British pharmacists' work-life balance - is it a problem?

PubMed

Seston, Elizabeth; Hassell, Karen

2014-04-01

Using a validated tool, the study aimed to explore pharmacists' experiences of maintaining work/life balance in a large, nationally representative sample of pharmacists in Great Britain (GB). A two-page postal questionnaire was sent in 2008 to all GB-domiciled pharmacists who were registered with the regulatory body for pharmacy in GB (just over 44 000 pharmacists). Demographic information, work patterns and other employment data were collected and analysed using regression techniques to explore the link between these characteristics and a validated measure of work/life balance. The response rate to the census was 69.6% (n = 30 517). Eighty-three per cent (n = 25 243) of respondents were working as a pharmacist and were therefore eligible to complete the work/life balance statements. The results reported here relate to 12 364 individuals who had full data for the work/life balance scale and the demographic and work variables. Findings indicate that age, ethnicity, having caring responsibilities, sector of practice, hours of work and type of job are significant predictors of work/life balance problems. Pharmacy employers and government should recognise the changing demographic characteristics of the profession and consider what support might be available to the workforce to help alleviate work/life balance problems being experienced by certain groups of pharmacists. © 2013 Royal Pharmaceutical Society.

Gender Differences in Filicide Offense Characteristics--A Comprehensive Register-Based Study of Child Murder in Two European Countries

ERIC Educational Resources Information Center

Putkonen, Hanna; Amon, Sabine; Eronen, Markku; Klier, Claudia M.; Almiron, Maria P.; Cederwall, Jenny Yourstone; Weizmann-Henelius, Ghitta

2011-01-01

Objective: This study searched for gender differences in filicidal offense characteristics and associated variables. Methods: In this binational register-based study all filicide perpetrators (75 mothers and 45 fathers) and their crimes in Austria and Finland 1995-2005 were examined for putative gender differences. The assessed variables were…

Personal, professional and workplace factors that contribute to burnout in Australian midwives.

PubMed

Fenwick, Jennifer; Lubomski, Anna; Creedy, Debra K; Sidebotham, Mary

2018-04-01

This study aimed to identify personal, professional and workplace factors that contribute to burnout in midwives. Burnout is prevalent in the midwifery workforce. Burnout adversely affects the well-being of midwives, diminishes the quality of care they provide and can shorten career duration. Self-administered online survey. The survey included the Copenhagen Burnout Inventory and personal and professional variables related to age, children, years of experience, role, model of care and satisfaction with work life. Midwives were invited to participate via an email sent from the Australian College of Midwives and through professional networks between June and July 2014. Variables associated with burnout were entered in a multinomial logistic regression. A total of 1,037 responses were received and 990 analysed. The prevalence of moderate to severe personal (N = 643; 64.9%) and work-related burnout (N = 428; 43.8%) were high. Having children, providing caseload midwifery care and working in a regional area were associated with low burnout. However, midwives registered for 5-10 years were more likely to report work and client-related burnout. Similarly, midwives reporting a lack of satisfaction with work-life balance were also more likely to report personal and work-related burnout. Family-friendly work environments that facilitate work-life balance can help to reduce the personal and organizational costs of burnout. Similarly, providing continuity of midwifery care in a caseload model can facilitate work-life balance and provide significant mental health benefits to participating midwives. © 2017 John Wiley & Sons Ltd.

Education, sense of mastery and mental health: results from a nation wide health monitoring study in Norway

PubMed Central

Dalgard, Odd Steffen; Mykletun, Arnstein; Rognerud, Marit; Johansen, Rune; Zahl, Per Henrik

2007-01-01

Background Earlier studies have shown that people with low level of education have increased rates of mental health problems. The aim of the present study is to investigate the association between level of education and psychological distress, and to explore to which extent the association is mediated by sense of mastery, and social variables like social support, negative life events, household income, employment and marital status. Methods The data for the study were obtained from the Level of Living Survey conducted by Statistics Norway in 2002. Data on psychological distress and psychosocial variables were gathered by a self-administered questionnaire, whereas socio-demographic data were based on register statistics. Psychological distress was measured by Hopkins Symptom Checklist 25 items. Results There was a significant association between low level of education and psychological distress in both genders, the association being strongest in women aged 55–67 years. Low level of education was also significantly associated with low sense of mastery, low social support, many negative life events (only in men), low household income and unemployment,. Sense of mastery emerged as a strong mediating variable between level of education and psychological distress, whereas the other variables played a minor role when adjusting for sense of mastery. Conclusion Low sense of mastery seems to account for much of the association between low educational level and psychological distress, and should be an important target in mental health promotion for groups with low level of education. PMID:17519014

Homophobia in Registered Nurses: Impact on LGB Youth

ERIC Educational Resources Information Center

Blackwell, Christopher W.; Kiehl, Ermalynn M.

2008-01-01

This study examined registered nurses' overall attitudes and homophobia towards gays and lesbians in the workplace. Homophobia scores, represented by the Attitudes Toward Lesbians and Gay Men (ATLG) Scale, was the dependent variable. Overall homophobia scores were assessed among a randomized stratified sample of registered nurses licensed in the…

Education and Health: the Role of Cognitive Ability*

PubMed Central

Bijwaard, Govert; Veenman, Justus

2015-01-01

We aim to disentangle the relative impact of (i) cognitive ability, and (ii) education on health and mortality using a structural equation model suggested by Conti et al. (2010). We extend their model by allowing for a duration dependent variable (mortality), and an ordinal educational variable. Data come from a Dutch cohort born between 1937 and 1941, including detailed measures of cognitive ability and family background in the final grade of primary school. The data are linked to the mortality register 1995–2011, such that we observe mortality between ages 55 and 75. The results suggest that at least half of the unconditional survival differences between educational groups are due to a ‘selection effect’, primarily on the basis of cognitive ability. Conditional survival differences across those having finished just primary school and those entering secondary education are still substantial, and amount to a 4 years gain in life expectancy, on average. PMID:25912224

The changing well-being of older adult registered Indians: an analysis using the Registered Indian Human Development Index.

PubMed

Cooke, Martin; Guimond, Eric; McWhirter, Jennifer

2008-01-01

The demographic aging of the Registered Indian population suggests that the social, economic, and health conditions of older Registered Indians will be increasingly important for communities and policymakers. We have adapted the United Nations Development Program's Human Development Index using data from the Census of Canada and the Indian Register to measure whether improvements seen in the knowledge, standard of living, and health of the Registered Indian population between 1981 and 2001 are also observed among Registered Indians of older ages. The absolute levels of well-being of older Registered Indians were found to have improved, but gaps with other older Canadians had widened, particularly in terms of income and male life expectancy.

CLECOS_P: clinical evolution control system on Parkinsonian patients undergoing neural transplantation.

PubMed

Morales, F; Molina, H; Cruz, N; Valladares, P; Muñoz, J; Ortega, I; Torres, O; Leon, M

1995-01-01

The CLECOS_P system was conceived for registering and automating the processing of clinical evaluations performed on patients with Parkinson's disease who undergo functional neurosurgery and/or neural transplant. CLECOS_P represents the first time a computerized system is able to offer--with high precision and considerable time-savings--an integral analysis of the evolutive behavior of the universe in integrated variables at the core assessment program for intracerebral transplantations (CAPIT). CAPIT is used internationally for the evaluation and follow-up of patients with this pathology who have undergone neural transplant. We used the so-called MEDSAC methodology for the preparation of this system. The methodology that was used for the design of an intelligent system aimed at medical decision-making was based on the quantitative analysis of the clinical evolution. At the present moment, there are 20 patients controlled by this system: 11 bilaterally transplanted, 9 unilaterally (registered in ranks of 3 months before operation up to 1, 2, 3, 6, 9, 12, 18, and 24 months after operation). The application of CLECOS_P to these patients permitted the evaluation of 400 clinical variables, where a better evolutive characterization of the patients was obtained, thus getting most favorable results with personalized therapeutic methods aimed at raising their quality of life. CLECOS_P is used in a multi-user environment on a local area network running Novell Netware version 3.11.

The impact of pharmaceutical innovation on premature cancer mortality in Switzerland, 1995-2012.

PubMed

Lichtenberg, Frank R

2016-09-01

The premature cancer mortality rate has been declining in Switzerland, but there has been considerable variation in the rate of decline across cancer sites (e.g., breast or digestive organs). I analyze the effect that pharmaceutical innovation had on premature cancer mortality in Switzerland during the period 1995-2012 by investigating whether the cancer sites that experienced more pharmaceutical innovation had larger declines in premature mortality, controlling for the number of people diagnosed and mean age at diagnosis. Premature cancer mortality before ages 75 and 65 is significantly inversely related to the cumulative number of drugs registered 5, 10, and 15 years earlier. The number of drugs registered during 1980-1997 explains 63 % of the variation across cancer sites in the 1995-2012 log change in the premature (before age 75) mortality rate. Controlling for the cumulative number of drugs, the cumulative number of chemical subgroups does not have a statistically significant effect on premature mortality. This suggests that drugs (chemical substances) within the same class (chemical subgroup) are not "therapeutically equivalent". Over 17,000 life-years before age 75 were gained in 2012 due to drugs registered during 1990-2007. The number of life-years before age 75 gained in 2012 from drugs registered during two earlier periods (1985-2002 and 1980-1997) were more than twice as great. Since mean utilization of new drugs is much lower than mean utilization of older drugs, more recent drug registrations may have a smaller effect on premature mortality than earlier drug registrations even if the average quality of newer drugs is higher. Estimates of the cost per life-year gained before ages 75 and 65 in 2012 from drugs registered during 1990-2007 are $21,228 and $28,673, respectively. These figures are below even the lowest estimates from the value-of-life literature of the value of a quality-adjusted life-year. The estimates indicate that the cost per life-year before age 75 gained from drugs registered during earlier periods (1985-2002 and 1980-1997) were considerably lower: $5299 and $3218, respectively. The largest reductions in premature mortality occur at least a decade after drugs are registered, when their utilization increases significantly. This suggests that if Switzerland is to obtain substantial additional reductions in premature cancer mortality in the future (a decade or more from now) at a modest cost, pharmaceutical innovation (registration of new drugs) is needed today.

Registered nurses' self-nurturance and life and career satisfaction.

PubMed

Nemcek, Mary Ann

2007-08-01

Knowledge of factors that help nurses thrive, including satisfaction with life and self-nurturance, can be used to enhance retention of a healthy work force. This study determined whether nurses are happy or satisfied with their lives; how self-nurturing or "good to self" they are; and whether a relationship exists among self-nurturance, life satisfaction, and career satisfaction. A descriptive, correlational study of 136 registered nurses involving measures of self-nurturance and life and career satisfaction was conducted. Mean scores for life satisfaction and self-nurturance were consistent with those from studies of well adults. Self-nurturance, life satisfaction, and career satisfaction were positively correlated with each other; thus, improving one is expected to improve the others. Knowledge of the significant positive correlation among life satisfaction, self-nurturance, and career satisfaction may prove useful in improving the mental health and safety of nurses. Strategies consistent with Magnet hospital characteristics are suggested for the occupational health nurse.

A national quality registers as a tool to audit items of the fundamentals of care to older patients with hip fractures.

PubMed

Hommel, Ami; Bååth, Carina

2016-06-01

The Swedish healthcare system has a unique resource in the national quality registers. A national quality registry contains individualised data concerning patient problems, medical interventions and outcomes after treatment, within all healthcare settings. Many healthcare settings face challenges related to the way they deliver the fundamentals of care, therefore, it is important to audit the outcome. It is estimated that the number of people aged 80 years or older will have almost quadrupled between 2000 and 2050. Hip fracture has been recognised as the most serious consequence of osteoporosis because of the risk of its complications, which include pain, acute confusional state, pressure ulcers, infections, disability, diminished quality of life and mortality. The aim of this study was therefore to explore if and how a national quality register can be used as an audit tool for the fundamentals of care when it concerns older patients suffering from a hip fracture. For this study we retrospectively selected and audited variables retrieved from the national quality hip fracture register. The audit included 1083 patients 80 years and older, consecutively admitted to a university hospital in the south of Sweden, in 2011-2013. Nearly half of the patients were admitted from their own homes and were living alone. Almost half of the patients could walk outdoors before the fracture occurred. After 4 months, 28.5% of the patients walked outdoors. Additionally, after 4 months about 30% of the patients were still suffering from pain after hip fracture surgery and still using analgesics. There was a reduction in length of stay between 2011 and 2013. As a part of the national quality register the questions from EQ5D were used before surgery and after 4 months. Before discharge from hospital there were less registered complications in 2012 and 2013 compared with 2011. The national hip fracture quality register allows healthcare staff to analyse nursing outcomes and to highlight some fundamental aspects of care. Greater awareness, among hospital staff, of risk factors for complications in hip fracture patients may lead to improved patient care. Through registration in a quality register and working with the results we as Registered Nurses can ensure quality health care for older adults. © 2015 John Wiley & Sons Ltd.

Initial Assessment of the Effects of Nonmetallic Inclusions on Fatigue Life of Powder-Metallurgy-Processed Udimet(TM) 720

NASA Technical Reports Server (NTRS)

Gabb, T. P.; Telesman, J.; Kantzos, P. T.; Bonacuse, P. J.; Barrie, R. L.

2002-01-01

The fatigue lives of modern powder metallurgy (PM) disk alloys are influenced by variabilities in alloy microstructure and mechanical properties. These properties can vary due to the different steps of materials/component processing and machining. One of these variables, the presence of nonmetallic inclusions, has been shown to significantly degrade low-cycle fatigue (LCF) life. Nonmetallic inclusions are inherent defects in powder alloys that are a by-product of powder-processing techniques. Contamination of the powder can occur in the melt, during powder atomization, or during any of the various handling processes through consolidation. In modern nickel disk powder processing facilities, the levels of inclusion contamination have been reduced to less than 1 part per million by weight. Despite the efforts of manufacturers to ensure the cleanliness of their powder production processes, the presence of inclusions remains a source of great concern for the designer. the objective of this study was to investigate the effects on fatigue life of these inclusions. Since natural inclusions occur so infrequently, elevated levels of inclusions were carefully introduced in a nickel-based disk superalloy, Udimet 720 (registered trademark of Special Metals Corporation), produced using PM processing. Multiple strain-controlled fatigue tests were then performed on this material at 650 C. Analyses were performed to compare the LCF lives and failure initiation sites as functions of inclusion content and fatigue conditions. A large majority of the failures in specimens with introduced inclusions occurred at cracks initiating from inclusions at the specimen surface. The inclusions could reduce fatigue life by up to 100 times. These effects were found to be dependent on strain range and strain ratio. Tests at lower strain ranges and higher strain ratios produced larger effects of inclusions on life.

Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial.

PubMed

dos Reis Santos, Israel; Danaga, Aline Roberta; de Carvalho Aguiar, Isabella; Oliveira, Ezequiel Fernandes; Dias, Ismael Souza; Urbano, Jessica Julioti; Martins, Aline Almeida; Ferraz, Leonardo Macario; Fonsêca, Nina Teixeira; Fernandes, Virgilio; Fernandes, Vinicius Alves Thomaz; Lopes, Viviane Cristina Delgado; Leitão Filho, Fernando Sérgio Studart; Nacif, Sérgio Roberto; de Carvalho, Paulo de Tarso Camillo; Sampaio, Luciana Maria Malosá; Giannasi, Lílian Christiane; Romano, Salvatore; Insalaco, Giuseppe; Araujo, Ana Karina Fachini; Dellê, Humberto; Souza, Nadia Karina Guimarães; Giannella-Neto, Daniel; Oliveira, Luis Vicente Franco

2013-10-08

Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life. A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life. CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients. The protocol for this study is registered with the Brazilian Registry of Clinical Trials (ReBEC RBR-7yhr4w and World Health Organization under Universal Trial Number UTN: U1111-1127-9390 [http://www.ensaiosclinicos.gov.br/rg/RBR-7yhr4w/]).

Critical thinking of registered nurses in a fellowship program.

PubMed

Zori, Susan; Kohn, Nina; Gallo, Kathleen; Friedman, M Isabel

2013-08-01

Critical thinking is essential to nursing practice. This study examined differences in the critical thinking dispositions of registered nurses (RNs) in a nursing fellowship program. Control and experimental groups were used to compare differences in scores on the California Critical Thinking Disposition Inventory (CCTDI) of RNs at three points during a fellowship program: baseline, week 7, and month 5. The control group consisted of RNs who received no education in critical thinking. The experimental group received education in critical thinking using simulated scenarios and reflective journaling. CCTDI scores examined with analysis of variance showed no significant difference within groups over time or between groups. The baseline scores of the experimental group were slightly higher than those of the control group. Chi-square analysis of demographic variables between the two groups showed no significant differences. Critical thinking dispositions are a combination of attitudes, values, and beliefs that make up one's personality based on life experience. Lack of statistical significance using a quantitative approach did not capture the development of the critical thinking dispositions of participants. A secondary qualitative analysis of journal entries is being conducted. Copyright 2013, SLACK Incorporated.

Childhood adverse life events and parental psychopathology as risk factors for bipolar disorder.

PubMed

Bergink, V; Larsen, J T; Hillegers, M H J; Dahl, S K; Stevens, H; Mortensen, P B; Petersen, L; Munk-Olsen, T

2016-10-25

Childhood adverse events are risk factors for later bipolar disorder. We quantified the risks for a later diagnosis of bipolar disorder after exposure to adverse life events in children with and without parental psychopathology. This register-based population cohort study included all persons born in Denmark from 1980 to 1998 (980 554 persons). Adversities before age 15 years were: familial disruption; parental somatic illness; any parental psychopathology; parental labour market exclusion; parental imprisonment; placement in out-of-home care; and parental natural and unnatural death. We calculated risk estimates of each of these eight life events as single exposure and risk estimates for exposure to multiple life events. Main outcome variable was a diagnosis of bipolar disorder after the age of 15 years, analysed with Cox proportional hazard regression. Single exposure to most of the investigated adversities were associated with increased risk for bipolar disorder, exceptions were parental somatic illness and parental natural death. By far the strongest risk factor for bipolar disorder in our study was any mental disorder in the parent (hazard ratio 3.53; 95% confidence interval 2.73-4.53) and the additional effects of life events on bipolar risk were limited. An effect of early adverse life events on bipolar risk later in life was mainly observed in children without parental psychopathology. Our findings do not exclude early-life events as possible risk factors, but challenge the concept of adversities as important independent determinants of bipolar disorder in genetically vulnerable individuals.

Perioperative registered nurses knowledge, attitudes, behaviors, and barriers regarding pressure ulcer prevention in perioperative patients.

PubMed

Tallier, Peggy C; Reineke, Patricia R; Asadoorian, Kathy; Choonoo, John G; Campo, Marc; Malmgreen-Wallen, Christine

2017-08-01

Hospital acquired pressure ulcers have a detrimental effect on patient quality of life, morbidity, mortality, and cost to the healthcare industry. Little is known about pressure ulcer prevention in perioperative services. The objectives of this study were to describe perioperative registered nurses (RNs) knowledge, attitudes, behaviors, and barriers about pressure ulcer prevention and to determine if knowledge and the availability of a pressure ulcer staging tool are predictors of pressure ulcer prevention behavior. A cross-sectional descriptive pilot study was conducted. Sixty-two perioperative RNs from 10 acute care hospitals participated. Perioperative nurses believed carrying out pressure ulcer prevention strategies is essential to nursing practice but only two-thirds reported conducting pressure ulcer risk assessment on all patients and daily assessment on at risk patients. Results indicated a knowledge deficit regarding assessment and prevention of pressure ulcers as performance on the PUKT (72%) fell below the recommended score of 90%. Results of binary logistic regression indicated that knowledge as measured by the PUKT and availability of a pressure ulcer staging tool were statistically significant (p=0.03) predictors of pressure ulcer prevention behavior. The initial model without the predictor variables, indicated an overall success rate of correct predictions of 64% which increase to 73% when the predictor variables were added to the initial model. Although perioperative nurses believe that pressure ulcer prevention is important, a knowledge deficit exists and there is a need for pressure ulcer prevention education. Copyright © 2017 Elsevier Inc. All rights reserved.

Recent advances in managing idiopathic pulmonary fibrosis

PubMed Central

Scelfo, Chiara; Caminati, Antonella; Harari, Sergio

2017-01-01

Idiopathic pulmonary fibrosis (IPF) is a rare pulmonary disease with a poor prognosis and severe impact on quality of life. Early diagnosis is still challenging and important delays are registered before final diagnosis can be reached. Available tools fail to predict the variable course of the disease and to evaluate response to antifibrotic drugs. Despite the recent approval of pirfenidone and nintedanib, significant challenges remain to improve prognosis and quality of life. It is hoped that the new insights gained in pathobiology in the last few years will lead to further advances in the diagnosis and management of IPF. Currently, early diagnosis and prompt initiation of treatments reducing lung function loss offer the best hope for improved outcomes. This article aims at providing an overview of recent advances in managing patients with IPF and has a particular focus on how to reach a diagnosis, manage comorbidities and lung transplantation, care for the non-pharmacological needs of patients, and address palliative care. PMID:29225786

Utility of brief questionnaires of health-related quality of life (Airways Questionnaire 20 and Clinical COPD Questionnaire) to predict exacerbations in patients with asthma and COPD

PubMed Central

2013-01-01

Background There is some evidence that quality of life measured by long disease-specific questionnaires may predict exacerbations in asthma and COPD, however brief quality of life tools, such as the Airways Questionnaire 20 (AQ20) or the Clinical COPD Questionnaire (CCQ), have not yet been evaluated as predictors of hospital exacerbations. Objectives To determine the ability of brief specific health-related quality of life (HRQoL) questionnaires (AQ20 and CCQ) to predict emergency department visits (ED) and hospitalizations in patients with asthma and COPD, and to compare them to longer disease-specific questionnaires, such as the St George´s Respiratory Questionnaire (SGRQ), the Chronic Respiratory Disease Questionnaire (CRQ) and the Asthma Quality of Life Questionnaire (AQLQ). Methods We conducted a two-year prospective cohort study of 208 adult patients (108 asthma, 100 COPD). Baseline sociodemographic, clinical, functional and psychological variables were assessed. All patients completed the AQ20 and the SGRQ. COPD patients also completed the CCQ and the CRQ, while asthmatic patients completed the AQLQ. We registered all exacerbations that required ED or hospitalizations in the follow-up period. Differences between groups (zero ED visits or hospitalizations versus ≥ 1 ED visits or hospitalizations) were tested with Pearson´s X2 or Fisher´s exact test for categorical variables, ANOVA for normally distributed continuous variables, and Mann–Whitney U test for non-normally distributed variables. Logistic regression analyses were performed to estimate the predictive ability of each HRQoL questionnaire. Results In the first year of follow-up, the AQ20 scores predicted both ED visits (OR: 1.19; p = .004; AUC 0.723) and hospitalizations (OR: 1.21; p = .04; AUC 0.759) for asthma patients, and the CCQ emerged as independent predictor of ED visits in COPD patients (OR: 1.06; p = .036; AUC 0.651), after adjusting for sociodemographic, clinical, and psychological variables. Among the longer disease-specific questionnaires, only the AQLQ emerged as predictor of ED visits in asthma patients (OR: 0.9; p = .002; AUC 0.727). In the second year of follow-up, none of HRQoL questionnaires predicted exacerbations. Conclusions AQ20 predicts exacerbations in asthma and CCQ predicts ED visits in COPD in the first year of follow-up. Their predictive ability is similar to or even higher than that of longer disease-specific questionnaires. PMID:23706146

Technologies for participatory medicine and health promotion in the elderly population

PubMed Central

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M. Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-01-01

Abstract Introduction: The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called “geriatric syndromes” frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. Objective: The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. Methods and Analysis: The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a “quasi-experimental” type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group. The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants’ occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. Ethics and Dissemination: The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813. PMID:29768372

Technologies for participatory medicine and health promotion in the elderly population.

PubMed

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-05-01

The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called "geriatric syndromes" frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a "quasi-experimental" type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group.The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants' occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813.

The association between health utility and joint status among people with severe haemophilia A: findings from the KAPPA register.

PubMed

Osooli, M; Steen Carlsson, K; Baghaei, F; Holmström, M; Rauchensteiner, S; Holme, P A; Hvitfeldt, L; Astermark, J; Berntorp, E

2017-05-01

People with severe haemophilia A have reportedly impaired health related quality of life (utility) mainly due to recurrent bleeding, arthropathy and treatment burden. To estimate utilities and evaluate their potential correlates - most importantly the joint status - among people with severe haemophilia A. In this cross-sectional study, eligible participants had severe haemophilia A, were aged ≥15, negative for factor VIII inhibitor and included in the KAPPA register of Denmark, Norway and Sweden. Data on demographics, treatment history, haemophilia joint health score, and EQ-5D utility were obtained from the register. We used box plots to present utilities and joint status and ordinary least squares regression to evaluate correlates of utilities. Participants were consecutively enrolled in the KAPPA register between April 2013 and June 2016. Overall, 173 participants with median age of 34 (interquartile range: 25-45) were included. Twelve (6.9%) participants were on episodic treatment while 161 (93.1%) were treated using prophylaxis. Concomitant diseases and positive inhibitor history were reported for 73 (43.2%) and 21 (12.1%) participants, respectively. The highest median utility (1.0) was observed among those aged <29 on prophylaxis and those aged 30-44 who had started prophylaxis by age 3. In the multi-variable regression, joint scores of 16-25 (Coef. -0.18, 95% CI: -0.30, -0.06), 26-35 (Coef. -0.21, 95% CI: -0.36, -0.06) and >35 (Coef. -0.37, 95% CI: -0.52, -0.23) were associated with lower utilities. Moderate to severe joint manifestations are associated with reduced utilities among persons with severe haemophilia A. © 2017 John Wiley & Sons Ltd.

Implementation of a salaried compensation program for registered nurses.

PubMed

Sills, L R

1993-01-01

Compensation is a key variable in recruitment and retention of registered nurses. A 6-month trial of an exempt/salaried wage program for registered nurses, based on normative change theory, was implemented in the adult critical care division of a 491-bed community hospital. A total of 58 registered nurses participated in the trial. At the end of 6 months on salary, 94% (53) of the nurses voted to remain salaried. The staff perceived that the new wage program increased flexibility in work schedules and promoted teamwork and professional autonomy.

13A. Integrative Cancer Care: The Life Over Cancer Model

PubMed Central

Block, Keith; Block, Penny; Shoham, Jacob

2013-01-01

Focus Areas: Integrative Algorithms of Care Integrative cancer treatment fully blends conventional cancer treatment with integrative therapies such as diet, supplements, exercise and biobehavioral approaches. The Life Over Cancer model comprises three spheres of intervention: improving lifestyle, improving biochemical environment (terrain), and improving tolerance of conventional treatment. These levels are applied within the context of a life-affirming approach to cancer patients and treatment. Clinical staff involved include MDs, psychosocial, physical therapy, and dietetic professionals, all located in a single private clinic, the Block Center for Integrative Cancer Treatment. This session will describe the rationale and operation of the clinical model. An outpatient chemotherapy unit is incorporated in the clinic. Chronomodulated chemotherapy is used for selected chemotherapy drugs. Physical care includes massage, exercise and other therapies as directed by the center's physical therapy staff. Notably, cancer patients who are physically active have lower mortality and recurrence risks. Behavioral approaches are being shown increasingly to affect physiological parameters and expression of genes potentially related to cancer. Thus, biobehavioral approaches such as relaxed abdominal breathing and comfort space imagery are taught to patients by a staff including a clinical psychologist and other practitioners. Nutrition is also emerging as a relevant area of intervention in cancer, with recent guidelines from the American Cancer Society. A team of registered dietitians counsels patients individually and conducts cooking classes. Finally, the Life Over Cancer model includes analysis of multiple biological parameters relevant to cancer and general health, with standard laboratory tests. Inflammation, glycemic variables, immune functioning and other variables are regularly monitored. Dietary changes and where necessary supplements are suggested when laboratory results are abnormal. Interaction of supplements with cancer treatment drugs is monitored. The session will highlight the roles played by both conventional and integrative therapies in the treatment of cancer patients.

Spatial variation in density and size structure indicate habitat selection throughout life stages of two Southwestern Atlantic snappers.

PubMed

Aschenbrenner, Alexandre; Hackradt, Carlos Werner; Ferreira, Beatrice Padovani

2016-02-01

The early life history of Lutjanus alexandrei and Lutjanus jocu in Southwestern Atlantic is still largely unknown. Habitat use of different life stages (i.e. size categories and densities) of the Brazilian snapper (L. alexandrei) and dog snapper (L. jocu) was examined in a tropical portion of NE coast of Brazil. Visual surveys were conducted in different shallow habitats (mangroves and reefs). Both snapper species showed higher densities in early life stages in mangrove habitat, with a clear increase in fish size from mangrove to adjacent reefs. Post-settler individuals were exclusively found in mangroves for both species. Juveniles of L. alexandrei were also registered only in mangroves, while sub-adult individuals were associated with both mangrove and reef habitats. Mature individuals of L. alexandrei were only observed in reef habitats. Juvenile and sub-adult individuals of the dog snapper were both associated with mangrove and reef habitats, with high densities registered in mangroves. Mature individuals of L. jocu were not registered in the study area. This pattern suggests preference for mangrove habitat in early life stages for both species. Ontogenetic movement between habitats was also recorded. This pattern denotes habitat selection across different life cycle of both species. Such information highlights the importance of directing management and conservation efforts to these habitats to secure the continuity of contribution to adult populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: a cross-sectional study.

PubMed

Zurita-Cruz, Jessie N; Manuel-Apolinar, Leticia; Arellano-Flores, María Luisa; Gutierrez-Gonzalez, Alejandro; Najera-Ahumada, Alma Gloria; Cisneros-González, Nelly

2018-05-15

Type 2 diabetes mellitus (DM2) is a chronic disease, and for treatment to succeed, it is necessary to harmonize the mental health of the patient with the environment, which impacts quality of life and adherence to medical regimens. The objetive of this study is describe the quality of life of patients with DM2 and the factors relates to its modification. This investigation was a cross-sectional study. Patients over 18 years of age with DM2 were selected. The following variables related to quality of life were studied: age, sex, occupation, marital status, years of DM2 evolution, comorbidities and presence of depression (Beck Depression Inventory). Perceived quality of life was measured with a health-related quality of life (HRQoL) scale, the 36-Item Short-Form Survey (SF-36). Patients were classified according to SF-36 HRQoL score (< 50, 51-75 and > 76 points). Among the 1394 patients included, the median age was 62 years. Global HRQoL had a median of 50.1 points. Bivariate analysis showed that age, marital status, sex, occupation, comorbidities, duration of DM2 and comorbidities had impacts on HRQoL. The logistic regression model identified age (odds ratio [OR] 1.04) and depression (OR 4.4) as independent factors that influenced overall quality of life. Patients with DM2 have poor HRQoL, which is associated with a high frequency of depression. Older age and the presence of depression impair patient HRQoL. R-2013-781-052. Registered 20 December 2014.

31 CFR 306.11 - Forms of registration for transferable securities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) (123-45-6789). (d) Life tenant under will. A security may be registered in the name of a life tenant followed by an adequate identifying reference to the will. Example: Anne B. Smith, life tenant under the will of Adam A. Smith, deceased (12-3456789). The life tenant will be considered a fiduciary. (e...

Exploring end-of-life interaction in dyads of parents and adult children: a protocol for a mixed-methods study.

PubMed

Stiel, Stephanie; Stelzer, Eva-Maria; Schneider, Nils; Herbst, Franziska A

2018-04-27

A considerable number of terminally-ill adult children are outlived by at least one parent and receive palliative care prior to their death. At the same time, adult children continue to be confronted with their parents' terminal illnesses and end-of-life situations. The current study explores the specifics of dyadic interaction at the end of life between a) adult children suffering from a life-threatening disease and their parents, and b) terminally ill parents and their adult children. This prospective observational study aims at filling the existing gap on adult child-parent interaction specifics at the end of life using an exploratory mixed-methods framework. The mixed-methods framework combines a qualitative face-to face interview and quantitative self-report questionnaires to study the topic at hand. The qualitative interview will focus on experiences, expectations, and wishes with regard to dyadic communication, information about illness and prognosis, expressed and perceived burden and support as well as caregiving role at the end of life. The questionnaires will cover socio-demographics, loneliness, attachment style, social support, and emotional closeness. The research group is currently adjusting a semi-structured interview guide and questionnaire instructions based on the results of a multiprofessional scientific advisory board meeting (Jan. 2018). In a next step, and prior to qualitative and quantitative data collection, the questionnaires will be piloted on patients and their family members in a palliative care setting. The main expected results are i) a description of the specifics of the interaction within and between both dyads, ii) the development of hypotheses and a theoretical framework on the specifics, similarities, and differences for both study groups, and iii) clinical conclusions on specific psychosocial care needs of both groups. The study was registered prospectively in the Health Services Research Germany register (Versorgungsforschung Deutschland - Datenbank) (Registration N° VfD_Dy@EoL_17_003897; date of registration: November 22, 2017) and in the German Clinical Trials Register (Deutsches Register Klinischer Studien) (Registration N° DRKS00013206 ; date of registration: October 27, 2017). The study is visible in the International Clinical Trials Registry Platform Search Portal of the World Health Organization under the German Clinical Trials Register number.

Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study.

PubMed

Kausto, Johanna; Virta, Lauri; Luukkonen, Ritva; Viikari-Juntura, Eira

2010-06-23

Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland.

76 FR 79171 - Pesticide Products; Receipt of Applications To Register New Uses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... disk or CD-ROM you submit. If EPA cannot read your comment due to technical difficulties and cannot... docket ID number and other identifying information (subject heading, Federal Register date and page... Name and Address: Arysta LifeScience, North America LLC., 15401 Weston Parkway, Suite 150, Cary, NC...

Aquatic Life Benchmarks and Ecological Risk Assessments for Registered Pesticides

EPA Pesticide Factsheets

Each Aquatic Life Benchmark is based on the most sensitive, scientifically acceptable toxicity endpoint available to EPA for a given taxon (for example, freshwater fish) of all scientifically acceptable toxicity data available to EPA.

Factors predicting Registered Nurses' intentions to leave their organization and profession: A job demands-resources framework.

PubMed

Moloney, Willoughby; Boxall, Peter; Parsons, Matthew; Cheung, Gordon

2018-04-01

To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. A cross-sectional survey design. Data were collected in 2014-2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources' variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater self-efficacy also have strong effects in lowering intentions to leave through higher engagement. Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention. © 2017 John Wiley & Sons Ltd.

Health related quality of life among elderly living in region of high vulnerability for health in Belo Horizonte, Minas Gerais, Brazil.

PubMed

Camelo, Lidyane do Valle; Giatti, Luana; Barreto, Sandhi Maria

2016-01-01

To investigate whether social relations, sociodemographic characteristics, lifestyle, and health conditions are associated with health-related quality of life (HRQOL) among elderly persons living in regions classified as high vulnerable in terms of health. A cross-sectional study conducted with a population-based random sample of 366 elderly (≥ 60 years of age) persons registered at a primary health-care unit in Belo Horizonte, Minas Gerais, Brazil. HRQOL was measured using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and the scores obtained in the physical component score (PCS) and mental component score (MCS) were our response variables. Social relations, sociodemographic characteristics, lifestyle, and health conditions were considered our groups of explanatory variables. Multiple linear regression models were used for the analysis. In the final multivariate models, we found that elevated number of diagnosis of chronic diseases, and being bedridden for the last 15 days were variables associated with worse PCS and MCS. However, lack of education, dissatisfaction with personal relationships, lack of support and help when bedridden or to go to the doctor, and to prepare meals were associated with worse HRQOL only in MCS. Participants who reported black race/color, absence of work activity, lack of physical activity, no alcohol consumption, and hospitalization in the last 12 months had worse HRQOL only in PCS. In addition to the aspects related to social adversity, lifestyle, and health conditions, some functional aspects of social relations were important for understanding the HRQOL in elderly persons living in social vulnerability.

Life expectancies for individuals with psychiatric diagnoses.

PubMed

Hannerz, H; Borgå, P; Borritz, M

2001-09-01

The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.

Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? A cross-sectional study based on the West Jutland cohort study

PubMed Central

2013-01-01

Background Previous research suggests that perceived stress in adolescence is socially patterned, but that this relationship may depend on the measure of socioeconomic status (SES) used. This study examines if social gradients in perceived stress, negative life events, and coping exist amongst Danish adolescents, and, if life events and coping strategies can partly account for an association between SES and perceived stress. These relationships are studied separately for two different measures of SES. Methods Questionnaire data were collected from 3054 14–15 year old youths (83% response rate) during baseline measurement in the West Jutland birth cohort study. Parents were identified via the Central Office of Civil Registration in which the respondents are linked to their parents or guardians via their CPR-number, a personal identification number given to everyone in Denmark. The study employs data from two independent sources, adolescent self-report data (stress, life events and coping) and national registers (parental educational level, household income and confounder variables). Ordinary Least Squares regression estimated the effects of parental SES, negative life events and coping on perceived stress. Analyses were stratified by gender. Results Girls reported more perceived stress than boys. SES accounted for a small but significant amount of the variance in perceived stress. Lower parental education and lower household income were associated with higher stress levels irrespective of gender, but the social gradient was strongest amongst girls when parents’ education was used to measure SES, and strongest for boys when income was used. Life events and coping were also found to be associated with SES and both mediated part of the SES-perceived stress relationship. In general, the social gradient in perceived stress was accounted for by the study variables to a higher degree among girls than among boys. Conclusions Lower parental education and household income are associated with higher levels of perceived stress amongst Danish adolescents. Furthermore, both life events and coping appear to mediate this relation. Gender differences in the ways SES and stress are related may exist. PMID:23724872

Quality of life in children with adverse drug reactions: a narrative and systematic review.

PubMed

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-10-01

Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn's disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. © 2014 The British Pharmacological Society.

Quality of life in children with adverse drug reactions: a narrative and systematic review

PubMed Central

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-01-01

Aims Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. Methods We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Results Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn’s disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. Conclusions To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. PMID:24833305

The relationship between quality of work life and location of cross-training among obstetric nurses in urban northeastern Ontario, Canada: A population-based cross sectional study.

PubMed

Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

2015-01-01

The purpose of this mixed methods study was to examine the quality of work life of registered nurses working in obstetrics at 4 hospitals in northeastern Ontario and explore demographic and occupational factors related to nurses' quality of work life (QWL). A stratified random sample of registered nurses (N = 111) selected from the 138 eligible registered nurses (80.4%) of staff in the labor, delivery, recovery, and postpartum areas at the 4 hospitals participated. Logistic regression analyses were used to consider QWL in relation to the following: 1) demographic factors, and 2) stress, employment status and educational attainment. In the logistic regression model, the odds of a higher quality of work life for nurses who were cross trained (nurses who can work across all areas of obstetrical care) were estimated to be 3.82 (odds ratio = 3.82, 95% confidence interval: 1.01-14.5) times the odds of a higher quality of work life for nurses who were not cross trained. This study highlights a relationship between quality of work life and associated factors including location of cross-training among obstetrical nurses in northeastern Ontario. These findings are supported by the qualitative interviews that examine in depth their relationship to QWL. Given the limited number of employment opportunities in the rural and remote regions, it is paramount that employers and employees work closely together in creating positive environments that promote nurses' QWL. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

75 FR 21632 - Draft Guidance for Industry and Food and Drug Administration Staff; Total Product Life Cycle...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-26

...] Draft Guidance for Industry and Food and Drug Administration Staff; Total Product Life Cycle: Infusion... the draft guidance document entitled ``Total Product Life Cycle: Infusion Pump--Premarket Notification... this issue of the Federal Register, FDA is announcing a public meeting regarding external infusion...

Caring in nursing homes to promote autonomy and participation.

PubMed

Hedman, Maria; Häggström, Elisabeth; Mamhidir, Anna-Greta; Pöder, Ulrika

2017-01-01

Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care. The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation. A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed. The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people. Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents in nursing homes.

75 FR 11585 - Lincoln Variable Insurance Products Trust, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-11

...] Lincoln Variable Insurance Products Trust, et al.; Notice of Application March 5, 2010. AGENCY: Securities... registered open-end management investment companies and unit investment trusts (``UITs'') that are within and...: Lincoln Variable Insurance Products Trust (``Trust'') and Lincoln Investment Advisors Corporation...

CuidaCare: effectiveness of a nursing intervention on the quality of life’s caregiver: cluster-randomized clinical trial

PubMed Central

2014-01-01

Background In Spain, family is the main source of care for dependent people. Numerous studies suggest that providing informal (unpaid) care during a prolonged period of time results in a morbidity-generating burden. Caregivers constitute a high-risk group that experiences elevated stress levels, which reduce their quality of life. Different strategies have been proposed to improve management of this phenomenon in order to minimize its impact, but definitive conclusions regarding their effectiveness are lacking. Methods/Design A community clinical trial is proposed, with a 1-year follow-up period, that is multicentric, controlled, parallel, and with randomized allocation of clusters in 20 health care centers within the Community of Madrid. The study's objective is to evaluate the effectiveness of a standard care intervention in primary health care (intervention CuidaCare) to improve the quality of life of the caregivers, measured at 0, 6, and 12 months after the intervention. One hundred and forty two subjects (71 from each group) ≥65 years, identified by the nurse as the main caregivers, and who provide consent to participate in the study will be included. The main outcome variable will be perceived quality of life as measured by the Visual Analogue Scale (VAS) of EuroQol-5D (EQ-5D). The secondary outcome variables will be EQ-5D Dimensions, EQ-5D Index, nursing diagnosis, and Zarit's test. Prognostic variables will be recorded for the dependent patient and the caregiver. The principle analysis will be done by comparing the average change in EQ-5D VAS value before and after intervention between the two groups. All statistical tests will be performed as intention-to-treat. Prognostic factors' estimates will be adjusted by mixed-effects regression models. Possible confounding or effect-modifying factors will be taken into account. Discussion Assistance for the caregiver should be integrated into primary care services. In order to do so, incorporating standard, effective interventions with relevant outcome variables such as quality of life is necessary. Community care nurses are at a privileged position to develop interventions like the proposed one. Trial registration This trial has been registered in ClinicalTrials.gov under code number NCT 01478295. PMID:24467767

Why are more women working in Britain?

PubMed

Joshi, H E; Layard, R; Owen, S J

1985-01-01

Using a pooled time series, cross section supply function for single year age groups of Britain women, it is determined that female labor force participation rose steadily from World War II to 1977. Until the 1970s, the main increase was among married women aged 35 and over. Possible explanations for the post World War II rise in female labor participation are: 1) part time jobs were more available to women, 2) the drop in real prices of domestic appliances, processed foods, and easy care fabrics reduced the time required to take care of a family, and 3) the effect of long term changes in the roles women see for themselves in life. Women's wages rose sharply between 1973 and 1975, by around 15%; this was due to the Equal Pay Act of 1970. In addition, the educational attainment of women relative to men was constant or declining for cohorts entering the labor force up to the 1960s. Age specific employment rates are explained by 3 kinds of variables: 1) those whose values change from year to year and are age specific--life cycle variables, 2) those whose values change from year to year but affect all ages equally--calendar time variables, and 3) those that differ between cohorts but do not change over the life cycle--cohort variables. Results show that: 1) each preschool child lowers participation by 35% each primary school child by 14% and each secondary school child by 7%; 2) the relative earnings of women are highest early in life, 3) age leads to a decline in participation at an increasing rate, and 4) vacancies registered at employment exchanges are more or less untrended between 1950 and 1974. Completed family size, education, and early unemployment and wartime work experience do not explain the strong trend in the coefficients on the cohort dummies; however, real wages do. In time series, men's wages and women's wages are highly correlated, and each is nearly as highly correlated with time. During the 1970s, the female/male ratio index in each industry rose by 4.5 percentage points, reflecting the vast expansion of service industries. There were also sharp increases in the proportion of women workers within each industry, in spite of the sharp rises in women's pay.

Singing for children and adults with cystic fibrosis.

PubMed

Irons, Jung Yoon; Kenny, Dianna Theadora; Chang, Anne B

2010-05-12

Cystic fibrosis is a genetically inherited, life-threatening condition that affects major organs. The management of cystic fibrosis involves a multi-faceted daily treatment regimen that includes airway clearance physiotherapy, taking pancreatic enzymes and other medications. Previous studies identified that compliance with this intensive treatment especially among adolescents with cystic fibrosis is poor. Because of both the nature and consequences of the illness and the relentless demands of treatments, many individuals with cystic fibrosis are likely to have a poor quality of life. Anecdotal evidence suggests that singing may provide rigorous exercises for the whole respiratory system as well as a means for emotional expression, which may enhance quality of life. To evaluate the effects of a singing intervention in addition to usual therapy on the quality of life, morbidity, respiratory muscle strength and pulmonary function of children and adults with cystic fibrosis. We searched the Group's Cystic Fibrosis Trials Register, the Cochrane Central Register of Controlled Trials, major allied complementary data bases, and clinical trial registers. Hand searching for relevant conference proceedings and journals was also carried out.Date of search of Trials Register: 02 September 2009.Date of additional searches: 17 September 2009. Randomised controlled trials in which singing (as an adjunctive intervention) is compared with either a sham intervention or no singing in people with cystic fibrosis. No trials were found that met the selection criteria. No meta-analysis could be performed. As no studies that met the criteria were found, this review is unable to support or refute the benefits of singing as a therapy for people with cystic fibrosis. Future randomised controlled trials are required to evaluate singing therapy for people with cystic fibrosis.

A national medical register: balancing public transparency and professional privacy.

PubMed

Healy, Judith M; Maffi, Costanza L; Dugdale, Paul

2008-02-18

The first aim of a medical registration scheme should be to protect patients. Medical registration boards currently offer variable information to the public on doctors' registration status. Current reform proposals for a national registration scheme should include free public access to professional profiles of registered medical practitioners. Practitioner profiles should include: practitioner's full name and practice address; type of qualifications; year first registered, and duration and type of registration; any conditions on registration and practice; any disciplinary action taken; and participation in continuing professional education.

The Storied Experiences of Registered Nurses' Transition from Paper to Electronic Nursing Documentation

ERIC Educational Resources Information Center

Smith, Jeff S.

2010-01-01

This narrative inquiry was designed to bring to life the storied experiences of registered nurses who have transitioned from paper to electronic nursing documentation and to provide a foundation for others who may be preparing to implement electronic documentation and wish to consider the significance of these nurses' stories of change in their…

Municipal resources and patient outcomes through the first year after a hip fracture.

PubMed

Ruths, Sabine; Baste, Valborg; Bakken, Marit Stordal; Engesæter, Lars Birger; Lie, Stein Atle; Haugland, Siren

2017-02-16

Hip fractures represent major critical events for older people, and put huge demands on economic and personnel resources. Most hip fracture patients are in need of postoperative rehabilitation services. Through the Coordination Reform, the municipalities in Norway were given increased responsibility for community-based treatment and rehabilitation after surgery. The purpose of this study was to examine associations between municipal resources and patient outcomes through the first year after a hip fracture, focusing on survival and health-related quality of life. We conducted a nationwide cohort study on people experiencing a hip fracture in 2011-2012 in Norway, with a 1-year follow-up. We obtained data on date of hip fracture, demographics, total morbidity (ASA) score, health-related quality of life (EQ-5D-3 L), date of death if applicable, municipality of residence (Norwegian Hip Fracture Register), date of hospital readmission due to complications (Norwegian Patient Register), and information on municipalities' characteristics (Municipality-State-Reporting). The study population comprised 15,757 patients, mean age 80.8 years, 68.6% women. All-cause mortality was 8.6% at 30 days, and 25.3% at 12 months. Mortality was lower in the municipalities with the highest overall staff time for rehabilitation. A high proportion of the population aged 80+, was associated with low rates of self-reported anxiety/depression 12 months after surgery, as well as higher general health scores (EQ-5D VAS). There were no other differences in outcome according to rehabilitation resources, when comparing municipalities with the highest and lowest staffing. The study revealed no substantial impact of municipal resources on survival and health-related quality of life through the first year after a hip fracture. To evaluate major organizational changes and allocate resources according to best practice, there is a need to monitor health outcomes and use of resources over time through reliable measures, including variables related to coordination between services.

An improved approach of register allocation via graph coloring

NASA Astrophysics Data System (ADS)

Gao, Lei; Shi, Ce

2005-03-01

Register allocation is an important part of optimizing compiler. The algorithm of register allocation via graph coloring is implemented by Chaitin and his colleagues firstly and improved by Briggs and others. By abstracting register allocation to graph coloring, the allocation process is simplified. As the physical register number is limited, coloring of the interference graph can"t succeed for every node. The uncolored nodes must be spilled. There is an assumption that almost all the allocation method obeys: when a register is allocated to a variable v, it can"t be used by others before v quit even if v is not used for a long time. This may causes a waste of register resource. The authors relax this restriction under certain conditions and make some improvement. In this method, one register can be mapped to two or more interfered "living" live ranges at the same time if they satisfy some requirements. An operation named merge is defined which can arrange two interfered nodes occupy the same register with some cost. Thus, the resource of register can be used more effectively and the cost of memory access can be reduced greatly.

[Burnout symptoms in Austrian student nurses in their third year of training].

PubMed

Hausmann, Clemens

2009-08-01

Burnout is considered a major negative outcome of work related distress in social and health care services, especially in nursing. In the present study 179 student nurses in their third year of training and 47 registered nurses, all working in the Austrian province of Salzburg, were examined with the Maslach Burnout Inventory and the Satisfaction With Life Scale. Compared on a regional and national level, burnout scores of student nurses were equal to those of registered nurses and workers in social and nursing professions. The specific stressors of education and training lead to strain comparable to years of professional experience and exposure to stressors. The relatively high level of satisfaction with life in student nurses may be due to specific resources and ways of compensation, that require further examination. Differences between urban and rural districts (with lower burnout scores and higher satisfaction with life sores in rural districts) were strong in student nurses. Compared with international nurse and health care samples, burnout is relatively low in the examined groups. Registered nurses and student nurses in rural districts show the lowest scores of all in emotional exhaustion and depersonalization, respectively.

31 CFR 315.36 - Payment during life of sole owner.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Payment during life of sole owner. 315.36 Section 315.36 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... § 315.36 Payment during life of sole owner. A savings bond registered in single ownership form (i.e...

Immediate versus delayed loading of strategic mini dental implants for the stabilization of partial removable dental prostheses: a patient cluster randomized, parallel-group 3-year trial.

PubMed

Mundt, Torsten; Al Jaghsi, Ahmad; Schwahn, Bernd; Hilgert, Janina; Lucas, Christian; Biffar, Reiner; Schwahn, Christian; Heinemann, Friedhelm

2016-07-30

Acceptable short-term survival rates (>90 %) of mini-implants (diameter < 3.0 mm) are only documented for mandibular overdentures. Sound data for mini-implants as strategic abutments for a better retention of partial removable dental prosthesis (PRDP) are not available. The purpose of this study is to test the hypothesis that immediately loaded mini-implants show more bone loss and less success than strategic mini-implants with delayed loading. In this four-center (one university hospital, three dental practices in Germany), parallel-group, controlled clinical trial, which is cluster randomized on patient level, a total of 80 partially edentulous patients with unfavourable number and distribution of remaining abutment teeth in at least one jaw will receive supplementary min-implants to stabilize their PRDP. The mini-implant are either immediately loaded after implant placement (test group) or delayed after four months (control group). Follow-up of the patients will be performed for 36 months. The primary outcome is the radiographic bone level changes at implants. The secondary outcome is the implant success as a composite variable. Tertiary outcomes include clinical, subjective (quality of life, satisfaction, chewing ability) and dental or technical complications. Strategic implants under an existing PRDP are only documented for standard-diameter implants. Mini-implants could be a minimal invasive and low cost solution for this treatment modality. The trial is registered at Deutsches Register Klinischer Studien (German register of clinical trials) under DRKS-ID: DRKS00007589 ( www.germanctr.de ) on January 13(th), 2015.

2017 Draft Aquatic Life Criteria for Aluminum in Freshwater

EPA Pesticide Factsheets

EPA has released draft updated aluminum aquatic life ambient water quality criteria for freshwater under Section 304(a)(1) of the Clean Water Act. EPA will accept public comments on the draft criteria for 60 days upon publication in the Federal Register.

Capacity of dental equipment to interfere with cardiac implantable electrical devices.

PubMed

Lahor-Soler, Eduard; Miranda-Rius, Jaume; Brunet-Llobet, Lluís; Sabaté de la Cruz, Xavier

2015-06-01

Patients with cardiac implantable electrical devices should take precautions when exposed to electromagnetic fields. Possible interference as a result of proximity to electromagnets or electricity flow from electronic tools employed in clinical odontology remains controversial. The objective of this study was to examine in vitro the capacity of dental equipment to provoke electromagnetic interference in pacemakers and implantable cardioverter defibrillators. Six electronic dental instruments were tested on three implantable cardioverter defibrillators and three pacemakers from different manufacturers. A simulator model, submerged in physiological saline, with elements that reproduced life-size anatomic structures was used. The instruments were analyzed at differing distances and for different time periods of application. The dental instruments studied displayed significant differences in their capacity to trigger electromagnetic interference. Significant differences in the quantity of registered interference were observed with respect to the variables manufacturer, type of cardiac implant, and application distance but not with the variable time of application. The electronic dental equipment tested at a clinical application distance (20 cm) provoked only slight interference in the pacemakers and implantable cardioverter defibrillators employed, irrespective of manufacturer. © 2015 Eur J Oral Sci.

77 FR 11584 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... County Nahant Life--Saving Station, 96 Nahant Rd., Nahant, 12000133 NEW YORK Seneca County Women's Rights... St. NW., MS 2280, Washington, DC 20240; by all other carriers, National Register of Historic Places, National Park Service,1201 Eye St. NW., 8th Floor, Washington DC 20005; or by fax, 202-371-6447. Written or...

Comparison of Online and Traditional Basic Life Support Renewal Training Methods for Registered Professional Nurses.

PubMed

Serwetnyk, Tara M; Filmore, Kristi; VonBacho, Stephanie; Cole, Robert; Miterko, Cindy; Smith, Caitlin; Smith, Charlene M

2015-01-01

Basic Life Support certification for nursing staff is achieved through various training methods. This study compared three American Heart Association training methods for nurses seeking Basic Life Support renewal: a traditional classroom approach and two online options. Findings indicate that online methods for Basic Life Support renewal deliver cost and time savings, while maintaining positive learning outcomes, satisfaction, and confidence level of participants.

Webinar: Clean Air in the Classroom: Improve Air Quality, Extend HVAC System Life with Preventive Maintenance

EPA Pesticide Factsheets

A page to register to view the May 17, 2018, webinar in the IAQ Knowledge-to-Action Professional Training Webinar Series: Clean Air in the Classroom: Improve Air Quality, Extend HVAC System Life with Preventive Maintenance

Communication during haematological consultations; patients' preferences and professionals' performances.

PubMed

van Bruinessen, Inge R; van der Hout, Lotte E; van Weel-Baumgarten, Evelyn M; Gouw, Hans; Zijlstra, Josée M; van Dulmen, Sandra

2016-06-01

Many patients with haematological malignancies experience barriers in clinical communication. Reaching effective communication is of great importance as it has been linked to a range of improved patient outcomes such as satisfaction, compliance to treatment, perceived quality of life and physical and mental health. To get a better understanding how communication in haematological consultations can be improved, the current study focussed on patients' preferences and perceived performances regarding the communicative behaviour of their health care professional. Secondly, the mediation of an online communication tool for patients was analysed. Within a controlled pre- post-test design, 78 datasets of clinical consultations could be analysed. Patients considered both affective and instrumental communication aspects important. The affective communication behaviour of the health care professional met the patients' pre-visit preferences well. In the information exchange, more variability and discrepancies were found. Overall, the online intervention did not seem to influence the patients' perceived communication performance of their health care professional much. To further improve the communication during clinical consultations, health care professionals should inquire about patients' expectations, especially during the exchange of information and advices. At the same time, patients should be supported to express their preferences at the start of the consultation. The study was registered in the Netherlands Trial Register, number 3779.

[Epidemiological characteristics of out-of-hospital cardiorespiratory arrest recorded by the 061 emergencies system (SAMU) in the Balearic Islands (Spain), 2009-2012].

PubMed

Socias Crespí, L; Ceniceros Rozalén, M I; Rubio Roca, P; Martínez Cuellar, N; García Sánchez, A; Ripoll Vera, T; Lesmes Serrano, A

2015-05-01

To describe the epidemiology of out-of-hospital cardiorespiratory arrest (OHCA) and identify factors associated with recovery of spontaneous circulation (ROSC). Observational study of OHCA registered on a continuous basis in the Emergency Medical Services (EMS) database during 2009-2012. The islands of Mallorca, Ibiza, Menorca and Formentera (Balearic Islands, Spain). OHCA in patients ≥ 18 years of age. The main variables were: Patient sex, age, probable cause, place of arrest, bystander, witnessed, basic life support (BLS), shockable rhythm, intervention time, semi-automatic defibrillator (AED), duration of cardiopulmonary arrest (CA), and ROSC. Independent variables were defined according to the Utstein protocol, and the dependent variable was defined as ROSC. The EMS treated 1170 OHCAs (28/100,000 persons-year). We included 1130 CA. The mean age was 61.4 years (73.4% males). Most CA (72.3%) were of cardiac etiology, and 84.7% were witnessed. A total of 840 (74.3%) received BLS and 400 (47.6%) did so before arrival of the EMS (45 by bystander relatives). AED was available in 330 cases CA (29.2%) (96 with shockable rhythm). The interval between emergency call and BLS and between emergency call and advanced life support was 8.4 and 15.8min, respectively. Shockable rhythm was monitored in 257 CAs (22.7%). ROSC occurred in 261 (23.1%). Factors associated with ROSC were age, shockable rhythm, BLS before EMS arrival, and CA duration less than 30min. The incidence rate of the OHCA is low. The proportion of patients receiving BLS from relatives was low. Age, shockable rhythm and BSL before EMS arrival were associated with ROSC. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Moral Perception and Judgment and a Truly Radical Change of Social Practices: A Reply to Paul Standish's "Registers of the Religious"

ERIC Educational Resources Information Center

Smeyers, Paul

2012-01-01

This article presents the author's response to Paul Standish's "Registers of the Religious". Addressing what he calls the "global", Paul Standish starts from MacIntyre's observation that people live in a world characterized by a vocabulary of value whose purchase on life is no longer authentically experienced: "MacIntyre's diagnosis of the…

Hospital organizational factors influence work-family conflict in registered nurses: Multilevel modeling of a nation-wide cross-sectional survey in Sweden.

PubMed

Leineweber, C; Chungkham, H S; Westerlund, H; Tishelman, C; Lindqvist, R

2014-05-01

The present shortage of registered nurses (RNs) in many European countries is expected to continue and worsen, which poses a substantial threat to the maintenance of healthcare in this region. Work-family conflict is a known risk factor for turnover and sickness absence. This paper empirically examines whether the nurse practice environment is associated with experienced work-family conflict. A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analyzed here is based on a national sample of 8356 female and 592 male RNs from 369 hospital departments. We found that 6% of the variability in work-family conflict experienced by RNs was at the department level. Organizational level factors significantly accounted for most of the variability at this level with two of the work practice environment factors examined, staffing adequacy and nurse involvement in hospital affairs, significantly related to work-family conflict. Due to the design of the study, factors on ward and work group levels could not be analyzed, but are likely to account for additional variance which in the present analysis appears to be on the individual level, with private life factors likely explaining another major part. These results suggest that higher level organizational factors in health care have a significant impact on the risk of work-family conflict among RNs through their impact on the nurse practice environment. Lower level organizational factors should be investigated in future studies using hierarchical multilevel sampling. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Register of experts for information on mechanics of structural failure

NASA Technical Reports Server (NTRS)

Carpenter, J. L., Jr.; Stuhrke, W. F.

1975-01-01

This register is comprised of a list of approximately 300 experts from approximately 90 organizations who have published results of theoretical and/or experimental research related to six problem areas in the mechanics of structural failure: (1) life prediction for structural materials, (2) fracture toughness testing, (3) fracture mechanics analysis; (4) hydrogen embrittlement; (5) protective coatings; and (6) composite materials. The criteria for the selection of names for the register are recent contributions to the literature, participation in or support of relevant research programs, and referral by peers. Each author included is listed by organizational affiliation, address, and principal field of expertise. The purpose of the register is to present, in easy reference form, sources for dependable information regarding failure modes and mechanisms of aerospace structures. The register includes two indexes; an alphabetical listing of the experts and an alphabetical listing of the organizations with whom they are affiliated.

Measuring the impact of an interprofessional multimedia learning resource on Japanese nurses and nursing students using the Theory of Planned Behavior Medication Safety Questionnaire.

PubMed

Omura, Mieko; Levett-Jones, Tracy; Stone, Teresa Elizabeth; Maguire, Jane; Lapkin, Samuel

2015-12-01

Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety. Using a quasi-experimental design, Japanese registered nurses and nursing students (n = 203) were allocated to an experimental (n = 109) or control group (n = 94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire. Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables. The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted. © 2015 Wiley Publishing Asia Pty Ltd.

Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study

PubMed Central

2010-01-01

Background Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Methods Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Results Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. Conclusions This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland. PMID:20573207

The Family & Life Education Program.

ERIC Educational Resources Information Center

Brand, Mellie R.

The Family and Life Education program at Aims Community College (ACC) in Colorado began in 1967 as prenatal classes taught by volunteer instructors who were registered nurses with backgrounds in maternal-child health. Currently, the program, which is co-sponsored by ACC and North Colorado Medical Center, involves a program coordinator, three staff…

Using the Paper around Us to Supplement a Life Skills Curriculum.

ERIC Educational Resources Information Center

Hayes, Miriam F.

1987-01-01

Such everyday paper materials as cash register receipts, labels, travel pamphlets, and train schedules provide a wealth of excellent materials for teaching life skills and functional reading to multihandicapped hearing-impaired students. Possible activities include comparing grocery receipts and conjecturing about the shoppers and reading medicine…

Early Onset of Type 1 Diabetes and Educational Field at Upper Secondary and University Level: Is Own Experience an Asset for a Health Care Career?

PubMed Central

Steen Carlsson, Katarina

2017-01-01

Ill health in early life has a significant negative impact on school grades, grade repetition, educational level, and labor market outcomes. However, less is known about qualitative socio-economic consequences of a health shock in childhood or adolescence. We investigate the relationship between onset of type 1 diabetes up to age 15 and the probability of choosing and completing a health-oriented path at upper secondary and university level of education. We analyze the Swedish Childhood Diabetes Register, the National Educational Register, and other population registers in Sweden for 2756 people with type 1 diabetes and 10,020 matched population controls. Educational decisions are modeled as unsorted series of binary choices to assess the choice of educational field as a potential mechanism linking early life health to adult outcomes. The analyses reject the hypothesis of no systematic differences in choice of educational field between people with and without type 1 diabetes at both levels. The results are robust to selection on ability proxies and across sensitivity analysis. We conclude that the observed pro health-oriented educational choices among people with type 1 diabetes in our data are consistent with disease onset in childhood and adolescence having qualitative impact on life-course choices. PMID:28665347

Early Onset of Type 1 Diabetes and Educational Field at Upper Secondary and University Level: Is Own Experience an Asset for a Health Care Career?

PubMed

Lovén, Ida; Steen Carlsson, Katarina

2017-06-30

Ill health in early life has a significant negative impact on school grades, grade repetition, educational level, and labor market outcomes. However, less is known about qualitative socio-economic consequences of a health shock in childhood or adolescence. We investigate the relationship between onset of type 1 diabetes up to age 15 and the probability of choosing and completing a health-oriented path at upper secondary and university level of education. We analyze the Swedish Childhood Diabetes Register, the National Educational Register, and other population registers in Sweden for 2756 people with type 1 diabetes and 10,020 matched population controls. Educational decisions are modeled as unsorted series of binary choices to assess the choice of educational field as a potential mechanism linking early life health to adult outcomes. The analyses reject the hypothesis of no systematic differences in choice of educational field between people with and without type 1 diabetes at both levels. The results are robust to selection on ability proxies and across sensitivity analysis. We conclude that the observed pro health-oriented educational choices among people with type 1 diabetes in our data are consistent with disease onset in childhood and adolescence having qualitative impact on life-course choices.

Current Literature Review of Registered Nurses' Competency in the Global Community.

PubMed

Liu, Ying; Aungsuroch, Yupin

2018-03-01

In order to enhance international standards of nursing service, this article aims to analyze the English full-text peer-reviewed published articles from the past 10 years that describe contemporary registered nurses' (RNs') competency in the global community. An integrative review of literature was conducted between June 2016 and January 2017. A systematic search was completed using four databases (Science Direct, Scopus, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) that covered the years between 2007 and 2017, and used the key words nurs * OR (staff nurs * ) OR (register nurs * ) AND competenc * AND international OR global. Ultimately, 32 studies meeting inclusion and exclusion criteria were selected for analysis. Nursing competency trended towards definitions using a holistic lens and behavior statements reflecting the skills, knowledge, attitudes, and judgment required for effective performance in the nursing profession. By using inductive content analysis, 11 components emerged. Additionally, six instruments were found to measure generalist RNs' competencies across countries. The variables related to generalist nursing competency included sociodemographic variables, professional-related variables, and work environment variables. This review provides the research evidence for updating definitions, components, measurements, and variables related to RNs' competency in the global community. Further research should consider cross-cultural validation of instruments and influencing factors related to nursing competency. The components and measurements identified in this review can be used by nursing administrators to select or evaluate qualified nurses. The multivariables related to nursing competency can assistant hospital administrators to recognize and find effective ways to improve nursing competency. © 2018 Sigma Theta Tau International.

Registered Nurses’ Perceptions about the Situation of Family Caregivers to Patients with Heart Failure - A Focus Group Interview Study

PubMed Central

2016-01-01

Introduction Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. Aims The aims of this study are to explore registered nurses’ perceptions about the situation of family caregivers to patients with heart failure, and registered nurses’ interventions, in order to improve family caregivers’ situation. Methods The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Results Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area “Family caregivers' situation” includes two categories: “To be unburdened” and “To comprehend the heart failure condition and its consequences”. The content area “Interventions to improve family caregivers' situation” includes two categories: “Individualized support and information” and “Bridging contact”. Conclusions Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care" and or Family-centred care. Registered nurses consider it necessary to have a coordinated individual care plan as a basis for collaboration between the county council and the municipality. PMID:27505287

Registered Nurses' Perceptions about the Situation of Family Caregivers to Patients with Heart Failure - A Focus Group Interview Study.

PubMed

Gusdal, Annelie K; Josefsson, Karin; Thors Adolfsson, Eva; Martin, Lene

2016-01-01

Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. The aims of this study are to explore registered nurses' perceptions about the situation of family caregivers to patients with heart failure, and registered nurses' interventions, in order to improve family caregivers' situation. The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area "Family caregivers' situation" includes two categories: "To be unburdened" and "To comprehend the heart failure condition and its consequences". The content area "Interventions to improve family caregivers' situation" includes two categories: "Individualized support and information" and "Bridging contact". Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care" and or Family-centred care. Registered nurses consider it necessary to have a coordinated individual care plan as a basis for collaboration between the county council and the municipality.

[Pharmacokinetics and effects of xylazine (Rompun) in dogs].

PubMed

Rector, E; Otto, K; Kietzmann, M; Nolte, I; Lehmacher, W

1996-01-01

Six beagle dogs were treated with xylazine hydrochloride (1 mg/kg i.m.). The plasma xylazine concentration was measured by HPLC. Additionally, clinical effects were registered (cardiac rate, respiratory activity, electrocardiogram, body temperature, motoric activity, attention, analgesia). Maximum plasma concentrations were measured after 15 minutes (476 ng/ml). The plasma half-life was 24 minutes. Sedation was registered over one hour (xylazine concentration of more than 150 ng/ml). Within the first 30 minutes after treatment (xylazine concentration of more than 300 ng/ml), a low-grade analgesia was observed. In contrast, cardiac and respiratoric depression and also significantly diminished body temperature were registered over 2 to 3 hours.

Variability modifies life satisfaction's association with mortality risk in older adults

PubMed Central

Boehm, Julia K.; Winning, Ashley; Segerstrom, Suzanne; Kubzansky, Laura D.

2015-01-01

Life satisfaction is associated with greater longevity, but its variability across time has not been examined relative to longevity. We investigated whether mean levels of life satisfaction across time, variability in life satisfaction across time, and their interaction were associated with mortality over 9 years of follow-up. Participants were 4,458 Australians initially ≥50 years old. During the follow-up, 546 people died. Adjusting for age, greater mean life satisfaction was associated with reduced risk and greater variability in life satisfaction was associated with increased risk of mortality. These findings were qualified by a significant interaction such that individuals with low mean satisfaction and high variability in satisfaction had the greatest risk of mortality over the follow-up period. In combination with mean levels of life satisfaction, variability in life satisfaction is relevant for mortality risk among older adults. Considering intraindividual variability provides additional insight into associations between psychological characteristics and health. PMID:26048888

The relationship between health literacy and quality of life among frequent users of health care services: a cross-sectional study.

PubMed

Couture, Éva Marjorie; Chouinard, Maud-Christine; Fortin, Martin; Hudon, Catherine

2017-07-06

Although health literacy and quality of life are important concepts in health care, the link between them is unclear, especially for a population of frequent users of health care services with chronic diseases. Low health literacy is a common problem that has been linked to several negative health outcomes. Quality of life is an important health outcome in patient-centered care. Frequent users of health care services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. The objective of this study was to examine the relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services with chronic diseases. This study presents the cross-sectional analysis of data collected through the V1SAGES project, a randomized controlled trial on the effectiveness of a case management intervention in primary care in Quebec, Canada. Participants (n = 247) were frequent users of health care services presenting at least one chronic condition. Health literacy was measured by the Newest Vital Sign (NVS), and the physical and mental components of quality of life were evaluated by the Short Form Health Survey Version 2 (SF-12v2). The association between health literacy (independent variable) and the physical and mental components of quality of life was examined using biserial correlation. No association was found between health literacy and quality of life (physical component: r = 0.108, ρ = 0.11; mental component: r = 0.147, ρ = 0.15). This study suggests that there is no relationship between health literacy and the physical and mental components of quality of life among frequent users of health care services. NCT01719991 . Registered October 25, 2012.

46 CFR 2.01-25 - International Convention for Safety of Life at Sea, 1974.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Guard, an authorized classification society may issue international convention certificates as permitted... request of the government of a country in which is registered a vessel engaged in an international voyage... 46 Shipping 1 2012-10-01 2012-10-01 false International Convention for Safety of Life at Sea, 1974...

46 CFR 2.01-25 - International Convention for Safety of Life at Sea, 1974.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Guard, an authorized classification society may issue international convention certificates as permitted... request of the government of a country in which is registered a vessel engaged in an international voyage... 46 Shipping 1 2014-10-01 2014-10-01 false International Convention for Safety of Life at Sea, 1974...

46 CFR 2.01-25 - International Convention for Safety of Life at Sea, 1974.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Guard, an authorized classification society may issue international convention certificates as permitted... request of the government of a country in which is registered a vessel engaged in an international voyage... 46 Shipping 1 2013-10-01 2013-10-01 false International Convention for Safety of Life at Sea, 1974...

19 CFR 10.450 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of Origin § 10.450 Definitions. For purposes of §§ 10.450 through 10.463 of this subpart: (a..., and other marine life) taken from the sea by vessels registered or recorded with a Party and flying... recovered goods; (2) Have the same life expectancy and meet the same performance standards as new goods; and...

76 FR 57034 - Pesticide Products; Receipt of Applications To Register New Uses

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

...-OPP-2009-0677. Company Name and Address: Arysta LifeScience, North America LLC, 15401 Weston Parkway...: 66330-45 and 66330-46. Docket Number: EPA- HQ-OPP-2011-0641. Company Name and Address: Arysta LifeScience North America LLC, 15401 Weston Parkway, Suite 150, Cary, NC 27513. Active Ingredient...

District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena

2014-08-01

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.

Interventions and decision-making at the end of life: the effect of establishing the terminal illness situation.

PubMed

Campos-Calderón, C; Montoya-Juárez, R; Hueso-Montoro, C; Hernández-López, E; Ojeda-Virto, F; García-Caro, M P

2016-11-07

Many 'routine' interventions performed in hospital rooms have repercussions for the comfort of the patient, and the decision to perform them should depend on whether the patient is identified as in a terminal phase. The aim of this study is to analyse the health interventions performed and decisions made in the last days of life in patients with advanced oncological and non-oncological illness to ascertain whether identifying the patient's terminal illness situation has any effect on these decisions. Retrospective study of the clinical histories of deceased patients in four hospitals in Granada (Spain) in 2010. Clinical histories corresponding to the last three months of the patient's life were reviewed. A total of 202 clinical histories were reviewed, 60 % of which were those of non-oncology patients. Opioid prescriptions (58.4 %), palliative sedation (35.1 %) and Do Not Resuscitate (DNR) orders (34.7 %) were the decisions most often reflected in the histories, and differences in these decisions were found between patients registered as terminal and those who were not registered as terminal. The most frequent interventions in the final 14 days and 48 h were parenteral hydration (96-83 %), peripheral venous catheter (90.1-82 %) and oxygen therapy (81.2-70.5 %). There were statistically significant differences between the patients who were registered as terminal and those not registered as terminal in the number of interventions applied in the final 14 days and 48 h (p = 0.01-p = 0.00) and in many of the described treatments. The recognition of a patient's terminal status in the clinical history conditions the decisions that are made and is generally associated with a lower number of interventions.

Neighbourhood disadvantage and individual adversities in adolescence and total alcohol consumption up to mid-life-Results from the Northern Swedish Cohort.

PubMed

Johansson, Klara; San Sebastian, Miguel; Hammarström, Anne; Gustafsson, Per E

2015-05-01

This study tests if neighbourhood socioeconomic disadvantage and family social and material adversities during adolescence are independently related to total alcohol consumption from adolescence through to mid-life. Self-reports from the Northern Swedish Cohort (effective sample=950) at ages 16, 18, 21, 30 and 42 was combined with register data on the socioeconomic composition of neighbourhoods at age 16. Total volume of alcohol consumed between age 16-42 was estimated based on the five survey waves, and self-reported social and material adversities were computed as composite variables. Neighbourhood socioeconomic disadvantage at age 16 was associated with alcohol consumption age 16-42 for men but not for women. Social adversities at age 16 were associated with alcohol consumption age 16-42 for both women and men, but material adversity or parental class was not. In conclusion, neighbourhood socioeconomic disadvantage in adolescence has a significant relationship with later alcohol consumption among men, even independently from individual factors. On family level, social factors but not socioeconomic factors in adolescence independently predict later alcohol consumption. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Nurses’ Well-Being Index and Factors Influencing This Index among Nurses in Central China: A Cross-Sectional Study

PubMed Central

Liu, Bing; Hu, Ying; Yu, Chuanhua

2015-01-01

Backgrounds/Objectives A discussion and analysis of factors that contribute to nurses’ happiness index can be useful in developing effective interventions to improve nurses’ enthusiasm, sense of honor and pride and to improve the efficiency and quality of medical services. Methods In this study, 206 registered nurses at the 2011 annual encounter for 12 Hanchuan hospitals completed a questionnaire survey that covered three aspects of the well-being index and thus served as a comprehensive well-being and general information tool. Results Based on their index score, the nurses’ overall happiness level was moderate. The dimensions of the happiness index are listed in descending order of their contribution to the nurses’ comprehensive happiness levels: health concerns, friendly relationships, self-worth, altruism, vitality, positive emotions, personality development, life satisfaction and negative emotions. Four variables (positive emotion, life satisfaction, negative emotions, and friendly relationships) jointly explained 47.80% of the total variance of the happiness index; positive emotions had the greatest impact on the happiness index. Conclusions Appropriate nursing interventions can improve nurses’ happiness index scores, thereby increasing nurses’ motivation and promoting the development of their nursing practice. PMID:26680594

The Nurses' Well-Being Index and Factors Influencing This Index among Nurses in Central China: A Cross-Sectional Study.

PubMed

Meng, Runtang; Luo, Yi; Liu, Bing; Hu, Ying; Yu, Chuanhua

2015-01-01

A discussion and analysis of factors that contribute to nurses' happiness index can be useful in developing effective interventions to improve nurses' enthusiasm, sense of honor and pride and to improve the efficiency and quality of medical services. In this study, 206 registered nurses at the 2011 annual encounter for 12 Hanchuan hospitals completed a questionnaire survey that covered three aspects of the well-being index and thus served as a comprehensive well-being and general information tool. Based on their index score, the nurses' overall happiness level was moderate. The dimensions of the happiness index are listed in descending order of their contribution to the nurses' comprehensive happiness levels: health concerns, friendly relationships, self-worth, altruism, vitality, positive emotions, personality development, life satisfaction and negative emotions. Four variables (positive emotion, life satisfaction, negative emotions, and friendly relationships) jointly explained 47.80% of the total variance of the happiness index; positive emotions had the greatest impact on the happiness index. Appropriate nursing interventions can improve nurses' happiness index scores, thereby increasing nurses' motivation and promoting the development of their nursing practice.

Do spatiotemporal parameters and gait variability differ across the lifespan of healthy adults? A systematic review.

PubMed

Herssens, Nolan; Verbecque, Evi; Hallemans, Ann; Vereeck, Luc; Van Rompaey, Vincent; Saeys, Wim

2018-06-12

Aging is often associated with changes in the musculoskeletal system, peripheral and central nervous system. These age-related changes often result in mobility problems influencing gait performance. Compensatory strategies are used as a way to adapt to these physiological changes. The aim of this review is to investigate the differences in spatiotemporal and gait variability measures throughout the healthy adult life. This systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (no. CRD42017057720). Databases MEDLINE (Pubmed), Web of Science (Web of Knowledge), Cochrane Library and ScienceDirect were systematically searched until March 2018. Eighteen of the 3195 original studies met the eligibility criteria and were included in this review. The majority of studies reported spatiotemporal and gait variability measures in adults above the age of 65, followed by the young adult population, information of middle-aged adults is lacking. Spatiotemporal parameters and gait variability measures were extracted from 2112 healthy adults between 18 and 98 years old and, in general, tend to deteriorate with increasing age. Variability measures were only reported in an elderly population and show great variety between studies. The findings of this review suggest that most spatiotemporal parameters significantly differ across different age groups. Elderly populations show a reduction of preferred walking speed, cadence, step and stride length, all related to a more cautious gait, while gait variability measures remain stable over time. A preliminary framework of normative reference data is provided, enabling insights into the influence of aging on spatiotemporal parameters, however spatiotemporal parameters of middle-aged adults should be investigated more thoroughly. Copyright © 2018 Elsevier B.V. All rights reserved.

Can volunteering in later life reduce the risk of dementia? A 5-year longitudinal study among volunteering and non-volunteering retired seniors.

PubMed

Griep, Yannick; Hanson, Linda Magnusson; Vantilborgh, Tim; Janssens, Laurens; Jones, Samantha K; Hyde, Martin

2017-01-01

We propose that voluntary work, characterized by social, physical and cognitive activity in later life is associated with fewer cognitive problems and lower dementia rates. We test these assumptions using 3-wave, self-reported, and registry data from the 2010, 2012, and 2014 Swedish National Prescribed Drug Register. We had three groups of seniors in our data: 1) no volunteering (N = 531), 2) discontinuous volunteering (N = 220), and 3) continuous volunteering (N = 250). We conducted a path analysis in Mplus to investigate the effect of voluntary work (discontinuously and continuously) on self-reported cognitive complaints and the likelihood of being prescribed an anti-dementia treatment after controlling for baseline and relevant background variables. Our results indicated that seniors, who continuously volunteered, reported a decrease in their cognitive complaints over time, whereas no such associations were found for the other groups. In addition, they were 2.44 (95%CI [1.86; 3.21]) and 2.46 (95%CI [1,89; 3.24]) times less likely to be prescribed an anti-dementia treatment in 2012 and 2014, respectively. Our results largely support the assumptions that voluntary work in later life is associated with lower self-reported cognitive complaints and a lower risk for dementia, relative to those who do not engage, or only engage episodically in voluntary work.

Can volunteering in later life reduce the risk of dementia? A 5-year longitudinal study among volunteering and non-volunteering retired seniors

PubMed Central

Hanson, Linda Magnusson; Vantilborgh, Tim; Janssens, Laurens; Jones, Samantha K.; Hyde, Martin

2017-01-01

We propose that voluntary work, characterized by social, physical and cognitive activity in later life is associated with fewer cognitive problems and lower dementia rates. We test these assumptions using 3-wave, self-reported, and registry data from the 2010, 2012, and 2014 Swedish National Prescribed Drug Register. We had three groups of seniors in our data: 1) no volunteering (N = 531), 2) discontinuous volunteering (N = 220), and 3) continuous volunteering (N = 250). We conducted a path analysis in Mplus to investigate the effect of voluntary work (discontinuously and continuously) on self-reported cognitive complaints and the likelihood of being prescribed an anti-dementia treatment after controlling for baseline and relevant background variables. Our results indicated that seniors, who continuously volunteered, reported a decrease in their cognitive complaints over time, whereas no such associations were found for the other groups. In addition, they were 2.44 (95%CI [1.86; 3.21]) and 2.46 (95%CI [1,89; 3.24]) times less likely to be prescribed an anti-dementia treatment in 2012 and 2014, respectively. Our results largely support the assumptions that voluntary work in later life is associated with lower self-reported cognitive complaints and a lower risk for dementia, relative to those who do not engage, or only engage episodically in voluntary work. PMID:28301554

Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

PubMed Central

2012-01-01

Background Medically unexplained symptoms are an important mental health problem in primary care and generate a high cost in health services. Cognitive behavioral therapy and psychodynamic therapy have proven effective in these patients. However, there are few studies on the effectiveness of psychosocial interventions by primary health care. The project aims to determine whether a cognitive-behavioral group intervention in patients with medically unexplained symptoms, is more effective than routine clinical practice to improve the quality of life measured by the SF-12 questionary at 12 month. Methods/design This study involves a community based cluster randomized trial in primary healthcare centres in Madrid (Spain). The number of patients required is 242 (121 in each arm), all between 18 and 65 of age with medically unexplained symptoms that had seeked medical attention in primary care at least 10 times during the previous year. The main outcome variable is the quality of life measured by the SF-12 questionnaire on Mental Healthcare. Secondary outcome variables include number of consultations, number of drug (prescriptions) and number of days of sick leave together with other prognosis and descriptive variables. Main effectiveness will be analyzed by comparing the percentage of patients that improve at least 4 points on the SF-12 questionnaire between intervention and control groups at 12 months. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion This study aims to provide more insight to address medically unexplained symptoms, highly prevalent in primary care, from a quantitative methodology. It involves intervention group conducted by previously trained nursing staff to diminish the progression to the chronicity of the symptoms, improve quality of life, and reduce frequency of medical consultations. Trial registration The trial was registered with ClinicalTrials.gov, number NCT01484223 [ http://ClinicalTrials.gov]. PMID:22551252

[Bioacoustic of the advertisement call of Ceratophrys cranwelli (Anura: Ceratophryidae)].

PubMed

Valetti, Julián Alonso; Salas, Nancy Edith; Martino, Adolfo Ludovico

2013-03-01

The advertisement call plays an important role in the life history of anuran amphibians, mainly during the breeding season. Call features represent an important character to discriminate species, and sound emissions are very effective to assure or reinforce genetic incompatibility, especially in the case of sibling species. Since frogs are ectotherms, acoustic properties of their calls will vary with temperature. In this study, we described the advertisement call of C. cranwelli, quantifying the temperature effect on its components. The acoustic emissions were recorded during 2007 using a DAT record Sony TCD-100 with stereo microphone ECM-MS907 Sony and tape TDK DAT-RGX 60. As males emit their calls floating in temporary ponds, water temperatures were registered after recording the advertisement calls with a digital thermometer TES 1300+/-0.1 degreeC. Altogether, 54 calls from 18 males were analyzed. The temporal variables of each advertisement call were measured using oscillograms and sonograms and the analyses of dominant frequency were performed using a spectrogram. Multiple correlation analysis was used to identify the temperature-dependent acoustic variables and the temperature effect on these variables was quantified using linear regression models. The advertisement call of C. cranwelli consists of a single pulse group. Call duration, Pulse duration and Pulse interval decreased with the temperature, whereas the Pulse rate increased with temperature. The temperature-dependent variables were standardized at 25 degreeC according to the linear regression model obtained. The acoustic variables that were correlated with the temperature are the variables which emissions depend on laryngeal muscles and the temperature constraints the contractile properties of muscles. Our results indicated that temperature explains an important fraction of the variability in some acoustic variables (79% in the Pulse rate), and demonstrated the importance of considering the effect of temperature in acoustic components. The results suggest that acoustic variables show geographic variation to compare data with previous works.

Stringent or nonstringent complete remission and prognosis in acute myeloid leukemia: a Danish population-based study

PubMed Central

Øvlisen, Andreas K.; Oest, Anders; Bendtsen, Mette D.; Bæch, John; Johansen, Preben; Lynggaard, Line S.; Mølle, Ingolf; Mortensen, Thomas B.; Weber, Duruta; Ertner, Gideon; Schöllkopf, Claudia; Thomassen, Jesper Q.; Nielsen, Ove Juul; Østgård, Lene Sofie Granfeldt; Bøgsted, Martin; Dybkær, Karen; Johnsen, Hans E.

2018-01-01

Stringent complete remission (sCR) of acute myeloid leukemia is defined as normal hematopoiesis after therapy. Less sCR, including non-sCR, was introduced as insufficient blood platelet, neutrophil, or erythrocyte recovery. These latter characteristics were defined retrospectively as postremission transfusion dependency and were suggested to be of prognostic value. In the present report, we evaluated the prognostic impact of achieving sCR and non-sCR in the Danish National Acute Leukaemia Registry, including 769 patients registered with classical CR (ie, <5% blasts in the postinduction bone marrow analysis). Individual patients were classified as having sCR (n = 360; 46.8%) or non-sCR (n = 409; 53.2%) based on data from our national laboratory and transfusion databases. Survival analysis revealed that patients achieving sCR had superior overall survival (hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.10-1.64) as well as relapse-free survival (HR, 1.25; 95% CI, 1.03-1.51) compared with those with non-sCR after adjusting for covariates. Cox regression analysis regarding the impact of the stringent criteria for blood cell recovery identified these as significant and independent variables. In conclusion, this real-life register study supports the international criteria for response evaluation on prognosis and, most importantly, documents each of the 3 lineage recovery criteria as contributing independently. PMID:29523528

Bleeding complications and mortality in warfarin-treated VTE patients, dependence of INR variability and iTTR.

PubMed

Sandén, Per; Renlund, Henrik; Svensson, Peter J; Själander, Anders

2017-01-05

High quality of warfarin treatment is important to prevent recurrence of venous thromboembolism (VTE) without bleeding complications. The aim of this study was to examine the effect of individual time in therapeutic range (iTTR) and International Normalised Ratio (INR) variability on bleeding risk and mortality in a large cohort of well-managed patients with warfarin due to VTE. A cohort of 16612 patients corresponding to 19502 treatment periods with warfarin due to VTE between January 1, 2006 and December 31, 2011 was retrieved from the Swedish national quality register AuriculA and matched with the Swedish National Patient Register for bleeding complications and background characteristics and the Cause of death register for occurrence and date of death. The rate of bleeding was 1.79 (confidence interval (CI) 95 % 1.66-1.93) per 100 treatment years among all patients. Those with poor warfarin treatment quality had a higher rate of clinically relevant bleeding, both when measured as iTTR below 70 %, 2.91 (CI 95 % 2.61-3.21) or as INR variability over the mean value 0.85, 2.61 (CI 95 % 2.36-2.86). Among those with both high INR variability and low iTTR the risk of clinically relevant bleeding was clearly increased hazard ratio (HR) 3.47 (CI 95 % 2.89-4.17). A similar result was found for all-cause mortality with a HR of 3.67 (CI 95 % 3.02-4.47). Both a low iTTR and a high INR variability increase the risk of bleeding complications or mortality. When combining the two treatment quality indicators patients at particular high risk of bleeding or death can be identified.

Contributing to Overall Life Satisfaction: Personality Traits Versus Life Satisfaction Variables Revisited—Is Replication Impossible?

PubMed Central

Lachmann, Bernd; Sariyska, Rayna; Kannen, Christopher; Błaszkiewicz, Konrad; Trendafilov, Boris; Andone, Ionut; Eibes, Mark; Markowetz, Alexander; Li, Mei; Kendrick, Keith M.

2017-01-01

Virtually everybody would agree that life satisfaction is of immense importance in everyday life. Thus, it is not surprising that a considerable amount of research using many different methodological approaches has investigated what the best predictors of life satisfaction are. In the present study, we have focused on several key potential influences on life satisfaction including bottom-up and top-down models, cross-cultural effects, and demographic variables. In four independent (large scale) surveys with sample sizes ranging from N = 488 to 40,297, we examined the associations between life satisfaction and various related variables. Our findings demonstrate that prediction of overall life satisfaction works best when including information about specific life satisfaction variables. From this perspective, satisfaction with leisure showed the highest impact on overall life satisfaction in our European samples. Personality was also robustly associated with life satisfaction, but only when life satisfaction variables were not included in the regression model. These findings could be replicated in all four independent samples, but it was also demonstrated that the relevance of life satisfaction variables changed under the influence of cross-cultural effects. PMID:29295529

78 FR 24249 - Lincoln National Life Insurance Company, et al; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... Life Insurance Company, et al; Notice of Application April 18, 2013 AGENCY: Securities and Exchange... Section 17(a) of the Act. APPLICANTS: Lincoln National Life Insurance Company (``Lincoln Life''), Lincoln National Variable Annuity Account C, Lincoln National Variable Annuity Account L, Lincoln Life Variable...

Dimensions and predictors of disability—A baseline study of patients entering somatic rehabilitation in secondary care

PubMed Central

2018-01-01

Purpose The purpose of this study was to investigate disability among patients who were accepted for admission to a Norwegian rehabilitation center and to identify predictors of disability. Materials and methods In a cross-sectional study including 967 adult participants, the World Health Organization Disability Assessment Schedule version 2.0 36-item version was used for assessing overall and domain-specific disability as outcome variables. Patients completed the Hospital Anxiety and Depression Scale (HADS), EuroQoL EQ-5D-5L and questions about multi-morbidity, smoking and perceived physical fitness. Additionally, the main health condition, sociodemographic and environmental variables obtained from referrals and public registers were used as predictor variables. Descriptive statistics and linear regression analyses were performed. Results The mean (standard error) overall disability score was 30.0 (0.5), domain scores ranged from 11.9 to 44.7. Neurological diseases, multi-morbidity, low education, impaired physical fitness, pain, and higher HADS depressive score increased the overall disability score. A low HADS depressive score predicted a lower disability score in all domains. Conclusions A moderate overall disability score was found among patients accepted for admission to a rehabilitation center but “life activities” and “participation in society” had the highest domain scores. This should be taken into account when rehabilitation strategies are developed. PMID:29499064

78 FR 62354 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-18

... Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls... Department of State pertaining to the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times... of the Federal Register (volume 77, number 203) to change the exhibition name to ``The Dead Sea...

78 FR 24462 - Culturally Significant Objects Imported for Exhibition; Determinations: “The Dead Sea Scrolls...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

...; Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls... Department of State pertaining to the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times... of the Federal Register (volume 77, number 203) to change the exhibition name to ``The Dead Sea...

78 FR 16565 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls... Department of State pertaining to the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times... of the Federal Register (volume 77, number 203) to change the exhibition name to ``The Dead Sea...

Relating Social Welfare to Life Satisfaction in the Postmodern Era of Hong Kong

ERIC Educational Resources Information Center

Cheung, Chau-kiu; Leung, Kwan-kwok

2007-01-01

Social welfare is supposedly beneficial not only to the needy receiving it but to citizens in general who expect social welfare to help the needy. Whereas direct benefits to the needy represent the gratification of material needs, the fulfillment of citizens' expectation registers an idealistic path to life satisfaction. These materialistic and…

Life sciences licensing deals in the fourth quarter of 2017: updates and trends.

PubMed

D'Souza, P

2018-02-01

During the fourth quarter of 2017, Cortellis Competitive Intelligence registered 1,107 new deals (excluding mergers & acquisitions) as part of its ongoing coverage of licensing activity in the life sciences sector compared to 1,043 in the third quarter and 1,035 in the fourth quarter of 2016. Copyright 2018 Clarivate Analytics.

31 CFR 315.36 - Payment during life of sole owner.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES General Provisions for Payment § 315.36 Payment during life of sole owner. A savings bond registered in single ownership form (i.e...

Telehealthcare for asthma.

PubMed

McLean, Susannah; Chandler, David; Nurmatov, Ulugbek; Liu, Joseph; Pagliari, Claudia; Car, Josip; Sheikh, Aziz

2010-10-06

Healthcare systems internationally need to consider new models of care to cater for the increasing numbers of people with asthma. Telehealthcare interventions are increasingly being seen by policymakers as a potential means of delivering asthma care. We defined telehealthcare as being healthcare delivered from a distance, facilitated electronically and involving the exchange of information through the personalised interaction between a healthcare professional using their skills and judgement and the patient providing information. To assess the effectiveness of telehealthcare interventions in people with asthma. We searched in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; this was supplemented by handsearching of respiratory journals. We also searched registers of ongoing and unpublished trials. We selected completed randomised controlled trials of telehealthcare initiatives aiming to improve asthma care. Two review authors independently appraised studies for inclusion and extracted data and performed meta-analyses. We analysed dichotomous variables to produce an odds ratio (OR) and continuous variables to produce a mean difference. We included 21 trials in this review. The 21 included studies investigated a range of technologies aiming to support the provision of care from a distance. These included: telephone (n = 9); video-conferencing (n = 2); Internet (n = 2); other networked communications (n = 6); text Short Messaging Service (n = 1); or a combination of text and Internet (n = 1). Meta-analysis showed that these interventions did not result in clinically important improvements in asthma quality of life (minimum clinically important difference = 0.5): mean difference in Juniper's Asthma Quality of Life Questionnaire (AQLQ) 0.08 (95% CI 0.01 to 0.16). Telehealthcare for asthma resulted in a non-significant increase in the odds of emergency department visits over a 12-month period: OR 1.16 (95% CI 0.52 to 2.58). There was, however, a significant reduction in hospitalisations over a 12-month period: OR 0.21 (95% CI 0.07 to 0.61), the effect being most marked in people with more severe asthma managed predominantly in secondary care settings. Telehealthcare interventions are unlikely to result in clinically relevant improvements in health outcomes in those with relatively mild asthma, but they may have a role in those with more severe disease who are at high risk of hospital admission. Further trials evaluating the effectiveness and cost-effectiveness of a range of telehealthcare interventions are needed.

Caring behaviour perceptions from nurses of their first-line nurse managers.

PubMed

Peng, Xiao; Liu, Yilan; Zeng, Qingsong

2015-12-01

Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.

Malaysian registered nurses' professional learning.

PubMed

Chiu, Lee H

2006-01-01

Findings of a study of the impact of professional learning on Malaysian registered nurses are reported. The offshore delivery post-registration nursing degree programme is a formal aspect of professional learning, which enables Malaysian registered nurses to upgrade their hospital-based training or diploma of nursing qualification to a degree. Using a qualitative case study approach, data were collected from twelve programme graduates, through individual and focus group interviews. The programme promoted their personal professional growth and enhanced their professional development. It increased self-confidence, knowledge, self-fulfillment, critical thinking ability, interpersonal skills, interest in research and research utilisation, and life-long learning. There was evidence of career mobility and a raised awareness of their professional role and responsibility.

Educational differences in life expectancy over five decades among the oldest old in Norway.

PubMed

Kinge, Jonas Minet; Steingrímsdóttir, Ólöf Anna; Moe, Joakim Oliu; Skirbekk, Vegard; Næss, Øyvind; Strand, Bjørn Heine

2015-11-01

Socioeconomic inequalities in life expectancy have been shown among the middle aged and the youngest of the old individuals, but the situation in the oldest old is less clear. The aim of this study was to investigate trends in life expectancy at ages 85, 90 and 95 years by education in Norway in the period 1961-2009. This was a register-based population study including all residents in Norway aged 85 and over. Individual-level data were provided by the Central Population Register and the National Education Database. For each decade during 1961-2009, death rates by 1-year age groups were calculated separately for each sex and three educational categories. Annual life tables were used to calculate life expectancy at ages 85 (e85), 90 (e90) and 95 (e95). Educational differentials in life expectancy at each age were non-significant in the early decades, but became significant over time. For example, for the decade 2000-9, a man aged 90 years with primary education had a life expectancy of 3.4 years, while a man with tertiary education could expect to live for 3.8 years. Similar numbers in women were 4.1 and 4.5 years, respectively. Even among 95-year-old men, statistically significant differences in life expectancy were found by education in the two last decades. Education matters regarding remaining life expectancy also for the oldest old in Norway. Life expectancy at these ages is low, so a growth of 0.5 years in the life expectancy differential is sizeable. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Differences in characteristics between suicide cases of farm managers compared to those of farm labourers in Queensland, Australia.

PubMed

Arnautovska, Urska; McPhedran, Samara; De Leo, Diego

2015-01-01

Farmers constitute an occupation group at a heightened suicide risk compared to the general population. To date, research has tried to explain this peculiarity by identifying suicide risk factors that are common to the whole of the farming population. There are, however, indications that risk factors may be different for different sub-populations of farmers, such as younger/older farmers or farm managers/farm labourers. This study compared the characteristics of suicides by farm managers and farm labourers, while controlling for the effect of age. A review of two datasets, the Queensland Suicide Register and the National Coroners Information System, was conducted in which a total of 78 cases of farm managers and 69 cases of farm labourers were identified as a suicide during 2000-2009, Queensland, Australia. The main outcome measures included various demographic characteristics, circumstances related to death, health and mental health variables, and history of stressful life events. The two groups differed in marital status, living arrangements, ethnicity, physical and mental illness, alcohol and drug abuse, contact with a health professional prior to death, and specific life events such as relationship breakdown and recent/pending unemployment. The majority of these differences were not statistically significant once age was accounted for. However, differences in psychiatric variables and experience of a recent/pending unemployment remained significant. This study contributes towards better understanding of suicide among farmers in different job positions, and highlights the need for tailored suicide prevention initiatives that consider a combination of age- and job-specific suicide risk and protective factors among farmers.

Deformably registering and annotating whole CLARITY brains to an atlas via masked LDDMM

NASA Astrophysics Data System (ADS)

Kutten, Kwame S.; Vogelstein, Joshua T.; Charon, Nicolas; Ye, Li; Deisseroth, Karl; Miller, Michael I.

2016-04-01

The CLARITY method renders brains optically transparent to enable high-resolution imaging in the structurally intact brain. Anatomically annotating CLARITY brains is necessary for discovering which regions contain signals of interest. Manually annotating whole-brain, terabyte CLARITY images is difficult, time-consuming, subjective, and error-prone. Automatically registering CLARITY images to a pre-annotated brain atlas offers a solution, but is difficult for several reasons. Removal of the brain from the skull and subsequent storage and processing cause variable non-rigid deformations, thus compounding inter-subject anatomical variability. Additionally, the signal in CLARITY images arises from various biochemical contrast agents which only sparsely label brain structures. This sparse labeling challenges the most commonly used registration algorithms that need to match image histogram statistics to the more densely labeled histological brain atlases. The standard method is a multiscale Mutual Information B-spline algorithm that dynamically generates an average template as an intermediate registration target. We determined that this method performs poorly when registering CLARITY brains to the Allen Institute's Mouse Reference Atlas (ARA), because the image histogram statistics are poorly matched. Therefore, we developed a method (Mask-LDDMM) for registering CLARITY images, that automatically finds the brain boundary and learns the optimal deformation between the brain and atlas masks. Using Mask-LDDMM without an average template provided better results than the standard approach when registering CLARITY brains to the ARA. The LDDMM pipelines developed here provide a fast automated way to anatomically annotate CLARITY images; our code is available as open source software at http://NeuroData.io.

Registered nurse supply grows faster than projected amid surge in new entrants ages 23-26.

PubMed

Auerbach, David I; Buerhaus, Peter I; Staiger, Douglas O

2011-12-01

The vast preponderance of the nation's registered nurses are women. In the 1980s and 1990 s, a decline in the number of women ages 23-26 who were choosing nursing as a career led to concerns that there would be future nurse shortages unless the trend was reversed. Between 2002 and 2009, however, the number of full-time-equivalent registered nurses ages 23-26 increased by 62 percent. If these young nurses follow the same life-cycle employment patterns as those who preceded them--as they appear to be thus far--then they will be the largest cohort of registered nurses ever observed. Because of this surge in the number of young people entering nursing during the past decade, the nurse workforce is projected to grow faster during the next two decades than previously anticipated. However, it is uncertain whether interest in nursing will continue to grow in the future.

[Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study].

PubMed

Zarghooni, Kourosh; Beyer, Frank; Papadaki, Joanna; Boese, Christoph Kolja; Siewe, Jan; Schiffer, Gereon; Eysel, Peer; Bredow, Jan

2017-08-01

Introduction Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango). Methods 36 patients were included in this single-center, prospective, observational study from January 2013 to June 2014. Data were collected from the Spine Tango or DWG Register. The core outcome measure index (COMI), Oswestry Disability Index (ODI), and the quality of life questionnaire EuroQoL-5D were used. Data were collected prior to surgery as well as six weeks, six months, and twelve months after the operation. Results The patient cohort comprised 13 females and 23 males (36.1 and 63.9 %). Complete 12-month follow-up data on 21 patients were available for analysis. Compared to preoperative measures, the COMI score increased 8.1 ± 1.5 over the entire follow up, with 4.5 ± 3.1 at 6 weeks (p < 0.001), 4.8 ± 3.1 at 6 months, and 3.8 ± 3.2 at 12 months. ODI scores, measuring spinal function impairment, were significantly better than preoperative values overall (47.5 ± 17.3) and after 6 weeks (29.1 ± 22.4; p < 0.005), 6 months (30.0 ± 19.3), and 12 months (23.8 ± 18.2). Quality of life measures improved in a similar manner (preoperative: 0.36 ± 0.38; 6 weeks: 0.57 ± 0.34 (p < 0.019); 6 months: 0.62 ± 0.28; 12 months: 0.67 ± 0.31). Conclusion Our study shows that LSS patients without previous surgery and neurologic deficits can expect significant pain relief and improved quality of life already six weeks after undergoing stabilizing decompression. There was an increase in positive postoperative effects over 12 months. The DWG Register provides a standardized and validated means to compare non-operative and operative treatments of the spine over the long term. Georg Thieme Verlag KG Stuttgart · New York.

Predictors of sickness absence in college and university educated self-employed: a historic register study

PubMed Central

2014-01-01

Background Despite a large proportion of the workforce being self-employed, few studies have been conducted on risk factors for sickness absence in this population. The aim of this study is to identify risk factors for future sickness absence in a population of college and university educated self-employed. Methods In a historic register study based on insurance company files risk factors were identified by means of logistic regression analysis. Data collected at application for private disability insurance from 634 applicants were related to subsequent sickness absence periods of 30 days or more during a follow-up period of 7.95 years. Variables studied were self-reported lifestyle variables, variables concerning medical history and present health conditions and variables derived from the general medical examination including blood tests and urinary analysis. Results Results from analysis of data from 634 applicants for private disability insurance show that previous periods of sickness absence (OR 2.07), female gender (OR 2.04), health complaints listed in the health declaration (OR 1.88), elevated erythrocyte sedimentation rate (ESR) (OR 4.05) and the nature of the profession were related to a higher risk of sickness absence. Conclusions Sickness absence was found to be related to demographic variables (gender, profession), medical variables (health complaints and erythrocyte sedimentation rate) and to variables with both a medical and a behavioural component (previous sickness absence). PMID:24886527

Choosing who shall not be treated in the NHS.

PubMed

Charny, M C; Lewis, P A; Farrow, S C

1989-01-01

In the face of severe resource constraints, health care systems are seeking both to control costs and to ensure maximum benefits for the resources consumed. The use of Quality Adjusted Life Years (QALYs) is becoming more widely advocated as a decision aid in the solution of resource allocation problems. The QALY combines two dimensions of health outcome--the quantity of life and its quality--in such a way that choices between different services with different purposes can be made using comparisons based on common units of measurement. The combination of these two dimensions allows comparisons between services with different objectives, such as curing and caring services. The QALY, however, lacks a third dimension which is vital to the decision-making process to which it is intended to contribute: the worth of a specific life relative to others. This paper presents results based on interviews of 719 residents of Cardiff drawn at random from the electoral register. The results suggest that further development of the novel methodology used to establish the relative value placed on various human lives is worthwhile. Evidence is given which indicates that the public consider lives to be of unequal worth. The results also show that these values are consistent for different types of choices phrased in different ways on a large number of control variables, implying the existence of a cultural stable value system which is a necessary prerequisite if consensus values of human life are to be used to assist decision-making in non-private health care systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Introducing contemporary shift patterns in a hospice setting.

PubMed

Greene, Kay

For many nurses, quality of life is dependent on the balance of work and home life. Registered, skilled and experienced nurses are necessary to ensure that a high-quality service is provided. The hospice recognised that its main asset in providing such a service is its nursing workforce. This article describes how the hospice introduced new working patterns for nursing staff.

A Register Study of Life Events in Young Adults Born to Mothers with Mild Intellectual Disability

ERIC Educational Resources Information Center

Lindblad, Ida; Billstedt, Eva; Gillberg, Christopher; Fernell, Elisabeth

2014-01-01

Background: Young adults, born to population-representative mothers with intellectual disability (ID), were targeted for psychosocial/life event follow-up. Methods: The whole group originally comprised 42 individuals but 3 had died and 1 had moved abroad. The remaining 38 were approached and 10 consented to participate in an interview study.…

Do Exercise Interventions Improve Participation in Life Roles in Older Adults? A Systematic Review and Meta-Analysis

PubMed Central

Lee, Annemarie; Ward, Rachel F.; Harrison, Samantha M.; Bain, Paul A.; Goldstein, Roger S.; Brooks, Dina; Bean, Jonathan F; Jette, Alan M

2017-01-01

Abstract Background The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence base for interventions to improve participation remains inconclusive. In particular, whether exercise interventions improve participation in life roles is unclear. Purpose The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles in older adults residing in the community. Data sources The PubMed, Embase, CINAHL, Cochrane, and PEDro databases were searched from inception through March 2015. Study selection Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults who were 60 years of age or older were included in this review. Data extraction Teams of 2 investigators independently extracted data on participation. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The protocol was registered with Prospero (CRD42014014880). Data synthesis Eighteen randomized controlled trials with a total of 2,315 participants met the inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. A meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD = 0.03; 95% CI = −0.10 to 0.16). Subgroup analysis showed that exercise interventions lasting 12 months or more had a small positive effect on participation (SMD = 0.15; 95% CI = 0.02 to 0.28). Limitations Limitations included variability in definitions and measures of participation. Conclusions In general, exercise interventions do not improve participation in life roles in older adults. The results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted. PMID:29029557

Do Exercise Interventions Improve Participation in Life Roles in Older Adults? A Systematic Review and Meta-Analysis.

PubMed

Beauchamp, Marla K; Lee, Annemarie; Ward, Rachel F; Harrison, Samantha M; Bain, Paul A; Goldstein, Roger S; Brooks, Dina; Bean, Jonathan F; Jette, Alan M

2017-10-01

The World Health Organization recognizes participation in meaningful life roles as a key component of health. However, the evidence base for interventions to improve participation remains inconclusive. In particular, whether exercise interventions improve participation in life roles is unclear. The aim of this review was to evaluate the effect of physical exercise interventions on participation in life roles in older adults residing in the community. The PubMed, Embase, CINAHL, Cochrane, and PEDro databases were searched from inception through March 2015. Randomized controlled trials comparing the effects of an exercise intervention to usual care on participation in life roles in adults who were 60 years of age or older were included in this review. Teams of 2 investigators independently extracted data on participation. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The protocol was registered with Prospero (CRD42014014880). Eighteen randomized controlled trials with a total of 2,315 participants met the inclusion criteria. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. A meta-analysis of 16 studies showed no overall effect of the exercise interventions on participation (SMD = 0.03; 95% CI = -0.10 to 0.16). Subgroup analysis showed that exercise interventions lasting 12 months or more had a small positive effect on participation (SMD = 0.15; 95% CI = 0.02 to 0.28). Limitations included variability in definitions and measures of participation. In general, exercise interventions do not improve participation in life roles in older adults. The results do not support the implicit assumption that exercise-based interventions associated with improved function/activity also result in improved participation. Investigation of complex interventions that go beyond exercise to address participation in life roles for older adults is warranted. © 2017 American Physical Therapy Association

Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study.

PubMed

Andersson, Sofia; Årestedt, Kristofer; Lindqvist, Olav; Fürst, Carl-Johan; Brännström, Margareta

2018-05-01

Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. The aim of the study was to explore the presence of symptoms and symptom relief and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (N = 22,855). Univariate and multiple logistic regression analyses were conducted. Pain was reported as the most frequent symptom of the four symptoms (68.8%) and the one that most often had been totally relieved (84.7%) by care professionals. Factors associated with relief from at least one symptom were gender; age; time in the RCH; use of a validated pain or symptom assessment scale; documented end-of-life discussions with physicians for both the residents and family members; consultations with other units; diseases other than cancer as cause of death; presence of ulcers; assessment of oral health; and prescribed pro re nata injections for pain, nausea, and anxiety. Our results indicate that use of a validated pain assessment scale, assessment of oral health, and prescribed pro re nata injections for pain, nausea, and anxiety might offer a way to improve symptom relief. These clinical tools and medications should be implemented in the care of the dying in RCHs, and controlled trials should be undertaken to prove the effect. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

[Inequalities regarding death in the past].

PubMed

Blum, A; Houdaille, J

1989-01-01

Was mortality differentiated socio-economically in past centuries, as it is nowadays? The issue has been hotly debated. Certain demographers admitted that, periods of famine excepted, the death risk was evenly distributed among the ancient populations, regardless of wealth, instruction or social status. On the other hand, the research project currently carried out at the French National Institute of Demographic Studies is evidencing wide mortality social differentials in the 19th century. In Paris, male life expectancy at the age of 40 reached 29.7 years for the nobility and bourgeoisie, but decreased to 25.6 years among merchants and 23.7 years among workers and day-labourers. Generally speaking, regional differentials were less pronounced than socioeconomic differentials. Mortality decline was found among the elites: life expectancy at 40 of the Knights of the Holy Spirit, for instance, increased to 30.8 years in the 18th century, from 27.8 years in the 16th century. The same life expectancy today (at 40 years of age) reaches 35.7 years among French professionals. The main problem with this kind of research is how to identify and collect relevant information. The researchers make use here of marriage registers from the past century. These registers recorded not only particulars of the married couple but also those of their parents (occupation, age, and date of death, if any). This information allows the calculation of mortality rates (and life expectancy) of ancient birth cohorts in various occupational groups. The primary condition is that the registers have been well kept and soundly stored until now. This is the case in certain city halls: the 4th arrondissement of Paris (1860-1863), Ivry-sur-Seine (1817-1823)... etc...

Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study.

PubMed

Johnston, Nina; Bodegard, Johan; Jerström, Susanna; Åkesson, Johanna; Brorsson, Hilja; Alfredsson, Joakim; Albertsson, Per A; Karlsson, Jan-Erik; Varenhorst, Christoph

2016-08-01

Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients. Multicenter, randomized trial. A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale). Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]). In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

48 CFR 2101.104-1 - Publication and code arrangement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MANAGEMENT, FEDERAL EMPLOYEES GROUP LIFE INSURANCE FEDERAL ACQUISITION REGULATION GENERAL FEDERAL ACQUISITION... its subsequent changes are published in: (1) Daily issues of the Federal Register; and (2) The Code of...

An open-access, mobile compatible, electronic patient register for rheumatic heart disease ('eRegister') based on the World Heart Federation's framework for patient registers.

PubMed

van Dam, Joris; Musuku, John; Zühlke, Liesl J; Engel, Mark E; Nestle, Nick; Tadmor, Brigitta; Spector, Jonathan; Mayosi, Bongani M

2015-01-01

Rheumatic heart disease (RHD) remains a major disease burden in low-resource settings globally. Patient registers have long been recognised to be an essential instrument in RHD control and elimination programmes, yet to date rely heavily on paper-based data collection and non-networked data-management systems, which limit their functionality. To assess the feasibility and potential benefits of producing an electronic RHD patient register. We developed an eRegister based on the World Heart Federation's framework for RHD patient registers using CommCare, an open-source, cloud-based software for health programmes that supports the development of customised data capture using mobile devices. The resulting eRegistry application allows for simultaneous data collection and entry by field workers using mobile devices, and by providers using computer terminals in clinics and hospitals. Data are extracted from CommCare and are securely uploaded into a cloud-based database that matches the criteria established by the WHF framework. The application can easily be tailored to local needs by modifying existing variables or adding new ones. Compared with traditional paper-based data-collection systems, the eRegister reduces the risk of data error, synchronises in real-time, improves clinical operations and supports management of field team operations. The user-friendly eRegister is a low-cost, mobile, compatible platform for RHD treatment and prevention programmes based on materials sanctioned by the World Heart Federation. Readily adaptable to local needs, this paperless RHD patient register program presents many practical benefits.

77 FR 54621 - Pruco Life Insurance Company, et al;

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... SECURITIES AND EXCHANGE COMMISSION [Release No. IC-30186; File No. 812-13990] Pruco Life Insurance.... Applicants: Pruco Life Insurance Company (``Pruco Life''), Pruco Life Flexible Premium Variable Annuity Account (``Pruco Life Variable Annuity Account''), Pruco Life Insurance Company of New Jersey (``Pruco...

Analysis of warm season thunderstorms using an object-oriented tracking method based on radar and total lightning data

NASA Astrophysics Data System (ADS)

Rigo, T.; Pineda, N.; Bech, J.

2010-09-01

Monitoring thunderstorms activity is an essential part of operational weather surveillance given their potential hazards, including lightning, hail, heavy rainfall, strong winds or even tornadoes. This study has two main objectives: firstly, the description of a methodology, based on radar and total lightning data to characterise thunderstorms in real-time; secondly, the application of this methodology to 66 thunderstorms that affected Catalonia (NE Spain) in the summer of 2006. An object-oriented tracking procedure is employed, where different observation data types generate four different types of objects (radar 1-km CAPPI reflectivity composites, radar reflectivity volumetric data, cloud-to-ground lightning data and intra-cloud lightning data). In the framework proposed, these objects are the building blocks of a higher level object, the thunderstorm. The methodology is demonstrated with a dataset of thunderstorms whose main characteristics, along the complete life cycle of the convective structures (development, maturity and dissipation), are described statistically. The development and dissipation stages present similar durations in most cases examined. On the contrary, the duration of the maturity phase is much more variable and related to the thunderstorm intensity, defined here in terms of lightning flash rate. Most of the activity of IC and CG flashes is registered in the maturity stage. In the development stage little CG flashes are observed (2% to 5%), while for the dissipation phase is possible to observe a few more CG flashes (10% to 15%). Additionally, a selection of thunderstorms is used to examine general life cycle patterns, obtained from the analysis of normalized (with respect to thunderstorm total duration and maximum value of variables considered) thunderstorm parameters. Among other findings, the study indicates that the normalized duration of the three stages of thunderstorm life cycle is similar in most thunderstorms, with the longest duration corresponding to the maturity stage (approximately 80% of the total time).

Chronic hand eczema--self-management and prognosis: a study protocol for a randomised clinical trial.

PubMed

Mollerup, Annette; Veien, Niels Kren; Johansen, Jeanne Duus

2012-06-12

Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual's daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named 'The Healthy Skin Clinic' or to the control group. Block-wise randomisation according to setting and gender is carried out.The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results. The trial is registered in ClinicalTrials.Gov with registration number NCT01482663.

Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial

PubMed Central

2012-01-01

Background Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. Methods/design This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out. The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. Discussion The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results. Trial registration The trial is registered in ClinicalTrials.Gov with registration number NCT01482663. PMID:22691871

[Spatio-temporal analysis of the biophysical and ecological conditions of Triatoma dimidiata (Hemiptera: Reduviidae: Triatominae) in the northeast region of Colombia].

PubMed

Badel-Mogollón, Jaime; Rodríguez-Figueroa, Laura; Parra-Henao, Gabriel

2017-03-29

Due to the lack of information regarding biophysical and spatio-temporal conditions (hydrometheorologic and vegetal coverage density) in areas with Triatoma dimidiata in the Colombian departments of Santander and Boyacá, there is a need to elucidate the association patterns of these variables to determine the distribution and control of this species. To make a spatio-temporal analysis of biophysical variables related to the distribution of T. dimidiate observed in the northeast region of Colombia. We used the Intergovernmental Panel on Climate Change Special Report on Emissions Scenarios (IPCC SRES) data bases registering vector presence and hydrometheorologic data. We studied the variables of environmental temperature, relative humidity, rainfall and vegetal coverage density at regional and local levels, and we conducted spatial geostatistic, descriptive statistical and Fourier temporal series analyses. Temperatures two meters above the ground and on covered surface ranged from 14,5°C to 18,8°C in the areas with the higher density of T. dimidiata. The environmental temperature fluctuated between 30 and 32°C. Vegetal coverage density and rainfall showed patterns of annual and biannual peaks. Relative humidity values fluctuated from 66,8 to 85,1%. Surface temperature and soil coverage were the variables that better explained the life cycle of T. dimidiata in the area. High relative humidity promoted the seek of shelters and an increase of the geographic distribution in the annual and biannual peaks of regional rainfall. The ecologic and anthropic conditions suggest that T. dimidiata is a highly resilient species.

77 FR 3804 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

.... braille, large print), please notify Bill Dosch, Chief, Work Life and Benefits Branch, at (301) 415-6200...) (Tentative) a. Final Rule: Requirements for Distribution of Byproduct Material, 10 CFR parts 30, 31, 32, 40...

75 FR 52047 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... print), please notify Angela Bolduc, Chief, Employee/Labor Relations and Work Life Branch, at 301-492.... 52-027-COL & 52-028-COL; Appeal of Sierra Club & Friends of the Earth (MAR. 26, 2010), Challenging...

General practitioners' experiences as nursing home medical consultants.

PubMed

Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

2017-03-01

To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial.

PubMed

van Veen, Mark; Koekkoek, Bauke; Mulder, Niels; Postulart, Debby; Adang, Eddy; Teerenstra, Steven; Schoonhoven, Lisette; van Achterberg, Theo

2015-05-02

This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study. Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18-65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts. No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care. Netherlands Trial Register (NTR): 3988 . Registered 13th of May 2013.

Did They Sell Their Soul to the Devil? Some Comparative Case-Studies on Academic Entrepreneurs in the Life Sciences in Europe

ERIC Educational Resources Information Center

Provasi, Giancarlo; Squazzoni, Flaminio; Tosio, Beatrice

2012-01-01

This paper looks at eight comparative case-studies on academic entrepreneurs in life sciences conducted in Europe in 2008. The interviewees were selected from the KEINS database that lists all academic inventors from Italy, France, Sweden and the Netherlands who have one or more patent applications registered at the European Patent Office,…

Job satisfaction and horizontal violence in hospital staff registered nurses: the mediating role of peer relationships.

PubMed

Purpora, Christina; Blegen, Mary A

2015-08-01

To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined. Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between horizontal violence and job satisfaction. Cross-sectional mediational model testing. An anonymous four-part survey of a random sample of 175 hospital staff registered nurses working in California provided the data. Data about horizontal violence, peer relationships, job satisfaction, and nurse and work characteristics were collected between March-August 2010. A statistically significant negative relationship was found between horizontal violence and peer relationships, job satisfaction and a statistically significant positive relationship was found between peer relationships and job satisfaction. Peer relationships mediated the association between horizontal violence and job satisfaction. Job satisfaction was reported as higher by nurses who worked in teaching hospitals. There were no statistically significant differences in job satisfaction based on gender, ethnicity, basic registered nurse education, highest degree held, size of hospital or clinical area. The results suggest that peer relationships can attenuate the negative relationship between horizontal violence and job satisfaction. This adds to the extant literature on the relationship between horizontal violence and job satisfaction. The findings highlight peer relationships as an important factor when considering effective interventions that foster hospital staff registered nurses' job satisfaction in the presence of horizontal violence. © 2015 John Wiley & Sons Ltd.

Metabolic risk management, physical exercise and lifestyle counselling in low-active adults: controlled randomized trial (BELLUGAT).

PubMed

Ensenyat, Assumpta; Espigares-Tribo, Gemma; Machado, Leonardo; Verdejo, Francisco José; Rodriguez-Arregui, Rosa; Serrano, José; Miret, Marta; Galindo, Gisela; Blanco, Alfonso; Marsal, Josep-Ramon; Sarriegui, Susana; Sinfreu-Bergues, Xenia; Serra-Paya, Noemi

2017-03-14

The primary aim of this study is to evaluate the effectiveness of different doses (intensity) of supervised exercise training - concomitant with lifestyle counselling - as a primary care intervention tool for the management of metabolic syndrome risk factors in low-active adults with one or more such factors (programme name in Catalan: Bellugat de CAP a peus). Three-arm, randomized controlled clinical trial implemented in the primary care setting, with a duration of 40 weeks (16 weeks intervention and 24-week follow-up). Adults aged 30 to 55 years with metabolic risk factors will be randomized into three intervention groups: 1) aerobic interval training (16 supervised training lessons) plus a healthy lifestyle counselling programme (6 group and 3 individual meetings); 2) low-to-moderate intensity continuous training (16 supervised training lessons) plus the same counselling programme; or 3) the counselling- programme without any supervised physical exercise. The main output variables assessed will be risk factors for metabolic syndrome (waist circumference, blood pressure, and levels of plasma triglycerides, high-density lipoproteins and glucose), systemic inflammation, cardiorespiratory fitness, physical activity and sedentary behaviour, dietary habits, health-related quality of life, self-efficacy and empowerment. Economic factors will also be analysed in order to determine the cost-effectiveness of the programme. These variables will be assessed three times during the study: at baseline, at the end of the intervention, and at follow-up. We estimate to recruit 35 participants per group. The results of this study will provide insight into the immediate and medium-term effects on metabolic risk and lifestyle of a combined approach involving aerobic interval training and a multidisciplinary behavioural intervention. If effective, the proposed intervention would provide both researchers and practitioners in this field with a platform on which to develop similar intervention programmes for tackling the repercussions of an unhealthy lifestyle. Clinical trials.gov. NTC02832453 . Registered 6 July 2016 (retrospectively registered).

Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study.

PubMed

Gliddon, Emma; Lauder, Sue; Berk, Lesley; Cosgrove, Victoria; Grimm, David; Dodd, Seetal; Suppes, Trisha; Berk, Michael

2015-10-14

Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes. The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users. The present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up. The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly. ClinicalTrials.gov NCT02118623 registered April 15 2014 and NCT02106078 registered May 16 2013.

Quality of life and oral health among hypertensive and diabetic people in a Brazilian Southeastern city.

PubMed

Oliveira, Eduardo José Pereira; Rocha, Vinício Felipe Brasil; Nogueira, Denismar Alves; Pereira, Alessandro Aparecido

2018-03-01

This research aimed to assess the oral health related to quality of life among hypertensive and diabetic patients in the city of Alfenas, Brazil. This was a domiciliary-based, descriptive-analytical, cross-sectional research with a random, systematic sample stratified by the Family Health Team, consisting of 218 individuals. The following indexes were applied: DMFT, T-Health, FS-T, SiC index, use and need of prosthesis and OHIP-14. Most of the patients (56.42%) had only high blood pressure, were females (67.43%), with an average age of 64.83 (±11.99) years old, varying between 35 and 93 years old. No significant differences on the variables between hypertensives, diabetics and hypertensive-diabetics were noticed. The following data was registered: DMFT=27.16 (± 6.15), with 22.94 (± 10.46) of missing teeth; T-Health=5.23 (± 6.52); FS-T=8.53 (± 10.12) and SiC=32 (± 0.00). 85.78% of the individuals were using prosthesis (58.72% Dentures) and 61.01% needed prostheses (58.26% in the jaw).The correlations between OHIP-14 (5.37 [± 4.95]) and oral health evidenced the increase in the number of teeth affecting psychological dimensions, besides the use and need of prostheses were associated to physical and social impacts (p < 0.05). We concluded that edentulism, use and need of prostheses affected quality of life in hypertensive and diabetic patients concerning psychological, physical and social aspects.

76 FR 52717 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

...), please notify Bill Dosch, Chief, Work Life and Benefits Branch, at 301-415-6200, TDD: 301-415-2100, or by....; Combined Licenses for Vogtle Electric Generating Plant, Units 3 and 4, and Limited Work Authorizations...

76 FR 6837 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... format (e.g. braille, large print), please notify Angela Bolduc, Chief, Employee/Labor Relations and Work Life Branch, at 301-492-2230, TDD: 301-415-2100, or by e-mail at [email protected] . Determinations...

17 CFR 270.6e-2 - Exemptions for certain variable life insurance separate accounts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... variable life insurance separate accounts. 270.6e-2 Section 270.6e-2 Commodity and Securities Exchanges...-2 Exemptions for certain variable life insurance separate accounts. (a) A separate account, and the... a life insurance company pursuant to the insurance laws or code of (i) any state or territory of the...

17 CFR 270.6e-2 - Exemptions for certain variable life insurance separate accounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... variable life insurance separate accounts. 270.6e-2 Section 270.6e-2 Commodity and Securities Exchanges...-2 Exemptions for certain variable life insurance separate accounts. (a) A separate account, and the... a life insurance company pursuant to the insurance laws or code of (i) any state or territory of the...

17 CFR 270.6e-2 - Exemptions for certain variable life insurance separate accounts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... variable life insurance separate accounts. 270.6e-2 Section 270.6e-2 Commodity and Securities Exchanges...-2 Exemptions for certain variable life insurance separate accounts. (a) A separate account, and the... a life insurance company pursuant to the insurance laws or code of (i) any state or territory of the...

76 FR 20727 - National Life Insurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... SECURITIES AND EXCHANGE COMMISSION [Release No. IC-29627; File No. 812-13806] National Life... ``1940 Act''). Applicants: National Life Insurance Company (``NLIC''), National Variable Annuity Account II (``Annuity Account''), National Variable Life Insurance Account (``Life Account'', and together...

Using Dynamic Mathematics Software to Teach One-Variable Inequalities by the View of Semiotic Registers

ERIC Educational Resources Information Center

Kabaca, Tolga

2013-01-01

Solution set of any inequality or compound inequality, which has one-variable, lies in the real line which is one dimensional. So a difficulty appears when computer assisted graphical representation is intended to use for teaching these topics. Sketching a one-dimensional graph by using computer software is not a straightforward work. In this…

The indirect costs of palliative care in end-stage cancer: A real-life longitudinal register- and questionnaire-based study.

PubMed

Haltia, Olli; Färkkilä, Niilo; Roine, Risto Paavo; Sintonen, Harri; Taari, Kimmo; Hänninen, Juha; Lehto, Juho Tuomas; Saarto, Tiina

2018-02-01

Palliative care needs are increasing as more people are dying from incurable diseases. Healthcare costs have been reported to be highest during the last year of life, but studies on the actual costs of palliative care are scarce. To explore the resource use and costs of palliative care among end-stage breast, colorectal and prostate cancer patients after termination of life-prolonging oncological treatments, that is, during the palliative care period. A real-life longitudinal register- and questionnaire-based study of cancer patients' resource use and costs. In total, 70 patients in palliative care with no ongoing oncological treatments were recruited from the Helsinki University Hospital or from the local hospice. Healthcare costs, productivity costs and informal care costs were included. The mean duration of the palliative care period was 179 days. The healthcare cost accounted for 55%, informal care for 27% and productivity costs for 18% of the total costs. The last 2 weeks of life contributed to 37% of the healthcare cost. The costs of the palliative care period were higher in patients living alone, which was mostly caused by inpatient care ( p = 0.018). The 45% share of indirect costs is substantial in end-of-life care. The healthcare costs increase towards death, which is especially true of patients living alone. This highlights the significant role of caregivers. More attention should be paid to home care and caregiver support to reduce inpatient care needs and control the costs of end-of-life care.

Demographic factors affect willingness to register as an organ donor more than a personal relationship with a transplant candidate

PubMed Central

Regalia, Kirsten; Zheng, Patricia; Sillau, Stefan; Aggarwal, Anuj; Bellevue, Oliver; Fix, Oren K.; Prinz, Jennifer; Dunn, Susan; Biggins, Scott W.

2014-01-01

Background Transplant candidate caregivers (TCCs) are an under-utilized but potentially devoted pool of advocates who themselves may be recruited to register for deceased organ donation. Aim To assess and compare recruitment barriers to deceased donor registration efforts in TCCs and health fair attendees (HFAs). Methods A 42-item questionnaire assessing willingness to register as an organ donor and perceptions and knowledge about organ donation was administered to 452 participants (174 in Denver, 278 in San Francisco). Logistic regression, stratified by study site, was used to assess associations between explanatory variables and willingness to register as an organ donor. Results In Denver, 83% of TCCs vs 68% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were female gender (OR 2.4), Caucasian race (OR 2.3), college graduate (OR 11.1), married (OR 2.4) and higher positive perception of organ donation (OR 1.2), each p<0.05. In San Francisco, 58% of TCCs vs 70% of HFAs indicated a willingness to register (p = 0.03). Controlling for study group (TCC vs HFA), predictors of willingness to register were Caucasian race (OR 3.5), college graduate (OR 2.2), married (OR 1.9), higher knowledge (OR 1.6) and higher positive perception of organ donation (OR 1.2), each p<0.05. In both locales, Caucasians were more likely to have positive perceptions about organ donation and were more willing to register. Conclusions Demographic characteristics, not personal connection to a transplant candidate, explain willingness to register as an organ donor. PMID:24519521

76 FR 35245 - Country Investors Life Assurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... Life Assurance Company, et al. June 9, 2011. AGENCY: Securities and Exchange Commission (the.... Applicants: COUNTRY Investors Life Assurance Company (the ``Company''), COUNTRY Investors Variable Life Account (the ``Life Account'') and COUNTRY Investors Variable Annuity Account (the ``Annuity Account...

[Clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register].

PubMed

Volobuev, V V

2014-01-01

In the article the clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register is described. The necessity of differentiated approach is analyzed in accomplishing of psychotherapy of this contingent of patients taking into account the high level of anxiety, emotional stress, decreased mood, low levels of the quality of life in the remote period of strong stressful factor's action.

Nurse Knowledge, Work Environment, and Turnover in Highly Specialized Pediatric End-of-Life Care.

PubMed

Lindley, Lisa C; Cozad, Melanie J

2017-07-01

To examine the relationship between nurse knowledge, work environment, and registered nurse (RN) turnover in perinatal hospice and palliative care organizations. Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β = -.032, P < .05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3 percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study; Organizations serving micropolitan (β = -.041, P < .05) and rural areas (β = -.037, P < .05) had lower RN turnover compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β = .036, P < .05). The findings revealed that advanced professional experience in the form of APNs was associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization.

Staff perspectives on the provision of end-of-life care in a community residence for older adults with developmental disabilities.

PubMed

Kirkendall, Abbie M; Waldrop, Deborah

2013-09-01

The purpose of the study was to describe the perceptions of community residence (CR) staff who have cared for older adults with developmental disabilities (ADDs) that are at the end of life. This exploratory, descriptive study utilized qualitative methods that involved semistructured interviews with CR staff members. The setting was a CR that was also an intermediate care facility (ICF) that provided 24-hour residential treatment for medical and/or behavioral needs. At least one registered nurse was present at all times. A CR with at least one resident who was over the age of 40 and had a diagnosis of a life-limiting illness was chosen. Participants included three frontline workers, four managers, and one registered nurse. In-person interviews included open-ended questions about end-of-life care for older ADDs. Demographics such as age, length of time working with ADDs, and education were analyzed using descriptive statistics. Descriptive statistics were used to analyze demographics such as age, and length of time working with ADDs. Interviews were digitally recorded, transcribed, and analyzed using grounded theory techniques. Four themes illuminated unique elements of the provision of end-of-life care in a CR: (1) influence of relationships, (2) expression of individuality, (3) contribution of hospice, (4) grief and bereavement, and (5) challenges to end-of-life care. The results provided insight into the unique needs of older ADDs at the end of life and how this influences their care. Emphasis was also placed on the importance of specialized care that involved collaborations with hospice for older ADDs who remain in a CR at the end of life.

Ancilla-driven quantum computation for qudits and continuous variables

NASA Astrophysics Data System (ADS)

Proctor, Timothy; Giulian, Melissa; Korolkova, Natalia; Andersson, Erika; Kendon, Viv

2017-05-01

Although qubits are the leading candidate for the basic elements in a quantum computer, there are also a range of reasons to consider using higher-dimensional qudits or quantum continuous variables (QCVs). In this paper, we use a general "quantum variable" formalism to propose a method of quantum computation in which ancillas are used to mediate gates on a well-isolated "quantum memory" register and which may be applied to the setting of qubits, qudits (for d >2 ), or QCVs. More specifically, we present a model in which universal quantum computation may be implemented on a register using only repeated applications of a single fixed two-body ancilla-register interaction gate, ancillas prepared in a single state, and local measurements of these ancillas. In order to maintain determinism in the computation, adaptive measurements via a classical feed forward of measurement outcomes are used, with the method similar to that in measurement-based quantum computation (MBQC). We show that our model has the same hybrid quantum-classical processing advantages as MBQC, including the power to implement any Clifford circuit in essentially one layer of quantum computation. In some physical settings, high-quality measurements of the ancillas may be highly challenging or not possible, and hence we also present a globally unitary model which replaces the need for measurements of the ancillas with the requirement for ancillas to be prepared in states from a fixed orthonormal basis. Finally, we discuss settings in which these models may be of practical interest.

[Attitudes of physicians and nurses towards health prevention and promotion activities in Primary Care].

PubMed

Ramos-Morcillo, Antonio Jesús; Ruzafa-Martínez, María; Fernández-Salazar, Serafín; del-Pino-Casado, Rafael; Armero Barranco, David

2014-11-01

To determine the attitudes of physicians and registered nurses in the Andalusian Public Health System towards preventive and health promotion (PHP) interventions in the context of Primary Health Care and the relationship with occupational variables and self-reported competence in PHP. Multicenter, observational, descriptive study. Primary Health Care (PHC), Andalusia, Spain. A total of 282 professionals (physicians and nurses) from 22 Healthcare centers of the Andalusian public health system and who participated in the validation of CAPPAP were included. The attitude of physicians and registered nurses towards PHP activities consisted of five dimensions: improvements necessary, perception of peers attitude, importance, obstacles, and improvement opportunities. The validated CAPPAP questionnaire was used. Occupational variables and questions about self-reported competence in PHP were also included. All dimensions of CAPPAP exceeded the midpoint of the scale (2.5), with their values varying between 3.06 (SD: 0.76) in "improvement necessary", and 4.39 (SD: 0.49) in "importance". The self-declared social, occupational, and competences variables have a statistically significant relationship with the dimensions of the attitude of the professionals except: job experience in PHC, training and implementation of scheduled PHP activities. The attitudes of physicians and registered nurses towards PHP activities are acceptable, and work must be done to sustain it. Healthcare organizations should implement interventions adapted to different professional profiles. They should also increase activities to improve professional skills in order to provide the appropriate care. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Anticipatory scaling of grip forces when lifting objects of everyday life.

PubMed

Hermsdörfer, Joachim; Li, Yong; Randerath, Jennifer; Goldenberg, Georg; Eidenmüller, Sandra

2011-07-01

The ability to predict and anticipate the mechanical demands of the environment promotes smooth and skillful motor actions. Thus, the finger forces produced to grasp and lift an object are scaled to the physical properties such as weight. While grip force scaling is well established for neutral objects, only few studies analyzed objects known from daily routine and none studied grip forces. In the present study, eleven healthy subjects each lifted twelve objects of everyday life that encompassed a wide range of weights. The finger pads were covered with force sensors that enabled the measurement of grip force. A scale registered load forces. In a control experiment, the objects were wrapped into paper to prevent recognition by the subjects. Data from the first lift of each object confirmed that object weight was anticipated by adequately scaled forces. The maximum grip force rate during the force increase phase emerged as the most reliable measure to verify that weight was actually predicted and to characterize the precision of this prediction, while other force measures were scaled to object weight also when object identity was not known. Variability and linearity of the grip force-weight relationship improved for time points reached after liftoff, suggesting that sensory information refined the force adjustment. The same mechanism seemed to be involved with unrecognizable objects, though a lower precision was reached. Repeated lifting of the same object within a second and third presentation block did not improve the precision of the grip force scaling. Either practice was too variable or the motor system does not prioritize the optimization of the internal representation when objects are highly familiar.

Annual Certification Data for Vehicles and Engines

EPA Pesticide Factsheets

The Annual Certification Test Results Report (often referred to as Federal Register Test Results Report) includes light-duty vehicle and heavy-duty engine reports of projected emission levels at the end of the useful life of a vehicle.

77 FR 40376 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

..., College St. & W. Oak Grove Rd., Hernando, 12000430 Forrest County Hub City Historic District (Boundary... City Central States Life Insurance Company Building, 3207 Washington Blvd., St. Louis (Independent City...

The Effect of Childhood Family Size on Fertility in Adulthood: New Evidence From IV Estimation.

PubMed

Cools, Sara; Kaldager Hart, Rannveig

2017-02-01

Although fertility is positively correlated across generations, the causal effect of children's experience with larger sibships on their own fertility in adulthood is poorly understood. With the sex composition of the two firstborn children as an instrumental variable, we estimate the effect of sibship size on adult fertility using high-quality data from Norwegian administrative registers. Our study sample is all firstborns or second-borns during the 1960s in Norwegian families with at least two children (approximately 110,000 men and 104,000 women). An additional sibling has a positive effect on male fertility, mainly causing them to have three children themselves, but has a negative effect on female fertility at the same margin. Investigation into mediators reveals that mothers of girls shift relatively less time from market to family work when an additional child is born. We speculate that this scarcity in parents' time makes girls aware of the strains of life in large families, leading them to limit their own number of children in adulthood.

Growth, behavior, development and intelligence in rural children between 1-3 years of life.

PubMed

Agarwal, D K; Awasthy, A; Upadhyay, S K; Singh, P; Kumar, J; Agarwal, K N

1992-04-01

In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.

The Impact Of Dispositional Variables Of Elders, Relatives, And Paid Caregivers On Elders' Empowerment And Life Satisfaction.

PubMed

Tomai, Manuela; Pezzuti, Lina; Mebane, Minou; Benedetti, Maura; Moro, Annalisa

2017-01-01

Background/Study Context: The impact of dispositional characteristic of elders' closest network members on elders' life satisfaction and empowerment has remained largely unexplored. This innovative study aimed to assess the impact of dispositional variables of elders, relatives, and paid caregivers on life satisfaction and empowerment of elders. One hundred forty-three triads (one elder, one paid caregiver, and one relative) completed six scales measuring modifiable personality characteristics (loneliness, optimism, regulation of positive and negative emotions), life satisfaction, and sense of empowerment. Two dispositional variables of relatives (positivity and ability to set goals) and one dispositional variable of care workers (self-satisfaction) were significantly related to life satisfaction of elders. Positivity of elders and the capacity to set objectives of the family members affected empowerment of elders. Future interventions aiming to improve life satisfaction and empowerment of elders should focus on these modifiable dispositional variables.

Prophylaxis of acute respiratory infections via improving the immune system in late preterm newborns with E. coli strain Nissle 1917: a controlled pilot trial.

PubMed

Aryayev, Mykola L; Senkivska, Liudmyla I; Bredeleva, Nataliya K; Talashova, Irina V

2018-01-01

Acute respiratory infections (ARIs), caused by the high level of immaturity of the immune system, are a major cause of morbidity in preterm newborns. The probiotic Escherichia coli strain Nissle 1917 (EcN) is well known for its immuno-modulatory properties and may therefore enhance the immune competence. Thus, EcN administration may provide a promising possibility to decrease the risk of ARIs in this vulnerable group of children. However, clinical data supporting or refuting this hypothesis are, to our knowledge, not available. Therefore, the aim of the presented pilot trial was to collect first data on the efficacy and safety of EcN treatment to prevent ARIs in late preterm newborns. Right after birth, 62 late preterm newborns were included into an open-labeled, controlled 4-week trial with two parallel groups and a follow-up phase until the age of 1 year. All children of the treatment group received an EcN suspension orally for 3 weeks, whereas the control group was only observed. Primary efficacy variable was the number of participants with at least one ARI during the first 28 days of life. Secondary efficacy variables were the number of ARIs and the number and duration of hospitalizations caused by ARIs during the first year of life. The number of participants with at least one ARI during the first 28 days of life was significantly lower in the group treated with EcN compared to that in the control group. Although only of exploratory nature, analyses of secondary efficacy variables suggest that EcN treatment may also reduce the average number of ARIs, the average number of hospitalizations caused by ARIs, and the mean duration of such hospitalizations. There is also some evidence that early EcN treatment may have long-term benefits on newborns' health status. The present pilot trial provides first evidence that EcN is able to reduce the incidence of ARIs in the neonatal period of late preterm newborns. Additionally, EcN is characterized by an excellent individual biocompatibility in the absence of adverse drug reactions. Limitations of the current trial are discussed and recommendations for future confirmatory studies are made. ClinicalTrials.gov identifier: NCT01540162; retrospectively registered on 16 February 2012.

Promissory accounts of personalisation in the commercialisation of genomic knowledge.

PubMed

Arribas-Ayllon, Michael; Sarangi, Srikant; Clarke, Angus

2011-01-01

As part of personalised medicine emerging from the human genomics revolution, many websites now offer direct-to-consumer genetic testing. Here, we examine three personal genomics companies--Navigenics, deCODEme and 23andMe--each of which represents contrasting registers of 'personalisation'. We identify three distinctive registers in these websites: a paternalistic (medical) register; a translational (scientific) register and a democratic (consumerist) register. We explore in detail the rhetorical and discourse devices employed in these websites to assess how personalised healthcare is promised to the public. Promising information that will empower prevention of common complex diseases and ensure better quality of life is conflated with promising greater access to personal information. The presence and absence of scientific legitimacy is related to concerns about accuracy and validity on the one side, and fears of paternalism and elitism on the other. Nevertheless, a common strategy uniting these different styles of personalisation is consumer empowerment. Finally, we consider the tension between the drive of translational medicine to make human genomic research practically relevant, and the intrinsic uncertainties of scientific research and show how, in the commercial domain, future risks are transformed into discourses of promise by concealing these uncertainties.

A study examining senior nursing students' expectations of work and the workforce.

PubMed

Saber, Deborah A; Anglade, Debbie; Schirle, Lori M

2016-03-01

This study explored traditional and accelerated Bachelor of Science nursing students' expectations of nursing work and the workforce. Role transition difficulty is blamed for much of the 15-60% newly licensed registered nurse turnover in their first 3 years of employment. This qualitative study consisted of 14 focus groups (n = 98) to determine Bachelor of Science nursing students' expectations of work as newly licensed registered nurses. Two overriding themes for accelerated and traditional students emerged: stressors and coping strategies. Students believe four stressors will affect their progression into the newly licensed registered nurse role and have developed coping strategies. This study suggests that students have experienced stressors in the clinical environment and anticipate them in the newly licensed registered nurse role. During transition, strategies such as 'fitting in' and 'staying safe' will be employed to ensure work success. Younger generations value a healthy work-life balance and a positive working environment. These nurses will not tolerate positions that do not align with their values. With the aging of citizens in the USA and the predicted nursing shortage, nursing management needs to employ strategies to retain newly licensed registered nurses. © 2015 John Wiley & Sons Ltd.

The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

PubMed

Carlson, Elisabeth; Bengtsson, Mariette

2014-04-01

The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. © 2013.

Relationshp between Academic Variables and Personality Type to Progression in an Associate Degree Nursing Program and Achievement on NCLEX-RN.

ERIC Educational Resources Information Center

Wood, Ione Norma

This retrospective study was done to identify academic and personality variables that predict student progression through an associate degree nursing program and achievement on the National Council Licensing Examination for Registered Nurses (NCLEX-RN). The study searched for evidence of a decline in academic ability in the students over the 7…

Identifying profiles of service users in housing services and exploring their quality of life and care needs.

PubMed

Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

2016-11-23

Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be provided on all dimensions of recovery at the same time, therefore mental health care organisations should work together and integrate their services. ISRCTN registry ISRCTN77355880 retrospectively registered 05/07/2013.

Nursing work life in acute care.

PubMed

Brooks, Beth A; Anderson, Mary Ann

2004-01-01

The purpose of this project was to explore how acute care nurses in a midwestern state rate the quality of their work life. A simple random sample of 1500 registered nurses was surveyed. Data were collected using Brooks' Quality of Nursing Worklife Survey (Brooks BA. Development of an Instrument to Measure Quality of Nursing Work Life [unpublished doctoral dissertation]. Chicago: University of Illinois at Chicago; 2001). Findings suggested that nursing workload was too heavy, and there was not enough time todo the job well. This study revealed that there remain ongoing and fundamental work life concerns for staff nurses that the profession has neither addressed nor resolved in any meaningful, long-term way.

Ethnotaxonomy of birds by the inhabitants of Pedra Branca Village, Santa Teresinha municipality, Bahia state, Brazil

PubMed Central

2014-01-01

Background Studies on popular names of birds help to understand the relationship between human beings and birds and it also contributes to the field of ornithology. Methods This study aims to register the ethnotaxonomy of birds in the village of Pedra Branca, Santa Teresinha municipality, Bahia State, Brazil, by cataloguing and identifying their popular names, besides understanding the ethnoclassification system of local bird species. The ethno-ornithological data were obtained by means of semi-structured open interviews, and projective tests. Results We interviewed 48 residents and, in order to identify species, we chose five informants with a more detailed knowledge on local avifauna. We registered 139 common names, distributed into 108 ethnospecies and 33 synonyms, referring to 117 species. Nomenclatural criteria more frequently used were vocalization and coloring patterns. Following Berlin’s principles of ethnobiological classification, three hierarchical levels were registered: life form, generic and specific, with three types of correspondence between Linnaean and folk classification systems. The bird life form (“pássaro” in Portuguese) was associated only to wild species. Conclusions The ethno-ornithological research in Pedra Branca Village has contributed with new information on popular nomenclature of birds and their etymology, showing that folk knowledge on birds is conveyed within the community. PMID:25012812

A Prototype Silicon Compiler in Prolog

DTIC Science & Technology

1988-12-01

A Prototype Silicon Compiler in Prolog 04 William Bush Gino Cheng Partrick C. McGeer Alvin M. Despain DTIC ELECTV JUL 281989 B Report No. UCB/CSD 88...the same register to variables in the same positions in invo- cation and head. Thus in ... g(A, B ),.. and g(X, Y) A and X share one register, and B ...example for a one-bit adder is given below. x = compl(or(and(c,or(a, b )),and(a, b ))). y = compl(or(and(x,or(a, b ,c)),and(a2b,c))). sum = compl(y). carry

An open-access mobile compatible electronic patient register for rheumatic heart disease (‘eRegister’) based on the World Heart Federation’s framework for patient registers

PubMed Central

van Dam, Joris; Tadmor, Brigitta; Spector, Jonathan; Musuku, John; Zühlke, Liesl J; Zühlke, Liesl J; Engel, Mark E; Mayosi, Bongani M; Nestle, Nick

2015-01-01

Summary Background Rheumatic heart disease (RHD) remains a major disease burden in low-resource settings globally. Patient registers have long been recognised to be an essential instrument in RHD control and elimination programmes, yet to date rely heavily on paper-based data collection and non-networked data-management systems, which limit their functionality. Objectives To assess the feasibility and potential benefits of producing an electronic RHD patient register. Methods We developed an eRegister based on the World Heart Federation’s framework for RHD patient registers using CommCare, an open-source, cloud-based software for health programmes that supports the development of customised data capture using mobile devices. Results The resulting eRegistry application allows for simultaneous data collection and entry by field workers using mobile devices, and by providers using computer terminals in clinics and hospitals. Data are extracted from CommCare and are securely uploaded into a cloud-based database that matches the criteria established by the WHF framework. The application can easily be tailored to local needs by modifying existing variables or adding new ones. Compared with traditional paper-based data-collection systems, the eRegister reduces the risk of data error, synchronises in real-time, improves clinical operations and supports management of field team operations. Conclusions The user-friendly eRegister is a low-cost, mobile, compatible platform for RHD treatment and prevention programmes based on materials sanctioned by the World Heart Federation. Readily adaptable to local needs, this paperless RHD patient register program presents many practical benefits. PMID:26444995

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

PubMed

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

2013-08-01

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

Correlates of life satisfaction among older people in China: an examination of two cultural variables.

PubMed

Huang, Yunong; Wu, Lei

2012-01-01

This article examines the relationships between the two cultural variables of having mianzi in social interactions and Chinese cultural beliefs of adversity and life satisfaction among older people in a coastal city in mainland China. The mediating effect of having mianzi in social interactions on the relationship between Chinese cultural beliefs of adversity and life satisfaction is also examined. The study applies a non-probability sampling and adopts a face-to-face interview approach using a questionnaire composed of close-ended questions. A total of 532 valid questionnaires are obtained. Multiple regression analysis is used to test the hypotheses. Findings indicate that the two cultural variables are associated significantly with life satisfaction, while controlling for socio-demographic variables. The variable of Chinese cultural beliefs of adversity is also indirectly associated with life satisfaction through its effect on having mianzi in social interactions. Older people with higher endorsement of positive Chinese cultural beliefs of adversity and higher degree of having mianzi in social interactions tend to have higher life satisfaction. Professionals working with older people should be sensitive to cultural variables that exert impacts on older people's life satisfaction.

Neonatal Procalcitonin Intervention Study (NeoPInS): Effect of Procalcitonin-guided decision making on duration of antibiotic therapy in suspected neonatal early-onset sepsis: A multi-centre randomized superiority and non-inferiority Intervention Study.

PubMed

Stocker, Martin; Hop, Wim C J; van Rossum, Annemarie M C

2010-12-08

Early diagnosis and treatment of the newborn infant with suspected sepsis are essential to prevent severe and life threatening complications. Diagnosis of neonatal sepsis is difficult because of the variable and nonspecific clinical presentation. Therefore, many newborns with nonspecific symptoms are started on antibiotic treatment before the presence of sepsis has been proven. With our recently published single-centre intervention study we were able to show that Procalcitonin determinations allowed to shorten the duration of antibiotic therapy in newborns with suspected early-onset sepsis. The study is designed as randomized controlled international multicenter intervention trial on the efficacy and safety of Procalcitonin guided treatment. Term and near-term infants (gestational age ≥ 34 0/7 weeks) with suspected sepsis in the first 3 days of life requiring empiric antibiotic therapy will be included. The duration of antibiotic therapy in the standard group is based on the attending physician's assessment of the likelihood of infection (infection unlikely, possible, probable or proven). In the Procalcitonin group, if infection is considered to be unlikely or possible, antibiotic therapy is discontinued when two consecutive Procalcitonin values are within the normal range. Co-primary outcome measures are the duration of antibiotic therapy (superiority aspect of the trial) and the proportion of infants with a recurrence of infection requiring additional courses of antibiotic therapy and/or death in the first month of life (safety of study intervention, non-inferiority aspect of the trial). The number of infants to be included equals 800 per arm. With these numbers the power of the study to demonstrate superiority for duration of antibiotic therapy as well as non-inferiority regarding safety, i.e. excluding a disadvantage difference larger than 2% for the experimental arm, will both be greater than 80%. Benefit of the study is a possible limitation of unnecessary use of antibiotics. The results of our first study suggest that there is a low risk on discontinuing antibiotic treatment too early, resulting in the development of a neonatal infection with its morbidity and mortality. This trial is registered in the U.S. National Institutes of Health's register, located at http://www.clinicaltrials.gov. (NCT00854932).

RSM 1.0 - A RESUPPLY SCHEDULER USING INTEGER OPTIMIZATION

NASA Technical Reports Server (NTRS)

Viterna, L. A.

1994-01-01

RSM, Resupply Scheduling Modeler, is a fully menu-driven program that uses integer programming techniques to determine an optimum schedule for replacing components on or before the end of a fixed replacement period. Although written to analyze the electrical power system on the Space Station Freedom, RSM is quite general and can be used to model the resupply of almost any system subject to user-defined resource constraints. RSM is based on a specific form of the general linear programming problem in which all variables in the objective function and all variables in the constraints are integers. While more computationally intensive, integer programming was required for accuracy when modeling systems with small quantities of components. Input values for component life cane be real numbers, RSM converts them to integers by dividing the lifetime by the period duration, then reducing the result to the next lowest integer. For each component, there is a set of constraints that insure that it is replaced before its lifetime expires. RSM includes user-defined constraints such as transportation mass and volume limits, as well as component life, available repair crew time and assembly sequences. A weighting factor allows the program to minimize factors such as cost. The program then performs an iterative analysis, which is displayed during the processing. A message gives the first period in which resources are being exceeded on each iteration. If the scheduling problem is unfeasible, the final message will also indicate the first period in which resources were exceeded. RSM is written in APL2 for IBM PC series computers and compatibles. A stand-alone executable version of RSM is provided; however, this is a "packed" version of RSM which can only utilize the memory within the 640K DOS limit. This executable requires at least 640K of memory and DOS 3.1 or higher. Source code for an APL2/PC workspace version is also provided. This version of RSM can make full use of any installed extended memory but must be run with the APL2 interpreter; and it requires an 80486 based microcomputer or an 80386 based microcomputer with an 80387 math coprocessor, at least 2Mb of extended memory, and DOS 3.3 or higher. The standard distribution medium for this package is one 5.25 inch 360K MS-DOS format diskette. RSM was developed in 1991. APL2 and IBM PC are registered trademarks of International Business Machines Corporation. MS-DOS is a registered trademark of Microsoft Corporation.

The effect of playing tactics and situational variables on achieving score-box possessions in a professional soccer team.

PubMed

Lago-Ballesteros, Joaquin; Lago-Peñas, Carlos; Rey, Ezequiel

2012-01-01

The aim of this study was to analyse the influence of playing tactics, opponent interaction and situational variables on achieving score-box possessions in professional soccer. The sample was constituted by 908 possessions obtained by a team from the Spanish soccer league in 12 matches played during the 2009-2010 season. Multidimensional qualitative data obtained from 12 ordered categorical variables were used. Sampled matches were registered by the AMISCO PRO system. Data were analysed using chi-square analysis and multiple logistic regression analysis. Of 908 possessions, 303 (33.4%) produced score-box possessions, 477 (52.5%) achieved progression and 128 (14.1%) failed to reach any sort of progression. Multiple logistic regression showed that, for the main variable "team possession type", direct attacks and counterattacks were three times more effective than elaborate attacks for producing a score-box possession (P < 0.05). Team possession originating from the middle zones and playing against less than six defending players (P < 0.001) registered a higher success than those started in the defensive zone with a balanced defence. When the team was drawing or winning, the probability of reaching the score-box decreased by 43 and 53 percent, respectively, compared with the losing situation (P < 0.05). Accounting for opponent interactions and situational variables is critical to evaluate the effectiveness of offensive playing tactics on producing score-box possessions.

Aircraft Noise Perception Study in Brazil: A Perspective on Airport Sustainable Growth and Environmental Awareness

NASA Technical Reports Server (NTRS)

deArantesGomesEller, Rogerio; Urbina, Ligia Maria Soto; Porto, Protogenes Pires

2003-01-01

Aircraft noise perception is related to several variables that are tangible and objective, such as the number of operations, flight schedules. Other variables, instead, are more subjective, such as preferences. However, although their elusiveness, they contribute to determine the individuals' perception of this type of externality. Despite the fact that the complaints related to aeronautical noise have been registered since the decade of 50, it has been observed that the perception of noise seems to have grown, especially since the 80's. It has been argued that this change in noise perception has its roots on the accelerated expansion of air traffic. But, it is necessary to point out the important role played on modeling preferences, by the growing environmental conscience and the higher welfare and quality of life standards and expectations. In that context, the main objective of this paper is to study the aeronautical noise perception in the neighborhoods of the Aeroporto Internacional de Sao Paulo - AISP (the biggest airport of South America). Specifically, it analyzes the relationship between aircraft noise perception and social class, which is expected to be positive. Since noise perception is an intangible variable, this study chose as a proxy the value losses of residential properties, caused by aeronautical noise. The variable social class has been measured utilizing average per capita income of the population who live nearby the airport. The comparison of both, the lowest and the highest social class suggests that the relationship between social class and noise perception is positive in the AISP region. Moreover, it was observed that all social classes are very susceptible to aircraft noise annoyance. In fact, the magnitude of the noise perception proxy for both social classes -the residential value losses- was found to be comparable to levels encountered in developed countries.

Life satisfaction of women of working age shortly after breast cancer surgery.

PubMed

Olsson, Mariann; Nilsson, Marie; Fugl-Meyer, Kerstin; Petersson, Lena-Marie; Wennman-Larsen, Agneta; Kjeldgård, Linnea; Alexanderson, Kristina

2017-03-01

To explore, among women of working age, satisfaction with life as a whole and with different life domains, and its associations with social and health variables, shortly after breast cancer surgery. This cross-sectional study included 605 women, aged 20-63 years, who had had breast cancer surgery with no distant metastasis, pre-surgical chemotherapy, or previous breast cancer. Associations between LiSat-11 and demographic and social factors as well as health- and treatment-related variables were analysed by multivariable logistic regression. Compared with Swedish reference levels, the women were, after breast cancer surgery, less satisfied with life, particularly sexual life. Women working shortly after breast cancer surgery were more often satisfied with life in provision domains compared with the reference population. Although most included variables showed associations with satisfaction, after adjustment for all significantly associated variables, only six variables-having children, being in work, having emotional and informational social support, and having good physical and emotional functioning-were positively associated with satisfaction with life as a whole. The odds ratios for satisfaction were higher in most life domains if the woman had social support and good emotional and cognitive functioning. One month after breast cancer surgery, satisfaction with different life domains was associated primarily with social support and health-related functioning. However, this soon after surgery, treatment-related variables showed no significant associations with life satisfaction. These results are useful for planning interventions to enhance e.g. social support and emotional as well as cognitive functioning.

Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders.

PubMed

Wahlbeck, Kristian; Westman, Jeanette; Nordentoft, Merete; Gissler, Mika; Laursen, Thomas Munk

2011-12-01

People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision. To evaluate trends in health outcomes of people with serious mental disorders. We examined nationwide 5-year consecutive cohorts of people admitted to hospital for mental disorders in Denmark, Finland and Sweden in 1987-2006. In each country the risk population was identified from hospital discharge registers and mortality data were retrieved from cause-of-death registers. The main outcome measure was life expectancy at age 15 years. People admitted to hospital for a mental disorder had a two- to threefold higher mortality than the general population in all three countries studied. This gap in life expectancy was more pronounced for men than for women. The gap decreased between 1987 and 2006 in these countries, especially for women. The notable exception was Swedish men with mental disorders. In spite of the positive general trend, men with mental disorders still live 20 years less, and women 15 years less, than the general population. During the era of deinstitutionalisation the life expectancy gap for people with mental disorders has somewhat diminished in the three Nordic countries. Our results support further development of the Nordic welfare state model, i.e. tax-funded community-based public services and social protection. Health promotion actions, improved access to healthcare and prevention of suicides and violence are needed to further reduce the life expectancy gap.

77 FR 74231 - Hatteras Variable Trust, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... 6e-3(T)(b)(15) thereunder in cases where a life insurance company separate account supporting variable life insurance contracts (``VLI Accounts'') holds shares of an existing portfolio of the Trust (an... investors also hold shares of the Funds: (i) Any life insurance company separate account supporting variable...

Risk of multiple sclerosis inversely associated with birth order position.

PubMed

Isager, H; Andersen, E; Hyllested, K

1980-06-01

The aim of this study was to ascertain whether there is an association between risk of multiple sclerosis (MS) and birth order position. Our reference population was 198,000 persons born in the period 1930-50 and recorded in the register of school health records from the school health service of the Copenhagen council. We compared 46 persons from the register who had developed MS with matched controls from the register, three for each case. An inverse association between risk of MS and birth order position was found. Early birth orders tend to delay exposure to an infectous agent from early childhood to a later age. Therefore, our finding supports the hypothesis that MS is causally related to an infection that is inapparent when it occurs in early childhood, while infection later in life may result in severe disease

Reflecting on one's own death: The existential questions that nurses face during end-of-life care.

PubMed

Karlsson, Margareta; Kasén, Anne; Wärnå-Furu, Carola

2017-04-01

When registered nurses care for patients at the end of life, they are often confronted with different issues related to suffering, dying, and death whether working in hospital or community care. Serious existential questions that challenge nurses' identities as human beings can arise as a result of these situations. The aim of our study was to describe and gain a deeper understanding of nurses' existential questions when caring for dying patients. Focus-group interviews with registered nurses who shared similar experiences and backgrounds about experiences in end-of-life care were employed to gain a deeper understanding about this sensitive subject. Focus-group interviews were performed in hospice care, in community care, and in a palliative care unit in western Sweden. A qualitative hermeneutic approach was employed to interpret the data. Nurses' existential questions balanced between responsibility and guilt in relation to their patients, between fear and courage in relation to being professional caregivers and fellow human beings, and between hope and despair in relation to the other's and their own death. Nurses in end-of-life care experience various emotions from patients related to things physical, spatial, and temporal. When nurses encounter these emotions as expressing a patient's suffering, they lead to challenges of balancing between different feelings in relation to patients, as both professional caregivers and fellow human beings. Nurses can experience growth both professionally and as human beings when caring for patients at the end of life.

Social relations and healthcare utilisation among middle-aged and older people: study protocol for an implementation and register-based study in Denmark.

PubMed

Mikkelsen, Anne Sophie Bech; Lund, Rikke; Kristiansen, Maria

2017-11-15

While previous research establishes an association between social relations, health and use of healthcare services among older people, how to implement this knowledge in real-life settings has received much less attention. This study will explore the relationship between social relations, health and use of healthcare services in a Danish mid-life population sample. In addition, the study will explore individual and contextual factors affecting the implementation of a group-based life story intervention aimed at establishing and strengthening social relations among older people at nursing homes in Denmark. A combined quantitative register-based approach and a qualitative implementation approach will be applied in this study. First, we will quantitatively analyse the relationship between social relations, health status and use of healthcare services among middle-aged people in Denmark by linking survey data on social relations, loneliness, self-perceived health and disease status from the Copenhagen Aging and Midlife Biobank (CAMB) (n = 7191) with national registries through the Public Health Database on use of healthcare services and demographic and socioeconomic factors. Second, we will qualitatively analyse individual and contextual factors affecting the implementation process of the group-based life story intervention based on semi-structured interviews (n = 16), observations and field notes with and among intervention stakeholders, i.e., participants and group leaders facilitating the intervention. The results of this study are expected to improve knowledge about mechanisms through which social relations are associated with health status and use of healthcare services and to inform the implementation of future interventions targeting social relations among older people at nursing homes. The study has been registered and approved by the Danish Data Protection Agency. Seperate approvals have been attained for the qualitative data (Approval No. SUND-2016-08), and for the quantitative data in the CAMB database which has also received approval from the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814, respectively).

[Triage evaluation making in a pediatric emergency department of a tertiary hospital].

PubMed

Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

2014-03-01

Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p < 0.001). Among the nurses working in the unit more than 7 years did not register pain level 472 (12.3%), identified inappropriate principal symptoms 197 (5%) and did not register hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

76 FR 17720 - American Family Life Insurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... SECURITIES AND EXCHANGE COMMISSION [Rel. No. IC-29617; File No. 812-13842] American Family Life... amended (the ``1940 Act''). Applicants: American Family Life Insurance Company (the ``Company''), American Family Variable Account I (the ``Life Account''), and American Family Variable Account II (the ``Annuity...

Impact of survey workflow on precision and accuracy of terrestrial LiDAR datasets

NASA Astrophysics Data System (ADS)

Gold, P. O.; Cowgill, E.; Kreylos, O.

2009-12-01

Ground-based LiDAR (Light Detection and Ranging) survey techniques are enabling remote visualization and quantitative analysis of geologic features at unprecedented levels of detail. For example, digital terrain models computed from LiDAR data have been used to measure displaced landforms along active faults and to quantify fault-surface roughness. But how accurately do terrestrial LiDAR data represent the true ground surface, and in particular, how internally consistent and precise are the mosaiced LiDAR datasets from which surface models are constructed? Addressing this question is essential for designing survey workflows that capture the necessary level of accuracy for a given project while minimizing survey time and equipment, which is essential for effective surveying of remote sites. To address this problem, we seek to define a metric that quantifies how scan registration error changes as a function of survey workflow. Specifically, we are using a Trimble GX3D laser scanner to conduct a series of experimental surveys to quantify how common variables in field workflows impact the precision of scan registration. Primary variables we are testing include 1) use of an independently measured network of control points to locate scanner and target positions, 2) the number of known-point locations used to place the scanner and point clouds in 3-D space, 3) the type of target used to measure distances between the scanner and the known points, and 4) setting up the scanner over a known point as opposed to resectioning of known points. Precision of the registered point cloud is quantified using Trimble Realworks software by automatic calculation of registration errors (errors between locations of the same known points in different scans). Accuracy of the registered cloud (i.e., its ground-truth) will be measured in subsequent experiments. To obtain an independent measure of scan-registration errors and to better visualize the effects of these errors on a registered point cloud, we scan from multiple locations an object of known geometry (a cylinder mounted above a square box). Preliminary results show that even in a controlled experimental scan of an object of known dimensions, there is significant variability in the precision of the registered point cloud. For example, when 3 scans of the central object are registered using 4 known points (maximum time, maximum equipment), the point clouds align to within ~1 cm (normal to the object surface). However, when the same point clouds are registered with only 1 known point (minimum time, minimum equipment), misalignment of the point clouds can range from 2.5 to 5 cm, depending on target type. The greater misalignment of the 3 point clouds when registered with fewer known points stems from the field method employed in acquiring the dataset and demonstrates the impact of field workflow on LiDAR dataset precision. By quantifying the degree of scan mismatch in results such as this, we can provide users with the information needed to maximize efficiency in remote field surveys.

26 CFR 1.801-7 - Variable annuities.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.801-7 Variable annuities. (a) In general. (1... variable annuity contract vary with the insurance company's investment experience with respect to such.... Accordingly, a company issuing variable annuity contracts shall qualify as a life insurance company for...

26 CFR 1.801-7 - Variable annuities.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.801-7 Variable annuities. (a) In general. (1... variable annuity contract vary with the insurance company's investment experience with respect to such.... Accordingly, a company issuing variable annuity contracts shall qualify as a life insurance company for...

26 CFR 1.801-7 - Variable annuities.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.801-7 Variable annuities. (a) In general. (1... variable annuity contract vary with the insurance company's investment experience with respect to such.... Accordingly, a company issuing variable annuity contracts shall qualify as a life insurance company for...

26 CFR 1.801-7 - Variable annuities.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) INCOME TAXES (CONTINUED) Life Insurance Companies § 1.801-7 Variable annuities. (a) In general. (1... variable annuity contract vary with the insurance company's investment experience with respect to such.... Accordingly, a company issuing variable annuity contracts shall qualify as a life insurance company for...

No Evidence of the Ego-Depletion Effect across Task Characteristics and Individual Differences: A Pre-Registered Study

PubMed Central

Lurquin, John H.; Michaelson, Laura E.; Barker, Jane E.; Gustavson, Daniel E.; von Bastian, Claudia C.; Carruth, Nicholas P.; Miyake, Akira

2016-01-01

Ego-depletion, a psychological phenomenon in which participants are less able to engage in self-control after prior exertion of self-control, has become widely popular in the scientific community as well as in the media. However, considerable debate exists among researchers as to the nature of the ego-depletion effect, and growing evidence suggests the effect may not be as strong or robust as the extant literature suggests. We examined the robustness of the ego-depletion effect and aimed to maximize the likelihood of detecting the effect by using one of the most widely used depletion tasks (video-viewing attention control task) and by considering task characteristics and individual differences that potentially moderate the effect. We also sought to make our research plan transparent by pre-registering our hypotheses, procedure, and planned analyses prior to data collection. Contrary to the ego-depletion hypothesis, participants in the depletion condition did not perform worse than control participants on the subsequent self-control task, even after considering moderator variables. These findings add to a growing body of evidence suggesting ego-depletion is not a reliable phenomenon, though more research is needed that uses large sample sizes, considers moderator variables, and pre-registers prior to data collection. PMID:26863227

No Evidence of the Ego-Depletion Effect across Task Characteristics and Individual Differences: A Pre-Registered Study.

PubMed

Lurquin, John H; Michaelson, Laura E; Barker, Jane E; Gustavson, Daniel E; von Bastian, Claudia C; Carruth, Nicholas P; Miyake, Akira

2016-01-01

Ego-depletion, a psychological phenomenon in which participants are less able to engage in self-control after prior exertion of self-control, has become widely popular in the scientific community as well as in the media. However, considerable debate exists among researchers as to the nature of the ego-depletion effect, and growing evidence suggests the effect may not be as strong or robust as the extant literature suggests. We examined the robustness of the ego-depletion effect and aimed to maximize the likelihood of detecting the effect by using one of the most widely used depletion tasks (video-viewing attention control task) and by considering task characteristics and individual differences that potentially moderate the effect. We also sought to make our research plan transparent by pre-registering our hypotheses, procedure, and planned analyses prior to data collection. Contrary to the ego-depletion hypothesis, participants in the depletion condition did not perform worse than control participants on the subsequent self-control task, even after considering moderator variables. These findings add to a growing body of evidence suggesting ego-depletion is not a reliable phenomenon, though more research is needed that uses large sample sizes, considers moderator variables, and pre-registers prior to data collection.

Integration of NASA-Developed Lifing Technology for PM Alloys into DARWIN (registered trademark)

NASA Technical Reports Server (NTRS)

McClung, R. Craig; Enright, Michael P.; Liang, Wuwei

2011-01-01

In recent years, Southwest Research Institute (SwRI) and NASA Glenn Research Center (GRC) have worked independently on the development of probabilistic life prediction methods for materials used in gas turbine engine rotors. The two organizations have addressed different but complementary technical challenges. This report summarizes a brief investigation into the current status of the relevant technology at SwRI and GRC with a view towards a future integration of methods and models developed by GRC for probabilistic lifing of powder metallurgy (P/M) nickel turbine rotor alloys into the DARWIN (Darwin Corporation) software developed by SwRI.

Primary Nursing: A Call for Clarity, Empowerment, and Accountability.

PubMed

Ruch, Shirley

2018-04-01

Registered nurses' (RNs') unique educational preparation, skills, scope of practice, and relationship with those we serve must be articulated and honored. The Primary Nursing care delivery model gives practical, functional life to the relationship of professional trust between RNs and their patients.

More alike than different: a comparison of male and female RNs in rural and remote Canada.

PubMed

Andrews, Mary E; Stewart, Norma J; Morgan, Debra G; D'Arcy, Carl

2012-05-01

To explore gender differences and similarities on personal, employment and work-life factors and predictors of job satisfaction among registered nurses in rural and remote Canada. Research suggests that men and women are attracted to nursing for different reasons, with job security, range of employment opportunities and wages being important for male nurses. Using data from a large national survey of registered nurses in rural and remote Canada, descriptive and multiple linear regression analyses were used to identify gender differences and similarities. A larger proportion of male nurses reported experiencing aggression in the workplace. Age, annual gross income and colleague support in medicine were not found to be predictors of work satisfaction for the male nurses, although they were for women. There are more similarities than differences between male and female registered nurses in factors that affect job satisfaction. Nursing management needs to increase their awareness of the potential for workplace aggression towards male registered nurses and to explore the perceptions of interpersonal interactions that affect satisfaction in the workplace. © 2011 Blackwell Publishing Ltd.

Attention to nurses' rewarding - an interview study of registered nurses working in primary and private healthcare in Finland.

PubMed

Seitovirta, Jaana; Vehviläinen-Julkunen, Katri; Mitronen, Lasse; De Gieter, Sara; Kvist, Tarja

2017-04-01

To identify meaningful types of rewards and the consequences of rewards as expressed by Finnish registered nurses working in primary and private healthcare. Previous studies have found significant associations between nurses' rewards and both their commitment and job satisfaction. Furthermore, appropriate rewards can have beneficial effects on factors including workforce stability and occupational satisfaction that are highly important in times of nurse shortages. A cross-sectional, qualitative interview study. Data were collected via individual semi-structured interviews (n = 20) with registered nurses working in Finland's primary and private healthcare, and subjected to qualitative content analysis. Six meaningful types of rewards were identified by the registered nurses: Financial compensation and benefits, Work-Life balance, Work content, Professional development, Recognition, and Supportive leadership. Rewards encouraged respondents to perform their work correctly and reinforced occupational satisfaction, but also caused feelings of envy and stress. It is essential to pay attention to nurses' preferences for particular rewards and to reward management. When designing effective reward systems for registered nurses, it is not sufficient to provide financial rewards alone, as various kinds of non-financial rewards are both meaningful and necessary. When trying to improve registered nurses' commitment and job satisfaction through reward management, it is important to listen to nurses' opinions to create a reward system that integrates financial and non-financial rewards and is fair from their perspective. Healthcare organisations that offer registered nurses a holistic reward system are more likely to retain satisfied and committed nurses at a time of increasing nursing shortages. © 2016 John Wiley & Sons Ltd.

Work productivity in a population-based cohort of patients with spondyloarthritis.

PubMed

Haglund, Emma; Bremander, Ann; Bergman, Stefan; Jacobsson, Lennart T H; Petersson, Ingemar F

2013-09-01

To assess work productivity and associated factors in patients with SpA. This cross-sectional postal survey included 1773 patients with SpA identified in a regional health care register. Items on presenteeism (reduced productivity at work, 0-100%, 0 = no reduction) were answered by 1447 individuals. Absenteeism was defined as register-based sick leave using data from a national register. Disease duration, disease activity (BASDAI), physical function (BASFI), health-related quality of life (EQ-5D), anxiety (HAD-a), depression (HAD-d), self-efficacy [Arthritis Self-efficacy Scale (ASES) pain and symptom], physical activity and education were also measured. Forty-five per cent reported reduced productivity at work with a mean reduction of 20% (95% CI 18, 21) and women reported a higher mean reduction than men (mean 23% vs 17%, P < 0.001). Worse quality of life, disease activity, physical function and anxiety all correlated with reduced productivity (r = 0.52-0.66, P < 0.001), while sick leave did not. Worse outcomes on the EQ-5D (β-est -9.6, P < 0.001), BASDAI (β-est 7.8, P < 0.001), BASFI (β-est 7.3, P < 0.001), ASES pain (β-est -0.5, P < 0.001) and HAD-d (β-est 3.4, P < 0.001) were associated with reduced productivity at work in patients with SpA regardless of age, gender and disease subgroup. ASES symptoms, HAD-a and education level <12 years were associated with reduced productivity but were not significant in all strata for age, gender and disease subgroup. Work productivity was reduced in patients with SpA and more so in women. Worse quality of life, disease activity, physical function, self-efficacy and depression were all associated with reduced productivity at work in patients with SpA.

Trials with patient-reported outcomes registered on the Australian New Zealand Clinical Trials Registry (ANZCTR).

PubMed

Mercieca-Bebber, Rebecca; Williams, Douglas; Tait, Margaret-Ann; Roydhouse, Jessica; Busija, Lucy; Sundaram, Chindhu Shunmuga; Wilson, Michelle; Langford, Ailsa; Rutherford, Claudia; Roberts, Natasha; King, Madeleine; Vodicka, Elisabeth; Devine, Beth

2018-06-18

It is important to understand the number, types and regions of trials that include patient-reported outcomes (PROs) to appreciate how patient experiences have been considered in studies of health and interventions. Twenty-seven percent of trials registered with ClinicalTrials.gov (2007-2013) included PROs; however, a regional breakdown was not provided and no reviews have been conducted of the Australia New Zealand Clinical Trials Registry (ANZCTR). We aimed to identify trials registered with ANZCTR with PRO endpoints and describe their characteristics. ANZCTR was systematically searched from inception (2005) to 31 March 2017 for trials with PRO endpoints. Search terms included PRO measures listed in Patient-Reported Outcomes Quality of Life Instrument Database and Grid-Enabled Measures, as well as generic PRO terms (e.g. "quality of life" (QOL)). Trial endpoints were individually coded using an established framework to identify trials with PROs for the analysis. Of 13,666 registered trials, 6168 (45.1%) included a PRO. The proportion of studies including PROs increased between 2006 and 2016 (r = 0.74, p = 0.009). Among the 6168 trials, there were 17,961 individual PRO endpoints, including symptoms/functional outcomes/condition-specific QOL (65.6%), generic QOL (13.2%), patient-reported experiences (9.9%), patient-reported behaviours (7.9%). Mental health was the most common category (99.8% included PROs), followed by physical medicine/rehabilitation (65.6%), musculoskeletal (63.5%), public health (63.1%), and cancer (54.2%). Our findings suggest growing use of PROs in the assessment of health and interventions in ANZ. Our review identifies trial categories with limited patient-reported information and provides a basis for future work on the impact of PRO findings in clinical care.

Lethal and teratogenic effects of phenol on Bufo arenarum embryos.

PubMed

Paisio, Cintia Elizabeth; Agostini, Elizabeth; González, Paola Solange; Bertuzzi, Mabel Lucía

2009-08-15

Phenol and their derivatives are used in several industries and they have a high potential toxicity for animal and plant species. They were found in variable concentrations, as high as 1000 mg/L, in industrial wastewater and, they are often discharged into the environment. Amphibian embryos are useful indicators of environmental pollution. However, to our knowledge, there are not studies focussed on the toxic effects of phenol on Bufo arenarum, which is an anuran widely distributed in South America. Therefore, the effect of phenol on the survival and morphogenesis of these amphibian embryos was evaluated by means of AMPHITOX test. Embryos at 25 stage of development (acute test) and embryos at 2-4 blastomers stage (early life stage test), were exposed to phenol solutions in concentrations ranging from 25 to 250 mg/L, which were frequently found in the environment. Mortality and malformations were registered each 24h. LC(50), LC(99), NOEC, TC(50) and TI(50) values were 183.70, 250, 60, 113 mg/L and 1.62, respectively, at 96 h of treatment. Mortality and the percentage of malformations increased with increasing phenol concentrations. Teratogenic effects more frequently produced by phenol were: axial flexure, persistent yolk plug and different abnormalities which caused death of blastulae. Moreover, other malformations were registered, such as irregular form, acephalism, edema, axial shortening and underdevelopment of gills, among others. Larvae of B. arenarum, at early embryonic stages (blastulae), showed higher sensitivity to phenol than tadpoles at stage 25. Results confirm high susceptibility of amphibians to phenol and that environmental concentrations of this pollutant might be harmful to these populations.

Application modeling ipv6 (internet protocol version 6) on e-id card for identification number for effectiveness and efficiency of registration process identification of population

NASA Astrophysics Data System (ADS)

Pardede, A. M. H.; Maulita, Y.; Buaton, R.

2018-03-01

When someone wants to be registered in an institution such as Birth Certificate, School, Higher Education, e-ID card, Tax, BPJS, Bank, Driving License, Passport and others then have to register and do registration one by one and have registration number or account respectively agency. It may be said that everyone is bothered with the registration process, from the moment of birth must be registered to be registered as a resident, to enter the school must also registration, it is considered ineffective and efficient because one must continue to register one by one and there is repetition of ownership registration number which vary each agency. Seeing these problems need to find a solution or attempt how to keep the affairs of registration is not repetitive and quite once and the number applies to all agencies. The presence of the latest technology that IPv6 brings opportunities for the efficiency and effectiveness of the registration system. The method used in this research is the exploration and modeling of system development with NDLC (Network Development Life Cycle) to produce a model to build IPv6 implementation on e-ID card. The results of the study will show that the public has one registration number.

Position of the American Dietetic Association: the roles of registered dietitians and dietetic technicians, registered in health promotion and disease prevention.

PubMed

Stitzel, Kimberly F

2006-11-01

It is the position of the American Dietetic Association (ADA) that primary prevention is the most effective, affordable course of action for preventing and reducing risk for chronic disease. Registered dietitians and dietetic technicians, registered, are leaders in delivering preventive services in both clinical and community settings, including advocating for funding and inclusion of these services in programs and policy initiatives at local, state, and federal levels. In addition, registered dietitians are leaders in facilitating and participating in research in chronic disease prevention and health promotion. Diet, nutrition, and physical activity are important factors in the promotion and maintenance of good health throughout the life cycle. Cost-effective interventions that produce a change in personal health practices are likely to lead to substantial reductions in the incidence and severity of the leading causes of disease in the United States. In an era of increasing health care expenditures and relative decreases in availability of federal funds, there is increasing demand on health promotion and disease prevention to be economically viable. Through clinical involvement and rigorous participation in research on chronic disease prevention and health promotion, the field of dietetics can lead the way to effectively translate the impact of nutrition on all ages.

Over my dead body: body donation and the rise in donor registrations in The Netherlands.

PubMed

Bolt, Sophie; Eisinga, Rob; Altena, Marga; Venbrux, Eric; Gerrits, Peter O

In The Netherlands, the number of body donor registrations has been increasing for several years. Body donors are people who register at an anatomical institute to donate their entire body, after death, for scientific education and research. Although only 0.1% of the Dutch population is registered as a body donor, this is sufficient to realize the anatomical demand of about 650 bodies annually. Due to the recent rise of registrations many anatomical institutes have (temporarily) stopped registering new donors to prevent a surplus of bodies. Based on a large body donor survey (n=759) and in-depth anthropological interviews with 20 body donors, we try to give an explanation for the rising registration numbers. We argue that the choice for body donation in contemporary, individualized Dutch society is an autonomous way to give meaning and sense to life and death outside the framework of institutionalized religion.

Enhancing resilience in registered aged care nurses.

PubMed

Cameron, Fiona; Brownie, Sonya

2010-06-01

To identify the factors that impact the resilience of registered aged care nurses, that is their capacity to adapt to the physical, mental and emotional demands of working in aged care facilities. This study explored the lived experience of nine registered nurses working in residential aged care facilities on the Sunshine Coast, Queensland, who were asked to reflect on the phenomenon of resilience in the workplace. This study found that clinical expertise, a sense of purpose in a holistic care environment, a positive attitude and work-life balance are important determinants of resilience in aged care nurses. Resilience in nurses in residential aged care facilities is enhanced when they are able to maintain long-term, meaningful relationships with residents. Collegial support that provides opportunities to debrief and validate experiences as well as the use of humour to defuse stress promotes well-being and builds resilience in the workplace.

Bioenergy | National Agricultural Library

Science.gov Websites

Skip to main content Home National Agricultural Library United States Department of Agriculture Ag , graphs), Agricultural Products html Data from: Comparative farm-gate life cycle assessment of oilseed registered trademark of Dries Buytaert. NAL Home | USDA.gov | Agricultural Research Service | Plain Language

Nontraditional Degree Options for Nurses: A Model Program

ERIC Educational Resources Information Center

Walston, Sydney C.

1978-01-01

The Institute for Personal and Career Development of Central Michigan University offers external degree programs for adult learners using nontraditional study. The competency-based programs described include credit given for the educational background and relevant career-life experiences of registered nurses in Michigan. (Author/LBH)

Neonatal diabetes in Ukraine: incidence, genetics, clinical phenotype and treatment

PubMed Central

Globa, Evgenia; Zelinska, Nataliya; Mackay, Deborah J.G.; Temple, Karen I.; Houghton, Jayne A.L.; Hattersley, Andrew T.; Flanagan, Sarah E.; Ellard, Sian

2016-01-01

Background Neonatal diabetes has not been previously studied in Ukraine. We investigated the genetic etiology in patients with onset of diabetes during the first 9 months of life. Methods We established a Pediatric Diabetes Register to identify patients diagnosed with diabetes before 9 months of age. Genetic testing was undertaken for 42 patients with permanent or transient diabetes diagnosed within the first 6 months of life (n=22) or permanent diabetes diagnosed between 6 and 9 months (n=20). Results We determined the genetic etiology in 23 of 42 (55%) patients; 86% of the patients diagnosed before 6 months and 20% diagnosed between 6 and 9 months. The incidence of neonatal diabetes in Ukraine was calculated to be 1 in 126,397 live births. Conclusions Genetic testing for patients identified through the Ukrainian Pediatric Diabetes Register identified KCNJ11 and ABCC8 mutations as the most common cause (52%) of neonatal diabetes. Transfer to sulfonylureas improved glycemic control in all 11 patients. PMID:26208381

Hominin life history: reconstruction and evolution

PubMed Central

Robson, Shannen L; Wood, Bernard

2008-01-01

In this review we attempt to reconstruct the evolutionary history of hominin life history from extant and fossil evidence. We utilize demographic life history theory and distinguish life history variables, traits such as weaning, age at sexual maturity, and life span, from life history-related variables such as body mass, brain growth, and dental development. The latter are either linked with, or can be used to make inferences about, life history, thus providing an opportunity for estimating life history parameters in fossil taxa. We compare the life history variables of modern great apes and identify traits that are likely to be shared by the last common ancestor of Pan-Homo and those likely to be derived in hominins. All great apes exhibit slow life histories and we infer this to be true of the last common ancestor of Pan-Homo and the stem hominin. Modern human life histories are even slower, exhibiting distinctively long post-menopausal life spans and later ages at maturity, pointing to a reduction in adult mortality since the Pan-Homo split. We suggest that lower adult mortality, distinctively short interbirth intervals, and early weaning characteristic of modern humans are derived features resulting from cooperative breeding. We evaluate the fidelity of three life history-related variables, body mass, brain growth and dental development, with the life history parameters of living great apes. We found that body mass is the best predictor of great ape life history events. Brain growth trajectories and dental development and eruption are weakly related proxies and inferences from them should be made with caution. We evaluate the evidence of life history-related variables available for extinct species and find that prior to the transitional hominins there is no evidence of any hominin taxon possessing a body size, brain size or aspects of dental development much different from what we assume to be the primitive life history pattern for the Pan-Homo clade. Data for life history-related variables among the transitional hominin grade are consistent and none agrees with a modern human pattern. Aside from mean body mass, adult brain size, crown and root formation times, and the timing and sequence of dental eruption of Homo erectus are inconsistent with that of modern humans. Homo antecessor fossil material suggests a brain size similar to that of Homo erectus s. s., and crown formation times that are not yet modern, though there is some evidence of modern human-like timing of tooth formation and eruption. The body sizes, brain sizes, and dental development of Homo heidelbergensis and Homo neanderthalensis are consistent with a modern human life history but samples are too small to be certain that they have life histories within the modern human range. As more life history-related variable information for hominin species accumulates we are discovering that they can also have distinctive life histories that do not conform to any living model. At least one extinct hominin subclade, Paranthropus, has a pattern of dental life history-related variables that most likely set it apart from the life histories of both modern humans and chimpanzees. PMID:18380863

Register-based predictors of violations of animal welfare legislation in dairy herds.

PubMed

Otten, N D; Nielsen, L R; Thomsen, P T; Houe, H

2014-12-01

The assessment of animal welfare can include resource-based or animal-based measures. Official animal welfare inspections in Denmark primarily control compliance with animal welfare legislation based on resource measures (e.g. housing system) and usually do not regard animal response parameters (e.g. clinical and behavioural observations). Herds selected for welfare inspections are sampled by a risk-based strategy based on existing register data. The aim of the present study was to evaluate register data variables as predictors of dairy herds with violations of the animal welfare legislation (VoAWL) defined as occurrence of at least one of the two most frequently violated measures found at recent inspections in Denmark, namely (a) presence of injured animals not separated from the rest of the group and/or (b) animals in a condition warranting euthanasia still being present in the herd. A total of 25 variables were extracted from the Danish Cattle Database and assessed as predictors using a multivariable logistic analysis of a data set including 73 Danish dairy herds, which all had more than 100 cows and cubicle loose-housing systems. Univariable screening was used to identify variables associated with VoAWL at a P-value<0.2 for the inclusion in a multivariable logistic regression analysis. Backward selection procedures identified the following variables for the final model predictive of VoAWL: increasing standard deviation of milk yield for first lactation cows, high bulk tank somatic cell count (⩾250 000 cells/ml) and suspiciously low number of recorded veterinary treatments (⩽25 treatments/100 cow years). The identified predictors may be explained by underlying management factors leading to impaired animal welfare in the herd, such as poor hygiene, feeding and management of dry or calving cows and sick animals. However, further investigations are required for causal inferences to be established.

Novel nursing terminologies for the rapid response system.

PubMed

Wong, Elizabeth

2009-01-01

Nursing terminology with implications for the rapid response system (RRS) is introduced and proposed: critical incident nursing diagnosis (CIND), defined as the recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication; critical incident nursing intervention, defined as any indirect or direct care registered nurse-initiated treatment, based upon clinical judgment and knowledge that a registered nurse performs in response to a CIND; and critical incident control, defined as a response that attempts to reverse a life-threatening condition. The current literature, research studies, meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing diagnoses, nursing interventions, and nursing outcomes listed in the North American Nursing Diagnosis Association International Classification, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), respectively, are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of such standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations when activating the RRS. The North American Nursing Diagnosis Association International Classification, NIC, and NOC are urged to refine their classifications and include CIND, critical incident nursing intervention, and critical incident control. The RRS should incorporate standardized nursing terminology to describe patient care during life-threatening situations. Refining the diagnoses, interventions, and outcomes classifications will permit nursing researchers, among others, to conduct studies on the efficacy of the proposed novel nursing terminology when providing care to patients during life-threatening situations. In addition, including the proposed novel nursing terminology in the RRS offers a means of improving care in such situations.

Nurse knowledge, work environment, and turnover in highly specialized pediatric end-of-life care

PubMed Central

Lindley, Lisa C.; Cozad, Melanie J.

2016-01-01

Objective To examine the relationship between nurse knowledge and work environment and Registered Nurse (RN) turnover in perinatal hospice and palliative care organizations. Methods Using nurse intellectual capital theory, a multivariate analysis was conducted with 2007 National Home and Hospice Care Survey data. Results Perinatal hospice and palliative care organizations experienced a 5% turnover rate. The professional experience of advanced practice nurses (APNs) was significantly related to turnover among RNs (β= −0.032, P< 0.05). Compared to organizations with no APNs professional experience, clinical nurse specialists and nurse practitioners significantly reduced RN turnover by 3-percentage points. No other nurse knowledge or work environment variables were associated with RN turnover. Several of the control variables were also associated with RN turnover in the study: organizations serving micropolitan (β= −0.041, P< 0.05) and rural areas (β= −0.037, P< 0.05) had lower RN turnover, compared to urban areas. Organizations with a technology climate where nurses used electronic medical records had a higher turnover rate than those without (β= 0.036, P< 0.05). Conclusions The findings revealed that advanced professional experience in the form of APNs were associated with reductions in RN turnover. This suggests that having a clinical nurse specialist or nurse practitioner on staff may provide knowledge and experience to other RNs, creating stability within the organization. PMID:27188758

Cognitive Training and Transcranial Direct Current Stimulation for Mild Cognitive Impairment in Parkinson's Disease: A Randomized Controlled Trial

PubMed Central

Gasson, Natalie; Johnson, Andrew R.; Booth, Leon; Loftus, Andrea M.

2018-01-01

This study examined whether standard cognitive training, tailored cognitive training, transcranial direct current stimulation (tDCS), standard cognitive training + tDCS, or tailored cognitive training + tDCS improved cognitive function and functional outcomes in participants with PD and mild cognitive impairment (PD-MCI). Forty-two participants with PD-MCI were randomized to one of six groups: (1) standard cognitive training, (2) tailored cognitive training, (3) tDCS, (4) standard cognitive training + tDCS, (5) tailored cognitive training + tDCS, or (6) a control group. Interventions lasted 4 weeks, with cognitive and functional outcomes measured at baseline, post-intervention, and follow-up. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12614001039673). While controlling for moderator variables, Generalized Linear Mixed Models (GLMMs) showed that when compared to the control group, the intervention groups demonstrated variable statistically significant improvements across executive function, attention/working memory, memory, language, activities of daily living (ADL), and quality of life (QOL; Hedge's g range = 0.01 to 1.75). More outcomes improved for the groups that received standard or tailored cognitive training combined with tDCS. Participants with PD-MCI receiving cognitive training (standard or tailored) or tDCS demonstrated significant improvements on cognitive and functional outcomes, and combining these interventions provided greater therapeutic effects. PMID:29780572

Prevention of depression and anxiety in adolescents: a randomized controlled trial testing the efficacy and mechanisms of Internet-based self-help problem-solving therapy.

PubMed

Hoek, Willemijn; Schuurmans, Josien; Koot, Hans M; Cuijpers, Pim

2009-10-12

Even though depression and anxiety are highly prevalent in adolescence, youngsters are not inclined to seek help in regular healthcare. Therapy through the Internet, however, has been found to appeal strongly to young people. The main aim of the present study is to examine the efficacy of preventive Internet-based guided self-help problem-solving therapy with adolescents reporting depressive and anxiety symptoms. A secondary objective is to test potential mediating and moderating variables in order to gain insight into how the intervention works and for whom it works best. This study is a randomized controlled trial with an intervention condition group and a wait-list control group. The intervention condition group receives Internet-based self-help problem-solving therapy. Support is provided by a professional and delivered through email. Participants in the wait-list control group receive the intervention four months later. The study population consists of adolescents (12-18-year-olds) from the general population who report mild to moderate depressive and/or anxiety symptoms and are willing to complete a self-help course. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are quality of life, social anxiety, and cost-effectiveness. The following variables are examined for their moderating role: demographics, motivation, treatment credibility and expectancy, externalizing behaviour, perceived social support from parents and friends, substance use, the experience of important life events, physical activity, the quality of the therapeutic alliance, and satisfaction. Mediator variables include problem-solving skills, worrying, mastery, and self-esteem. Data are collected at baseline and at 3 weeks, 5 weeks, 4 months, 8 months, and 12 months after baseline. Both intention-to-treat and completer analyses will be conducted. This study evaluates the efficacy and mechanisms of Internet-based problem-solving therapy for adolescents. If Internet-based problem-solving therapy is shown to reduce depressive and anxiety symptoms in adolescents, the implication is to implement the intervention in clinical practice. Strengths and limitations of the study are discussed. Netherlands Trial Register NTR1322.

Relationship between temperature variability and brain injury on magnetic resonance imaging in cooled newborn infants after perinatal asphyxia.

PubMed

Brotschi, B; Gunny, R; Rethmann, C; Held, U; Latal, B; Hagmann, C

2017-09-01

The objective of the study was whether temperature management during therapeutic hypothermia correlates with the severity of brain injury assessed on magnetic resonance imaging in term infants with hypoxic-ischemic encephalopathy. Prospectively collected register data from the National Asphyxia and Cooling Register of Switzerland were analyzed. Fifty-five newborn infants were cooled for 72 h with a target temperature range of 33 to 34 °C. Individual temperature variability (odds ratio (OR) 40.17 (95% confidence interval (CI) 1.37 to 1037.67)) and percentage of temperatures within the target range (OR 0.95 (95% CI 0.90 to 0.98)) were associated with the severity of brain injury seen on magnetic resonance imaging (MRI). Neither the percentage of measured temperatures above (OR 1.08 (95% CI 0.96 to 1.21)) nor below (OR 0.99 (95% CI 0.92 to 1.07) the target range was associated with the severity of brain injury seen on MRI. In a national perinatal asphyxia cohort, temperature variability and percentage of temperatures within the target temperature range were associated with the severity of brain injury.

Pre-surgical register of tobacco consumption.

PubMed

Gavilán, Eva; Moreno, Montse; Pérez, Àngels; Castellano, Yolanda; Fernández, Esteve; Martínez, Cristina

2018-03-24

Smoking cessation before surgery decreases the risk of complications. The aim of this study was to analyse the smoking register, associated variables and a short talk given to smokers in pre-surgical visits. Cross-sectional study. The pre-surgical records of 680 patients were assessed. We selected patient sociodemographic variables, surgical intervention characteristics, smoking status and consumption pattern. Logistic regression was used to study the variables association with smoking. A percentage of 97.2 of the pre-surgical records include information on tobacco consumption. Overall 20% of surgical patients are smokers. The probability of smoking is higher among men (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.7-4.0) and≤60 years (aOR 5.4, 95% CI 3.2-9.1). None of the records had information regarding a short talk given to patients to give up smoking. Smoking consumption was prevalent, but the characterisation of a smoker's profile and short talk given to patient before surgery was practically nonexistent. Ensuring that patients who smokes receives a short talk to give up smoking before surgery is necessary. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

The impact of pharmaceutical innovation on premature cancer mortality in Canada, 2000-2011.

PubMed

Lichtenberg, Frank R

2015-09-01

The premature cancer mortality rate has been declining in Canada, but there has been considerable variation in the rate of decline across cancer sites. I analyze the effect that pharmaceutical innovation had on premature cancer mortality in Canada during the period 2000-2011, by investigating whether the cancer sites that experienced more pharmaceutical innovation had larger declines in the premature mortality rate, controlling for changes in the incidence rate. Premature mortality before age 75 is significantly inversely related to the cumulative number of drugs registered at least 10 years earlier. Since mean utilization of drugs that have been marketed for less than 10 years is only one-sixth as great as mean utilization of drugs that have been marketed for at least a decade, it is not surprising that premature mortality is strongly inversely related only to the cumulative number of drugs that had been registered at least ten years earlier. Premature mortality before age 65 and 55 is also strongly inversely related to the cumulative number of drugs that had been registered at least ten years earlier. None of the estimates of the effect of incidence on mortality are statistically significant. Controlling for the cumulative number of drugs, the cumulative number of chemical subgroups does not have a statistically significant effect on premature mortality. This suggests that drugs (chemical substances) within the same class (chemical subgroup) are not therapeutically equivalent. During the period 2000-2011, the premature (before age 75) cancer mortality rate declined by about 9 %. The estimates imply that, in the absence of pharmaceutical innovation during the period 1985-1996, the premature cancer mortality rate would have increased about 12 % during the period 2000-2011. A substantial decline in the "competing risk" of death from cardiovascular disease could account for this. The estimates imply that pharmaceutical innovation during the period 1985-1996 reduced the number of years of potential life lost to cancer before age 75 in 2011 by 105,366. The cost per life-year before age 75 gained from previous pharmaceutical innovation is estimated to have been 2730 USD. Most of the previously-registered drugs were off-patent by 2011, but evidence suggests that, even if these drugs had been sold at branded rather than generic prices, the cost per life-year gained would have been below 11,000 USD, a figure well below even the lowest estimates of the value of a life-year gained. The largest reductions in premature mortality occur at least a decade after drugs are registered, when their utilization increases significantly. This suggests that, if Canada is to obtain substantial additional reductions in premature cancer mortality in the future (a decade or more from now) at a modest cost, pharmaceutical innovation (registration of new drugs) is needed today.

Does glycemic variability impact mood and quality of life?

PubMed

Penckofer, Sue; Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-04-01

Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy," and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

Nutrition for Nurses: Nursing 245.

ERIC Educational Resources Information Center

Palermo, Karen R.

A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…

75 FR 18907 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

...)-191, Assessment of Debris Accumulation on Pressurized Water Reactor (PWR) Sump Performance (Public... Fuel Cycle Oversight Process Revisions (Public Meeting). (Contact: Michael Raddatz, 301-492-3108.) This... Bolduc, Chief, Employee/Labor Relations and Work Life Branch, at 301-492-2230, TDD: 301-415-2100, or by e...

77 FR 1521 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-10

... Nuclear Power Plant Operating Licenses (Part 51) (Public Meeting) (Contact: Jeremy Susco, (301) 415-2927... another format (e.g. braille, large print), please notify Bill Dosch, Chief, Work Life and Benefits Branch...), or send an email to [email protected] . Dated: January 5, 2012. Rochelle C. Bavol, Policy...

76 FR 76199 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... Operating Licenses (Part 51) (Public Meeting) (Contact: Jeremy Susco, (301) 415-2927). This meeting will be... print), please notify Bill Dosch, Chief, Work Life and Benefits Branch, at (301) 415-6200, TDD: ([email protected] . Dated: December 1, 2011. Rochelle C. Bavol, Policy Coordinator, Office of the Secretary...

Comparison of IVF cycles reported in a voluntary ART registry with a mandatory registry in Spain.

PubMed

Luceño, F; Castilla, J A; Gómez-Palomares, J L; Cabello, Y; Hernández, J; Marqueta, J; Herrero, J; Vidal, E; Fernández-Shaw, S; Coroleu, B

2010-12-01

Monitoring assisted reproductive technology (ART) is essential to evaluate the performance of fertility treatment and its impact on birth rates. In Europe, there are two kinds of ART registers: voluntary and mandatory. The validity of register data is very important with respect to the quality of register-based observational studies. The aim of this paper is to determine the degree of agreement between voluntary and mandatory ART registers. The two sources for the data compared in this study (referring to 2005 and 2006) were FIVCAT.NET (an official compulsory Assisted Reproduction Registry within the Health Ministry of the Regional Government of Catalonia, to which all authorized clinics, both public and private, performing assisted reproduction in the region are obliged to report) and the register of the Spanish Fertility Society (SEF), to which data are provided on a voluntary basis. The SEF register data were divided into two groups: (i) data from clinics in Catalonia (SEF-CAT); (ii) data from the rest of Spain, excluding Catalonia (SEF-wCAT). The techniques compared were IVF cycle using patients' own eggs (IVF cycle) versus donor egg cycles. For IVF cycles, the voluntary ART register reflected 77.2% of those on the official one, but the corresponding figure was only 34.4% with respect to donated eggs. The variables analysed in the IVF cycle (insemination technique used, patients' age, number of embryos transferred, pregnancy rates, multiple pregnancies and deliveries) were similar in the three groups studied. However, we observed significant differences in donor egg cycles with regard to the insemination technique used, pregnancy rates and multiple pregnancies between the voluntary and the official register. Data from the voluntary ART register for IVF cycles are valid, but those for donor egg cycles are not. Further study is necessary to determine the reasons for this difference.

17 CFR 274.302 - Form N-27I-1, notice of right of withdrawal and refund for variable life insurance...

Code of Federal Regulations, 2010 CFR

2010-04-01

... of withdrawal and refund for variable life insurance contractholders required pursuant to Rule 6e-2... for Exemptions § 274.302 Form N-27I-1, notice of right of withdrawal and refund for variable life insurance contractholders required pursuant to Rule 6e-2 (§ 270.6e-2 of this chapter). [41 FR 47032, Oct. 27...

17 CFR 274.303 - Form N-27I-2, notice of withdrawal right and statement of charges for variable life insurance...

Code of Federal Regulations, 2010 CFR

2010-04-01

... variable life insurance contractholders required pursuant to Rule 6e-2 (§ 270.6e-2 of this chapter). [41 FR... withdrawal right and statement of charges for variable life insurance contractholders required pursuant to Rule 6e-2 (§ 270.6e-2 of this chapter). 274.303 Section 274.303 Commodity and Securities Exchanges...

REGULATION OF GEOGRAPHIC VARIABILITY IN HAPLOID:DIPLOD RATIOS OF BIPHASIC SEAWEED LIFE CYCLES(1).

PubMed

da Silva Vieira, Vasco Manuel Nobre de Carvalho; Santos, Rui Orlando Pimenta

2012-08-01

The relative abundance of haploid and diploid individuals (H:D) in isomorphic marine algal biphasic cycles varies spatially, but only if vital rates of haploid and diploid phases vary differently with environmental conditions (i.e. conditional differentiation between phases). Vital rates of isomorphic phases in particular environments may be determined by subtle morphological or physiological differences. Herein, we test numerically how geographic variability in H:D is regulated by conditional differentiation between isomorphic life phases and the type of life strategy of populations (i.e. life cycles dominated by reproduction, survival or growth). Simulation conditions were selected using available data on H:D spatial variability in seaweeds. Conditional differentiation between ploidy phases had a small effect on the H:D variability for species with life strategies that invest either in fertility or in growth. Conversely, species with life strategies that invest mainly in survival, exhibited high variability in H:D through a conditional differentiation in stasis (the probability of staying in the same size class), breakage (the probability of changing to a smaller size class) or growth (the probability of changing to a bigger size class). These results were consistent with observed geographic variability in H:D of natural marine algae populations. © 2012 Phycological Society of America.

[Usefulness of electronic drug registers: Spanish register of patients treated with fingolimod (Gilenya ®)].

PubMed

Fernández, Óscar; Rodríguez-Antigüedad, Alfredo; Oreja-Guevara, Celia; Garcia-Garcia, Margarida; Montalban, Xavier

2014-01-16

This study outlines the design of an electronic register of patients with multiple sclerosis who began treatment with fingolimod in Spain. The system is intended to serve as a tool to monitor its utilisation in daily clinical practice and thus allow optimisation of the way it is used. To establish the profile of patients with multiple sclerosis undergoing treatment with fingolimod and to determine the effectiveness and safety of this treatment in daily clinical practice. An observation-based, retrospective and prospective, multi-centre registry is set up, which will be active for five years. Forty neurologists working in Spain will participate in the project. Patients treated with fingolimod who fulfil the selection criteria will be included in the study. The effectiveness variables that will be evaluated are: disability measured by means of the Expanded Disability Status Scale, the rate of attacks, T1 gadolinium-enhancing lesions and new lesions in T2, and the percentage of patients who were free of activity and those who require concomitant treatments. The tolerability variables that will be evaluated are: the rate of patients who present events and adverse reactions, respectively, with a separate analysis of those presenting after the first dose or that are related to the fingolimod risk management plan and the treatment dropout rate. New pharmaceuticals that have only recently been commercialised require more information about their effectiveness and safety, beyond the controlled environment of a clinical trial. Initiatives involving electronic registries such as the Gilenya register are a solution that can respond to such needs by providing information in the shortest possible time about the most suitable management in order to be able to make the best and most efficient use of it.

Sickness absence in gender-equal companies: a register study at organizational level.

PubMed

Sörlin, Ann; Ohman, Ann; Lindholm, Lars

2011-07-11

The differences in sickness absence between men and women in Sweden have attracted a great deal of interest nationally in the media and among policymakers over a long period. The fact that women have much higher levels of sickness absence has been explained in various ways. These explanations are contextual and one of the theories points to the lack of gender equality as an explanation. In this study, we evaluate the impact of gender equality on health at organizational level. Gender equality is measured by an index ranking companies at organizational level; health is measured as days on sickness benefit. Gender equality was measured using the Organizational Gender Gap Index or OGGI, which is constructed on the basis of six variables accessible in Swedish official registers. Each variable corresponds to a key word illustrating the interim objectives of the "National Plan for Gender Equality", implemented by the Swedish Parliament in 2006. Health is measured by a variable, days on sickness benefit, also accessible in the same registers. We found significant associations between company gender equality and days on sickness benefit. In gender-equal companies, the risk for days on sickness benefit was 1.7 (95% CI 1.6-1.8) higher than in gender-unequal companies. The differences were greater for men than for women: OR 1.8 (95% CI 1.7-2.0) compared to OR 1.4 (95% CI 1.3-1.5). Even though employees at gender-equal companies had more days on sickness benefit, the differences between men and women in this measure were smaller in gender-equal companies. Gender equality appears to alter health patterns, converging the differences between men and women.

Sickness absence in gender-equal companies A register study at organizational level

PubMed Central

2011-01-01

Background The differences in sickness absence between men and women in Sweden have attracted a great deal of interest nationally in the media and among policymakers over a long period. The fact that women have much higher levels of sickness absence has been explained in various ways. These explanations are contextual and one of the theories points to the lack of gender equality as an explanation. In this study, we evaluate the impact of gender equality on health at organizational level. Gender equality is measured by an index ranking companies at organizational level; health is measured as days on sickness benefit. Methods Gender equality was measured using the Organizational Gender Gap Index or OGGI, which is constructed on the basis of six variables accessible in Swedish official registers. Each variable corresponds to a key word illustrating the interim objectives of the "National Plan for Gender Equality", implemented by the Swedish Parliament in 2006. Health is measured by a variable, days on sickness benefit, also accessible in the same registers. Results We found significant associations between company gender equality and days on sickness benefit. In gender-equal companies, the risk for days on sickness benefit was 1.7 (95% CI 1.6-1.8) higher than in gender-unequal companies. The differences were greater for men than for women: OR 1.8 (95% CI 1.7-2.0) compared to OR 1.4 (95% CI 1.3-1.5). Conclusions Even though employees at gender-equal companies had more days on sickness benefit, the differences between men and women in this measure were smaller in gender-equal companies. Gender equality appears to alter health patterns, converging the differences between men and women. PMID:21745375

Populations and outcome measures used in ongoing research in sarcopenia.

PubMed

Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

2017-08-01

Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

Use of a Microprocessor to Implement an ADCCP Protocol (Federal Std-1003) Operating in the Unbalanced Normal Mode.

DTIC Science & Technology

1980-05-01

andcoptrpormigfrteublne nra ls fpoeue nacrac with Federal Standard 1003 fTelecommunications: Synchronous Bit Oriented Data Link Control Procedures...and the higher level user. The solution to the producer/consumer problem involves the use of PASS and SICHAL primitives and event variables or... semaphores . The event variables have been defined for the LS-microprocessor interface as part of I-1 the internal registers that are included in the F6856

Alpha1 LASSO data bundles Lamont, OK

DOE Data Explorer

Gustafson, William Jr; Vogelmann, Andrew; Endo, Satoshi; Toto, Tami; Xiao, Heng; Li, Zhijin; Cheng, Xiaoping; Krishna, Bhargavi (ORCID:000000018828528X)

2016-08-03

A data bundle is a unified package consisting of LASSO LES input and output, observations, evaluation diagnostics, and model skill scores. LES input includes model configuration information and forcing data. LES output includes profile statistics and full domain fields of cloud and environmental variables. Model evaluation data consists of LES output and ARM observations co-registered on the same grid and sampling frequency. Model performance is quantified by skill scores and diagnostics in terms of cloud and environmental variables.

Utilization of physicochemical variables developed from changes in sensory attributes and consumer acceptability to predict the shelf life of fresh-cut mango fruit.

PubMed

Salinas-Hernández, Rosa María; González-Aguilar, Gustavo A; Tiznado-Hernández, Martín Ernesto

2015-01-01

Sensory evaluation is the ideal tool for shelf-life determination. With the objective to develop an easy shelf-life indicator, color (L*, a*, b*, chroma and hue angle), total soluble solids (TSS), firmness (F), pH, acidity, and the sensory attributes of appearance, brightness, browning, odor, flavor, texture, color, acidity and sweetness were evaluated in fresh cut mangoes (FCM) stored at 5, 10, 15 and 20 °C. Overall acceptability was evaluated by consumers. Correlation analysis between sensory attributes and physicochemical variables was carried out. Physicochemical cut-off points based on sensory attributes and consumer acceptability was obtained by regression analysis and utilized to estimate FCM shelf-life by kinetic models fitted to each variable. The validation of the model was done by comparing the shelf life estimated by kinetic models and consumers. It was recorded large correlations between appearance, brightness, and color with L*; appearance and color with chroma and hue angle; sweetness and flavor with TSS, and between F and texture. The shelf life estimated based on consumer using a 9 point hedonic scale was in the range of 10-12, 2.3-2.6, 1.3-1.5 and 1.0-1.1 days for 5, 10, 15 and 20 °C. It was recorded large correlation coefficients between the shelf life estimated by consumer acceptability scores and physicochemical variables. Kinetic models based on physicochemical variables showed a tendency to overestimate the shelf life as compared with the models bases on the sensory attributes. It was concluded that physicochemical variables can be used as a tool to estimate the FCM shelf life.

The schedule of administration of canakinumab in cryopyrin associated periodic syndrome is driven by the phenotype severity rather than the age

PubMed Central

2013-01-01

Introduction Interleukin-1 (IL-1) blockade is the treatment of choice of cryopyrin associated periodic syndromes (CAPS). Anti-IL-1 monoclonal antibody (canakinumab) was recently registered. However no clear data are available on the optimal schedule of administration of this drug. The aim of the present study was to analyse the impact of canakinumab on CAPS patients in daily clinical practice and to identify the best schedule of administration according to age and phenotype. Methods 13 CAPS patients (10 children and 3 young adults) treated with canakinumab were followed for 12 months. Clinical and laboratory parameters were collected at each visit. Health-related quality of life (HRQoL) was recorded at month 12. Complete response was defined as absence of clinical manifestations and normal examinations. Clinical and laboratory variables at last follow-up were compared with those registered at the moment of anakinra discontinuation. Results seven patients with chronic infantile neurological cutaneous articular (CINCA) syndrome, four patients with Muckle-Wells syndrome (MWS) and two patients with an overlapping MWS/CINCA phenotype were analysed. CINCA patients experienced a higher number of modifications of the treatment (increased dosage or decreased dosing interval) in respect to MWS patients. At the end of the follow-up CINCA patients displayed a higher frequency of administration with a median dose of 3.7 mg/kg (2.1 mg/kg for MWS patients). Canakinumab was withdrawn in a patient with CINCA for incomplete response and poor compliance. The effect of canakinumab on HRQoL was similar to that observed during treatment with anakinra, with the exception of an improvement of the psychosocial concepts after the introduction of canakinumab. Conclusions The use of canakinumab in daily practice is associated with persistent satisfactory control of disease activity but needs progressive dose adjustments in more severe patients. The clinical phenotype, rather than the age, represents the main variable able to determine the need of more frequent administrations of the drug at higher dosage. PMID:23442610

Intestinal microbiota composition after antibiotic treatment in early life: the INCA study.

PubMed

Rutten, N B M M; Rijkers, G T; Meijssen, C B; Crijns, C E; Oudshoorn, J H; van der Ent, C K; Vlieger, A M

2015-12-09

The acquisition and development of infant gut microbiota can be influenced by numerous factors, of which early antibiotic treatment is an important one. However, studies on the effects of antibiotic treatment in early life on clinical outcomes and establishment and development of the gut microbiota of term infants are limited. Disturbed microbiota composition is hypothesized to be an underlying mechanism of an aberrant development of the immune system. This study aims to investigate the potential clinical and microbial consequences of empiric antibiotic use in early life. 450 term born infants, of whom 150 are exposed to antibiotic treatment in early life and 300 are not (control group), are included in this observational cohort study with a one-year follow-up. Clinical outcomes, including coughing, wheezing, fever >38 °C, runny nose, glue ear, rash, diarrhea and >3 crying hours a day, are recorded daily by parents and examined by previously defined doctor's diagnosis. A blood sample is taken at closure to investigate the infant's vaccination response and sensitization for food and inhalant allergens. Fecal samples are obtained at eight time points during the first year of life. Potential differences in microbial profiles of infants treated with antibiotics versus healthy controls will be determined by use of 16S-23S rRNA gene analysis (IS-pro). Microbiota composition will be described by means of abundance, diversity and (dis)similarity. Diversity is calculated using the Shannon index. Dissimilarities between samples are calculated as the cosine distance between each pair of samples and analyzed with principal coordinate analysis. Clinical variables and possible associations are assessed by appropriate statistics. Both clinical quantitative and qualitative microbial effects of antibiotic treatment in early life may be demonstrated. These findings can be important, since there is evidence that manipulation of the infant microbiota by using pre- or probiotics can restore the ecological balance of the microbiota and may mitigate potential negative effects on the developing immune system, when use of antibiotics cannot be avoided. ClinicalTrials.gov NCT02536560. Registered 28 August 2015.

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

28 CFR 811.9 - Periodic verification of registration information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration information. (a) Sex offenders who are required to register for life must verify registration information quarterly pursuant to the procedures set forth in paragraph (d) of this section. (b) All other sex offenders...

Trends in United States Biological Materials Oversight and Institutional Biosafety Committees

ERIC Educational Resources Information Center

Jenkins, Chris

2014-01-01

Biological materials oversight in life sciences research in the United States is a challenging endeavor for institutions and the scientific, regulatory compliance, and federal communities. In order to assess biological materials oversight at Institutional Biosafety Committees (IBCs) registered with the United States National Institutes of Health,…

The Staff of Life.

ERIC Educational Resources Information Center

Jones, Rebecca

1994-01-01

Some children have chronic illnesses that require diet modifications as part of their medical treatment. Advises school districts to hire a registered dietitian or look for resources at a local hospital or public health office. In addition, schools should work with parents, improve staff training, and conduct spot checks of school cafeterias. (MLF)

Nurses' Needs for Education on Cancer and End-of-life Care.

ERIC Educational Resources Information Center

Meraviglia, Martha G.; McGuire, Catherine; Chesley, Dorothy A.

2003-01-01

From a random sample of Texas registered nurses, 352 respondents (8.3%) primarily obtained continuing education from workshops, inservice education, and independent studies, citing cost, location, content, and length of course as influencing factors. Their cancer educational needs included clinical trials, genetics, complementary therapies, and…

76 FR 63329 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... Electric Company (Diablo Canyon Nuclear Power Plant, Units 1 and 2), Applicant's Notice of Appeal, Brief in... on the Fuel Cycle Oversight Program (Public Meeting) (Contact: Margie Kotzalas, 301-492-3550) This... another format (e.g. braille, large print), please notify Bill Dosch, Chief, Work Life and Benefits Branch...

AACJC/Metropolitan Life Foundation Registered Nurse Shortage Project: Status Report.

ERIC Educational Resources Information Center

McKenney, James F.

The American Association of Community and Junior Colleges's Nurse Shortage Project was designed to alleviate the nurse shortage by helping community colleges improve recruitment, retention, and graduation in nursing programs through direct mini-grants, with a special emphasis on Tech Prep/Associate Degree initiatives between secondary schools and…

Nest size is predicted by female identity and the local environment in the blue tit (Cyanistes caeruleus), but is not related to the nest size of the genetic or foster mother

PubMed Central

Parker, Timothy H.; Griffith, Simon C.

2018-01-01

The potential for animals to respond to changing climates has sparked interest in intraspecific variation in avian nest structure since this may influence nest microclimate and protect eggs and offspring from inclement weather. However, there have been relatively few large-scale attempts to examine variation in nests or the determinates of individual variation in nest structure within populations. Using a set of mostly pre-registered analyses, we studied potential predictors of variation in the size of a large sample (803) of blue tit (Cyanistes caeruleus) nests across three breeding seasons at Wytham Woods, UK. While our pre-registered analyses found that individual females built very similar nests across years, there was no evidence in follow-up (post hoc) analyses that their nest size correlated to that of their genetic mother or, in a cross-fostering experiment, to the nest where they were reared. In further pre-registered analyses, spatial environmental variability explained nest size variability at relatively broad spatial scales, and especially strongly at the scale of individual nest boxes. Our study indicates that nest structure is a characteristic of individuals, but is not strongly heritable, indicating that it will not respond rapidly to selection. Explaining the within-individual and within-location repeatability we observed requires further study. PMID:29765658

The Danish Neuro-Oncology Registry: establishment, completeness and validity.

PubMed

Hansen, Steinbjørn; Nielsen, Jan; Laursen, René J; Rasmussen, Birthe Krogh; Nørgård, Bente Mertz; Gradel, Kim Oren; Guldberg, Rikke

2016-08-30

The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database completeness of patient registration and validity of data. The completeness of the number of patients registered in the database was evaluated in the study period from January 2009 through December 2014 by comparing cases reported to the DNOR with the Danish National Patient Registry and the Danish Pathology Registry. The data validity of important clinical variables was evaluated by a random sample of 100 patients from the DNOR using the medical records as reference. A total of 2241 patients were registered in the DNOR by December 2014 with an overall patient completeness of 92 %, which increased during the study period (from 78 % in 2009 to 96 % in 2014). Medical records were available for all patients in the validity analyses. Most variables showed a high agreement proportion (56-100 %), with a fair to good chance-corrected agreement (k = 0.43-1.0). The completeness of patient registration was very high (92 %) and the validity of the most important patient data was good. The DNOR is a newly established national database, which is a reliable source for future scientific studies and clinical quality assessments among patients with gliomas.

Mapping health outcome measures from a stroke registry to EQ-5D weights.

PubMed

Ghatnekar, Ola; Eriksson, Marie; Glader, Eva-Lotta

2013-03-07

To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n=272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for "dressing", "toileting", "mobility", "mood", "general health" and "proxy-responders" were applied to the validation set (n=272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥ 0.5 (P<0.01). This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility.

Care management role in end-of-life discussions.

PubMed

Meyer, Star

2012-01-01

How do we prepare our patients for decisions that will need to be made for end-of-life care? End-of-life care discussions should occur early on in the patient's disease process and often requires a great deal of coordination between multiple caregivers. There are also ethical, cultural social and spiritual considerations during this very important time in the disease process. Research suggests that we are not doing an adequate job of addressing end-of-life care with our patients and that a great deal of money and resources are being spent in the last days of life when there may be no clinical indication to do so. Registered nurse case managers have a unique knowledge base to serve in the role of coordinating care and leading the multidisciplinary care team in an effort to use resources responsibly while providing patients and families with options for end-of-life care.

Optimism as a predictor of health-related quality of life in psoriatics

PubMed Central

Miniszewska, Joanna; Chodkiewicz, Jan; Zalewska-Janowska, Anna

2013-01-01

Introduction Psoriasis is a chronic and relapsing disease which significantly affects the quality of life and social functioning of the affected people. It is one of the so-called psychodermatological diseases, which means that there exists a psychological component in the image of the disease. Aim To examine the relationship between health-related quality of life (HRQoL) in psoriatics and selected demographic, medical and psychological (dispositional optimism) variables and to determine the predictors of HRQoL in the examined group. Material and methods The study consisted of 138 patients with the diagnosis of psoriasis vulgaris. Most respondents (125) had psoriasis on exposed parts of the body. Methods used: SKINDEX, Life Orientation Test, PASI. Results The gender does not differentiate patients in terms of HRQoL and optimism. Almost all of analyzed variables correlate with HRQoL and all examined variables explain the results variability for overall HRQoL but only optimism explains the highest percentage of the variability (β = –0.35). Conclusions The study demonstrated a very interesting relationship – the stronger optimism the better quality of life in psoriatics. So, a generalized expectation of positive life events is related to better assessment of HRQoL. PMID:24278054

Coining and defining novel nursing terminology. Part 2: critical incident nursing intervention.

PubMed

Wong, Elizabeth

2008-01-01

In the second of a three-part series, a novel nursing terminology is introduced and proposed for inclusion in the Nursing Interventions Classification (NIC): Critical incident nursing intervention (CINI), defined as any indirect or direct care registered nurse-initiated treatment, based upon clinical judgment and knowledge that a registered nurse performs in response to a critical incident nursing diagnosis (CIND). A CIND is defined as recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication. The literature, research studies, meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing interventions in the NIC are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations. Coining and defining novel nursing terminology, CINI, for patient care during life-threatening situations is important and fills the gap in the current standardized nursing terminology. Refining the NIC will permit nursing researchers, among others, to conduct studies on nursing interventions in conjunction with the proposed novel nursing terminology, CINI. The first article in this series (Part 1) introduced the novel nursing terminology: CIND; the present article (Part 2) introduces the novel nursing terminology: CINI; and the third article in this series (Part 3) will introduce the novel nursing terminology: critical incident control.

Does Glycemic Variability Impact Mood and Quality of Life?

PubMed Central

Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-01-01

Abstract Background Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. Methods A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as “energy,” and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Results Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Conclusions Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life. PMID:22324383

Life-cycle modification in open oceans accounts for genome variability in a cosmopolitan phytoplankton.

PubMed

von Dassow, Peter; John, Uwe; Ogata, Hiroyuki; Probert, Ian; Bendif, El Mahdi; Kegel, Jessica U; Audic, Stéphane; Wincker, Patrick; Da Silva, Corinne; Claverie, Jean-Michel; Doney, Scott; Glover, David M; Flores, Daniella Mella; Herrera, Yeritza; Lescot, Magali; Garet-Delmas, Marie-José; de Vargas, Colomban

2015-06-01

Emiliania huxleyi is the most abundant calcifying plankton in modern oceans with substantial intraspecific genome variability and a biphasic life cycle involving sexual alternation between calcified 2N and flagellated 1N cells. We show that high genome content variability in Emiliania relates to erosion of 1N-specific genes and loss of the ability to form flagellated cells. Analysis of 185 E. huxleyi strains isolated from world oceans suggests that loss of flagella occurred independently in lineages inhabiting oligotrophic open oceans over short evolutionary timescales. This environmentally linked physiogenomic change suggests life cycling is not advantageous in very large/diluted populations experiencing low biotic pressure and low ecological variability. Gene loss did not appear to reflect pressure for genome streamlining in oligotrophic oceans as previously observed in picoplankton. Life-cycle modifications might be common in plankton and cause major functional variability to be hidden from traditional taxonomic or molecular markers.

Exploring sources of knowledge utilized in practice among Jordanian registered nurses.

PubMed

Al-Ghabeesh, Suhair Husni; Abu-Moghli, Fathieh; Salsali, Mahvash; Saleh, Mohammad

2013-10-01

Understanding sources of knowledge used in everyday practice is very helpful in improving the quality of health care services. There is a consensus in the literature that nurses mostly relied in their practice on experiential knowledge gained through their interactions with other members of health care professionals and patients. The general aim of this study is to explore the sources of knowledge Jordanian registered nurses use during their practice. A descriptive correlational design was used to collect data from 539 Jordanian registered nurses from 10 hospitals using a self-administered questionnaire. The mean year of experience of the sample was 7.08 years. Of the 615 questionnaires distributed, 555 were returned. This yields a response rate of 87.6%. Results revealed that the top five ranked sources used by Jordanian registered nurses include: the information that nurses learned during nursing education, personal experience in nursing over time, what was learned through providing care to patients, information gained through discussion between physicians and nurses about patients, and information from policy and procedure manuals. Jordanian registered nurses recognize the value of research and that research utilization (RU) is an important issue and must not be ignored. The study has many implications for practice, education and research. Health care managers and decision makers need to play a more visible and instrumental role in encouraging RU to improve patients' quality of life. © 2012 John Wiley & Sons Ltd.

The Austrian Toxoplasmosis Register, 1992-2008.

PubMed

Prusa, Andrea-Romana; Kasper, David C; Pollak, Arnold; Gleiss, Andreas; Waldhoer, Thomas; Hayde, Michael

2015-01-15

We aimed to determine the incidence of primary gestational infections with Toxoplasma gondii and congenital toxoplasmosis in Austria, a country with a nationwide prenatal serological screening program since 1974. We analyzed retrospective data from the Austrian Toxoplasmosis Register of pregnant women with Toxoplasma infection and their offspring with births between 1992 and 2008, identified by the prenatal mandatory screening program. Treatment was administered to women from diagnosis of a Toxoplasma infection until delivery. Infected infants were treated up to 1 year of life routinely. Clinical manifestations in infected infants were monitored at least for 1 year and documented in the register. The Austrian Toxoplasmosis Register included 2147 pregnant women with suspected Toxoplasma infection. Annually, 8.5 per 10 000 women acquired Toxoplasma infection during pregnancy, and 1.0 per 10 000 infants had congenital toxoplasmosis (13% mean transmission rate). Our data showed that women treated according to the Austrian scheme had a 6-fold decrease in the maternofetal transmission rate compared to women without treatment. Results from the Austrian Toxoplasmosis Register show the efficiency of the prenatal screening program. Our results are of clinical relevance for infants, healthcare systems, and policy makers to consider preventive Toxoplasma screening as a potential tool to reduce the incidence of congenital toxoplasmosis. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Socially disparate trends in lifespan variation: a trend study on income and mortality based on nationwide Danish register data.

PubMed

Brønnum-Hansen, Henrik

2017-05-17

Social inequality trends in life expectancy are not informative as to changes in social disparity in the age-at-death distribution. The purpose of the study was to investigate social differentials in trends and patterns of adult mortality in Denmark. Register data on income and mortality from 1986 to 2014 were used to investigate trends in life expectancy, life disparity and the threshold age that separates 'premature' and 'late' deaths. Mortality compression was quantified and compared between income quartiles. Since 1986, male life expectancy increased by 4.2 years for the lowest income quartile and by 8.4 years for the highest income quartile. The clear compression of mortality apparent in the highest income quartile did not occur for the lowest income quartile. Premature and late deaths accounted both by 2.1 years of the increase in life expectancy in the lowest income quartile and by 6.0 and 2.4 years, respectively, in the highest income quartile. Life expectancy increased by 5.2 years among women in the lowest income quartile, 2.4 years due to premature deaths and 2.8 years due to late deaths. The gain in life expectancy among women in the highest income quartile of 5.6 years was distributed by 5.0 and 0.6 years due to premature and late deaths, respectively. The study demonstrates that the increasing social gap in mortality appears differently in the change of the age-at-death distribution. Thus, no compression of mortality was seen in the lowest income quartile. The results do not provide support for a uniformly extension of pension age for all. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Onset of disability and life satisfaction: evidence from the German Socio-Economic Panel.

PubMed

Pagán-Rodríguez, Ricardo

2010-10-01

This paper analyses the effect of the onset of disability on the well-being of individuals. In particular, we are interested in studying whether people can adapt to disability over time after its onset. Using longitudinal data from the German Socio-Economic Panel (GSOEP) for the period 1984-2006, we estimate life satisfaction equations using a fixed-effects model for working-age males (aged 21-58). The results show that disability has a significant negative effect on life satisfaction, but, in time, hedonic adaptation will return disabled males to life satisfaction levels registered by those who have not become disabled. These findings contribute to supporting the idea within psychology literature that individuals bounce back from painful events or adversities (such as the onset of disability) to achieve initial life satisfaction scores.

Complete overdentures retained by mini implants: A systematic review.

PubMed

Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Batista, Victor Eduardo de Souza; Júnior, Joel Ferreira Santiago; Mello, Caroline Cantieri; Pellizzer, Eduardo Piza

2017-02-01

The purpose of this systematic review was to evaluate the use of mini implants to retain complete overdentures in terms of survival rates of mini implants, marginal bone loss, satisfaction, and quality of life. This report followed the PRISMA Statement and PICO question. This review has been registered at PROSPERO under the number CRD42016036141. Two independent reviewers performed a comprehensive search of studies published until September 2016 and listed in the PubMed/MEDLINE, Embase, and The Cochrane Library databases. The focused question was: is the use of mini implants feasible for prosthodontic rehabilitation with complete overdentures? The 24 studies selected for review evaluated 1273 patients whose mean age was 65.93 years; these patients had received 2494 mini implants and 386 standard implants for retaining overdenture prosthesis. The mean follow-up time was 2.48 years (range: 1-7 years). There was a higher survival rate of mini implants (92.32%). More frequent failures for maxillary (31.71%) compared with mandibular arches (4.89%). The majority of studies revealed marginal bone loss values similar to those of standard implants (<1.5mm). All studies verified an increase in satisfaction and quality of life after rehabilitation treatment with mini dental implants. The present systematic review indicates that the use of mini implants for retaining overdenture prosthesis is considered an alternative treatment when standard treatment is not possible, since it presents high survival rates, acceptable marginal bone loss, and improvements in variables related to satisfaction and quality of life. Based on the results of this study, the use of a minimum 4 and 6 mini implants can be considered a satisfactory treatment option for rehabilitation of the mandibular and maxillary arches respectively with a complete overdenture. Copyright © 2016. Published by Elsevier Ltd.

Effects of combined high-intensity aerobic interval training program and Mediterranean diet recommendations after myocardial infarction (INTERFARCT Project): study protocol for a randomized controlled trial.

PubMed

Maldonado-Martín, Sara; Jayo-Montoya, Jon Ander; Matajira-Chia, Tatiana; Villar-Zabala, Beatriz; Goiriena, Juan José; Aispuru, G Rodrigo

2018-03-02

Exercise therapy has long been used for rehabilitation purposes after myocardial infarction (MI) and the benefit of regular physical exercise is also well-established. High-intensity interval training (HIIT) has been proposed to be more effective than continuous exercise for improving exercise capacity and health-related adaptations to low-volume (LV) and HIIT are also known. Furthermore, the Mediterranean diet (Mediet) has been widely reported to be a model of healthy eating for its contribution to a favorable health status and a better quality of life, reducing overall mortality. This study will investigate the effects of different HIIT programs (high-volume [HV] vs LV) and Mediet recommendations in clinical condition, cardiorespiratory fitness, biomarkers, ventricular function, and perception of quality of life after MI, and compared to an attention control group that is recommended to Mediet and physical activity without supervision sessions. In this randomized controlled trial, cardiorespiratory fitness, anthropometry, central and peripheral cardiovascular variables, biochemical and nutritional condition, and quality of life will be assessed before and after 16 weeks of intervention in 177 participants diagnosed with MI type 1. All participants will be randomly (1:1:1) assigned to the attention control group or two exercise groups (Mediet recommendations plus supervised aerobic exercise two days/week: (1) HV (40 min) HIIT group and (2) LV (20 min) HIIT group. This study will be the first clinical trial comparing the effects of two different volumes of HIIT programs with Mediet recommendations for people after MI. The results of this study will provide good evidence for physical rehabilitation in this population. ClinicalTrials.gov, NCT02876952 . Registered on 24 August 2016.

Quality of life in young adults with cerebral palsy.

PubMed

Jiang, Benran; Walstab, Janet; Reid, Susan M; Davis, Elise; Reddihough, Dinah

2016-10-01

Little is known about the quality of life (QOL) of young adults with cerebral palsy. This cross-sectional analysis compares the QOL of a cohort of young Australian adults with CP with a cohort of able-bodied peers to explore the relationship between QOL and impairments, functioning, and social participation. Young adults identified from the Victorian Cerebral Palsy Register were invited to complete a survey about QOL, gross motor function, independence in self-care, and social participation. QOL was assessed with the Quality of Life Instrument for Young Adults (YAQOL). A general population sample of young North American adults, who had completed the YAQOL was selected for comparison. Surveys and consent forms were completed by 335 young adults or their proxies, an overall participation rate of 63% of those located. The mean age of the study participants was 24.7 [s.d = 2.8] years; 51% were male and 49% female. Two hundred and seven (62%) of the 335 participants self-reported their QOL. When compared with the general population sample, self-reporting participants had similar QOL scores for the social relationship and environmental context domains (p > 0.05), while QOL scores were lower for the physical health, psychological well-being, and role function domains (p < 0.001). There was no association between psychological well-being and variables related to body structure and gross motor function in young adults with CP. Contrary to the assumption that young adults with severe CP have low psychosocial well-being, it is apparent that these individuals can have good psychosocial well-being regardless of their disability. Copyright © 2016 Elsevier Inc. All rights reserved.

Family Aggregation and Risk Factors in Phobic Disorders over Three-Generations in a Nation-Wide Study

PubMed Central

Steinhausen, Hans-Christoph; Jakobsen, Helle; Meyer, Andrea; Jørgensen, Povl Munk; Lieb, Roselind

2016-01-01

Objective This nation-wide register-based study investigated how often phobic disorders (PHO) and co-morbid disorders occur in affected families compared to control families. Furthermore, the study addressed the impact of sex, year of birth, and degree of urbanization in terms of risk factors. Method A total of N = 746 child and adolescent psychiatric participants born between 1969 and 1986 and registered in the Danish Psychiatric Central Research Register (DPCRR) with a diagnosis of a mental disorder before the age of 18, and developed PHO at some point during their life-time until a maximum age of 40 years were included. In addition, N = 2229 controls without any diagnosis of mental disorders before age 18 and that were matched for age, sex, and residential region were included. Diagnoses of mental disorders were also obtained from the first- degree relatives as a part of the Danish Three Generation Study (3GS). A family load component was obtained by using various mixed regression models. Results PHO occurred significantly more often in case than in control families, in particular, in mothers and siblings. Substance use disorders (SUD), Depressive disorders (DEP), anxiety disorders (ANX) and personality disorders (PERS) in the family were significantly associated with specific phobia in the case-probands. After controlling for various mental disorders comorbid to PHO it was found that some of the family transmission could be caused by various other mental disorders in family members rather than the PHO itself. Female sex and more recent year of birth were further risk factors while region of residence was not related to the manifestation of PHO. Case-relatives did not develop PHO earlier than control relatives. After adjusting for various additional explanatory variables, the family load explained only 0.0013% of the variance in the manifestation of PHO in the case-probands Discussion These findings, based on a very large and representative dataset, provide evidence for the family aggregation and further risk factors in PHO. In contrast to anxiety disorders and other major mental disorders the family load of PHO in this nation-wide study was rather low. PMID:26785257

Family Aggregation and Risk Factors in Phobic Disorders over Three-Generations in a Nation-Wide Study.

PubMed

Steinhausen, Hans-Christoph; Jakobsen, Helle; Meyer, Andrea; Jørgensen, Povl Munk; Lieb, Roselind

2016-01-01

This nation-wide register-based study investigated how often phobic disorders (PHO) and co-morbid disorders occur in affected families compared to control families. Furthermore, the study addressed the impact of sex, year of birth, and degree of urbanization in terms of risk factors. A total of N = 746 child and adolescent psychiatric participants born between 1969 and 1986 and registered in the Danish Psychiatric Central Research Register (DPCRR) with a diagnosis of a mental disorder before the age of 18, and developed PHO at some point during their life-time until a maximum age of 40 years were included. In addition, N = 2229 controls without any diagnosis of mental disorders before age 18 and that were matched for age, sex, and residential region were included. Diagnoses of mental disorders were also obtained from the first- degree relatives as a part of the Danish Three Generation Study (3GS). A family load component was obtained by using various mixed regression models. PHO occurred significantly more often in case than in control families, in particular, in mothers and siblings. Substance use disorders (SUD), Depressive disorders (DEP), anxiety disorders (ANX) and personality disorders (PERS) in the family were significantly associated with specific phobia in the case-probands. After controlling for various mental disorders comorbid to PHO it was found that some of the family transmission could be caused by various other mental disorders in family members rather than the PHO itself. Female sex and more recent year of birth were further risk factors while region of residence was not related to the manifestation of PHO. Case-relatives did not develop PHO earlier than control relatives. After adjusting for various additional explanatory variables, the family load explained only 0.0013% of the variance in the manifestation of PHO in the case-probands. These findings, based on a very large and representative dataset, provide evidence for the family aggregation and further risk factors in PHO. In contrast to anxiety disorders and other major mental disorders the family load of PHO in this nation-wide study was rather low.

Embedded Literacy: Knowledge as Meaning

ERIC Educational Resources Information Center

Martin, J. R.

2013-01-01

This paper takes as point of departure the register variable field, and explores its application to the discourse of History and Biology in secondary school classrooms from the perspective of systemic functional linguistics. In particular it considers the functions of technicality and abstraction in these subject specific discourses, and their…

Heart position variability during voluntary moderate deep inspiration breath-hold radiotherapy for breast cancer determined by repeat CBCT scans.

PubMed

van Haaren, Paul; Claassen-Janssen, Fiere; van de Sande, Ingrid; Boersma, Liesbeth; van der Sangen, Maurice; Hurkmans, Coen

2017-08-01

Voluntary moderate deep inspiration breath hold (vmDIBH) in left-sided breast cancer radiotherapy reduces cardiac dose. The aim of this study was to investigate heart position variability in vmDIBH using CBCT and to compare this variability with differences in heart position between vmDIBH and free breathing (FB). For 50 patients initial heart position with respect to the field edge (HP-FE) was measured on a vmDIBH planning CT scan. Breath-hold was monitored using an in-house developed vertical plastic stick. On pre-treatment CBCT scans, heart position variability with respect to the field edge (Δ HP-FE ) was measured, reflecting heart position variability when using an offline correction protocol. After registering the CBCT scan to the planning CT, heart position variability with respect to the chest wall (Δ HP-CW ) was measured, reflecting heart position variability when using an online correction protocol. As a control group, vmDIBH and FB computed tomography (CT) scans were acquired for 30 patients and registering both scans on the chest wall. For 34 out of 50 patients, the average HP-FE and HP-CW increased over the treatment course in comparison to the planning CT. Averaged over all patients and all treatment fractions, the Δ HP-FE and the Δ HP-CW was 0.8±4.2mm (range -9.4-+10.6mm) and 1.0±4.4mm (range -8.3-+10.4mm) respectively. The average gain in heart to chest wall distance was 11.8±4.6mm when using vmDIBH instead of FB. In conclusion, substantial variability in heart position using vmDIBH was observed during the treatment course. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

An Exploratory Study of Resting Cardiac Rate and Variability from the Last Trimester of Prenatal Life Through the First Year of Postnatal Life

ERIC Educational Resources Information Center

Lewis, Michael; And Others

1970-01-01

The data indicate no relationship between maternal and fetal data. Moreover, there are clear developmental patterns of resting cardiac response over the first year of life, with rate and variability showing linear decreases. (Author/WY)

Quality of life for women after a myocardial infarction.

PubMed

Wingate, S

1995-01-01

To assess the level of quality of life and to determine the relationship of selected variables to quality of life in a sample of women after a myocardial infarction (MI). Ex post facto, one-group, correlational survey. Offices of cardiologists in private practice. Consecutive sample of 96 women who had a diagnosis of MI, and who had not undergone cardiac surgery. The mean quality of life score was 21.6. Significant variables in the regression equation were employment status (p < 0.01), social support (p < 0.01), and self-esteem (p = 0.04), and these three variables accounted for 45% of the variance in quality of life. The quality of life scores in this sample were higher than expected and similar to those of healthy populations. Those women in the sample who returned to their former employment status and had higher levels of social support and self-esteem had higher levels of quality of life.

Test Population Selection from Weibull-Based, Monte Carlo Simulations of Fatigue Life

NASA Technical Reports Server (NTRS)

Vlcek, Brian L.; Zaretsky, Erwin V.; Hendricks, Robert C.

2008-01-01

Fatigue life is probabilistic and not deterministic. Experimentally establishing the fatigue life of materials, components, and systems is both time consuming and costly. As a result, conclusions regarding fatigue life are often inferred from a statistically insufficient number of physical tests. A proposed methodology for comparing life results as a function of variability due to Weibull parameters, variability between successive trials, and variability due to size of the experimental population is presented. Using Monte Carlo simulation of randomly selected lives from a large Weibull distribution, the variation in the L10 fatigue life of aluminum alloy AL6061 rotating rod fatigue tests was determined as a function of population size. These results were compared to the L10 fatigue lives of small (10 each) populations from AL2024, AL7075 and AL6061. For aluminum alloy AL6061, a simple algebraic relationship was established for the upper and lower L10 fatigue life limits as a function of the number of specimens failed. For most engineering applications where less than 30 percent variability can be tolerated in the maximum and minimum values, at least 30 to 35 test samples are necessary. The variability of test results based on small sample sizes can be greater than actual differences, if any, that exists between materials and can result in erroneous conclusions. The fatigue life of AL2024 is statistically longer than AL6061 and AL7075. However, there is no statistical difference between the fatigue lives of AL6061 and AL7075 even though AL7075 had a fatigue life 30 percent greater than AL6061.

Test Population Selection from Weibull-Based, Monte Carlo Simulations of Fatigue Life

NASA Technical Reports Server (NTRS)

Vlcek, Brian L.; Zaretsky, Erwin V.; Hendricks, Robert C.

2012-01-01

Fatigue life is probabilistic and not deterministic. Experimentally establishing the fatigue life of materials, components, and systems is both time consuming and costly. As a result, conclusions regarding fatigue life are often inferred from a statistically insufficient number of physical tests. A proposed methodology for comparing life results as a function of variability due to Weibull parameters, variability between successive trials, and variability due to size of the experimental population is presented. Using Monte Carlo simulation of randomly selected lives from a large Weibull distribution, the variation in the L10 fatigue life of aluminum alloy AL6061 rotating rod fatigue tests was determined as a function of population size. These results were compared to the L10 fatigue lives of small (10 each) populations from AL2024, AL7075 and AL6061. For aluminum alloy AL6061, a simple algebraic relationship was established for the upper and lower L10 fatigue life limits as a function of the number of specimens failed. For most engineering applications where less than 30 percent variability can be tolerated in the maximum and minimum values, at least 30 to 35 test samples are necessary. The variability of test results based on small sample sizes can be greater than actual differences, if any, that exists between materials and can result in erroneous conclusions. The fatigue life of AL2024 is statistically longer than AL6061 and AL7075. However, there is no statistical difference between the fatigue lives of AL6061 and AL7075 even though AL7075 had a fatigue life 30 percent greater than AL6061.

Eight Years of Severe Allergic Reactions in Finland: A Register-Based Report

PubMed Central

2008-01-01

Background No data have been available on severe allergic reactions in Finland. Materials and Methods We summarize the data accumulated from 2000 to 2007 in the national register established at the Skin and Allergy Hospital of the Helsinki University Central Hospital, where physicians voluntarily report on patients with severe allergic reactions. Results During the period, the 530 reported cases of severe allergic reactions represented an annual frequency of 0.001%. Of the patients, 66% were adults and 56% were female, with a median age of 27 years. Food was the causative agent in 53% of the cases, drugs in 26%, allergen preparations in 12%, and insects in 8%. Dermatologic symptoms were reported in 85%, respiratory in 76%, cardiovascular in 50%, gastrointestinal in 33%, and eye/nose symptoms in 18%. The reaction was a life-threatening anaphylactic shock in 26% of the cases, with no deaths reported. Patients were treated with intramuscular adrenaline in 75% of the cases. Not only nuts and seeds, but also fruit and vegetables were the most important allergens for the adults. Nuts were also important allergens for children, along with milk, egg, and wheat. In addition, many "exotic" allergens were identified: patent blue, carmine dye, yeast, buckwheat, and macrogol. Conclusions Severe allergic reactions are underreported, but a register reflects the real-life situation and helps to identify new causative agents. It also contributes to improvements in first aid treatment practice. PMID:23282762

Switch of noninvasive ventilation (NIV) to continuous positive airway pressure (CPAP) in patients with obesity hypoventilation syndrome: a pilot study.

PubMed

Orfanos, Sarah; Jaffuel, Dany; Perrin, Christophe; Molinari, Nicolas; Chanez, Pascal; Palot, Alain

2017-03-14

Obesity is a major worldwide public health issue. The main respiratory complication stemming from obesity is obesity hypoventilation syndrome (OHS). Most of the OHS patients diagnosed during an exacerbation are treated with non invasive ventilation (NIV). Up to date, no prospective study has demonstrated in real life conditions the feasibility of a systematic protocoled switch of NIV to continuous positive airway pressure (CPAP), once stability is achieved. In this prospective study, we included stable patients with OHS, with moderate to severe concomitant obstructive sleep apnea (OSA) and without obstructive pulmonary disease, who had been undergoing NIV for more than 2 months. The following measurements were performed, first with NIV and then after the switch to CPAP: diurnal arterial blood gas measurements; nocturnal oximetry and capnometry; mean compliance and AHI; measures of quality of life and quality of sleep. 22/30 patients accepted to participate in the study and 15/22 patients completed the study. There were no significant differences for pooled data in diurnal alveolar blood gases, nocturnal capnometry (p = 0.534), nocturnal oximetry (p = 0.218), mean compliance (p = 0.766), mean AHI (p = 0.334), quality of life or quality of sleep. Eighty percent of the patients treated in this study favored CPAP over NIV. This pilot study showed in real life conditions the possibility of a systematic switch of NIV to CPAP, in most stable patients with OHS, with similar efficacy on diurnal and nocturnal alveolar gas exchange, quality of life and quality of sleep. ISRCTN13981084 . Registered: 27 February 2017 (retrospectively registered).

Use of Medications of Questionable Benefit During the Last Year of Life of Older Adults With Dementia.

PubMed

Morin, Lucas; Vetrano, Davide L; Grande, Giulia; Fratiglioni, Laura; Fastbom, Johan; Johnell, Kristina

2017-06-01

To investigate the prevalence and factors associated with the use of medications of questionable benefit throughout the final year of life of older adults who died with dementia. Register-based, longitudinal cohort study. Entire Sweden. All older adults (≥75 years) who died with dementia between 2007 and 2013 (n = 120,067). Exposure to medications of questionable benefit was calculated for each of the last 12 months before death, based on longitudinal data from the Swedish Prescribed Drug Register. The proportion of older adults with dementia who received at least 1 medication of questionable benefit decreased from 38.6% 12 months before death to 34.7% during the final month before death (P < .001 for trend). Among older adults with dementia who used at least 1 medication of questionable benefit 12 months before death, 74.8% remained exposed until their last month of life. Living in an institution was independently associated with a 15% reduction of the likelihood to receive ≥1 medication of questionable benefit during the last month before death (odds ratio 0.85, 95% confidence interval 0.88-0.83). Antidementia drugs accounted for one-fifth of the total number of medications of questionable benefit. Lipid-lowering agents were used by 8.3% of individuals during their final month of life (10.2% of community-dwellers and 6.6% of institutionalized people, P < .001). Clinicians caring for older adults with advanced dementia should be provided with reliable tools to help them reduce the burden of medications of questionable benefit near the end of life. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Eawag-Soil in enviPath: a new resource for exploring regulatory pesticide soil biodegradation pathways and half-life data.

PubMed

Latino, Diogo A R S; Wicker, Jörg; Gütlein, Martin; Schmid, Emanuel; Kramer, Stefan; Fenner, Kathrin

2017-03-22

Developing models for the prediction of microbial biotransformation pathways and half-lives of trace organic contaminants in different environments requires as training data easily accessible and sufficiently large collections of respective biotransformation data that are annotated with metadata on study conditions. Here, we present the Eawag-Soil package, a public database that has been developed to contain all freely accessible regulatory data on pesticide degradation in laboratory soil simulation studies for pesticides registered in the EU (282 degradation pathways, 1535 reactions, 1619 compounds and 4716 biotransformation half-life values with corresponding metadata on study conditions). We provide a thorough description of this novel data resource, and discuss important features of the pesticide soil degradation data that are relevant for model development. Most notably, the variability of half-life values for individual compounds is large and only about one order of magnitude lower than the entire range of median half-life values spanned by all compounds, demonstrating the need to consider study conditions in the development of more accurate models for biotransformation prediction. We further show how the data can be used to find missing rules relevant for predicting soil biotransformation pathways. From this analysis, eight examples of reaction types were presented that should trigger the formulation of new biotransformation rules, e.g., Ar-OH methylation, or the extension of existing rules, e.g., hydroxylation in aliphatic rings. The data were also used to exemplarily explore the dependence of half-lives of different amide pesticides on chemical class and experimental parameters. This analysis highlighted the value of considering initial transformation reactions for the development of meaningful quantitative-structure biotransformation relationships (QSBR), which is a novel opportunity offered by the simultaneous encoding of transformation reactions and corresponding half-lives in Eawag-Soil. Overall, Eawag-Soil provides an unprecedentedly rich collection of manually extracted and curated biotransformation data, which should be useful in a great variety of applications.

Honest, Open, Proud for adolescents with mental illness: pilot randomized controlled trial.

PubMed

Mulfinger, Nadine; Müller, Sabine; Böge, Isabel; Sakar, Vehbi; Corrigan, Patrick W; Evans-Lacko, Sara; Nehf, Luise; Djamali, Julia; Samarelli, Anna; Kempter, Michael; Ruckes, Christian; Libal, Gerhard; Oexle, Nathalie; Noterdaeme, Michele; Rüsch, Nicolas

2018-06-01

Due to public stigma or self-stigma and shame, many adolescents with mental illness (MI) struggle with the decision whether to disclose their MI to others. Both disclosure and nondisclosure are associated with risks and benefits. Honest, Open, Proud (HOP) is a peer-led group program that supports participants with disclosure decisions in order to reduce stigma's impact. Previously, HOP had only been evaluated among adults with MI. This two-arm pilot randomized controlled trial included 98 adolescents with MI. Participants were randomly assigned to HOP and treatment as usual (TAU) or to TAU alone. Outcomes were assessed pre (T0/baseline), post (T1/after the HOP program), and at 3-week follow-up (T2/6 weeks after T0). Primary endpoints were stigma stress at T1 and quality of life at T2. Secondary outcomes included self-stigma, disclosure-related distress, empowerment, help-seeking intentions, recovery, and depressive symptoms. The trial is registered on ClinicalTrials (NCT02751229; http://www.clinicaltrials.gov). Compared to TAU, adolescents in the HOP program showed significantly reduced stigma stress at T1 (d = .92, p < .001) and increased quality of life at T2 (d = .60, p = .004). In a longitudinal mediation model, the latter effect was fully mediated by stigma stress reduction at T1. HOP further showed significant positive effects on self-stigma, disclosure-related distress, secrecy, help-seeking intentions, attitudes to disclosure, recovery, and depressive symptoms. Effects at T1 remained stable or improved further at follow-up. In a limited economic evaluation HOP was cost-efficient in relation to gains in quality of life. As HOP is a compact three-session program and showed positive effects on stigma and disclosure variables as well as on symptoms and quality of life, it could help to reduce stigma's negative impact among adolescents with MI. © 2017 Association for Child and Adolescent Mental Health.

Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial

PubMed Central

Horst, Ferdinand; Den Oudsten, Brenda; Zijlstra, Wobbe; de Jongh, Ad; Lobbestael, Jill; De Vries, Jolanda

2017-01-01

Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL). Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and 3 months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-min sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3. Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive. Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients. Trial Registration: Dutch Trial Register, Nr. 3134 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3134 PMID:28868042

Patient-centered and clinical outcomes of mandibular overdentures retained with the locator system: A prospective observational study.

PubMed

Fernandez-Estevan, Lucia; Montero, Javier; Selva Otaolaurruchi, Eduardo J; Sola Ruiz, Fernanda

2017-03-01

Whether clinical or demographic variables affect the perception of treatment in terms of quality of life and satisfaction is unknown. The purpose of this prospective study was to make an evidence-based assessment of the treatment outcomes (patient- and clinically based) of locator-retained mandibular overdentures. This prospective observational study assessed patients with edentulism who had worn mandibular overdentures supported by 2 implants and retained by the locator system for at least 1 year of functional life (N=80). Medical histories were reviewed, and patients underwent oral examinations. Prosthetic clinical outcomes and patient well-being were registered using the Oral Health Impact Profile 20 (OHIP-20) and Oral Satisfaction Scale (OSS). Patient well-being scored an overall OHIP-20 score of 19.0 ±14.0 of 80 (the higher the score, the greater the impact and the worse the oral health-related quality of life); overall oral satisfaction was 8.3 ±1.7 of 10. Women suffered greater social impact (0.8 ±1.0) and disability (0.4 ±0.8) than men (0.4 ±0.7 versus 0.2 ±0.4, respectively). Impact on well-being was inversely proportional to both patient age and the age of the prosthesis (r=-0.25; P<.01). Implants had been placed on average 73.6 ±39.2 months previously, showing a survival rate of 82.5%. Most of the overdentures had been functioning for over 60 months. Relining (46.3%), readjustments (82.5%), and changes of nylon retention (1.5 ±1.8 per patient over 60 months of use) devices negatively influenced well-being. Mandibular overdentures produced good results with regard to quality of life and oral satisfaction, but attention should be paid to factors affecting clinical outcomes and patient well-being. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The health Oriented pedagogical project (HOPP) - a controlled longitudinal school-based physical activity intervention program.

PubMed

Fredriksen, Per Morten; Hjelle, Ole Petter; Mamen, Asgeir; Meza, Trine J; Westerberg, Ane C

2017-04-28

The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20 th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.

The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years

PubMed Central

Shapley, M; Blagojevic, M; Jordan, KP; Croft, PR

2012-01-01

Objective To obtain estimates of the rate of spontaneous resolution of heavy menstrual bleeding and to explore any association with specific menstrual symptoms. Design Two-year prospective cohort study. Setting Seven general practices, with 67 100 registered patients. Population All women aged 40–54 years on the practices age–sex registers. Methods Baseline postal questionnaire, with follow-up questionnaires sent to naturally menstruating respondents at 6, 12, 18 and 24 months. Main outcome measures Rate of spontaneous resolution of heavy menstrual bleeding in naturally menstruating women. Results A total of 7121 baseline questionnaires were sent out, with an initial response rate of 63%. We recruited 2051 naturally menstruating women for the prospective cohort study. The spontaneous rate of resolution of heavy menstrual bleeding varied from 8.1% (95% CI 5.3–12%) in women aged 45–49 years, who had resolution without recurrence for 24 months, to 35% (95% CI 30–41%) in women aged 50–54 years, who had resolution without recurrence for 6 months. Rates were lower in those who reported interference with life from heavy menstrual bleeding. There was a strong association between the spontaneous resolution of heavy menstrual bleeding and skipped periods in women aged over 45 years. The association with ‘cycle too variable to say’ was significant, but weaker. Conclusion There is a high prevalence, incidence and significant spontaneous rate of resolution of heavy menstrual bleeding in naturally menstruating women during the perimenopausal years. The rates have potential use for individual women, clinical decisions, devising and implementing interventions and planning the care of populations. Please cite this paper as: Shapley M, Blagojevic M, Jordan K, Croft P. The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years. BJOG 2012;119:545–553. PMID:22313942

Longitudinal Associations between Physical Activity and Educational Outcomes.

PubMed

Kari, Jaana T; Pehkonen, Jaakko; Hutri-Kähönen, Nina; Raitakari, Olli T; Tammelin, Tuija H

2017-11-01

This longitudinal study examined the role of leisure-time physical activity in academic achievement at the end of compulsory basic education and educational attainment in adulthood. The data were drawn from the ongoing longitudinal Cardiovascular Risk in Young Finns Study, which was combined with register-based data from Statistics Finland. The study consisted of children who were 12 yr (n = 1723, 49% boys) and 15 yr (n = 2445, 48% boys) of age at the time when physical activity was measured. The children were followed up until 2010, when their mean age was 40 yr. Physical activity was self-reported and included several measurements: overall leisure-time physical activity outside school hours, participation in sports club training sessions, and participation in sports competitions. Individuals' educational outcomes were measured with the self-reported grade point average at age 15 yr and register-based information on the years of completed postcompulsory education in adulthood. Ordinary least squares models and the instrumental variable approach were used to analyze the relationship between physical activity and educational outcomes. Physical activity in adolescence was positively associated with educational outcomes. Both the physical activity level at age 15 yr and an increase in the physical activity level between the ages of 12 and 15 yr were positively related to the grade point average at age 15 yr and the years of postcompulsory education in adulthood. The results were robust to the inclusion of several individual and family background factors, including health endowments, family income, and parents' education. The results provide evidence that physical activity in adolescence may not only predict academic success during compulsory basic education but also boost educational outcomes later in life.

Longitudinal Associations between Physical Activity and Educational Outcomes

PubMed Central

KARI, JAANA T.; PEHKONEN, JAAKKO; HUTRI-KÄHÖNEN, NINA; RAITAKARI, OLLI T.; TAMMELIN, TUIJA H.

2017-01-01

ABSTRACT Purpose This longitudinal study examined the role of leisure-time physical activity in academic achievement at the end of compulsory basic education and educational attainment in adulthood. Methods The data were drawn from the ongoing longitudinal Cardiovascular Risk in Young Finns Study, which was combined with register-based data from Statistics Finland. The study consisted of children who were 12 yr (n = 1723, 49% boys) and 15 yr (n = 2445, 48% boys) of age at the time when physical activity was measured. The children were followed up until 2010, when their mean age was 40 yr. Physical activity was self-reported and included several measurements: overall leisure-time physical activity outside school hours, participation in sports club training sessions, and participation in sports competitions. Individuals’ educational outcomes were measured with the self-reported grade point average at age 15 yr and register-based information on the years of completed postcompulsory education in adulthood. Ordinary least squares models and the instrumental variable approach were used to analyze the relationship between physical activity and educational outcomes. Results Physical activity in adolescence was positively associated with educational outcomes. Both the physical activity level at age 15 yr and an increase in the physical activity level between the ages of 12 and 15 yr were positively related to the grade point average at age 15 yr and the years of postcompulsory education in adulthood. The results were robust to the inclusion of several individual and family background factors, including health endowments, family income, and parents’ education. Conclusion The results provide evidence that physical activity in adolescence may not only predict academic success during compulsory basic education but also boost educational outcomes later in life. PMID:29045322

Therapeutic touch for healing acute wounds.

PubMed

O'Mathúna, Dónal P; Ashford, Robert L

2014-07-29

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications. To identify and review all relevant data to determine the effects of TT on healing acute wounds. In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria. No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias. There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds.

PubMed

O'Mathúna, Dónal P

2016-08-23

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications. To identify and review all relevant data to determine the effects of TT on healing acute wounds. In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria. No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias. There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds.

PubMed

O'Mathúna, Dónal P; Ashford, Robert L

2012-06-13

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications. To identify and review all relevant data to determine the effects of TT on healing acute wounds. For this fourth update, we searched The Cochrane Wounds Group Specialised Register (searched 27 January 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1); Ovid MEDLINE (2010 to January Week 2 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, January 26, 2012); Ovid EMBASE (2010 to 2012 Week 03); and EBSCO CINAHL (2010 to January 6 2012). All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria. No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias. There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds.

PubMed

O'Mathúna, Dónal P

2016-05-03

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications. To identify and review all relevant data to determine the effects of TT on healing acute wounds. In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria. No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias. There is no robust evidence that TT promotes healing of acute wounds.

Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study.

PubMed

Gauffin, Karl; Vinnerljung, Bo; Fridell, Mats; Hesse, Morten; Hjern, Anders

2013-08-01

To investigate whether socio-economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. Register study in a Swedish national cohort born 1973-88 (n = 1,405,763), followed from age 16 to 20-35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio-demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than -1 standard deviation and/or no grades in core subjects. School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76-5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20-2.37) compared with the highest stratum as the reference, when adjusted for other socio-demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19-1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13-4.31). School failure and childhood socio-economic status predict illicit drug abuse independently in youth and young adults in Sweden. © 2013 Society for the Study of Addiction.

Placement matching of alcohol-dependent patients based on a standardized intake assessment: rationale and design of a randomized controlled trial.

PubMed

Buchholz, Angela; Friedrichs, Anke; Berner, Michael; König, Hans-Helmut; Konnopka, Alexander; Kraus, Ludwig; Kriston, Levente; Küfner, Heinrich; Piontek, Daniela; Rist, Fred; Röhrig, Jeanette

2014-10-14

Despite considerable research on substance-abuse placement matching, evidence is still inconclusive. The aims of this exploratory trial are to evaluate (a) the effects of following matching guidelines on health-care costs and heavy drinking, and (b) factors affecting the implementation of matching guidelines in the treatment of alcohol-dependent patients. A total of 286 alcohol-dependent patients entering one of four participating detoxification units and having no arrangements for further treatment will be recruited. During the first week of treatment, all patients will be administered Measurements in the Addictions for Triage and Evaluation (MATE), European Quality of Life-Five Dimensions health status questionnaire (EQ-5D), and the Client Socio--Demographic and Service Receipt Inventory-European Version (CSSRI-EU). Patients who are randomly allocated to the intervention group will receive feedback regarding their assessment results, including clear recommendations for subsequent treatment. Patients of the control group will receive treatment as usual and, if requested, global feedback regarding their assessment results, but no recommendations for subsequent treatment. At discharge, treatment outcome and referral decisions will be recorded. Six months after discharge, patients will be administered MATE-Outcome, EQ-5D, and CSSRI-EU during a telephone interview. This trial will provide evidence on the effects and costs of using placement-matching guidelines based on a standardized assessment with structured feedback in the treatment of alcohol-dependent patients. A process evaluation will be conducted to facilitate better understanding of the relationship between the use of guidelines, outcomes, and potential mediating variables. German Clinical Trials Register DRKS00005035. Registered 03 June 2013.

EVALUATION OF SPERM CHROMATIN STRUCTURE ASSAY (SCSA REGISTERED TRADEMARK) IN HUMAN SPERM AFTER SIMULATED OVERNIGHT SHIPMENT

EPA Science Inventory

Home semen collection kits allow men to collect a sample at their convenience and send it via overnight mail to the laboratory. Benefits of this approach include facilitated sample collection from different geographic locations, minimized variability through analysis by a central...

Nurses' workplace distress and ethical dilemmas in Tanzanian health care.

PubMed

Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro

2008-07-01

The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.

Conformational switching in the coiled-coil domains of a proteasomal ATPase regulates substrate processing.

PubMed

Snoberger, Aaron; Brettrager, Evan J; Smith, David M

2018-06-18

Protein degradation in all domains of life requires ATPases that unfold and inject proteins into compartmentalized proteolytic chambers. Proteasomal ATPases in eukaryotes and archaea contain poorly understood N-terminally conserved coiled-coil domains. In this study, we engineer disulfide crosslinks in the coiled-coils of the archaeal proteasomal ATPase (PAN) and report that its three identical coiled-coil domains can adopt three different conformations: (1) in-register and zipped, (2) in-register and partially unzipped, and (3) out-of-register. This conformational heterogeneity conflicts with PAN's symmetrical OB-coiled-coil crystal structure but resembles the conformational heterogeneity of the 26S proteasomal ATPases' coiled-coils. Furthermore, we find that one coiled-coil can be conformationally constrained even while unfolding substrates, and conformational changes in two of the coiled-coils regulate PAN switching between resting and active states. This switching functionally mimics similar states proposed for the 26S proteasome from cryo-EM. These findings thus build a mechanistic framework to understand regulation of proteasome activity.

77 FR 59202 - Center for Scientific Review Amended; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review... Federal Register on September 6, 2012, FR 77 54921-54922. The meeting title has been changed to ``Health Issues Across the Life Span''. The meeting is closed to the public. Dated: September 19, 2012. David...

Wittgenstein's "Relativity": Training in Language-Games and Agreement in "Forms of Life"

ERIC Educational Resources Information Center

Stickney, Jeff

2008-01-01

Taking Wittgenstein's love of music as my impetus, I approach aporetic problems of epistemic relativity through a round of three overlapping (canonical) inquiries delivered in contrapuntal (higher and lower) registers. I first take up the question of scepticism surrounding "groundless knowledge" and contending paradigms in "On Certainty" (physics…

Best Consumer Health Books of 2007

ERIC Educational Resources Information Center

Bibel, Barbara

2008-01-01

Strategies to fix America's ailing health-care system seemed to fly off the presses every month in 2007. Doctors, journalists, and policymakers clamored to have their say, as did supporters and opponents of the controversial life-extension movement. These top trends, which registered in 2006 as well, and will only balloon in this election year,…

75 FR 28463 - Airworthiness Directives; BAE SYSTEMS (Operations) Limited Model BAe 146 Airplanes and Model Avro...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... Section (ALS) of the Instructions for Continued Airworthiness to incorporate life limits for certain items... proposed to continue to require revising the Airworthiness Limitations Section (ALS) of the Instructions... Cost per U.S.- Action Work hours labor rate Parts airplane registered Fleet cost per hour airplanes ALS...

75 FR 13800 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-23

..., Assessment of Debris Accumulation on Pressurized Water Reactor (PWR) Sump Performance (Public Meeting..., 2010. Week of April 26, 2010--Tentative Thursday, April 29, 2010 9:30 a.m. Briefing on the Fuel Cycle... and Work Life Branch, at 301-492-2230, TDD: 301-415-2100, or by e-mail at [email protected

76 FR 44624 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

...) (Tentative) Final Rule: Definition of Construction in 10 CFR Parts 30, 36, 39, 40, 51, 70, and 150 (Tentative... public meetings in another format (e.g. braille, large print), please notify Bill Dosch, Chief, Work Life... (301-415-1969), or send an e-mail to [email protected] . Dated: July 21, 2011. Rochelle C. Bavol...

Effect of occupational mobility and health status on life satisfaction of Chinese residents of different occupations: logistic diagonal mobility models analysis of cross-sectional data on eight Chinese provinces.

PubMed

Liang, Ying; Lu, Peiyi

2014-02-08

Life satisfaction research in China is in development, requiring new perspectives for enrichment. In China, occupational mobility is accompanied by changes in economic liberalization and the emergence of occupational stratification. On the whole, however, occupational mobility has rarely been used as an independent variable. Health status is always used as the observed or dependent variable in studies of the phenomenon and its influencing factors. A research gap still exists for enriching this field. The data used in this study were obtained from the China Health and Nutrition Survey (CHNS). The study included nine provinces in China. The survey was conducted from 1989 to 2009.Every survey involved approximately 4400 families or 19,000 individual samples and parts of community data. First, we built a 5 × 5 social mobility table and calculated life satisfaction of Chinese residents of different occupations in each table. Second, gender, age, marital status, education level, annual income and hukou, health status, occupational mobility were used as independent variables. Lastly, we used logistic diagonal mobility models to analyze the relationship between life satisfaction and the variables. Model 1 was the basic model, which consisted of the standard model and controlled variables and excluded drift variables. Model 2 was the total model, which consisted of all variables of interest in this study. Model 3 was the screening model, which excluded the insignificant drift effect index in Model 2. From the perspective of the analysis of controlled variables, health conditions, direction, and distance of occupational mobility significantly affected life satisfaction of Chinese residents of different occupations. (1) From the perspective of health status, respondents who have not been sick or injured had better life satisfaction than those who had been sick or injured. (2) From the perspective of occupational mobility direction, the coefficients of occupational mobility in the models are less than 0, which means that upward mobility negatively affects life satisfaction. (3) From the perspective of distance, when analyzing mobility distance in Models 2 and 3, a greater distance indicates better life satisfaction.

Effect of occupational mobility and health status on life satisfaction of Chinese residents of different occupations: logistic diagonal mobility models analysis of cross-sectional data on eight Chinese provinces

PubMed Central

2014-01-01

Background Life satisfaction research in China is in development, requiring new perspectives for enrichment. In China, occupational mobility is accompanied by changes in economic liberalization and the emergence of occupational stratification. On the whole, however, occupational mobility has rarely been used as an independent variable. Health status is always used as the observed or dependent variable in studies of the phenomenon and its influencing factors. A research gap still exists for enriching this field. Methods The data used in this study were obtained from the China Health and Nutrition Survey (CHNS). The study included nine provinces in China. The survey was conducted from 1989 to 2009.Every survey involved approximately 4400 families or 19,000 individual samples and parts of community data. Results First, we built a 5 × 5 social mobility table and calculated life satisfaction of Chinese residents of different occupations in each table. Second, gender, age, marital status, education level, annual income and hukou, health status, occupational mobility were used as independent variables. Lastly, we used logistic diagonal mobility models to analyze the relationship between life satisfaction and the variables. Model 1 was the basic model, which consisted of the standard model and controlled variables and excluded drift variables. Model 2 was the total model, which consisted of all variables of interest in this study. Model 3 was the screening model, which excluded the insignificant drift effect index in Model 2. Conclusion From the perspective of the analysis of controlled variables, health conditions, direction, and distance of occupational mobility significantly affected life satisfaction of Chinese residents of different occupations. (1) From the perspective of health status, respondents who have not been sick or injured had better life satisfaction than those who had been sick or injured. (2) From the perspective of occupational mobility direction, the coefficients of occupational mobility in the models are less than 0, which means that upward mobility negatively affects life satisfaction. (3) From the perspective of distance, when analyzing mobility distance in Models 2 and 3, a greater distance indicates better life satisfaction. PMID:24506976

Cognitive and Life Event Correlates of Depressive Symptoms in Children.

ERIC Educational Resources Information Center

Mullins, Larry L.; And Others

The present study examines the relationship of various cognitive and life event variables to depressive symptoms in children. The variables studied are locus of control, interpersonal and impersonal problem-solving ability, and objective and subjective life stress. Subjects were 47 students in the fourth grade, 58 students in the fifth grade, and…

The role of marriage in the causal pathway from economic conditions early in life to mortality.

PubMed

van den Berg, Gerard J; Gupta, Sumedha

2015-03-01

This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity. Results show that conditions around birth and school going ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage, whereas women suffer during childbearing ages. However, having been born under favorable economic conditions reduces female mortality during childbearing ages. Copyright © 2014 Elsevier B.V. All rights reserved.

Influence of fatigue, depression, and demographic, socioeconomic, and clinical variables on quality of life of patients with epilepsy.

PubMed

Senol, Vesile; Soyuer, Ferhan; Arman, Fehim; Oztürk, Ahmet

2007-02-01

The purpose of this study was to define the influence of fatigue, depression, and clinical, demographic, and socioeconomic factors on the quality of life of patients with epilepsy. The study was performed on 103 adult patients who visited Erciyes University Epilepsy Outpatient Clinic between 2004 and 2005. Patients were evaluated with the Form of Negotiation, Quality of Life in Epilepsy Inventory (QOLIE-89), Beck Depression Inventory, and Fatigue Severity Scale. Mean age of the patients was 34.3+/-12.6, and mean duration of disease was 12.6+/-9.3 years. Among these patients, 52.4% were men, 49.5% were married, 15.5% had a university education, 53.4% had low incomes, 45.6% had generalized seizures, and 35.0% had experienced one or more seizures per month during the preceding year. The most significant variables in the domain of Overall quality of life were seizure frequency (P<0.001), depression (P<0.001), and fatigue (P<0.001); the variables in the domain of Mental Health were seizure frequency (P<0.001) and fatigue (P<0.001); the variable in the Cognitive domain was fatigue (P<0.001); the variables in the domain of Physical Health were social insurance coverage (P<0.01), fatigue (P<0.01), and age (P<0.01); the variables in the Epilepsy Targeted domain were depression (P<0.001), seizure frequency (P<0.001), and fatigue (P<0.01). Although quality of life has multiple determinants, seizure frequency, fatigue, and depression are the most important factors affecting quality of life in patients with epilepsy. One or more seizures per month, severe fatigue, and depression are associated with lower quality of life in some but not all domains. Partial correlations demonstrated that fatigue was a significant independent predictor of quality of life. The present study confirms that fatigue can be a powerful predictor of quality of life.

Human Pharmacology of Mephedrone in Comparison with MDMA.

PubMed

Papaseit, Esther; Pérez-Mañá, Clara; Mateus, Julián-Andrés; Pujadas, Mitona; Fonseca, Francina; Torrens, Marta; Olesti, Eulàlia; de la Torre, Rafael; Farré, Magí

2016-10-01

Mephedrone (4-methylmethcathinone) is a novel psychoactive substance popular among drug users because it displays similar effects to MDMA (3,4-methylenedioxymethamphetamine, ecstasy). Mephedrone consumption has been associated with undesirable effects and fatal intoxications. At present, there is no research available on its pharmacological effects in humans under controlled and experimental administration. This study aims to evaluate the clinical pharmacology of mephedrone and its relative abuse liability compared with MDMA. Twelve male volunteers participated in a randomized, double-blind, crossover, and placebo-controlled trial. The single oral dose conditions were: mephedrone 200 mg, MDMA 100 mg, and placebo. Outcome variables included physiological, subjective, and psychomotor effects, and pharmacokinetic parameters. The protocol was registered in ClinicalTrials.gov (NCT02232789). Mephedrone produced a significant increase in systolic and diastolic blood pressure, heart rate, and pupillary diameter. It elicited stimulant-like effects, euphoria, and well-being, and induced mild changes in perceptions with similar ratings to those observed after MDMA administration although effects peaked earlier and were shorter in duration. Maximal plasma concentration values for mephedrone and MDMA peaked at 1.25 h and 2.00 h, respectively. The elimination half-life for mephedrone was 2.15 h and 7.89 h for MDMA. In a similar manner to MDMA, mephedrone exhibits high abuse liability. Its earlier onset and shorter duration of effects, probably related to its short elimination half-life, could explain a more compulsive pattern of use as described by the users.

A population-level study of place of death and associated factors in Sweden.

PubMed

Håkanson, Cecilia; Öhlén, Joakim; Morin, Lucas; Cohen, Joachim

2015-11-01

The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care. This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics. The results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70-0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death. The majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life. © 2015 the Nordic Societies of Public Health.

[Incidence of haematological neoplasms in Castilla y León, Spain].

PubMed

Rodríguez-García, José Antonio; Vázquez, Lourdes; Ramos, Fernando; Cuevas, Beatriz; Martín, Alejandro; Smucler, Alicia; Guerola, Dulce Nombre; Cantalapiedra, Alberto; Alonso, José María; Fernández, Silvia; Díez, Eva; Rodríguez, María Jesús; Calmuntia, María José; Aguilar, Carlos; Sierra, Magdalena; Gracia, José Antonio; Cebeira, María José; Cantalejo, Rosa

2015-06-08

We aimed to assess the incidence of haematological neoplasms (HNs) in Castilla y León (2,5 million inhabitants) and its distribution by age, gender and histological type. The epidemiological profile based on the described variables of the 10,943 HNs diagnosed during a 10-years period was analyzed, compared with other studies. The overall age-adjusted incidence was 29.4 cases/10(5) inhabitants-year, with some geographical differences. The mean age was 67.3 years, with a turning point between the 6th-7th decades of life from which there was a very significant increase of incidence. Two relevant facts where simultaneous with advancing age: decreased lymphoid neoplasms incidence and increased low degree neoplasms incidence. Lymphoid low degree neoplasms accounted for half of the registered processes, showed the greatest preference for male and reached the mode before the rest of neoplasms. Myeloid neoplasms incidence (9.5) was higher than that reported in other European registries, specially compared to southern European countries, opposite to lymphoid neoplasms incidence (20.0). A higher myeloid neoplasms incidence and lower lymphoid one than expected was observed. The turning point of incidence is between the 6th-7th decades of life, with a preference for male that decreases with age. There is an increased incidence of HNs in the area where a higher density of potentially polluting facilities is concentrated. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Reduced work/academic performance and quality of life in patients with allergic rhinitis and impact of allergen immunotherapy.

PubMed

Roger, A; Arcalá Campillo, E; Torres, M C; Millan, C; Jáuregui, I; Mohedano, E; Liñan, S; Verdu, P; Rubira, N; Santaolalla, M; González, P; Orovitg, A; Villarrubia, E

2016-01-01

Allergic rhinitis (AR) is characterised by burdensome nasal and/or ocular symptoms. This inflammatory disease can be debilitating and thus result in considerable health-related and economic consequences. In a cross-sectional study, adult subjects with AR (N = 683) completed three allergy-specific questionnaires that assessed the impact of AR on the work/academic performance, daily activities, health-related quality of life (HRQOL), and satisfaction with allergen immunotherapy (AIT). Regression analyses were used to examine the associations between several clinical variables and the patient-reported outcomes. Total loss of productivity was 21.0 and 21.2 % for employed and student patients, respectively, whereas the impairment of daily activities was 22.0 %. The mean overall HRQOL score was 1.94 ± 1.29 (on the scale of 0-6 points). Global score for satisfaction with AIT was 65.5 ± 24.8 (on a 0-100 scale). Simple regression analysis found statistically significant associations between loss of work and academic productivity, impairment of daily activities and the type and severity of AR. AIT was a protective factor. The persistent and more severe types of AR and lack of AIT contributed to the worsening of HRQOL. AR (the persistent and more severe form of the disease) has an impact on functional characteristics of adult patients in Spain. AIT might reduce the effect of this disease on the work/academic performance and HRQOL. Trial registration Retrospectively registered.

[Lower urinary tract symptoms in women and impact on quality of life. Results of the application of the King's Health Questionnaire].

PubMed

Espuña Pons, M; Puig Clota, M

2006-01-01

The self-assessment of quality of life (QoL) of women with urinary symptoms may help in selecting the best treatment in each case. Epidemiologic, observational, cross-sectional and multicentric study of 674 women who underwent to a gynecology unit with symptoms suggesting Overactive Bladder, with or without urinary incontinence (UI). All women fill out the King's Health Questionnaire. Sociodemographic data and a complete register of urinary symptoms and the degree of afectation which caused, were also collected. Most frequent symptoms were "frequency" (612 women-90.8%), followed by "urgency" (562-83.4%), "nocturia" (543-80.6%) and "stres UI" (535-79.4%). Symptoms of "frecuency", "nocturia", "urgency" and "urgency UI" were more frequent in women aged 65 or under 65 years and that of "stress UI", in women over 65 years (79.8% vs 77.9%). 210 women did not fill out all the KHQ dimensions, mainly "Personal Limitations", "Personal Relationship", "Social limitations" and "Incontinence Impact". Global KHQ score was38.3 (SD=19.2). Higher scores (worse QoL) corresponded to "Incontinence Impact", "Severity Measures", "Personal Limitations" and "Role Limitations". Variables associated to global KHQ score were (multiple linear regression): age, BMI, urgency UI, UI in sexual intercourse, frequent urinary infections. QoL impact in women with urinary symptoms is important. The symptoms with higher association with QoL are: UI in sexual intercourse, urgency UI and frequent urinary infections.

Examination of socio-demographics and job satisfaction in Australian registered nurses.

PubMed

Reid, Carol; Hurst, Cameron; Anderson, Debra

2013-01-01

The results of the few studies found investigating relationships between sociodemographic variables and job satisfaction in nurses are mixed. Nevertheless some evidence exists which indicates that some socio-demographic variables are related to nurses' job satisfaction. Moreover reports indicate that job satisfaction is Linked to the retention of nurses. Relationships between socio-demographics and job satisfaction of Australian nurses are examined in the current study. To examine relationships between socio-demographic factors and job satisfaction and identify if these factors predicted job satisfaction Levels in Australian nurses. A cross sectional survey was conducted of 2000 Australian registered nurses who were at the time members of an industrial and professional organisation. The nurses were randomised and stratified according to gender and were asked to answer questions on a socio-demographic questionnaire developed by the researcher. The majority of respondents showed positive job satisfaction scores. Pearson's correlation coefficients (r) found the covariates age, years of experience and years in current job were all moderately to highly positively correlated with each other (all r > 0.40, p < 0.001), however there were no significant interactions between these covariates and Job Satisfaction. Multivariable analysis found significant positive relationships existed between job satisfaction, specialty area and health sector. Specialty area and health sector showed significant associations with job satisfaction in nurses. These variables should be considered by governments, nursing, organisational leaders and policy makers when developing future policies and strategies aimed at retention. These variables should be investigated further in relation to nursing job satisfaction.

Cardiovascular disease in Adult Life after Childhood Cancer in Scandinavia: A population-based cohort study of 32,308 one-year survivors.

PubMed

Gudmundsdottir, Thorgerdur; Winther, Jeanette F; de Fine Licht, Sofie; Bonnesen, Trine G; Asdahl, Peter H; Tryggvadottir, Laufey; Anderson, Harald; Wesenberg, Finn; Malila, Nea; Hasle, Henrik; Olsen, Jørgen H

2015-09-01

The lifetime risk for cardiovascular disease in a large cohort of childhood cancer survivors has not been fully assessed. In a retrospective population-based cohort study predicated on comprehensive national health registers, we identified a cohort of 32,308 one-year survivors of cancer diagnosed before the age of 20 in the five Nordic countries between the start of cancer registration in the 1940s and 1950s to 2008; 211,489 population comparison subjects were selected from national population registers. Study subjects were linked to national hospital registers, and the observed numbers of first hospital admission for cardiovascular disease among survivors were compared with the expected numbers derived from the population comparison cohort. Cardiovascular disease was diagnosed in 2,632 childhood cancer survivors (8.1%), yielding a standardized hospitalization rate ratio (RR) of 2.1 (95% CI 2.0-2.2) and an overall absolute excess risk (AER) of 324 per 100,000 person-years. At the end of follow-up 12% of the survivors were ≥ 50 years of age and 4.5% ≥ 60 years of age. Risk estimates were significantly increased throughout life, with an AER of ∼500-600 per 100,000 person-years at age ≥ 40. The highest relative risks were seen for heart failure (RR, 5.2; 95% CI 4.5-5.9), valvular dysfunction (4.6; 3.8-5.5) and cerebrovascular diseases (3.7; 3.4-4.1). Survivors of hepatic tumor, Hodgkin lymphoma and leukemia had the highest overall risks for cardiovascular disease, although each main type of childhood cancer had increased risk with different risk profiles. Nordic childhood cancer survivors are at markedly increased risk for cardiovascular disorders throughout life. These findings indicate the need for preventive interventions and continuous follow-up for this rapidly growing population. © 2015 UICC.

Serious delinquency and later schizophrenia: A nationwide register-based follow-up study of Finnish pretrial 15- to 19-year-old offenders sent for a forensic psychiatric examination.

PubMed

Lindberg, N; Miettunen, J; Heiskala, A; Kaltiala-Heino, R

2017-07-01

Aggressive and disruptive behaviors often precede the onset of schizophrenia. In this register-based follow-up study with a case-control design, we wanted to investigate if serious delinquency was associated with future diagnoses of schizophrenia or schizoaffective disorder (here, broadly defined schizophrenia) among a nationwide consecutive sample of 15- to 19-year-old Finnish delinquents sent for a forensic psychiatric examination in 1989-2010. The sample comprised 313 delinquents with no past or current psychotic disorder. For each delinquent, four age-, gender- and place of birth -matched controls were randomly selected from the Central Population Register. Five controls (0.4%) had been treated for schizophrenia before their respective index-dates and were thus excluded from further analysis, leaving us with a control population of 1247 individuals. The subjects were followed till death, emigration or the end of 2015, whichever occurred first. Diagnoses were obtained from the Care Register for Health Care. Forty (12.8%) of the delinquents and 11 (0.9%) of the controls were diagnosed with schizophrenia later in life (HR 16.6, 95% CI 8.53-32.39, P<0.001). Almost half of the pretrial adolescents with later schizophrenia were diagnosed within 5years of the forensic psychiatric examination, but latency was longer among the other half of the sample, reaching up to 20.5years. The study supports the previous research indicating a potential link between serious delinquency and later schizophrenia. Accurate psychiatric assessments should be made in correctional services but also later in life so that any possible psychotic symptoms can be detected in individuals with a history of serious delinquency even if there were no signs of psychosis before or at the time of the crime. Future research should explore which factors influence the delinquent's risk of developing later schizophrenia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Changes in bioactive compounds and oxidative enzymes of fresh-cut pomegranate arils during storage as affected by deficit irrigation and postharvest vapor heat treatments.

PubMed

Peña-Estévez, María E; Gómez, Perla A; Artés, Francisco; Aguayo, Encarna; Martínez-Hernández, Ginés Benito; Galindo, Alejandro; Torecillas, Arturo; Artés-Hernández, Francisco

2016-12-01

The effect of postharvest vapor heat treatments at 95℃ (4, 7, and 10 s) regarding a conventional sanitizing treatment with 100 mg NaClO l -1 on enzyme activities (phenylalanine ammonia lyase, polyphenol oxidase, and peroxidase), phenolic content, and total antioxidant capacity of fresh-cut pomegranates arils throughout 18 days at 5℃ was studied. Furthermore, the effect of two sustained deficit irrigation (SDI) strategies, compared to a standardly irrigated control (CTRL), was also studied on such quality parameters throughout storage. Arils from CTRL-irrigated fruit registered phenylalanine ammonia lyase, peroxidase, and polyphenol oxidase initial activities of 60.6, 382, and 14.4 U g -1  fw, respectively. Arils from sustained deficit irrigation fruit registered 46-58% lower phenylalanine ammonia lyase values while polyphenol oxidase and peroxidase activities did not register great variants (<9%) among both sustained deficit irrigation treatments. Postharvest vapor heat treatments enhanced phenylalanine ammonia lyase activity in those samples from sustained deficit irrigation fruit although no great peroxidase and polyphenol oxidase (<2-5%) increases were observed. Arils from SDI 1 fruit registered higher phenolic content than those values reported for CTRL samples. However, phenolic compounds decreased during storage, in a greater extent for sustained deficit irrigation samples, although 7 s arils achieved better phenolic compounds retention in sustained deficit irrigation samples. Vapor heat treatments reduced up to twofold the total antioxidant capacity losses observed in samples sanitized by conventional NaOCl treatment during shelf life. Conclusively, postharvest vapor heat treatment for 7 and 10 s used to extend the shelf life of pomegranate arils up to 18 days at 5℃ reduced the losses of health-promoting compounds during storage compared to conventional NaOCl sanitizing treatment. © The Author(s) 2016.

Divergent pathways to influence: Cognition and behavior differentially mediate the effects of optimism on physical and mental quality of life in Chinese university students.

PubMed

Ramsay, Jonathan E; Yang, Fang; Pang, Joyce S; Lai, Ching-Man; Ho, Roger Cm; Mak, Kwok-Kei

2015-07-01

Previous research has indicated that both cognitive and behavioral variables mediate the positive effect of optimism on quality of life; yet few attempts have been made to accommodate these constructs into a single explanatory framework. Adopting Fredrickson's broaden-and-build perspective, we examined the relationships between optimism, self-rated health, resilience, exercise, and quality of life in 365 Chinese university students using path analysis. For physical quality of life, a two-stage model, in which the effects of optimism were sequentially mediated by cognitive and behavioral variables, provided the best fit. A one-stage model, with full mediation by cognitive variables, provided the best fit for mental quality of life. This suggests that optimism influences physical and mental quality of life via different pathways. © The Author(s) 2013.

A poly-herbal blend (Herbagut®) on adults presenting with gastrointestinal complaints: a randomised, double-blind, placebo-controlled study.

PubMed

Lopresti, Adrian L; Gupta, Hemant; Smith, Stephen J

2018-03-20

To evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits. This was a randomised, double-blind, placebo-controlled trial. Fifty adults with self-reported unsatisfactory bowel habits, primarily characterised by chronic constipation were randomly allocated to take Herbagut or a matching placebo for 28 days. Efficacy of gastrointestinal changes was measured by the completion of a patient daily diary evaluating changes in stool type (Bristol Stool Form Scale), ease of bowel movements, and feeling of complete evacuation; and the Gastrointestinal Symptom Rating Scale (GSRS). Changes in quality of life were also examined using the World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF), and the Patient Assessment of Constipation-Quality of Life (PAC-QOL). All participants completed the 28-day trial with no adverse events reported. Compared to the placebo, weekly bowel movements increased over time (p < .001), as did self-reported, normal bowel motions (76% vs 4%; p < .001). Self-reported incomplete evacuation was also lower in the Herbagut group compared to placebo (24% vs 76%; p = <.001). GSRS domain ratings for abdominal pain, constipation, diarrhoea, indigestion, and reflux also decreased significantly in people taking Herbagut compared to placebo (p < .001, for all domains). Moreover, quality of life significantly improved in the Herbagut group compared to placebo as indicated by significantly greater improvement in WHOQOL-BREF domain ratings for overall quality of life, social relations, environmental health, psychological health, and physical health (p < .001, for all domains); and PAC-QOL domain ratings for physical discomfort, psychosocial discomfort, worries and concerns, and life satisfaction (p < .001, for all domains). The changes were considered clinically meaningful as evidenced by their large effect sizes. Herbagut ingestion over a 28-day period resulted in improvements in several gastrointestinal symptoms and overall quality of life. Further investigation utilising larger sample sizes and diverse clinical and cultural populations are needed. Clinical Trials Registry- India /2016/11/007479 . Registered 24 April 2015 (retrospectively registered).

Emotion rendering in music: range and characteristic values of seven musical variables.

PubMed

Bresin, Roberto; Friberg, Anders

2011-10-01

Many studies on the synthesis of emotional expression in music performance have focused on the effect of individual performance variables on perceived emotional quality by making a systematical variation of variables. However, most of the studies have used a predetermined small number of levels for each variable, and the selection of these levels has often been done arbitrarily. The main aim of this research work is to improve upon existing methodologies by taking a synthesis approach. In a production experiment, 20 performers were asked to manipulate values of 7 musical variables simultaneously (tempo, sound level, articulation, phrasing, register, timbre, and attack speed) for communicating 5 different emotional expressions (neutral, happy, scary, peaceful, sad) for each of 4 scores. The scores were compositions communicating four different emotions (happiness, sadness, fear, calmness). Emotional expressions and music scores were presented in combination and in random order for each performer for a total of 5 × 4 stimuli. The experiment allowed for a systematic investigation of the interaction between emotion of each score and intended expressed emotions by performers. A two-way analysis of variance (ANOVA), repeated measures, with factors emotion and score was conducted on the participants' values separately for each of the seven musical factors. There are two main results. The first one is that musical variables were manipulated in the same direction as reported in previous research on emotional expressive music performance. The second one is the identification for each of the five emotions the mean values and ranges of the five musical variables tempo, sound level, articulation, register, and instrument. These values resulted to be independent from the particular score and its emotion. The results presented in this study therefore allow for both the design and control of emotionally expressive computerized musical stimuli that are more ecologically valid than stimuli without performance variations. Copyright © 2011 Elsevier Srl. All rights reserved.

Mapping health outcome measures from a stroke registry to EQ-5D weights

PubMed Central

2013-01-01

Purpose To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. Methods We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n = 272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for “dressing“, “toileting“, “mobility”, “mood”, “general health” and “proxy-responders” were applied to the validation set (n = 272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). Results The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥0.5 (P < 0.01). Conclusion This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility. PMID:23496957

Patient identification errors: the detective in the laboratory.

PubMed

Salinas, Maria; López-Garrigós, Maite; Lillo, Rosa; Gutiérrez, Mercedes; Lugo, Javier; Leiva-Salinas, Carlos

2013-11-01

The eradication of errors regarding patients' identification is one of the main goals for safety improvement. As clinical laboratory intervenes in 70% of clinical decisions, laboratory safety is crucial in patient safety. We studied the number of Laboratory Information System (LIS) demographic data errors registered in our laboratory during one year. The laboratory attends a variety of inpatients and outpatients. The demographic data of outpatients is registered in the LIS, when they present to the laboratory front desk. The requests from the primary care centers (PCC) are made electronically by the general practitioner. A manual step is always done at the PCC to conciliate the patient identification number in the electronic request with the one in the LIS. Manual registration is done through hospital information system demographic data capture when patient's medical record number is registered in LIS. Laboratory report is always sent out electronically to the patient's electronic medical record. Daily, every demographic data in LIS is manually compared to the request form to detect potential errors. Fewer errors were committed when electronic order was used. There was great error variability between PCC when using the electronic order. LIS demographic data manual registration errors depended on patient origin and test requesting method. Even when using the electronic approach, errors were detected. There was a great variability between PCC even when using this electronic modality; this suggests that the number of errors is still dependent on the personnel in charge of the technology. © 2013.

Implementation of a Novel Electronic Health Record-Embedded Physician Orders for Life-Sustaining Treatment System.

PubMed

Zive, Dana M; Cook, Jennifer; Yang, Charissa; Sibell, David; Tolle, Susan W; Lieberman, Michael

2016-11-01

In April 2015, Oregon Health & Science University (OHSU) deployed a web-based, electronic medical record-embedded application created by third party vendor Vynca Inc. to allow real-time education, and completion of Physician Orders for Life Sustaining Treatment (POLST). Forms are automatically linked to the Epic Systems™ electronic health record (EHR) patient header and submitted to a state Registry, improving efficiency, accuracy, and rapid access to and retrieval of these important medical orders. POLST Forms, implemented in Oregon in 1992, are standardized portable medical orders used to document patient treatment goals for end-of-life care. In 2009, Oregon developed the first POLST-only statewide registry with a legislative mandate requiring POLST form signers to register the form unless the patient opts out. The Registry offers 24/7 emergency access to POLST Forms for Emergency Medical Services, Emergency Departments, and Acute Care Units. Because POLST is intended for those nearing end of life, immediate access to these forms at the time of an emergency is critical. Delays in registering a POLST Form may result in unwanted treatment if the paper form is not immediately available. An electronic POLST Form completion system (ePOLST) was implemented to support direct Registry submission. Other benefits of the system include single-sign-on, transmission of HL7 data for patient demographics and other relevant information, elimination of potential errors in form completion using internalized logic, built-in real-time video and text-based education materials for both patients and health care professionals, and mobile linkage for signature capture.

Quality of life following hip fractures: results from the Norwegian hip fracture register.

PubMed

Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

2016-07-07

Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

PubMed Central

Kondo, Yutaka; Fukuda, Tatsuma; Uchimido, Ryo; Hifumi, Toru; Hayashida, Kei

2017-01-01

Introduction Advanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature. Methods and analysis We will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ2 test of homogeneity, and any observed heterogeneity will be quantified using the I2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence. Ethics and dissemination Our study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information. Trial registration number PROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389. PMID:29061611

Attitudes toward Money and Demographic Variables as Related to Income and Life Satisfaction: USA Vs. Spain.

ERIC Educational Resources Information Center

Tang, Thomas Li-Ping; Arocas, Roberto Luna; Whiteside, Harold D.

A study of 207 faculty at a state university in the southeastern United States and 102 faculty members at the University of Valencia (Spain) examined demographic variables and attitudes toward money, income, and life satisfaction. Demographic variables (sex, age, education, marital status, race, current job experience, total work experience, and…

Development and pilot phase of a European MS register.

PubMed

Flachenecker, Peter; Khil, Laura; Bergmann, Sverrir; Kowalewski, Mariusz; Pascu, Ion; Pérez-Miralles, Francisco; Sastre-Garriga, Jaume; Zwingers, Thomas

2010-10-01

The MS-ID (Multiple Sclerosis Information Dividend) project was initiated by the European Multiple Sclerosis Platform (EMSP) in 2007 in order to identify and address major inequalities of MS treatment and care and thus eliminate disparities across the EU. One major approach to reach these goals in the longer term is the implementation of a European MS register for MS. The feasibility of an EU MS register was piloted among five countries (Germany, Iceland, Poland, Romania and Spain). Each country liaised with one documentation centre. Countries and test centres were both chosen in a way that a heterogeneous health care structure was provided. After reaching consensus about the data set, comprehension and acceptability of the two questionnaires-representing both the physician's and the patient's perspective-were tested with 20 MS patients in each country. In a 6-month data collection period, data from 547 patients were recorded. Most sections of the questionnaires were available for more than 90% of patients. The results obtained from the pilot phase of the European MS register indicate that it is feasible to collect standardized data across Europe. Thus, the European MS register may be a valuable instrument to compare treatment and care of MS across countries, estimate the cost of MS in Europe and monitor the implementation of and adherence to guidelines. It may help to reduce the disparities in MS care and treatment throughout Europe and eventually improve the quality of life of people with MS.

Using Artificial Life to Assess the Typicality of Terrestrial Life: Implications for Human Mission Planetary Protection

NASA Technical Reports Server (NTRS)

Lupisella, Mark; Powers, Edward I. (Technical Monitor)

2001-01-01

The extent to which extraterrestrial life questions can be addressed, in the absence of an actual example, rests in some measure on the extent to which terrestrial life is representative of life in general since we will likely have to draw heavily, if not completely, from terrestrial life research. One example of a practical question involving extraterrestrial life that arises in preparing for a human mission to another planet such as Mars, is trying to assess and minimize the possible adverse effects of the presence of humans on possible indigenous extraterrestrial life-forms. This paper will present some key planetary protection challenges for a human Mars mission and then focus on one possible approach for assessing the extent to which terrestrial life is representative of biological phenomena in general, informing perhaps, the level of confidence we might have in applying terrestrial research - to extraterrestrial life issues. The approach involves appealing to the relatively new field of Artificial Life (A-Life) to: (1) use what might be the most basic minimal set of life-defining characteristics in (2) a large number of open-ended Artificial Life simulations to generate a "life possibility space" (3) the products of which can be examined for their plausibility within the context of relevant constraining knowledge, so that (4) the remaining possibility space can be examined for its variability relative to terrestrial life, where low variability might suggest that terrestrial life is representative of life in general, and high variability would indicate otherwise.

Primates and the evolution of long, slow life histories.

PubMed

Jones, James Holland

2011-09-27

Primates are characterized by relatively late ages at first reproduction, long lives and low fertility. Together, these traits define a life-history of reduced reproductive effort. Understanding the optimal allocation of reproductive effort, and specifically reduced reproductive effort, has been one of the key problems motivating the development of life-history theory. Because of their unusual constellation of life-history traits, primates play an important role in the continued development of life-history theory. In this review, I present the evidence for the reduced reproductive effort life histories of primates and discuss the ways that such life-history tactics are understood in contemporary theory. Such tactics are particularly consistent with the predictions of stochastic demographic models, suggesting a key role for environmental variability in the evolution of primate life histories. The tendency for primates to specialize in high-quality, high-variability food items may make them particularly susceptible to environmental variability and explains their low reproductive-effort tactics. I discuss recent applications of life-history theory to human evolution and emphasize the continuity between models used to explain peculiarities of human reproduction and senescence with the long, slow life histories of primates more generally. Copyright © 2011 Elsevier Ltd. All rights reserved.

Primates and the Evolution of Long-Slow Life Histories

PubMed Central

Jones, James Holland

2011-01-01

Summary Primates are characterized by relatively late ages at first reproduction, long lives and low fertility. Together, these traits define a life-history of reduced reproductive effort. Understanding the optimal allocation of reproductive effort, and specifically reduced reproductive effort, has been one of the key problems motivating the development of life history theory. Because of their unusual constellation of life-history traits, primates play an important role in the continued development of life history theory. In this review, I present the evidence for the reduced reproductive effort life histories of primates and discuss the ways that such life-history tactics are understood in contemporary theory. Such tactics are particularly consistent with the predictions of stochastic demographic models, suggesting a key role for environmental variability in the evolution of primate life histories. The tendency for primates to specialize in high-quality, high-variability food items may make them particularly susceptible to environmental variability and explain their low reproductive-effort tactics. I discuss recent applications of life history theory to human evolution and emphasize the continuity between models used to explain peculiarities of human reproduction and senescence with the long, slow life histories of primates more generally. PMID:21959161

Benefits of a holistic breathing technique in patients on hemodialysis.

PubMed

Stanley, Ruth; Leither, Thomas W; Sindelir, Cathy

2011-01-01

Health-related quality of life and heart rate variability are often depressed in patients on hemodialysis. This pilot program used a simple holistic, self-directed breathing technique designed to improve heart rate variability, with the hypothesis that improving heart rate variability would subsequently enhance health-related quality of life. Patient self-reported benefits included reductions in anxiety, fatigue, insomnia, and pain. Using holistic physiologic techniques may offer a unique and alternative tool for nurses to help increase health-related quality of life in patients on hemodialysis.

Quality of life as a cancer nursing outcome variable.

PubMed

Padilla, G V; Grant, M M

1985-10-01

A reliable and valid multidimensional instrument for measuring quality of life in cancer patients has been developed. Furthermore, a model has been offered that describes how quality of life works as an outcome variable. Using this model, predictions were made of how nursing interventions may directly or indirectly impact on quality of life. Initial testing of the model using data from 135 colostomy patients showed how satisfaction with nursing care and personal control act as cognitive mediators of self-worth, which then impacts on dimensions of quality of life.

Impact of resistance training on body composition and metabolic syndrome variables during androgen deprivation therapy for prostate cancer: a pilot randomized controlled trial.

PubMed

Dawson, Jacqueline K; Dorff, Tanya B; Todd Schroeder, E; Lane, Christianne J; Gross, Mitchell E; Dieli-Conwright, Christina M

2018-04-03

Prostate cancer patients on androgen deprivation therapy (ADT) experience adverse effects such as lean mass loss, known as sarcopenia, fat gain, and changes in cardiometabolic factors that increase risk of metabolic syndrome (MetS). Resistance training can increase lean mass, reduce body fat, and improve physical function and quality of life, but no exercise interventions in prostate cancer patients on ADT have concomitantly improved body composition and MetS. This pilot trial investigated 12 weeks of resistance training on body composition and MetS changes in prostate cancer patients on ADT. An exploratory aim examined if a combined approach of training and protein supplementation would elicit greater changes in body composition. Prostate cancer patients on ADT were randomized to resistance training and protein supplementation (TRAINPRO), resistance training (TRAIN), protein supplementation (PRO), or control stretching (STRETCH). Exercise groups (EXE = TRAINPRO, TRAIN) performed supervised exercise 3 days per week for 12 weeks, while non-exercise groups (NoEXE = PRO, STRETCH) performed a home-based stretching program. TRAINPRO and PRO received 50 g⋅day - 1 of whey protein. The primary outcome was change in lean mass assessed through dual energy x-ray absorptiometry. Secondary outcomes examined changes in sarcopenia, assessed through appendicular skeletal mass (ASM) index (kg/m 2 ), body fat %, strength, physical function, quality of life, MetS score and the MetS components of waist circumference, blood pressure, glucose, high-density lipoprotein-cholesterol, and triglyceride levels. A total of 37 participants were randomized; 32 participated in the intervention (EXE n = 13; NoEXE n = 19). At baseline, 43.8% of participants were sarcopenic and 40.6% met the criteria for MetS. Post-intervention, EXE significantly improved lean mass (d = 0.9), sarcopenia prevalence (d = 0.8), body fat % (d = 1.1), strength (d = 0.8-3.0), and prostate cancer-specific quality of life (d = 0.9) compared to NoEXE (p < 0.05). No significant differences were observed between groups for physical function or MetS-related variables except waist circumference (d = 0.8). A 12-week resistance training intervention effectively improved sarcopenia, body fat %, strength and quality of life in hypogonadal prostate cancer patients, but did not change MetS or physical function. PRO did not offer additional benefit in improving body composition. ClinicalTrials.gov: NCT01909440 . Registered 24 July 2013.

A pilot cluster randomised trial to assess the effect of a structured communication approach on quality of life in secure mental health settings: The Comquol Study.

PubMed

MacInnes, Douglas; Kinane, Catherine; Parrott, Janet; Mansfield, Jacqueline; Craig, Tom; Eldridge, Sandra; Marsh, Ian; Chan, Claire; Hounsome, Natalia; Harrison, George; Priebe, Stefan

2016-09-29

There is a lack of research in forensic settings examining therapeutic relationships. A structured communication approach, placing patients' perspectives at the heart of discussions about their care, was used to improve patients' quality of life in secure settings. The objectives were to: • Establish the feasibility of the trial design • Determine the variability of the outcomes of interest • Estimate the costs of the intervention • If necessary, refine the intervention METHODS: A pilot cluster randomised controlled trial was conducted. Data was collected from July 2012 to January 2015 from participants in 6 medium secure in-patient services in London and Southern England. 55 patients and 47 nurses were in the intervention group with 57 patients and 45 nurses in the control group. The intervention comprised 6 nurse-patient meetings over a 6 month period. Patients rated their satisfaction with a range of domains followed by discussions on improving patient identified problems. Assessments took place at baseline, 6 months, and 12 months. Participants were not blind to their allocated group. The primary outcome was self-reported quality of life collected by a researcher blind to participants' allocation status. The randomisation procedures and intervention approach functioned well. The measures used were understood by the participants and gave relevant outcome information. The response rates were good with low patient withdrawal rates. The quality of life estimated treatment effect was 0.2 (95 % CI: -0.4 to 0.8) at 6 months and 0.4 (95 % CI: -0.3 to 1.1) indicating the likely extreme boundaries of effect in the main trial. The estimated treatment effect of the primary outcome is clinically important, and a positive effect of the intervention is not ruled out. The estimate of the ICC for the primary outcome at 6 and 12 months was 0.04 (0.00 to 0.17) and 0.05 (0.00 to 0.18). The cost of the intervention was £529 per patient. The trial design was viable as the basis for a full-scale trial. A full trial is justified to estimate the effect of the intervention with greater certainty. The variability of the outcomes could be used to calculate numbers needed for a full-scale trial. Ratings of need for therapeutic security may be useful in any future study. Current Controlled Trials ISRCTN34145189 . Retrospectively registered 22 June 2012.

Social support as a mediator variable of the relationship between depression and life satisfaction in a sample of Saudi caregivers of patients with Alzheimer's disease.

PubMed

Khusaifan, Shatha Jamil; El Keshky, Mogeda El Sayed

2017-02-01

Caring for someone with Alzheimer's disease (AD) is very challenging. Social support may play a crucial role in helping caregivers to adapt better to their caregiving role. The aim of this study is to explore the role of social support as a moderator variable of the relationship between depression and life satisfaction in caregivers for patients with AD in Saudi Arabia. In this cross-sectional study, 122 caregivers for patients with AD completed questionnaires assessing informal social support, depressive symptoms, and general life satisfaction. The demographic characteristics showed that 79% (n = 96) of caregivers were females and between the ages of 20 and 50. Higher levels of social support positively correlated with reported higher levels of life satisfaction (r = 0.483, p < 0.001). Depression was negatively correlated with social support (r = -0.418, p < 0.001) and life satisfaction scores (r = -0.553, p = < 0.001). Social support was found to be a partial mediator variable, mediating approximately 23.05% of the total effect of depression on life satisfaction (Sobel = -3.065, p = 0.002). Informal social support can act as a mediator variable in the relationship of depression and life satisfaction in caregivers of AD patients. Improving the informal social support networks may help in coping with caregiving burden and better quality of life.

An evaluation of service use outcomes in a Recovery College.

PubMed

Bourne, Philippa; Meddings, Sara; Whittington, Adrian

2017-12-23

Recovery Colleges offer educational courses about recovery and mental health which are co-produced by mental health professionals and experts by lived experience. Previous evaluations have found positive effects of Recovery Colleges on a range of outcomes including wellbeing, recovery and quality of life. To evaluate service use outcomes for Sussex Recovery College students who use mental health services. The study used a controlled-before-and-after design. It used archival data to analyse service use before and after participants registered with the Recovery College (n = 463). Participants acted as their own control. Students used mental health services less after attending the Recovery College than before. Students who attended the Recovery College showed significant reductions in occupied hospital bed days, admissions, admissions under section and community contacts in the 18 months post compared with the 18 months before registering. Reductions in service use were greater for those who completed a course than those who registered but did not complete a course. These findings suggest that attending Recovery College courses is associated with reduced service use. The reductions equate to non-cashable cost-savings of £1200 per registered student and £1760 for students who completed a course. Further research is needed to investigate causality.

Impact of region contouring variability on image-based focal therapy evaluation

NASA Astrophysics Data System (ADS)

Gibson, Eli; Donaldson, Ian A.; Shah, Taimur T.; Hu, Yipeng; Ahmed, Hashim U.; Barratt, Dean C.

2016-03-01

Motivation: Focal therapy is an emerging low-morbidity treatment option for low-intermediate risk prostate cancer; however, challenges remain in accurately delivering treatment to specified targets and determining treatment success. Registered multi-parametric magnetic resonance imaging (MPMRI) acquired before and after treatment can support focal therapy evaluation and optimization; however, contouring variability, when defining the prostate, the clinical target volume (CTV) and the ablation region in images, reduces the precision of quantitative image-based focal therapy evaluation metrics. To inform the interpretation and clarify the limitations of such metrics, we investigated inter-observer contouring variability and its impact on four metrics. Methods: Pre-therapy and 2-week-post-therapy standard-of-care MPMRI were acquired from 5 focal cryotherapy patients. Two clinicians independently contoured, on each slice, the prostate (pre- and post-treatment) and the dominant index lesion CTV (pre-treatment) in the T2-weighted MRI, and the ablated region (post-treatment) in the dynamic-contrast- enhanced MRI. For each combination of clinician contours, post-treatment images were registered to pre-treatment images using a 3D biomechanical-model-based registration of prostate surfaces, and four metrics were computed: the proportion of the target tissue region that was ablated and the target:ablated region volume ratio for each of two targets (the CTV and an expanded planning target volume). Variance components analysis was used to measure the contribution of each type of contour to the variance in the therapy evaluation metrics. Conclusions: 14-23% of evaluation metric variance was attributable to contouring variability (including 6-12% from ablation region contouring); reducing this variability could improve the precision of focal therapy evaluation metrics.

[Variability in the in-hospital management of acute myocardial infarction in Spain. IBERICA Study (Investigación, Búsqueda Específica y Registro de Isquemia Coronaria Aguda)].

PubMed

Fiol, M; Cabadés, A; Sala, J; Marrugat, J; Elosua, R; Vega, G; José Tormo Díaz, M; Segura, A; Aldasoro, E; Moreno-Iribas, C; Muñiz, J; Hurtado de Saracho, I; García, J

2001-04-01

Introduction and objective. Although some in-hospital studies have described the management of acute myocardial infarction (MI) patients in Spain, none has been able to guarantee the exhaustiveness of patient registry. This study sought to determine the clinical characteristics and in-hospital management of patients with MI in eight Spanish population registries.Methods. The IBERICA study is a population-based MI registry carried out in the 25 to 74 year-old population, in eight Spanish regions in 1997. A standardized methodology was used to register and investigate all MI arriving alive to a hospital. Clinical characteristics, cardiovascular risk factors prevalence, pharmacological treatment, invasive and non-invasive procedures performed and complications at 28 days of evolution were recorded. A descriptive analysis was performed and the variation coefficient (VC) was calculated.Results. In 1997, 4,041 MI patients were registered, 79.9% were men with a mean age of 61.1 years. Although 10.9% (95% CI: 9.9-11.9%) were not admitted to the coronary care unit, a large variability existed among different areas (VC = 53%). There was a high variability in the utilization and performance of non-invasive and invasive procedures among regions, as well as in the use of pharmacological treatment. Only the use of antiaggregants (91.5%) and thrombolytic therapy (41.8%) showed a low variability (VC < 10%). Twenty-eight day mortality was 16.2% (95% CI: 15.1-17.4%) with a high variability being observed among the different regions (VC = 20.6%).Conclusion. Patient characteristics vary among the different Spanish regions. The differences in management and prognosis suggest a lack of equality in the health care provided to MI patients in the different regions in Spain.

Improving palliative care provision in primary care: a pre- and post-survey evaluation among PaTz groups.

PubMed

van der Plas, Annicka Gm; Pasman, H Roeline W; Schweitzer, Bart; Onwuteaka-Philipsen, Bregje D

2018-05-01

In PaTz (PAlliatieve Thuis Zorg, palliative care at home), modelled after the Gold Standards Framework, GPs and community nurses meet on a regular basis to identify patients with palliative care needs (the PaTz register), and to discuss care for these patients. To study the effects of the implementation of PaTz, and provide additional analyses on two important elements: the PaTz register and patient discussions. A pre- and post-evaluation among Dutch GPs ( n = 195 before the start of PaTz; n = 166, 1 year after the start of PaTz). The GPs also provided data on recently deceased patients ( n = 460 before the start of PaTz; n = 305 14 months after the start of PaTz). GPs from all 37 PaTz groups filled in questionnaires. Pre- and post-test differences were analysed using multilevel analyses to adjust for PaTz group. Identification of patients with palliative care needs was done systematically for more patients after implementation of PaTz compared with before (54.3% versus 17.6%). After implementation, 64.8% of deceased patients had been included on the PaTz register. For these patients, when compared with patients not included on the PaTz register, preferred place of death was more likely to be known (88.1% of patients not on the register and 97.3% of deceased patients included on the register), GPs were more likely to have considered a possible death sooner (>1 month before death: 53.0% and 80.2%), and conversations on life expectancy, physical complaints, existential issues, and possibilities of care occurred more often (60.8% and 81.3%; 68.6% and 86.1%; 22.5% and 34.2%; 60.8% and 84.0%, respectively). Implementation of PaTz improved systematic identification of palliative care patients within the GP practice. Use of the PaTz register has added value. © British Journal of General Practice 2018.

76 FR 44625 - Northern Lights Variable Trust, et al.;

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... business on their own. Use of a portfolio as a common investment vehicle for VLI Accounts would reduce or... is designed to fund VA Accounts and/or VLI Accounts (as defined below) and for which Gemini or any of... be sold and held by: (i) Separate accounts registered as investment companies or separate accounts...

12 CFR 250.411 - Interlocking relationships between member bank and variable annuity insurance company.

Code of Federal Regulations, 2010 CFR

2010-01-01

... recommend any changes in the fundamental investment policy of the accumulation fund. In addition, the Board... fundamental investment policy. In the opinion of the Board of Governors, the board of managers of the... member banks and (1) the board of managers of an accumulation fund, registered under the Investment...

Structural Relationships among E-Learners' Sense of Presence, Usage, Flow, Satisfaction, and Persistence

ERIC Educational Resources Information Center

Joo, Young Ju; Joung, Sunyoung; Kim, Eun Kyung

2013-01-01

This study aimed to investigate the structural relationships among teaching presence, cognitive presence, usage, learning flow, satisfaction, and learning persistence in corporate e-learners. The research participants were 462 e-learners registered for cyber-lectures through an electronics company in South Korea. The extrinsic variables were sense…

76 FR 49279 - Energy Efficiency Design Standards for New Federal Commercial and Multi-Family High-Rise...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... Management. The life-cycle cost guidance and required discount rates and energy price projections are... Supplement to The National Institute of Standards and Technology Handbook 135: ``Energy Price Indices and...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0...

77 FR 27120 - Safety Zone; Virginia Beach Oceanfront Air Show, Atlantic Ocean, Virginia Beach, VA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... restriction of vessel traffic is necessary to protect life, property and the environment during the fireworks... property and could cause significant injury or death to mariners observing the air shows. Due to the need... the Federal Register. The commenter suggested that the Coast Guard add a chart to the regulation to...

Learning Outside the Lines: Six Innovative Programs That Reach Youth.

ERIC Educational Resources Information Center

Jobs for the Future, Boston, MA.

Six programs are profiled that garner both deep engagement and high achievement from young people. All build upon fundamental needs of adolescent life: to register positive impact upon the world, to feel respected and connected, and to construct one's own narrative. A community action initiative at a high school in Texas' Rio Grande Valley is…

75 FR 17452 - Sunshine Federal Register Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-06

... of April 26, 2010--Tentative Thursday, April 29, 2010 9:30 a.m. Briefing on the Fuel Cycle Oversight... Authority (Watts Bar Nuclear Plant, Unit 2), Notice of Appeal, and Brief on Appeal of LBP-09-26 by Sierra..., Employee/Labor Relations and Work Life Branch, at 301-492-2230, TDD: 301-415-2100, or by e-mail at angela...

CMMI(Registered) for Development, Version 1.3

DTIC Science & Technology

2010-11-01

ISO /IEC 15288:2008 Systems and Software Engineering – System Life Cycle Processes [ ISO 2008b] ISO /IEC 27001 :2005 Information technology – Security...IEC 2005 International Organization for Standardization and International Electrotechnical Commission. ISO /IEC 27001 Information Technology...International Electrotechnical Commission ( ISO /IEC) body of standards. CMMs focus on improving processes in an organization. They contain the

CMMI(Registered) for Acquisition, Version 1.3. CMMI-ACQ, V1.3

DTIC Science & Technology

2010-11-01

and Software Engineering – System Life Cycle Processes [ ISO 2008b] ISO /IEC 27001 :2005 Information technology – Security techniques – Information...International Organization for Standardization and International Electrotechnical Commission. ISO /IEC 27001 Information Technology – Security Techniques...International Organization for Standardization/International Electrotechnical Commission ( ISO /IEC) body of standards. CMMs focus on improving processes

AACJC/Metropolitan Life Foundation Registered Nurse Shortage Project: Final Report.

ERIC Educational Resources Information Center

Hawaii Univ., Lihue. Kauai Community Coll.

In an effort to increase the number of graduating Kauai High School (KHS) seniors prepared to enter the Kauai Community College (KCC) Career Ladder Nursing Program, a special 2 + 2 program was initiated involving college/high school curriculum articulation, academic and career counseling, and early admission to KCC. At the outset of the project,…

A Study of the Participation of Women in the Health Care Industry Labor Force. Executive Summary.

ERIC Educational Resources Information Center

Lebowitz, Ann, Ed.

A study was conducted to explore the relationship between socioeconomic and personal circumstances of women in health occupations and their labor market behavior. Using a conceptual framework (the Life Patterning Process), discussions were held in six states with a total of 279 women representing five health occupations: registered nurses,…

Utilization of Emotional Freedom Techniques (EFT) to Reduce Test Anxiety in High Stakes Testing

ERIC Educational Resources Information Center

Mohler, Marie Elaine

2013-01-01

There are many reasons a person may fail a high stakes test such as the National Council Licensure Examination for Registered Nurses (NCLEX-RN®). Sleep deprivation, illness, life stressors, knowledge deficit, and test anxiety are some of the common explanations. A student with test anxiety may feel threatened by this evaluation process. This…

Hierarchical organization in the temporal structure of infant-direct speech and song.

PubMed

Falk, Simone; Kello, Christopher T

2017-06-01

Caregivers alter the temporal structure of their utterances when talking and singing to infants compared with adult communication. The present study tested whether temporal variability in infant-directed registers serves to emphasize the hierarchical temporal structure of speech. Fifteen German-speaking mothers sang a play song and told a story to their 6-months-old infants, or to an adult. Recordings were analyzed using a recently developed method that determines the degree of nested clustering of temporal events in speech. Events were defined as peaks in the amplitude envelope, and clusters of various sizes related to periods of acoustic speech energy at varying timescales. Infant-directed speech and song clearly showed greater event clustering compared with adult-directed registers, at multiple timescales of hundreds of milliseconds to tens of seconds. We discuss the relation of this newly discovered acoustic property to temporal variability in linguistic units and its potential implications for parent-infant communication and infants learning the hierarchical structures of speech and language. Copyright © 2017 Elsevier B.V. All rights reserved.

The validity of ACT-PEP test scores for predicting academic performance of registered nurses in BSN programs.

PubMed

Yang, J C; Noble, J

1990-01-01

This study investigated the validity of three American College Testing-Proficiency Examination Program (ACT-PEP) tests (Maternal and Child Nursing, Psychiatric/Mental Health Nursing, Adult Nursing) for predicting the academic performance of registered nurses (RNs) enrolled in bachelor's degree BSN programs nationwide. This study also examined RN students' performance on the ACT-PEP tests by their demographic characteristics: student's age, sex, race, student status (full- or part-time), and employment status (full- or part-time). The total sample for the three tests comprised 2,600 students from eight institutions nationwide. The median correlation coefficients between the three ACT-PEP tests and the semester grade point averages ranged from .36 to .56. Median correlation coefficients increased over time, supporting the stability of ACT-PEP test scores for predicting academic performance over time. The relative importance of selected independent variables for predicting academic performance was also examined; the most important variable for predicting academic performance was typically the ACT-PEP test score. Across the institutions, student demographic characteristics did not contribute significantly to explaining academic performance, over and above ACT-PEP scores.

The Different Paths in the Franchising Entrepreneurship Choice

NASA Astrophysics Data System (ADS)

Tomaras, Petros; Konstantopoulos, Nikolaos; Zondiros, Dimitris

2007-12-01

This study aims to testify the scientific veracity of the question: is the franchisees' choice on entrepreneurial start-up univocal or many-valued? Two variables are examined by registering daily activities of the entrepreneurial franchisees, as they appear by the answers given to a closed-ended questionnaire. We proceeded with a multiple variable statistical analysis (principal component analysis) of survey data collected from franchisees of a Greece-based franchise system. The results of the research indicate that among different value standards, the entrepreneurs conclude in choosing the franchising.

Does Distress Tolerance Moderate the Impact of Major Life Events on Psychosocial Variables and Behaviors Important in the Management of HIV?

ERIC Educational Resources Information Center

O'Cleirigh, Conall; Ironson, Gail; Smits, Jasper A. J.

2007-01-01

Living with HIV involves management of multiple stressful disease-related and other life events. Distress tolerance may provide a functional, individual-based context for qualifying the established relationships between major life events and psychosocial variables important in the management of HIV. The present study provided a preliminary test of…

Economic, Social, and Cultural Determinants of Life Satisfaction: Are There Differences between Asia and Europe?

ERIC Educational Resources Information Center

Jagodzinski, Wolfgang

2010-01-01

This paper investigates the influence of the economic, social, and cultural variables on life satisfaction in Asia and Europe. The second section sets a unifying theoretical framework for all three domains by defining life satisfaction as a function of aspirations and expectations which in turn are affected by micro- and macro-level variables. On…

Lower life satisfaction, active coping and cardiovascular disease risk factors in older African Americans: outcomes of a longitudinal church-based intervention.

PubMed

Mendez, Yesenia P; Ralston, Penny A; Wickrama, Kandauda K A S; Bae, Dayoung; Young-Clark, Iris; Ilich, Jasminka Z

2018-06-01

This study examined lower life satisfaction, active coping and cardiovascular disease risk factors (diastolic and systolic blood pressure, body mass index, and circumferences) in older African Americans over the phases of an 18-month church-based intervention, using a quasi-experimental design. Participants (n = 89) were 45 years of age and older from six churches (three treatment, three comparison) in North Florida. Lower life satisfaction had a persistent unfavorable effect on weight variables. Active coping showed a direct beneficial effect on selected weight variables. However, active coping was adversely associated with blood pressure, and did not moderate the association between lower life satisfaction and cardiovascular risk factors. The intervention had a beneficial moderating influence on the association between lower life satisfaction and weight variables and on the association between active coping and these variables. Yet, this pattern did not hold for the association between active coping and blood pressure. The relationship of lower life satisfaction and selected cardiovascular risk factors and the positive effect of active coping were established, but findings regarding blood pressure suggest further study is needed.

Physical Restraint Use With Elderly Patients: Perceptions of Nurses and Nursing Assistants in Spanish Acute Care Hospitals.

PubMed

Fariña-López, Emilio; Estévez-Guerra, Gabriel J; Polo-Luque, M Luz; Hanzeliková Pogrányivá, Alica; Penelo, Eva

Physical restraint is often used during the hospitalization of elderly people. However, this procedure is associated with adverse outcomes; therefore, it is necessary to be aware of the circumstances that promote restraint use, such as the perceptions of professionals who use it. The purpose of the research was to determine the situations in which nursing staff considered the use of physical restraint as most important and to evaluate the possible associations with the sociodemographic and professional variables. A descriptive cross-sectional multicenter study was carried out in 52 units of eight Spanish acute hospitals. A survey of registered nurses and nursing assistants was used to collect data related to sociodemographic characteristics, experience, training in restraint use, and the Perception of Restraint Use Questionnaire (PRUQ)-which assesses the perceived importance of reasons frequently given for the use of physical restraint. The sample comprised 508 registered nurses and 347 nursing assistants. Almost all (98%) had used physical restraint, and 82% thought their training in the use of physical restraint was insufficient. Nursing assistants scored higher than registered nurses (p < .005, d = .68) on PRUQ total score and individual item scores, suggesting they thought the factors were more important in restraint use. Both registered nurses and nursing assistants considered restraint as most important in the prevention of falls and in the removal of medical devices such as intravenous lines and urinary catheters. Associations between PRUQ total score and other variables (unit type, sociodemographic factors, hospital) were nonsignificant. The professionals considered restraint as very important in preventing safety problems. In order to improve the quality of care, it is essential to identify the factors that can have an effect on the application of physical restraint. Educational programs are of fundamental importance, but to be more effective in reducing the use of physical restraint, they should address commonly held views on rationale for restraint use and be accompanied by institutional policies promoting a restraint-free environment.

A New Binary Star System of EW Type in Draco: GSC 03905-01870

NASA Astrophysics Data System (ADS)

Barquin, S.

2018-05-01

Discovery of a new binary star system (GSC 03905-01870 = USNO-B1.0 1431-0327922 = UCAC4 716-059522) in the Draco constellation is presented. It was discovered during a search for previously unreported eclipsing binary stars through the ASAS-SN database. The shape of the light curve and its characteristics (period of 0.428988+-0.000001 d, amplitude of 0.34+-0.02 V Mag, primary minimum epoch HJD 2457994.2756+-0.0002) indicates that the new variable star is an eclipsing binary of W Ursae Majoris type. I registered this variable star in The International Variable Star Index (VSX), its AAVSO UID is 000-BMP-891.

Influence of work-family-school role conflicts and social support on psychological wellbeing among registered nurses pursuing advanced degree.

PubMed

Xu, Lijuan; Song, Rhayun

2016-08-01

The purpose of the study was to determine how work-family-school role conflict and social support influence psychological well-being among registered nurses pursuing an advanced degree. A cross-sectional, correlational study design was used. Convenience sampling was used to recruit 320 registered nurses pursuing an advanced nursing degree at 13 hospitals in Korea, from June to October 2011. Data were analyzed using structural equation modeling with the AMOS program. Confirmatory factor analyses were conducted to evaluate the measurement model prior to the testing of study hypotheses before and after controlling for extraneous variables. The fit parameters of the modified model (χ(2)/df=2.01, GFI=0.91, AGFI=0.89, CFI=0.92, SRMR=0.068, and RMSEA=0.065) indicated its suitability as the research model. This model explained 45% of the variance in work-related psychological well-being and 52% of the variance in general psychological well-being. Both social support and work-family-school role conflict exerted significant effects on work-related psychological well-being and general psychological well-being. The findings of the present study imply that work-family-school role conflict influences the psychological well-being of registered nurses pursuing an advanced degree. It is necessary for nursing administrators to develop strategies to help registered nurses to manage their multiple roles and improve both their work-related psychological well-being and their general psychological well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

Reuma.pt - the rheumatic diseases portuguese register.

PubMed

Canhão, H; Faustino, A; Martins, F; Fonseca, J E

2011-01-01

Since June 2008, Portuguese rheumatologists have been collecting on a routine basis, data into the nationwide Reuma.pt, the Rheumatic Diseases Portuguese Register from the Portuguese Society of Rheumatology (SPR), which includes rheumatic patients (rheumatoid arthritis - RA, ankylosing spondylitis - AS, psoriatic arthritis - PsA and juvenile idiopathic arthritis - JIA) receiving biological therapies or patients receiving synthetic disease modifying anti-rheumatic drugs (DMARDs). The aim of this publication is to describe the structure of Reuma.pt and the population registered since June 2008. Demographic and anthropometric data, life style habits, work status, co-morbidities, disease activity and functional assessment scores, previous and current therapies, adverse events codified by the Medical Dictionary for Regulatory Activities (MedDRA), reasons for discontinuation and laboratory measurements are registered at each visit. The platform is based on a structured electronic medical record linked to a SQL Server database. All Rheumatology Departments assigned to the Portuguese National Health Service (n=21), 2 Military Hospitals (Lisboa and Porto), 1 public-private Institution and 6 private centers adhered to the Register. Until now, 18 centers have entered data into Reuma.pt. By January 2011, 3438 patients and 16130 visits had been registered. 2162 (63%) were RA patients, 700 of them treated with biological agents and 1462 with synthetic DMARDs. From the 515 (15%) AS patients, 297 were medicated with biological and 218 with non-biological therapies. 293 (8%) were PsA patients, 151 treated with biological drugs and 142 with other treatment strategies. 368 (11%) had the diagnosis of JIA, 68 were under biological treatment and 300 were managed with other treatment options. The register also includes 100 (3%) patients with other rheumatic diseases, submitted to treatments that required hospital day care infusions including 18 exposed to biological therapies. Registers are crucial to ensure correct clinical use, adequate assessment of post-marketing biological therapies' efficacy and safety, thus contributing for a better cost-benefit ratio. Reuma.pt, is a powerful and accurate tool to answer to these unmet needs. It presents a national coverage of the rheumatology centers and constitutes an invaluable resource for scientific research and to improve rheumatic patients care.

Rest break organization in geriatric care and turnover: a multimethod cross-sectional study.

PubMed

Wendsche, Johannes; Hacker, Winfried; Wegge, Jürgen; Schrod, Nadine; Roitzsch, Katharina; Tomaschek, Anne; Kliegel, Matthias

2014-09-01

Various determinants of nurses' work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization. We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses' turnover assessed over a period of one year. We designed a multimethod cross-sectional study. 80 nursing units (n=45 nursing homes, n=35 home care) in 51 German geriatric care services employing 597 registered nurses. We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses' turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio). The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses' turnover and affected indirectly the relation between care setting and registered nurses' turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses' turnover was higher in for-profit care units than in public or non-profit units. This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover. Copyright © 2014 Elsevier Ltd. All rights reserved.

Coiled-coil destabilizing residues in the group A Streptococcus M1 protein are required for functional interaction.

PubMed

Stewart, Chelsea M; Buffalo, Cosmo Z; Valderrama, J Andrés; Henningham, Anna; Cole, Jason N; Nizet, Victor; Ghosh, Partho

2016-08-23

The sequences of M proteins, the major surface-associated virulence factors of the widespread bacterial pathogen group A Streptococcus, are antigenically variable but have in common a strong propensity to form coiled coils. Paradoxically, these sequences are also replete with coiled-coil destabilizing residues. These features are evident in the irregular coiled-coil structure and thermal instability of M proteins. We present an explanation for this paradox through studies of the B repeats of the medically important M1 protein. The B repeats are required for interaction of M1 with fibrinogen (Fg) and consequent proinflammatory activation. The B repeats sample multiple conformations, including intrinsically disordered, dissociated, as well as two alternate coiled-coil conformations: a Fg-nonbinding register 1 and a Fg-binding register 2. Stabilization of M1 in the Fg-nonbinding register 1 resulted in attenuation of Fg binding as expected, but counterintuitively, so did stabilization in the Fg-binding register 2. Strikingly, these register-stabilized M1 proteins gained the ability to bind Fg when they were destabilized by a chaotrope. These results indicate that M1 stability is antithetical to Fg interaction and that M1 conformational dynamics, as specified by destabilizing residues, are essential for interaction. A "capture-and-collapse" model of association accounts for these observations, in which M1 captures Fg through a dynamic conformation and then collapses into a register 2-coiled coil as a result of stabilization provided by binding energy. Our results support the general conclusion that destabilizing residues are evolutionarily conserved in M proteins to enable functional interactions necessary for pathogenesis.

Pilot study for supervised target detection applied to spatially registered multiparametric MRI in order to non-invasively score prostate cancer.

PubMed

Mayer, Rulon; Simone, Charles B; Skinner, William; Turkbey, Baris; Choykey, Peter

2018-03-01

Gleason Score (GS) is a validated predictor of prostate cancer (PCa) disease progression and outcomes. GS from invasive needle biopsies suffers from significant inter-observer variability and possible sampling error, leading to underestimating disease severity ("underscoring") and can result in possible complications. A robust non-invasive image-based approach is, therefore, needed. Use spatially registered multi-parametric MRI (MP-MRI), signatures, and supervised target detection algorithms (STDA) to non-invasively GS PCa at the voxel level. This study retrospectively analyzed 26 MP-MRI from The Cancer Imaging Archive. The MP-MRI (T2, Diffusion Weighted, Dynamic Contrast Enhanced) were spatially registered to each other, combined into stacks, and stitched together to form hypercubes. Multi-parametric (or multi-spectral) signatures derived from a training set of registered MP-MRI were transformed using statistics-based Whitening-Dewhitening (WD). Transformed signatures were inserted into STDA (having conical decision surfaces) applied to registered MP-MRI determined the tumor GS. The MRI-derived GS was quantitatively compared to the pathologist's assessment of the histology of sectioned whole mount prostates from patients who underwent radical prostatectomy. In addition, a meta-analysis of 17 studies of needle biopsy determined GS with confusion matrices and was compared to the MRI-determined GS. STDA and histology determined GS are highly correlated (R = 0.86, p < 0.02). STDA more accurately determined GS and reduced GS underscoring of PCa relative to needle biopsy as summarized by meta-analysis (p < 0.05). This pilot study found registered MP-MRI, STDA, and WD transforms of signatures shows promise in non-invasively GS PCa and reducing underscoring with high spatial resolution. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Scandinavian Sarcoma Group Central Register: 6,000 patients after 25 years of monitoring of referral and treatment of extremity and trunk wall soft-tissue sarcoma.

PubMed

Trovik, Clement; Bauer, Henrik C F; Styring, Emelie; Sundby Hall, Kirsten; Vult Von Steyern, Fredrik; Eriksson, Sigvard; Johansson, Ingela; Sampo, Mika; Laitinen, Minna; Kalén, Anders; Jónsson, Halldór; Jebsen, Nina; Eriksson, Mikael; Tukiainen, Erkki; Wall, Najme; Zaikova, Olga; Sigurðsson, Helgi; Lehtinen, Tuula; Bjerkehagen, Bodil; Skorpil, Mikael; Egil Eide, Geir; Johansson, Elisabeth; Alvegard, Thor A

2017-06-01

Purpose - We wanted to examine the potential of the Scandinavian Sarcoma Group (SSG) Central Register, and evaluate referral and treatment practice for soft-tissue sarcomas in the extremities and trunk wall (STS) in the Nordic countries. Background - Based on incidence rates from the literature, 8,150 (7,000-9,300) cases of STS of the extremity and trunk wall should have been diagnosed in Norway, Finland, Iceland, and Sweden from 1987 through 2011. The SSG Register has 6,027 cases registered from this period, with 5,837 having complete registration of key variables. 10 centers have been reporting to the Register. The 5 centers that consistently report treat approximately 90% of the cases in their respective regions. The remaining centers have reported all the patients who were treated during certain time periods, but not for the entire 25-year period. Results - 59% of patients were referred to a sarcoma center untouched, i.e. before any attempt at open biopsy. There was an improvement from 52% during the first 5 years to 70% during the last 5 years. 50% had wide or better margins at surgery. Wide margins are now achieved less often than 20 years ago, in parallel with an increase in the use of radiotherapy. For the centers that consistently report, 97% of surviving patients are followed for more than 4 years. Metastasis-free survival (MFS) increased from 67% to 73% during the 25-year period. Interpretation - The Register is considered to be representative of extremity and trunk wall sarcoma disease in the population of Scandinavia, treated at the reporting centers. There were no clinically significant differences in treatment results at these centers.

The Scandinavian Sarcoma Group Central Register: 6,000 patients after 25 years of monitoring of referral and treatment of extremity and trunk wall soft-tissue sarcoma

PubMed Central

Trovik, Clement; Bauer, Henrik C F; Styring, Emelie; Sundby Hall, Kirsten; Vult Von Steyern, Fredrik; Eriksson, Sigvard; Johansson, Ingela; Sampo, Mika; Laitinen, Minna; Kalén, Anders; Jónsson, Halldór; Jebsen, Nina; Eriksson, Mikael; Tukiainen, Erkki; Wall, Najme; Zaikova, Olga; Sigurðsson, Helgi; Lehtinen, Tuula; Bjerkehagen, Bodil; Skorpil, Mikael; Egil Eide, Geir; Johansson, Elisabeth; Alvegard, Thor A

2017-01-01

Purpose We wanted to examine the potential of the Scandinavian Sarcoma Group (SSG) Central Register, and evaluate referral and treatment practice for soft-tissue sarcomas in the extremities and trunk wall (STS) in the Nordic countries. Background Based on incidence rates from the literature, 8,150 (7,000–9,300) cases of STS of the extremity and trunk wall should have been diagnosed in Norway, Finland, Iceland, and Sweden from 1987 through 2011. The SSG Register has 6,027 cases registered from this period, with 5,837 having complete registration of key variables. 10 centers have been reporting to the Register. The 5 centers that consistently report treat approximately 90% of the cases in their respective regions. The remaining centers have reported all the patients who were treated during certain time periods, but not for the entire 25-year period. Results 59% of patients were referred to a sarcoma center untouched, i.e. before any attempt at open biopsy. There was an improvement from 52% during the first 5 years to 70% during the last 5 years. 50% had wide or better margins at surgery. Wide margins are now achieved less often than 20 years ago, in parallel with an increase in the use of radiotherapy. For the centers that consistently report, 97% of surviving patients are followed for more than 4 years. Metastasis-free survival (MFS) increased from 67% to 73% during the 25-year period. Interpretation The Register is considered to be representative of extremity and trunk wall sarcoma disease in the population of Scandinavia, treated at the reporting centers. There were no clinically significant differences in treatment results at these centers. PMID:28266233

An exploration of predictors of children's nurses' attitudes, knowledge, confidence and clinical behavioural intentions towards children and young people who self-harm.

PubMed

Carter, Tim; Latif, Asam; Callaghan, Patrick; Manning, Joseph C

2018-03-22

To explore the potential predictors of children's nurses' attitudes, knowledge and confidence towards caring for children and young people admitted to hospital with self-harm. Admissions to paediatric inpatient settings for individuals who have self-harmed are growing. Limited previous research suggests that nurses have mixed attitudes towards people who have self-harmed and potentially lack the confidence to provide effective care. There is a specific paucity of research in this area for children's nurses. A cross-sectional descriptive survey was used to gather data for exploration of variables associated with attitudes, confidence, knowledge and clinical behavioural intentions of 98 registered children's nurses in a single tertiary children's hospital, colocated in a large acute NHS Trust in the UK. Data were collected over a 4 weeks in 2015, using an online survey tool. The predictive effect of several demographic variables was tested on the outcomes of attitudes, knowledge, confidence and behavioural intentions, which were collected using relevant, previously used outcome measures. Increased experience was found to be associated with improved attitudes relating to negativity. Previous training in caring for children who had self-harmed was found to be associated with improved attitudes around perceived effectiveness of their care. Higher academic qualifications and having undertaken previous training on self-harm were each found to be associated with increased knowledge of self-harm, and increased age was associated with reduced knowledge of self-harm. This study provides an initial exploration of variables associated with attitudes, knowledge, confidence and behaviour intentions of registered children's nurses in relation to caring for CYP who have self-harmed. Targeted training on caring for CYP who have self-harmed should be considered as a component of continuing education for registered children's nurses in the UK to improve the experience and outcomes for this patient group. ©2018 The Authors Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

[Healthy life style as part of strategy of active longevity].

PubMed

Golubeva, E Iu; Danilova, R I

2011-01-01

The contemporary approaches to the conception of healthy aging are discussed. The insufficient propaganda of healthy style of life of elderly population results in non-satisfaction of own health in old age; lack of information about opportunities to strengthen the health in the system of social services managing is also a problem. Weak skills and motivation of elder generation for taking care of the own health are registered. Gender and age features of health self-evaluation have been considered. Low meaning of spending spare time to use physical culture activity for strengthening health have been determinated.

Risk factors of fatal occupational accidents in Iran.

PubMed

Asady, Hadi; Yaseri, Mehdi; Hosseini, Mostafa; Zarif-Yeganeh, Morvarid; Yousefifard, Mahmoud; Haghshenas, Mahin; Hajizadeh-Moghadam, Parisa

2018-01-01

Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure ( p  = 0.01), damaged parts of the body ( p  < 0.001) and injury cause ( p  < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01-43.74; p  = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05-0.70; p  = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.

Life history theory predicts fish assemblage response to hydrologic regimes.

PubMed

Mims, Meryl C; Olden, Julian D

2012-01-01

The hydrologic regime is regarded as the primary driver of freshwater ecosystems, structuring the physical habitat template, providing connectivity, framing biotic interactions, and ultimately selecting for specific life histories of aquatic organisms. In the present study, we tested ecological theory predicting directional relationships between major dimensions of the flow regime and life history composition of fish assemblages in perennial free-flowing rivers throughout the continental United States. Using long-term discharge records and fish trait and survey data for 109 stream locations, we found that 11 out of 18 relationships (61%) tested between the three life history strategies (opportunistic, periodic, and equilibrium) and six hydrologic metrics (two each describing flow variability, predictability, and seasonality) were statistically significant (P < or = 0.05) according to quantile regression. Our results largely support a priori hypotheses of relationships between specific flow indices and relative prevalence of fish life history strategies, with 82% of all significant relationships observed supporting predictions from life history theory. Specifically, we found that (1) opportunistic strategists were positively related to measures of flow variability and negatively related to predictability and seasonality, (2) periodic strategists were positively related to high flow seasonality and negatively related to variability, and (3) the equilibrium strategists were negatively related to flow variability and positively related to predictability. Our study provides important empirical evidence illustrating the value of using life history theory to understand both the patterns and processes by which fish assemblage structure is shaped by adaptation to natural regimes of variability, predictability, and seasonality of critical flow events over broad biogeographic scales.

Demographic, clinical, and quality of life variables related to embarrassment in veterans living with an intestinal stoma.

PubMed

Mitchell, Kimberly A; Rawl, Susan M; Schmidt, C Max; Grant, Marcia; Ko, Clifford Y; Baldwin, Carol M; Wendel, Christopher; Krouse, Robert S

2007-01-01

The study aims were to identify demographic, clinical, and quality of life variables related to embarrassment for people living with ostomies and to determine the experiences and/or feelings of veterans who were embarrassed by their ostomy. This was a cross-sectional, correlational study. A convenience sample of veterans (n = 239) living with ostomies from 3 VA medical centers was studied. The veterans were primarily Caucasian (84%), male (92%), and older (M = 69). The modified City of Hope Quality of Life-Ostomy questionnaire was used. Additionally, an open-ended question related to living with an ostomy was asked. The questionnaire packets were mailed to participants and self-administered. Approximately half of the participants (48%) rated their embarrassment as low, but 26% reported high embarrassment. Participants with high embarrassment were compared to those with low embarrassment on demographic, clinical, and quality of life variables. High embarrassment was associated with poorer total quality of life (P < .001) and poorer quality of life on the physical (P < .001), psychological (P < .001), social (P < .001), and spiritual (P < .001) subscales. Younger (P < .001) and unpartnered veterans (P < .001) were more likely to be highly embarrassed. Veterans with high embarrassment had higher anxiety (P < .001) and depression (P < .001), more difficulty with intimacy (P < .001), and felt more isolated (P < .001). Spiritual domain variables like hopefulness were associated with low embarrassment (P < .001). Sources of embarrassment included leakage, odor, and noise. Embarrassment may negatively impact a person's quality of life; therefore, the variables associated with high embarrassment should be recognized and addressed.

From stage to age in variable environments: life expectancy and survivorship.

PubMed

Tuljapurkar, Shripad; Horvitz, Carol C

2006-06-01

Stage-based demographic data are now available on many species of plants and some animals, and they often display temporal and spatial variability. We provide exact formulas to compute age-specific life expectancy and survivorship from stage-based data for three models of temporal variability: cycles, serially independent random variation, and a Markov chain. These models provide a comprehensive description of patterns of temporal variation. Our formulas describe the effects of cohort (birth) environmental condition on mortality at all ages, and of the effects on survivorship of environmental variability experienced over the course of life. This paper complements existing methods for time-invariant stage-based data, and adds to the information on population growth and dynamics available from stochastic demography.

Fatigue life prediction of rotor blade composites: Validation of constant amplitude formulations with variable amplitude experiments

NASA Astrophysics Data System (ADS)

Westphal, T.; Nijssen, R. P. L.

2014-12-01

The effect of Constant Life Diagram (CLD) formulation on the fatigue life prediction under variable amplitude (VA) loading was investigated based on variable amplitude tests using three different load spectra representative for wind turbine loading. Next to the Wisper and WisperX spectra, the recently developed NewWisper2 spectrum was used. Based on these variable amplitude fatigue results the prediction accuracy of 4 CLD formulations is investigated. In the study a piecewise linear CLD based on the S-N curves for 9 load ratios compares favourably in terms of prediction accuracy and conservativeness. For the specific laminate used in this study Boerstra's Multislope model provides a good alternative at reduced test effort.

Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology

PubMed Central

Azar, Marleine; Riehm, Kira E.; McKay, Dean; Thombs, Brett D.

2015-01-01

Background Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Methods Eligible RCTs were published in JCCP in 2013–2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Results Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). Conclusions The quality of published outcome analysis definitions and trial registrations in JCCP is suboptimal. Greater attention to proper trial registration and outcome analysis definition in published reports is needed. PMID:26581079

Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

PubMed

Azar, Marleine; Riehm, Kira E; McKay, Dean; Thombs, Brett D

2015-01-01

Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). The quality of published outcome analysis definitions and trial registrations in JCCP is suboptimal. Greater attention to proper trial registration and outcome analysis definition in published reports is needed.

Housing characteristics and their influence on health-related quality of life in persons living with HIV in Ontario, Canada: results from the positive spaces, healthy places study.

PubMed

Rourke, Sean B; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W; Dunn, James; Hambly, Keith

2012-11-01

Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables-including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing-and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

The effect of work on people with severe mental illness in Taiwan using a stress-social support model: an exploratory study.

PubMed

Wu, Hui-Ching

2006-06-01

Satisfaction with quality of life is one aspect of a positive and successful life, and this remains true in the rehabilitation of people with severe mental illness. This study explores the meaning and impact of work on people with severe mental illness in Taiwan and, specifically, the value of encouraging people with severe mental illness to work to enhance their quality of life. We apply stress-social support theory (a Western model) to examine daily life and work stressors in an Eastern cultural environment (Taiwan). We use multiple regression models to analyze predictive factors for their effect on life quality. There are five categories: socio-demographic characteristics, mental illness history, current work status variables (as controls), stress variable and social support variable. Unlike Western studies, current work status, in itself, did not lead to better satisfaction with quality of life, but the stress-social support model did. The implications for rehabilitation success are discussed.

Variety Is Not the Spice of Life for People with Autism Spectrum Disorders: Frequency Ratings of Central, Variable and Inappropriate Aspects of Common Real-Life Events

ERIC Educational Resources Information Center

Loth, Eva; Happe, Francesca; Gomez, Juan Carlos

2010-01-01

This study used a novel rating task to investigate whether high-functioning individuals with autism spectrum disorder (ASD) have difficulties distinguishing essential from variable aspects of familiar events. Participants read stories about everyday events and judged how often central, variable, and inappropriate event-components normally occur in…

Family (Dis)Advantage and Life Course Expectations*

PubMed Central

Johnson, Monica Kirkpatrick; Hitlin, Steven

2016-01-01

Optimistic assessments of life chances can positively influence life outcomes, but conflicting theories suggest these assessments either reflect structural privilege or develop as a result of childhood hardship. In addition, competing hypotheses suggest that these assessments may matter differently depending on who holds them. We examine whether family socioeconomic status shapes adolescents’ expectations about how successful their lives will turn out. We distinguish generalized life expectations (GLE), capturing anticipated success in life across multiple domains, from intergenerational comparative expectations (ICE), which register expectations about improvement relative to observed success within the respondent’s family lineage. We find that adolescents from higher socioeconomic status families are simultaneously more optimistic about their likely success in life (GLE) but less likely to anticipate relative improvement in life success across generations (ICE). Holding high GLE in combination with low ICE predicted doing better in adulthood across a range of health, attainment, and well-being outcomes, though in most cases high GLE, regardless of ICE, was the key. These beneficial patterns are, for the most part, at least as beneficial for socioeconomically disadvantaged youth as they are for advantaged youth. PMID:28408766

Inter-observer variability within BI-RADS and RANZCR mammographic density assessment schemes

NASA Astrophysics Data System (ADS)

Damases, Christine N.; Mello-Thoms, Claudia; McEntee, Mark F.

2016-03-01

This study compares variability associated with two visual mammographic density (MD) assessment methods using two separate samples of radiologists. The image test-set comprised of images obtained from 20 women (age 42-89 years). The images were assessed for their MD by twenty American Board of Radiology (ABR) examiners and twenty-six radiologists registered with the Royal Australian and New Zealand College of Radiologists (RANZCR). Images were assessed using the same technology and conditions, however the ABR radiologists used the BI-RADS and the RANZCR radiologists used the RANZCR breast density synoptic. Both scales use a 4-point assessment. The images were then grouped as low- and high-density; low including BIRADS 1 and 2 or RANZCR 1 and 2 and high including BI-RADS 3 and 4 or RANZCR 3 and 4. Four-point BI-RADS and RANZCR showed no or negligible correlation (ρ=-0.029 p<0.859). The average inter-observer agreement on the BI-RADS scale had a Kappa of 0.565; [95% CI = 0.519 - 0.610], and ranged between 0.328-0.669 while the inter-observer agreement using the RANZCR scale had a Kappa of 0.360; [95% CI = 0.308 - 0.412] and a range of 0.078-0.499. Our findings show a wider range of inter-observer variability among RANZCR registered radiologists than the ABR examiners.

Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach.

PubMed

Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke

2013-07-01

To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

Recruitment of older adults to three preventative lifestyle improvement studies.

PubMed

Chatters, Robin; Newbould, Louise; Sprange, Kirsty; Hind, Daniel; Mountain, Gail; Shortland, Katy; Powell, Lauren; Gossage-Worrall, Rebecca; Chater, Tim; Keetharuth, Anju; Lee, Ellen; Woods, Bob

2018-02-20

Recruiting isolated older adults to clinical trials is complex, time-consuming and difficult. Previous studies have suggested querying existing databases to identify appropriate potential participants. We aim to compare recruitment techniques (general practitioner (GP) mail-outs, community engagement and clinician referrals) used in three randomised controlled trial (RCT) studies assessing the feasibility or effectiveness of two preventative interventions in isolated older adults (the Lifestyle Matters and Putting Life In Years interventions). During the three studies (the Lifestyle Matters feasibility study, the Lifestyle Matters RCT, the Putting Life In Years RCT) data were collected about how participants were recruited. The number of letters sent by GP surgeries for each study was recorded. In the Lifestyle Matters RCT, we qualitatively interviewed participants and intervention facilitators at 6 months post randomisation to seek their thoughts on the recruitment process. Referrals were planned to be the main source of recruitment in the Lifestyle Matters feasibility study, but due to a lack of engagement from district nurses, community engagement was the main source of recruitment. District nurse referrals and community engagement were also utilised in the Lifestyle Matters and Putting Life In Years RCTs; both mechanisms yielded few participants. GP mail-outs were the main source of recruitment in both the RCTs, but of those contacted, recruiting yield was low (< 3%). Facilitators of the Lifestyle Matters intervention questioned whether the most appropriate individuals had been recruited. Participants recommended that direct contact with health professionals would be the most beneficial way to recruit. Recruitment to the Lifestyle Matters RCT did not mirror recruitment to the feasibility study of the same intervention. Direct district nurse referrals were not effective at recruiting participants. The majority of participants were recruited via GP mail-outs, which may have led to isolated individuals not being recruited to the trials. Further research is required into alternative recruitment techniques, including respondent-driven sampling plus mechanisms which will promote health care professionals to recruit vulnerable populations to research. International Standard Randomised Controlled Trial Registry, ID: ISRCTN28645428 (Putting Life In Years RCT). Registered on 11 April 2012; International Standard Randomised Controlled Trial Registry, ID: ISRCTN67209155 (Lifestyle Matters RCT). Registered on 22 March 2012; ClinicalTrials.gov , ID: NCT03054311 (Lifestyle Matters feasibility study). Registered retrospectively on 19 January 2017.

The impact of health changes on labor supply: evidence from merged data on individual objective medical diagnosis codes and early retirement behavior.

PubMed

Christensen, Bent Jesper; Kallestrup-Lamb, Malene

2012-06-01

The justification bias in the estimated impact of health shocks on retirement is mitigated by using objective health measures from a large, register-based longitudinal data set including medical diagnosis codes, along with labor market status, financial, and socio-economic variables. The duration until retirement is modeled using single and competing risk specifications, observed and unobserved heterogeneity, and flexible baseline hazards. Wealth is used as a proxy for elapsed duration to mitigate the potential selection bias stemming from conditioning on initial participation. The competing risk specification distinguishes complete multiperiod routes to retirement, such as unemployment followed by early retirement. A result on comparison of coefficients across all states is offered. The empirical results indicate a strong impact of health changes on retirement and hence a large potential for public policy measures intended to retain older workers longer in the labor force. Disability responds more to health shocks than early retirement, especially to diseases of the circulatory, respiratory, and musculoskeletal systems, as well as mental and behavioral disorders. Some unemployment spells followed by early retirement appear voluntary and spurred by life style diseases. Copyright © 2012 John Wiley & Sons, Ltd.

The effect of head nurse behaviors on nurse job satisfaction and performance.

PubMed

Sorrentino, E A; Nalli, B; Schriesheim, C

1992-01-01

Many nursing executives ponder the repeated problems at the unit level and occasionally surmise that effective supervision at that level holds the key to quality patient care. These pragmatic concerns, while commonplace, have yet to be explored empirically. The relationship of head nurse direction and support on subordinate job satisfaction and performance is not clearly understood. This study examines these relationships in the context of three moderating factors--role clarity, job anxiety, and unit size. Additionally, head nurse support is examined as a moderator of relationships between head nurse direction and subordinate satisfaction and job performance. Using a sample of 103 registered nurses in a medium-capacity metropolitan general hospital, the results show some significant correlations between head nurse behavior and job satisfaction and performance, and in moderating the effects of job anxiety, unit size, and support. The study highlights the need for replication in other settings. Additionally, other variables relevant to job satisfaction and performance such as life stressors (death or illness in the family) require investigation. The findings of this study reveal implications for management at the unit level and the importance of understanding subordinate behaviors in the context of head nurse support and direction.

The evaluation of bulbar dysfunction in amyotrophic lateral sclerosis: survey of clinical practice patterns in the United States.

PubMed

Plowman, Emily K; Tabor, Lauren C; Wymer, James; Pattee, Gary

2017-08-01

Speech and swallowing impairments are highly prevalent in individuals with amyotrophic lateral sclerosis (ALS) and contribute to reduced quality of life, malnutrition, aspiration, pneumonia and death. Established practice parameters for bulbar dysfunction in ALS do not currently exist. The aim of this study was to identify current practice patterns for the evaluation of speech and swallowing function within participating Northeast ALS clinics in the United States. A 15-item survey was emailed to all registered NEALS centres. Thirty-eight sites completed the survey. The majority (92%) offered Speech-Language Pathology, augmentative and alternative communication (71%), and dietician (92%) health care services. The ALS Functional Rating Scale-Revised and body weight represented the only parameters routinely collected in greater then 90% of responding sites. Referral for modified barium swallow study was routinely utilised in only 27% of sites and the use of percutaneous gastrostomy tubes in ALS patient care was found to vary considerably. This survey reveals significant variability and inconsistency in the management of bulbar dysfunction in ALS across NEALS sites. We conclude that a great need exists for the development of bulbar practice guidelines in ALS clinical care to accurately detect and monitor bulbar dysfunction.

Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.

PubMed

Park, Brian Y; Wilson, Gary; Berger, Jonathan; Christman, Matthew; Reina, Bryn; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2016-08-05

Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.

The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia.

PubMed

Galderisi, Silvana; Rossi, Alessandro; Rocca, Paola; Bertolino, Alessandro; Mucci, Armida; Bucci, Paola; Rucci, Paola; Gibertoni, Dino; Aguglia, Eugenio; Amore, Mario; Bellomo, Antonello; Biondi, Massimo; Brugnoli, Roberto; Dell'Osso, Liliana; De Ronchi, Diana; Di Emidio, Gabriella; Di Giannantonio, Massimo; Fagiolini, Andrea; Marchesi, Carlo; Monteleone, Palmiero; Oldani, Lucio; Pinna, Federica; Roncone, Rita; Sacchetti, Emilio; Santonastaso, Paolo; Siracusano, Alberto; Vita, Antonio; Zeppegno, Patrizia; Maj, Mario

2014-10-01

In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictors of real-life functioning in people with schizophrenia, and to assess their relative contribution. Based on previous literature and clinical experience, several factors were selected and grouped into three categories: illness-related variables, personal resources and context-related factors. Some of these variables were never investigated before in relationship with real-life functioning. In 921 patients with schizophrenia living in the community, we found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a structural equation model. Neurocognition exhibited the strongest, though indirect, association with real-life functioning. Positive symptoms and disorganization, as well as avolition, proved to have significant direct and indirect effects, while depression had no significant association and poor emotional expression was only indirectly and weakly related to real-life functioning. Availability of a disability pension and access to social and family incentives also showed a significant direct association with functioning. Social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services served as mediators. The observed complex associations among investigated predictors, mediators and real-life functioning strongly suggest that integrated and personalized programs should be provided as standard treatment to people with schizophrenia. Copyright © 2014 World Psychiatric Association.

Operator Variability in Scan Positioning is a Major Component of HR-pQCT Precision Error and is Reduced by Standardized Training

PubMed Central

Bonaretti, Serena; Vilayphiou, Nicolas; Chan, Caroline Mai; Yu, Andrew; Nishiyama, Kyle; Liu, Danmei; Boutroy, Stephanie; Ghasem-Zadeh, Ali; Boyd, Steven K.; Chapurlat, Roland; McKay, Heather; Shane, Elizabeth; Bouxsein, Mary L.; Black, Dennis M.; Majumdar, Sharmila; Orwoll, Eric S.; Lang, Thomas F.; Khosla, Sundeep; Burghardt, Andrew J.

2017-01-01

Introduction HR-pQCT is increasingly used to assess bone quality, fracture risk and anti-fracture interventions. The contribution of the operator has not been adequately accounted in measurement precision. Operators acquire a 2D projection (“scout view image”) and define the region to be scanned by positioning a “reference line” on a standard anatomical landmark. In this study, we (i) evaluated the contribution of positioning variability to in vivo measurement precision, (ii) measured intra- and inter-operator positioning variability, and (iii) tested if custom training software led to superior reproducibility in new operators compared to experienced operators. Methods To evaluate the operator in vivo measurement precision we compared precision errors calculated in 64 co-registered and non-co-registered scan-rescan images. To quantify operator variability, we developed software that simulates the positioning process of the scanner’s software. Eight experienced operators positioned reference lines on scout view images designed to test intra- and inter-operator reproducibility. Finally, we developed modules for training and evaluation of reference line positioning. We enrolled 6 new operators to participate in a common training, followed by the same reproducibility experiments performed by the experienced group. Results In vivo precision errors were up to three-fold greater (Tt.BMD and Ct.Th) when variability in scan positioning was included. Inter-operator precision errors were significantly greater than short-term intra-operator precision (p<0.001). New trained operators achieved comparable intra-operator reproducibility to experienced operators, and lower inter-operator reproducibility (p<0.001). Precision errors were significantly greater for the radius than for the tibia. Conclusion Operator reference line positioning contributes significantly to in vivo measurement precision and is significantly greater for multi-operator datasets. Inter-operator variability can be significantly reduced using a systematic training platform, now available online (http://webapps.radiology.ucsf.edu/refline/). PMID:27475931

Electroglottographic parameterization of the effects of gender, vowel and phonatory registers on vocal fold vibratory patterns: an Indian perspective.

PubMed

Paul, Nilanjan; Kumar, Suman; Chatterjee, Indranil; Mukherjee, Biswarup

2011-01-01

In-depth study on laryngeal biomechanics and vocal fold vibratory patterns reveal that a single vibratory cycle can be divided into two major phases, the closed and open phase, which is subdivided into opening and closing phases. Studies reveal that the relative time course of abduction and adduction, which in turn is dependent on the relative relaxing and tensing of the vocal fold cover and body, to be the determining factor in production of a particular vocal register like the modal (or chest), falsetto, glottal fry registers. Studies further point out Electroglottography to be particularly suitable for the study of vocal vibratory patterns during register changes. However, to date, there has been limited study on quantitative parameterization of EGG wave form in vocal fry register. Moreover, contradictory findings abound in literature regarding effects of gender and vowel types on vocal vibratory patterns, especially during phonation at different registers. The present study endeavors to find out the effects of vowel and gender differences on the vocal fold vibratory patterns in different registers and how these would be reflected in standard EGG parameters of Contact Quotient (CQ) and Contact Index (CI), taking into consideration the Indian sociolinguistic context. Electroglottographic recordings of 10 young adults (5 males and 5 females) were taken while the subjects phonated the three vowels /a/,/i/,/u/ each in two vocal registers, modal and vocal fry. Obtained raw EGG were further normalized using the Derived EGG algorithm and theCQ and CI values were derived. Obtained data were subject to statistical analysis using the 3-way ANOVA with gender, vowel and vocal register as the three variables. Post-hoc Dunnett C multiple comparison analysis were also performed. Results reveal that CQ values are significantly higher in vocal fry than modal phonation for both males and females, indicating a relatively hyperconstricted vocal system during vocal fry. The males have significantly greater CQ values than females both at modal and vocal fry phonations which indicate that the males are predisposed to greater vocal fold constriction. Females demonstrated no significant increase in CI values in vocal fry state; and in some cases actually decrease in the CI values which suggest an inherently distinct vocal fold physiological adjustment from that in males. No vowel effects were found in any conditions. Perturbation values (CQP and CIP) are significantly more in vocal fry register than in modal register, and the increase was more in case of females than males. The findings give strong evidence to certain hypotheses in literature regarding effects of vowel, gender and phonatory register on vocal fold vibratory patterns.

LEARN 2 MOVE 7-12 years: a randomized controlled trial on the effects of a physical activity stimulation program in children with cerebral palsy.

PubMed

Van Wely, Leontien; Becher, Jules G; Reinders-Messelink, Heleen A; Lindeman, Eline; Verschuren, Olaf; Verheijden, Johannes; Dallmeijer, Annet J

2010-11-02

Regular participation in physical activities is important for all children to stay fit and healthy. Children with cerebral palsy have reduced levels of physical activity, compared to typically developing children. The aim of the LEARN 2 MOVE 7-12 study is to improve physical activity by means of a physical activity stimulation program, consisting of a lifestyle intervention and a fitness training program. This study will be a 6-month single-blinded randomized controlled trial with a 6-month follow up. Fifty children with spastic cerebral palsy, aged 7 to 12 years, with Gross Motor Function Classification System levels I-III, will be recruited in pediatric physiotherapy practices and special schools for children with disabilities. The children will be randomly assigned to either the intervention group or control group. The children in the control group will continue with their regular pediatric physiotherapy, and the children in the intervention group will participate in a 6-month physical activity stimulation program. The physical activity stimulation program consists of a 6-month lifestyle intervention, in combination with a 4-month fitness training program. The lifestyle intervention includes counseling the child and the parents to adopt an active lifestyle through Motivational Interviewing, and home-based physiotherapy to practise mobility-related activities in the daily situation. Data will be collected just before the start of the intervention (T0), after the 4-month fitness training program (T4), after the 6-month lifestyle intervention (T6), and after six months of follow-up (T12). Primary outcomes are physical activity, measured with the StepWatch Activity Monitor and with self-reports. Secondary outcomes are fitness, capacity of mobility, social participation and health-related quality of life. A random coefficient analysis will be performed to determine differences in treatment effect between the control group and the intervention group, with primary outcomes and secondary outcomes as the dependent variables. This is the first study that investigates the effect of a combined lifestyle intervention and fitness training on physical activity. Temporary effects of the fitness training are expected to be maintained by changes to an active lifestyle in daily life and in the home situation. This study is registered in the Dutch Trial Register as NTR2099.

Better health-related quality of life (mental component summary), having a higher level of education, and being less than 75 years of age are predictors of hospital admission among cognitively intact nursing home residents: a 5-year follow-up study

PubMed Central

Drageset, Jorunn; Eide, Geir Egil; Ranhoff, Anette Hylen

2016-01-01

Objective To study whether health-related quality of life (HRQOL), activities of daily living (ADL), and anxiety and depression symptoms affect the risk of hospital admission and potential interactions with having a cancer diagnosis. Methods This study was a prospective observational study with 5-year follow-up and analyzed the follow-up data on hospital admissions until 2010 using baseline data from 227 cognitively intact nursing home (NH) residents (60 of whom had cancer) in 2004–2005. Data on HRQOL were collected by using the Short Form-36 Health Survey, divided into physical component summary (PCS) and mental component summary (MCS), and symptoms of anxiety and depression were collected by using the Hospital Anxiety and Depression Scale (HADS). ADL were obtained from registered observation and sociodemographic variables, diagnoses, and hospital admissions from the NH records. Personal identification numbers were linked to the record systems of the hospitals, thereby registering all hospital admissions. We analyzed the time elapsing between inclusion and the first hospital admission. Results Residents with higher HRQOL (MCS) had significantly more hospital admissions after adjustment for age, sex, marital status, education, and comorbidity. HRQOL (PCS), ADL, depression, and anxiety symptoms were not associated with hospital admissions. Cancer increased the risk after adjustment for all other risk factors but did not increase the effects of MCS, PCS, ADL, or depression or anxiety symptoms. Having a higher level of education and being less than 75 years of age were associated with hospitalization. The residents diagnosed with cancer had the most days in hospital related to diseases of the respiratory system and cancer, and diseases of the circulatory and respiratory systems were more frequent among the residents without a cancer diagnosis. Conclusion Better self-reported HRQOL (MCS) was associated with hospital admissions, whereas self-reported HRQOL (PCS), ADL, and depression and anxiety symptoms were not. Cancer increased the risk but not the effects of MCS, PCS, ADL, or depression or anxiety symptoms. Having a higher level of education and being less than 75 years of age were also associated with hospitalization. PMID:27022249

Income and "Outcomes" for Elderly: Do the Poor Have a Poorer Life?

ERIC Educational Resources Information Center

Arendt, Jacob Neilsen

2005-01-01

The objective of this paper is to analyze the relationship between income and living conditions and well-being of elderly. The best from two worlds is used for this purpose: a Danish survey covering 1440 elderly aged 72 and 77 from 1997, connected to reliable register information on income, 1988-1996. Indicators of physical activity, social and…

Martin Van Buren's "Return to the Soil." Teaching with Historic Places.

ERIC Educational Resources Information Center

National Register of Historic Places, Washington, DC. Interagency Resources Div.

Using primary documents, maps, and visual data, this lesson packet focuses on Martin Van Buren and his retirement home, Lindenwald, which is on the National Register of Historic Places. The lesson materials compliment classroom study of early 19th century politics by tracing the life of Martin Van Buren and his role in the Jacksonian Era. Included…

History as a "GPS": On the Uses of Historical Narrative for French Canadian Students' Life Orientation and Identity

ERIC Educational Resources Information Center

Lévesque, Stéphane

2017-01-01

This article presents the results of a study that analyses students' historical narratives of the nation in relation to historical consciousness and how their sense of self-identification with groups affects their narrative structure and orientation. This study was conducted with French Canadian students registered in two high schools (n = 58) and…

17 CFR 274.11b - Form N-3, registration statement of separate accounts organized as management investment companies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... statement of separate accounts organized as management investment companies. 274.11b Section 274.11b... accounts organized as management investment companies. Form N-3 shall be used as the registration statement... offer variable annuity contracts to register as management investment companies. This form shall also be...

Demographic Profiling--A Determination of Academic Performance in a Postgraduate Diploma in Marketing Management

ERIC Educational Resources Information Center

Beneke, J.; Beeming, C.

2011-01-01

This article analyses the direct effect of demographic variables on academic outcomes. The study concludes that ethnic group plays a pivotal role in determining the academic performance of students registered for the Postgraduate Diploma in Marketing Management at the University of Cape Town. White students (presumed to emanate from a privileged…

Examining Student Achievement and Curriculum in a Nursing Program at a Midwestern Community College

ERIC Educational Resources Information Center

Cooper, Sandra E.

2012-01-01

The purpose of this study was to examine the pathway model of a nursing curriculum and evaluate the relationship and predictive ability of demographic and academic variables on the success or failure of those taking the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) and to determine the impact of noncognitive role…

Investigating Teacher Candidates' Beliefs about Standardized Testing

ERIC Educational Resources Information Center

Kinay, Ismail; Ardiç, Tuncay

2017-01-01

The purpose of this study is to examine the beliefs of prospective teachers' about standardized testing in terms of some variables. This piece of research is in survey model. The study is carried out with 442 randomly selected prospective teachers registered in different departments at Dicle University in Turkey during the 2015-2016 academic year.…

Dynamic Modeling of Process Technologies for Closed-Loop Water Recovery Systems

NASA Technical Reports Server (NTRS)

Allada, Rama Kumar; Lange, Kevin E.; Anderson, Molly S.

2012-01-01

Detailed chemical process simulations are a useful tool in designing and optimizing complex systems and architectures for human life support. Dynamic and steady-state models of these systems help contrast the interactions of various operating parameters and hardware designs, which become extremely useful in trade-study analyses. NASA s Exploration Life Support technology development project recently made use of such models to compliment a series of tests on different waste water distillation systems. This paper presents dynamic simulations of chemical process for primary processor technologies including: the Cascade Distillation System (CDS), the Vapor Compression Distillation (VCD) system, the Wiped-Film Rotating Disk (WFRD), and post-distillation water polishing processes such as the Volatiles Removal Assembly (VRA). These dynamic models were developed using the Aspen Custom Modeler (Registered TradeMark) and Aspen Plus(Registered TradeMark) process simulation tools. The results expand upon previous work for water recovery technology models and emphasize dynamic process modeling and results. The paper discusses system design, modeling details, and model results for each technology and presents some comparisons between the model results and available test data. Following these initial comparisons, some general conclusions and forward work are discussed.

The Impact of Socioeconomic Conditions, Social Networks, and Health on Frail Older People's Life Satisfaction: A Cross-Sectional Study

PubMed Central

Berglund, Helene; Hasson, Henna; Wilhelmson, Katarina; Dunér, Anna; Dahlin-Ivanoff, Synneve

2016-01-01

It has been shown that frailty is associated with low levels of well-being and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people’s life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self-rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people’s life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction – such as social support – should be promoted. PMID:27403463

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis.

PubMed

Kondo, Yutaka; Fukuda, Tatsuma; Uchimido, Ryo; Hifumi, Toru; Hayashida, Kei

2017-10-22

Advanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature. We will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ 2 test of homogeneity, and any observed heterogeneity will be quantified using the I 2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence. Our study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information. PROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Morbidities and hospital resource use during the first 3 years of life among very preterm infants.

PubMed

Korvenranta, Emmi; Lehtonen, Liisa; Peltola, Mikko; Häkkinen, Unto; Andersson, Sture; Gissler, Mika; Hallman, Mikko; Leipälä, Jaana; Rautava, Liisi; Tammela, Outi; Linna, Miika

2009-07-01

The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g). The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model. A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities. Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.

78 FR 62716 - Pacific Life Insurance Company, et al; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... SECURITIES AND EXCHANGE COMMISSION [Release No. IC-30744; File No. 812-14141] Pacific Life... Act''). Applicants: Pacific Life Insurance Company (``Pacific Life''), Pacific Life's Separate Account A (``Separate Account A''), Pacific Life's Pacific Select Variable Annuity Separate Account...

Interrelationships between childbearing and housing transitions in the family life course.

PubMed

Kulu, Hill; Steele, Fiona

2013-10-01

Research has examined the effect of family changes on housing transitions and childbearing patterns within various housing types. Although most research has investigated how an event in one domain of family life depends on the current state in another domain, the interplay between them has been little studied. This study examines the interrelationships between childbearing decisions and housing transitions. We use rich longitudinal register data from Finland and apply multilevel event history analysis to allow for multiple births and housing changes over the life course. We investigate the timing of fertility decisions and housing choices with respect to each other. We model childbearing and housing transitions jointly to control for time-invariant unobserved characteristics of women, which may simultaneously influence their fertility behavior and housing choices, and we show how joint modeling leads to a deeper understanding of the interplay between the two domains of family life.

Effects of High-Temperature Exposures on the Fatigue Life of Superalloy Udimet(Registered Trademark) 720

NASA Technical Reports Server (NTRS)

Gabb, Timothy P.; Telesman, Jack; Kantzos, Peter T.; Sweeney, Joseph W.; Browning, Paul F.

2002-01-01

The purpose of this study was to examine the effects of extended exposures on the near-surface fatigue resistance of a disk superalloy. Powder metallurgy processed, supersolvus heat-treated Udimet 720 (U720) fatigue specimens were exposed in air at temperatures from 650 to 705 C for 100 hr to over 1000 hr. They were then tested using conventional fatigue tests at 650 C to determine the effects of exposure on fatigue resistance. The exposures reduced life by up to 70% and increased the scatter in life, compared to unexposed levels. Fractographic evaluations indicated the failure mode was shifted by the exposures from internal to surface crack initiations. The increased scatter in life was related to the competition between internal crack initiations at inclusions or large grains producing longer lives, and surface crack initiations at an environmentally affected surface layer producing shorter lives.

Health Monitoring of Composite Overwrapped Pressure Vessels (COPVs) Using Meandering Winding Magnetometer ((MWM(Registered Trademark)) Eddy Current Sensors

NASA Technical Reports Server (NTRS)

Russell, Rick; Grundy, David; Jablonski, David; Martin, Christopher; Washabaugh, Andrew; Goldfine, Neil

2011-01-01

There are 3 mechanisms that affect the life of a COPV are: a) The age life of the overwrap; b) Cyclic fatigue of the metallic liner; c) Stress Rupture life. The first two mechanisms are understood through test and analysis. A COPV Stress Rupture is a sudden and catastrophic failure of the overwrap while holding at a stress level below the ultimate strength for an extended time. Currently there is no simple, deterministic method of determining the stress rupture life of a COPV, nor a screening technique to determine if a particular COPV is close to the time of a stress rupture failure. Conclusions: Demonstrated a correlation between MWM response and pressure or strain. Demonstrated the ability to monitor stress in COPV at different orientations and depths. FA41 provides best correlation with bottle pressure or stress.

Ancilla-driven quantum computation for qudits and continuous variables

DOE PAGES

Proctor, Timothy; Giulian, Melissa; Korolkova, Natalia; ...

2017-05-10

Although qubits are the leading candidate for the basic elements in a quantum computer, there are also a range of reasons to consider using higher-dimensional qudits or quantum continuous variables (QCVs). In this paper, we use a general “quantum variable” formalism to propose a method of quantum computation in which ancillas are used to mediate gates on a well-isolated “quantum memory” register and which may be applied to the setting of qubits, qudits (for d>2), or QCVs. More specifically, we present a model in which universal quantum computation may be implemented on a register using only repeated applications of amore » single fixed two-body ancilla-register interaction gate, ancillas prepared in a single state, and local measurements of these ancillas. In order to maintain determinism in the computation, adaptive measurements via a classical feed forward of measurement outcomes are used, with the method similar to that in measurement-based quantum computation (MBQC). We show that our model has the same hybrid quantum-classical processing advantages as MBQC, including the power to implement any Clifford circuit in essentially one layer of quantum computation. In some physical settings, high-quality measurements of the ancillas may be highly challenging or not possible, and hence we also present a globally unitary model which replaces the need for measurements of the ancillas with the requirement for ancillas to be prepared in states from a fixed orthonormal basis. In conclusion, we discuss settings in which these models may be of practical interest.« less

Identification and validation of multiple cell surface markers of clinical-grade adipose-derived mesenchymal stromal cells as novel release criteria for good manufacturing practice-compliant production.

PubMed

Camilleri, Emily T; Gustafson, Michael P; Dudakovic, Amel; Riester, Scott M; Garces, Catalina Galeano; Paradise, Christopher R; Takai, Hideki; Karperien, Marcel; Cool, Simon; Sampen, Hee-Jeong Im; Larson, A Noelle; Qu, Wenchun; Smith, Jay; Dietz, Allan B; van Wijnen, Andre J

2016-08-11

Clinical translation of mesenchymal stromal cells (MSCs) necessitates basic characterization of the cell product since variability in biological source and processing of MSCs may impact therapeutic outcomes. Although expression of classical cell surface markers (e.g., CD90, CD73, CD105, and CD44) is used to define MSCs, identification of functionally relevant cell surface markers would provide more robust release criteria and options for quality control. In addition, cell surface expression may distinguish between MSCs from different sources, including bone marrow-derived MSCs and clinical-grade adipose-derived MSCs (AMSCs) grown in human platelet lysate (hPL). In this work we utilized quantitative PCR, flow cytometry, and RNA-sequencing to characterize AMSCs grown in hPL and validated non-classical markers in 15 clinical-grade donors. We characterized the surface marker transcriptome of AMSCs, validated the expression of classical markers, and identified nine non-classical markers (i.e., CD36, CD163, CD271, CD200, CD273, CD274, CD146, CD248, and CD140B) that may potentially discriminate AMSCs from other cell types. More importantly, these markers exhibit variability in cell surface expression among different cell isolates from a diverse cohort of donors, including freshly prepared, previously frozen, or proliferative state AMSCs and may be informative when manufacturing cells. Our study establishes that clinical-grade AMSCs expanded in hPL represent a homogeneous cell culture population according to classical markers,. Additionally, we validated new biomarkers for further AMSC characterization that may provide novel information guiding the development of new release criteria. Use of Autologous Bone Marrow Aspirate Concentrate in Painful Knee Osteoarthritis (BMAC): Clinicaltrials.gov NCT01931007 . Registered August 26, 2013. MSC for Occlusive Disease of the Kidney: Clinicaltrials.gov NCT01840540 . Registered April 23, 2013. Mesenchymal Stem Cell Therapy in Multiple System Atrophy: Clinicaltrials.gov NCT02315027 . Registered October 31, 2014. Efficacy and Safety of Adult Human Mesenchymal Stem Cells to Treat Steroid Refractory Acute Graft Versus Host Disease. Clinicaltrials.gov NCT00366145 . Registered August 17, 2006. A Dose-escalation Safety Trial for Intrathecal Autologous Mesenchymal Stem Cell Therapy in Amyotrophic Lateral Sclerosis. Clinicaltrials.gov NCT01609283 . Registered May 18, 2012.

Physical Activity Levels and Well-Being in Older Adults.

PubMed

Bae, Wonyul; Ik Suh, Young; Ryu, Jungsu; Heo, Jinmoo

2017-04-01

The objective of this study was to identify the interconnectedness of different intensity levels of physical activity and psychological (life satisfaction and positive affect) and physical (physical health) well-being. Participants were from the National Study of Midlife in the United States with assessments in 2004 and aged 25 to 74 living in the United States were included in the analyses. We conducted bivariate correlations to examine significant relationships among the study variables. In addition, after multicollinearity among the independent variable was checked, a series of hierarchical regression analyses with physical health, positive affect, and life satisfaction as criterion variables were conducted. The results showed that light physical activities were positively associated with physical health and life satisfaction in summer, whereas light physical activities and all dependent variables were positively correlated in winter. Furthermore, engaging in moderate physical activities was positively related only with physical health. Meanwhile, vigorous physical activities were not associated with life satisfaction, physical health, and positive affect in summer and winter.

Cost-utility of medication withdrawal in older fallers: results from the improving medication prescribing to reduce risk of FALLs (IMPROveFALL) trial.

PubMed

Polinder, Suzanne; Boyé, Nicole D A; Mattace-Raso, Francesco U S; Van der Velde, Nathalie; Hartholt, Klaas A; De Vries, Oscar J; Lips, Paul; Van der Cammen, Tischa J M; Patka, Peter; Van Beeck, Ed F; Van Lieshout, Esther M M

2016-11-04

The use of Fall-Risk-Increasing-Drugs (FRIDs) has been associated with increased risk of falls and associated injuries. This study investigates the effect of withdrawal of FRIDs versus 'care as usual' on health-related quality of life (HRQoL), costs, and cost-utility in community-dwelling older fallers. In a prospective multicenter randomized controlled trial FRIDs assessment combined with FRIDs-withdrawal or modification was compared with 'care as usual' in older persons, who visited the emergency department after experiencing a fall. For the calculation of costs the direct medical costs (intramural and extramural) and indirect costs (travel costs) were collected for a 12 month period. HRQoL was measured at baseline and at 12 months follow-up using the EuroQol-5D and Short Form-12 version 2. The change in EuroQol-5D and Short Form-12 scores over 12 months follow-up within the control and intervention groups was compared using the Wilcoxon Signed Rank test for continuous variables and the McNemar test for dichotomous variables. The change in scores between the control and intervention groups were compared using a two-way analysis of variance. We included 612 older persons who visited an emergency department because of a fall. The mean cost of the FRIDs intervention was €120 per patient. The total fall-related healthcare costs (without the intervention costs) did not differ significantly between the intervention group and the control group (€2204 versus €2285). However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant. Furthermore, the control group had a greater decline in EuroQol-5D utility score during the 12-months follow-up than the intervention group (p = 0.02). The change in the Short Form-12 Physical Component Summary and Mental Component Summary scores did not differ significantly between the two groups. Withdrawal of FRID's in older persons who visited an emergency department due to a fall, did not lead to reduction of total health-care costs. However, the withdrawal of FRIDs reduced medication costs with a mean of €38 per participant in combination with less decline in HRQoL is an important result. The trial is registered in the Netherlands Trial Register ( NTR1593 - October 1 st 2008).

Psychologically mediated effects of the physical healthcare environment on work-related outcomes of healthcare personnel.

PubMed

Tanja-Dijkstra, Karin; Pieterse, Marcel E

2010-12-08

The physical healthcare environment is capable of affecting patients. This concept of 'healing environments' refers to the psychological impact of environmental stimuli through sensory perceptions. It excludes more physiological effects such as those produced by ergonomic (i.e. fall prevention) or facilitative (i.e. hygiene-related) variables. The importance of an atmosphere in the healthcare environment that promotes the health and well-being of patients is evident, but this environment should not negatively affect healthcare personnel. The physical healthcare environment is part of the personnel's 'workscape'. This can make the environment an important determinant of subjective work-related outcomes like job satisfaction and well-being, as well as of objective outcomes like absenteeism or quality of care. In order to effectively build or renovate healthcare facilities, it is necessary to pay attention to the needs of both patients and healthcare personnel. To assess the psychological effects of the physical healthcare environment on healthcare personnel. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials; Database of Abstracts and Reviews of Effects; MEDLINE; EMBASE; CINAHL; Civil Engineering Database and Compendex. We also searched the reference lists of included studies. We included randomised controlled trials (RCT), controlled clinical trials (CCT), controlled before and after studies (CBA), and interrupted time series (ITS) of psychological effects of the physical healthcare environment interventions for healthcare staff. The outcomes included measures of job satisfaction, satisfaction with the physical healthcare environment, quality of life, and quality of care. Two reviewers independently assessed studies for eligibility, extracted data, and assessed methodological quality. We identified one study, which adopted a CBA study design to investigate the simultaneous effects of multiple environmental stimuli. Staff mood improved in this study, while no effects were found on ward atmosphere or unscheduled absences. One study was included in this review. This review therefore indicates that, at present, there is insufficient evidence to support or refute the impact of the physical healthcare environment on work-related outcomes of healthcare staff. Methodological shortcomings, particularly confounding with other variables and the lack of adequate control conditions, partially account for this lack of evidence. Given these methodological issues, the field is in need of well-conducted controlled trials.

The psychological effects of the physical healthcare environment on healthcare personnel.

PubMed

Tanja-Dijkstra, Karin; Pieterse, Marcel E

2011-01-19

The physical healthcare environment is capable of affecting patients. This concept of 'healing environments' refers to the psychological impact of environmental stimuli through sensory perceptions. It excludes more physiological effects such as those produced by ergonomic (i.e. fall prevention) or facilitative (i.e. hygiene-related) variables. The importance of an atmosphere in the healthcare environment that promotes the health and well-being of patients is evident, but this environment should not negatively affect healthcare personnel. The physical healthcare environment is part of the personnel's 'workscape'. This can make the environment an important determinant of subjective work-related outcomes like job satisfaction and well-being, as well as of objective outcomes like absenteeism or quality of care. In order to effectively build or renovate healthcare facilities, it is necessary to pay attention to the needs of both patients and healthcare personnel. To assess the psychological effects of the physical healthcare environment on healthcare personnel. We searched the Cochrane EPOC Group Specialised Register; Cochrane Central Register of Controlled Trials; Database of Abstracts and Reviews of Effects; MEDLINE; EMBASE; CINAHL; Civil Engineering Database and Compendex. We also searched the reference lists of included studies. We included randomised controlled trials (RCT), controlled clinical trials (CCT), controlled before and after studies (CBA), and interrupted time series (ITS) of psychological effects of the physical healthcare environment interventions for healthcare staff. The outcomes included measures of job satisfaction, satisfaction with the physical healthcare environment, quality of life, and quality of care. Two reviewers independently assessed studies for eligibility, extracted data, and assessed methodological quality. We identified one study, which adopted a CBA study design to investigate the simultaneous effects of multiple environmental stimuli. Staff mood improved in this study, while no effects were found on ward atmosphere or unscheduled absences. One study was included in this review. This review therefore indicates that, at present, there is insufficient evidence to support or refute the impact of the physical healthcare environment on work-related outcomes of healthcare staff. Methodological shortcomings, particularly confounding with other variables and the lack of adequate control conditions, partially account for this lack of evidence. Given these methodological issues, the field is in need of well-conducted controlled trials.

The predictors of quality of life in women with polycystic ovarian syndrome.

PubMed

Aliasghari, Fatemeh; Mirghafourvand, Mojgan; Charandabi, Sakineh Mohammad-Alizadeh; Lak, Tahereh Behroozi

2017-06-01

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder that may be effective in reducing the quality of life. This study aimed to determine the predictors of quality of life in women with PCOS. This cross-sectional study was conducted on 174 women with PCOS who attended in public and private fertility clinics in Urmia (West Azerbaijan, Iran), 2015. The data were collected through the questionnaires of sociodemographic and obstetrics characteristics, quality of life and Beck depression inventory-II. Multivariate linear regression was used to estimate the effect rate of the independent variables (depression and sociodemographic characteristics) on the dependent variable (quality of life). In this study, the mean (standard deviation) of total score of the quality of life was obtained, 45.8 (11.3) in the range 0-100. The highest and lowest mean scores were in the subdomains of weight and hirsutism. The variables of depression, body mass index, woman's job, menstrual cycle intervals, and sexual satisfaction were predictors of the quality of life in women with PCOS. Because of various effective factors on quality of life in these women such as depression, necessary strategies must be implemented to control these factors and improve the quality of life. © 2017 John Wiley & Sons Australia, Ltd.

Poverty and mortality among the elderly: measurement of performance in 33 countries 1960-92.

PubMed

Wang, J; Jamison, D T; Bos, E; Vu, M T

1997-10-01

This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.

Caritas, spirituality and religiosity in nurses' coping.

PubMed

Ekedahl, M A; Wengström, Y

2010-07-01

The purpose of this qualitative study was to investigate registered nurses' coping processes when working with terminally ill and dying cancer patients, with special focus on religious aspects of coping resources. What religious components can be identified as coping resources in oncology nurses' orienting system and what function has religiosity in the nurse's work? The theoretical reference is care philosophy and the psychology of religion and coping. The material consists of interviews with 15 Swedish registered oncology nurses. The results highlight different dynamic aspects of the nurses' life orientation such as caritas, religiosity, spirituality and atheism and demonstrate that religiosity can have a protective function that facilitates coping, as the nurse has something to turn to. Religious coping dominated by basic trust where prayer is used as a coping strategy may support the nurse.

Empowerment variables for rehabilitation clients on perceived beliefs concerning work quality of life domains.

PubMed

Tschopp, Molly K; Frain, Michael P; Bishop, Malachy

2009-01-01

This article describes and presents an initial analysis of variables generally associated with empowerment towards perceived beliefs concerning quality of life work domains for individuals with disabilities. The model examines the domains of importance, satisfaction, control and degree of interference of disability that an individual feels towards work. The internet based study used results from 70 individuals with disabilities in varying aspects of work. The variables composing empowerment that correlated strongly with the work domains include: self-advocacy, self-efficacy, perceived stigma, and family resiliency as measured through coping. Quality of Life concerning work was measured through the DSC-C a domain specific QOL instrument.

Life skills and subjective well-being of people with disabilities: a canonical correlation analysis.

PubMed

da Silva Cardoso, Elizabeth; Blalock, Kacie; Allen, Chase A; Chan, Fong; Rubin, Stanford E

2004-12-01

This study examined the canonical relationships between a set of life skill variables and a set of subjective well-being variables among a national sample of vocational rehabilitation clients in the USA. Self-direction, work tolerance, general employability, and self-care were related to physical, family and social, and financial well-being. This analysis also found that communication skill is related to family and social well-being, while psychological well-being is not related to any life skills in the set. The results showed that vocational rehabilitation services aimed to improve life functioning will lead to an improvement in subjective quality of life.

Discrepancies in the use of chemotherapy and artificial nutrition near the end of life for hospitalised patients with metastatic gastric or oesophageal cancer. A countrywide, register-based study.

PubMed

Kempf, Emmanuelle; Tournigand, Christophe; Rochigneux, Philippe; Aubry, Régis; Morin, Lucas

2017-07-01

To evaluate the frequency and the factors associated with the use of chemotherapy and artificial nutrition near the end of life in hospitalised patients with metastatic oesophageal or gastric cancer. Nationwide, register-based study, including all hospitalised adults (≥20 years) who died with metastatic oesophageal or gastric cancer between 2010 and 2013, in France. Chemotherapy and artificial nutrition during the final weeks of life were considered as primary outcomes. A total of 4031 patients with oesophageal cancer and 10,423 patients with gastric cancer were included. While the proportion of patients receiving chemotherapy decreased from 35.9% during the 3rd month before death to 7.9% in the final week (p < 0.001 for trend), the use of artificial nutrition rose from 9.6% to 16.0% of patients. During the last week before death, patients with stomach cancer were more likely to receive chemotherapy (adjusted odds ratio (aOR) = 1.35, 95% CI = 1.17-1.56) but less likely to receive artificial nutrition (aOR = 0.80, 95%CI = 0.73-0.88) than patients with cancer of the oesophagus. The adjusted rates of chemotherapy use during the last week of life varied from 1.6% in rural hospitals to 11.2% in comprehensive cancer centres, while the adjusted probability to receive artificial nutrition varied from 12.1% in private for-profit clinics up to 19.9% in rehabilitation care facilities (p < 0.001). Our study shows that in hospitalised patients with metastatic oesophageal or gastric cancer, the use of chemotherapy decreases while the use of artificial nutrition increases as death approaches. This raises important questions, as clinical guidelines clearly recommend to limit the use of artificial nutrition in contexts of limited life expectancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

The COSMAM TRIAL a prospective cohort study of quality of life and cosmetic outcome in patients undergoing breast conserving surgery.

PubMed

Catsman, Coriene J L M; Beek, Martinus A; Voogd, Adri C; Mulder, Paul G H; Luiten, Ernest J T

2018-04-23

Cosmetic result in breast cancer surgery is gaining increased interest. Currently, some 30-40% of the patients treated with breast conserving surgery (BCS) are dissatisfied with their final cosmetic result. In order to prevent disturbing breast deformity oncoplastic surgical techniques have been introduced. The extent of different levels of oncoplastic surgery incorporated in breast conserving surgery and its value with regard to cosmetic outcome, patient satisfaction and quality of life remains to be defined. The aim of this prospective cohort study is to investigate quality of life and satisfaction with cosmetic result in patients with breast cancer, undergoing standard lumpectomy versus level I or II oncoplastic breast conserving surgery. Female breast cancer patients scheduled for BCS, from 18 years of age, referred to our outpatient clinic from July 2015 are asked to participate in this study. General, oncologic and treatment information will be collected. Patient satisfaction will be scored preceding surgery, and at 1 month and 1 year follow up. Photographs of the breast will be used to score cosmetic result both by the patient, an independent expert panel and BCCT.Core software. Quality of life will be measured by using the BREAST-Q BCT, EORTC-QLQ and EQ-5D-5 L questionnaires. The purpose of this prospective study is to determine the clinical value of different levels of oncoplastic techniques in breast conserving surgery, with regard to quality of life and cosmetic result. Analysis will be carried out by objective measurements of the final cosmetic result in comparison with standard breast conserving surgery. The results of this study will be used to development of a clinical decision model to guide the use oncoplastic surgery in future BCS. Central Commission of Human Research (CCMO), The Netherlands: NL54888.015.15. Medical Ethical Commission (METC), Maxima Medical Centre, Veldhoven, The Netherlands: 15.107. Dutch Trial Register: NTR5665 , retrospectively registered, 02-25-2016.

Clinical effectiveness, quality of life and cost-effectiveness of Flaminal® versus Flamazine® in the treatment of partial thickness burns: study protocol for a randomized controlled trial.

PubMed

Rashaan, Zjir M; Krijnen, Pieta; van den Akker-van Marle, M Elske; van Baar, Margriet E; Vloemans, Adrianus F P; Dokter, Jan; Tempelman, Fenike R H; van der Vlies, Cees H; Breederveld, Roelf S

2016-03-05

Partial thickness burns are painful, difficult to manage and can have a negative effect on quality of life through scarring, permanent disfigurement and loss of function. The aim of burn treatment in partial thickness burns is to save lives, stimulate wound healing by creating an optimumly moist wound environment, to have debriding and analgesic effects, protect the wound from infection and be convenient for the patient and caregivers. However, there is no consensus on the optimal treatment of partial thickness wounds. Flaminal® and Flamazine® are two standard treatment options that provide the above mentioned properties in burn treatment. Nevertheless, no randomized controlled study has yet compared these two common treatment modalities in partial thickness burns. Thus, the aim of this study is to evaluate the clinical effectiveness, quality of life and cost-effectiveness of Flaminal® versus Flamazine® in the treatment of partial thickness burns. In this two-arm open multi-center randomized controlled trial, 90 patients will be randomized between Flaminal® and Flamazine® and followed for 12 months. The study population will consist of competent or temporarily non-competent (because of sedation and/or intubation) patients, 18 years of age or older, with acute partial thickness burns and a total body surface area (TBSA) of less than 30 %. The main study outcome is time to complete re-epithelialization (greater than 95 %). Secondary outcome measures include need for grafting, wound colonization/infection, number of dressing changes, pain and anxiety, scar formation, health-related quality of life (HRQoL), and costs. This study will contribute to the optimal treatment of patients with partial thickness burn wounds and will provide evidence on the (cost-)effectiveness and quality of life of Flaminal® versus Flamazine® in the treatment of partial thickness burns. Netherlands Trial Register NTR4486 , registered on 2 April 2014.

Case management to increase quality of life after cancer treatment: a randomized controlled trial.

PubMed

Scherz, Nathalie; Bachmann-Mettler, Irène; Chmiel, Corinne; Senn, Oliver; Boss, Nathalie; Bardheci, Katarina; Rosemann, Thomas

2017-03-28

Case management has been shown to be beneficial in phases of cancer screening and treatment. After treatment is completed, patients experience a loss of support due to reduced contact with medical professionals. Case management has the potential to offer continuity of care and ease re-entry to normal life. We therefore aim to investigate the effect of case management on quality of life in early cancer survivors. Between 06/2010 and 07/2012, we randomized 95 patients who had just completed cancer treatment in 11 cancer centres in the canton of Zurich, Switzerland. Patients in the case management group met with a case manager at least three times over 12 months. Patient-reported outcomes were assessed after 3, 6 and 12 months using the Functional Assessment of Cancer Therapy (FACT-G) scale, the Patient Assessment of Chronic Illness Care (PACIC) and the Self-Efficacy scale. The change in FACT-G over 12 months was significantly greater in the case management group than in the control group (16.2 (SE 2.0) vs. 9.2 (SE 1.5) points, P = 0.006). The PACIC score increased by 0.20 (SE 0.14) in the case management group and decreased by 0.29 (SE 0.12) points in the control group (P = 0.009). Self-Efficacy increased by 3.1 points (SE 0.9) in the case management group and by 0.7 (SE 0.8) points in the control group (P = 0.049). Case management has the potential to improve quality of life, to ease re-entry to normal life and to address needs for continuity of care in early cancer survivors. The study has been submitted to the ISRCTN register under the name "Case Management in Oncology Rehabilitation" on the 12th of October 2010 and retrospectively registered under the number ISRCTN41474586 on the 24th of November 2010.

Sexual Dysfunctions in Men and Women with Inflammatory Bowel Disease: The Influence of IBD-Related Clinical Factors and Depression on Sexual Function.

PubMed

Bel, Linda G J; Vollebregt, Anna M; Van der Meulen-de Jong, Andrea E; Fidder, Herma H; Ten Hove, Willem R; Vliet-Vlieland, Cornelia W; Ter Kuile, Moniek M; de Groot, Helena E; Both, Stephanie

2015-07-01

Inflammatory bowel disease (IBD) is likely to have an impact on sexual function because of its symptoms, like diarrhea, fatigue, and abdominal pain. Depression is commonly reported in IBD and is also related to impaired sexual function. This study aimed to evaluate sexual function and its association with depression among patients with IBD compared with controls. IBD patients registered at two hospitals participated. The control group consisted of a general practitioner practice population. The web-based questionnaire included the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. Other variables evaluated were depression, disease activity, IBD-related quality of life, body image, and fatigue. In total, 168 female and 119 male patients were available for analysis (response rate 24%). Overall, patients with IBD did not significantly differ in prevalence of sexual dysfunctions from controls: female patients 52%, female controls 44%, male patients and male controls both 25%. However, men and women with an active disease scored significantly lower than patients in remission and controls, indicating impaired sexual functioning during disease activity. Significant associations were found between active disease, fatigue, depressive mood, quality of life, and sexual function for both male and female patients. The association between disease activity and sexual function was totally mediated by depression. Male and female IBD patients with an active disease show impaired sexual function relative to patients in remission and controls. Depression is the most important determinant for impaired sexual function in IBD. © 2015 International Society for Sexual Medicine.

A national Swedish longitudinal twin-sibling study of criminal convictions from adolescence through early adulthood.

PubMed

Kendler, Kenneth S; Lönn, Sara Larsson; Maes, Hermine H; Morris, Nancy A; Lichtenstein, Paul; Sundquist, Jan; Sundquist, Kristina

2015-06-01

Prior twin and adoption studies have demonstrated the importance of both genetic and shared environmental factors in the etiology of criminal behavior (CB). However, despite substantial interest in life-course theories of CB, few genetically informative studies have examined CB in a developmental context. In 69,767 male-male twin pairs and full-sibling pairs with ≤ 2 years' difference in age, born 1958-1976 and ascertained from the Swedish Twin and Population Registries, we obtained information on all criminal convictions from 1973 to 2011 from the Swedish Crime Register. We fitted a Cholesky structural model, using the OpenMx package, to CB in these pairs over three age periods: 15-19, 20-24, and 25-29. The Cholesky model had two main genetic factors. The first began at ages 15-19 and declined in importance over development. The second started at ages 20-24 and was stable over time. Only one major shared environmental factor was seen, beginning at ages 15-19. Heritability for CB declined from ages 15-29, as did shared environmental effects, although at a slower rate. Genetic risk factors for CB in males are developmentally dynamic, demonstrating both innovation and attenuation. These results are consistent with theories of adolescent-limited and life-course persistent CB subtypes. Heritability for CB did not increase over time as might be predicted from active gene-environmental correlation. However, consistent with expectation, the proportion of variability explained by shared environmental effects declined slightly as individuals aged and moved away from their original homes and neighborhoods.

[The intelligence quotient and malnutrition. Iron deficiency and the lead concentration as confusing variables].

PubMed

Vega-Franco, L; Mejía, A M; Robles, B; Moreno, L; Pérez, Y

1991-11-01

This study gave us the opportunity to know the roles iron deficiency and the presence of lead in blood play, as confounding variables, in relation to the state of malnutrition and the intellect of those children. A sample of 169 school children were classified according to their state of nutrition, their condition in reference to serum iron and lead concentrations. In addition, their intelligence was evaluated. The results confirmed that those children with lower weights and heights registered lesser points of intelligence; in fact, iron deficiency cancels out the difference in favor of those taller and weighing more. Lead did not contribute as a confounding variable, but more than half of the children showed possible toxic levels of this metal.

Does contextual unemployment matter for health status across the life course? A longitudinal multilevel study exploring the link between neighbourhood unemployment and functional somatic symptoms.

PubMed

Brydsten, Anna; Gustafsson, Per E; Hammarström, Anne; San Sebastian, Miguel

2017-01-01

This study examines whether neighbourhood unemployment is related to functional somatic symptoms, independently of the individual employment, across the life course and at four specific life course periods (age 16, 21, 30 and 42). Self-reported questioner data was used from a 26-year prospective Swedish cohort (n=1010) with complementary neighbourhood register data. A longitudinal and a set of age-specific cross-sectional hierarchal linear regressions was carried out. The results suggest that living in a neighbourhood with high unemployment has implications for residents' level of functional somatic symptoms, regardless of their own unemployment across time, particularly at age 30. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The effect of individual differences and manipulated life expectancies on the willingness to engage in sexual coercion.

PubMed

Dunkel, Curtis S; Mathes, Eugene

2011-12-16

The role of the individual difference variables of mate value, short-term and long-term mating preferences, and life history strategy along with the manipulated variable of life expectancy were used to predict differences in the willingness to engage in sexually coercive behaviors. Short-term preferences and long-term preferences were correlated with the willingness to engage in sexual coercion at all life expectancies. Life history strategy was correlated with the willingness to engage in sexual coercion at only the shortest and longest life expectancies. Most importantly short-term and long-term mating preferences interacted with life expectancy to predict the willingness to engage in sexually coercive behaviors. Short life expectancies increased willingness in individuals with high short-term and low long-term preferences. The results are discussed in terms of the varying theories of sexual coercion with emphasis put on a life history approach.

The Relationship Between Posttraumatic Growth and Psychosocial Variables in Survivors of State Terrorism and Their Relatives.

PubMed

Cárdenas-Castro, Manuel; Faúndez-Abarca, Ximena; Arancibia-Martini, Héctor; Ceruti-Mahn, Cristián

2017-08-01

The present study explores reports of growth in survivors and family members of victims of state terrorism ( N = 254) in Chile from 1973 to 1990. The results indicate the presence of reports of posttraumatic growth ( M = 4.69) and a positive and statistically significant correlation with variables related to the life impact of the stressful events ( r = .46), social sharing of emotions ( r = .32), deliberate rumination ( r = .37), positive reappraisal ( r = .35), reconciliation ( r = .39), spiritual practices ( r = .33), and meaning in life ( r = .51). The relationship between growth and forgiveness is not statistically significant. The variables that best predict posttraumatic growth are positive reappraisal (β = .28), life impact (β = .24), meaning in life β = .23), and reconciliation (β = .20). The forward-method hierarchical model indicates that these variables are significant predictors of growth levels, R 2 = .53, F(8, 210) = 30.08, p < .001. The results indicate that a large proportion of the victims of state terrorism manage to grow after these experiences, and the redefinition of meaning in life and the positive reappraisal of the traumatic experiences are the elements that make it possible to create a new narrative about the past.

Coping strategies and quality of life in caregivers of dependent elderly relatives.

PubMed

Rodríguez-Pérez, Margarita; Abreu-Sánchez, Ana; Rojas-Ocaña, María Jesús; Del-Pino-Casado, Rafael

2017-04-14

Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the relationship between coping strategies and quality of life dimensions in primary caregivers of dependent elderly relatives. A cross-sectional study was conducted from 86 caregivers. Predictive variables were coping strategies (problem-focused, emotion-focused, socially-supported, and dysfunctional); dependent variables were quality of life dimensions (psychological, physical, relational, and environmental); and potential confounding variables were age, gender, perceived health and burden of caregiver, and functional capacity of care receiver. Correlation coefficients were calculated and multiple linear regression analysis was performed. After controlling for potential confounders, dysfunctional coping was related to worse quality of life in the psychological dimension, while emotion-focused and socially-supported coping were related to superior psychological and environmental dimensions of quality of life. The physical and relational dimensions of quality of life were not related to coping strategies. 1) it is important to consider coping strategies in the assessment of primary caregivers of dependent elderly relatives; 2) the quality of life of caregivers is related to their coping strategies, 3) their quality of life can be worsened by avoidance-type coping, and 4) their quality of life can be improved by active emotion-focused coping and socially-supported coping.

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

PubMed

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

2018-06-01

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

Differential utilization of primary health care services among older immigrants and Norwegians: a register-based comparative study in Norway.

PubMed

Diaz, Esperanza; Kumar, Bernadette N

2014-11-26

Aging in an unfamiliar landscape can pose health challenges for the growing numbers of immigrants and their health care providers. Therefore, better understanding of how different immigrant groups use Primary Health Care (PHC), and the underlying factors that explain utilization is needed to provide adequate and appropriate public health responses. Our aim is to describe and compare the use of PHC between elderly immigrants and Norwegians. Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration database. All 50 year old or older Norwegians with both parents from Norway (1,516,012) and immigrants with both parents from abroad (89,861) registered in Norway in 2008 were included. Descriptive analyses were carried out. Immigrants were categorised according to country of origin, reason for migration and length of stay in Norway. Binary logistic regression analyses were conducted to study the utilization of PHC comparing Norwegians and immigrants, and to assess associations between utilization and both length of stay and reason for immigration, adjusting for other socioeconomic variables. A higher proportion of Norwegians used PHC services compared to immigrants. While immigrants from high-income countries used PHC less than Norwegians disregarding age (OR from 0.65 to 0.92 depending on age group), they had similar number of diagnoses when in contact with PHC. Among immigrants from other countries, however, those 50 to 65 years old used PHC services more often (OR 1.22) than Norwegians and had higher comorbidity levels, but this pattern was reversed for older adults (OR 0.56 to 0.47 for 66-80 and 80+ years respectively). For all immigrants, utilization of PHC increased with longer stay in Norway and was higher for refugees (1.67 to 1.90) but lower for labour immigrants (0.33 to 0.45) compared to immigrants for family reunification. However, adjustment for education and income levels reduced most differences between groups. Immigrants' lower utilization of PHC services might reflect better health among immigrants, but it could also be due to barriers to access that pose public health challenges. The heterogeneity of life courses and migration trajectories should be taken into account when developing public policies.

Prevalence of Depression and Depression Care for Populations Registered in Primary Care in Two Remote Cities in the Brazilian Amazon.

PubMed

Ribeiro Dos Santos, Edinilza; Huang, Hsiang; Menezes, Paulo Rossi; Scazufca, Marcia

2016-01-01

The prevalence of depression has been widely studied in high-income countries and in large cities of low-income countries; however, little is known about the prevalence and treatment gap of depression in remote areas of the Amazonian region in Brazil. The objectives of this study are to estimate the prevalence of depression in adults registered with the Family Health Strategy in two remote cities in the Brazilian Amazon and to investigate the proportion of individuals with depression that received mental health care. This is a cross-sectional study of an adult population registered with primary care clinics in the cities of Coari and Tefé, State of Amazon, Brazil. Depression was defined as a score of ≥10 on the Patient Health Questionnaire-9. Depression care was evaluated by asking participants with depression if they received antidepressants and/or had been seen by a health professional at a community mental health center in the three months prior to the interview. Poisson regression was used to examine the unadjusted and adjusted associations between depression and exposure variables. The overall prevalence of depression was 19.1% (95% CI: 17.2-21.1), with 22.2% (95% CI: 19.3-25.0) among women and 16.0% (95% CI: 13.4-18.5) among men. The prevalence of depression in Coari and Tefé were 18.3% (CI 95% 15.7-21.0) and 19.9% (95% CI:17.2-22.7), respectively. Being a woman, lacking social support, increasing exposure to stressful life events and having a higher number medical comorbidities were consistently associated with depression. Lower educational attainment and income, tobacco use, and risky alcohol use were also associated with depression in the unadjusted analyses. Only 11.5% of those with depression were receiving antidepressants and/or visited the mental health care facility during the three months prior to the interview. Approximately one in five adults in our sample had depression. A high proportion of participants presented indicators of social disadvantage and other risk factors previously associated with depression worldwide. There was a large treatment gap for depression in the Amazonian region, which demonstrates the need for innovative models of depression care in primary care settings in Brazil.

The influence of regional geological settings on the seismic hazard level in copper mines in the Legnica-Głogów Copper Belt Area (Poland)

NASA Astrophysics Data System (ADS)

Burtan, Zbigniew

2017-11-01

The current level of rockburst hazard in copper mines of the (LGOM) Legnica- Głogów Copper Belt Area is mostly the consequence of mining-induced seismicity, whilst the majority of rockbursting events registered to date were caused by high-energy tremors. The analysis of seismic readings in recent years reveals that the highest seismic activity among the copper mines in the LGOM is registered in the mine Rudna. This study investigates the seismic activity in the rock strata in the Rudna mine fields over the years 2006-2015. Of particular interest are the key seismicity parameters: the number of registered seismic events, the total energy emissions, the energy index. It appears that varied seismic activity in the area may be the function of several variables: effective mining thickness, the thickness of burst-prone strata and tectonic intensity. The results support and corroborate the view that principal factors influencing the actual seismic hazard level are regional geological conditions in the copper mines within the Legnica-Głogów Copper Belt Area.

Work ability and work-related stress: A cross-sectional study of obstetrical nurses in urban northeastern Ontario.

PubMed

Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

2015-01-01

The aim of this study was to determine: 1) if quality of work life (QWL), location of cross-training, stress variables, and various demographic factors in nurses are associated with work ability, and 2) nursing occupational stress, QWL, and various associated factors are related with nurses' work ability. There is limited research examining the obstetrical nursing environment. Given the amount of time and energy people expend at the workplace, it is crucial for employees to be satisfied with their lives at work. This cross sectional study was conducted in 2012 in four hospitals in northeastern Ontario, Canada. A stratified random sample of registered nurses (n= 111) were selected. The majority of participants were female (94.6%) ranging in age from 24 to 64 years (M = 41.9, s.d. = 10.2). For the stress and QWL model, one variable: QWL (home-work support - see Methods for definition) (p= 0.015), cross-trained (see Methods for definition) nurses (p= 0.048), and having more than 4 patients per shift (p= 0.024) significantly contributed to the variance in work ability scores. In the logistic regression model, the odds of a higher work ability for nurses who received home-work support were estimated to be 1.32 (95% CI, 1.06 to 1.66) times the odds of a higher work ability for nurses who did not receive home-work support. Work ability in the work environment of obstetrical nursing is important. To be high functioning, workplaces should maximize the use of their employees' actual and potential skills.

Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.

PubMed

Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E

2017-04-01

Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.

Nursing unit environment associated with provision of language services in pediatric hospices

PubMed Central

Lindley, Lisa C.; Held, Mary L.; Henley, Kristen M.; Miller, Kathryn A.; Pedziwol, Katherine E.; Rumley, Laurie E.

2016-01-01

Background Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Methods Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1,251 pediatric hospice agencies. Variable selection was guided by Structural Contingency Theory, which posits that organizational effectiveness is dependent upon how well an organization’s structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. Results The majority of hospices provided translation services (74.9%) and interpreter services (87.1%). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Conclusions Findings indicate that nursing unit environment predict provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staff who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency, and ultimately reduce ethnic disparities in end-of-life care for children and their families. PMID:27059050

Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis

PubMed Central

McLean, Susannah; Nurmatov, Ulugbek; Liu, Joseph LY; Pagliari, Claudia; Car, Josip; Sheikh, Aziz

2012-01-01

Background Chronic obstructive pulmonary disease (COPD) is common. Telehealthcare, involving personalised health care over a distance, is seen as having the potential to improve care for people with COPD. Aim To systematically review the effectiveness of telehealthcare interventions in COPD to improve clinical and process outcomes. Design and setting Cochrane Systematic Review of randomised controlled trials. Methods The study involved searching the Cochrane Airways Group Register of Trials, which is derived from the Cochrane Central Register of Controlled Trials, MEDLINE®, embase™, and CINAHL®, as well as searching registers of ongoing and unpublished trials. Randomised controlled trials comparing a telehealthcare intervention with a control intervention in people with a clinical diagnosis of COPD were identified. The main outcomes of interest were quality of life and risk of emergency department visit, hospitalisation, and death. Two authors independently selected trials for inclusion and extracted data. Study quality was assessed using the Cochrane Collaboration’s risk of bias method. Meta-analysis was undertaken using fixed effect and/or random effects modelling. Results Ten randomised controlled trials were included. Telehealthcare did not improve COPD quality of life: mean difference –6.57 (95% confidence interval [CI] = –13.62 to 0.48). However, there was a significant reduction in the odds ratios (ORs) of emergency department attendance (OR = 0.27; 95% CI = 0.11 to 0.66) and hospitalisation (OR = 0.46; 95% CI = 0.33 to 0.65). There was a non-significant change in the OR of death (OR = 1.05; 95% CI = 0.63 to 1.75). Conclusion In COPD, telehealthcare interventions can significantly reduce the risk of emergency department attendance and hospitalisation, but has little effect on the risk of death. PMID:23211177

Singing for children and adults with bronchiectasis.

PubMed

Irons, Jung Yoon; Kenny, Dianna Theadora; Chang, Anne B

2010-02-17

Bronchiectasis is a common respiratory disease, especially in developing countries. Its cause varies from chronic infection to rare immune deficiencies. Bronchiectasis can be present with other respiratory diseases, such as chronic obstructive pulmonary disease (COPD). People with bronchiectasis may suffer from chronic cough, fatigue, shortness of breath, chest pain and coughing up blood. Their lung function may decline with time. These can also have a negative impact on their quality of life. Thus, a holistic management is needed to provide treatment and support. Therapies which include breathing manoeuvres, such as singing, may have health benefits for respiratory function and psychological well being. To evaluate the effects of a singing intervention as a therapy on the quality of life, morbidity, respiratory muscle strength and pulmonary function of children and adults with bronchiectasis. We searched the Cochrane Airways Group (CAG) trials register, the Cochrane Central Register of Controlled Trials, major allied complementary databases, and clinical trials registers. Professional organisations and individuals were also contacted. CAG performed searches in February, and additional searches were carried out in June 2009. Randomised controlled trials in which singing (as an intervention) is compared with either a sham intervention or no singing in patients with bronchiectasis. Two authors independently reviewed the titles, abstracts and citations to assess potential relevance for full review. No eligible trials were identified and thus no data were available for analysis. No meta-analysis could be performed. In the absence of data, we cannot draw any conclusion to support or refute the adoption of singing as an intervention for people with bronchiectasis. Given the simplicity of the potentially beneficial intervention, future randomised controlled trials are required to evaluate singing therapy for people with bronchiectasis.

Identifying determinants of quality of life of children with cancer and childhood cancer survivors: a systematic review.

PubMed

Klassen, Anne F; Anthony, Samantha J; Khan, Aalia; Sung, Lillian; Klaassen, Robert

2011-09-01

This paper describes a systematic review conducted to identify factors that have been investigated as explanations of variability in the quality of life of children with cancer and childhood cancer survivors. Our purpose was to build an evidence base that could be used to guide and direct future research. MEDLINE, CINAHL, EMBASE, PsycINFO, Cancerlit, and Sociological Abstracts were searched from the inception of each database to June 15, 2009 using the following search terms: "quality of life," "health-related quality of life," "quality adjusted life years," "health status," "functional status," "well-being," or "patient-reported outcome." Sample characteristics and information about the relationship between a quality of life domain or total scale score and at least one factor (e.g., child gender or age, coping skills, family income) were extracted from eligible studies. Nine cancer-specific and nine generic QOL questionnaires were used in 58 publications described 239 factors (50 unique factors). The large number of cancer, treatment, child, and family variables considered indicates that extensive research activity has occurred. However, most of the variables identified were examined in only a few studies and most represent medical and treatment variables with less research attention paid to child and family variables. Our study has compiled evidence about determinants of QOL for children with cancer and childhood cancer survivors from the existing literature. Future research can build on this evidence base to expand the range of factors studied as most research to date has focused on medical and treatment factors.

Quality of life in small-scaled homelike nursing homes: an 8-month controlled trial.

PubMed

Kok, Jeroen S; Nielen, Marjan M A; Scherder, Erik J A

2018-02-27

Quality of life is a clinical highly relevant outcome for residents with dementia. The question arises whether small scaled homelike facilities are associated with better quality of life than regular larger scale nursing homes do. A sample of 145 residents living in a large scale care facility were followed over 8 months. Half of the sample (N = 77) subsequently moved to a small scaled facility. Quality of life aspects were measured with the QUALIDEM and GIP before and after relocation. We found a significant Group x Time interaction on measures of anxiety meaning that residents who moved to small scale units became less anxious than residents who stayed on the regular care large-scale units. No significant differences were found on other aspects of quality of life. This study demonstrates that residents who move from a large scale facility to a small scale environment can improve an aspect of quality of life by showing a reduction in anxiety. Current Controlled Trials ISRCTN11151241 . registration date: 21-06-2017. Retrospectively registered.

Determinants of subjective quality of life in first-episode schizophrenia: perspective from Malaysia.

PubMed

Chee, K Y

2010-05-01

This study sought to examine the determinants of subjective quality of life among patients with first-episode schizophrenia in a developing country. One-hundred and twenty patients registered with National Mental Health Registry for Schizophrenia from 1 January 2003 to 31 August 2005 were included. They were diagnosed with first-episode schizophrenia, schizoaffective and schizophreniform disorders and had been compliant to treatment. Sociodemographic data were obtained and the Brief Psychiatric Rating Scale-Anchored Version, Health of The Nation Outcome Scales, Simpson-Angus Extrapyramidal Side Effects Scale, Barnes Akathisia Scale and the World Health Organization Quality of Life were used to assess psychopathology, side effects from antipsychotics and subjective quality of life. Gender, positive and disorganized symptoms of schizophrenia, and cognitive and physical impairments appeared to be the most important predictors of subjective quality of life among the patients from this centre in Malaysia. Different domains of self-rated quality of life correlated with different sociodemographic and clinical characteristics. Some of the characteristics were malleable and a better understanding of these could lead to improvements in the management of patients with schizophrenia.

The influence of physical and mental health on life satisfaction is mediated by self-rated health: A study with Brazilian elderly.

PubMed

Pinto, Juliana Martins; Fontaine, Anne Marie; Neri, Anita Liberalesso

2016-01-01

Chronic diseases, signals and symptoms of health problems and objective losses in functionality are seen as strongly related to low levels of life satisfaction in old age. Among seniors, self-rated health is associated with both quality of health and life satisfaction, but its relationships with objective health measures are controversial. This study aimed at identifying the influence of self-rated health as a mediator of the relationships between objectives indicators of physical and mental health and the elderly's life satisfaction. Self-reporting and physical performance measures were derived from the data basis of the FIBRA Study, which investigated frailty and associated variables in a cross-sectional sample of 2164 subjects aged 65 and above, randomly selected in seven Brazilian cities. A model considering satisfaction as a dependent variable, the number of diseases, frailty, cognitive status and depressive symptoms as predictors and self-rated health as a mediating variable was tested through path analysis. The model fit the data well and explained 19% of life satisfaction's variance. According to the bootstrapping method, indirect effects were significant for all trajectories, suggesting that self-rated health is a mediator variable between physical and mental health and elderlýs life satisfaction. In conclusion, adverse conditions of physical and mental health can influence the elderlýs life satisfaction, mostly when they determine a decrease in their levels of self-rated health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

How effective are volunteers at supporting people in their last year of life? A pragmatic randomised wait-list trial in palliative care (ELSA).

PubMed

Walshe, Catherine; Dodd, Steven; Hill, Matt; Ockenden, Nick; Payne, Sheila; Preston, Nancy; Perez Algorta, Guillermo

2016-12-09

Clinical care alone at the end of life is unlikely to meet all needs. Volunteers are a key resource, acceptable to patients, but there is no evidence on care outcomes. This study aimed to determine whether support from a social action volunteer service is better than usual care at improving quality of life for adults in the last year of life. A pragmatic, multi-centre wait-list controlled trial, with participants randomly allocated to receive the volunteer support intervention either immediately or after a 4 week wait. Trained volunteers provided tailored face-to-face support including befriending, practical support and signposting to services, primarily provided within the home, typically for 2-3 hours per week. The primary outcome was rate of change of quality of life at 4 weeks (WHO QOL BREF, a general, culturally sensitive measure). Secondary outcomes included rate of change of quality of life at 8 weeks and Loneliness (De Jong Gierveld Loneliness Scale), social support (mMOS-SS), and reported use of health and social care services at 4 and 8 weeks. In total, 196 adults (61% (n = 109) female; mean age 72 years) were included in the study. No significant difference was found in main or secondary outcomes at 4 weeks. Rate of change of quality of life showed trends in favour of the intervention (physical quality of life domain: b = 3.98, CI, -0.38 to 8.34; psychological domain: b = 2.59, CI, -2.24 to 7.43; environmental domain: b = 3, CI, -4.13 to 4.91). Adjusted analyses to control for hours of volunteer input found significantly less decrease in physical quality of life in the intervention group (slope (b) 4.43, CI, 0.10 to 8.76). While the intervention also favoured the rate of change of emotional (b = -0.08; CI, -0.52 to 0.35) and social loneliness (b = -0.20; CI, -0.58 to 0.18), social support (b = 0.13; CI, -0.13 to 0.39), and reported use of health and social care professionals (b = 0.16; CI, -0.22 to 0.55), these were not statistically significant. No adverse events were reported. Clinicians can confidently refer to volunteer services at the end of life. Future research should focus on 'dose' to maximise likely impact. The trial was prospectively registered. ISRCTN Registry: ISRCTN12929812 , registered 20 May 2015.

Concurrent validity of the Swedish version of the life-space assessment questionnaire.

PubMed

Fristedt, Sofi; Kammerlind, Ann-Sofi; Bravell, Marie Ernsth; Fransson, Eleonor I

2016-11-08

The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one's hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility. The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated. Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual's own physical function. LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.

Growth and life history variability of the grey reef shark (Carcharhinus amblyrhynchos) across its range

PubMed Central

Bradley, Darcy; Conklin, Eric; Papastamatiou, Yannis P.; McCauley, Douglas J.; Pollock, Kydd; Kendall, Bruce E.; Gaines, Steven D.; Caselle, Jennifer E.

2017-01-01

For broadly distributed, often overexploited species such as elasmobranchs (sharks and rays), conservation management would benefit from understanding how life history traits change in response to local environmental and ecological factors. However, fishing obfuscates this objective by causing complex and often mixed effects on the life histories of target species. Disentangling the many drivers of life history variability requires knowledge of elasmobranch populations in the absence of fishing, which is rarely available. Here, we describe the growth, maximum size, sex ratios, size at maturity, and offer a direct estimate of survival of an unfished population of grey reef sharks (Carcharhinus amblyrhynchos) using data from an eight year tag-recapture study. We then synthesized published information on the life history of C. amblyrhynchos from across its geographic range, and for the first time, we attempted to disentangle the contribution of fishing from geographic variation in an elasmobranch species. For Palmyra’s unfished C. amblyrhynchos population, the von Bertalanffy growth function (VBGF) growth coefficient k was 0.05 and asymptotic length L∞ was 163.3 cm total length (TL). Maximum size was 175.5 cm TL from a female shark, length at maturity was estimated at 116.7–123.2 cm TL for male sharks, maximum lifespan estimated from VBGF parameters was 18.1 years for both sexes combined, and annual survival was 0.74 year-1. Consistent with findings from studies on other elasmobranch species, we found significant intraspecific variability in reported life history traits of C. amblyrhynchos. However, contrary to what others have reported, we did not find consistent patterns in life history variability as a function of biogeography or fishing. Ultimately, the substantial, but not yet predictable variability in life history traits observed for C. amblyrhynchos across its geographic range suggests that regional management may be necessary to set sustainable harvest targets and to recover this and other shark species globally. PMID:28207874

Growth and life history variability of the grey reef shark (Carcharhinus amblyrhynchos) across its range.

PubMed

Bradley, Darcy; Conklin, Eric; Papastamatiou, Yannis P; McCauley, Douglas J; Pollock, Kydd; Kendall, Bruce E; Gaines, Steven D; Caselle, Jennifer E

2017-01-01

For broadly distributed, often overexploited species such as elasmobranchs (sharks and rays), conservation management would benefit from understanding how life history traits change in response to local environmental and ecological factors. However, fishing obfuscates this objective by causing complex and often mixed effects on the life histories of target species. Disentangling the many drivers of life history variability requires knowledge of elasmobranch populations in the absence of fishing, which is rarely available. Here, we describe the growth, maximum size, sex ratios, size at maturity, and offer a direct estimate of survival of an unfished population of grey reef sharks (Carcharhinus amblyrhynchos) using data from an eight year tag-recapture study. We then synthesized published information on the life history of C. amblyrhynchos from across its geographic range, and for the first time, we attempted to disentangle the contribution of fishing from geographic variation in an elasmobranch species. For Palmyra's unfished C. amblyrhynchos population, the von Bertalanffy growth function (VBGF) growth coefficient k was 0.05 and asymptotic length L∞ was 163.3 cm total length (TL). Maximum size was 175.5 cm TL from a female shark, length at maturity was estimated at 116.7-123.2 cm TL for male sharks, maximum lifespan estimated from VBGF parameters was 18.1 years for both sexes combined, and annual survival was 0.74 year-1. Consistent with findings from studies on other elasmobranch species, we found significant intraspecific variability in reported life history traits of C. amblyrhynchos. However, contrary to what others have reported, we did not find consistent patterns in life history variability as a function of biogeography or fishing. Ultimately, the substantial, but not yet predictable variability in life history traits observed for C. amblyrhynchos across its geographic range suggests that regional management may be necessary to set sustainable harvest targets and to recover this and other shark species globally.

Effects on employees of controlling working hours and working schedules.

PubMed

Kubo, T; Takahashi, M; Togo, F; Liu, X; Shimazu, A; Tanaka, K; Takaya, M

2013-03-01

High levels of control over working time and low variability in working hours have been associated with improved health-related outcomes. The potential mechanisms for this association remain unclear. To examine how work-time control and variability of working times are associated with fatigue recovery, sleep quality, work-life balance, and 'near misses' at work. Manufacturing sector employees completed a questionnaire that assessed work-time control, work-time variability, fatigue recovery, sleep quality, work-life balance and the frequency of near misses in the past 6 months. Mixed model analysis of covariance and multiple logistic regression analysis tested the main effects of work-time control and variability and their interaction, while adjusting for age, sex, work schedules, and overtime work in the past month. Subscales of work-time control were also investigated (control over daily working hours and over days off). One thousand three hundred and seventy-two completed questionnaires were returned, a response rate of 69%. A significantly higher quality of sleep and better work-life balance were found in the 'high control with low variability' reference group than in the other groups. Significantly better recovery of fatigue was also observed in the group having control over days off with low variability. While near misses were more frequent in the group with high control over daily working hours coupled with high variability compared with the reference group this was not significant. High work-time control and low variability were associated with favourable outcomes of health and work-life balance. This combined effect was not observed for the safety outcome addressed here.

Subterranean termite control examinations on current and former experimental forests and ranges

Treesearch

T. G. Shelton; T. L. Wagner; C. J Peterson; J. E. Mulrooney

2014-01-01

For more than 70 years, the USDA Forest Service’s Termite Team has engaged in research to extend the life of wood in service by studying chemical (and a few nonchemical) subterranean termite control products. These efficacy data are produced in distinct field trials on experimental forests across the USA, and are used by industry cooperators to register their products...

Huntington’s Disease Clinical Trials Corner: February 2018

PubMed Central

Rodrigues, Filipe B.; Wild, Edward J.

2018-01-01

In the second edition of the Huntington’s Disease Clinical Trials Corner we list all currently registered and ongoing clinical trials, summarise the top-line results of the recently-announced IONIS-HTTRX trial (NCT02519036), expand on Wave Life Sciences’ PRECISION-HD1 (NCT03225833) and PRECISION-HD2 (NCT03225846), and cover one recently finished trial: the FIRST-HD deutetrabenazine trial (NCT01795859). PMID:29480210

78 FR 42902 - Safety Zone; Olympus Tension Leg Platform, Mississippi Canyon Block 807, Outer Continental Shelf...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

..., an email address, or a telephone number in the body of your document so that we can contact you if we... Federal Register (73 FR 3316). 4. Public Meeting We do not now plan to hold a public meeting. But you may... the purpose of protecting life, property and the marine environment (33 CFR 147.1). Placing a safety...

Same Sex Attraction, Homophobic Bullying and Mental Health of Young People in Northern Ireland

ERIC Educational Resources Information Center

McNamee, Helen; Lloyd, Katrina; Schubotz, Dirk

2008-01-01

This article reports on the relationship between same-sex attraction, experience of bullying in school and mental health measured using the 12-item version of the General Health Questionnaire (GHQ12). A random sample of 16 year olds, drawn from the Child Benefit Register, was invited to take part in the 2005 Young Life and Times survey, which is a…

Enhancing Literacy in the Second Grade: Five Related Studies Using the Register Music/Reading Curriculum

ERIC Educational Resources Information Center

Darrow, Alice-Ann; Cassidy, Jane W.; Flowers, Patricia J.; Register, Dena; Sims, Wendy; Standley, Jayne M.; Menard, Elizabeth; Swedberg, Olivia

2009-01-01

The purpose of these five related studies was to ascertain the effects of a music curriculum designed to enhance reading skills of second-grade students. The dependent variables were subtest scores on the Gates-MacGinitie Reading Test administered pre and post the music/reading intervention. Results showed that the total test gain scores of…

Predictors of Success and Failure for ADN Students on the NCLEX-RN

ERIC Educational Resources Information Center

Benefiel, Diane

2011-01-01

The purpose of this study was to: 1) analyze the relationship of preprogram and nursing program variables on National Council Licensure Examination for Registered Nurses (NCLEX-RN) success and failure, and 2) develop a model to predict success and failure on the NCLEX-RN. The convenience sample was comprised of 245 spring, summer, and fall midterm…

Modeling old-age wealth with endogenous early-life outcomes: The case of Mexico

PubMed Central

DeGraff, Deborah S.; Wong, Rebeca

2014-01-01

This paper contributes to the literature on the life course and aging by examining the association between early-life outcomes and late-life well being, using data from the Mexican Health and Aging Study. Empirical research in this area has been challenged by the potential endogeneity of the early-life outcomes of interest, an issue which most studies ignore or downplay. Our contribution takes two forms: (1) we examine in detail the potential importance of two key life-cycle outcomes, age at marriage (a measure of family formation) and years of educational attainment (a measure of human capital investment) for old-age wealth, and (2) we illustrate the empirical value of past context variables that could help model the association between early-life outcomes and late-life well being. Our illustrative approach, matching macro-level historical policy and census variables to individual records to use as instruments in modeling the endogeneity of early-life behaviors, yields a statistically identified two-stage model of old-age wealth with minimum bias. We use simulations to show that the results for the model of wealth in old age are meaningfully different when comparing the approach that accounts for endogeneity with an approach that assumes exogeneity of early-life outcomes. Furthermore, our results suggest that in the Mexican case, models which ignore the potential endogeneity of early-life outcomes are likely to under-estimate the effects of such variables on old-age wealth. PMID:25170434

Occupational accidents among mototaxi drivers.

PubMed

Amorim, Camila Rego; de Araújo, Edna Maria; de Araújo, Tânia Maria; de Oliveira, Nelson Fernandes

2012-03-01

The use of motorcycles as a means of work has contributed to the increase in traffic accidents, in particular, mototaxi accidents. The aim of this study was to estimate and characterize the incidence of occupational accidents among the mototaxis registered in Feira de Santana, BA. This is a cross-sectional study with descriptive and census data. Of the 300 professionals registered at the Municipal Transportation Service, 267 professionals were interviewed through a structured questionnaire. Then, a descriptive analysis was conducted and the incidence of accidents was estimated based on the variables studied. Relative risks were calculated and statistical significance was determined using the chi-square test and Fisher's exact test, considering p < 0.05. Logistic regression was used in order to perform simultaneous adjustment of variables. Occupational accidents were observed in 10.5% of mototaxis. There were mainly minor injuries (48.7%), 27% of them requiring leaves of absence from work. There was an association between the days of work per week, fatigue in lower limbs and musculoskeletal complaints, and accidents. Knowledge of the working conditions and accidents involved in this activity can be of great importance for the adoption of traffic education policies, and to help prevent accidents by improving the working conditions and lives of these professionals.

Associated and mediating variables related to quality of life among service users with mental disorders.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

2018-02-01

This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study.

PubMed

Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol

2016-06-01

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Variability of Climate In Serbia In The Second Half of The 20thc Entury

NASA Astrophysics Data System (ADS)

Radovanovic, M.; Ducic, V.

According to data of IPCC, the global surface temperature increased to 0.6 °C in the 20th century. It is claimed that the most studies registered significant changes of climate and that those changes also show that there is a small probability that the registered trend of worming is caused in general by natural factors . Weber quotes that the increase of global temperature in the last 140 years is 0.3 °C, and that there is a trend of cold in the last 60 years in the middle latitudes including Europe, too. Starting from already mentioned perplexities we have tried to perceive the problem of climate variability in Serbia in the second half of the 20th century, when it came to very important increasing of concentration of CO2. With that aim we observed the decade values of average annual temperatures in the system of 20 climatic stations. Until 1990 a decrease of temperature was registered in 13 stations while in other stations an increase that was less than 0.1 °C was registered from 1951. Explorers from Bulgaria and Hungary came to similar results, too. However, if we take in account the last decade the picture is changed and the number of stations with positive changes is enlarged on 15. Stations that have small changes and those with decrease of temperature were localized in the south and south - eastern part of the country and they are mainly coincided with before separated climatic regions. That regional differentiation referred us to search for circulation reasons of temperature change. Using Dzerdzevski division on three main types of circulation in the south hemisphere, we found that the incr ease of temperatures in the last decade is above all caused by change of dominant type of circulation from the meridian south to zonal. An analysis of seasonal changes showed that in the last five decades it came to decrease of winter temperatures in almost half of the stations. On the basis of analogy with warm periods of Holocene that Budiko and Zubakov give it is expected that if an antropogenic effect of greenhouse is present then winter temperatures will be increased which is not a part of mentioned concept. In one sentence, the contemporary climate variability in Serbia could be explained by natural causes, not only according to values of temperature changes but to its structure, too.

Characteristics of clinical trials registered in ClinicalTrials.gov, 2007-2010.

PubMed

Califf, Robert M; Zarin, Deborah A; Kramer, Judith M; Sherman, Rachel E; Aberle, Laura H; Tasneem, Asba

2012-05-02

Recent reports highlight gaps between guidelines-based treatment recommendations and evidence from clinical trials that supports those recommendations. Strengthened reporting requirements for studies registered with ClinicalTrials.gov enable a comprehensive evaluation of the national trials portfolio. To examine fundamental characteristics of interventional clinical trials registered in the ClinicalTrials.gov database. A data set comprising 96,346 clinical studies from ClinicalTrials.gov was downloaded on September 27, 2010, and entered into a relational database to analyze aggregate data. Interventional trials were identified and analyses were focused on 3 clinical specialties-cardiovascular, mental health, and oncology-that together encompass the largest number of disability-adjusted life-years lost in the United States. Characteristics of registered clinical trials as reported data elements in the trial registry; how those characteristics have changed over time; differences in characteristics as a function of clinical specialty; and factors associated with use of randomization, blinding, and data monitoring committees (DMCs). The number of registered interventional clinical trials increased from 28,881 (October 2004-September 2007) to 40,970 (October 2007-September 2010), and the number of missing data elements has generally declined. Most interventional trials registered between 2007 and 2010 were small, with 62% enrolling 100 or fewer participants. Many clinical trials were single-center (66%; 24,788/37,520) and funded by organizations other than industry or the National Institutes of Health (NIH) (47%; 17,592/37,520). Heterogeneity in the reported methods by clinical specialty; sponsor type; and the reported use of DMCs, randomization, and blinding was evident. For example, reported use of DMCs was less common in industry-sponsored vs NIH-sponsored trials (adjusted odds ratio [OR], 0.11; 95% CI, 0.09-0.14), earlier-phase vs phase 3 trials (adjusted OR, 0.83; 95% CI, 0.76-0.91), and mental health trials vs those in the other 2 specialties. In similar comparisons, randomization and blinding were less frequently reported in earlier-phase, oncology, and device trials. Clinical trials registered in ClinicalTrials.gov are dominated by small trials and contain significant heterogeneity in methodological approaches, including reported use of randomization, blinding, and DMCs.

[Therapeutic benefit of a registered psychoeducation program on treatment adherence, objective and subjective quality of life: French pilot study for schizophrenia].

PubMed

Sauvanaud, F; Kebir, O; Vlasie, M; Doste, V; Amado, I; Krebs, M-O

2017-05-01

In schizophrenic disorders, supportive psychosocial therapies have been used as adjuncts to pharmacotherapy to help alleviate residual symptoms and to improve social functioning and quality of life. Among these therapies, psychoeducational therapies showed a significant efficacy on improving drug adherence and on reducing relapses. However, according to the French Health Agency, fewer than 10% of psychiatric structures in France offer registered psychoeducation programs. Caregiver apprehension of patients' depressive reactions to the awareness of the disease could underlie the underuse of psychoeducation therapies. Indeed, the psychoeducation programs' impact on objective and subjective quality of life is discussed among the literature. In this context, we conducted a retrospective, monocentric, open-labelled and non-controlled pilot study to measure the impact of a registered psychoeducation program on objective and subjective quality of life of patients suffering from schizophrenia. Secondary objectives included measures of the effects on drug observance and awareness of the disease. We included stabilized patients over the age of eighteen suffering from schizophrenia. Referent psychiatrics were asked to inform the patient of the diagnosis and to prescribe psychoeducation therapy. From 2011 to 2014, we offered three ambulatory programs, each program including fifteen two-hour group sessions. The groups were opened for three to six patients and managed by two caregivers. Themes discussed during the sessions included: schizophrenic disease, treatments, relationships to family, diet, social issues, toxics, relaxation. Objective and subjective quality of life were evaluated one month before and one month after the program using respectively the global assessment functioning (GAF) and the subjective quality of life (SQoL) scales. The Medical Adherence Rating Scale (MARS) and the French IQ8 scale evaluated respectively drug adherence and awareness of the disease. All patients gave their written consent for the study. Based on medical records and scales, we compared data before and after the program using the Wilcoxon test, adapted for small samples. Fourteen patients, with a mean age of 37.6 years, were included. All patients had a chronic antipsychotic treatment and four benefitted from a bitherapy with a mood stabilizer. The mean length of disease was 15.3 years, with a mean number of 3.4 hospitalizations before inclusion. The participation rate was nearly twelve sessions out of fifteen. Mean GAF score before the program was 48/100. After the program, mean GAF score was significantly increased to 54/100 (P=0.008). As to SQoL score, we found a significant difference of the sub item psychological well-being from 3.2/5 before the program to 3.8/5 after the program (P=0.03). Global SQoL score and other sub items (self-esteem, resilience, and physical well-being) showed a slight but not significant improvement. The sub items family relationships and sentimental life were diminished, non-significantly. Concerning the drug adherence, the mean MARS score was significantly increased from 6.1 to 6.4/8 (P=0.03). Comparison of the insight IQ8 scale showed a slight but non-significant increase. When asked to note the program, patients were globally very satisfied, with a mean rate of 8.6/10. Of fourteen patients, one needed to be hospitalized three years after program. This retrospective study on a small sample of patients suffering from schizophrenic disorder pointed out a significant improvement on drug adherence, objective quality of life and psychological well-being, after an eight-month registered program of psychoeducational therapy. These results are in line with a recent report from the Cochrane group who reported a significant raise of GAF associated with psychoeducational therapies. The literature data for subjective quality of life are more contradictory. Despite the small sample and evaluation means that need to be corrected in further studies, we reproduced the results described in the literature regarding the improvement on drug adherence. However, the stability of these effects should be checked in the medium and long term. Adjunctive psychoeducation therapy has a positive impact on reducing relapses in schizophrenia. In this study, we showed a significant benefit on drug adherence, objective quality of life and psychological well-being on a small sample of patients and provide arguments for the development of psychoeducation programs which are currently underrepresented in France. Our results encourage conducting a further prospective multicenter controlled study on a larger sample to clarify the benefit of psychoeducational therapy on objective and subjective quality of life in schizophrenia. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial.

PubMed

Janssen, Noortje; Huibers, Marcus J H; Lucassen, Peter; Voshaar, Richard Oude; van Marwijk, Harm; Bosmans, Judith; Pijnappels, Mirjam; Spijker, Jan; Hendriks, Gert-Jan

2017-06-26

Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists. The recent introduction of the mental health nurse in primary care centres in the Netherlands has created major opportunities for improving the accessibility of psychological treatments for late-life depression in primary care. BA may thus address the needs of older patients while improving treatment outcome and lowering costs.The primary objective of this study is to compare the effectiveness and cost-effectiveness of BA in comparison with treatment as usual (TAU) for late-life depression in Dutch primary care. A secondary goal is to explore several potential mechanisms of change, as well as predictors and moderators of treatment outcome of BA for late-life depression. Cluster-randomised controlled multicentre trial with two parallel groups: a) behavioural activation, and b) treatment as usual, conducted in primary care centres with a follow-up of 52 weeks. The main inclusion criterion is a PHQ-9 score > 9. Patients are excluded from the trial in case of severe mental illness that requires specialized treatment, high suicide risk, drug and/or alcohol abuse, prior psychotherapy, change in dosage or type of prescribed antidepressants in the previous 12 weeks, or moderate to severe cognitive impairment. The intervention consists of 8 weekly 30-min BA sessions delivered by a trained mental health nurse. We expect BA to be an effective and cost-effective treatment for late-life depression compared to TAU. BA delivered by mental health nurses could increase the availability and accessibility of non-pharmacological treatments for late-life depression in primary care. This study is retrospectively registered in the Dutch Clinical Trial Register NTR6013 on August 25th 2016.

The Tölz Temporal Topography Study: mapping the visual field across the life span. Part II: cognitive factors shaping visual field maps.

PubMed

Poggel, Dorothe A; Treutwein, Bernhard; Calmanti, Claudia; Strasburger, Hans

2012-08-01

Part I described the topography of visual performance over the life span. Performance decline was explained only partly by deterioration of the optical apparatus. Part II therefore examines the influence of higher visual and cognitive functions. Visual field maps for 95 healthy observers of static perimetry, double-pulse resolution (DPR), reaction times, and contrast thresholds, were correlated with measures of visual attention (alertness, divided attention, spatial cueing), visual search, and the size of the attention focus. Correlations with the attentional variables were substantial, particularly for variables of temporal processing. DPR thresholds depended on the size of the attention focus. The extraction of cognitive variables from the correlations between topographical variables and participant age substantially reduced those correlations. There is a systematic top-down influence on the aging of visual functions, particularly of temporal variables, that largely explains performance decline and the change of the topography over the life span.

Life Satisfaction Among Mothers of Individuals with Prader-Willi Syndrome.

PubMed

Shivers, Carolyn M; Leonczyk, Caroline L; Dykens, Elisabeth M

2016-06-01

Mothers of individuals with Prader-Willi syndrome (PWS) often experience numerous stressors, even when compared to mothers of children with other intellectual and developmental disabilities. Despite this, these mothers show great variability in self-reported life satisfaction. Using data from a longitudinal study of individuals with PWS and their families, the present study analyzed factors related to maternal life satisfaction, both cross-sectionally and over time. Results show that both child factors (e.g., behavior problems, hyperphagia) and maternal factors (e.g., stress, coping style) were significantly related to maternal life satisfaction. However, none of the tested variables predicted change in life satisfaction over time. Research and practice implications are discussed.

Positive correlation between care given by specialists and registered nurses and improved outcomes for stroke patients.

PubMed

Han, Kyu-Tae; Kim, Sun Jung; Jang, Sung-In; Kim, Seung Ju; Lee, Seo Yoon; Lee, Hyo Jung; Park, Eun-Cheol

2015-01-01

Cerebrovascular diseases are the second-highest cause of death in South Korea (9.6% of all causes of mortality in 2013). South Korea has a shortage of trained medical personnel compared with other countries and the demands for health care are continuously increasing. Our study sought to determine the relationship between hospital human resources and the outcomes of stroke patients. We used data from NHI claims (n=99,464) at 120 hospitals to analyze readmission or death within 30 days after discharge or hospitalization for stroke patients during 2010-2013. We used multilevel models that included both patient-level and hospital-level variables to examine factors associated with readmission or death within 30 days. A total of 1782 (1.8%) patients were readmitted within 30 days, and death occurred within 30 days for 6926 (7.0%) patients. Patients cared for by a higher percentages of specialists or registered nurses had a lower risk of readmission or death within 30 days (readmission per 10% increase in registered nurses, OR=0.89 and SD=0.85-0.94; death per 10% increase in specialists, OR=0.93 and SD=0.89-0.98). The percentages of specialist and registered nurses caring for stroke patients were positively correlated with better patient outcomes, particularly for patients with cerebral infarction. Copyright © 2015 Elsevier B.V. All rights reserved.

Proportion and characteristics of men with unknown risk category in the National Prostate Cancer Register of Sweden.

PubMed

Tomic, Katarina; Westerberg, Marcus; Robinson, David; Garmo, Hans; Stattin, Pär

2016-12-01

Knowledge on missing data in a clinical cancer register is important to assess the validity of research results. For analysis of prostate cancer (Pca), risk category, a composite variable based on serum levels of prostate specific antigen (PSA), stage, and Gleason score, is crucial for treatment decisions and a strong determinant of outcome. The aim of this study was to assess the proportion and characteristics of men in the National Prostate Cancer Register (NPCR) of Sweden with unknown risk category. Men diagnosed with Pca between 1998 and 2012 registered in NPCR with known or unknown risk category were compared with respect to age, socioeconomic factors, comorbidity, cancer characteristics, cancer treatment, and mortality from Pca and other causes. In total, 3315 of 129 391 (3%) men had unknown risk category. Compared to other men in NPCR, these men more often had a concomitant bladder cancer diagnosis, 19% versus 1%, diagnosis of benign prostatic hyperplasia 31% versus 5%, received unspecified Pca treatment 16% versus 3%, had higher comorbidity, Charlson Comorbidity Index 2 or higher, 34% versus 13%, and had lower Pca mortality 12% versus 30%, but similar mortality from other causes. Men with unknown risk category were rare in NPCR but distinctly different from other men in NPCR in many aspects including higher comorbidity and lower Pca mortality.

Automatic Extraction of Small Spatial Plots from Geo-Registered UAS Imagery

NASA Astrophysics Data System (ADS)

Cherkauer, Keith; Hearst, Anthony

2015-04-01

Accurate extraction of spatial plots from high-resolution imagery acquired by Unmanned Aircraft Systems (UAS), is a prerequisite for accurate assessment of experimental plots in many geoscience fields. If the imagery is correctly geo-registered, then it may be possible to accurately extract plots from the imagery based on their map coordinates. To test this approach, a UAS was used to acquire visual imagery of 5 ha of soybean fields containing 6.0 m2 plots in a complex planting scheme. Sixteen artificial targets were setup in the fields before flights and different spatial configurations of 0 to 6 targets were used as Ground Control Points (GCPs) for geo-registration, resulting in a total of 175 geo-registered image mosaics with a broad range of geo-registration accuracies. Geo-registration accuracy was quantified based on the horizontal Root Mean Squared Error (RMSE) of targets used as checkpoints. Twenty test plots were extracted from the geo-registered imagery. Plot extraction accuracy was quantified based on the percentage of the desired plot area that was extracted. It was found that using 4 GCPs along the perimeter of the field minimized the horizontal RMSE and enabled a plot extraction accuracy of at least 70%, with a mean plot extraction accuracy of 92%. The methods developed are suitable for work in many fields where replicates across time and space are necessary to quantify variability.

75 FR 60833 - Jackson National Life Insurance Company, et al.;

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

...] Jackson National Life Insurance Company, et al.; Notice of Application September 27, 2010. AGENCY... National Life Insurance Company (``Jackson''), Jackson National Life Insurance Company of New York... Companies and serve as the underlying investment vehicles for the variable life insurance contracts and...

[Food satisfaction in Mapuche persons in the Metropolitan Region of Santiago, Chile].

PubMed

Schnettler, Berta; Miranda, Horacio; Sepúlveda, José; Denegri, Marianela; Mora, Marcos; Lobos, Germán

2011-06-01

Although the study and measurement of satisfaction with life has generated great interest in the last 15 years, there are few works which address satisfaction with food-related life. In order to identify variables which have an influence on satisfaction with food-related life among Mapuche persons, a survey was applied to 400 Mapuche subjects in the Santiago Metropolitan Region, Chile. The scales evaluated in the questionnaire included: SWFL (Satisfaction with Food-related Life), lifestyles, food, and Mapuche acculturation. It was found that 41.0% were extremely satisfied, 40.5% satisfied, 17.2% somewhat satisfied and 1.2% dissatisfied with their food-related life. To identify variables which have an influence on satisfaction with food, an ordinal multinomial logit model was proposed, which was significant (p < 0.01) as a whole. The probability of high satisfaction with food-related life increases as there are fewer children in the household, the person's expenditure on food increases, the person consumes some Mapuche foods, is aged 55 or more, consumes red meat in moderation, consumes foods without additives, try to balance work and private life, does not read the labels of products, and if he/she had Mapuche friends at school. Thus satisfaction with food-related life in Mapuche persons in the Metropolitan Region is related to demographic variables, expenditure on food, consumption of Mapuche foods and life-style.

Changes in health-related quality of life in people with morbid obesity attending a learning and mastery course. A longitudinal study with 12-months follow-up

PubMed Central

2012-01-01

Background Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual’s overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up. Methods A single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery. Results At the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL. Conclusions Participation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course. Trial registration The study is registered in Clinical Trials: NCT01336725. PMID:22901031

Operationalizing multimorbidity and autonomy for health services research in aging populations - the OMAHA study

PubMed Central

2011-01-01

Background As part of a Berlin-based research consortium on health in old age, the OMAHA (Operationalizing Multimorbidity and Autonomy for Health Services Research in Aging Populations) study aims to develop a conceptual framework and a set of standardized instruments and indicators for continuous monitoring of multimorbidity and associated health care needs in the population 65 years and older. Methods/Design OMAHA is a longitudinal epidemiological study including a comprehensive assessment at baseline and at 12-month follow-up as well as brief intermediate telephone interviews at 6 and 18 months. In order to evaluate different sampling procedures and modes of data collection, the study is conducted in two different population-based samples of men and women aged 65 years and older. A geographically defined sample was recruited from an age and sex stratified random sample from the register of residents in Berlin-Mitte (Berlin OMAHA study cohort, n = 299) for assessment by face-to-face interview and examination. A larger nationwide sample (German OMAHA study cohort, n = 730) was recruited for assessment by telephone interview among participants in previous German Telephone Health Surveys. In both cohorts, we successfully applied a multi-dimensional set of instruments to assess multimorbidity, functional disability in daily life, autonomy, quality of life (QoL), health care services utilization, personal and social resources as well as socio-demographic and biographical context variables. Response rates considerably varied between the Berlin and German OMAHA study cohorts (22.8% vs. 59.7%), whereas completeness of follow-up at month 12 was comparably high in both cohorts (82.9% vs. 81.2%). Discussion The OMAHA study offers a wide spectrum of data concerning health, functioning, social involvement, psychological well-being, and cognitive capacity in community-dwelling older people in Germany. Results from the study will add to methodological and content-specific discourses on human resources for maintaining quality of life and autonomy throughout old age, even in the face of multiple health complaints. PMID:21352521

Life expectancy in bipolar disorder.

PubMed

Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

2015-08-01

Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we calculated remaining life expectancies for values of age 15, 25, 35 ⃛ 75 years among all individuals alive in year 2000. For the typical male or female patient aged 25 to 45 years, the remaining life expectancy was decreased by 12.0-8.7 years and 10.6-8.3 years, respectively. The ratio between remaining life expectancy in bipolar disorder and that of the general population decreased with age, indicating that patients with bipolar disorder start losing life-years during early and mid-adulthood. Life expectancy in bipolar disorder is decreased substantially, but less so than previously reported. Patients start losing life-years during early and mid-adulthood. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species

EPA Science Inventory

The authors developed a toxicity database for unionid mussels to examine the extent of intra- and interlaboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the 2 life stages; and the variation in se...

Reading through the Life Span: Individual Differences in Psycholinguistic Effects

ERIC Educational Resources Information Center

Davies, Rob A. I.; Arnell, Ruth; Birchenough, Julia M. H.; Grimmond, Debbie; Houlson, Sam

2017-01-01

The effects of psycholinguistic variables are critical to the evaluation of theories about the cognitive reading system. However, reading research has tended to focus on the impact of key variables on average performance. We report the first investigation examining variation in psycholinguistic effects across the life span, from childhood into old…

Situational and Intrapersonal Predictors of School and Life Satisfaction of Elementary School Students

ERIC Educational Resources Information Center

Drost, Amy Linden

2012-01-01

This study examined predictors of school and life satisfaction of fifth-grade students. Two situational predictor variables (school climate and school stress) and two intrapersonal predictor variables (locus of control and academic self-concept) were examined. It was hypothesized that positive school climate, low levels of school stress, internal…

Is continence status associated with quality of life in young children with spina bifida?

PubMed

Freeman, Kurt A; Smith, Kathryn; Adams, Elizabeth; Mizokawa, Stacey; Neville-Jan, Ann

2013-01-01

To evaluate the relationship between child- and parent-reported quality of life (QOL) and bowel and bladder continence among young children with spina bifida (SB). 104 children ages 5-12 years and one of their parents/guardians completed the Pediatric Quality of Life Inventory - Generic Form (PedsQL; parent and child) and the Quality of Life in Spina Bifida Questionnaire (QOLSBQ, parent only). Data on continence, child age, and condition-specific variables were obtained by chart review. Parent and child QOL scores (on all measures of QOL) were positively correlated; parents rated child QOL lower than children's self report. QOL scores did not differ based on continence status. Total PedsQL scores were associated with age and mobility based on child report and with mobility based on parent report. QOL may not be affected by continence status among young children with SB, though demographic (i.e., age) and condition-specific (i.e., functional mobility status) variables appear relevant. Additional research is needed to further evaluate condition-specific variables, other protective variables, and possible measurement issues that influence QOL in young children with SB.

78 FR 38413 - American Family Life Insurance Company, et al.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

...] American Family Life Insurance Company, et al. June 20, 2013. AGENCY: Securities and Exchange Commission...: American Family Life Insurance Company (the ``Company''), American Family Variable Account I (the ``Life... Products Fund (``Fidelity Fund''), currently held by the Life Account and the Annuity Account (each an...

78 FR 75581 - Minnesota Life Insurance Company, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... SECURITIES AND EXCHANGE COMMISSION [Release No. IC-30821; File No. 812-14158] Minnesota Life...: Minnesota Life Insurance Company (``Minnesota Life'' or ``Insurance Company''), Variable Annuity Account...., Washington, D.C. 20549- 1090. Applicants, c/o Daniel P. Preiner, Counsel, Minnesota Life Insurance Company...

Social and medical determinants of quality of life and life satisfaction in women with Turner syndrome.

PubMed

Jeż, Wacław; Tobiasz-Adamczyk, Beata; Brzyski, Piotr; Majkowicz, Mikołaj; Pankiewicz, Piotr; Irzyniec, Tomasz J

2018-02-01

Turner syndrome (TS) appears in women as a result of the lack of part or the whole of one of the X chromosomes. It is characterized by the occurrence of low height, hypogonadism, numerous developmental defects, and is often accompanied by psychological disturbances. Although the phenotype characteristics of women with TS are quite well documented, the knowledge of the impact of Turner syndrome on the satisfaction with life is still insufficient. The aim of our study was to assess the impact of TS on selected variables of quality of life, and hence also life satisfaction in women with this syndrome. The research was carried out in a group of 176 women with TS starting March 1995. The patients underwent anthropological and medical examinations, and their medical histories were taken using a questionnaire that included demographic and psychosocial items as well as issues related to selected variables of quality of life. In our research model, general life satisfaction was a dependent variable. The statistical analysis was conducted using the eta and Cramer's V correlation coefficients as well as a multidimensional logistic regression model. The main determinants of dissatisfaction with life in women with TS were short stature and feelings of loneliness and being handicapped. The determinants of life satisfaction in women with Turner syndrome were closely related to the private life of the study participants, in particular self-perception and feelings concerning their health status.

[A predictive model for the quality of sexual life in hysterectomized women].

PubMed

Urrutia, María Teresa; Araya, Alejandra; Rivera, Soledad; Viviani, Paola; Villarroel, Luis

2007-03-01

The effects of hysterectomy on sexuality has been extensively studied. To establish a model to predict the quality of sexual life in hysterectomized women, six months after surgery. Analytical, longitudinal and prospective study of 90 hysterectomized women aged 45+/-7 years. Two structured interviews at the time of surgery and six months later were carried out to determine the characteristics of sexuality and communication within the couple. In the two interviews, communication and the quality of sexual life were described as "good" in 72 and 77% of women, respectively (NS). The variables that had a 40% influence on the quality of sexual life sixth months after surgery, were oophorectomy status, the presence of orgasm, the characteristics of communication and the basal sexuality with the couple. The sexuality of the hysterectomized women will depend, on a great extent, of pre-surgical variables. Therefore, it is important to consider these variables for the education of hysterectomized women.

The cumulative effects of life event, personal and social resources on subjective well-being of elderly widowers.

PubMed

Balaswamy, S; Richardson, V E

2001-01-01

A multidimensional Life Stress Model was used to test the independent contributions of background characteristics, personal resources, life event, and environmental influences on 200 widowers' levels of well-being, measured by the Affect Balance Scale. Stepwise regression analyses revealed that environmental resources were unrelated to negative affect which is influenced more by the life event and personal resource variables. The environmental resource variables, particularly interactions with friends and neighbors, mostly influenced positive affect. The explanatory model for well-being included multiple variables and explained 33 percent of the variance. Although background characteristics had the greatest impact, absence of hospitalization, higher mastery, higher self-esteem, contacts with friends, and interaction with neighbors enhanced well-being. The results support previous speculations on the importance of positive exchanges for positive affect. African-American widowers showed higher levels of well-being than Caucasian widowers did. The results advance knowledge about differences among elderly men.

Masked expression of life-history traits in a highly variable environment

USGS Publications Warehouse

DeBoer, Jason A.; Fontaine, Joseph J.; Chizinski, Christopher J.; Pope, Kevin L.

2015-01-01

Differing life-history strategies may act as a constraint on reproductive expression that ultimately limits the ability of individual species to respond to changes in the magnitude or frequency of environmental variation, and potentially underlies the variation often inherent in phenotypic and evolved responses to anthropogenic change. Alternatively, if there are environmental cues that predict reproductive potential, differential expression of life-history strategies may represent differences in the adaptive capacity to optimize current reproductive value given variation in environmental conditions. We compared several aspects of walleye Sander vitreus spawning ecology at two reservoirs that differ in environmental variability (i.e., annual water-level fluctuation) to identify the capacity of phenotypic expression and the corresponding association with age. Despite significant differences in female body and liver masses between reservoirs that differ in environmental variability, we found no difference in reproductive investment measured by egg size and fecundity. Walleye in a highly variable environment appear to exhibit reproductive traits more typical of a short-lived life-history strategy, which may be resultant from the interaction of environmental and anthropogenic pressures. This finding emphasizes the need to identify the degree to which life-history expression represents physiological constraints versus ecological optimization, particularly as anthropogenic change continues to alter environmental conditions. 

Anxiety and depression among amyloid light-chain cardiac amyloidosis patients: The role of life satisfaction.

PubMed

Smorti, Martina; Guarnieri, Silvia; Bergesio, Franco; Perfetto, Federico; Cappelli, Francesco

2016-06-01

The present study aimed to provide a contribution to the study of a rare disease, amyloid light-chain (AL) cardiac amyloidosis, which is the most common type of systemic amyloidosis. In AL amyloidosis prognosis is determined by cardiac involvement. Although the association between psychological distress (e.g. anxiety and depression) and AL cardiac amyloidosis is documented, very little is known about the psychosocial variables that may mediate the association. The aim of the study is therefore to examine the potential mediating role of life satisfaction in the relationship between cardiac symptom severity (independent variable) and anxious and depressive symptoms (dependent variables) in AL patients. Forty-three AL amyloidosis patients (57.1% males) with cardiac amyloidosis were administered the Satisfaction with Life Scale, the State-Trait Anxiety Inventory and the Centre for Epidemiological Study-Depression Scale. Clinical variables such as months since cardiac symptom onset and cardiac symptom severity were collected. Findings showed significant relationships between symptom severity and psychological disorders (e.g. anxiety and depression) and these were mediated by life satisfaction. Overall, findings highlight the importance of subjective well-being (e.g. life satisfaction) to reduce anxious and depressive symptoms and to improve general health in AL patients. © The European Society of Cardiology 2015.

Improved self-management skills predict improvements in quality of life and depression in patients with chronic disorders.

PubMed

Musekamp, Gunda; Bengel, Jürgen; Schuler, Michael; Faller, Hermann

2016-08-01

Self-management programs aim to improve patients' skills to manage their chronic condition in everyday life. Improvement in self-management is assumed to bring about improvements in more distal outcomes, such as quality of life. This study aimed to test the hypothesis that changes in self-reported self-management skills observed after participation in self-management programs predict changes in both quality of life and depressive symptoms three months later. Using latent change modeling, the relationship between changes in latent variables over three time points (start and end of rehabilitation, after three months) was analysed. The sample comprised 580 patients with different chronic conditions treated in inpatient rehabilitation clinics. The influence of additional predictor variables (age, sex, perceived social support) and type of disorder as a moderator variable was also tested. Changes in self-reported self-management skills after rehabilitation predicted changes in both quality of life and depressive symptoms at the end of rehabilitation and the 3 months follow-up. These relationships remained significant after the inclusion of other predictor variables and were similar across disorders. The findings provide support for the hypothesis that improvements in proximal outcomes of self-management programs may foster improvements in distal outcomes. Further studies should investigate treatment mechanisms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Predicting Clinical Gains and Side Effects of Stimulant Medication in Pediatric Attention-Deficit/Hyperactivity Disorder by Combining Measures From qEEG and ERPs in a Cued GO/NOGO Task.

PubMed

Ogrim, Geir; Kropotov, Juri D

2018-06-01

The study aim was to develop 2 scales: predicting clinical gains and risk of acute side effects of stimulant medication in pediatric attention-deficit/hyperactivity disorder (ADHD), combining measures from EEG spectra, event-related potentials (ERPs), and a cued visual GO/NOGO task. Based on 4-week systematic medication trials, 87 ADHD patients aged 8 to 17 years were classified as responders (REs, n = 62) or non-REs (n = 25), and belonging to the side effects (SEs, n = 42) or no-SEs (n = 45) groups. Before starting the trial, a 19-channel EEG was registered twice: Test 1 (T1) without medication and T2 on a single dose of stimulant medication a few days before the trial. EEG was registered T1 and T2: 3 minutes eyes-closed, 3 minutes eyes-open, and 20 minutes cued GO/NOGO. EEG spectra, ERPs, omissions, commissions, reaction time (RT), and RT variability were computed. Groups were compared at T1 and T2 on quantitative EEG (qEEG), ERPs and behavioral parameters; effect sizes ( d) were estimated. Variables with d > 0.5 were converted to quartiles, multiplied by corresponding d, and summed to obtain 2 global scales. Six variables differed significantly between REs and non-REs (T1: theta/alpha ratio, P3NOGO amplitude. Differences T2-T1: Omissions, RT variability, P3NOGO, contingent negative variation [CNV]). The global scale d was 1.86. Accuracy (receiver operating characteristic) was 0.92. SEs and no-SEs differed significantly on 4 variables. (T1: RT, T2: novelty component and alpha peak frequency, and RT changes. Global scale d = 1.08 and accuracy = 0.78. Gains and side effects of stimulants in pediatric ADHD can be predicted with high accuracy by combining EEG spectra, ERPs, and behavior from baseline and single-dose tests. ClinicalTrials.gov identifier: NCT02695355.

Multimorbidity among registered immigrants in Norway: the role of reason for migration and length of stay.

PubMed

Diaz, Esperanza; Kumar, Bernadette N; Gimeno-Feliu, Luis-Andrés; Calderón-Larrañaga, Amaia; Poblador-Pou, Beatriz; Prados-Torres, Alexandra

2015-12-01

International migration is rapidly increasing worldwide. However, the health status of migrants differs across groups. Information regarding health at arrival and subsequent periodic follow-up in the host country is necessary to develop equitable health care to immigrants. The objective of this study was to determine the impact of the length of stay in Norway and other sociodemographic variables on the prevalence of multimorbidity across immigrant groups (refugees, labour immigrants, family reunification immigrants and education immigrants). This is a register-based study merging data from the National Population Register and the Norwegian Health Economics Administration database. Sociodemographic variables and multimorbidity across the immigrant groups were compared using Persons' chi-square test and anova as appropriate. Several binary logistic regression models were conducted. Multimorbidity was significantly lower among labour immigrants (OR (95% CI) 0.23 (0.21-0.26) and 0.45 (0.40-0.50) for men and women, respectively) and education immigrants (OR (95% CI) 0.40 (0.32-0.50) and 0.38 (0.33-0.43)) and higher among refugees (OR (95% CI) 1.67 (1.57-1.78) and 1.83 (1.75-1.92)), compared to family reunification immigrants. For all groups, multimorbidity doubled after a five-year stay in Norway. Effect modifications between multimorbidity and sociodemographic characteristics across the different reasons for migration were observed. Multimorbidity was highest among refugees at arrival but increased rapidly among labour immigrants, especially females. Health providers need to ensure tailor-made preventive and management strategies that take into account pre-migration and post-migration experiences for immigrants in order to address their needs. © 2015 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

The Norwegian preeclampsia family cohort study: a new resource for investigating genetic aspects and heritability of preeclampsia and related phenotypes.

PubMed

Roten, Linda Tømmerdal; Thomsen, Liv Cecilie Vestrheim; Gundersen, Astrid Solberg; Fenstad, Mona Høysæter; Odland, Maria Lisa; Strand, Kristin Melheim; Solberg, Per; Tappert, Christian; Araya, Elisabeth; Bærheim, Gunhild; Lyslo, Ingvill; Tollaksen, Kjersti; Bjørge, Line; Austgulen, Rigmor

2015-12-01

Preeclampsia is a major pregnancy complication without curative treatment available. A Norwegian Preeclampsia Family Cohort was established to provide a new resource for genetic and molecular studies aiming to improve the understanding of the complex pathophysiology of preeclampsia. Participants were recruited from five Norwegian hospitals after diagnoses of preeclampsia registered in the Medical birth registry of Norway were verified according to the study's inclusion criteria. Detailed obstetric information and information on personal and family disease history focusing on cardiovascular health was collected. At attendance anthropometric measurements were registered and blood samples were drawn. The software package SPSS 19.0 for Windows was used to compute descriptive statistics such as mean and SD. P-values were computed based on t-test statistics for normally distributed variables. Nonparametrical methods (chi square) were used for categorical variables. A cohort consisting of 496 participants (355 females and 141 males) representing 137 families with increased occurrence of preeclampsia has been established, and blood samples are available for 477 participants. Descriptive analyses showed that about 60% of the index women's pregnancies with birth data registered were preeclamptic according to modern diagnosis criteria. We also found that about 41% of the index women experienced more than one preeclamptic pregnancy. In addition, the descriptive analyses confirmed that preeclamptic pregnancies are more often accompanied with delivery complications. The data and biological samples collected in this Norwegian Preeclampsia Family Cohort will provide an important basis for future research. Identification of preeclampsia susceptibility genes and new biomarkers may contribute to more efficient strategies to identify mothers "at risk" and contribute to development of novel preventative therapies.

Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study

PubMed Central

Verdú-Rotellar, Jose María; Frigola-Capell, Eva; Alvarez-Pérez, Rosa; da Silva, Daniela; Enjuanes, Cristina; Domingo, Mar; Mena, Amparo; Muñoz, Miguel-Angel

2017-01-01

Abstract Background: Heart failure (HF) diagnosis as reported in primary care medical records is not always properly confirmed and could result in over-registration. Objectives: To determine the proportion of registered HF that can be confirmed with information from primary care medical records and to analyse related factors. Methods: A cross-sectional study. The medical records of 595 HF patients attended in two primary healthcare centres in Barcelona (Spain) were revised and validated by a team of experts who classified diagnosis into confirmed, unconfirmed, and misdiagnosis. Variables potentially related to the confirmation of the diagnosis were analysed. The revision of medical records and data collection took place from 15 January to 31 March 2014. Results: Mean (standard deviation) age was 78 (10) years and 58% were women. The diagnosis could be confirmed in 53.6% of patients. Factors associated with a greater probability of having a confirmed diagnosis were age (yearly OR: 0.97, 95%CI: 0.95–0.99), cardiologist follow-up (OR: 3.66, 95%CI: 2.46–5.48), history of ischaemic heart disease (OR: 2.18, 95%CI: 1.36–2.48), atrial fibrillation (OR: 2.01, 95%CI: 1.34–3.03), and prescription of loop diuretics (OR: 3.24, 95%CI: 2.14–4.89). Conclusion: Only in half of the patients labelled as HF in primary care medical records could this diagnosis be further confirmed. Variables regularly registered in clinical practice could help general practitioners identify those patients requiring a revision of their HF diagnosis. PMID:28376668

Factors Influencing Female Registered Nurses' Work Behavior

PubMed Central

Brewer, Carol S; Kovner, Christine T; Wu, Yow-Wu; Greene, William; Liu, Yu; Reimers, Cordelia W

2006-01-01

Objective To analyze factors that are related to whether registered nurses (RNs) work (WK) or do not work (NW) in nursing; and if the RN works, whether she works full- (FT) or part-time (PT). Data Sources Secondary data from National Sample Survey of Registered Nurses 2000 (NSSRN), the InterStudy Competitive Edge Part III Regional Market Analysis (2001), and the Area Resource File (2002). Study Design Using a cross-sectional design we tested the relationship between WK or NW and FT or PT; and demographic, job-related, and metropolitan statistical area (MSA)-level variables. Data Collection/Extraction Methods We combined the data sources noted above to produce the analytic sample of 25,471 female RNs. Principal Findings Working in nursing is not independent of working FT or PT. Age (55 and older), other family income, and prior other work experience in health care are negatively related to working as an RN. The wage is not related to working as an RN, but negatively influences FT work. Age, children, minority status, student status, employment status, other income, and some job settings have a negative impact on working FT. Previous health care work has a positive effect on whether married RNs worked. Married RNs who are more dissatisfied are less likely to work FT. A greater number of market-level factors influence FT/PT than WK/NW behavior. Conclusions An important contribution of this study is demonstrating that MSA-level variables influence RN work behavior. The market environment seems to have little effect on whether a nurse works, but is influential on how much the nurse works, and has differential effects on married versus single nurses. PMID:16704517

SU-E-J-88: Deformable Registration Using Multi-Resolution Demons Algorithm for 4DCT.

PubMed

Li, Dengwang; Yin, Yong

2012-06-01

In order to register 4DCT efficiently, we propose an improved deformable registration algorithm based on improved multi-resolution demons strategy to improve the efficiency of the algorithm. 4DCT images of lung cancer patients are collected from a General Electric Discovery ST CT scanner from our cancer hospital. All of the images are sorted into groups and reconstructed according to their phases, and eachrespiratory cycle is divided into 10 phases with the time interval of 10%. Firstly, in our improved demons algorithm we use gradients of both reference and floating images as deformation forces and also redistribute the forces according to the proportion of the two forces. Furthermore, we introduce intermediate variable to cost function for decreasing the noise in registration process. At the same time, Gaussian multi-resolution strategy and BFGS method for optimization are used to improve speed and accuracy of the registration. To validate the performance of the algorithm, we register the previous 10 phase-images. We compared the difference of floating and reference images before and after registered where two landmarks are decided by experienced clinician. We registered 10 phase-images of 4D-CT which is lung cancer patient from cancer hospital and choose images in exhalationas the reference images, and all other images were registered into the reference images. This method has a good accuracy demonstrated by a higher similarity measure for registration of 4D-CT and it can register a large deformation precisely. Finally, we obtain the tumor target achieved by the deformation fields using proposed method, which is more accurately than the internal margin (IM) expanded by the Gross Tumor Volume (GTV). Furthermore, we achieve tumor and normal tissue tracking and dose accumulation using 4DCT data. An efficient deformable registration algorithm was proposed by using multi-resolution demons algorithm for 4DCT. © 2012 American Association of Physicists in Medicine.

Effects of poor asthma control, insomnia, anxiety and depression on quality of life in young asthmatics.

PubMed

Sundbom, Fredrik; Malinovschi, Andrei; Lindberg, Eva; Alving, Kjell; Janson, Christer

2016-01-01

Asthma-related quality of life has previously been shown to be associated with asthma control. The aims of the present study were to further analyze this correlation, identify other variables with impact on asthma-related quality of life and investigate the covariance among these variables. Information was retrieved from a cohort of 369 patients, aged 12-35, with physician-diagnosed asthma requiring anti-inflammatory treatment for at least 3 months per year. Questionnaire data [including the mini-Asthma Quality of Life Questionnaire (mAQLQ), asthma control test (ACT) and Hospital Anxiety and Depression Scale (HADS)], quality of sleep, lung function data and blood samples were analyzed. Linear regression models with the mAQLQ score as the dependent scalar variable were calculated. ACT was the single variable that had the highest explanatory value for the mAQLQ score (51.5%). High explanatory power was also observed for anxiety and depression (17.0%) and insomnia (14.1%). The population was divided into groups depending on the presence of anxiety and depression, uncontrolled asthma and insomnia. The group that reported none of these conditions had the highest mean mAQLQ score (6.3 units), whereas the group reporting all of these conditions had the lowest mAQLQ score (3.8 units). The ACT score was the single most important variable in predicting asthma-related quality of life. Combining the ACT score with the data on insomnia, anxiety and depression showed considerable additive effects of the conditions. Hence, we recommend the routine use of the ACT and careful attention to symptoms of insomnia, anxiety or depression in the clinical evaluation of asthma-related quality of life.

Sexual dimorphism in immune function changes during the annual cycle in house sparrows

NASA Astrophysics Data System (ADS)

Pap, Péter László; Czirják, Gábor Árpád; Vágási, Csongor István; Barta, Zoltán; Hasselquist, Dennis

2010-10-01

Difference between sexes in parasitism is a common phenomenon among birds, which may be related to differences between males and females in their investment into immune functions or as a consequence of differential exposure to parasites. Because life-history strategies change sex specifically during the annual cycle, immunological responses of the host aiming to reduce the impact of parasites may be sexually dimorphic. Despite the great complexity of the immune system, studies on immunoecology generally characterise the immune status through a few variables, often overlooking potentially important seasonal and gender effects. However, because of the differences in physiological and defence mechanisms among different arms of the immune system, we expect divergent responses of immune components to environmental seasonality. In male and female house sparrows ( Passer domesticus), we measured the major components of the immune system (innate, acquired, cellular and humoral) during four important life-history stages across the year: (1) mating, (2) breeding, (3) moulting and (4) during the winter capture and also following introduction to captivity in aviary. Different individuals were sampled from the same population during the four life cycle stages. We found that three out of eight immune variables showed a significant life cycle stage × sex interaction. The difference in immune response between the sexes was significant in five immune variables during the mating stage, when females had consistently stronger immune function than males, while variables varied generally non-significantly with sex during the remaining three life cycle stages. Our results show that the immune system is highly variable between life cycle stages and sexes, highlighting the potential fine tuning of the immune system to specific physiological states and environmental conditions.

Needs and challenges of daily life for people with Down syndrome residing in the city of Rome, Italy.

PubMed

Bertoli, M; Biasini, G; Calignano, M T; Celani, G; De Grossi, G; Digilio, M C; Fermariello, C C; Loffredo, G; Luchino, F; Marchese, A; Mazotti, S; Menghi, B; Razzano, C; Tiano, C; Zambon Hobart, A; Zampino, G; Zuccalà, G

2011-08-01

Population-based surveys on the quality of life of people with Down syndrome (DS) are difficult to perform because of ethical and legal policies regarding privacy and confidential information, but they are essential for service planning. Little is known about the sample size and variability of quality of life of people with DS living in the city of Rome, which has a population of 2.7 million inhabitants. The aim of the present study is to explore the needs and challenges in health, social integration and daily life, of people with DS living in Rome. A cross-sectional, census-based survey was conducted in 2006. All family doctors (3016 in total) of the National Health Service were involved by the Statistical Bureau of the Municipality of Rome. As per the census, every resident citizen is registered with a family doctor and every person with disabilities is coded. Associations for Down Syndrome encouraged their members to participate in the research. Questionnaires were completed by families of people with DS, in accordance with privacy laws. An initial survey, conducted via a letter and a telephone contact with family doctors, identified 884 people with DS residing in the city of Rome. Data on the medical and social conditions of 518 people with DS, ranging in age from 0 to 64 years, were collected. Some 88% of these were living with their original family; 82.1% had one or more siblings, and 19.5% had lost one or both parents. A full 100% of children with DS were enrolled in the public school system. This ensures that they are fully occupied and entirely integrated in society. After secondary school there is a lack of opportunities. Thus, only 10% of adults were working with a regular contract. A mere 42.2% of people with DS aged 25-30 were involved in some form of regular activity (although not always on a daily basis). After the age of 30, the percentage of people demonstrating decline in function increased sharply, while disability-related support decreased. In other words, as people with DS age, daily life evolves increasingly around the home, with only occasional outdoor activities. The health, employment and social needs of the majority of people with DS in the city of Rome are not being met. The findings of this study underscore the urgent need for more comprehensive inclusion in society of adults with DS and for the provision of support services to create an enabling environment for inclusion. Because of the variability of performance among individuals with DS, there is a need to create more case-specific options in terms of work, living arrangements, social networking and medical services. Schooling and social inclusion in childhood alone do not guarantee a satisfactory quality of life in adulthood. It is argued herewith that policy of inclusion and support should extend over the entire lifetime of people with DS. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Needs and challenges of daily life for people with Down syndrome residing in the city of Rome, Italy

PubMed Central

Bertoli, M; Biasini, G; Calignano, M T; Celani, G; De Grossi, G; Digilio, M C; Fermariello, C C; Loffredo, G; Luchino, F; Marchese, A; Mazotti, S; Menghi, B; Razzano, C; Tiano, C; Zambon Hobart, A; Zampino, G; Zuccalà, G

2011-01-01

Background Population-based surveys on the quality of life of people with Down syndrome (DS) are difficult to perform because of ethical and legal policies regarding privacy and confidential information, but they are essential for service planning. Little is known about the sample size and variability of quality of life of people with DS living in the city of Rome, which has a population of 2.7 million inhabitants. The aim of the present study is to explore the needs and challenges in health, social integration and daily life, of people with DS living in Rome. Methodology A cross-sectional, census-based survey was conducted in 2006. All family doctors (3016 in total) of the National Health Service were involved by the Statistical Bureau of the Municipality of Rome. As per the census, every resident citizen is registered with a family doctor and every person with disabilities is coded. Associations for Down Syndrome encouraged their members to participate in the research. Questionnaires were completed by families of people with DS, in accordance with privacy laws. Findings An initial survey, conducted via a letter and a telephone contact with family doctors, identified 884 people with DS residing in the city of Rome. Data on the medical and social conditions of 518 people with DS, ranging in age from 0 to 64 years, were collected. Some 88% of these were living with their original family; 82.1% had one or more siblings, and 19.5% had lost one or both parents. A full 100% of children with DS were enrolled in the public school system. This ensures that they are fully occupied and entirely integrated in society. After secondary school there is a lack of opportunities. Thus, only 10% of adults were working with a regular contract. A mere 42.2% of people with DS aged 25–30 were involved in some form of regular activity (although not always on a daily basis). After the age of 30, the percentage of people demonstrating decline in function increased sharply, while disability-related support decreased. In other words, as people with DS age, daily life evolves increasingly around the home, with only occasional outdoor activities. Conclusion The health, employment and social needs of the majority of people with DS in the city of Rome are not being met. The findings of this study underscore the urgent need for more comprehensive inclusion in society of adults with DS and for the provision of support services to create an enabling environment for inclusion. Because of the variability of performance among individuals with DS, there is a need to create more case-specific options in terms of work, living arrangements, social networking and medical services. Schooling and social inclusion in childhood alone do not guarantee a satisfactory quality of life in adulthood. It is argued herewith that policy of inclusion and support should extend over the entire lifetime of people with DS. PMID:21668802

Gene-diet interactions with polymorphisms of the MGLL gene on plasma low-density lipoprotein cholesterol and size following an omega-3 polyunsaturated fatty acid supplementation: a clinical trial.

PubMed

Ouellette, Catherine; Rudkowska, Iwona; Lemieux, Simone; Lamarche, Benoit; Couture, Patrick; Vohl, Marie-Claude

2014-05-24

Omega-3 (n-3) polyunsaturated fatty acid (PUFA) consumption increases low-density lipoprotein (LDL) cholesterol (C) concentrations and particle size. Studies showed that individuals with large, buoyant LDL particles have decreased risk of cardiovascular diseases. However, a large inter-individual variability is observed in LDL particle size. Genetic factors may explain the variability of LDL-C concentrations and particle size after an n-3 PUFA supplementation. The monoglyceride lipase (MGLL) enzyme, encoded by the MGLL gene, plays an important role in lipid metabolism, especially lipoprotein metabolism. The aim of this study was to investigate if polymorphisms (SNPs) of the MGLL gene influence the variability of LDL-C and LDL particle size in response to an n-3 PUFA supplementation. 210 subjects completed the study. They consumed 5 g/d of a fish oil supplement (1.9-2.2 g eicosapentaenoic acid and 1.1 g docosaexaenoic acid) during 6 weeks. Plasma lipids were measured before and after the supplementation period and 18 SNPs of the MGLL gene, covering 100% of common genetic variations (minor allele frequency ≥0.05), have been genotyped using TaqMan technology (Life Technologies Inc., Burlington, ON, CA). Following the n-3 PUFA supplementation, 55% of subjects increased their LDL-C levels. In a model including the supplementation, genotype and supplementation*genotype effects, gene-diet interaction effects on LDL-C concentrations (rs782440, rs6776142, rs555183, rs6780384, rs6787155 and rs1466571) and LDL particle size (rs9877819 and rs13076593) were observed for the MGLL gene SNPs (p < 0.05). SNPs within the MGLL gene may modulate plasma LDL-C levels and particle size following an n-3 PUFA supplementation. This trial was registered at clinicaltrials.gov as NCT01343342.

Contributions of dynamic environmental signals during life-cycle transitions to early life-history traits in lodgepole pine (Pinus contorta Dougl.)

NASA Astrophysics Data System (ADS)

Liu, Y.; Wang, T.; El-Kassaby, Y. A.

2015-08-01

Environmental signals are important triggers in the life-cycle transitions and play a crucial role in the life-history evolution. Yet, very little is known about the leading ecological factors contributing to the variations of life-history traits in perennial plants. This paper explores both the causes and consequences for the evolution of life-history traits (i.e., seed dormancy and size) in lodgepole pine (Pinus contorta Dougl.) across British Columbia (B.C.), Canada. We selected 83 logepole pine populations covering 22 ecosystem zones of B.C. and through their geographic coordinate, 197 climatic variables were generated accordingly for the reference (1961-1990) and future (2041-2070) periods. We found that dynamic climatic variables rather than constant geographic variables are the true environmental driving forces in seed dormancy and size variations and thus provide reliable predictors in response to global climate change. Evapotranspiration and precipitation in the plant-to-seed chronology are the most critical climate variables for seed dormancy and size variations, respectively. Hence, we predicted that levels of seed dormancy in lodgepole pine would increase across large tracts of B.C. in 2050s. Winter-chilling is able to increase the magnitude of life-history plasticity and lower the bet-hedge strategy in the seed-to-plant transition; however, winter-chilling is likely to be insufficient in the north of 49° N in 2050s, which may delay germination while unfavourable conditions during dry summers may result in adverse consequences in the survival of seedlings owing to extended germination span.

Development and evaluation of an articulated registration algorithm for human skeleton registration

NASA Astrophysics Data System (ADS)

Yip, Stephen; Perk, Timothy; Jeraj, Robert

2014-03-01

Accurate registration over multiple scans is necessary to assess treatment response of bone diseases (e.g. metastatic bone lesions). This study aimed to develop and evaluate an articulated registration algorithm for the whole-body skeleton registration in human patients. In articulated registration, whole-body skeletons are registered by auto-segmenting into individual bones using atlas-based segmentation, and then rigidly aligning them. Sixteen patients (weight = 80-117 kg, height = 168-191 cm) with advanced prostate cancer underwent the pre- and mid-treatment PET/CT scans over a course of cancer therapy. Skeletons were extracted from the CT images by thresholding (HU>150). Skeletons were registered using the articulated, rigid, and deformable registration algorithms to account for position and postural variability between scans. The inter-observers agreement in the atlas creation, the agreement between the manually and atlas-based segmented bones, and the registration performances of all three registration algorithms were all assessed using the Dice similarity index—DSIobserved, DSIatlas, and DSIregister. Hausdorff distance (dHausdorff) of the registered skeletons was also used for registration evaluation. Nearly negligible inter-observers variability was found in the bone atlases creation as the DSIobserver was 96 ± 2%. Atlas-based and manual segmented bones were in excellent agreement with DSIatlas of 90 ± 3%. Articulated (DSIregsiter = 75 ± 2%, dHausdorff = 0.37 ± 0.08 cm) and deformable registration algorithms (DSIregister = 77 ± 3%, dHausdorff = 0.34 ± 0.08 cm) considerably outperformed the rigid registration algorithm (DSIregsiter = 59 ± 9%, dHausdorff = 0.69 ± 0.20 cm) in the skeleton registration as the rigid registration algorithm failed to capture the skeleton flexibility in the joints. Despite superior skeleton registration performance, deformable registration algorithm failed to preserve the local rigidity of bones as over 60% of the skeletons were deformed. Articulated registration is superior to rigid and deformable registrations by capturing global flexibility while preserving local rigidity inherent in skeleton registration. Therefore, articulated registration can be employed to accurately register the whole-body human skeletons, and it enables the treatment response assessment of various bone diseases.

Work engagement of older registered nurses: the impact of a caring-based intervention.

PubMed

Bishop, Mary

2013-10-01

The aim of this evaluation research was to measure the impact of a caring-based intervention on the level of work engagement in older nurses. Every effort is needed to retain older nurses at the bedside by assisting them to revitalise the internal motivation and self- reward that brought them to nursing. A mixed method evaluation research approach using both qualitative and quantitative measurements was used to determine the impact of a caring-based programme on improving the work engagement scores of older Registered Nurses (RNs). The results of this study suggest that leadership strategies aimed at improving work engagement using caring theories have a significant positive impact. The findings contribute to our understanding of how work engagement can be enhanced through building work environments where there is a sense of belonging and teamwork, where staff are allowed time to decompress as well as build positive work relationships. Nurse Leaders (NLs) bear a responsibility to partner with older Registered Nurses (RNs) to build engagement in their work life while enhancing the quality of care. Successful leaders will find ways to meet these unique challenges by creating a healthy work environment. © 2013 John Wiley & Sons Ltd.

Life on an Island: Early Settlers off the Rock Bound Coast of Maine. Teaching with Historic Places.

ERIC Educational Resources Information Center

Hobbs-Olson, Laurie

This lesson, based on National Register of Historic Places files, describes early settlers' lives on some of the approximately 5,000 islands off the coast of Maine. During the mid-18th century many of these islands began to be inhabited by settlers eager to take advantage of this interface between land and sea. The lesson discusses the Blue Duck…

[Quantified self movement--the new mantra of life insurance companies].

PubMed

Becher, St

2016-06-01

Wearables are small personal minicomputers that register biometric data. In such a way, the insurance industry hopes to create new sales opportunities and products, and simplify underwriting. Lower premiums will promote the use of wearables. The related possibilities and unanswered questions are discussed in this article. Utilisation of big data offers the insurance industry a range of new opportunities. The benefit must be proven in the future, however.

Disparities in Prostate Cancer Treatment Modality and Quality of Life

DTIC Science & Technology

2010-11-01

Exclusion Criteria: White and African American men, age 35 and over, diagnosed with localized prostate cancer who entered the North Carolina Central...Americans, have been diagnosed with localized prostate cancer. Therefore, stage at diagnosis will not be used to exclude participants. The age to begin... Locale : Males 35 and over who are registered in the North Carolina Central Cancer Registry and have met the inclusion/exclusion criteria

How to Steal a Dog and Other Lessons in Life

ERIC Educational Resources Information Center

O'Connor, Barbara

2007-01-01

In this article, the author relates how a lost dog gave her the idea for writing her book, "How to Steal a Dog." Her tale of serendipity began when she, a dog-lover, walked into a garden center near her home and saw a sign for a lost dog taped beside the cash register. She states that, although her story is about a girl who stole a dog and…