From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): a retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities.

PubMed

Lefevere, Eva; Theeten, Heidi; Hens, Niel; De Smet, Frank; Top, Geert; Van Damme, Pierre

2015-09-22

School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12-18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage - 3 important parameters contributing to the effectiveness of the vaccination programs - under both vaccination systems. We used retrospective administrative data from different sources. Our sample consisted of all female members of the National Alliance of Christian Mutualities born in 1995, 1996, 1998 or 1999 (N=66,664). For each vaccination system we described the cumulative proportion HPV vaccination initiation and completion over time. We used life table analysis to calculate age-specific rates of HPV vaccination initiation and completion. Analyses were done separately for higher income and low income groups. Under non school-based, co-payment vaccination the proportions HPV vaccination initiation and completion slowly rose over time. By age 17, the proportion HPV vaccination initiation/completion was 0.75 (95% CI 0.74-076)/0.66 (95% CI 0.65-0.67). The median age at vaccination initiation/completion was 14.4 years (95% CI 14.4-14.5)/15.4 years (95% CI 15.3-15.4). Socio-economic inequalities in coverage widened over time and with age. Under school-based, free vaccination rates of HPV vaccination initiation were substantially higher. By age 14,the proportion HPV vaccination initiation/completion was 0.90 (95% CI 0.90-0.90)/0.87 (95% CI 0.87-0.88). The median age at vaccination initiation/completion was 12.7 years (95% CI 12.7-12.7)/13.3 years (95% CI 13.3-13.3). Socio-economic inequalities in coverage and in age-specific coverage were substantially smaller. Copyright © 2015. Published by Elsevier Ltd.

The relationship between borderline symptoms and vantage perspective during autobiographical memory retrieval in a community sample.

PubMed

Van den Broeck, Kris; Reza, Jasmin; Nelis, Sabine; Claes, Laurence; Pieters, Guido; Raes, Filip

2014-01-01

Recent findings show that (previously) depressed and traumatised patients, compared to controls, make more frequently use of an observer perspective (as set against a field perspective) when retrieving memories. Because patients with borderline personality disorder (BPD) often report mood disturbances and past traumatic experiences, it would be plausible to expect that these patients too would retrieve higher proportions of observer memories. Therefore, and given the phenotypical variance of BPD, we examined whether vantage perspective during recall is associated with one or more BPD symptom clusters. A community sample consisting of 148 volunteers (66 males) completed the Autobiographical Memory Test, the Borderline Syndrome Index, and the Depression Scale of the Depression Anxiety Stress Scales. Interpersonal and anxious-neurotic BPD features were associated with higher proportions of observer memories. The proportion of observer memories was not associated with the total number of BPD symptoms. Nevertheless, our data suggest the existence of substantial connections between perspective taking during recall on the one hand and interpersonal difficulties and anxious-neurotic symptoms on the other hand, especially following cues that tap into domains that are highly discrepant towards one's actual self-concept.

Transmission risk behaviour at enrolment in participants in the INSIGHT Strategic Timing of AntiRetroviral Treatment trial

PubMed Central

Rodger, Alison J; Lampe, Fiona C; Grulich, Andrew E; Fisher, Martin; Friedland, Gerald; Phanuphak, Nittaya; Bogner, Johannes R.; Pereira, Luiz Carlos; Rietmeijer, Cornelis; Burman, Bill; Phillips, Andrew

2014-01-01

Background A proportion of HIV-positive people have condomless sex. Antiretroviral treatment (ART) reduces infectiousness, but a substantial proportion of HIV-diagnosed people are not yet on ART. We describe baseline self-reported risk behaviours in ART-naïve START trial participants. Methods All START participants completed a risk behaviour questionnaire. Data were collected on sociodemographics, lifestyle factors, health and wellbeing status, and clinical status. Recent sexual behaviour and HIV transmission beliefs in the context of ART were also assessed. The primary interest was in condomless sex with serodifferent partners (CLS-D). Results 4601 of 4685 HIV-positive participants (98%) completed the questionnaire (2559 men who have sex with men [MSM]; 803 heterosexual men; 1239 women). Region of recruitment was Europe/Israel 33%, South America/Mexico 25%; Africa 22%; other 21%. Median age was 36 years (IQR 29, 44). 45% reported white ethnicity and 31% black ethnicity. 2% had HIV viral load <50 copies/mL. 17% (767/4601) reported CLS-D; 20% of MSM compared to 10% in heterosexual men and 14% in women. MSM were also more likely to report multiple CLS-D partners. Possible risk limitation measures in MSM included seropositioning. CLS-D was more commonly reported by participants from South America/Mexico compared to Europe. Knowledge of ART impact on transmission risk was low. Discussion A substantial minority recruited to the START study reported CLS-D at baseline. CLS-D reporting was higher in MSM than heterosexuals and varied significantly according to region of recruitment. A substantial proportion of MSM reporting CLS-D appear to take transmission risk limitation measures. PMID:25711325

Per-Capita Medicare Expenditures, Primary Care Access, Mortality Rates, and the Least Healthy Cities in America.

PubMed

Weeks, William B; Weinstein, James N

2017-01-01

To determine whether several measures of health care expenditures, access, and outcomes for the 25 recently identified "least healthy cities in America" differed from those in the rest of America. For 2004 and 2013, we obtained publicly available price-, age-, sex-, and race-adjusted hospital service area per-capita Medicare expenditures; age-, sex-, and race-adjusted Medicare mortality rates; and 2 indicators of primary care access: the proportion of enrollees having at least one ambulatory visit to a primary care clinician and the per-capita discharge rate for ambulatory care sensitive conditions. Using population weighting, we used Student t test for expenditure data and the chi-squared test for access and outcomes data to compare results of the 25 least healthy cities in aggregate to the rest of America. In both years examined, the 25 least healthy cities had substantially (about $500 per capita per year) and statistically significantly higher total per-capita Medicare Part A and Part B expenditures than the rest of America: about 4/5 of this difference was due to higher hospital and skilled nursing facility expenditures; physician expenditures were modestly lower in the 25 least healthy cities. While a greater proportion of Medicare beneficiaries in the least healthy cities had a primary care clinician both years, mortality and ambulatory care sensitive condition admission rates were substantially higher in the least healthy cities. Policymakers and health system executives should work together to determine the best asset allocation across determinants of health that maximizes value creation from a community health perspective. Copyright © 2016 Elsevier Inc. All rights reserved.

Mental Disorder Symptoms among Public Safety Personnel in Canada.

PubMed

Carleton, R Nicholas; Afifi, Tracie O; Turner, Sarah; Taillieu, Tamara; Duranceau, Sophie; LeBouthillier, Daniel M; Sareen, Jitender; Ricciardelli, Rose; MacPhee, Renee S; Groll, Dianne; Hozempa, Kadie; Brunet, Alain; Weekes, John R; Griffiths, Curt T; Abrams, Kelly J; Jones, Nicholas A; Beshai, Shadi; Cramm, Heidi A; Dobson, Keith S; Hatcher, Simon; Keane, Terence M; Stewart, Sherry H; Asmundson, Gordon J G

2018-01-01

Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP. An online survey was made available in English or French from September 2016 to January 2017. The survey assessed current symptoms, and participation was solicited from national PSP agencies and advocacy groups. Estimates were derived using well-validated screening measures. There were 5813 participants (32.5% women) who were grouped into 6 categories (i.e., call center operators/dispatchers, correctional workers, firefighters, municipal/provincial police, paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported current symptoms consistent with 1 (i.e., 15.1%) or more (i.e., 26.7%) mental disorders based on the screening measures. There were significant differences across PSP categories with respect to proportions screening positive based on each measure. The estimated proportion of PSP reporting current symptom clusters consistent with 1 or more mental disorders appears higher than previously published estimates for the general population; however, direct comparisons are impossible because of methodological differences. The available data suggest that Canadian PSP experience substantial and heterogeneous difficulties with mental health and underscore the need for a rigorous epidemiologic study and category-specific solutions.

Factors Influencing Nutritional Adequacy among Rural Households in Nigeria: How Does Dietary Diversity Stand among Influencers?

PubMed

Akerele, D; Sanusi, R A; Fadare, O A; Ashaolu, O F

2017-01-01

This study examined the influence of food consumption diversity on adequate intakes of food calories, proteins and micronutrients among households in rural Nigeria within the framework of panel data econometrics using a nationally representative data. We found that substantial proportion of households suffered deficiency of calories, proteins and certain micronutrients; with higher percentage of sufferer households occurring in the post-planting season. The different measures of dietary diversity (constructed and used for analysis) consistently indicate significant and positive influence of dietary diversity on the likelihood of adequate consumption of food nutrients. While higher level of income, education and non-farm enterprise engagement may strongly stimulate adequate nutrient intakes, increases in the number of adolescents would substantially diminish it. Although our findings call for renewed attention on diet diverseness, we stress the complementary/synergistic roles of education and rural income improvement, especially through non-farm enterprise diversification in tackling multiple nutritional deficiencies in rural Nigeria.

Geographic Disparity in the Use of Hypofractionated Radiation Therapy Among Elderly Women Undergoing Breast Conservation for Invasive Breast Cancer

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

Gillespie, Erin F.; Matsuno, Rayna K.; Xu, Beibei

Purpose: To evaluate geographic heterogeneity in the delivery of hypofractionated radiation therapy (RT) for breast cancer among Medicare beneficiaries across the United States. Methods and Materials: We identified 190,193 patients from the Centers for Medicare and Medicaid Services Chronic Conditions Warehouse. The study included patients aged >65 years diagnosed with invasive breast cancer treated with breast conservation surgery followed by radiation diagnosed between 2000 and 2012. We analyzed data by hospital referral region based on patient residency ZIP code. The proportion of women who received hypofractionated RT within each region was analyzed over the study period. Multivariable logistic regression models identified predictors ofmore » hypofractionated RT. Results: Over the entire study period we found substantial geographic heterogeneity in the use of hypofractionated RT. The proportion of women receiving hypofractionated breast RT in individual hospital referral regions varied from 0% to 61%. We found no correlation between the use of hypofractionated RT and urban/rural setting or general geographic region. The proportion of hypofractionated RT increased in regions with higher density of radiation oncologists, as well as lower total Medicare reimbursements. Conclusions: This study demonstrates substantial geographic heterogeneity in the use of hypofractionated RT among elderly women with invasive breast cancer treated with lumpectomy in the United States. This heterogeneity persists despite clinical data from multiple randomized trials proving efficacy and safety compared with standard fractionation, and highlights possible inefficiency in health care delivery.« less

Life history and demography of the common mud turtle Kinosternon subrubrum in South Carolina, USA

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

Frazier, N.B.; Gibbons, J.W.; Greene, J.L.

1992-01-01

This paper presents a life table for the common mud turtle, Kinosternon subrubrum, in a fluctuating aquatic habitat on the Upper Coastal Plain of South Carolina, USA, using data gathered in a 20-yr mark-recapture study. Data on survivorship and fecundity were assessed and compared to previously published life table statistics for the slider turtle, Trachemys scripta, in the same body of water and for the yellow mud turtle, K. flavscens, in Nebraska. The annual survival rate for adult female Kinosternon is significantly higher than that of adult female Trachemys. Similarly, male Kinosternon exhibit an annual survival rate significantly higher thanmore » that of male Trachemys. The mean annual proportion of female Kinosternon that are reproductively active also is significantly higher than that of Trachemys. In addition, survival rate from the time eggs are laid by Kinosternon until the hatchlings enter the aquatic environment is significantly higher than that for Trachemys. Comparisons of findings with those for K. flavesens indicate that these geographically separate populations of congeneric species also differ substantially in age at maturity, mean generation time, and the mean proportion of females that are reproductively active in any given year. Differences were also apparent in mean clutch frequencies and adult survival rates.« less

Temporal complexity of southern Beaufort Sea polar bear diets during a period of increasing land use

USGS Publications Warehouse

McKinney, Melissa A.; Atwood, Todd C.; Iverson, Sara J.; Peacock, Elizabeth

2017-01-01

From 2000 to 2013, use of land as a seasonal habitat by polar bears (Ursus maritimus) of the southern Beaufort Sea (SB) subpopulation substantially increased. This onshore use has been linked to reduced spatial and temporal availability of sea ice, as well as to the availability of subsistence‐harvested bowhead whale (Balaena mysticetus) bone piles. Here, we evaluated the role of climate conditions on consumption of traditional ice‐associated prey relative to onshore bowhead whale bone piles. We determined seasonal and interannual trends in the diets of SB polar bears using fatty acid‐based analysis during this period of increasing land use. Diet estimates of 569 SB polar bears from 2004 to 2012 showed high seasonal fluctuations in the proportions of prey consumed. Higher proportions of bowhead whale, as well as ringed seal (Pusa hispida) and beluga whale (Delphinapterus leucas), were estimated to occur in the winter–spring diet, while higher proportions of bearded seal (Erignathus barbatus) were estimated for summer–fall diets. Trends in the annual mean proportions of individual prey items were not found in either period, except for significant declines in the proportion of beluga in spring‐sampled bears. Nonetheless, in years following a high winter Arctic oscillation index, proportions of ice‐associated ringed seal were lower in the winter–spring diets of adult females and juveniles. Proportions of bowhead increased in the winter–spring diets of adult males with the number of ice‐free days over the continental shelf. In one or both seasons, polar bears that were in better condition were estimated to have consumed less ringed seal and/or more bowhead whale than those in worse condition. Therefore, climate variation over this recent period appeared to influence the extent of onshore vs. on‐ice food use, which in turn, appeared to be linked to fluctuating condition of SB polar bears.

Alcohol industry and governmental revenue from young Australians.

PubMed

Li, Ian W; Si, Jiawei

2016-11-01

Objective The aim of the present study was to estimate the revenues collected by government and industry from alcohol consumption by young Australians in 2010. Methods Statistical analyses were performed on data from the Australian National Drug Strategy Household Survey 2010 and alcohol data collected from an online retailer to calculate the proportion, frequency, quantity and revenues from alcohol consumption by young Australians. Results One-third of adolescents (12-17 years old) and 85% of young adults (18-25 years old) consume alcohol. More than half the adolescents' alcohol consumption is from ready-to-drink spirits. Revenue generated from alcohol consumption by 12-25 year olds is estimated at $4.8 billion in 2010 (2014 Australian dollars): $2.8 billion to industry (sales) and $2.0 billion to government (taxes). Conclusions Alcohol consumption by young Australians is prevalent, and young Australian drinkers consume alcohol in substantial amounts. The industry and taxation revenue from young drinkers is also considerable. It would be in the public interest to divert some of this revenue towards health initiatives to reduce drinking by young people, especially given the high societal costs of alcohol consumption. What is known about the topic? Australian adolescents aged 12-17 years consume substantial amounts of alcohol, and substantial amounts of revenue are generated from alcohol sales to them. What does this paper add? This paper provides recent estimates of alcohol consumption and revenue generated by Australian adolescents, and extends estimates to young adults aged 18-25 years. What are the implications for practitioners? A substantial proportion of Australian young people consume alcohol. The sales and taxation revenue generated from young people's drinking is substantial at A$4.8 billion in 2010 and is higher in real terms than estimates from previous studies. Some of the alcohol taxation revenue could be diverted to health promotion and education for young people, because the costs of alcohol consumption in terms of health outcomes and productivity losses for these age groups are expected to be especially high.

Expression of nestin in superior cervical ganglia of rats is influenced by gender and gonadectomy.

PubMed

Filipović, Natalija; Mašek, Tomislav; Grković, Ivica

2015-01-01

Neurons and glia arise from neural progenitor cells that express nestin. Although substantial changes in neuronal development were observed during the postnatal period, data concerning dynamics of nestin expression in the superior cervical ganglia (SCG) of rat during that period are lacking. It is known that gonadectomy and steroid hormones influence the development of neurons in the SCG during the postnatal period, but there are no data on how they influence the persistence of nestin expression in the SCG cells. The dynamics of nestin expression in the SCG in rats of three age groups, as well as the influence of gender and gonadectomy, was investigated. Three groups of male rats were sacrificed at 2, 3 and 6 months of age. Additional groups of male and female Sprague-Dawley rats were gonadectomized at the age of 2 months. After 30 days, they were sacrificed and SCGs were harvested and processed immunohistochemically. Immunoreactivity for nestin in the SCG was observed in satellite glia, based on their expression of s100. The proportion of neurons that were encircled with nestin-immunoreactive satellite cells (nestin encircled neurons, NEN) decreased between second and third month of age (p<0.05). The proportion of NEN was greater in the NPY+ than in the NPY- subpopulation. The proportion of NEN in the SCG of female rats was significantly higher (p<0.05) than that of both, the male rats and ovariectomised groups. The percentage of these neurons was significantly higher (p<0.05) in orchidectomised, in comparison to male rats. Results show the existence of nestin-immunoreactive satellite cells in the SCG of adult rats. A substantial decrease of nestin expression in SCG cells of rats, after the onset of sexual maturation, was observed. This decrease showed significant sex-dependence and was dramatically influenced by gonadal activity. Copyright © 2014 Elsevier B.V. All rights reserved.

Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys

PubMed Central

McLaughlin, Katie A.; Gadermann, Anne M.; Hwang, Irving; Sampson, Nancy A.; Al-Hamzawi, Ali; Andrade, Laura Helena; Angermeyer, Matthias C.; Benjet, Corina; Bromet, Evelyn J.; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; de Girolamo, Giovanni; de Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo Ruskov; Horiguchi, Itsuko; Hu, Chiyi; Karam, Aimee Nasser; Kovess-Masfety, Viviane; Lee, Sing; Murphy, Samuel D.; Nizamie, S. Haque; Posada-Villa, José; Williams, David R.; Kessler, Ronald C.

2012-01-01

Background Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity. Aims To examine the associations of parent with respondent disorders. Method Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews. Results Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0-19.9%) than other (7.1-14.0%) disorders. Conclusions Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders. PMID:22403085

Noise exposure and hearing impairment among Chinese restaurant workers and entertainment employees in Hong Kong.

PubMed

Lao, Xiang Qian; Yu, Ignatius Tak Sun; Au, Dennis Kin Kwok; Chiu, Yuk Lan; Wong, Claudie Chiu Yi; Wong, Tze Wai

2013-01-01

Noise-induced hearing loss (NIHL) is a major concern in the non-manufacturing industries. This study aimed to investigate the occupational noise exposure and the NIHL among Chinese restaurant workers and entertainment employees working in the service industry in Hong Kong. This cross-sectional survey involved a total of 1,670 participants. Among them, 937 were randomly selected from the workers of Chinese restaurants and 733 were selected from workers in three entertainment sectors: radio and television stations; cultural performance halls or auditoria of the Leisure and Cultural Services Department (LCSD); and karaoke bars. Noise exposure levels were measured in the sampled restaurants and entertainment sectors. Each participant received an audiometric screening test. Those who were found to have abnormalities were required to take another diagnostic test in the health center. The "Klockhoff digit" method was used to classify NIHL in the present study. The main source of noise inside restaurants was the stoves. The mean hearing thresholds showed a typical dip at 3 to 6 KHz and a substantial proportion (23.7%) of the workers fulfilled the criteria for presumptive NIHL. For entertainment sectors, employees in radio and television stations generally had higher exposure levels than those in the halls or auditoria of the LCSD and karaoke bars. The mean hearing thresholds showed a typical dip at 6 KHz and a substantial proportion of the employees fulfilled the criteria for presumptive NIHL (38.6%, 95%CI: 35.1-42.1%). Being male, older, and having longer service and daily alcohol consumption were associated with noise-induced hearing impairment both in restaurant workers and entertainment employees. Excessive noise exposure is common in the Chinese restaurant and entertainment industries and a substantial proportion of restaurant workers and entertainment employees suffer from NIHL. Comprehensive hearing conservation programs should be introduced to the service industry in Hong Kong.

Noise Exposure and Hearing Impairment among Chinese Restaurant Workers and Entertainment Employees in Hong Kong

PubMed Central

Lao, Xiang Qian; Yu, Ignatius Tak Sun; Au, Dennis Kin Kwok; Chiu, Yuk Lan; Wong, Claudie Chiu Yi; Wong, Tze Wai

2013-01-01

Background Noise-induced hearing loss (NIHL) is a major concern in the non-manufacturing industries. This study aimed to investigate the occupational noise exposure and the NIHL among Chinese restaurant workers and entertainment employees working in the service industry in Hong Kong. Methods This cross-sectional survey involved a total of 1,670 participants. Among them, 937 were randomly selected from the workers of Chinese restaurants and 733 were selected from workers in three entertainment sectors: radio and television stations; cultural performance halls or auditoria of the Leisure and Cultural Services Department (LCSD); and karaoke bars. Noise exposure levels were measured in the sampled restaurants and entertainment sectors. Each participant received an audiometric screening test. Those who were found to have abnormalities were required to take another diagnostic test in the health center. The “Klockhoff digit” method was used to classify NIHL in the present study. Results The main source of noise inside restaurants was the stoves. The mean hearing thresholds showed a typical dip at 3 to 6 KHz and a substantial proportion (23.7%) of the workers fulfilled the criteria for presumptive NIHL. For entertainment sectors, employees in radio and television stations generally had higher exposure levels than those in the halls or auditoria of the LCSD and karaoke bars. The mean hearing thresholds showed a typical dip at 6 KHz and a substantial proportion of the employees fulfilled the criteria for presumptive NIHL (38.6%, 95%CI: 35.1–42.1%). Being male, older, and having longer service and daily alcohol consumption were associated with noise-induced hearing impairment both in restaurant workers and entertainment employees. Conclusion Excessive noise exposure is common in the Chinese restaurant and entertainment industries and a substantial proportion of restaurant workers and entertainment employees suffer from NIHL. Comprehensive hearing conservation programs should be introduced to the service industry in Hong Kong. PMID:23976950

Elasticity of demand for water in Khartoum, Sudan.

PubMed

Cairncross, S; Kinnear, J

1992-01-01

A survey of the quantities of water purchased from vendors in the squatter areas of Khartoum, Sudan, was used to assess the effect of the price charged for water and of household income on domestic water consumption. Households in two squatter communities--Meiyo and Karton Kassala--were studied by observation and by interview. In spite of the substantially higher charges, water consumption in Karton Kassala was as high as that in Meiyo. Households within these communities showed no tendency to use less water when paying a higher price for it, or when their income was below average. In other words, no price elasticity or income elasticity was detectable. This was all the more striking in view of the high proportion of income that was spent on water; 17% in Meiyo, and 56% in Karton Kassala. One consequence of this lack of elasticity is that the poorest households devote the greatest percentage of their income to the purchase of water, although the only major item in their household budget which can be sacrificed to make this possible is food. The high price of water in urban Sudan is probably a major cause of the malnutrition prevalent in the squatter areas. Another consequence is that a low-income household's consumer surplus for domestic water is very high, amounting to a substantial proportion of its total income. This has important consequences for the economic appraisal of urban water supply schemes. It also follows that wealthier households with private connections would be willing to pay at least as much for water as that currently paid by the poor.

Gang homicides - five U.S. cities, 2003-2008.

PubMed

2012-01-27

Gang homicides account for a substantial proportion of homicides among youths in some U.S. cities; however, few surveillance systems collect data with the level of detail necessary to gang homicide prevention strategies. To compare characteristics of gang homicides with nongang homicides, CDC analyzed 2003-2008 data from the National Violent Death Reporting System (NVDRS) for five cities with high levels of gang homicide. This report describes the results of that analysis, which indicated that, consistent with similar previous research, a higher proportion of gang homicides than other homicides involved young adults and adolescents, racial and ethnic minorities, and males. Additionally, the proportion of gang homicides resulting from drug trade/use or with other crimes in progress was consistently low in the five cities, ranging from zero to 25%. Furthermore, this report found that gang homicides were more likely to occur with firearms and in public places, which suggests that gang homicides are quick, retaliatory reactions to ongoing gang-related conflict. These findings provide evidence for the need to prevent gang involvement early in adolescence and to increase youths' capacity to resolve conflict nonviolently.

Circumstances around weapon injury in Cambodia after departure of a peacekeeping force: prospective cohort study

PubMed Central

Meddings, David R; O’Connor, Stephanie M

1999-01-01

Objective To examine the circumstances surrounding weapon injury and combatant status of those injured by weapons. Design Prospective cohort study. Setting Northwestern Cambodia after departure of United Nations peacekeeping force. Subjects 863 people admitted to hospital for weapon injuries over 12 months. Main outcome measures Annual incidence of weapon injury by time period; proportions of injuries inflicted as a result of interfactional combat (combat injuries) and outside such combat (non-combat injuries) by combatant status and weapon type. Results The annual incidence of weapon injuries was higher than the rate observed before the peacekeeping operation. 30% of weapon injuries occurred in contexts other than interfactional combat. Most commonly these were firearm injuries inflicted intentionally on civilians. Civilians accounted for 71% of those with non-combat injuries, 42% of those with combat related injuries, and 51% of those with weapon injuries of either type. Conclusions The incidence of weapon injuries remained high when the disarmament component of a peacekeeping operation achieved only limited success. Furthermore, injuries occurring outside the context of interfactional combat accounted for a substantial proportion of all weapon injuries, were experienced disproportionately by civilians, and were most likely to entail the intentional use of a firearm against a civilian. Key messagesThe study took place in Cambodia after a United Nations peacekeeping operation that achieved only limited success in disarmamentA substantial proportion of weapon injuries was inflicted in contexts unrelated to interfactional combatThese injuries were most commonly firearm injuries inflicted intentionally on civiliansWidespread availability of weapons can facilitate social violence PMID:10445922

Advancing women and closing the leadership gap: the Executive Leadership in Academic Medicine (ELAM) program experience.

PubMed

Richman, R C; Morahan, P S; Cohen, D W; McDade, S A

2001-04-01

Women are persistently underrepresented in the higher levels of academic administration despite the fact that they have been entering the medical profession in increasing numbers for at least 20 years and now make up a large proportion of the medical student body and fill a similar proportion of entry level positions in medical schools. Although there are no easy remedies for gender inequities in medical schools, strategies have been proposed and implemented both within academic institutions and more broadly to achieve and sustain the advancement of women faculty to senior level positions. Substantial, sustained efforts to increase programs and activities addressing the major obstacles to advancement of women must be put in place so that the contributions of women can be fully realized and their skills fittingly applied in meeting the medical education and healthcare needs of all people in the 21st century.

Survey of animal shelter managers regarding shelter veterinary medical services.

PubMed

Laderman-Jones, B E; Hurley, K F; Kass, P H

2016-04-01

Veterinary services are increasingly used in animal shelters, and shelter medicine is an emerging veterinary specialty. However, little is known about working relationships between animal shelters and veterinarians. The aims of this survey were to characterize working relationships that shelter personnel have and want with veterinarians, identify opinions that shelter managers have regarding the veterinarians they work with, and determine areas for relationship growth between veterinarians and shelter managers. An electronic survey was distributed to 1373 managers of North American animal shelters; 536 (39.0%) responded. Almost all shelters had some veterinary relationship, and most had regular relationships with veterinarians. The proportion of shelters that used local clinics (73.9%) was significantly higher than the proportion that retained on-site paid veterinarians (48.5%). The proportion of respondents who did not have but wanted a paid on-site veterinarian (42%) was significantly higher than the proportion of respondents who did not use local clinics but wanted to (7.9%). These data suggest shelter managers valued veterinary relationships, and wished to expand on-site veterinary services. Almost all shelters in this study provided some veterinary care, and all respondents identified at least one common infectious disease, which, for most, had a substantial negative impact on shelter successes. Respondents indicated that the most important roles and greatest expertise of veterinarians were related to surgery, diagnosis and treatment of individual animals. Education of both veterinarians and shelter managers may help ensure that shelters benefit from the full range of services veterinarians can provide, including expertise in disease prevention and animal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do Sexually Oriented Massage Parlors Cluster in Specific Neighborhoods? A Spatial Analysis of Indoor Sex Work in Los Angeles and Orange Counties, California.

PubMed

Chin, John J; Kim, Anna J; Takahashi, Lois; Wiebe, Douglas J

2015-01-01

Social determinants of health may be substantially affected by spatial factors, which together may explain the persistence of health inequities. Clustering of possible sources of negative health and social outcomes points to a spatial focus for future interventions. We analyzed the spatial clustering of sex work businesses in Southern California to examine where and why they cluster. We explored economic and legal factors as possible explanations of clustering. We manually coded data from a website used by paying members to post reviews of female massage parlor workers. We identified clusters of sexually oriented massage parlor businesses using spatial autocorrelation tests. We conducted spatial regression using census tract data to identify predictors of clustering. A total of 889 venues were identified. Clusters of tracts having higher-than-expected numbers of sexually oriented massage parlors ("hot spots") were located outside downtowns. These hot spots were characterized by a higher proportion of adult males, a higher proportion of households below the federal poverty level, and a smaller average household size. Sexually oriented massage parlors in Los Angeles and Orange counties cluster in particular neighborhoods. More research is needed to ascertain the causal factors of such clusters and how interventions can be designed to leverage these spatial factors.

Complaints against nursing homes: comparing two sources of complaint information and predictors of complaints.

PubMed

Troyer, Jennifer L; Sause, Wendy L

2011-08-01

Two consumer-derived measures of nursing home quality that have been underutilized by researchers are consumer complaints to the state certification agency between inspections and complaints to the Long-Term Care Ombudsman Program. This article describes these complaints, considers facility-level predictors of complaints, and examines how complaints to the 2 entities are related. This article uses North Carolina complaint data from the state certification agency and Ombudsman from 2002 to 2006. First, we outline the similarities and differences in the 2 complaint sources by considering descriptive statistics and examining the structure of the 2 agencies. Second, we examine the relationship between complaints and facility characteristics that have been predictive of traditional quality measures. Finally, we examine the relationships between the 2 types of complaints. We find that complaints to the 2 agencies exhibit distinct differences in substantiation rates, although the top complaint category for both agencies is quality of care. Having a higher proportion of Medicaid residents is generally not predictive of complaint volume, whereas having a higher proportion of Medicare residents is associated with higher complaint levels. We find a lack of association between complaints to the 2 agencies when examining specific matched categories of complaints in many cases, suggesting that the 2 entities are not duplicating efforts in these categories.

Eating out is different from eating at home among individuals who occasionally eat out. A cross-sectional study among middle-aged adults from eleven European countries.

PubMed

Naska, Androniki; Katsoulis, Michail; Orfanos, Philippos; Lachat, Carl; Gedrich, Kurt; Rodrigues, Sara S P; Freisling, Heinz; Kolsteren, Patrick; Engeset, Dagrun; Lopes, Carla; Elmadfa, Ibrahim; Wendt, Andrea; Knüppel, Sven; Turrini, Aida; Tumino, Rosario; Ocké, Marga C; Sekula, Wlodzimierz; Nilsson, Lena Maria; Key, Tim; Trichopoulou, Antonia

2015-06-28

Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14,277 women aged 35-64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported higher intakes of fish OH than AH. Overall, substantial OH eating was more common among men, the younger and the more educated participants, but was weakly associated with total energy intake. The substantial OH eaters reported similar dietary intakes OH and AH. Individuals who were not identified as substantial OH eaters reported consuming proportionally higher quantities of sweet and savoury bakery products, soft drinks, juices and other non-alcoholic beverages OH than AH. The OH intakes were different from the AH ones, only among individuals who reported a relatively small contribution of OH eating to their daily intakes and this may partly explain the inconsistent findings relating eating out to the current obesity epidemic.

Out-of-pocket expenditures for primary health care in Tajikistan: a time-trend analysis.

PubMed

Schwarz, Joëlle; Wyss, Kaspar; Gulyamova, Zulfiya M; Sharipov, Soleh

2013-03-18

Aligned with the international call for universal coverage of affordable and quality health care, the government of Tajikistan is undertaking reforms of its health system aiming amongst others at reducing the out-of-pocket expenditures (OPE) of patients seeking care. Household surveys were conducted in 2005, 2007, 2008 and 2011 to explore the scale and determinants of OPE of users in four district of Tajikistan, where health care is legally free of charge at the primary level. Using the data from four cross-sectional household surveys conducted between 2005 and 2011, time trends in OPE for consultation fees, drugs and transport costs of adult users of family medicine services were analysed. To investigate differences along the economic status, an asset index was constructed using principal component analysis. Adjusted for inflation, OPE for primary care have substantially increased in the period 2005 to 2011. While the proportion of patients reporting the payment of informal consultation fees to providers and their amount were constant over time, the proportion of patients reporting expenditures for drugs has increased, and the median amounts have doubled from 5.3 US$ to 10.7 US$. Thus, the expenditures on medicine represent the biggest financial burden for patients accessing a primary care facility. Regression models showed that in 2011 patients from the most remote district with spread-out villages reported significant higher expenditures on medicine. Besides the steady increase in the median amount for OPE, the proportion of patients reporting making an informal payment to their care provider showed great variations across district of residence (between 20% and 73%) and economic status (between 33% among the 'worst-off' group and 68% among the 'better-off' group). In a context of limited governmental funds allocated to health and financing reforms aiming to improve financial access to primary care, the present paper indicates that in Tajikistan OPE - especially in relation to expenditures for drugs - have increased over time, and vary substantially across geographical areas and economic status. The fact that better-off households report disbursing more and in higher proportions hints towards a discrimination along the capacity to pay from providers. Increased public investments in the health sector, incentives for family doctors to provide PHC services free of charge and a strengthened drug control and supply system are necessary strategies to improve access of patients to services.

Gender Differentials in Self-Rated Health and Self-Reported Disability among Adults in India

PubMed Central

Bora, Jayanta Kumar; Saikia, Nandita

2015-01-01

Background The extant literature on gender differentials in health in developed countries suggests that women outlive men at all ages, but women report poorer health than men. It is well established that Indian women live longer than men, but few studies have been conducted to understand the gender dimension in self-rated health and self-reported disability. The present study investigates gender differentials in self-rated health (SRH) and self-reported disability (SRD) among adults in India, using a nationally representative data. Methods Using data on 10,736 respondents aged 18 and older in the 2007 WHO Study on Global Ageing and Adult Health in India, prevalence estimates of SRH are calculated separately for men and women by socio-economic and demographic characteristics. The association of SRH with gender is tested using a multinomial logistic regression method. SRD is assessed using 20 activities of daily living (ADL). Further, gender differences in total life expectancy (TLE), disability life expectancy (DLE) and the proportion of life spent with a disability at various adult ages are measured. Results The relative risk of reporting poor health by women was significantly higher than men (relative risk ratio: 1.660; 95% confidence Interval (CI): 1.430–1.927) after adjusting for socio-economic and demographic characteristics. Women reported higher prevalence of severe and extreme disability than men in 14 measures out of a total20 ADL measures. Women aged less than 60 years reported two times more than men in SRD ≥ 5 ADLs. Finally, both DLE and proportion of life spent with a disability were substantially higher for women irrespective of their ages. Conclusion Indian women live longer but report poorer health than men. A substantial gender differential is found in self-reported disability. This makes for an urgent call to health researchers and policy makers for gender-sensitive programs. PMID:26536133

Onset of a Declining Trend in Fatal Motor Vehicle Crashes Involving Drunk-driving in Japan

PubMed Central

Nakahara, Shinji; Katanoda, Kota; Ichikawa, Masao

2013-01-01

Background In Japan, introduction of severe drunk-driving penalties and a lower blood alcohol concentration (BAC) limit in June 2002 was followed by a substantial reduction in fatal alcohol-related crashes. However, previous research suggests that this reduction started before the legal amendments. The causes of the decrease have not been studied in detail. Methods Monthly police data on fatal road traffic crashes from January 1995 to August 2006 were analyzed using a joinpoint regression model to identify change-points in the trends of the proportion of drunk-driving among drivers primarily responsible for fatal crashes. We analyzed the data by BAC level (≥0.5 or <0.5 mg/ml), then conducted analyses stratified by vehicle type (car or motorcycle) and age group (<45 or ≥45 years) only for the proportion of those with a BAC of 0.5 mg/ml or higher. Results Among all drivers, the proportion of those with a BAC of 0.5 mg/ml or higher and those with a BAC greater than 0 but less than 0.5 mg/ml showed a change-point from increase to decrease in February 2000 and in May 2002, respectively. The proportion of those with a BAC of 0.5 mg/ml or higher showed a change-point from increase to decrease in October 1999 among car drivers and in April 2000 among drivers younger than 45 years. There was no change-point among motorcyclists. A change-point from no trend to a decrease in January 2002 was observed among those 45 years or older. Conclusions The change-point identified around the end of 1999 to the start of 2000 suggests that a high-profile fatal crash in November 1999, which drew media attention and provoked public debate, triggered subsequent changes in drunk-driving behavior. PMID:23604061

Reduction of magnetic field fluctuations in powered magnets for NMR using inductive measurements and sampled-data feedback control.

PubMed

Li, Mingzhou; Schiano, Jeffrey L; Samra, Jenna E; Shetty, Kiran K; Brey, William W

2011-10-01

Resistive and hybrid (resistive/superconducting) magnets provide substantially higher magnetic fields than those available in low-temperature superconducting magnets, but their relatively low spatial homogeneity and temporal field fluctuations are unacceptable for high resolution NMR. While several techniques for reducing temporal fluctuations have demonstrated varying degrees of success, this paper restricts attention to methods that utilize inductive measurements and feedback control to actively cancel the temporal fluctuations. In comparison to earlier studies using analog proportional control, this paper shows that shaping the controller frequency response results in significantly higher reductions in temporal fluctuations. Measurements of temporal fluctuation spectra and the frequency response of the instrumentation that cancels the temporal fluctuations guide the controller design. In particular, we describe a sampled-data phase-lead-lag controller that utilizes the internal model principle to selectively attenuate magnetic field fluctuations caused by the power supply ripple. We present a quantitative comparison of the attenuation in temporal fluctuations afforded by the new design and a proportional control design. Metrics for comparison include measurements of the temporal fluctuations using Faraday induction and observations of the effect that the fluctuations have on nuclear resonance measurements. Copyright © 2011. Published by Elsevier Inc.

Kawasaki Disease Increases the Incidence of Myopia.

PubMed

Kung, Yung-Jen; Wei, Chang-Ching; Chen, Liuh An; Chen, Jiin Yi; Chang, Ching-Yao; Lin, Chao-Jen; Lim, Yun-Ping; Tien, Peng-Tai; Chen, Hsuan-Ju; Huang, Yong-San; Lin, Hui-Ju; Wan, Lei

2017-01-01

The prevalence of myopia has rapidly increased in recent decades and has led to a considerable global public health concern. In this study, we elucidate the relationship between Kawasaki disease (KD) and the incidence of myopia. We used Taiwan's National Health Insurance Research Database to conduct a population-based cohort study. We identified patients diagnosed with KD and individuals without KD who were selected by frequency matched based on sex, age, and the index year. The Cox proportional hazards regression model was used to estimate the hazard ratio and 95% confidence intervals for the comparison of the 2 cohorts. The log-rank test was used to test the incidence of myopia in the 2 cohorts. A total of 532 patients were included in the KD cohort and 2128 in the non-KD cohort. The risk of myopia (hazard ratio, 1.31; 95% confidence interval, 1.08-1.58; P < 0.01) was higher among patients with KD than among those in the non-KD cohort. The Cox proportional hazards regression model showed that irrespective of age, gender, and urbanization, Kawasaki disease was an independent risk factor for myopia. Patients with Kawasaki disease exhibited a substantially higher risk for developing myopia.

A Multistate Life Table Analysis of Union Regimes in the United States: Trends and Racial Differentials, 1970–2002

PubMed Central

Morgan, S. Philip; Wang, Zhenglian; Gu, Danan; Yang, Chingli

2013-01-01

We estimate trends and racial differentials in marriage, cohabitation, union formation and dissolution (union regimes) for the period 1970–2002 in the United States. These estimates are based on an innovative application of multistate life table analysis to pooled survey data. Our analysis demonstrates (1) a dramatic increase in the lifetime proportions of transitions from never-married, divorced or widowed to cohabiting; (2) a substantial decrease in the stability of cohabiting unions; (3) a dramatic increase in mean ages at cohabiting after divorce and widowhood; (4) a substantial decrease in direct transition from never-married to married; (5) a significant decrease in the overall lifetime proportion of ever marrying and re-marrying in the 1970s to 1980s but a relatively stable pattern in the 1990s to 2000–2002; and (6) a substantial decrease in the lifetime proportion of transition from cohabiting to marriage. We also present, for the first time, comparable evidence on differentials in union regimes between four racial groups. PMID:24179311

The effectiveness of marine reserve systems constructed using different surrogates of biodiversity.

PubMed

Sutcliffe, P R; Klein, C J; Pitcher, C R; Possingham, H P

2015-06-01

Biological sampling in marine systems is often limited, and the cost of acquiring new data is high. We sought to assess whether systematic reserves designed using abiotic domains adequately conserve a comprehensive range of species in a tropical marine inter-reef system. We based our assessment on data from the Great Barrier Reef, Australia. We designed reserve systems aiming to conserve 30% of each species based on 4 abiotic surrogate types (abiotic domains; weighted abiotic domains; pre-defined bioregions; and random selection of areas). We evaluated each surrogate in scenarios with and without cost (cost to fishery) and clumping (size of conservation area) constraints. To measure the efficacy of each reserve system for conservation purposes, we evaluated how well 842 species collected at 1155 sites across the Great Barrier Reef seabed were represented in each reserve system. When reserve design included both cost and clumping constraints, the mean proportion of species reaching the conservation target was 20-27% higher for reserve systems that were biologically informed than reserves designed using unweighted environmental data. All domains performed substantially better than random, except when there were no spatial or economic constraints placed on the system design. Under the scenario with no constraints, the mean proportion of species reaching the conservation target ranged from 98.5% to 99.99% across all surrogate domains, whereas the range was 90-96% across all domains when both cost and clumping were considered. This proportion did not change considerably between scenarios where one constraint was imposed and scenarios where both cost and clumping constraints were considered. We conclude that representative reserve systems can be designed using abiotic domains; however, there are substantial benefits if some biological information is incorporated. © 2015 Society for Conservation Biology.

Comparison of Visual Assessment of Breast Density in BI-RADS 4th and 5th Editions With Automated Volumetric Measurement.

PubMed

Youk, Ji Hyun; Kim, So Jung; Son, Eun Ju; Gweon, Hye Mi; Kim, Jeong-Ah

2017-09-01

The purpose of this study was to compare visual assessments of mammographic breast density by radiologists using BI-RADS 4th and 5th editions in correlation with automated volumetric breast density measurements. A total of 337 consecutive full-field digital mammographic examinations with standard views were retrospectively assessed by two radiologists for mammographic breast density according to BI-RADS 4th and 5th editions. Fully automated measurement of the volume of fibroglandular tissue and total breast and percentage breast density was performed with a commercially available software program. Interobserver and intraobserver agreement was assessed with kappa statistics. The distributions of breast density categories for both editions of BI-RADS were compared and correlated with volumetric data. Interobserver agreement on breast density category was moderate to substantial (κ = 0.58-0.63) with use of BI-RADS 4th edition and substantial (κ = 0.63-0.66) with use of the 5th edition but without significant difference between the two editions. For intraobserver agreement between the two editions, the distributions of density category were significantly different (p < 0.0001), the proportions of dense breast increased, and the proportion of fatty breast decreased with use of the 5th edition compared with the 4th edition (p < 0.0001). All volumetric breast density data, including percentage breast density, were significantly different among density categories (p < 0.0001) and had significant correlation with visual assessment for both editions of BI-RADS (p < 0.01). Assessment using BI-RADS 5th edition revealed a higher proportion of dense breast than assessment using BI-RADS 4th edition. Nevertheless, automated volumetric density assessment had good correlation with visual assessment for both editions of BI-RADS.

Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

PubMed Central

2012-01-01

Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands. PMID:22824415

Weekend sun protection and sunburn in Australia trends (1987-2002) and association with SunSmart television advertising.

PubMed

Dobbinson, Suzanne J; Wakefield, Melanie A; Jamsen, Kris M; Herd, Natalie L; Spittal, Matthew J; Lipscomb, John E; Hill, David J

2008-02-01

The Australian state of Victoria has run a population-based skin cancer prevention program called SunSmart since 1988, incorporating substantial public education efforts and environmental change strategies. Trends over 15 years in behavioral risk factors for skin cancer were examined in a population exposed to the SunSmart program. Whether outcomes were associated with extent of SunSmart television advertising was then assessed. In nine cross-sectional surveys from 1987 to 2002, 11,589 adults were interviewed by telephone about their sun exposure and sun protection during outdoor activities on summer weekends. Analyses completed in 2007 adjusted for ambient temperature and ultraviolet radiation. Sun protection and sunburn show substantial general improvement over time, but have stalled in recent years. Use of hats and sunscreens significantly increased over time and peaked during the mid to late 1990s, compared with the pre-SunSmart baseline. The mean proportion of unprotected skin was reduced and was lowest in the summer of 1997-1998. Summer sunburn incidence declined over time and was 9.1% in 2002, almost half baseline (OR=0.53; 95% CI=0.39-0.73). Higher exposure to SunSmart advertising in the 4 weeks before the interview increased: (1) preference for no tan, (2) hat and sunscreen use, and (3) proportion of body surface protected from the sun. The general improvement in sun-protective behaviors over time highlight that a population's sun-protective behaviors are amenable to change. Population-based prevention programs incorporating substantial television advertising campaigns into the mix of strategies may be highly effective in improving a population's sun-protective behaviors.

Cluster analysis reveals seasonal variation of sperm subpopulations in extended boar semen

PubMed Central

IBĂNESCU, Iulian; LEIDING, Claus; BOLLWEIN, Heinrich

2017-01-01

This study aimed to identify motile sperm subpopulations in extended boar semen and to observe the presumptive seasonal variation in their distribution. Data from 4837 boar ejaculates collected over a two-year period were analyzed in terms of kinematic parameters by Computer Assisted Sperm Analysis (CASA). Individual sperm data were used to determine subgroups of motile sperm within the ejaculates using cluster analysis. Four motile sperm subpopulations (SP) were identified, with distinct movement patterns: SP1 sperm with high velocity and high linearity; SP2 sperm with high velocity but low linearity; SP3 sperm with low velocity but high linearity; and SP4 sperm with low velocity and low linearity. SP1 constituted the least overall proportion within the ejaculates (P < 0.05). Season of semen collection significantly influenced the different proportions of sperm subpopulations. Spring was characterized by similar proportions of SP1 and SP4 (NS) and higher proportions of SP3. Summer brought a decrease in both subgroups containing fast sperm (SP1 and SP2) (P < 0.05). During autumn, increases in SP2 and SP4 were recorded. Winter substantially affected the proportions of all sperm subpopulations (P < 0.05) and SP2 became the most represented subgroup, while SP1 (fast and linear) reached its highest proportion compared to other seasons. In conclusion, extended boar semen is structured in distinct motile sperm subpopulations whose proportions vary according to the season of collection. Summer and autumn seem to have a negative impact on the fast and linear subpopulation. Cluster analysis can be useful in revealing differences in semen quality that are not normally detected by classical evaluation based on mean values. PMID:29081440

Asian Americans and disproportionate exposure to carcinogenic hazardous air pollutants: A national study.

PubMed

Grineski, Sara E; Collins, Timothy W; Morales, Danielle X

2017-07-01

Studies have demonstrated disparate exposures to carcinogenic hazardous air pollutants (HAPs) in neighborhoods with high densities of Black and Hispanic residents in the US. Asians are the fastest growing racial/ethnic group in the US, yet they have been underemphasized in previous studies of environmental health and injustice. This cross-sectional study investigated possible disparities in residential exposure to carcinogenic HAPs among Asian Americans, including Asian American subgroups in the US (including all 50 states and the District of Columbia, n = 71,208 US census tracts) using National Air Toxics Assessment and US Census data. In an unadjusted analysis, Chinese and Korean Americans experience the highest mean cancer risks from HAPs, followed by Blacks. The aggregated Asian category ranks just below Blacks and above Hispanics, in terms of carcinogenic HAP risk. Multivariate models adjusting for socioeconomic status, population density, urban location, and geographic clustering show that an increase in proportion of Asian residents in census tracts is associated with significantly greater cancer risk from HAPs. Neighborhoods with higher proportions (as opposed to lower proportions) of Chinese, Korean, and South Asian residents have significantly greater cancer risk burdens relative to Whites. Tracts with higher concentrations of Asians speaking a non-English language and Asians that are US-born have significantly greater cancer risk burdens. Asian Americans experience substantial residential exposure to carcinogenic HAPs in US census tracts and in the US more generally. Copyright © 2017 Elsevier Ltd. All rights reserved.

Regional variation in bycatches associated with king scallop (Pecten maximus L.) dredge fisheries.

PubMed

Szostek, Claire L; Murray, Lee G; Bell, Ewen; Lambert, Gwladys; Kaiser, Michel J

2017-02-01

The biomass and composition of bycatch from king scallop dredge fisheries was assessed and compared between the English Channel, Cardigan Bay in Wales and around the Isle of Man. Bycatch composition varied significantly at localised, and broad, geographic scales. The mean proportion of scallop dredge bycatch biomass in the English Channel was 19% of total catch biomass. The proportion of bycatch was lower in Cardigan Bay (15%) but notably higher around the Isle of Man (53%). The proportion of individual bycatch species in dredge catches were low, therefore scallop dredging is unlikely to cause a substantial increase the population mortality of individual commercially fished species beyond that caused by the target fisheries for those species, or bycatches of other fisheries. The amount and mortality of organisms left on the seabed in the dredge path was not quantified in this study but should also be considered in management of the fishery. The discard rate of finfish and shellfish of commercial value from the king scallop dredge fishery in the English Channel was between 18 and 100%, with a higher rate of discarding occurring in the eastern English Channel compared to the west. The clear regional differences in bycatch composition and variation in the quantity of discards mean that an area by area approach to managing bycatch species is required in relation to the king scallop dredge fishery. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15

PubMed Central

Konty, Kevin J.; Van Wye, Gretchen; Barbot, Oxiris; Hadler, James L.; Linos, Natalia; Bassett, Mary T.

2016-01-01

Objectives. To assess potential reductions in premature mortality that could have been achieved in 2008 to 2012 if the minimum wage had been $15 per hour in New York City. Methods. Using the 2008 to 2012 American Community Survey, we performed simulations to assess how the proportion of low-income residents in each neighborhood might change with a hypothetical $15 minimum wage under alternative assumptions of labor market dynamics. We developed an ecological model of premature death to determine the differences between the levels of premature mortality as predicted by the actual proportions of low-income residents in 2008 to 2012 and the levels predicted by the proportions of low-income residents under a hypothetical $15 minimum wage. Results. A $15 minimum wage could have averted 2800 to 5500 premature deaths between 2008 and 2012 in New York City, representing 4% to 8% of total premature deaths in that period. Most of these avertable deaths would be realized in lower-income communities, in which residents are predominantly people of color. Conclusions. A higher minimum wage may have substantial positive effects on health and should be considered as an instrument to address health disparities. PMID:27077350

Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15.

PubMed

Tsao, Tsu-Yu; Konty, Kevin J; Van Wye, Gretchen; Barbot, Oxiris; Hadler, James L; Linos, Natalia; Bassett, Mary T

2016-06-01

To assess potential reductions in premature mortality that could have been achieved in 2008 to 2012 if the minimum wage had been $15 per hour in New York City. Using the 2008 to 2012 American Community Survey, we performed simulations to assess how the proportion of low-income residents in each neighborhood might change with a hypothetical $15 minimum wage under alternative assumptions of labor market dynamics. We developed an ecological model of premature death to determine the differences between the levels of premature mortality as predicted by the actual proportions of low-income residents in 2008 to 2012 and the levels predicted by the proportions of low-income residents under a hypothetical $15 minimum wage. A $15 minimum wage could have averted 2800 to 5500 premature deaths between 2008 and 2012 in New York City, representing 4% to 8% of total premature deaths in that period. Most of these avertable deaths would be realized in lower-income communities, in which residents are predominantly people of color. A higher minimum wage may have substantial positive effects on health and should be considered as an instrument to address health disparities.

The Use of Media as a Sleep Aid in Adults.

PubMed

Exelmans, Liese; Van den Bulck, Jan

2016-01-01

A sample of 844 adults, aged 18-94 years old, was queried about media habits and sleep behavior in face-to-face interviews with standardized questionnaires. A substantial proportion of this sample reported using books (39.8%), television (31.2%), music (26.0%), Internet (23.2%), and videogames (10.3%) as a sleep aid. The use of media as sleep aids was associated with increased fatigue and higher scores on the Pittsburgh Sleep Quality Index (PSQI), indicating poorer sleep quality. There was no relationship with sleep duration. Finally, results suggest that media use coincides with later bedtimes, but also later rise times, a process called time shifting.

Language processing and forms of immediate echolalia in autistic children.

PubMed

Paccia, J M; Curcio, F

1982-03-01

Several aspects of echolalic speech produced by five autistic children were investigated. We found that the incidence of echolalia was influenced by the type of question addressed to the child and, to a lesser extent, by the child's comprehension of the specific relationships expressed in the question. Additionally, acoustic analysis showed that a substantial proportion of echoes involved a prosodic modification of the examiner's question. Further analyses indicated that some of these modified echoes represent more than just a primitive conversational strategy. Specifically, they seem to reflect a higher level of processing and serve a semantic function, that of affirming the examiner's question.

Nitrate losses, nutrients and heavy metal accumulation from substrates assembled for urban soils reconstruction.

PubMed

Civeira, G; Lavado, R S

2008-09-01

Urban soils may suffer mild to severe degradation as a result of physical and chemical alterations. To reconstruct these soils, a new upper horizon must be created, usually through the application of organic matter, one source of which is biosolids. Different soil mixtures were evaluated with regard to loss of nitrates in percolates and the uptake and incorporation of nutrients and heavy metals into plant tissues. The experiment was conducted in trays; treatments were mixtures of biosolids and a coarse material (e.g., sand or pine wood sawdust), combined in different proportions. Randomized trays were seeded with a mix of tall fescue (Festuca arundinacea L.) and perennial ryegrass (Lolium perenne L.). Plant biomass was quantified. Nitrates in percolates were measured, as were nutrients and heavy metals in mixtures and plant tissues. Plants accumulated substantially more N, and biomass was 40% higher, in the treatments with higher levels of biosolids. The same treatments released more nitrogen and resulted in higher percolate nitrate levels. Plants had normal concentrations of all nutrients, except nitrogen, which was low. Heavy metal concentrations were not significantly different among treatments. Based on the analysis of these data, the proportion of biosolids appears to be the most important factor affecting the quality of reconstructed soil and the rate of improvement. The type of coarse material used did not significantly affect the outcome.

Do Sexually Oriented Massage Parlors Cluster in Specific Neighborhoods? A Spatial Analysis of Indoor Sex Work in Los Angeles and Orange Counties, California

PubMed Central

Kim, Anna J.; Takahashi, Lois; Wiebe, Douglas J.

2015-01-01

Objective Social determinants of health may be substantially affected by spatial factors, which together may explain the persistence of health inequities. Clustering of possible sources of negative health and social outcomes points to a spatial focus for future interventions. We analyzed the spatial clustering of sex work businesses in Southern California to examine where and why they cluster. We explored economic and legal factors as possible explanations of clustering. Methods We manually coded data from a website used by paying members to post reviews of female massage parlor workers. We identified clusters of sexually oriented massage parlor businesses using spatial autocorrelation tests. We conducted spatial regression using census tract data to identify predictors of clustering. Results A total of 889 venues were identified. Clusters of tracts having higher-than-expected numbers of sexually oriented massage parlors (“hot spots”) were located outside downtowns. These hot spots were characterized by a higher proportion of adult males, a higher proportion of households below the federal poverty level, and a smaller average household size. Conclusion Sexually oriented massage parlors in Los Angeles and Orange counties cluster in particular neighborhoods. More research is needed to ascertain the causal factors of such clusters and how interventions can be designed to leverage these spatial factors. PMID:26327731

Comparison of case fatality in south Asian and white patients after acute myocardial infarction: observational study.

PubMed

Wilkinson, P; Sayer, J; Laji, K; Grundy, C; Marchant, B; Kopelman, P; Timmis, A D

1996-05-25

To compare mortality in south Asian (Indian, Pakistani, and Bangladeshi) and white patients in the six months after hospital admission for acute myocardial infarction. Observational study. District general hospital in east London. 149 south Asian and 313 white patients aged < 65 years admitted to the coronary care unit with acute myocardial infarction from 1 December 1988 to 31 December 1992. All cause mortality in the first six months after myocardial infarction. The admission rate in the south Asians was estimated to be 2.04 times that in the white patients. Most aspects of treatment were similar in the two groups, except that a higher proportion of the south Asians received thrombolytic drugs (81.2% v 73.8%). After adjustment for age, sex, previous myocardial infarction, and treatment with thrombolysis or aspirin, or both, the south Asians had a poorer survival over the six months from myocardial infarction (hazard ratio 2.02 (95% confidence interval 1.14 to 3.56), P = 0.018), but a substantially higher proportion were diabetic (38% v 11%, P < 0.001), and additional adjustment for diabetes removed much of their excess risk (adjusted hazard ratio 1.26 (0.68 to 2.33), P = 0.47). South Asian patients had a higher risk of admission with myocardial infarction and a higher risk of death over the ensuing six months than the white patients. The higher case fatality among the south Asians, largely attributable to diabetes, may contribute to the increased risk of death from coronary heart disease in south Asians living in Britain.

Strangeness measurements with the PHOBOS experiment

NASA Astrophysics Data System (ADS)

Veres, Gábor I.; PHOBOS Collaboration; Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Chai, Z.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Halliwell, C.; Hamblen, J.; Hauer, M.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Holynski, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Seals, H.; Sedykh, I.; Smith, C. E.; Stankiewicz, M. A.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Vaurynovich, S. S.; Verdier, R.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wyslouch, B.

2006-12-01

Recent results on identified particle production from the PHOBOS experiment at the relativistic heavy-ion collider (RHIC) are summarized. Transverse momentum spectra of pions, kaons, protons and antiprotons from Au+Au collisions at \\sqrt{s_{NN}} = 62.4\\,GeV are presented close to mid-rapidity. Baryons have been found to have substantially harder transverse momentum spectra than mesons. The p/π+ ratio reaches unity at high pT, which fits into a smooth trend together with measurements at lower and higher collision energies. At very low transverse momenta no significant excess of particle yield was found, compared to extrapolations from higher pT. The net proton yield at mid-rapidity appears to be proportional to the number of participant nucleons in Au+Au collisions. The PHOBOS acceptance and mass resolution for the phi meson at low pT were studied in detail.

Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas

PubMed Central

2012-01-01

Background Nearly all California casinos currently allow smoking, which leads to potentially high patron exposure to secondhand tobacco smoke pollutants. Some argue that smoking restrictions or bans would result in a business drop, assuming > 50% of patrons smoke. Evidence in Nevada and responses from the 2008 California tobacco survey refute this assertion. The present study investigates the proportion of active smokers in southern California tribal casinos, as well as occupancy and PM2.5 levels in smoking and nonsmoking sections. Methods We measured active-smoker and total-patron counts during Friday or Saturday night visits (two per casino) to smoking and nonsmoking gaming areas inside 11 southern California casinos. We counted slot machines and table games in each section, deriving theoretical maximum capacities and occupancy rates. We also measured PM2.5 concentrations (or used published levels) in both nonsmoking and smoking areas. Results Excluding one casino visit with extremely high occupancy, we counted 24,970 patrons during 21 casino visits of whom 1,737 were actively smoking, for an overall active- smoker proportion of 7.0% and a small range of ~5% across casino visits (minimum of 5% and maximum of 10%). The differences in mean inter-casino active-smoker proportions were not statistically significant. Derived occupancy rates were 24% to 215% in the main (low-stakes) smoking-allowed slot or table areas. No relationship was found between observed active-smoker proportions and occupancy rate. The derived maximum capacities of nonsmoking areas were 1% to 29% of the overall casino capacity (most under 10%) and their observed occupancies were 0.1 to over 3 times that of the main smoking-allowed casino areas. Seven of twelve visits to nonsmoking areas with no separation had occupancy rates greater than main smoking areas. Unenclosed nonsmoking areas don’t substantially protect occupants from PM2.5 exposure. Nonsmoking areas encapsulated inside smoking areas or in a separate, but unenclosed, area had PM2.5 levels that were 10 to 60 μg/m3 and 6 to 23 μg/m3 higher than outdoor levels, respectively, indicating contamination from smoking. Conclusions Although fewer than roughly 10% of casino patrons are actively smoking on average, these individuals substantially increase PM2.5 exposure for all patrons in smoking and unenclosed nonsmoking areas. Nonsmoking areas may be too inconvenient, small, or undesirable to serve a substantial number of nonsmoking patrons. Imposing indoor smoking bans, or contained smoking areas with a maximum capacity of up to 10% of the total patronage, would offer protection from PM2.5 exposures for nonsmoking patrons and reduce employee exposures. PMID:22998850

Small proportions of actively-smoking patrons and high PM2.5 levels in southern California tribal casinos: support for smoking bans or designated smoking areas.

PubMed

Klepeis, Neil E; Omoto, Jason; Ong, Seow Ling; Omoto, Harmeena Sahota; Dhaliwal, Narinder

2012-09-22

Nearly all California casinos currently allow smoking, which leads to potentially high patron exposure to secondhand tobacco smoke pollutants. Some argue that smoking restrictions or bans would result in a business drop, assuming > 50% of patrons smoke. Evidence in Nevada and responses from the 2008 California tobacco survey refute this assertion. The present study investigates the proportion of active smokers in southern California tribal casinos, as well as occupancy and PM(2.5) levels in smoking and nonsmoking sections. We measured active-smoker and total-patron counts during Friday or Saturday night visits (two per casino) to smoking and nonsmoking gaming areas inside 11 southern California casinos. We counted slot machines and table games in each section, deriving theoretical maximum capacities and occupancy rates. We also measured PM(2.5) concentrations (or used published levels) in both nonsmoking and smoking areas. Excluding one casino visit with extremely high occupancy, we counted 24,970 patrons during 21 casino visits of whom 1,737 were actively smoking, for an overall active- smoker proportion of 7.0% and a small range of ~5% across casino visits (minimum of 5% and maximum of 10%). The differences in mean inter-casino active-smoker proportions were not statistically significant. Derived occupancy rates were 24% to 215% in the main (low-stakes) smoking-allowed slot or table areas. No relationship was found between observed active-smoker proportions and occupancy rate. The derived maximum capacities of nonsmoking areas were 1% to 29% of the overall casino capacity (most under 10%) and their observed occupancies were 0.1 to over 3 times that of the main smoking-allowed casino areas. Seven of twelve visits to nonsmoking areas with no separation had occupancy rates greater than main smoking areas. Unenclosed nonsmoking areas don't substantially protect occupants from PM2.5 exposure. Nonsmoking areas encapsulated inside smoking areas or in a separate, but unenclosed, area had PM(2.5) levels that were 10 to 60 μg/m(3) and 6 to 23 μg/m(3) higher than outdoor levels, respectively, indicating contamination from smoking. Although fewer than roughly 10% of casino patrons are actively smoking on average, these individuals substantially increase PM(2.5) exposure for all patrons in smoking and unenclosed nonsmoking areas. Nonsmoking areas may be too inconvenient, small, or undesirable to serve a substantial number of nonsmoking patrons. Imposing indoor smoking bans, or contained smoking areas with a maximum capacity of up to 10% of the total patronage, would offer protection from PM2.5 exposures for nonsmoking patrons and reduce employee exposures.

Comment on linking the sex difference in PCB concentrations of fish to release of eggs at spawning: Time to jettison the dogma

USGS Publications Warehouse

Madenjian, Charles P.

2017-01-01

For the past 20 years or so, a commonly used explanation in the scientific literature for higher polychlorinated biphenyl (PCB) concentrations in male fish than in female fish has been that females lose a high proportion of their PCB body burden by releasing eggs at spawning time, and therefore the females undergo a substantial decrease in their PCB concentration immediately after spawning due to shedding of their eggs [1]. Indeed, this explanation can be viewed as the conventional wisdom used by toxicologists to account for differences in PCB concentrations between the sexes of fish. On the surface, this explanation seems plausible. PCBs are lipid soluble, and eggs are thought to be relatively high in lipid concentration. If a sufficiently high proportion of the PCB body burden within a female fish is transferred to the eggs, then the release of eggs at spawning would be expected to result in a dramatic decrease in the PCB concentration of the female.

Trends in Dietary Supplement Use in a Cohort of Postmenopausal Women From Iowa

PubMed Central

Park, Kyong; Jacobs, David R.

2009-01-01

Although it is widely known that use of dietary supplements is common in the United States, little is known about use patterns among older Americans. The authors examined trends in dietary supplement use and its contribution to total nutrient intake in the Iowa Women's Health Study cohort in 1986 (baseline) and 2004 (follow-up). The proportion of women who reported using dietary supplements increased substantially between baseline (66%) and follow-up (85%). Moreover, a substantial proportion of women reported using multiple dietary supplements, with 27% using 4 or more products in 2004. Dietary supplements contributed substantially to total intake of many nutrients at baseline, and their contribution became relatively greater at follow-up for most nutrients examined. For most nutrients, no decline in intake was observed, as might have been expected in an aging cohort. Rather, intake of many nutrients increased, primarily because of the rising use of dietary supplements. Use of dietary supplements by older individuals is of particular importance because of the potential benefits of maintaining nutrient intake levels despite potentially declining food intake. However, possible risks from obtaining a large proportion of purified nutrients from dietary supplements rather than deriving them from foods should be studied. PMID:19208725

Should multifetal pregnancy reduction be used for prevention of preterm deliveries in triplet or higher order multiple pregnancies?

PubMed

Papiernik, E; Grangé, G; Zeitlin, J

1998-01-01

This article reviews the arguments for the use of multifetal pregnancy reduction (MFPR) for the prevention of preterm deliveries in triplet and higher order multiple pregnancies and evaluates its effectiveness based on data from published studies. The arguments in favour of pregnancy reduction are based on the substantial mortality and morbidity associated with these pregnancies. Triplets and higher order multiples have increased rates of preterm delivery and intrauterine growth retardation, both of which are independent risk factors for death and handicap. Even controlling for gestational age, rates of mortality and handicap are higher for multiples than for singletons. Moreover, the family's risk of losing a child or having a handicapped child is greater because there are more infants at risk. MFPR effectively lowers these risk by reducing the frequency of preterm delivery. However, its effectiveness may be limited. In some studies, the proportion of preterm deliveries in reduced pregnancies remains above levels found in spontaneous twin or singleton pregnancies and MFPR does not appear to reduce the prevalence of low birth weight. Furthermore, the procedure itself has unwanted side effects: it increases the risk of miscarriage, premature rupture of the membranes and causes adverse psychological effects such as grief or depression for many patients. The authors note that a majority of the higher order multiple pregnancies result from a medical intervention in the first place, either through IVF techniques or the use of ovulation stimulation drugs. Although MFPR is an effective measure for reducing the substantial morbidity and mortality associated with higher order multiple pregnancies, preventive methods, such as limiting to 2 the number of embryos transferred for IVF and better control of the use of ovulation induction drugs, remain more effective and less intrusive.

Out-of-pocket expenditures for primary health care in Tajikistan: a time-trend analysis

PubMed Central

2013-01-01

Background Aligned with the international call for universal coverage of affordable and quality health care, the government of Tajikistan is undertaking reforms of its health system aiming amongst others at reducing the out-of-pocket expenditures (OPE) of patients seeking care. Household surveys were conducted in 2005, 2007, 2008 and 2011 to explore the scale and determinants of OPE of users in four district of Tajikistan, where health care is legally free of charge at the primary level. Methods Using the data from four cross-sectional household surveys conducted between 2005 and 2011, time trends in OPE for consultation fees, drugs and transport costs of adult users of family medicine services were analysed. To investigate differences along the economic status, an asset index was constructed using principal component analysis. Results Adjusted for inflation, OPE for primary care have substantially increased in the period 2005 to 2011. While the proportion of patients reporting the payment of informal consultation fees to providers and their amount were constant over time, the proportion of patients reporting expenditures for drugs has increased, and the median amounts have doubled from 5.3 US$ to 10.7 US$. Thus, the expenditures on medicine represent the biggest financial burden for patients accessing a primary care facility. Regression models showed that in 2011 patients from the most remote district with spread-out villages reported significant higher expenditures on medicine. Besides the steady increase in the median amount for OPE, the proportion of patients reporting making an informal payment to their care provider showed great variations across district of residence (between 20% and 73%) and economic status (between 33% among the ‘worst-off’ group and 68% among the ‘better-off’ group). Conclusions In a context of limited governmental funds allocated to health and financing reforms aiming to improve financial access to primary care, the present paper indicates that in Tajikistan OPE – especially in relation to expenditures for drugs – have increased over time, and vary substantially across geographical areas and economic status. The fact that better-off households report disbursing more and in higher proportions hints towards a discrimination along the capacity to pay from providers. Increased public investments in the health sector, incentives for family doctors to provide PHC services free of charge and a strengthened drug control and supply system are necessary strategies to improve access of patients to services. PMID:23505990

Testing for Human Immunodeficiency Virus Among Cancer Survivors Under Age 65 in the United States

PubMed Central

Thompson, Trevor D.; Tai, Eric; Zhao, Guixiang; Oster, Alexandra M.

2014-01-01

Introduction Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes. However, there are no published data about HIV testing among cancer survivors in the United States. We sought to provide estimates of the proportion of cancer survivors tested for HIV and to characterize factors associated with having had HIV testing. Methods We used data from the 2009 Behavioral Risk Factor Surveillance System to calculate the proportion of cancer survivors under age 65 who had undergone HIV testing, by demographic and health-related factors and by state. Adjusted proportion estimates were calculated by multivariable logistic regression. Results Only 41% of cancer survivors in the United States under the age of 65 reported ever having had an HIV test. The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%). The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%). Multivariable analysis showed that factors associated with HIV testing included being non-Hispanic black or Hispanic, being younger, having higher education, not being married or living with a partner, not being disabled, and having medical cost concerns. Having an AIDS-related cancer was associated with HIV testing only among females. Conclusion The proportions of HIV testing varied substantially by demographic and health-related factors and by state. Our study points to the need for public health interventions to promote HIV testing among cancer survivors. PMID:25393748

The effect of land-use on the diversity and mass-abundance relationships of understory avian insectivores in Sri Lanka and southern India.

PubMed

Sreekar, Rachakonda; Srinivasan, Umesh; Mammides, Christos; Chen, Jin; Manage Goodale, Uromi; Kotagama, Sarath Wimalabandara; Sidhu, Swati; Goodale, Eben

2015-06-25

Understory avian insectivores are especially sensitive to deforestation, although regional differences in how these species respond to human disturbance may be linked to varying land-use histories. South Asia experienced widespread conversion of forest to agriculture in the nineteenth century, providing a comparison to tropical areas deforested more recently. In Sri Lanka and the Western Ghats of India, we compared understory insectivores to other guilds, and to insectivores with different vertical strata preferences, both inside mixed-species flocks and for the whole bird community. Overall species richness did not change across the land-use gradient, although there was substantial turnover in species composition between land-use types. We found that the proportion of species represented by insectivores was ~1.14 times higher in forest compared to agriculture, and the proportion of insectivores represented by understory species was ~1.32 times higher in forests. Mass-abundance relationships were very different when analyzed on mixed-species flocks compared to the total community, perhaps indicating reduced competition in these mutualisms. We show that South Asia fits the worldwide pattern of understory insectivores declining with increased land-use intensity, and conclude that these species can be used globally as indicator and/or umbrella species for conservation across different disturbance time scales.

The effect of land-use on the diversity and mass-abundance relationships of understory avian insectivores in Sri Lanka and southern India

PubMed Central

Sreekar, Rachakonda; Srinivasan, Umesh; Mammides, Christos; Chen, Jin; Manage Goodale, Uromi; Wimalabandara Kotagama, Sarath; Sidhu, Swati; Goodale, Eben

2015-01-01

Understory avian insectivores are especially sensitive to deforestation, although regional differences in how these species respond to human disturbance may be linked to varying land-use histories. South Asia experienced widespread conversion of forest to agriculture in the nineteenth century, providing a comparison to tropical areas deforested more recently. In Sri Lanka and the Western Ghats of India, we compared understory insectivores to other guilds, and to insectivores with different vertical strata preferences, both inside mixed-species flocks and for the whole bird community. Overall species richness did not change across the land-use gradient, although there was substantial turnover in species composition between land-use types. We found that the proportion of species represented by insectivores was ~1.14 times higher in forest compared to agriculture, and the proportion of insectivores represented by understory species was ~1.32 times higher in forests. Mass-abundance relationships were very different when analyzed on mixed-species flocks compared to the total community, perhaps indicating reduced competition in these mutualisms. We show that South Asia fits the worldwide pattern of understory insectivores declining with increased land-use intensity, and conclude that these species can be used globally as indicator and/or umbrella species for conservation across different disturbance time scales. PMID:26108368

Self-employment, specialty choice, and geographical distribution of physicians in Japan: A comparison with the United States.

PubMed

Matsumoto, Masatoshi; Inoue, Kazuo; Bowman, Robert; Kajii, Eiji

2010-08-01

Geographic and specialty maldistributions of physicians are political concerns in Japan. This study examined the associations of physician employment status with the number and geographic distribution of the physicians in each specialty in Japan, in comparison with the US. The number of physicians per unit population, proportion of clinic (Japan) or office (US) based physicians, and Gini coefficient of physicians against population were calculated in each of 20 specialties in Japan, and 21 specialties in the US. The geographic unit of Gini coefficient was municipality in Japan, and county in the US. Correlations among these three variables were also examined. The lower the proportion of clinic-based physicians was, the lower the number of physicians and the higher the Gini coefficient were in Japanese specialties, while there was no association between office-based rate and Gini coefficient in the US specialties. In radiology, anaesthesiology, emergency medicine, and pathology, Japanese clinic-based rates were less than one-tenth, and the numbers of physicians per unit population were less than half of the US values, and the Gini coefficients were substantially higher than the US values. Difficulty in being self-employed created low numbers in some specialties, and highly urban-biased distributions of these specialists in Japan. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study.

PubMed

Terzikhan, Natalie; Verhamme, Katia M C; Hofman, Albert; Stricker, Bruno H; Brusselle, Guy G; Lahousse, Lies

2016-08-01

COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC < 0.70). In absence of an interpretable spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician. Incidence rates were calculated by dividing the number of incident cases by the total number of person years of subjects at risk. In this cohort of 14,619 participants, 1993 subjects with COPD were identified of whom 689 as prevalent ones and 1304 cases as incident ones. The overall incidence rate (IR) of COPD was 8.9/1000 person-years (PY); 95 % Confidence Interval (CI) 8.4-9.4. The IR was higher in males and in smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial.

First Births to Maltreated Adolescent Girls: Differences Associated With Spending Time in Foster Care.

PubMed

King, Bryn

2017-05-01

Few studies have examined early parenting among girls receiving child welfare services (CWS) or disentangled the relationship between maltreatment, spending time in foster care, and adolescent childbirth. Using population-based, linked administrative data, this study calculated birth rates among maltreated adolescent girls and assessed differences in birth rates associated with spending time in foster care. Of the 85,766 girls with substantiated allegations of maltreatment during adolescence, nearly 18% subsequently gave birth. Among girls who spent time in foster care, the proportion was higher (19.5%). Significant variations ( p < .001) were observed in the rate of childbirth across demographic characteristics and maltreatment experiences. When accounting for all of the covariates, spending time in foster care was associated with a modestly higher rate of a first birth (Hazard Ratio [HR] = 1.10; 95% confidence interval = [1.06, 1.14]). While age at first substantiated allegation of maltreatment and race/ethnicity were significant predictors of adolescent childbirth, specific maltreatment experiences were associated with minimal or no differences in birth rates. The findings of this study suggest that the experience of spending time in care may not be a meaningful predictor of giving birth as a teen among CWS-involved adolescent girls and highlight subgroups of this population who may be more vulnerable to early childbirth.

A Review of Cancer in U.S. Hispanic Populations

PubMed Central

Haile, Robert W.; John, Esther M.; Levine, A. Joan; Cortessis, Victoria K.; Unger, Jennifer B.; Gonzales, Melissa; Ziv, Elad; Thompson, Patricia; Spruijt-Metz, Donna; Tucker, Katherine L.; Bernstein, Jonine L.; Rohan, Thomas E.; Ho, Gloria Y.F.; Bondy, Melissa L.; Martinez, Maria Elena; Cook, Linda; Stern, Mariana C.; Correa, Marcia Cruz; Wright, Jonelle; Schwartz, Seth J.; Baezconde-Garbanati, Lourdes; Blinder, Victoria; Miranda, Patricia; Hayes, Richard; Friedman-Jiménez, George; Monroe, Kristine R.; Haiman, Christopher A.; Henderson, Brian E.; Thomas, Duncan C.; Boffetta, Paolo

2018-01-01

There are compelling reasons to conduct studies of cancer in Hispanics, the fastest growing major demographic group in the United States (from 15% to 30% of the U.S. population by 2050). The genetically admixed Hispanic population coupled with secular trends in environmental exposures and lifestyle/behavioral practices that are associated with immigration and acculturation offer opportunities for elucidating the effects of genetics, environment, and lifestyle on cancer risk and identifying novel risk factors. For example, traditional breast cancer risk factors explain less of the breast cancer risk in Hispanics than in non-Hispanic whites (NHW), and there is a substantially greater proportion of never-smokers with lung cancer in Hispanics than in NHW. Hispanics have higher incidence rates for cancers of the cervix, stomach, liver, and gall bladder than NHW. With respect to these cancers, there are intriguing patterns that warrant study (e.g., depending on country of origin, the five-fold difference in gastric cancer rates for Hispanic men but not Hispanic women). Also, despite a substantially higher incidence rate and increasing secular trend for liver cancer in Hispanics, there have been no studies of Hispanics reported to date. We review the literature and discuss study design options and features that should be considered in future studies. PMID:22307564

Intermittent child employment and its implications for estimates of child labour

PubMed Central

LEVISON, Deborah; HOEK, Jasper; LAM, David; DURYEA, Suzanne

2008-01-01

Using longitudinal data from urban Brazil, the authors track the employment patterns of thousands of children aged 10-16 during four months of their lives in the 1980s and 1990s. The proportion of children who work at some point during a four-month period is substantially higher than the fraction observed working in any single month. The authors calculate an intermittency multiplier to summarize the difference between employment rates in one reference week vs. four reference weeks over a four-month period. They conclude that intermittent employment is a crucial characteristic of child labour which must be recognized to capture levels of child employment adequately and identify child workers. PMID:18815624

The Contribution of Oil Sands Industry Related Atmospheric THg and MeHg Deposition to Rivers of the Athabasca Oil Sands Region of Canada

NASA Astrophysics Data System (ADS)

Wasiuta, V. L.; Cooke, C. A.; Kirk, J.; Chambers, P. A.; Alexander, A. C.; Rooney, R. C.

2017-12-01

Rapid development of Oil Sands deposits in northern Alberta (Canada) raises concerns about human health and environmental impacts. We present results from a three-year study of winter-time atmospheric deposition of total mercury (THg) and methylmercury (MeHg) in six tributary watersheds of the Athabasca River. Seasonal snowpack THg and MeHg concentrations were obtained from spring-time sampling throughout the oil sands region. Winter-time Hg loads were then modeled at watershed and sub-basin scales using ArcGIS geostatistical kriging. To determine the potential impacts of snowmelt on aquatic ecosystems, six rivers were sampled at high frequency over 2012 to 2014 ice-free seasons. Hydrologic year (HY) and first discharge peak loads were then calculated from linear extrapolation of measured concentrations and mean daily discharge. Results showed high THg and MeHg loads from atmospheric deposition around regional upgrading facilities with loads diminishing outwards. This reflects the large proportion of particle bound Hg with a short atmospheric residence time, and deposition close to emission sources. Snowpacks within the six watersheds contained substantial proportions of tributary river THg and MeHg loads. For example, HY2014 snowpacks contained 24 to 46 % of river MeHg loads. All rivers showed a large proportion of HY loads discharged, within a few weeks, in the spring first discharge peak. HY2014 snowpack MeHg loads were greater than river loads in the first discharge peak for all watersheds except the High Hills. This first discharge peak is important as it occurs during critical growth periods for aquatic life. Large differences in tributary river THg and MeHg loads suggest factors other than atmospheric deposition and watershed scale contributed to the load. Considerably higher THg and MeHg snowpack loads in the Muskeg Watershed relative to river export suggest substantial losses to catchment soils or wetlands during snowmelt. Evaluation of factors that could contribute to the large differences in watershed Hg discharge, include proportion of wetlands along with different wetland classes, scale of industrial development, and development hydrologic connectivity. The consequence of long-term Hg loading to wetland ecosystems has yet to be assessed.

Mortality inequality in two native population groups.

PubMed

Saarela, Jan; Finnäs, Fjalar

2005-11-01

A sample of people aged 40-67 years, taken from a longitudinal register compiled by Statistics Finland, is used to analyse mortality differences between Swedish speakers and Finnish speakers in Finland. Finnish speakers are known to have higher death rates than Swedish speakers. The purpose is to explore whether labour-market experience and partnership status, treated as proxies for measures of variation in health-related characteristics, are related to the mortality differential. Persons who are single, disability pensioners, and those having experienced unemployment are found to have substantially higher death rates than those with a partner and employed persons. Swedish speakers have a more favourable distribution on both variables, which thus notably helps to reduce the Finnish-Swedish mortality gradient. A conclusion from this study is that future analyses on the topic should focus on mechanisms that bring a greater proportion of Finnish speakers into the groups with poor health or supposed unhealthy behaviour.

Conceptual Astronomy Knowledge among Amateur Astronomers

NASA Astrophysics Data System (ADS)

Berendsen, Margaret L.

Amateur astronomers regularly serve as informal astronomy educators for their communities. This research inquires into the level of knowledge of basic astronomy concepts among amateur astronomers and examines factors related to amateur astronomy that affect that knowledge. Using the concept questions from the Astronomy Diagnostic Test Version 2, an online survey was developed as an assessment. In particular, astronomy club members with at least some college-level astronomy education score substantially higher on the assessment (mean score: 85) than do college undergraduates after taking their first astronomy course (mean score: 47). Astronomy club members scored up to 17% higher than unaffiliated amateurs, an indication that regular contact with like-minded hobbyists improves basic knowledge. Proportionally more astronomy club members report doing outreach than do unaffiliated amateurs (87% vs. 46%). It appears that those who are likely to be more knowledgeable are also those doing more outreach.

Changes in fats and resins of Pinus radiata associated with heartwood formation

Treesearch

Richard W. Hemingway; W.E. Hillis

1971-01-01

In an analysis of Australian grown P. radiata marked changes were found in the relative proportions and compositions of the resin acids, fatty acids, and fatty acid esters associated with heartwood formation. While the proportion of resin acids increased substantially in the heartwood, there was little change in resin acid composition from outer...

Emotional Problems and Victimisation among Youth with National and International Migration Experience Living in Austria and Turkey

ERIC Educational Resources Information Center

Strohmeier, Dagmar; Dogan, Aysun

2012-01-01

Young people with international migration experiences constitute an increasing proportion of the population in many European countries. In Austria, a substantial proportion of these international migrants come from Turkey. In Turkey, many adolescents are national migrants, having moved from the eastern part to the western part of the country. This…

Analysis of energy use and CO2 emissions in the U.S. refining sector, with projections for 2025.

PubMed

Hirshfeld, David S; Kolb, Jeffrey A

2012-04-03

This analysis uses linear programming modeling of the U.S. refining sector to estimate total annual energy consumption and CO(2) emissions in 2025, for four projected U.S. crude oil slates. The baseline is similar to the current U.S. crude slate; the other three contain larger proportions of higher density, higher sulfur crudes than the current or any previous U.S. crude slates. The latter cases reflect aggressive assumptions regarding the volumes of Canadian crudes in the U.S. crude slate in 2025. The analysis projects U.S. refinery energy use 3.7%-6.3% (≈ 0.13-0.22 quads/year) higher and refinery CO(2) emissions 5.4%-9.3% (≈ 0.014-0.024 gigatons/year) higher in the study cases than in the baseline. Refining heavier crude slates would require significant investments in new refinery processing capability, especially coking and hydrotreating units. These findings differ substantially from a recent estimate asserting that processing heavy oil or bitumen blends could increase industry CO(2) emissions by 1.6-3.7 gigatons/year.

MARRIAGE GAP IN CHRISTIANS AND MUSLIMS.

PubMed

Fieder, Martin; Huber, Susanne; Pichl, Elmar; Wallner, Bernard; Seidler, Horst

2018-03-01

For modern Western societies with a regime of monogamy, it has recently been demonstrated that the socioeconomic status of men is positively associated with being or having been married. This study aims to compare marriage patterns (if a person has been married at least once) for cultures with a tradition of monogamy and polygyny. As no worldwide data on polygyny exist, religion was used as a proxy for monogamy (Christians) vs polygyny (Muslims). The analyses were based on 2000-2011 census data from 39 countries worldwide for 52,339,594 men and women, controlling for sex, sex ratio, age, education, migration within the last 5 years and employment. Overall, a higher proportion of Muslims were married compared with Christians, but the difference in the fraction of married men compared with married women at a certain age (the 'marriage gap') was much more pronounced in Muslims than in Christians, i.e. compared with Christians, a substantially higher proportion of Muslim women than men were married up to the age of approximately 31 years. As expected for a tradition of polygyny, the results indicate that the socioeconomic threshold for entering marriage is higher for Muslim than Christian men, and Muslim women in particular face a negative effect of socioeconomic status on the probability of ever being married. The large 'marriage gap' at a certain age in Muslim societies leads to high numbers of married women and unmarried young men, and may put such polygenic societies under pressure.

Jaw muscle fiber type distribution in Hawaiian gobioid stream fishes: histochemical correlations with feeding ecology and behavior.

PubMed

Maie, Takashi; Meister, Andrew B; Leonard, Gerald L; Schrank, Gordon D; Blob, Richard W; Schoenfuss, Heiko L

2011-12-01

Differences in fiber type distribution in the axial muscles of Hawaiian gobioid stream fishes have previously been linked to differences in locomotor performance, behavior, and diet across species. Using ATPase assays, we examined fiber types of the jaw opening sternohyoideus muscle across five species, as well as fiber types of three jaw closing muscles (adductor mandibulae A1, A2, and A3). The jaw muscles of some species of Hawaiian stream gobies contained substantial red fiber components. Some jaw muscles always had greater proportions of white muscle fibers than other jaw muscles, independent of species. In addition, comparing across species, the dietary generalists (Awaous guamensis and Stenogobius hawaiiensis) had a lower proportion of white muscle fibers in all jaw muscles than the dietary specialists (Lentipes concolor, Sicyopterus stimpsoni, and Eleotris sandwicensis). Among Hawaiian stream gobies, generalist diets may favor a wider range of muscle performance, provided by a mix of white and red muscle fibers, than is typical of dietary specialists, which may have a higher proportion of fast-twitch white fibers in jaw muscles to help meet the demands of rapid predatory strikes or feeding in fast-flowing habitats. Copyright © 2011 Elsevier GmbH. All rights reserved.

Child maltreatment in Taiwan for 2004-2013: A shift in age group and forms of maltreatment.

PubMed

Chen, Chih-Tsai; Yang, Nan-Ping; Chou, Pesus

2016-02-01

Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in the distribution of high-risk births associated with changes in contraceptive prevalence.

PubMed

Stover, John; Ross, John

2013-01-01

Several birth characteristics are associated with high mortality risk: very young or old mothers, short birth intervals and high birth order. One justification for family planning programs is the health benefits associated with better spacing and timing of births. This study examines the extent to which the prevalence of these risk factors changes as a country transitions from high to low fertility. We use data from 194 national surveys to examine both cross section and within-country variation in these risk factors as they relate to the total fertility rate. Declines in the total fertility rate are associated with large declines in the proportion of high order births, those to mothers over the age of 34 and those with multiple risk factors; as well as to increasing proportions of first order births. There is little change in the proportion of births with short birth intervals except in sub-Saharan Africa. The use of family planning is strongly associated with fertility declines. The proportion of second and higher order births with demographic risk factors declines substantially as fertility declines. This creates a potential for reducing child mortality rates. Some of the reduction comes from modifying the birth interval distribution or by bringing maternal age at the time of birth into the 'safe' range of 18-35 years, and some comes from the actual elimination of births that would have a high mortality risk (high parity births).

Variation in treatment and survival of older patients with non-metastatic breast cancer in five European countries: a population-based cohort study from the EURECCA Breast Cancer Group.

PubMed

Derks, Marloes G M; Bastiaannet, Esther; Kiderlen, Mandy; Hilling, Denise E; Boelens, Petra G; Walsh, Paul M; van Eycken, Elizabeth; Siesling, Sabine; Broggio, John; Wyld, Lynda; Trojanowski, Maciej; Kolacinska, Agnieszka; Chalubinska-Fendler, Justyna; Gonçalves, Ana Filipa; Nowikiewicz, Tomasz; Zegarski, Wojciech; Audisio, Riccardo A; Liefers, Gerrit-Jan; Portielje, Johanneke E A; van de Velde, Cornelis J H

2018-06-07

Older patients are poorly represented in breast cancer research and guidelines do not provide evidence based recommendations for this specific group. We compared treatment strategies and survival outcomes between European countries and assessed whether variance in treatment patterns may be associated with variation in survival. Population-based study including patients aged ≥ 70 with non-metastatic BC from cancer registries from the Netherlands, Belgium, Ireland, England and Greater Poland. Proportions of local and systemic treatments, five-year relative survival and relative excess risks (RER) between countries were calculated. In total, 236,015 patients were included. The proportion of stage I BC receiving endocrine therapy ranged from 19.6% (Netherlands) to 84.6% (Belgium). The proportion of stage III BC receiving no breast surgery varied between 22.0% (Belgium) and 50.8% (Ireland). For stage I BC, relative survival was lower in England compared with Belgium (RER 2.96, 95%CI 1.30-6.72, P < .001). For stage III BC, England, Ireland and Greater Poland showed significantly worse relative survival compared with Belgium. There is substantial variation in treatment strategies and survival outcomes in elderly with BC in Europe. For early-stage BC, we observed large variation in endocrine therapy but no variation in relative survival, suggesting potential overtreatment. For advanced BC, we observed higher survival in countries with lower proportions of omission of surgery, suggesting potential undertreatment.

Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States

PubMed Central

Knight, Tyler; Schaefer, Caroline; Chandran, Arthi; Zlateva, Gergana; Winkelmann, Andreas; Perrot, Serge

2013-01-01

Background Fibromyalgia (FM) is a chronic disorder characterized by widespread, persistent pain. Prospective and retrospective studies have demonstrated substantial health-care costs associated with FM in a number of countries. This study evaluated and compared health-resource use (HRU) and associated costs related to FM in routine clinical practice across the US, France, and Germany. Methods Two separate, cross-sectional, observational studies of subjects with FM were conducted: one in the US and one in France and Germany. HRU related to prescription medication, physician office visits, diagnostic tests, and hospitalizations was abstracted from chart review; patient out-of-pocket costs and lost productivity were collected via subject self-report. Costs were assigned to HRU based on standard algorithms. Direct and indirect costs were evaluated and compared by simple linear regression. Results A total of 442 subjects (203 US, 70 France, 169 Germany) with FM were analyzed. The mean (standard deviation) age in the US, France, and Germany was 47.9 (10.9), 51.2 (9.5), and 49.2 (9.8), respectively (P = 0.085). Most subjects were female (95% US, 83% France, 80% Germany) (P < 0.001). Adjusted annual direct costs per subject for FM were significantly higher in the US ($7087) than in France ($481, P < 0.001) or Germany ($2417, P < 0.001). Adjusted mean annual indirect costs per subject for FM were lower in the US ($6431) than in France ($8718) or Germany ($10,001), but represented a significant proportion of total costs in all countries. Conclusion The significant HRU and costs associated with FM in the US, France, and Germany documented in this study highlight the substantial global economic burden of FM. Indirect costs represented a significant proportion of the total costs, particularly in Europe. Comparisons between the three countries show differences in HRU, with significantly higher direct costs in the US compared with France and Germany. PMID:23637545

What are seasonal and meteorological factors are associated with the number of attendees at a sexual health service? An observational study between 2002-2012.

PubMed

Gamagedara, Nimal; Hocking, Jane S; Law, Mathew; Fehler, Glenda; Chen, Marcus Y; Bradshaw, Catriona S; Fairley, Christopher K

2014-12-01

Open access to sexual health services may be inefficient if there are substantial unpredictable fluctuations in presentations. Our aim was to determine whether the number of presentations over the last 11 years was associated with certain factors. This study involved all individuals presenting to Melbourne Sexual Health Centre (MSHC) from 2002 to 2012. The outcome measure was the number of presentations during a clinical session (half day). There were 270,070 presentations to the clinic among 86,717 individuals. The factors associated with the largest difference in mean presentations per session were morning or afternoon (60 vs 51 per session), days of the week (57-67 per session), months of the year (93-112 per day), year (77-131 per day), maximum temperatures of <15 °C vs. ≥30 °C (56-62 per morning session) and 5 working days after holiday periods (61 vs 54). A multiple linear regression model using these factors explained 64% of the variation in attendances per session. Peak attendance rates (>90th centile) were also strongly correlated with these same variables. Higher-risk heterosexuals (≤25 years of age) attended more commonly in the afternoons (37% of heterosexuals) than in the mornings (30%). No factor other than year of attendance substantially influenced the proportion of higher-risk men who have sex with men (MSM) (≥10 partners per year) who attended. A considerable proportion of the variability in presentations was explained by known factors that could predict client presentations to sexual health services and therefore allow optimal allocation of resources to match demand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Stapes Displacement and Intracochlear Pressure in Response to Very High Level, Low Frequency Sounds

PubMed Central

Greene, Nathaniel T.; Jenkins, Herman A.; Tollin, Daniel J.; Easter, James R.

2018-01-01

The stapes is held in the oval window by the stapedial annular ligament (SAL), which restricts total peak-to-peak displacement of the stapes. Previous studies have suggested that for moderate (< 130 dB SPL) sound levels intracochlear pressure (PIC), measured at the base of the cochlea far from the basilar membrane, increases directly proportionally with stapes displacement (DStap), thus a current model of impulse noise exposure (the Auditory Hazard Assessment Algorithm for Humans, or AHAAH) predicts that peak PIC will vary linearly with DStap up to some saturation point. However, no direct tests of DStap, or of the relationship with PIC during such motion, have been performed during acoustic stimulation of the human ear. In order to examine the relationship between DStap and PIC to very high level sounds, measurements of DStap and PIC were made in cadaveric human temporal bones. Specimens were prepared by mastoidectomy and extended facial recess to expose the ossicular chain. Measurements of PIC were made in scala vestibuli (PSV) and scala tympani (PST), along with the SPL in the external auditory canal (PEAC), concurrently with laser Doppler vibrometry (LDV) measurements of stapes velocity (VStap). Stimuli were moderate (~100 dB SPL) to very high level (up to ~170 dB SPL), low frequency tones (20–2560 Hz). Both DStap and PSV increased proportionally with sound pressure level in the ear canal up to approximately ~150 dB SPL, above which both DStap and PSV showed a distinct deviation from proportionality with PEAC. Both DStap and PSV approached saturation: DStap at a value exceeding 150 μm, which is substantially higher than has been reported for small mammals, while PSV showed substantial frequency dependence in the saturation point. The relationship between PSV and DStap remained constant, and cochlear input impedance did not vary across the levels tested, consistent with prior measurements at lower sound levels. These results suggest that PSV sound pressure holds constant relationship with DStap, described by the cochlear input impedance, at these, but perhaps not higher, stimulation levels. Additionally, these results indicate that the AHAAH model, which was developed using results from small animals, underestimates the sound pressure levels in the cochlea in response to high level sound stimulation, and must be revised. PMID:28189837

HIV risk perception among pregnant women in western India: need for reducing vulnerabilities rather than improving knowledge!

PubMed

Darak, Shrinivas; Gadgil, Mukta; Balestre, Eric; Kulkarni, Maitreyee; Kulkarni, Vinay; Kulkarni, Sanjeevani; Orne-Gliemann, Joanna

2014-01-01

Since the beginning of the HIV/AIDS epidemic in India, pregnant women attending antenatal clinics (ANC) have been considered as a low HIV risk population. Yet, a substantial proportion of new HIV infections are occurring among stable heterosexual couples. This paper sought to investigate the proportion and profile of women who, within the low-risk population, are potentially at higher risk of HIV infection. HIV risk perception of pregnant women enrolled within the ANRS 12127 Prenahtest trial was described and associated socio-behavioral characteristics, husband's characteristics, and HIV-related characteristics were analyzed using univariate and multivariate logistic regression models. Among 484 women enrolled, baseline data were collected for 479 women and 460 women with completed data were considered for the present analysis (96%). Eighty-nine (19.4%) women perceived themselves at risk of HIV. Women with educational level <11years (Adjusted Odds Ratio, AOR = 2.4 [CI = 1.28-4.53]), who stayed in joint families (AOR = 1.89 [CI = 1.12-3.12]), who had experienced insult or hurt from the partner (AOR = 1.91 [CI = 1.11-3.27]) and whose partner were alcoholic (AOR = 2.19 [CI = 1.31-3.66]) were significantly more likely to perceive themselves at risk of HIV. Women who had heard about sexually transmitted infections were also more likely to report HIV risk perception (AOR = 3.36 [CI = 1.83-6.18]). Substantial proportion of women (one out of five) perceived themselves at risk of HIV and most of these have reported some form of vulnerability in their couple relationship such as intimate partner violence, alcoholic partner, lack of communication, and spaces for communication with partner. Though awareness and knowledge is the first step for prevention, considering the vulnerabilities associated with HIV risk perception, HIV prevention interventions in India should target overall sources of vulnerability to HIV. Targeted risk reduction for women in ANC should be considered for primary HIV prevention among couples.

Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

ERIC Educational Resources Information Center

Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

2006-01-01

Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

Burial of downed deadwood is strongly affected by log attributes, forest ground vegetation, edaphic conditions, and climate zones

Treesearch

Jogeir N. Stokland; Christopher W. Woodall; Jonas Fridman; Göran Ståhl

2016-01-01

Deadwood can represent a substantial portion of forest ecosystem carbon stocks and is often reported following good practice guidance associated with national greenhouse gas inventories. In high-latitude forest ecosystems, a substantial proportion of downed deadwood is overgrown by ground vegetation and buried in the humus layer. Such burial obfuscates the important...

Who gets custody now? Dramatic changes in children's living arrangements after divorce.

PubMed

Cancian, Maria; Meyer, Daniel R; Brown, Patricia R; Cook, Steven T

2014-08-01

This article reexamines the living arrangements of children following their parents' divorce, using Wisconsin Court Records, updating an analysis that showed relatively small but significant increases in shared custody in the late 1980s and early 1990s. These changes have accelerated markedly in the intervening years: between 1988 and 2008, the proportion of mothers granted sole physical custody fell substantially, the proportion of parents sharing custody increased dramatically, and father-sole custody remained relatively stable. We explore changes in the correlates of alternative custody outcomes, showing that some results from the earlier analysis still hold (for example, cases with higher total family income are more likely to have shared custody), but other differences have lessened (shared-custody cases have become less distinctive as they have become more common). Despite the considerable changes in marriage and divorce patterns over this period, we do not find strong evidence that the changes in custody are related to changes in the characteristics of families experiencing a divorce; rather, changes in custody may be the result of changes in social norms and the process by which custody is determined.

Editor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns.

PubMed

Venermo, M; Wang, G; Sedrakyan, A; Mao, J; Eldrup, N; DeMartino, R; Mani, K; Altreuther, M; Beiles, B; Menyhei, G; Danielsson, G; Thomson, I; Heller, G; Setacci, C; Björck, M; Cronenwett, J

2017-04-01

The aim was to determine current practice for the treatment of carotid stenosis among 12 countries participating in the International Consortium of Vascular Registries (ICVR). Data from the United States Vascular Quality Initiative (VQI) and the Vascunet registry collaboration (including 10 registries in Europe and Australasia) were used. Variation in treatment modality of asymptomatic versus symptomatic patients was analysed between countries and among centres within each country. Among 58,607 procedures, octogenarians represented 18% of all patients, ranging from 8% (Hungary) to 22% (New Zealand and Australia). Women represented 36%, ranging from 29% (Switzerland) to 40% (USA). The proportion of carotid artery stenting (CAS) among asymptomatic patients ranged from 0% (Finland) to 26% (Sweden) and among symptomatic patients from 0% (Denmark) to 19% (USA). Variation among centres within countries for CAS was highest in the United States and Australia (from 0% to 80%). The overall proportion of asymptomatic patients was 48%, but varied from 0% (Denmark) to 73% (Italy). There was also substantial centre level variation within each country in the proportion of asymptomatic patients, most pronounced in Australia (0-72%), Hungary (5-55%), and the United States (0-100%). Countries with fee for service reimbursement had higher rates of treatment in asymptomatic patients than countries with population based reimbursement (OR 5.8, 95% CI 4.4-7.7). Despite evidence about treatment options for carotid artery disease, the proportion of asymptomatic patients, treatment modality, and the proportion of women and octogenarians vary considerably among and within countries. There was a significant association of treating more asymptomatic patients in countries with fee for service reimbursement. The findings reflect the inconsistency of the existing guidelines and a need for cooperation among guideline committees all over the world. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Sudden and unexpected childhood deaths investigated at the Pretoria Medico-Legal Laboratory, South Africa, 2007 - 2011.

PubMed

Van Deventer, B S; Rossouw, S H; Du Toit-Prinsloo, L

2016-09-06

 Sudden and unexpected death is well known to occur in infants, and although sudden deaths are less frequent after the first birthday, they still account for a significant proportion of childhood deaths. In 2009, 1.9% of the total deaths in the USA were childhood deaths. In South Africa (SA) this proportion was much higher at 11.85%. According to the law, sudden and unexpected deaths are generally investigated as unnatural deaths. Establishing an exact underlying anatomical cause of death will depend on available resources and can be difficult in a substantial proportion of cases.  A retrospective descriptive case audit was conducted at the Pretoria Medico-Legal Laboratory (PMLL), SA, from 1 January 2007 through to 31 December 2011. All children aged 1 - 18 years who died suddenly and unexpectedly were included.  Ninety-eight cases were identified, which constituted nearly 1% of total admissions to the PMLL. The majority of the deaths were of children aged 1 - 5 years, and the male/female ratio was 1.04:1. In the largest proportion of cases (n=28, 28.6%), the medicolegal investigation, including autopsy and ancillary investigations, did not establish an underlying anatomical cause of death. In the cases where a cause of death was established, pneumonia was the most common diagnosis (n=22, 22.4%).  The fact that the cause of the largest proportion of deaths could not be ascertained emphasises the need for consideration of additional investigative techniques, such as molecular/genetic screening, which have provided an underlying cause of death in a significant number of cases in other countries. There is a lack of published research on the causes and incidence of sudden unexpected deaths in children in SA, and further research in this area is needed.

Influence of individual rationality on continuous double auction markets with networked traders

NASA Astrophysics Data System (ADS)

Zhang, Junhuan

2018-04-01

This paper investigates the influence of individual rationality of buyers and sellers on continuous double auction market outcomes in terms of the proportion of boundedly-rational buyers and sellers. The individual rationality is discussed in a social network artificial stock market model by embedding network formation and information set. Traders automatically select the most profitable trading strategy based on individual and social learning of the profits and trading strategies of themselves and their neighbors, and submit orders to markets. The results show that (i) a higher proportion of boundedly-rational sellers induces a higher market price, higher sellers' profits and a higher market efficiency; (ii) a higher proportion of boundedly-rational sellers induces a lower number of trades and lower buyers' profits; (iii) a higher proportion of boundedly-rational buyers induces a lower market price, a lower number of trades, and lower sellers' profits; (iv) a higher proportion of boundedly-rational buyers induces higher buyers' profits and a higher market efficiency.

The potential and realized spread of wildfires across Canada.

PubMed

Wang, Xianli; Parisien, Marc-André; Flannigan, Mike D; Parks, Sean A; Anderson, Kerry R; Little, John M; Taylor, Steve W

2014-08-01

Given that they can burn for weeks or months, wildfires in temperate and boreal forests may become immense (eg., 10(0) - 10(4) km(2) ). However, during the period within which a large fire is 'active', not all days experience weather that is conducive to fire spread; indeed most of the spread occurs on a small proportion (e.g., 1 - 15 days) of not necessarily consecutive days during the active period. This study examines and compares the Canada-wide patterns in fire-conducive weather ('potential' spread) and the spread that occurs on the ground ('realized' spread). Results show substantial variability in distributions of potential and realized spread days across Canada. Both potential and realized spread are higher in western than in eastern Canada; however, whereas potential spread generally decreases from south to north, there is no such pattern with realized spread. The realized-to-potential fire-spread ratio is considerably higher in northern Canada than in the south, indicating that proportionally more fire-conducive days translate into fire progression. An exploration of environmental correlates to spread show that there may be a few factors compensating for the lower potential spread in northern Canada: a greater proportion of coniferous (i.e., more flammable) vegetation, lesser human impacts (i.e., less fragmented landscapes), sufficient fire ignitions, and intense droughts. Because a linear relationship exists between the frequency distributions of potential spread days and realized spread days in a fire zone, it is possible to obtain one from the other using a simple conversion factor. Our methodology thus provides a means to estimate realized fire spread from weather-based data in regions where fire databases are poor, which may improve our ability to predict future fire activity. © 2014 John Wiley & Sons Ltd.

The role of Criterion A2 in the DSM-IV diagnosis of post-traumatic stress disorder

PubMed Central

Karam, Elie George; Andrews, Gavin; Bromet, Evelyn; Petukhova, Maria; Ruscio, Ayelet Meron; Salamoun, Mariana; Sampson, Nancy; Stein, Dan J.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias; Demyttenaere, Koen; de Girolamo, Giovanni; de Graaf, Ron; Florescu, Silvia; Gureje, Oye; Kaminer, Debra; Kotov, Roman; Lee, Sing; Lepine, Jean Pierre; Mora, Maria Elena Medina; Browne, Mark A. Oakley; Posada-Villa, José; Sagar, Rajesh; Shalev, Arieh Y.; Takeshima, Tadashi; Tomov, Toma; Kessler, Ronald C.

2011-01-01

Background Controversy exists about the utility of DSM-IV post-traumatic stress disorder (PTSD) Criterion A2: that exposure to a potentially traumatic experience (PTE; PTSD Criterion A1) is accompanied by intense fear, helplessness, or horror. Methods Lifetime DSM-IV PTSD was assessed with the Composite International Diagnostic Interview in community surveys of 52,826 respondents across 21 countries in the World Mental Health Surveys. Results 37.6% of 28,490 representative PTEs reported by respondents met Criterion A2, a proportion higher than the proportions meeting other criteria (B-F; 5.4-9.6%). Conditional prevalence of meeting all other criteria for a diagnosis of PTSD given a PTE was significantly higher in the presence (9.7%) than absence (0.1%) of A2. However, as only 1.4% of respondents who met all other criteria failed A2, the estimated prevalence of PTSD increased only slightly (from 3.64% to 3.69%) when A2 was not required for diagnosis. PTSD with or without Criterion A2 did not differ in persistence or predicted consequences (subsequent suicidal ideation or secondary disorders) depending on presence-absence of A2. Furthermore, as A2 was by far the most commonly reported symptom of PTSD, initial assessment of A2 would be much less efficient than screening other criteria in quickly ruling out a large proportion of non-cases. Conclusion Removal of A2 from the DSM-IV criterion set would reduce the complexity of diagnosing PTSD while not substantially increasing the number of people who qualify for diagnosis. A2 should consequently be reconceptualized as a risk factor for PTSD rather than as a diagnostic requirement. PMID:20599189

Substantial proportion of MODY among multiplex families participating in a Type 1 diabetes prediction programme.

PubMed

Petruzelkova, L; Dusatkova, P; Cinek, O; Sumnik, Z; Pruhova, S; Hradsky, O; Vcelakova, J; Lebl, J; Kolouskova, S

2016-12-01

Patients with maturity-onset diabetes of the young (MODY) might be over-represented in families with histories of Type 1 diabetes. Our aim was to re-evaluate families participating in the Czech T1D Prediction Programme (PREDIA.CZ) with at least two members affected with diabetes to assess the proportion of MODY among these families and determine its most significant clinical predictors. Of the 557 families followed up by the PREDIA.CZ, 53 (9.5%) had two or more family members with diabetes. One proband with diabetes from these families was chosen for direct sequencing of the GCK, HNF1A, HNF4A and INS genes. Non-parametric tests and a linear logistic regression model were used to evaluate differences between MODY and non-MODY families. MODY was genetically diagnosed in 24 of the 53 families with multiple occurrences of diabetes (45%). Mutations were detected most frequently in GCK (58%), followed by HNF1A (38%) and INS (4%). MODY families were more likely to have a parent with diabetes and had a higher proportion of females with diabetes than non-MODY families. Higher age (P < 0.001), a lower level of HbA 1c (P < 0.001) at clinical onset and at least two generations affected by diabetes were the variables most predictive for probands of MODY families already presenting with diabetes. A prediction programme for Type 1 diabetes would provide a useful new source of patients with MODY most likely to benefit from an accurate diagnosis. This identification has implications for patient treatment and disease prognosis. © 2015 Diabetes UK.

Changes in Maladaptive Behaviors from Mid-Childhood to Young Adulthood in Autism Spectrum Disorder

PubMed Central

Anderson, Deborah K.; Maye, Melissa P.; Lord, Catherine

2011-01-01

The current study prospectively examined trajectories of change in symptoms of irritability, hyperactivity, and social withdrawal, as well as predictors of such behaviors from age 9 to 18 for youths with autism spectrum disorder (ASD) and a comparison group with nonspectrum developmental delays. Children with more severe core features of autism had consistently higher irritability and hyperactivity scores over time than those with broader ASD and nonspectrum delays. Across all diagnoses, behaviors related to hyperactivity showed the greatest improvement. Social withdrawal worsened with age for a substantial proportion of youths with ASD but not for the nonspectrum comparison group. Compared with nonspectrum youths, children with ASD showed greater heterogeneity in trajectories for maladaptive behaviors. PMID:21905806

Socioeconomic disadvantage and schizophrenia in migrants under mental health detention orders.

PubMed

Bulla, Jan; Hoffmann, Klaus; Querengässer, Jan; Ross, Thomas

2017-09-01

Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia. This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders. Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI). For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses. Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.

Are occupational factors important determinants of socioeconomic inequalities in musculoskeletal pain?

PubMed

Mehlum, Ingrid Sivesind; Kristensen, Petter; Kjuus, Helge; Wergeland, Ebba

2008-08-01

The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities. All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated. There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in low-back pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain. In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.

A comparative study of functional properties of normal and wooden breast broiler chicken meat with NaCl addition.

PubMed

Xing, Tong; Zhao, Xue; Han, Minyi; Cai, Linlin; Deng, Shaolin; Zhou, Guanghong; Xu, Xinglian

2017-09-01

The selection of broilers for augmented growth rate and breast has brought about wooden-breast (WB) muscle abnormalities, which caused substantial economic losses. The objective of this study was to compare water holding capacity, water mobility and distribution, salt-soluble protein (SSP) content, and protein profiles of normal and WB chicken meat with different additions of NaCl. Thirty WB and 30 normal chicken breasts were selected from a deboning line of a major Chinese processing plant at 2 to 3 h post mortem. Two different meat batters were formulated to 150 mg/g meat protein and different NaCl contents (0%, 1%, 2%, 3%, and 4%). Results indicated that as NaCl contents increased, the cooking loss of meat batters decreased (P < 0.05). Increasing the NaCl content to 3% or more increased the solubility of myofibrillar protein and the extraction of SSPs, which resulted in the improving of cooking yield. Over a range of salt concentrations, normal and WB meat showed different protein profiles, with myosin heavy chain exhibiting a higher intensity at ≥3% salt level. Low-field nuclear magnetic resonance (LF-NMR)revealed an increased T22 and higher P22 in raw WB meat compared to normal meat (P < 0.05). Regarding the meat batters, WB meat batters had reduced T21 and lower immobilized water proportions at low NaCl contents (<2%). After heating, T2 shifted towards higher relaxation times with increasing NaCl contents in meat gels. Meat gels prepared from WB had a lower proportion of water within the myofibrillar protein matrix and a greater proportion of exuded bulk water at NaCl contents <3% (P < 0.05), while at higher NaCl contents the difference was eliminated, thus improving water retention capacity. In conclusion, for raw meat, meat batters and gels, water distribution and mobility of WB exhibited significant differences compared to normal meat. The addition of NaCl affected water mobility and distributions in meat batters, with a level of 3% NaCl eliminating the differences between processed normal and WB meat products. © 2017 Poultry Science Association Inc.

The Narrowing Gap in New York City Teacher Qualifications and Its Implications for Student Achievement in High-Poverty Schools. Working Paper 10

ERIC Educational Resources Information Center

Boyd, Donald; Lankford, Hamilton; Loeb, Susanna; Rockoff, Jonah; Wyckoff, James

2007-01-01

Studies have found substantial sorting of teachers across schools, with the schools with the highest proportions of poor, non-white, and low-scoring students having the least qualified teachers as measured by certification, exam performance, and inexperience (Lankford, Loeb and Wyckoff, 2002). Yet, there have been substantial changes in the…

Screening for mental health needs of New Zealand youth in secure care facilities using the MAYSI-2.

PubMed

McArdle, Sean; Lambie, Ian

2018-06-01

Young people admitted to secure facilities generally have particularly high rates of mental, emotional and behavioural problems, but little is known about the mental health needs of this group in New Zealand. To describe prevalence of probable mental health disorder and related needs among young people in secure facilities in New Zealand. Massachusetts youth screening instrument - second version (MAYSI-2) data were obtained from the records of young people admitted to one secure care facility (n = 204) within a 12 month period. We used descriptive statistics to determine prevalence of problems overall and multivariate analysis of variance to compare MAYSI-2 scores between gender and ethnic groups. Nearly 80% of these young people scored above the 'caution' or 'warning' cut-off on the MAYSI-2, a substantially higher proportion than reported in studies in other countries. There was a tendency for girls and for Maori and Pacific Islander subgroups to have a higher rate of probable psychopathology. Young people in secure facilities in New Zealand have substantial service needs. Early intervention that engages them in services upon first contact with the youth justice system might help reduce this burden. Further validation of the MAYSI-2 in New Zealand may be warranted because of the unique ethnic make-up of these young offenders. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Microbiological profile and potential hazards associated with imported and local brands of tomato paste in Nigeria.

PubMed

Efiuvwevwere, B J; Atirike, O I

1998-03-01

Cans of three tomato paste brands (two of which are imported and one produced locally) showing defective or normal appearance were purchased from various retail outlets and analysed for microbial composition and pH values. Substantially higher total viable counts were observed in samples from defective cans but the lowest population was found in the local brand. Ratio of mesophilic to thermophilic micro-organisms increased in samples obtained from cans showing visible defects. Anaerobic spore counts were higher than the aerobic population in both normal and defective cans, but the counts varied with the brands. Four dominant bacterial genera (Bacillus, Clostridium, Lactobacillus and Leuconostoc) were isolated from the samples with the greater proportion being spore-formers. Percentage occurrence of Clostridium thermosaccharolyticum was appreciably higher in samples from defective cans while a preponderance of Lactobacillus occurred in samples from normal cans. Of the moulds isolated, Absidia and Aspergillus fumigatus showed a higher percentage in defective cans. pH values higher than the critical safe level of 4.6 were found in cans with visible defects and greater microbial diversity with higher microbial load was more often associated with these samples. Imported brands showed more undesirable microbial quality and pH values, making them potentially hazardous.

Nutrient intake and use of dietary supplements among US adults with disabilities.

PubMed

An, Ruopeng; Chiu, Chung-Yi; Andrade, Flavia

2015-04-01

Physical, mental, social, and financial hurdles in adults with disabilities may limit their access to adequate nutrition. To examine the impact of dietary supplement use on daily total nutrient intake levels among US adults 20 years and older with disabilities. Study sample came from 2007-2008 and 2009-2010 waves of the National Health and Nutrition Examination Survey, a nationally representative repeated cross-sectional survey. Disability was classified into 5 categories using standardized indices. Nutrient intakes from foods and dietary supplements were calculated from 2 nonconsecutive 24-hour dietary recalls. Two-sample proportion tests and multiple logistic regressions were used to examine the adherence rates to the recommended daily nutrient intake levels between dietary supplement users and nonusers in each disability category. The association between sociodemographic characteristics and dietary supplement use was assessed using multiple logistic regressions, accounting for complex survey design. A substantial proportion of the US adult population with disabilities failed to meet dietary guidelines, with insufficient intakes of multiple nutrients. Over half of the US adults with disabilities used dietary supplements. Dietary supplement use was associated with higher adherence rates for vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, calcium, copper, iron, magnesium, and zinc intake among adults with disabilities. Women, non-Hispanic Whites, older age, higher education, and higher household income were found to predict dietary supplement use. Proper use of dietary supplements under the guidance of health care providers may improve the nutritional status among adults with disabilities. Copyright © 2015 Elsevier Inc. All rights reserved.

Ethnicity and mortality from systemic lupus erythematosus in the US.

PubMed

Krishnan, E; Hubert, H B

2006-11-01

To study ethnic differences in mortality from systemic lupus erythematosus (lupus) in two large, population-based datasets. We analysed the national death data (1979-98) from the National Center for Health Statistics (Hyattsville, Maryland, USA) and hospitalisation data (1993-2002) from the Nationwide Inpatient Sample (NIS), the largest hospitalisation database in the US. The overall, unadjusted, lupus mortality in the National Center for Health Statistics data was 4.6 per million, whereas the proportion of in-hospital mortality from the NIS was 2.9%. African-Americans had disproportionately higher mortality risk than Caucasians (all-cause mortality relative risk adjusted for age = 1.24 (women), 1.36 (men); lupus mortality relative risk = 3.91 (women), 2.40 (men)). Excess risk was found among in-hospital deaths (odds ratio adjusted for age = 1.4 (women), 1.3 (men)). Lupus death rates increased overall from 1979 to 98 (p<0.001). The proportional increase was greatest among African-Americans. Among Caucasian men, death rates declined significantly (p<0.001), but rates did not change substantially for African-American men. The African-American:Caucasian mortality ratio rose with time among men, but there was little change among women. In analyses of the NIS data adjusted for age, the in-hospital mortality risk decreased with time among Caucasian women (p<0.001). African-Americans with lupus have 2-3-fold higher lupus mortality risk than Caucasians. The magnitude of the risk disparity is disproportionately higher than the disparity in all-cause mortality. A lupus-specific biological factor, as opposed to socioeconomic and access-to-care factors, may be responsible for this phenomenon.

The Effect of Early Marriages and Early Childbearing on Women's Nutritional Status in India.

PubMed

Goli, Srinivas; Rammohan, Anu; Singh, Deepti

2015-08-01

The consequences of early childbearing on the growth and nutritional status of women in India has not been quantified in previous studies. Our study aimed to fill this gap by analysing the association between early marriage and early childbearing on nutritional status of Indian women, with a focus on Bihar and Andhra Pradesh, the two states accounting for the highest proportion of women marrying and giving first birth before 18 years of age. Our findings revealed that a substantial number of women were married before 18 years and thereby exposed to early pregnancy. Furthermore, a significantly higher proportion of women in the 'thin' category were married before 18 years, both in the Indian sample (33 %, p < 0.001) and in the selected states, Andhra Pradesh (31 %, p < 0.001) and Bihar (43 %, p < 0.001), compared to those women married at higher ages. Similarly, across all our samples women whose first birth was before age 18 years also had a significantly higher probability of being in the 'thin' category across all our samples. This pattern was also observed for associations between early childbirth and anemia levels. We conclude that the net effect of the early age at marriage and age at first birth on nutritional status is significant. Our results underline the need for preventing early marriages and the consequent high adolescent pregnancies in India, particularly in high prevalence states. This will help to improve nutritional status and health care utilisation among women, thereby, prevent maternal and child mortality and thus, achieve the MDGs 4-5.

The impact of the mode of survey administration on estimates of daily smoking for mobile phone only users.

PubMed

Hanna, Joseph; Cordery, Damien V; Steel, David G; Davis, Walter; Harrold, Timothy C

2017-04-20

Over the past decade, there have been substantial changes in landline and mobile phone ownership, with a substantial increase in the proportion of mobile-only households. Estimates of daily smoking rates for the mobile phone only (MPO) population have been found to be substantially higher than the rest of the population and telephone surveys that use a dual sampling frame (landline and mobile phones) are now considered best practice. Smoking is seen as an undesirable behaviour; measuring such behaviours using an interviewer may lead to lower estimates when using telephone based surveys compared to self-administered approaches. This study aims to assess whether higher daily smoking estimates observed for the mobile phone only population can be explained by administrative features of surveys, after accounting for differences in the phone ownership population groups. Data on New South Wales (NSW) residents aged 18 years or older from the NSW Population Health Survey (PHS), a telephone survey, and the National Drug Strategy Household Survey (NDSHS), a self-administered survey, were combined, with weights adjusted to match the 2013 population. Design-adjusted prevalence estimates and odds ratios were calculated using survey analysis procedures available in SAS 9.4. Both the PHS and NDSHS gave the same estimates for daily smoking (12%) and similar estimates for MPO users (20% and 18% respectively). Pooled data showed that daily smoking was 19% for MPO users, compared to 10% for dual phone owners, and 12% for landline phone only users. Prevalence estimates for MPO users across both surveys were consistently higher than other phone ownership groups. Differences in estimates for the MPO population compared to other phone ownership groups persisted even after adjustment for the mode of collection and demographic factors. Daily smoking rates were consistently higher for the mobile phone only population and this was not driven by the mode of survey collection. This supports the assertion that the use of a dual sampling frame addresses coverage issues that would otherwise be present in telephone surveys that only made use of a landline sampling frame.

Assessing microbiological water quality in drinking water distribution systems with disinfectant residual using flow cytometry.

PubMed

Gillespie, Simon; Lipphaus, Patrick; Green, James; Parsons, Simon; Weir, Paul; Juskowiak, Kes; Jefferson, Bruce; Jarvis, Peter; Nocker, Andreas

2014-11-15

Flow cytometry (FCM) as a diagnostic tool for enumeration and characterization of microorganisms is rapidly gaining popularity and is increasingly applied in the water industry. In this study we applied the method to obtain a better understanding of total and intact cell concentrations in three different drinking water distribution systems (one using chlorine and two using chloramines as secondary disinfectants). Chloramine tended to result in lower proportions of intact cells than chlorine over a wider residual range, in agreement with existing knowledge that chloramine suppresses regrowth more efficiently. For chlorinated systems, free chlorine concentrations above 0.5 mg L(-1) were found to be associated with relatively low proportions of intact cells, whereas lower disinfectant levels could result in substantially higher percentages of intact cells. The threshold for chlorinated systems is in good agreement with guidelines from the World Health Organization. The fact that the vast majority of samples failing the regulatory coliform standard also showed elevated proportions of intact cells suggests that this parameter might be useful for evaluating risk of failure. Another interesting parameter for judging the microbiological status of water, the biological regrowth potential, greatly varied among different finished waters providing potential help for investment decisions. For its measurement, a simple method was introduced that can easily be performed by water utilities with FCM capability. Copyright © 2014 Elsevier Ltd. All rights reserved.

Decomposing socioeconomic inequality in child vaccination: results from Ireland.

PubMed

Doherty, Edel; Walsh, Brendan; O'Neill, Ciaran

2014-06-05

There is limited knowledge of the extent of or factors underlying inequalities in uptake of childhood vaccination in Ireland. This paper aims to measure and decompose socioeconomic inequalities in childhood vaccination in the Republic of Ireland. The analysis was performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of the carers of over 11,000 nine-month old babies collected in 2008 and 2009. Multivariate analysis was conducted to explore the child and parental factors, including socioeconomic factors that were associated with non-vaccination of children. A concentration index was calculated to measure inequality in childhood vaccination. Subsequent decomposition analysis identified key factors underpinning observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood vaccination in the Republic of Ireland. Concentration indices of vaccination (CI=-0.19) show a substantial pro-rich gradient. Results from the decomposition analysis suggest that a substantial proportion of the inequality is explained by household level variables such as socioeconomic status, household structure, income and entitlement to publicly funded care (29.9%, 24% 30.6% and 12.9% respectively). Substantial differences are also observed between children of Irish mothers and immigrant mothers from developing countries. Vaccination was less likely in lower than in higher income households. Access to publicly funded services was an important factor in explaining inequalities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of independently altering body weight and body mass on the metabolic cost of running.

PubMed

Teunissen, Lennart P J; Grabowski, Alena; Kram, Rodger

2007-12-01

The metabolic cost of running is substantial, despite the savings from elastic energy storage and return. Previous studies suggest that generating vertical force to support body weight and horizontal forces to brake and propel body mass are the major determinants of the metabolic cost of running. In the present study, we investigated how independently altering body weight and body mass affects the metabolic cost of running. Based on previous studies, we hypothesized that reducing body weight would decrease metabolic rate proportionally, and adding mass and weight would increase metabolic rate proportionally. Further, because previous studies show that adding mass alone does not affect the forces generated on the ground, we hypothesized that adding mass alone would have no substantial effect on metabolic rate. We manipulated the body weight and body mass of 10 recreational human runners and measured their metabolic rates while they ran at 3 m s(-1). We reduced weight using a harness system, increased mass and weight using lead worn about the waist, and increased mass alone using a combination of weight support and added load. We found that net metabolic rate decreased in less than direct proportion to reduced body weight, increased in slightly more than direct proportion to added load (added mass and weight), and was not substantially different from normal running with added mass alone. Adding mass alone was not an effective method for determining the metabolic cost attributable to braking/propelling body mass. Runners loaded with mass alone did not generate greater vertical or horizontal impulses and their metabolic costs did not substantially differ from those of normal running. Our results show that generating force to support body weight is the primary determinant of the metabolic cost of running. Extrapolating our reduced weight data to zero weight suggests that supporting body weight comprises at most 74% of the net cost of running. However, 74% is probably an overestimate of the metabolic demand of body weight to support itself because in reduced gravity conditions decrements in horizontal impulse accompanied decrements in vertical impulse.

Maternal Health Care Utilization Among Syrian Refugees in Lebanon and Jordan.

PubMed

Tappis, Hannah; Lyles, Emily; Burton, Ann; Doocy, Shannon

2017-09-01

Purpose The influx of Syrian refugees into Jordan and Lebanon over the last 5 years presents an immense burden to national health systems. This study was undertaken to assess utilization of maternal health services among Syrian refugees in both countries. Description A cross-sectional survey of Syrian refugees living in urban and rural (non-camp) settings was conducted using a two-stage cluster survey design with probability proportional to size sampling in 2014-2015. Eighty-six percent of surveyed households in Lebanon and 88% of surveyed households in Jordan included women with a live birth in the last year. Information from women in this sub-set of households was analyzed to understand antenatal and intrapartum health service utilization. Assessment A majority of respondents reported seeking antenatal care, 82% and 89% in Jordan and Lebanon, respectively. Women had an average of at least six antenatal care visits. Nearly all births (98% in Jordan and 94% in Lebanon) took place in a health facility. Cesarean rates were similar in both countries; approximately one-third of all births were cesarean deliveries. A substantial proportion of women incurred costs for intrapartum care; 33% of Syrian women in Jordan and 94% of Syrian women in Lebanon reported paying out of pocket for their deliveries. The proportion of women incurring costs for intrapartum care was higher in Jordan both countries for women with cesarean deliveries compared to those with vaginal deliveries; however, this difference was not statistically significant in either country (Jordan p-value = 0.203; Lebanon p-value = 0.099). Conclusion Syrian refugees living in Jordan and Lebanon had similar levels of utilization of maternal health services, despite different health systems and humanitarian assistance provisions. As expected, a substantial proportion of households incurred out-of-pocket costs for essential maternal and newborn health services, making cost a major factor in care-seeking decisions and locations. As health financing policies shift to account for the continued burden of refugee hosting on the health system, sustained attention to the availability and quality of essential maternal and newborn health services is needed to protect both refugee and host populations women's rights to health and health care during pregnancy, childbirth, and the postpartum period.

Birds have primate-like numbers of neurons in the forebrain

PubMed Central

Olkowicz, Seweryn; Kocourek, Martin; Lučan, Radek K.; Porteš, Michal; Fitch, W. Tecumseh; Herculano-Houzel, Suzana; Němec, Pavel

2016-01-01

Some birds achieve primate-like levels of cognition, even though their brains tend to be much smaller in absolute size. This poses a fundamental problem in comparative and computational neuroscience, because small brains are expected to have a lower information-processing capacity. Using the isotropic fractionator to determine numbers of neurons in specific brain regions, here we show that the brains of parrots and songbirds contain on average twice as many neurons as primate brains of the same mass, indicating that avian brains have higher neuron packing densities than mammalian brains. Additionally, corvids and parrots have much higher proportions of brain neurons located in the pallial telencephalon compared with primates or other mammals and birds. Thus, large-brained parrots and corvids have forebrain neuron counts equal to or greater than primates with much larger brains. We suggest that the large numbers of neurons concentrated in high densities in the telencephalon substantially contribute to the neural basis of avian intelligence. PMID:27298365

Changes in reports and incidence of child abuse following natural disasters.

PubMed

Curtis, T; Miller, B C; Berry, E H

2000-09-01

The aim of this research was to investigate if there is a higher incidence of child abuse following major natural disasters. Child abuse reports and substantiations were analyzed, by county, for 1 year before and after Hurricane Hugo, the Loma Prieta Earthquake. and Hurricane Andrew. Counties were included if damage was widespread, the county was part of a presidential disaster declaration, and if there was a stable data collection system in place. Based on analyses of numbers, rates, and proportions, child abuse reports were disproportionately higher in the quarter and half year following two of the three disaster events (Hurricane Hugo and Loma Prieta Earthquake). Most, but not all, of the evidence presented indicates that child abuse escalates after major disasters. Conceptual and methodological issues need to be resolved to more conclusively answer the question about whether or not child abuse increases in the wake of natural disasters. Replications of this research are needed based on more recent disaster events.

A social relations model of observed family negativity and positivity using a genetically informative sample.

PubMed

Rasbash, Jon; Jenkins, Jennifer; O'Connor, Thomas G; Tackett, Jennifer; Reiss, David

2011-03-01

The goal of this study was to investigate individual and relationship influences on expressions of negativity and positivity in families. Parents and adolescents were observed in a round-robin design in a sample of 687 families. Data were analyzed using a multilevel social relations model. In addition, genetic contributions were estimated for actor effects. Children showed higher mean levels of negativity and lower mean levels of positivity as actors than did parents. Mothers were found to express and elicit higher mean levels of positivity and negativity than fathers. Actor effects were much stronger than partner effects, accounting for between 18%-39% of the variance depending on the actor and the outcome. Genetic (35%) and shared environmental (19%) influences explained a substantial proportion of the actor effect variance for negativity. Dyadic reciprocities were lowest in dyads with a high power differential (i.e., parent-child dyads) and highest for dyads with equal power (sibling and marital dyads). (c) 2011 APA, all rights reserved

Analysis on economic carrying capacity index of pig breeding in China

NASA Astrophysics Data System (ADS)

Leng, Bi-Bin; Liu, Jia-Ling; Xu, Yue-Feng

2017-08-01

In this paper, factor analysis method was employed to analyze and calculate the Gross Domestic Product (GDP) per capita in the last decade, the proportion of research and experiment development (R&D) expenditure equivalent to GDP, urban and rural residents’ pork consumption and explored the scale of Chinese pig breeding on economic carrying capacity index. The result showed that the growth of GDP had led to better techniques and higher field investment, and stronger support like science and technology from the government provided good conditions for large scale of pig breeding. Besides, the substantial increase of pork consumption between rural and urban residents has contributed to the pig breeding in large scale. As a result, the economic carrying capacity index in Chinese pig farming is on the rise.

The importance of mean time in therapeutic range for complication rates in warfarin therapy of patients with atrial fibrillation: A systematic review and meta-regression analysis.

PubMed

Vestergaard, Anne Sig; Skjøth, Flemming; Larsen, Torben Bjerregaard; Ehlers, Lars Holger

2017-01-01

\\Anticoagulation is used for stroke prophylaxis in non-valvular atrial fibrillation, amongst other by use of the vitamin K antagonist, warfarin. Quality in warfarin therapy is often summarized by the time patients spend within the therapeutic range (percent time in therapeutic range, TTR). The correlation between TTR and the occurrence of complications during warfarin therapy has been established, but the influence of patient characteristics in that respect remains undetermined. The objective of the present papers was to examine the association between mean TTR and complication rates with adjustment for differences in relevant patient cohort characteristics. A systematic literature search was conducted in MEDLINE and Embase (2005-2015) to identify eligible studies reporting on use of warfarin therapy by patients with non-valvular atrial fibrillation and the occurrence of hemorrhage and thromboembolism. Both randomized controlled trials and observational cohort studies were included. The association between the reported mean TTR and major bleeding and stroke/systemic embolism was analyzed by random-effects meta-regression with and without adjustment for relevant clinical cohort characteristics. In the adjusted meta-regressions, the impact of mean TTR on the occurrence of hemorrhage was adjusted for the mean age and the proportion of populations with prior stroke or transient ischemic attack. In the adjusted analyses on thromboembolism, the proportion of females was, furthermore, included. Of 2169 papers, 35 papers met pre-specified inclusion criteria, holding relevant information on 31 patient cohorts. In univariable meta-regression, increasing mean TTR was significantly associated with a decreased rate of both major bleeding and stroke/systemic embolism. However, after adjustment mean TTR was no longer significantly associated with stroke/systemic embolism. The proportion of residual variance composed by between-study heterogeneity was substantial for all analyses. Although higher mean TTR in warfarin therapy was associated with lower complication rates in atrial fibrillation, the strength of the association was decreased when adjusting for differences in relevant clinical characteristics of the patient cohorts. This study suggests that mainly the safety of warfarin therapy increases with higher mean TTR, whereas effectiveness appears not to be substantially improved. Due to the limitations immanent in the meta-regression methods, the results of the present study should be interpreted with caution. Further research on the association between the quality of warfarin therapy and risk of complications is warranted with adjustment for clinically relevant characteristics.

Stapes displacement and intracochlear pressure in response to very high level, low frequency sounds.

PubMed

Greene, Nathaniel T; Jenkins, Herman A; Tollin, Daniel J; Easter, James R

2017-05-01

The stapes is held in the oval window by the stapedial annular ligament (SAL), which restricts total peak-to-peak displacement of the stapes. Previous studies have suggested that for moderate (<130 dB SPL) sound levels intracochlear pressure (P IC ), measured at the base of the cochlea far from the basilar membrane, increases directly proportionally with stapes displacement (D Stap ), thus a current model of impulse noise exposure (the Auditory Hazard Assessment Algorithm for Humans, or AHAAH) predicts that peak P IC will vary linearly with D Stap up to some saturation point. However, no direct tests of D Stap , or of the relationship with P IC during such motion, have been performed during acoustic stimulation of the human ear. In order to examine the relationship between D Stap and P IC to very high level sounds, measurements of D Stap and P IC were made in cadaveric human temporal bones. Specimens were prepared by mastoidectomy and extended facial recess to expose the ossicular chain. Measurements of P IC were made in scala vestibuli (P SV ) and scala tympani (P ST ), along with the SPL in the external auditory canal (P EAC ), concurrently with laser Doppler vibrometry (LDV) measurements of stapes velocity (V Stap ). Stimuli were moderate (∼100 dB SPL) to very high level (up to ∼170 dB SPL), low frequency tones (20-2560 Hz). Both D Stap and P SV increased proportionally with sound pressure level in the ear canal up to approximately ∼150 dB SPL, above which both D Stap and P SV showed a distinct deviation from proportionality with P EAC . Both D Stap and P SV approached saturation: D Stap at a value exceeding 150 μm, which is substantially higher than has been reported for small mammals, while P SV showed substantial frequency dependence in the saturation point. The relationship between P SV and D Stap remained constant, and cochlear input impedance did not vary across the levels tested, consistent with prior measurements at lower sound levels. These results suggest that P SV sound pressure holds constant relationship with D Stap , described by the cochlear input impedance, at these, but perhaps not higher, stimulation levels. Additionally, these results indicate that the AHAAH model, which was developed using results from small animals, underestimates the sound pressure levels in the cochlea in response to high level sound stimulation, and must be revised. Copyright © 2017 Elsevier B.V. All rights reserved.

Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.

PubMed

Tehrani, David M; Phelan, Michael J; Cao, Chenghua; Billimek, John; Datta, Rupak; Nguyen, Hoanglong; Kwark, Homin; Huang, Susan S

2014-10-01

States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings. A retrospective cohort study of 2009-2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals' proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values. Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0-102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40-0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment. When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.

The burden of disease in older people and implications for health policy and practice.

PubMed

Prince, Martin J; Wu, Fan; Guo, Yanfei; Gutierrez Robledo, Luis M; O'Donnell, Martin; Sullivan, Richard; Yusuf, Salim

2015-02-07

23% of the total global burden of disease is attributable to disorders in people aged 60 years and older. Although the proportion of the burden arising from older people (≥60 years) is highest in high-income regions, disability-adjusted life years (DALYs) per head are 40% higher in low-income and middle-income regions, accounted for by the increased burden per head of population arising from cardiovascular diseases, and sensory, respiratory, and infectious disorders. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%). A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people. Primary prevention in adults aged younger than 60 years will improve health in successive cohorts of older people, but much of the potential to reduce disease burden will come from more effective primary, secondary, and tertiary prevention targeting older people. Obstacles include misplaced global health priorities, ageism, the poor preparedness of health systems to deliver age-appropriate care for chronic diseases, and the complexity of integrating care for complex multimorbidities. Although population ageing is driving the worldwide epidemic of chronic diseases, substantial untapped potential exists to modify the relation between chronological age and health. This objective is especially important for the most age-dependent disorders (ie, dementia, stroke, chronic obstructive pulmonary disease, and vision impairment), for which the burden of disease arises more from disability than from mortality, and for which long-term care costs outweigh health expenditure. The societal cost of these disorders is enormous. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chronic Conditions Among Children Investigated by Child Welfare: A National Sample

PubMed Central

Hurlburt, Michael S.; Heneghan, Amy M.; Zhang, Jinjin; Rolls-Reutz, Jennifer; Silver, Ellen J.; Fisher, Emily; Landsverk, John; Horwitz, Sarah McCue

2013-01-01

OBJECTIVE: To assess the presence of chronic health conditions (CHCs) among a nationally representative sample of children investigated by child welfare agencies. METHODS: The study included 5872 children, aged 0 to 17.5 years, whose families were investigated for maltreatment between February 2008 and April 2009. Using data from the second National Survey of Child and Adolescent Well-Being, we examined the proportion of children who had CHC. We developed 2 categorical and 2 noncategorical measures of CHC from the available data and analyzed them by using bivariate and multivariable analyses. RESULTS: Depending on the measure used, 30.6% to 49.0% of all children investigated were reported by their caregivers to have a CHC. Furthermore, the children identified by using diverse methods were not entirely overlapping. In the multivariable analyses, children with poorer health were more likely to be male, older, and receiving special educational services but not more likely to be in out-of-home placements. CONCLUSIONS: The finding that a much higher proportion of these children have CHC than in the general population underscores the substantial health problems of children investigated by child welfare agencies and the need to monitor their health carefully, regardless of their placement postinvestigation. PMID:23420907

Biological properties and response to x-rays of first-generation transplants of spontaneous mammary carcinomas in C3H mice.

PubMed

Fowler, J F; Sheldon, P W; Begg, A C; Hill, S A; Smith, A M

1975-05-01

First-generation transplants of spontaneous mouse mammary carcinomas have been used extensively for radiobiological investigations of fractionated irradiation schedules, r.b.e. of fast neutrons and effectiveness of radiosensitizers, as reported elsewhere. The present work investigates the growth characteristics of the tumours; the criteria for the choice of end-points used in the definition of 'local control' of irradiated tumours; the reason for a decrease of 30 per cent in X-ray dose required to control tumours in females as compared with male mice; the proportion of hypoxic cells and its variation with time (reoxygenation) after a single dose of 1500 rad of X-rays; and the repair capacity of tumour cells within 24 hours after a substantial first dose of X-rays. Evidence is presented that the male-female difference was due to a higher proportion of hypoxic cells in tumours in male than in female mice. The repair of sub-lethal injury in tumour cells made hypoxic was slightly less than in skin made hypoxic but not significantly so. In the two-dose experiments on clamped tumours, no evidence of induced synchrony was found.

Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths.

PubMed

Awang, Halimah; Wong, Li Ping; Jani, Rohana; Low, Wah Yun

2014-03-01

This study examines the knowledge of sexually transmitted diseases (STDs) among male youths in Malaysia. A self-administered survey was carried out on a sample of 952 never-married males aged 15-24 years. The respondents were asked about their knowledge of STDs, how these diseases get transmitted and their sexual behaviours. The data showed that 92% of the respondents knew of at least one STD (syphilis, gonorrhoea, chlamydia, herpes, genital warts, yeast infection, trichomoniasis or HIV/AIDS). About 95% of them knew of at least one method of STD transmission. Urban and tertiary-educated male youths showed a substantially higher proportion of awareness of STDs and transmission methods compared with their rural and less-educated counterparts. The data also indicated that 10% of the study sample admitted to having had sexual experiences. There were still a large proportion of the respondents who were not aware of STDs other than syphilis and HIV/AIDS and the means of transmission, such as multiple sex partners, including those who claimed to be sexually active. Thus there is a need for more concerted efforts to disseminate information on STDs and transmission methods to a wider audience in Malaysia, especially youths in rural areas.

Toxoplasma gondii seroprevalence in breeding pigs in Estonia.

PubMed

Santoro, Azzurra; Tagel, Maarja; Must, Kärt; Laine, Miia; Lassen, Brian; Jokelainen, Pikka

2017-12-11

Toxoplasma gondii is a widespread occurring parasite infecting warm-blooded animals, including pigs and humans. The aims of this study were to estimate the prevalence of anti-T. gondii antibodies and to evaluate risk factors for T. gondii seropositivity in breeding pigs raised in Estonia. Sera from 382 pigs were tested with a commercial direct agglutination test, using a cut-off titer of 40 for seropositivity, for the presence of anti-T. gondii immunoglobulin G antibodies. Twenty-two (5.8%) of the 382 pigs tested seropositive for T. gondii, and 6 of the 14 herds had at least one seropositive pig. The proportion of seropositive pigs within the herds ranged between 0 and 43%. Gender appeared as a significant factor, with sows having 5.6 times higher odds to be seropositive to T. gondii than boars. Seroprevalence did not increase with age. Anti-T. gondii antibodies were present in a substantial proportion of breeding pig herds in Estonia. On the other hand, the presence of herds without seropositive pigs illustrates that porcine T. gondii infections can be avoided even in a country where the parasite is endemic and common in several other host species.

Human rhinoviruses and enteroviruses in influenza-like illness in Latin America

PubMed Central

2013-01-01

Background Human rhinoviruses (HRVs) belong to the Picornaviridae family with high similarity to human enteroviruses (HEVs). Limited data is available from Latin America regarding the clinical presentation and strains of these viruses in respiratory disease. Methods We collected nasopharyngeal swabs at clinics located in eight Latin American countries from 3,375 subjects aged 25 years or younger who presented with influenza-like illness. Results Our subjects had a median age of 3 years and a 1.2:1.0 male:female ratio. HRV was identified in 16% and HEV was identified in 3%. HRVs accounted for a higher frequency of isolates in those of younger age, in particular children < 1 years old. HRV-C accounted for 38% of all HRVs detected. Phylogenetic analysis revealed a high proportion of recombinant strains between HRV-A/HRV-C and between HEV-A/HEV-B. In addition, both EV-D68 and EV-A71 were identified. Conclusions In Latin America as in other regions, HRVs and HEVs account for a substantial proportion of respiratory viruses identified in young people with ILI, a finding that provides additional support for the development of pharmaceuticals and vaccines targeting these pathogens. PMID:24119298

The Arctic Soil Bacterial Communities in the Vicinity of a Little Auk Colony

PubMed Central

Zielińska, Sylwia; Kidawa, Dorota; Stempniewicz, Lech; Łoś, Marcin; Łoś, Joanna M.

2016-01-01

Due to deposition of birds' guano, eggshells or feathers, the vicinity of a large seabirds' breeding colony is expected to have a substantial impact on the soil's physicochemical features as well as on diversity of vegetation and the soil invertebrates. Consequently, due to changing physicochemical features the structure of bacterial communities might fluctuate in different soil environments. The aim of this study was to investigate the bacterial assemblages in the Arctic soil within the area of a birds' colony and in a control sample from a topographically similar location but situated away from the colony's impact area. A high number of OTUs found in both areas indicates a highly complex microbial populations structure. The most abundant phyla in both of the tested samples were: Proteobacteria, Acidobacteria, Actinobacteria, and Chloroflexi, with different proportions in the total share. Despite differences in the physicochemical soil characteristics, the soil microbial community structures at the phylum level were similar to some extent in the two samples. The only share that was significantly higher in the control area when compared to the sample obtained within the birds' colony, belonged to the Actinobacteria phylum. Moreover, when analyzing the class level for each phylum, several differences between the samples were observed. Furthermore, lower proportions of Proteobacteria and Acidobacteria were observed in the soil sample under the influence of the bird's colony, which most probably could be linked to higher nitrogen concentrations in that sample. PMID:27667982

Occurrence of breast cancer subtypes in adolescent and young adult women

PubMed Central

2012-01-01

Introduction Breast cancers are increasingly recognized as heterogeneous based on expression of receptors for estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2). Triple-negative tumors (ER-/PR-/HER2-) have been reported to be more common among younger women, but occurrence of the spectrum of breast cancer subtypes in adolescent and young adult (AYA) women aged between 15 and 39 years is otherwise poorly understood. Methods Data regarding all 5,605 AYA breast cancers diagnosed in California during the period 2005 to 2009, including ER and PR status (referred to jointly as hormone receptor (HR) status) and HER2 status, was obtained from the population-based California Cancer Registry. Incidence rates were calculated by subtype (triple-negative; HR+/HER2-; HR+/HER2+; HR-/HER2+), and logistic regression was used to evaluate differences in subtype characteristics by age group. Results AYAs had higher proportions of HR+/HER2+, triple-negative and HR-/HER2+ breast cancer subtypes and higher proportions of patients of non-White race/ethnicity than did older women. AYAs also were more likely to be diagnosed with stage III/IV disease and high-grade tumors than were older women. Rates of HR+/HER2- and triple-negative subtypes in AYAs varied substantially by race/ethnicity. Conclusions The distribution of breast cancer subtypes among AYAs varies from that observed in older women, and varies further by race/ethnicity. Observed subtype distributions may explain the poorer breast cancer survival previously observed among AYAs. PMID:22452927

Jumping the gun: the problematic discourse on socioeconomic status and cardiovascular health in India.

PubMed

Subramanian, S V; Corsi, Daniel J; Subramanyam, Malavika A; Smith, George Davey

2013-10-01

There has been an increased focus on non-communicable diseases (NCDs) in India, especially on cardiovascular diseases and associated risk factors. In this essay, we scrutinize the prevailing narrative that cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) are no longer confined to the economically advantaged groups but are an increasing burden among the poor in India. We conducted a comprehensive review of studies reporting the association between socioeconomic status (SES) and CVRF, CVD, and CVD-related mortality in India. With the exception of smoking and low fruit and vegetable intake, the studies clearly suggest that CVRF/CVD is more prevalent among high SES groups in India than among the low SES groups. Although CVD-related mortality rates appear to be higher among the lower SES groups, the proportion of deaths from CVD-related causes was found to be greatest among higher SES groups. The studies on SES and CVRF/CVD also reveal a substantial discrepancy between the data presented and the authors' interpretations and conclusions, along with an unsubstantiated claim that a reversal in the positive SES-CVRF/CVD association has occurred or is occurring in India. We conclude our essay by emphasizing the need to prioritize public health policies that are focused on the health concerns of the majority of the Indian population. Resource allocation in the context of efforts to make health care in India free and universal should reflect the proportional burden of disease on different population groups if it is not to entrench inequity.

National survey of tuberculosis notifications in England and Wales 1978--9. Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

PubMed Central

1980-01-01

A survey of all tuberculosis notifications in England and Wales for a six-month period showed that 70% of 3732 newly notified, previously untreated patients had respiratory disease only, 23% had non-respiratory disease only, and 7% had both. Fifty-seven per cent of patients were of white and 35% were of Indian subcontinent (Indian, Pakistani, or Bangladeshi) ethnic origin, the latter group contributing over half the cases of non-respiratory disease. The estimated overall annual notification rate per 100 000 population for 1978--9 was 16.4 for England and 13.5 for Wales. The rates differed considerably between the different ethnic groups in England, the highest rates occurring in the Indian and in the Pakistani and Bangladeshi groups and the lowest in the white group; the differences in the non-respiratory rates were the more striking. Nearly a quarter of patients with respiratory disease had large pulmonary lesions, the proportion being higher for the white group than for the Indian subcontinent group. Over half the patients had positive cultures for tubercle bacilli and over a third had positive smears; both proportions were higher for the white group. This survey has identified many of the problems which tuberculosis presents in England and Wales today. These include the substantial number of patients with sputum-positive disease, the considerable variation in the rates in the different ethnic groups, and the not uncommon occurrence of childhood tuberculosis. PMID:7427500

Diets of insectivorous birds along the Colorado River in Grand Canyon, Arizona

USGS Publications Warehouse

Yard, H.K.; van Riper, Charles; Brown, B.T.; Kearsley, M.J.

2004-01-01

We examined diets of six insectivorous bird species (n = 202 individuals) from two vegetation zones along the Colorado River in Grand Canyon National Park, Arizona, 1994. All bird species consumed similar quantities of caterpillars and beetles, but use of other prey taxa varied. Non-native leafhoppers (Opsius stactagolus) specific to non-native tamarisk (Tamarix chinensis) substantially augmented Lucy's Warbler (Vermivora luciae) diets (49%), while ants comprised 82% of Yellow-breasted Chat (Icteria virens) diets. Yellow Warbler (Dendroica petechia) diets were composed of 45% aquatic midges. All bird species consumed the non-native leafhopper specific to tamarisk. Comparison of bird diets with availability of arthropod prey from aquatic and terrestrial origins showed terrestrial insects comprised 91% of all avian diets compared to 9% of prey from aquatic origin. Seasonal shifts in arthropod prey occurred in diets of three bird species, although no seasonal shifts were detected in arthropods sampled in vegetation indicating that at least three bird species were not selecting prey in proportion to its abundance. All bird species had higher prey overlap with arthropods collected in the native, mesquite-acacia vegetation zone which contained higher arthropod diversity and better prey items (i.e., Lepidoptera). Lucy's Warbler and Yellow Warbler consumed high proportions of prey items found in greatest abundance in the tamarisk-dominated vegetation zone that has been established since the construction of Glen Canyon Dam. These species appeared to exhibit ecological plasticity in response to an anthropogenic increase in prey resources.

Effects of alfalfa flavonoids extract on the microbial flora of dairy cow rumen.

PubMed

Zhan, Jinshun; Liu, Mingmei; Wu, Caixia; Su, Xiaoshuang; Zhan, Kang; Zhao, Guo Qi

2017-09-01

The effect of flavonoids from alfalfa on the microbial flora was determined using molecular techniques of 16S ribosome deoxyribonucleic acid (rDNA) analysis. Four primiparous Holstein heifers fitted with ruminal cannulas were used in a 4×4 Latin square design and fed a total mixed ration to which alfalfa flavonoids extract (AFE) was added at the rates of 0 (A, control), 20 (B), 60 (C), or 100 (D) mg per kg of heifer BW. The number of operational taxonomic units in heifers given higher levels of flavonoid extract (C and D) was higher than for the two other treatments. The Shannon, Ace, and Chao indices for treatment C were significantly higher than for the other treatments (p<0.05). The number of phyla and genera increased linearly with increasing dietary supplementation of AFE (p<0.05). The principal co-ordinates analysis plot showed substantial differences in the microbial flora for the four treatments. The microbial flora in treatment A was similar to that in B, C, and D were similar by the weighted analysis. The richness of Tenericutes at the phylum level tended to increase with increasing AFE (p = 0.10). The proportion of Euryarchaeota at the phylum level increased linearly, whereas the proportion of Fusobacteria decreased linearly with increasing AFE supplementation (p = 0.04). The percentage of Mogibacterium , Pyramidobacter , and Asteroleplasma at the genus level decreased linearly with increasing AFE (p<0.05). The abundance of Spirochaeta , Succinivibrio , and Suttonella at the genus level tended to decrease linearly with increasing AFE (0.05

Sociodemographic variations in communication on sexuality and HIV/AIDS with parents, family members and teachers among in-school adolescents: a multi-site study in Tanzania and South Africa.

PubMed

Namisi, Francis Sande; Flisher, Alan J; Overland, Simon; Bastien, Sheri; Onya, Hans; Kaaya, Sylvia; Aarø, Leif Edvard

2009-06-01

To identify with whom in-school adolescents preferred to communicate about sexuality, and to study adolescents' communication on HIV/AIDS, abstinence and condoms with parents/guardians, other adult family members, and teachers. Data were obtained from a baseline questionnaire survey carried out in South Africa (Cape Town and Mankweng) and Tanzania (Dar es Salaam) in early 2004. We analysed data for 14,944 adolescents from 80 randomly selected schools. The mean ages were as follows: Cape Town, 13.38 years (standard deviation (SD) 1.15); Mankweng, 13.94 years (SD 1.35); and Dar es Salaam, 12.94 years (SD 1.31). Adolescent females preferred to receive sexuality information from their mothers, while among males there was a higher preference for fathers in two sites. Thirty-seven per cent, 41% and 29% reported never or hardly ever communicating about sexuality with parents, other adult family members, and teachers, respectively. "Silence'' was more prevalent in Dar es Salaam than in the other two sites. The odds of "never or hardly ever'' communicating with parents in Dar es Salaam were higher among girls than among boys (p < 0.01). For the two South African sites, boys had significantly higher odds of experiencing silence than did girls (both p < 0.001), and socioeconomic status was positively associated with parent-adolescent sexuality communication. In the logistic regression models, explained variation (Nagelkerke's R(2)) across sites ranged from 0.013 to 0.032. In all three sites, a substantial proportion of adolescents reported not communicating with their parents about HIV/AIDS, abstinence, or condoms. The low proportion of explained variation in sexuality communication implies that silence is common across sociodemographic subgroups.

Attaining the canopy in dry and moist tropical forests: strong differences in tree growth trajectories reflect variation in growing conditions.

PubMed

Brienen, Roel J W; Zuidema, Pieter A; Martínez-Ramos, Miguel

2010-06-01

Availability of light and water differs between tropical moist and dry forests, with typically higher understorey light levels and lower water availability in the latter. Therefore, growth trajectories of juvenile trees--those that have not attained the canopy--are likely governed by temporal fluctuations in light availability in moist forests (suppressions and releases), and by spatial heterogeneity in water availability in dry forests. In this study, we compared juvenile growth trajectories of Cedrela odorata in a dry (Mexico) and a moist forest (Bolivia) using tree rings. We tested the following specific hypotheses: (1) moist forest juveniles show more and longer suppressions, and more and stronger releases; (2) moist forest juveniles exhibit wider variation in canopy accession pattern, i.e. the typical growth trajectory to the canopy; (3) growth variation among dry forest juveniles persists over longer time due to spatial heterogeneity in water availability. As expected, the proportion of suppressed juveniles was higher in moist than in dry forest (72 vs. 17%). Moist forest suppressions also lasted longer (9 vs. 5 years). The proportion of juveniles that experienced releases in moist forest (76%) was higher than in dry forest (41%), and releases in moist forests were much stronger. Trees in the moist forest also had a wider variation in canopy accession patterns compared to the dry forest. Our results also showed that growth variation among juvenile trees persisted over substantially longer periods of time in dry forest (>64 years) compared to moist forest (12 years), most probably because of larger persistent spatial variation in water availability. Our results suggest that periodic increases in light availability are more important for attaining the canopy in moist forests, and that spatial heterogeneity in water availability governs long-term tree growth in dry forests.

Evidence for a remodelling of DNA-PK upon autophosphorylation from electron microscopy studies

PubMed Central

Morris, Edward P.; Rivera-Calzada, Angel; da Fonseca, Paula C. A.; Llorca, Oscar; Pearl, Laurence H.; Spagnolo, Laura

2011-01-01

The multi-subunit DNA-dependent protein kinase (DNA-PK), a crucial player in DNA repair by non-homologous end-joining in higher eukaryotes, consists of a catalytic subunit (DNA-PKcs) and the Ku heterodimer. Ku recruits DNA-PKcs to double-strand breaks, where DNA-PK assembles prior to DNA repair. The interaction of DNA-PK with DNA is regulated via autophosphorylation. Recent SAXS data addressed the conformational changes occurring in the purified catalytic subunit upon autophosphorylation. Here, we present the first structural analysis of the effects of autophosphorylation on the trimeric DNA-PK enzyme, performed by electron microscopy and single particle analysis. We observe a considerable degree of heterogeneity in the autophosphorylated material, which we resolved into subpopulations of intact complex, and separate DNA-PKcs and Ku, by using multivariate statistical analysis and multi-reference alignment on a partitioned particle image data set. The proportion of dimeric oligomers was reduced compared to non-phosphorylated complex, and those dimers remaining showed a substantial variation in mutual monomer orientation. Together, our data indicate a substantial remodelling of DNA-PK holo-enzyme upon autophosphorylation, which is crucial to the release of protein factors from a repaired DNA double-strand break. PMID:21450809

Large rainfall changes consistently projected over substantial areas of tropical land

NASA Astrophysics Data System (ADS)

Chadwick, Robin; Good, Peter; Martin, Gill; Rowell, David P.

2016-02-01

Many tropical countries are exceptionally vulnerable to changes in rainfall patterns, with floods or droughts often severely affecting human life and health, food and water supplies, ecosystems and infrastructure. There is widespread disagreement among climate model projections of how and where rainfall will change over tropical land at the regional scales relevant to impacts, with different models predicting the position of current tropical wet and dry regions to shift in different ways. Here we show that despite uncertainty in the location of future rainfall shifts, climate models consistently project that large rainfall changes will occur for a considerable proportion of tropical land over the twenty-first century. The area of semi-arid land affected by large changes under a higher emissions scenario is likely to be greater than during even the most extreme regional wet or dry periods of the twentieth century, such as the Sahel drought of the late 1960s to 1990s. Substantial changes are projected to occur by mid-century--earlier than previously expected--and to intensify in line with global temperature rise. Therefore, current climate projections contain quantitative, decision-relevant information on future regional rainfall changes, particularly with regard to climate change mitigation policy.

Comorbidities in ADHD children treated with methylphenidate: a database study

PubMed Central

2013-01-01

Background Methylphenidate (MPH) is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD) in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication. Methods We used health care data for the years 2004 to 2006 from the German Pharmacoepidemiological Research Database (GePaRD) which includes about 18% of the German population. MPH treatment prevalence and incidence was assessed based on at least one MPH prescription in the given year. In MPH users, the prevalence of psychiatric and other comorbidities was assessed in the quarter of the first MPH prescription and the three preceding quarters, whereas in controls it was assessed in the earliest four quarters of continuous insurance time starting at 01.01.2004 or the start of insurance if this was later. Differences in the presence of comorbid diagnoses between MPH users and controls were tested by logistic regression. Results In 2005, 1.5% of all children and adolescents aged 3 to 17 years (2.3% of males and 0.6% of females) received MPH in Germany. The proportion of children with a record of a psychiatric comorbidity in any of the nine ICD categories of diagnoses was substantially higher in new MPH users (83%) compared to controls (20%). Cerebro- and cardiovascular comorbidities were rare in general. Still, among new MPH users, 2% of males and females had a diagnosis of a pre-existing cardiovascular disorder but only 1.2% of controls. Conclusions Besides MPH treatment prevalence we first publish age-specific incidence rates for Germany. A high proportion of children who were started on MPH had a record of a psychiatric comorbidity preceding the first prescription. Cerebro- and cardiovascular conditions were rare in the studied age range, but still higher among children who received MPH than in the control group. Results show that in a substantial subgroup of patients, comorbidities require a thorough weighting of possible risks of MPH medication against the risks of untreated ADHD. PMID:23294623

Alcohol Consumption during Pregnancy and Postpartum Period and its Predictors in Sindhupalchowk District, Nepal.

PubMed

Aryal, K K; Thapa, N; Mehata, S; Thapa, P; Alvik, A; Stray-Pedersen, B

2016-09-01

A substantial proportion of women in Nepal consume alcohol and homebrewed alcoholic beverages are the most common type of alcohol. Alcohol being a part of tradition and culture in Nepal and evidences suggesting even low to moderate dose of alcohol having impacts on the birth outcomes, we aimed at exploring the alcohol consumption pattern during pregnancy and postpartum period along with its predictors. We studied all pregnant and recently delivered women using quantitative methods in selected wards within selected Village Development Committees of Sindhupalchowk district in Nepal after purposively choosing the district. We present the findings on pregnancy and postpartum period drinking and its predictors as proportion and adjusted odds ratio along with 95% CI. One-third of women drank alcohol during pregnancy and 43% during postpartum period. Nearly all drinking women mostly consumed homebrewed alcoholic beverages such as jaad/chhyang/localraksi. One-third consumed it daily during pregnancy, while three-quarters consumed daily during postpartum. One-fifth of currently drinking women drank ≥5 standard drinks on average per day in the last 30 days. Illiterate or women with low level of education were three times more likely to consume alcohol during pregnancy than women with secondary level education or higher. Similarly, women who didn't know that alcohol during pregnancy affects mother and child were four and half times more likely to consume alcohol during pregnancy than those who knew about it. Also, being dalits, disadvantaged and janajatis, husband's drinking and home brewing of alcohol were strongly associated with women's drinking during pregnancy and postpartum period. A substantial proportion of women consumed alcohol during pregnancy and postpartum period with high consumption frequency. Findings suggested, increasing awareness about consequences of drinking during pregnancy and postpartum period would be helpful probably as one of the components of routine antenatal care with a special focus to ethnic groups such as dalits, disadvantaged janajatis including relatively advantaged janajatis as well as the women with lower levels of education. Culture sensitive behavior change communication interventions aimed at reducing home brewing and husband's drinking would also be important Keywords: Alcohol consumption; home brewed; Nepal; postpartum period; pregnancy; predictor.

Fatty acid profile in vertical strata of elephant grass subjected to intermittent stocking.

PubMed

Dias, Kamila M; Schmitt, Daniel; Rodolfo, Giselle R; Deschamps, Francisco C; Camargo, Guilherme N; Pereira, Raphael S; Sbrissia, André F

2017-01-01

The milk and meat from animals with a pasture-based diet have higher proportions of CLA and C18:3 and lower omega-6:omega-3 ratios than products from animals with diets based on corn silage and concentrate. However, most of the published studies have evaluated fatty acid profiles in temperate climate grasses and the literature with tropical grasses is scarce. Thus, the aim of this study was to evaluate the morphological and fatty acid compositions in the vertical strata of elephant grass (Pennisetum purpureum Schum.) swards subjected to grazing heights (90 or 120 cm pre-grazing heights) and levels of defoliation (50% or 70% removal of the initial pre-grazing height). There were no interactions among pre-grazing height, the level of defoliation and grazing stratum. However, higher proportion of C18:3 (58% and 63%) was found in the 90-cm swards and in the half upper stratum. A higher proportion of C18:3 was associated with a higher leaf proportion and crude protein content. Thus, the upper stratum of sward or a grazing management scheme (e.g. first-last stocking) resulting in a higher proportion of leaves and crude protein both provide higher proportions of C18:3 to animals grazing in elephant grass swards.

The feasibility of age-specific travel restrictions during influenza pandemics

PubMed Central

2011-01-01

Background Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (~99%) would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. Methods A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Results Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group) were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Conclusions Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less of an impact on the economy compared to restricting adult travelers. However, as long as adults have at least a moderate potential to trigger an epidemic, selectively restricting the higher risk group (children) may not be a practical option to delay the arrival of an epidemic substantially. PMID:22078655

The feasibility of age-specific travel restrictions during influenza pandemics.

PubMed

Lam, Elson H Y; Cowling, Benjamin J; Cook, Alex R; Wong, Jessica Y T; Lau, Max S Y; Nishiura, Hiroshi

2011-11-11

Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (~99%) would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group) were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less of an impact on the economy compared to restricting adult travelers. However, as long as adults have at least a moderate potential to trigger an epidemic, selectively restricting the higher risk group (children) may not be a practical option to delay the arrival of an epidemic substantially.

Palliative Care Teams' Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities.

PubMed

May, Peter; Garrido, Melissa M; Cassel, J Brian; Kelley, Amy S; Meier, Diane E; Normand, Charles; Stefanis, Lee; Smith, Thomas J; Morrison, R Sean

2016-01-01

Patients with multiple serious conditions account for a high proportion of health care spending. Such spending is projected to continue to grow substantially as a result of increased insurance eligibility, the ever-rising cost of care, the continued use of nonbeneficial high-intensity treatments at the end of life, and demographic changes. We evaluated the impact of palliative care consultation on hospital costs for adults with advanced cancer, excluding those with dementia. We found that compared to usual care, the receipt of a palliative care consultation within two days of admission was associated with 22 percent lower costs for patients with a comorbidity score of 2-3 and with 32 percent lower costs for those with a score of 4 or higher. Earlier consultation was also found to be systematically associated with a larger cost-saving effect for all subsamples defined by multimorbidity. Given ongoing workforce shortages, targeting early specialist palliative care to hospitalized patients with advanced cancer and higher numbers of serious concurrent conditions could improve care while complementing strategies to curb the growth of health spending. Project HOPE—The People-to-People Health Foundation, Inc.

Quantifying Emergency Department Visits From Sport and Recreation: Focus on the Lower Extremity and Knee, 1997–2009

PubMed Central

Tenan, Matthew S.

2016-01-01

Context:  Few authors have reported nationally representative data on the number of sport and recreation (SR) injuries resulting in emergency department (ED) visitation. The existing studies have only provided 1 or 2 years of data and are not longitudinal in nature. Objective:  To use a novel algorithmic approach to determine if ED visitation is due to SR, resulting in a substantially larger longitudinal dataset. Design:  Descriptive epidemiology study. Setting:  Hospital. Patients or Other Participants:  The National Hospital Ambulatory Medical Care Survey, a stratified random-sample survey of US hospital EDs was combined for years 1997–2009. There were 15 699 unweighted patient visits determined to be from SR. Main Outcome Measure(s):  A custom algorithm classified SR visits based on the International Classification of Diseases, Ninth Revision, Clinical Modification E-code and pattern recognition of narrative text. Sport and recreation visits were assessed by age and categorized according to broad injury classifications. Additional quantification was performed on SR visits for lower extremity and knee-specific injuries. Sample weights were applied to provide national annual estimates. Results:  Annually, 4 243 000 ED visits resulted from SR. The largest classification of injury from SR was sprains and strains (896 000/y). Males had substantially more SR-related ED visits than females (2 929 000/y versus 1 314 000/y). For patients 10–49 years old, 1 093 000 lower extremity and 169 000 knee-specific injury visits annually were from SR. For both injury types, males had a higher rate of ED visitation; however, females had 25% and 39% greater odds of visitation for lower extremity and knee-specific injury, respectively. Conclusions:  The burden on the health system of ED visits from SR was substantial. Males presented in the ED at a higher rate for SR injury, though females had a higher proportion of lower extremity and knee-specific injury ED visitations from SR. This longitudinal analysis of population-level data provides the information to target research on specific subpopulations to mitigate SR injury. PMID:27075528

Adult vaccination against tetanus and diphtheria: the European perspective

PubMed Central

2016-01-01

Summary Besides immunizations against influenza, Streptococcus pneumoniae and herpes zoster, which are recommended specifically for elderly people, regular booster vaccinations against tetanus, diphtheria and in some cases pertussis and polio are recommended in many European countries for adults, including elderly people. Vaccination recommendations for adults differ greatly between individual countries and coverage data is scarce. Tetanus‐specific antibody concentrations are generally higher than diphtheria‐specific antibodies, and a substantial proportion of adults, and particularly of elderly people, do not have protective antibody concentrations against diphtheria. Antibody levels increase upon booster vaccination in all age groups, but diphtheria‐specific antibody concentrations remain below protective levels in some older individuals, even immediately after vaccination and long‐term protection is frequently not achieved. Future vaccination strategies should therefore include regular and well‐documented booster shots, e.g. against tetanus and diphtheria, throughout life. PMID:27279025

75 FR 52981 - Chrysler, LLC; Twinsburg Stamping Plant, Including On-Site Leased Workers from Caravan Knight...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... production of metal automotive stampings, a substantial proportion of which are shipped to an affiliated plant where they are used in the assembly of automotive vehicles. New information shows that workers...

Financial Management and Young Australian Workers

ERIC Educational Resources Information Center

Dowling, Nicki; Hoiles, Lauren; Corney, Tim; Clark, David

2008-01-01

In two studies of young Australian workers, participants generally displayed positive attitudes towards financial management practices; however, a substantial proportion failed to display positive financial management practices, experienced financial problems and dissatisfaction, and reported low rates of seeking financial assistance, particularly…

Membrane status of boar spermatozoa after cooling or cryopreservation.

PubMed

Maxwell, W M; Johnson, L A

1997-07-15

This study tested the hypothesis that sperm membrane changes during cooling contribute substantially to the membrane damage observed after cryopreservation of boar spermatozoa. Flow cytometry was used to assess viability (percentages of live and dead cells) of boar sperm cells after staining with SYBR-14 and propidium iodide (PI) and acrosome status after staining with FITC-pisum sativum agglutenin and PI. Incubation (38 degrees C, 4 h), cooling (to 15 or 5 degrees C) and freezing reduced the proportion of live spermatozoa compared with those in fresh semen. There were more membrane changes in spermatozoa cooled to 5 degrees C than to 15 degrees C. The proportion of live spermatozoa decreased during processing for cryopreservation and cooling to 5 degrees C, but was unaffected by freezing and thawing if held at 15 degrees C for 3.5 h during cooling. Spermatozoa not held during cooling exhibited further loss of viability after freezing and thawing. Holding the spermatozoa also increased the proportion of acrosome-intact spermatozoa at both 15 degrees C and 5 degrees C and at thawing compared with that of the unheld controls. The results of this study suggest that a substantial proportion of the membrane changes associated with cryopreservation of boar spermatozoa may be attributed to the cooling of the cells to 5 degrees C rather than to the freezing and thawing process, and that sperm membrane changes are reduced when semen is held at 15 degrees C during cooling.

Youth exposure to alcohol advertising on radio--United States, June-August 2004.

PubMed

2006-09-01

In the United States, more underage youth drink alcohol than smoke tobacco or use illicit drugs. Excessive alcohol consumption leads to many adverse health and social consequences and results in approximately 4,500 deaths among underage youth each year. Recent studies have emphasized the contribution of alcohol marketing to underage drinking and have demonstrated that a substantial proportion of alcohol advertising appears in media for which the audience composition is youth-oriented (i.e., composed disproportionately of persons aged 12-20 years). To determine the proportion of radio advertisements that occurred on radio programs with audiences composed disproportionately of underage youth and the proportion of total youth exposure to alcohol advertising that occurs as a result of such advertising, researchers at the Center on Alcohol Marketing and Youth (Health Policy Institute, Georgetown University, District of Columbia) evaluated the placement of individual radio advertisements for the most advertised U.S. alcohol brands and the composition of audiences in the largest 104 markets in the United States. This report summarizes the results of that study, which indicate that alcohol advertising is common on radio programs which have disproportionately large youth audiences and that this advertising accounts for a substantial proportion of all alcohol radio advertising heard by underage youth. These results further indicate that 1) the current voluntary standards limiting alcohol marketing to youth should be enforced and ultimately strengthened, and 2) ongoing monitoring of youth exposure to alcohol advertising should continue.

Microbiology of Shell Egg Production in the United States

USDA-ARS?s Scientific Manuscript database

A significant proportion of human illnesses caused by Salmonella are linked to the consumption of contaminated eggs. Substantial government and industry resources have been committed to comprehensive Salmonella testing and risk reduction programs for commercial egg-laying flocks. The implementation ...

Proportion of recovered waterfowl bands reported

USGS Publications Warehouse

Geis, A.D.; Atwood, E.L.

1961-01-01

Data from the annual mail survey of waterfowl hunters in the United States were used to estimate the total numbers of banded waterfowl that were shot. These estimates were compared with Banding Office records to estimate the proportion of recovered bands that was reported. On the average, about two banded birds were recovered for each one reported. The proportion reported was higher for some areas and for some species than for others. The proportion reported was higher when more of the reports came through employees of conservation agencies.

Financial Incentives for Linkage to Care and Viral Suppression Among HIV-Positive Patients: A Randomized Clinical Trial (HPTN 065).

PubMed

El-Sadr, Wafaa M; Donnell, Deborah; Beauchamp, Geetha; Hall, H Irene; Torian, Lucia V; Zingman, Barry; Lum, Garret; Kharfen, Michael; Elion, Richard; Leider, Jason; Gordin, Fred M; Elharrar, Vanessa; Burns, David; Zerbe, Allison; Gamble, Theresa; Branson, Bernard

2017-08-01

Achieving linkage to care and viral suppression in human immunodeficiency virus (HIV)-positive patients improves their well-being and prevents new infections. Current gaps in the HIV care continuum substantially limit such benefits. To evaluate the effectiveness of financial incentives on linkage to care and viral suppression in HIV-positive patients. A large community-based clinical trial that randomized 37 HIV test and 39 HIV care sites in the Bronx, New York, and Washington, DC, to financial incentives or standard of care. Participants at financial incentive test sites who had positive test results for HIV received coupons redeemable for $125 cash-equivalent gift cards upon linkage to care. HIV-positive patients receiving antiretroviral therapy at financial incentive care sites received $70 gift cards quarterly, if virally suppressed. Linkage to care: proportion of HIV-positive persons at the test site who linked to care within 3 months, as indicated by CD4+ and/or viral load test results done at a care site. Viral suppression: proportion of established patients at HIV care sites with suppressed viral load (<400 copies/mL), assessed at each calendar quarter. Outcomes assessed through laboratory test results reported to the National HIV Surveillance System. A total of 1061 coupons were dispensed for linkage to care at 18 financial incentive test sites and 39 359 gift cards were dispensed to 9641 HIV-positive patients eligible for gift cards at 17 financial incentive care sites. Financial incentives did not increase linkage to care (adjusted odds ratio, 1.10; 95% CI, 0.73-1.67; P = .65). However, financial incentives significantly increased viral suppression. The overall proportion of patients with viral suppression was 3.8% higher (95% CI, 0.7%-6.8%; P = .01) at financial incentive sites compared with standard of care sites. Among patients not previously consistently virally suppressed, the proportion virally suppressed was 4.9% higher (95% CI, 1.4%-8.5%; P = .007) at financial incentive sites. In addition, continuity in care was 8.7% higher (95% CI, 4.2%-13.2%; P < .001) at financial incentive sites. Financial incentives, as used in this study (HPTN 065), significantly increased viral suppression and regular clinic attendance among HIV-positive patients in care. No effect was noted on linkage to care. Financial incentives offer promise for improving adherence to treatment and viral suppression among HIV-positive patients. clinicaltrials.gov Identifier: NCT01152918.

Differentiation in light energy dissipation between hemiepiphytic and non-hemiepiphytic Ficus species with contrasting xylem hydraulic conductivity.

PubMed

Hao, Guang-You; Wang, Ai-Ying; Liu, Zhi-Hui; Franco, Augusto C; Goldstein, Guillermo; Cao, Kun-Fang

2011-06-01

Hemiepiphytic Ficus species (Hs) possess traits of more conservative water use compared with non-hemiepiphytic Ficus species (NHs) even during their terrestrial growth phase, which may result in significant differences in photosynthetic light use between these two growth forms. Stem hydraulic conductivity, leaf gas exchange and chlorophyll fluorescence were compared in adult trees of five Hs and five NHs grown in a common garden. Hs had significantly lower stem hydraulic conductivity, lower stomatal conductance and higher water use efficiency than NHs. Photorespiration played an important role in avoiding photoinhibition at high irradiance in both Hs and NHs. Under saturating irradiance levels, Hs tended to dissipate a higher proportion of excessive light energy through thermal processes than NHs, while NHs dissipated a larger proportion of electron flow than Hs through the alternative electron sinks. No significant difference in maximum net CO2 assimilation rate was found between Hs and NHs. Stem xylem hydraulic conductivity was positively correlated with maximum electron transport rate and negatively correlated with the quantum yield of non-photochemical quenching across the 10 studied Ficus species. These findings indicate that a canopy growth habit during early life stages in Hs of Ficus resulted in substantial adaptive differences from congeneric NHs not only in water relations but also in photosynthetic light use and carbon economy. The evolution of epiphytic growth habit, even for only part of their life cycle, involved profound changes in a suite of inter-correlated ecophysiological traits that persist to a large extent even during the later terrestrial growth phase.

BMI percentile curves for Chinese children aged 7-18 years, in comparison with the WHO and the US Centers for Disease Control and Prevention references.

PubMed

Ma, Jun; Wang, Zhiqiang; Song, Yi; Hu, Peijin; Zhang, Bing

2010-12-01

To establish BMI percentile curves that describe the contemporary BMI distribution among Chinese children, and to compare their BMI percentile curves with those in two recently developed international references: the WHO and the US Centers for Disease Control and Prevention (US CDC) growth references. A cross-sectional national survey. Thirty provinces, municipalities and autonomous regions in China. Nationally representative sample of 232 140 school students aged 7-18 years. BMI percentile curves were established using the LMS method, and were compared with the percentiles of the WHO and the US CDC references. BMI distributions and growth patterns in Chinese children were dramatically different from those in the two international reference populations. Compared with the international reference populations, younger Chinese boys (7-12 years of age) had higher values of the percentiles above the median and lower values of the percentiles below the median, suggesting that they had larger proportions of extreme BMI values in both directions. Chinese girls and older Chinese boys (15-18 years of age) had substantially lower BMI percentiles than their counterparts in the reference populations, particularly those high percentiles among older age groups. The present study described the unique patterns of BMI curves at the national level, and these curves are useful as a reference for comparing different regions and for monitoring changes over time in Chinese children. Higher proportions of children with extreme values in both directions indicate that China is currently facing both an increasing level of obesity and a high level of undernutrition, simultaneously.

Distinct Circular Single-Stranded DNA Viruses Exist in Different Soil Types

PubMed Central

Swanson, Maud M.; Dawson, Lorna; Freitag, Thomas E.; Singh, Brajesh K.; Torrance, Lesley; Mushegian, Arcady R.

2015-01-01

The potential dependence of virus populations on soil types was examined by electron microscopy, and the total abundance of virus particles in four soil types was similar to that previously observed in soil samples. The four soil types examined differed in the relative abundances of four morphological groups of viruses. Machair, a unique type of coastal soil in western Scotland and Ireland, differed from the others tested in having a higher proportion of tailed bacteriophages. The other soils examined contained predominantly spherical and thin filamentous virus particles, but the Machair soil had a more even distribution of the virus types. As the first step in looking at differences in populations in detail, virus sequences from Machair and brown earth (agricultural pasture) soils were examined by metagenomic sequencing after enriching for circular Rep-encoding single-stranded DNA (ssDNA) (CRESS-DNA) virus genomes. Sequences from the family Microviridae (icosahedral viruses mainly infecting bacteria) of CRESS-DNA viruses were predominant in both soils. Phylogenetic analysis of Microviridae major coat protein sequences from the Machair viruses showed that they spanned most of the diversity of the subfamily Gokushovirinae, whose members mainly infect obligate intracellular parasites. The brown earth soil had a higher proportion of sequences that matched the morphologically similar family Circoviridae in BLAST searches. However, analysis of putative replicase proteins that were similar to those of viruses in the Circoviridae showed that they are a novel clade of Circoviridae-related CRESS-DNA viruses distinct from known Circoviridae genera. Different soils have substantially different taxonomic biodiversities even within ssDNA viruses, which may be driven by physicochemical factors. PMID:25841004

Correcting for multiple-testing in multi-arm trials: is it necessary and is it done?

PubMed

Wason, James M S; Stecher, Lynne; Mander, Adrian P

2014-09-17

Multi-arm trials enable the evaluation of multiple treatments within a single trial. They provide a way of substantially increasing the efficiency of the clinical development process. However, since multi-arm trials test multiple hypotheses, some regulators require that a statistical correction be made to control the chance of making a type-1 error (false-positive). Several conflicting viewpoints are expressed in the literature regarding the circumstances in which a multiple-testing correction should be used. In this article we discuss these conflicting viewpoints and review the frequency with which correction methods are currently used in practice. We identified all multi-arm clinical trials published in 2012 by four major medical journals. Summary data on several aspects of the trial design were extracted, including whether the trial was exploratory or confirmatory, whether a multiple-testing correction was applied and, if one was used, what type it was. We found that almost half (49%) of published multi-arm trials report using a multiple-testing correction. The percentage that corrected was higher for trials in which the experimental arms included multiple doses or regimens of the same treatments (67%). The percentage that corrected was higher in exploratory than confirmatory trials, although this is explained by a greater proportion of exploratory trials testing multiple doses and regimens of the same treatment. A sizeable proportion of published multi-arm trials do not correct for multiple-testing. Clearer guidance about whether multiple-testing correction is needed for multi-arm trials that test separate treatments against a common control group is required.

Cardboard proportions and total solids contents as driving factors in dry co-fermentation of food waste.

PubMed

Capson-Tojo, Gabriel; Trably, Eric; Rouez, Maxime; Crest, Marion; Bernet, Nicolas; Steyer, Jean-Philippe; Delgenès, Jean-Philippe; Escudié, Renaud

2018-01-01

This study evaluated the influence of the co-substrate proportions (0-60% of cardboard in dry basis) and the initial total solid contents (20-40%) on the batch fermentation performance. Maximum hydrogen yields were obtained when mono-fermenting food waste at high solids contents (89mlH 2 ·gVS -1 ). The hydrogen yields were lower when increasing the proportions of cardboard. The lower hydrogen yields at higher proportions of cardboard were translated into higher yields of caproic acid (up to 70.1gCOD·kgCOD bio -1 ), produced by consumption of acetic acid and hydrogen. The highest substrate conversions were achieved at low proportions of cardboard, indicating a stabilization effect due to higher buffering capacities in co-fermentation. Clostridiales were predominant in all operational conditions. This study opens up new possibilities for using the cardboard proportions for controlling the production of high added-value products in dry co-fermentation of food waste. Copyright © 2017 Elsevier Ltd. All rights reserved.

75 FR 9777 - Magnet Schools Assistance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... the district-wide average of minority group students. This new flexibility is necessary to permit... elementary and secondary schools'' with substantial proportions of minority students, and ``the development and design of innovative educational methods and practices that promote diversity.'' 20 U.S.C. 7231...

Within-farm variability in age structure of breeding-female pigs and reproductive performance on commercial swine breeding farms.

PubMed

Koketsu, Yuzo

2005-03-15

This study investigated relationships between herd age structure and herd productivity in breeding herds; it also investigated a pattern in parity proportions of females over 2 years and its relationship with herd productivity in commercial swine herds. This study was based on data from 148 commercial farms in North America stored in the swine database program at the University of Minnesota. The primary selection criterion was fluctuations in breeding-female pig (female) inventories over a 2-year interval. Productivity measurements and parity proportions of females were extracted from the database. A 24-month time-plot in proportions of Parity 0 and Parities 3-5 females (mid-parity) was charted for each farm. Using these charts, a change in proportions of Parity 0 and mid-parity for each farm was categorized into patterns: FLUCTUATE (Parity 0 and mid-parity proportion lines crossed) or STABLE (the two proportion lines never crossed). Higher proportions of mid-parity sows were correlated with greater pigs weaned per female per year (PWFY; P < 0.01). Farms with a FLUCTUATE (73% of the 148 farms) pattern had lower PWFY than those with a STABLE pattern (P < 0.01). The STABLE farms had higher proportions of mid-parity sows, higher parity at culling, higher frequency of gilt deliveries per year, and lower replacement rate than the FLUCTUATE farms (P < 0.01). In conclusion, maintaining stable subpopulations with mid-parity and Parity 0 are recommended to optimize herd productivity.

[The present status and attempts toward the achievement of gender equality in the JAA].

PubMed

Senba, Emiko

2013-09-01

The proportion of female members in The Japanese Association of Anatomists (JAA) is 18% with the proportion of female members higher among the young generation (20-30 Y.O.; 34.8%, 30-40 Y.O.; 26.8%). However, the number of female members in the Board of Directors has been zero or one (0 or 6%) for many years. More than two female members are necessary on the Board to promote the diversity in the management of the JAA. The numbers of female members in other committees has shown gradual increase in recent years. A substantial increase in female faculty members including professors in each university and school will support the future development of the anatomical research field and the association. We have made the first great step by setting up the committee on promotion of gender equality in JAA in March, 2011. In the next year, JAA became a member of Japan Inter-Society Liaison Association Committee for Promoting Equal Participation of Men and Women in Science and Engineering (EPMEWSE). Our committee's activity includes holding workshops and seminars at the annual meetings to promote gender equality in the research field and to encourage mutual support and friendship, not only among women members but also among all members.

Altitude preexposure recommendations for inducing acclimatization.

PubMed

Muza, Stephen R; Beidleman, Beth A; Fulco, Charles S

2010-01-01

For many low-altitude (<1500 m) residents, their travel itineraries may cause them to ascend rapidly to high (>2400 m) altitudes without having the time to develop an adequate degree of altitude acclimatization. Prior to departing on these trips, low-altitude residents can induce some degree of altitude acclimatization by ascending to moderate (>1500 m) or high altitudes during either continuous or intermittent altitude preexposures. Generally, the degree of altitude acclimatization developed is proportional to the altitude attained and the duration of exposure. The available evidence suggests that continuous residence at 2200 m or higher for 1 to 2 days or daily 1.5- to 4-h exposures to >4000 m induce ventilatory acclimatization. Six days at 2200 m substantially decreases acute mountain sickness (AMS) and improves work performance after rapid ascent to 4300 m. There is evidence that 5 or more days above 3000 m within the last 2 months will significantly decrease AMS during a subsequent rapid ascent to 4500 m. Exercise training during the altitude preexposures may augment improvement in physical performance. The persistence of altitude acclimatization after return to low altitude appears to be proportional to the degree of acclimatization developed. The subsequent ascent to high altitude should be scheduled as soon as possible after the last altitude preexposure.

Effects of chronic copper exposure on development and survival in the southern leopard frog (Lithobates [Rana] sphenocephalus).

PubMed

Lance, Stacey L; Erickson, Matthew R; Flynn, R Wesley; Mills, Gary L; Tuberville, Tracey D; Scott, David E

2012-07-01

Exposure to environmental contaminants contributes to the global decline of amphibian populations. The impacts of organic contaminants on amphibians are well documented. However, substantially less is known concerning the potential effects of metals on amphibian populations. Copper (Cu) is an essential element, but it can be toxic at concentrations only slightly higher than the normal physiological range. The present study examines the effects of chronic Cu exposure on embryos and larvae of southern leopard frogs, Lithobates (Rana) sphenocephalus. Groups of eggs from multiple clutches were collected from two wetlands and exposed to a range of Cu concentrations (0-150 µg/L) until they reached the free-swimming stage, and then individual larvae were reared to metamorphosis. Higher Cu concentrations significantly reduced embryo survival to the free-swimming stage but did not further reduce survival to metamorphosis. Larval period was affected by Cu treatment, but the clutch from which larvae originated (i.e., parentage) explained a higher proportion of the variation. Embryo survival to hatching varied significantly among clutches, ranging from 42.9 to 79.2%. Measurable levels of Cu were found in larvae with body burdens up to 595 µg Cu/g dry mass in the 100 µg/L treatment, and larval Cu body burdens were higher than in metamorphs. The present study also demonstrated that higher initial egg density ameliorated embryo mortality at higher Cu levels and should be accounted for in future studies. Copyright © 2012 SETAC.

Planar Impacts in Rollover Crashes: Significance, Distribution and Injury Epidemiology

PubMed Central

Bose, Dipan; Kerrigan, Jason R.; Foster, Jonathan B.; Crandall, Jeff R.; Tobaru, Shigeo

2011-01-01

While one third of all fatal motor vehicle crashes involve rollover of the vehicle, a substantially large portion of these rollover crashes involve planar impacts (e.g., frontal, side or rear impact) that influence the crash kinematics and subsequently the injury outcome. The objective of the study was to evaluate the distribution of planar impacts in rollover crashes, and in particular, to describe the differences in the underlying crash kinematics, injury severity and the regional distribution of injuries when compared to the rollover-dominated crashes without significant planar impact (i.e., primary rollovers). Sampled cases (n=6,900) from the U.S. National Automotive Sampling System – Crashworthiness Data System, representing approximately 3.3 million belted drivers involved in a rollover crash in years 1998–2008, were analyzed. Single vehicle rollover crashes with significant planar impact (21% of all rollover crashes) were in general more likely to result in occupant fatality and involved higher incidence of moderate to severe injuries compared to single vehicle primary rollovers (p<0.05). A substantial proportion of the planar impact rollovers ended in single quarter turn crashes (30%), mostly resulting from a frontal impact (59%). While chest was the most frequently injured body region among all rollover victims sustaining severe injuries, severe injuries sustained in primary rollovers were more isolated (single body region) in comparison to the ones sustained in rollovers with planar impacts. The results emphasize the higher risk of rollover victims sustaining an injury and the differences in distribution of injuries sustained when a planar impact is associated with the rollover crash. PMID:22105400

[Prevalence of psychiatric disorders, psychopathology, and the need for treatment in female and male prisoners].

PubMed

von Schönfeld, C-E; Schneider, F; Schröder, T; Widmann, B; Botthof, U; Driessen, M

2006-07-01

While the international literature documents a high prevalence of psychiatric disorders in prisoners, German studies in this field are rare. The base of knowledge is even worse with regard to female prisoners. The purpose of this study was to investigate DSM-IV axis I and II psychiatric disorders and current psychopathology and to estimate treatment needs in prisoners. On the 1st of May 2002, all female prisoners in Brackwede I Prison in Bielefeld, Germany, were included; and a sample of incarcerated men was matched according to age, nationality, and length of stay. Sixty-three women and 76 men participated. Criminal history and current living conditions were investigated using a questionnaire and prison documents. Psychopathology and psychiatric disorders were investigated using structured clinical interviews. In 88.2% of the sample, at least one current axis I (83.5%) and/or axis II personality disorder (53.2%) was found. Comorbidity rates were high, with 3.5+/-2.7 diagnoses per case. Mean SCL scores revealed a substantial psychopathologic burden. In female prisoners, opiate-related and polysubstance use disorders and affective and post-traumatic stress disorders were more frequent than in the male subsample, which in turn showed higher rates of alcohol-related disorders. Specific treatment needs were indicated in 83.4% of the sample. These results indicate that the proportion of mentally ill persons in prisons is substantially higher than in specialized hospitals for mentally ill criminals. More treatment options are urgently needed than has been realized up to now.

Course and predictors of maternal eating disorders in the postpartum period

PubMed Central

Knoph, Cecilie; Holle, Ann Von; Zerwas, Stephanie; Torgersen, Leila; Tambs, Kristian; Stoltenberg, Camilla; Bulik, Cynthia M; Reichborn-Kjennerud, Ted

2012-01-01

Objective To investigate course and predictors of eating disorders in the postpartum period. Method A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for pre-pregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with pre-pregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. PMID:23307499

Differences in the cancer burden among foreign-born and US-born Arab Americans living in metropolitan Detroit.

PubMed

Khan, Fatima; Ruterbusch, Julie J; Gomez, Scarlett L; Schwartz, Kendra

2013-11-01

Migrant studies often provide clues for cancer etiology. We estimated the cancer burden among Arab Americans (ArA) by immigrant status in the metropolitan Detroit area, home to one of the highest concentrations of ArA in USA. A validated name algorithm was used to identify ArA cancer cases diagnosed 1990-2009 in the Detroit SEER database. Recorded birthplace was supplemented with imputation of nativity using birthdate and social security number. Age-adjusted, gender-specific proportional incidence ratios and 95 % confidence intervals were calculated comparing all ArA, foreign-born ArA, and US-born ArA, to non-Hispanic Whites (NHW). Foreign-born ArA males had higher proportions of multiple myeloma, leukemia, kidney, liver, stomach, and bladder cancer than NHW, while bladder cancer and leukemia were higher among US-born ArA males. For ArA women, gall bladder and thyroid cancers were proportionally higher among both foreign- and US-born compared with NHW. Stomach cancer was proportionally higher only among foreign-born women. Cancer proportional incidence patterns among ArA show some similarity to other migrant groups, with higher proportional incidences of stomach and liver cancers among foreign-born than US-born. Other patterns, such as tobacco-related cancers among ArA men and gall bladder and thyroid cancers among ArA women, will require more investigation of genetic, epigenetic, and environmental factors.

GFR at Initiation of Dialysis and Mortality in CKD: A Meta-analysis

PubMed Central

Susantitaphong, Paweena; Altamimi, Sarah; Ashkar, Motaz; Balk, Ethan M.; Stel, Vianda S.; Wright, Seth; Jaber, Bertrand L.

2012-01-01

Background The proportion of patients with advanced chronic kidney disease (CKD) initiating dialysis at higher glomerular filtration rate (GFR) has increased over the past decade. Recent data suggest that higher GFR may be associated with increased mortality. Study Design A meta-analysis of cohort studies and trials. Setting & Population Patients with advanced CKD. Selection Criteria for Studies We performed a systematic literature search in MEDLINE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, American Society of Nephrology abstracts, and bibliographies of retrieved articles to identify studies reporting on GFR at dialysis initiation and mortality. Predictor estimated or calculated GFR at dialysis initiation. Outcome Pooled adjusted hazard ratio (HR) of continuous GFR for all-cause mortality. Results Sixteen cohort studies and one randomized controlled trial were identified (n=1,081,116). By meta-analysis, restricted to the 15 cohorts (n=1,079,917), higher GFR at dialysis initiation was associated with a higher pooled adjusted HR for all-cause mortality (1.04; 95% CI, 1.03–1.05; P<0.001). However, there was significant heterogeneity (I2=97%; P<0.001). The association persisted among the 9 cohorts that adjusted analytically for nutritional covariates (HR 1.03; 95% CI 1.02, 1.04; P<0.001; residual I2=97%). The highest mortality risk was observed in hemodialysis cohorts (HR 1.05; 95% CI 1.02, 1.08; P<0.001) whereas there was no association between GFR and mortality in peritoneal dialysis cohorts (HR 1.04; 95% CI 0.99, 1.08, P=0.11; residual I2=98%). Finally, higher GFR was associated with a lower mortality risk in cohorts that calculated GFR (HR 0.80; 95% CI 0.71, 0.91; P=0.003), contrasting with a higher mortality risk in cohorts that estimated GFR (HR 1.04; 95% CI 1.03, 1.05; P<0.001; residual I2=97%). Limitations Paucity of randomized controlled trials; different methods for determining GFR; and substantial heterogeneity. Conclusions Higher estimated rather than calculated GFR at dialysis initiation is associated with a higher mortality risk among patients with advanced CKD, independent of nutritional status. Although there was substantial heterogeneity of effect size estimates across studies, this observation requires further study. PMID:22465328

Performance of rice husk ash produced using a new technology as a mineral admixture in concrete

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

Nehdi, M.; Duquette, J.; El Damatty, A

2003-08-01

This article investigates the use of a new technique for the controlled combustion of Egyptian rice husk to mitigate the environmental concerns associated with its uncontrolled burning and provide a supplementary cementing material for the local construction industry. The reactor used provides efficient combustion of rice husk in a short residency time via the suspension of processed particles by jets of a process air stream that is forced though stationary angled blades at high velocity. Investigations on the rice husk ash (RHA) thus produced included oxide analysis, X-ray diffraction, carbon content, grindability, water demand, pozzolanic activity index, surface area, andmore » particle size distribution measurements. In addition, concrete mixtures incorporating various proportions of silica fume (SF) and Egyptian RHA (EG-RHA) produced at different combustion temperatures were made and compared. The workability, superplasticizer and air-entraining admixture requirements, and compressive strength at various ages of these concrete mixtures were evaluated, and their resistance to rapid chloride penetrability and deicing salt surface scaling were examined. Test results indicate that contrary to RHA produced using existing technology, the superplasticizer and air-entraining agent requirements did not increase drastically when the RHA developed in this study was used. Compressive strengths achieved by concrete mixtures incorporating the new RHA exceeded those of concretes containing similar proportions of SF. The resistance to surface scaling of RHA concrete was better than that of concrete containing similar proportions of SF. While the chloride penetrability was substantially decreased by RHA, it remained slightly higher than that achieved by SF concrete.« less

Autism characteristics and behavioural disturbances in ~ 500 children with Down's syndrome in England and Wales.

PubMed

Warner, Georgina; Moss, Joanna; Smith, Patrick; Howlin, Patricia

2014-08-01

Recent research shows that a significant minority of children with Down's syndrome (DS) also meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated what proportion of children aged 6-15 years with a confirmed diagnosis of DS in England and Wales display autistic-type behaviours, and explored the characteristics of this group of children. The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7% (95% CI: 33.4-42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI: 13.2-19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who scored well below cut-off (total score < 10). However, the profile of their autism characteristics on the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in children with DS in England and Wales is substantially higher than in the general population. These children also experience significantly greater behavioural problems than children with DS only. Early detection of autism characteristics is important for appropriate intervention. However, the unusual profile of autism characteristics in this group may affect the recognition of the disorder and hinder the implementation of appropriate interventions. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Changes in formal sex education: 1995-2002.

PubMed

Lindberg, Laura Duberstein; Santelli, John S; Singh, Susheela

2006-12-01

Although comprehensive sex education is broadly supported by health professionals, funding for abstinence-only education has increased. Using data from the 1995 National Survey of Adolescent Males, the 1995 National Survey of Family Growth (NSFG) and the 2002 NSFG, changes in male and female adolescents' reports of the sex education they have received from formal sources were examined. Life-table methods were used to measure the timing of instruction, and t tests were used for changes over time. From 1995 to 2002, reports of formal instruction about birth control methods declined among both genders (males, from 81% to 66%; females, from 87% to 70%). This, combined with increases in reports of abstinence education among males (from 74% to 83%), resulted in a lower proportion of teenagers' overall receiving formal instruction about both abstinence and birth control methods (males, 65% to 59%; females, 84% to 65%), and a higher proportion of teenagers' receiving instruction only about abstinence (males, 9% to 24%; females, 8% to 21%). Teenagers in 2002 had received abstinence education about two years earlier (median age, 11.4 for males, 11.8 for females) than they had received birth control instruction (median age, 13.5 for both males and females). Among sexually experienced adolescents, 62% of females and 54% of males had received instruction about birth control methods prior to first sex. A substantial retreat from formal instruction about birth control methods has left increasing proportions of adolescents receiving only abstinence education. Efforts are needed to expand teenagers' access to medically accurate and comprehensive reproductive health information.

Hypochondriasis and somatization.

PubMed

Kellner, R

1987-11-20

Between 60% and 80% of healthy individuals experience somatic symptoms in any one week. About 10% to 20% of a random sample of people worry intermittently about illness. A substantial proportion of patients present physicians with somatic complaints for which no organic cause can be found. Patients who are hypochondriacal do not understand the benign nature of functional somatic symptoms and interpret these as evidence of disease. Hypochondriacal concerns range from common short-lived worries to persistent and distressing fears or convictions of having a disease. Hypochondriasis can be secondary to other psychiatric disorders (eg, melancholia or panic disorder), and hypochondriacal attitudes remit when the primary disorder is successfully treated. Patients with primary hypochondriasis are also anxious or depressed, but the fear of disease, or the false belief of having a disease, persists and is the most important feature of their psychopathology. There are substantial differences among hypochondriacal patients in their personalities and psychopathologies. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies on the value of psychotherapy in hypochondriasis; the recommended guidelines are based on uncontrolled studies of hypochondriasis and on controlled studies of the psychotherapy in similar disorders. The prognosis of functional somatic symptoms as well as that of hypochondriasis is good in a substantial proportion of patients.

Shape and size distribution of chaos areas on Europa

NASA Astrophysics Data System (ADS)

Mikell, T.; Cox, R.

2008-12-01

Chaos terrain is ubiquitous on Europa's surface, but not randomly distributed. The global distribution of chaos areas shows a significant concentration between 30° N and S latitude, decreasing dramatically at higher latitudes. The low-latitude clustering is not an artifact of recognizability, as there is a greater proportion of images with high solar incidence angle (low light) at higher latitudes. Clustering is especially marked in context of the few but vast regional chaos tracts (>15,000 km2) that occupy a substantial proportion of the equatorial region: i.e. the low latitudes have not only greater numbers but much greater areal chaos coverage. Apex-antapex asymmetry is difficult to evaluate because the Galileo longitudinal coverage is so poor; but comparison of the image swaths that follow great circles across the leading and trailing hemispheres respectively shows greater numbers of chaos areas on the leading side. In spite of the equatorial location of a few vast chaos tracts, there is no apparent relationship between chaos area size and latitude. Chaos area outlines vary from smoothly circular to extremely jagged: the irregularity index ranges from 2- 270% (based on the ratio between measured chaos area perimeter and the circumference of a circle of equal area). There is a range of shapes in all size brackets, but smaller chaos areas on average have simpler, more equidimensional shapes, and edge complexity increases for larger chaos areas. Chaos areas of ~10 km equivalent circle diameter (ECD) have outlines that are 4-90% irregular, ones ~50 km ECD are 15-180% and those >100 km ECD are 35-270% irregular. In general, chaos areas with higher irregularity indices also have a higher raft:matrix ratio. These results, while preliminary, are consistent with experimental evidence suggesting an impact origin for some chaos terrain on Europa. In particular, the relationship between shape and size parallels the results of impact experiments into ice over water, in which lower-energy impacts produce small, circular bullet-holes with few or no rafts; and higher-energy impacts generate wide-field fragmentation of the ice, producing large and highly irregular openings with abundant floating crustal blocks.

Self-esteem Is Mostly Stable Across Young Adulthood: Evidence from Latent STARTS Models.

PubMed

Wagner, Jenny; Lüdtke, Oliver; Trautwein, Ulrich

2016-08-01

How stable is self-esteem? This long-standing debate has led to different conclusions across different areas of psychology. Longitudinal data and up-to-date statistical models have recently indicated that self-esteem has stable and autoregressive trait-like components and state-like components. We applied latent STARTS models with the goal of replicating previous findings in a longitudinal sample of young adults (N = 4,532; Mage  = 19.60, SD = 0.85; 55% female). In addition, we applied multigroup models to extend previous findings on different patterns of stability for men versus women and for people with high versus low levels of depressive symptoms. We found evidence for the general pattern of a major proportion of stable and autoregressive trait variance and a smaller yet substantial amount of state variance in self-esteem across 10 years. Furthermore, multigroup models suggested substantial differences in the variance components: Females showed more state variability than males. Individuals with higher levels of depressive symptoms showed more state and less autoregressive trait variance in self-esteem. Results are discussed with respect to the ongoing trait-state debate and possible implications of the group differences that we found in the stability of self-esteem. © 2015 Wiley Periodicals, Inc.

Screening for Housing Instability and Homelessness Among Families Undergoing Child Maltreatment Investigation.

PubMed

Farrell, Anne F; Dibble, Kate E; Randall, Kellie G; Britner, Preston A

2017-09-01

This paper reports results of mixed methods, population survey of housing instability, and homelessness. Child welfare personnel conducted the Quick Risks and Assets for Family Triage (QRAFT), a three-question screening tool intended to identify housing instability and homelessness. The QRAFT requires users to assess family housing history, current housing arrangement, and current housing condition, on a four-point scale from "asset/not a risk" to "severe risk." The QRAFT was completed among 6828 families undergoing new child maltreatment investigations. Approximately 5.4% of families demonstrated significant to severe housing problems; approximately one-third exhibited moderate housing risk. Housing problems and homelessness were significantly associated with the outcome of child welfare investigations; among families with substantiated child welfare determinations, 21% demonstrated significant to severe housing risk, a significantly higher proportion than among families where the investigation outcome was unsubstantiated or differential response (i.e., voluntary services). Of significant to severe housing risk families, 15.7% later met eligibility criteria for a supportive housing intervention, suggesting that housing concerns combined with substantial parent and child functional difficulties. Qualitative data indicated the QRAFT was perceived as easy to administer, effective as a screening tool, and useful to "apply the housing lens" early in child welfare involvement. © Society for Community Research and Action 2017.

Genome-wide association study identifies multiple loci influencing human serum metabolite levels

PubMed Central

Kettunen, Johannes; Tukiainen, Taru; Sarin, Antti-Pekka; Ortega-Alonso, Alfredo; Tikkanen, Emmi; Lyytikäinen, Leo-Pekka; Kangas, Antti J; Soininen, Pasi; Würtz, Peter; Silander, Kaisa; Dick, Danielle M; Rose, Richard J; Savolainen, Markku J; Viikari, Jorma; Kähönen, Mika; Lehtimäki, Terho; Pietiläinen, Kirsi H; Inouye, Michael; McCarthy, Mark I; Jula, Antti; Eriksson, Johan; Raitakari, Olli T; Salomaa, Veikko; Kaprio, Jaakko; Järvelin, Marjo-Riitta; Peltonen, Leena; Perola, Markus; Freimer, Nelson B; Ala-Korpela, Mika; Palotie, Aarno; Ripatti, Samuli

2013-01-01

Nuclear magnetic resonance assays allow for measurement of a wide range of metabolic phenotypes. We report here the results of a GWAS on 8,330 Finnish individuals genotyped and imputed at 7.7 million SNPs for a range of 216 serum metabolic phenotypes assessed by NMR of serum samples. We identified significant associations (P < 2.31 × 10−10) at 31 loci, including 11 for which there have not been previous reports of associations to a metabolic trait or disorder. Analyses of Finnish twin pairs suggested that the metabolic measures reported here show higher heritability than comparable conventional metabolic phenotypes. In accordance with our expectations, SNPs at the 31 loci associated with individual metabolites account for a greater proportion of the genetic component of trait variance (up to 40%) than is typically observed for conventional serum metabolic phenotypes. The identification of such associations may provide substantial insight into cardiometabolic disorders. PMID:22286219

Discovery of cancer drug targets by CRISPR-Cas9 screening of protein domains.

PubMed

Shi, Junwei; Wang, Eric; Milazzo, Joseph P; Wang, Zihua; Kinney, Justin B; Vakoc, Christopher R

2015-06-01

CRISPR-Cas9 genome editing technology holds great promise for discovering therapeutic targets in cancer and other diseases. Current screening strategies target CRISPR-Cas9-induced mutations to the 5' exons of candidate genes, but this approach often produces in-frame variants that retain functionality, which can obscure even strong genetic dependencies. Here we overcome this limitation by targeting CRISPR-Cas9 mutagenesis to exons encoding functional protein domains. This generates a higher proportion of null mutations and substantially increases the potency of negative selection. We also show that the magnitude of negative selection can be used to infer the functional importance of individual protein domains of interest. A screen of 192 chromatin regulatory domains in murine acute myeloid leukemia cells identifies six known drug targets and 19 additional dependencies. A broader application of this approach may allow comprehensive identification of protein domains that sustain cancer cells and are suitable for drug targeting.

Bucking the Trend: Is Ethnoracial Diversity Declining in American Communities?

PubMed Central

Lee, Barrett A.; Hughes, Lauren A.

2015-01-01

Although increasing diversity at the national scale is a well-documented trend, substantial variation in patterns of ethnoracial change occurs across American communities. Our research considers one theoretically implied path: that some communities are ‘bucking the trend’, becoming more homogeneous over time. Using 1980 through 2010 decennial census data, we calculate panethnic (five-group) entropy index scores to measure the magnitude of diversity for nearly 11,000 census-defined places. Our results indicate that while certain places reach their diversity peak in 1980 or 1990, they are few in number. Moreover, they experience a variety of post-peak trajectories other than monotonic diversity decline. Decreasing diversity is concentrated in the South and West, among places with higher levels of diversity and larger proportions of Hispanic or black residents at the beginning of the study period. These places exhibit complex shifts in racial-ethnic structure, but Hispanic succession predominates. PMID:26023247

Awake craniotomy: improving the patient's experience.

PubMed

Potters, Jan-Willem; Klimek, Markus

2015-10-01

Awake craniotomy patients are exposed to various stressful stimuli while their attention and vigilance is important for the success of the surgery. We describe several recent findings on the perception of awake craniotomy patients and address nonpharmacological perioperative factors that enhance the experience of awake craniotomy patients. These factors could also be applicable to other surgical patients. Proper preoperative counseling gives higher patient satisfaction and should be individually tailored to the patient. Furthermore, there is a substantial proportion of patients who have significant pain or fear during an awake craniotomy procedure. There is a possibility that this could induce post-traumatic stress disorder or related symptoms. Preoperative preparation is of utmost importance in awake craniotomy patients, and a solid doctor-patient relationship is an important condition. Nonpharmacological intraoperative management should focus on reduction of fear and pain by adaptation of the environment and careful and well considered communication.

Long-term follow-up of children conceived through assisted reproductive technology.

PubMed

Lu, Yue-hong; Wang, Ning; Jin, Fan

2013-05-01

Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced.

42 CFR 51c.303 - Project elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY HEALTH... population including a substantial proportion of individuals of limited English-speaking ability, have developed a plan and made arrangements responsive to the needs of such populations for providing services to...

Research to inform policy on headwater streams: ongoing and future directions

EPA Science Inventory

Headwater streams are the exterior links of stream networks and represent a substantial proportion of U.S. stream miles. Alteration and loss of headwater streams have occurred without an understanding of the potential consequences to larger downstream waterbodies. Recent court ca...

Reinterpretation of Students' Ideas When Reasoning about Particle Model Illustrations

ERIC Educational Resources Information Center

Langbeheim, Elon

2015-01-01

The article, "Using Animations in Identifying General Chemistry Students' Misconceptions and Evaluating Their Knowledge Transfer Relating to Particle Position in Physical Changes" (Smith and Villarreal, 2015), reports that a substantial proportion of undergraduate students expressed misconceived ideas regarding the motion of particles in…

Is acculturation always adverse to Korean immigrant health in the United States?

PubMed

Ra, Chaelin Karen; Cho, Youngtae; Hummer, Robert A

2013-06-01

This study examined the association between individuals' proportion of life spent in the United States and the health status and health behaviors among Korean immigrants aged 25 and above. The analysis is stratified by level of education to test whether a higher proportion of time spent in the United States is associated with poorer health among both less educated and highly educated Korean immigrants. California health interview survey data from 2005 to 2007 were used to estimate logistic regression models of health and health behaviour among Korean immigrants, stratified by educational attainment. The health and health behaviour of less educated Korean immigrants tended to be worse among those with a higher proportion of residence in the United States. However, more highly educated Korean immigrants tended to exhibit lower odds of being unhealthy and lower odds of poor health behavior with a higher proportion of life spent in the United States. Acculturation is not always associated with poorer immigrant health outcomes. A higher proportion of life spent in the United States tends to be associated with more favorable health and health behavior among highly educated Korean immigrants.

Dropout rates and factors associated with dropout from treatment among elderly patients attending the outpatient services of a tertiary care hospital.

PubMed

Grover, Sandeep; Dua, Devakshi; Chakrabarti, Subho; Avasthi, Ajit

2018-01-01

This study aimed to evaluate the "dropout" rates from treatment and associated factors among elderly patients attending a tertiary care psychiatry outpatient facility. Data of 1422 patients aged ≥60 years, attending the walk-in clinic were evaluated. Out of 1422 patients, 406 (28.55%) belonged to the "dropout" group. In the "dropout" group, the age of patients was significantly higher than the followed-up group, and a higher proportion of patients were >70 years old. Significantly lower proportion of patients with diagnosis of depressive disorders belonged to the "dropout" group and significantly higher proportion of patients with "other" diagnoses belonged to the dropped out group. In patients with depressive disorders, a higher proportion of the patients in the "dropout" group were Hindu by religion (68.7% vs. 58.7%; χ 2 = 4.26; P = 0.03). In patients with bipolar disorder, patients in the "dropout" group had significantly higher income (Rs. 13,323 [standard deviation [SD] = 16,769] vs. 5681 [SD = 9422]; t -test value: 2-25; P = 0.028) and lesser proportion of patients were of the male gender (63.15 vs. 86.95%; Mann-Whitney U value = 257.5; P = 0.039). In the group of other diagnoses, a higher proportion of patients in the "dropout" group were currently single (32.3% vs. 18.7%; χ 2 = 4.12; P = 0.042), from rural locality (63.1% vs. 46.72%; χ 2 = 4.33; P = 0.037) and were not prescribed medications (40% vs. 22.4%; χ 2 = 6.05; P = 0.04). Dropout from treatment among elderly patients is associated with higher age, not being prescribed medications, and diagnosis other than the affective disorders, psychotic disorders, and the cognitive disorders.

What population factors influence the decision to donate blood?

PubMed

Hollingsworth, Bruce; Wildman, John

2004-02-01

Donations of blood in most of the developed world are by nonremunerated volunteers. As such factors, which impact upon the motivation of individuals to donate, are critical to achieving a stable supply, we analyze the factors, which influence the decision to donate. Using data on 130,356 [corrected] individuals from 1999 and 2000, we investigate which factors determine the proportion of blood donors in postcode areas. Variables analyzed include blood donation status and sociodemographic characteristics in order to provide information on donation decisions. We find the proportion of donors in an area is significantly increased by higher proportions of women aged 20-29 and 40-49, and of men aged 60-69. Conversely, a higher proportion of males aged 20-29 significantly reduces proportion of donors. Also, a higher proportion of individuals born overseas significantly reduces the proportion of blood donors in an area. To increase supplies, blood collection agencies should target specific groups. Young men and men and women aged 30-49 need to be encouraged to donate. Collection agencies also need to target individuals who are born overseas to participate in the process. Using these results to aid targeting should help to maintain the blood supply.

Distributions of PCB congeners and homologues in white sucker and coho salmon from Lake Michigan

USGS Publications Warehouse

Stapanian, Martin A.; Madenjian, Charles P.; Batterman, Stuart A.; Chernyak, Sergei M.; Edwards, William H.; McIntyre, Peter B.

2018-01-01

We tested the hypothesis of the proportion of higher chlorinated biphenyl (PCB) congeners increasing with increasing trophic level by comparing the respective PCB homologue distributions in an omnivore, white sucker (Catostomus commersoni), and a top predator, coho salmon (Oncorhynchus kisutch), from Lake Michigan. Adult females had the same congener and homologue proportions of total PCB concentration (ΣPCB) as adult males in both species. Hexachlorinated congeners comprised the largest proportion (32%) found in white sucker, followed by heptachlorinated (21%) and octochlorinated (18%) congeners. In contrast, pentachlorinated congeners comprised the largest proportion (33%) of ΣPCB found in coho salmon, followed by hexachlorinated (26%) and tetrachlorinated (24%) congeners. Coho salmon contained significantly higher proportions of tri-, tetra-, and pentachlorinated congeners, whereas white sucker contained significantly higher proportions of hexa- through decachlorinated congeners. Our results were opposite of the hypothesis of greater degree of PCB chlorination with increasing trophic level, and supported the contention that the PCB congener proportions in fish depends mainly on diet, and does not necessarily reflect the trophic level of the fish. Our results also supported the contention that diets do not vary between the sexes in most fish populations.

The earnings of informal carers: wage differentials and opportunity costs.

PubMed

Heitmueller, Axel; Inglis, Kirsty

2007-07-01

A substantial proportion of working age individuals in Britain are looking after sick, disabled or elderly people, often combining their work and caring responsibilities. Previous research has shown that informal care is linked with substantial opportunity costs for the individual due to forgone wages as a result of non-labour market participation. In this paper we show that informal carers exhibit further disadvantages even when participating. Using the British Household Panel Study (BHPS) we decompose wage differentials and show that carers can expect lower returns for a given set of characteristics, with this wage penalty varying along the pay distribution and by gender. Furthermore, opportunity costs from forgone wages and wage penalties are estimated and found to be substantial.

Pharmacogenetics of schizophrenia.

PubMed

Reynolds, Gavin P; Templeman, Lucy A; Godlewska, Beata R

2006-08-01

There is substantial unexplained interindividual variability in the drug treatment of schizophrenia. A substantial proportion of patients respond inadequately to antipsychotic drugs, and many experience limiting side effects. As genetic factors are likely to contribute to this variability, the pharmacogenetics of schizophrenia has attracted substantial effort. The approaches have mainly been limited to association studies of polymorphisms in candidate genes, which have been indicated by the pharmacology of antipsychotic drugs. Although some advances have been made, particularly in understanding the pharmacogenetics of some limiting side effects, genetic prediction of symptom response remains elusive. Nevertheless, with improvements in defining the response phenotype in carefully assessed and homogeneous subject groups, the near future is likely to see the identification of genetic predictors of outcome that may inform the choice of pharmacotherapy.

Agreement between core laboratory and study investigators for imaging scores in a thrombectomy trial.

PubMed

Fahed, Robert; Ben Maacha, Malek; Ducroux, Célina; Khoury, Naim; Blanc, Raphaël; Piotin, Michel; Lapergue, Bertrand

2018-05-14

We aimed to assess the agreement between study investigators and the core laboratory (core lab) of a thrombectomy trial for imaging scores. The Alberta Stroke Program Early CT Score (ASPECTS), the European Collaborative Acute Stroke Study (ECASS) hemorrhagic transformation (HT) classification, and the Thrombolysis In Cerebral Infarction (TICI) scores as recorded by study investigators were compared with the core lab scores in order to assess interrater agreement, using Cohen's unweighted and weighted kappa statistics. There were frequent discrepancies between study sites and core lab for all the scores. Agreement for ASPECTS and ECASS HT classification was less than substantial, with disagreement occurring in more than one-third of cases. Agreement was higher on MRI-based scores than on CT, and was improved after dichotomization on both CT and MRI. Agreement for TICI scores was moderate (with disagreement occurring in more than 25% of patients), and went above the substantial level (less than 10% disagreement) after dichotomization (TICI 0/1/2a vs 2b/3). Discrepancies between scores assessed by the imaging core lab and those reported by study sites occurred in a significant proportion of patients. Disagreement in the assessment of ASPECTS and day 1 HT scores was more frequent on CT than on MRI. The agreement for the dichotomized TICI score (the trial's primary outcome) was substantial, with less than 10% of disagreement between study sites and core lab. NCT02523261, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The influence of differential response on decision-making in child protective service agencies.

PubMed

Janczewski, Colleen E

2015-01-01

Differential response (DR) profoundly changes the decision pathways of public child welfare systems, yet little is known about how DR shapes the experiences of children whose reports receive an investigation rather than an alternate response. Using data from the National Child Abuse and Neglect Data System (NCANDS), this study examined the relationship between DR implementation and decision outcomes in neglect cases, as measured by investigation, substantiation, and removal rates in 297 U.S. counties. Multivariate regression models included county-level measures of child poverty and proportions of African American children. Path analyses were also conducted to identify mediating effects of prior decision points and moderating effects of DR on poverty and race's influence on decision outcomes. Results indicate that compared to non-DR counties, those implementing DR have significantly lower investigation and substantiation rates within county populations but higher substantiation rates among investigated cases. Regression models showed significant reductions in removal rates associated with DR implementation, but these effects became insignificant in path models that accounted for mediation effects of previous decision points. Findings also suggest that DR implementation may reduce the positive association between child poverty rates and investigation rates, but additional studies with larger samples are needed to confirm this moderation effect. Two methods of calculating decision outcomes, population- and decision-based enumeration, were used, and policy and research implications of each are discussed. This study demonstrates that despite their inherit complexity, large administrative datasets such as NCANDS can be used to assess the impact of wide-scale system change across jurisdictions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of nonpharmaceutical interventions to reduce transmission of 2009 pandemic influenza A (pH1N1) in Pennsylvania public schools.

PubMed

Miller, Jeffrey R; Short, Vanessa L; Wu, Henry M; Waller, Kirsten; Mead, Paul; Kahn, Emily; Bahn, Beth A; Dale, Jon W; Nasrullah, Muazzam; Walton, Sabrina E; Urdaneta, Veronica; Ostroff, Stephen; Averhoff, Francisco

2013-04-01

School-based recommendations for nonpharmaceutical interventions (NPIs) were issued in response to the threat of 2009 pandemic influenza A (pH1N1). The implementation and effectiveness of these recommendations has not been assessed. In November 2009, a Web-based survey of all Pennsylvania public schools was conducted to assess the use of recommended NPIs. Overall, 1040 (31%) of 3351 schools participated in the survey. By fall 2009, 820 (84%) of 979 respondents reported that their school had an influenza plan in place, a 44% higher proportion than in the spring 2009 (p < .01). Most schools communicated health messages (eg, staying home when sick), implemented return to school requirements, and made hand sanitizer available. Schools with a spring influenza plan (N = 568) were less likely to report substantial influenza-like illness (ILI) during the fall wave of influenza than the 299 schools without a spring influenza plan (63% vs 71%, p = .02). This association persisted after controlling for schools with substantial ILI in the spring. The reported use of NPIs in participating Pennsylvania public schools improved substantially from spring to fall and was generally consistent with issued recommendations. The proactive implementation of a number of NPIs and the early implementation of communication and education initiatives might have cumulatively reduced the impact of pH1N1 in some schools. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Alternative feeding strategies and potential disease transmission in Wisconsin white-tailed deer

USGS Publications Warehouse

Thompson, A.K.; Samuel, M.D.; VanDeelen, T.R.

2008-01-01

We conducted experimental feeding using 3 feeding methods (pile, spread, trough) and 2 quantities (rationed, ad libitum) of shelled corn to compare deer activity and behavior with control sites and evaluate potential direct and indirect transmission of infectious disease in white-tailed deer (Odocoileus virginianus) in central Wisconsin, USA. Deer use was higher at 2 of the feeding sites than at natural feeding areas (P ??? 0.02). Deer spent a higher proportion of time (P < 0.01) feeding at pile (49%) and spread (61%) treatments than at natural feeding areas (36%). We found higher deer use for rationed than ad libitum feeding quantities and feeding intensity was greatest at rationed piles and lowest at ad libitum spreads. We also observed closer pairwise distances (???0.3 m) among deer when corn was provided in a trough relative to spread (P=0.03). Supplemental feeding poses risks for both direct and indirect disease transmission due to higher deer concentration and more intensive use relative to control areas. Concentrated feeding and contact among deer at feeding sites can also increase risk for disease transmission. Our results indicated that restrictions on feeding quantity would not mitigate the potential for disease transmission None of the feeding strategies we evaluated substantially reduced the potential risk for disease transmission and banning supplemental feeding to reduce transmission is warranted.

A submerged tubular ceramic membrane bioreactor for high strength wastewater treatment.

PubMed

Sun, D D; Zeng, J L; Tay, J H

2003-01-01

A 4 L submerged tubular ceramic membrane bioreactor (MBR) was applied in laboratory scale to treat 2,400 mg-COD/L high strength wastewater. A prolonged sludge retention time (SRT) of 200 day, in contrast to the conventional SRT of 5 to 15 days, was explored in this study, aiming to reduce substantially the amount of disposed sludge. The MBR system was operated for a period of 142 days in four runs, differentiated by specific oxygen utilization rate (SOUR) and hydraulic retention time (HRT). It was found that the MBR system produced more than 99% of suspended solid reduction. Mixed liquor suspended solids (MLSS) was found to be adversely proportional to HRT, and in general higher than the value from a conventional wastewater treatment plant. A chemical oxygen demand (COD) removal efficiency was achieved as high as 98% in Run 1, when SOUR was in the range of 100-200 mg-O/g-MLVSS/hr. Unexpectedly, the COD removal efficiency in Run 2 to 4 was higher than 92%, on average, where higher HRT and abnormally low SOUR of 20-30 mg-O/g-MLVSS/hr prevailed. It was noted that the ceramic membrane presented a significant soluble nutrient rejection when the microbial metabolism of biological treatment broke down.

Assessing Ongoing Electronic Resource Purchases: Linking Tools to Synchronize Staff Workflows

ERIC Educational Resources Information Center

Carroll, Jeffrey D.; Major, Colleen; O'Neal, Nada; Tofanelli, John

2012-01-01

Ongoing electronic resource purchases represent a substantial proportion of collections budgets. Recognizing the necessity of systematic ongoing assessment with full selector engagement, Columbia University Libraries appointed an Electronic Resources Assessment Working Group to promote the inclusion of such resources within our current culture of…

Continued pheromone release by boll weevils (Coleoptera: curculionidae) following host removal

USDA-ARS?s Scientific Manuscript database

Pheromone traps are a key component of management and eradication programs directed against the boll weevil, Anthonomus grandis (Boheman), but trap data remain difficult to interpret because of the day-to-day variability in captures. Our prior observations suggested a substantial proportion of boll...

Microbiological Consequences of Different Housing Systems for Laying Hens: Field and Experimental Infection Studies

USDA-ARS?s Scientific Manuscript database

A significant proportion of human illnesses caused by Salmonella are linked to the consumption of contaminated eggs. In response, substantial government and private industry resources are committed to comprehensive Salmonella testing and risk reduction programs for commercial egg-laying flocks. Envi...

Accuracy of Surgery Clerkship Performance Raters.

ERIC Educational Resources Information Center

Littlefield, John H.; And Others

1991-01-01

Interrater reliability in numerical ratings of clerkship performance (n=1,482 students) in five surgery programs was studied. Raters were classified as accurate or moderately or significantly stringent or lenient. Results indicate that increasing the proportion of accurate raters would substantially improve the precision of class rankings. (MSE)

Evaluation of the reach and impact of the 100% Jeune youth social marketing program in Cameroon: findings from three cross-sectional surveys.

PubMed

Plautz, Andrea; Meekers, Dominique

2007-02-26

The 100% Jeune youth social marketing program in Cameroon aims to address the high STI/HIV prevalence rates and the high levels of unwanted pregnancy. This study evaluates the 100% Jeune program, analyzing its reach and impact on condom use, level of sexual activity, and predictors of condom use. This analysis uses data from three waves of the Cameroon Adolescent Reproductive Health Survey, implemented at 18-month intervals between 2000 and 2003. The sample is restricted to unmarried youth aged 15-24; sample sizes are 1,956 youth in 2000, 3,237 in 2002, and 3,370 in 2003. Logistic regression analyses determine trends in reproductive health behavior and their predictors, as well as estimate the effect of program exposure on these variables. All regression analyses control for differences in sample characteristics. A comparison of trends over the 36-month study period shows that substantial positive changes occurred among youth. Results of dose response analyses indicate that some of these positive changes in condom use and predictors of use can be attributed to the 100% Jeune youth social marketing program. The program contributed to substantial increases in condom use, including consistent use with regular partners among youth of both sexes. Among males, it also contributed to consistent use with casual partners. While condom use increased with both regular and casual partners, levels of use are higher with the latter. Observed secular trends indicate that factors besides the 100% Jeune program also contributed to the observed improvements. Despite efforts to promote abstinence, the 100% Jeune program had no effect on levels of sexual activity or number of sexual partners. Likewise, there is no evidence that reproductive health programs for youth lead to increased sexual activity. Results show that 100% Jeune successfully used a variety of mass media and interpersonal communication channels to reach a high proportion of youth throughout the intervention period. In a context in which a variety of governmental and nongovernmental partners are increasing youth-focused reproductive health programming, the 100% Jeune program reached a higher proportion of youth than did other programs. Collective efforts of multiple organizations over time can lead to improvements in adolescent reproductive health. Resources should be allocated to identify and understand predictors of abstinence and partner reduction to inform future programming decisions.

Demographic variation in incidence of adult glioma by subtype, United States, 1992-2007.

PubMed

Dubrow, Robert; Darefsky, Amy S

2011-07-29

We hypothesized that race/ethnic group, sex, age, and/or calendar period variation in adult glioma incidence differs between the two broad subtypes of glioblastoma (GBM) and non-GBM. Primary GBM, which constitute 90-95% of GBM, differ from non-GBM with respect to a number of molecular characteristics, providing a molecular rationale for these two broad glioma subtypes. We utilized data from the Surveillance, Epidemiology, and End Results Program for 1992-2007, ages 30-69 years. We compared 15,088 GBM cases with 9,252 non-GBM cases. We used Poisson regression to calculate adjusted rate ratios and 95% confidence intervals. The GBM incidence rate increased proportionally with the 4th power of age, whereas the non-GBM rate increased proportionally with the square root of age. For each subtype, compared to non-Hispanic Whites, the incidence rate among Blacks, Asians/Pacific Islanders, and American Indians/Alaskan Natives was substantially lower (one-fourth to one-half for GBM; about two-fifths for non-GBM). Secondary to this primary effect, race/ethnic group variation in incidence was significantly less for non-GBM than for GBM. For each subtype, the incidence rate was higher for males than for females, with the male/female rate ratio being significantly higher for GBM (1.6) than for non-GBM (1.4). We observed significant calendar period trends of increasing incidence for GBM and decreasing incidence for non-GBM. For the two subtypes combined, we observed a 3% decrease in incidence between 1992-1995 and 2004-2007. The substantial difference in age effect between GBM and non-GBM suggests a fundamental difference in the genesis of primary GBM (the driver of GBM incidence) versus non-GBM. However, the commonalities between GBM and non-GBM with respect to race/ethnic group and sex variation, more notable than the somewhat subtle, albeit statistically significant, differences, suggest that within the context of a fundamental difference, some aspects of the complex process of gliomagenesis are shared by these subtypes as well. The increasing calendar period trend of GBM incidence coupled with the decreasing trend of non-GBM incidence may at least partly be due to a secular trend in diagnostic fashion, as opposed to real changes in incidence of these subtypes.

Evaluation of the reach and impact of the 100% Jeune youth social marketing program in Cameroon: findings from three cross-sectional surveys

PubMed Central

Plautz, Andrea; Meekers, Dominique

2007-01-01

Background The 100% Jeune youth social marketing program in Cameroon aims to address the high STI/HIV prevalence rates and the high levels of unwanted pregnancy. This study evaluates the 100% Jeune program, analyzing its reach and impact on condom use, level of sexual activity, and predictors of condom use. Methods This analysis uses data from three waves of the Cameroon Adolescent Reproductive Health Survey, implemented at 18-month intervals between 2000 and 2003. The sample is restricted to unmarried youth aged 15–24; sample sizes are 1,956 youth in 2000, 3,237 in 2002, and 3,370 in 2003. Logistic regression analyses determine trends in reproductive health behavior and their predictors, as well as estimate the effect of program exposure on these variables. All regression analyses control for differences in sample characteristics. Results A comparison of trends over the 36-month study period shows that substantial positive changes occurred among youth. Results of dose response analyses indicate that some of these positive changes in condom use and predictors of use can be attributed to the 100% Jeune youth social marketing program. The program contributed to substantial increases in condom use, including consistent use with regular partners among youth of both sexes. Among males, it also contributed to consistent use with casual partners. While condom use increased with both regular and casual partners, levels of use are higher with the latter. Observed secular trends indicate that factors besides the 100% Jeune program also contributed to the observed improvements. Despite efforts to promote abstinence, the 100% Jeune program had no effect on levels of sexual activity or number of sexual partners. Likewise, there is no evidence that reproductive health programs for youth lead to increased sexual activity. Conclusion Results show that 100% Jeune successfully used a variety of mass media and interpersonal communication channels to reach a high proportion of youth throughout the intervention period. In a context in which a variety of governmental and nongovernmental partners are increasing youth-focused reproductive health programming, the 100% Jeune program reached a higher proportion of youth than did other programs. Collective efforts of multiple organizations over time can lead to improvements in adolescent reproductive health. Resources should be allocated to identify and understand predictors of abstinence and partner reduction to inform future programming decisions. PMID:17324289

Comparison of text messaging data collection vs face-to-face interviews for public health surveys: a cluster randomized crossover study of care-seeking for childhood pneumonia and diarrhoea in rural China.

PubMed

van Velthoven, Michelle Helena; Wang, Wei; Wu, Qiong; Li, Ye; Scherpbier, Robert W; Du, Xiaozhen; Chen, Li; Zhang, Yanfeng; Car, Josip; Rudan, Igor

2018-06-01

To compare text messaging and face-to-face interviews to conduct a survey on childhood diarrhoea and pneumonia. Caregivers of young children able to send text messages in Zhao County in rural China were included in this crossover study. Villages (clusters) were randomized into two groups using the ratio 1:1.6 to account for an expected higher drop-out in group 2. In group 1, participants first completed the face-to-face and then text messaging survey; this order was reversed in group 2. We determined data equivalence of 17 questions that were answered by participants who were the same person in both surveys. For the text messaging survey, we assessed the overall and item response rate. We included 1014 participants between 16 and 28 March 2013: 371 in 15 villages in group 1 and 643 in 27 villages in group 2. A total of 662 (65.3%) out of 1014 participants responded (first text message question) and a significantly higher proportion who did not respond were from rural areas ( P  = 0.005). Of 651 participants willing to participate, 356 (54.7%) completed the text messaging survey, which was marginally significantly different between the groups ( P  = 0.05). In total, 409 participants took part in both surveys: 183 in group 1 and 226 in group 2. There was a significantly higher proportion of caregivers from rural areas in Zhao County in the non-responder group compared to the responder group ( P  = 0.004). Kappas were substantial for six (0.61-0.80), moderate for two (0.58 and 0.60), and fair for three questions (0.31, 0.35 and 0.37). The proportion of agreement was >90% for five questions; 80.0%-90.0% for five questions; 70.0%, 65.0% and 45.5%. The remaining questions had too small numbers to calculate these values. This study shows that text messaging data collection produces data similar to data from face-to-face interviews in a middle-income setting, but the response rate was insufficient for use in public health surveys. Improving the response rate is important, because text message surveys could be of greater value in rural remote areas due to the cost-saving potential.

Education and employment outcomes of young adults with a history of developmental language disorder

PubMed Central

Durkin, Kevin; Toseeb, Umar; Botting, Nicola; Pickles, Andrew

2017-01-01

Abstract Background Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes. Aims To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age‐matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes? Methods & Procedures Participants included 84 individuals with DLD (67% males) and 88 age‐matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income. Outcomes & Results Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age‐matched peers was in work full time. Participants with DLD were much more likely to be in non‐professional occupations. However, when examining pay in relation to types of occupation, the groups’ incomes were broadly comparable. Conclusions & Implications At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD. PMID:29139196

Estimating the prevalence and intensity of Schistosoma mansoni infection among rural communities in Western Tanzania: The influence of sampling strategy and statistical approach

PubMed Central

Bakuza, Jared S.; Denwood, Matthew J.; Nkwengulila, Gamba

2017-01-01

Background Schistosoma mansoni is a parasite of major public health importance in developing countries, where it causes a neglected tropical disease known as intestinal schistosomiasis. However, the distribution of the parasite within many endemic regions is currently unknown, which hinders effective control. The purpose of this study was to characterize the prevalence and intensity of infection of S. mansoni in a remote area of western Tanzania. Methodology/Principal findings Stool samples were collected from 192 children and 147 adults residing in Gombe National Park and four nearby villages. Children were actively sampled in local schools, and adults were sampled passively by voluntary presentation at the local health clinics. The two datasets were therefore analysed separately. Faecal worm egg count (FWEC) data were analysed using negative binomial and zero-inflated negative binomial (ZINB) models with explanatory variables of site, sex, and age. The ZINB models indicated that a substantial proportion of the observed zero FWEC reflected a failure to detect eggs in truly infected individuals, meaning that the estimated true prevalence was much higher than the apparent prevalence as calculated based on the simple proportion of non-zero FWEC. For the passively sampled data from adults, the data were consistent with close to 100% true prevalence of infection. Both the prevalence and intensity of infection differed significantly between sites, but there were no significant associations with sex or age. Conclusions/Significance Overall, our data suggest a more widespread distribution of S. mansoni in this part of Tanzania than was previously thought. The apparent prevalence estimates substantially under-estimated the true prevalence as determined by the ZINB models, and the two types of sampling strategies also resulted in differing conclusions regarding prevalence of infection. We therefore recommend that future surveillance programmes designed to assess risk factors should use active sampling whenever possible, in order to avoid the self-selection bias associated with passive sampling. PMID:28934206

Cancer incidence attributable to lifestyle and environmental factors in Alberta in 2012: summary of results

PubMed Central

Grundy, Anne; Poirier, Abbey E.; Khandwala, Farah; Grevers, Xin; Friedenreich, Christine M.; Brenner, Darren R.

2017-01-01

Background: Estimates of the proportion of cancer cases that can be attributed to modifiable risk factors are not available for Canada and, more specifically, Alberta. The purpose of this study was to estimate the total proportion of cancer cases in Alberta in 2012 that could be attributed to a set of 24 modifiable lifestyle and environmental risk factors. Methods: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre intake, excess red and processed meat consumption, salt consumption, inadequate calcium and vitamin D intake], alcohol, hormones [oral contraceptives and hormone therapy], infections [Epstein-Barr virus, hepatitis B and C viruses, human papillomavirus, Helicobacter pylori], air pollution, natural and artificial ultraviolet radiation, radon and water disinfection by-products) by combining population attributable risk estimates for each of the 24 factors that had been previously estimated. To account for the possibility that individual cancer cases were the result of a combination of multiple risk factors, we subtracted the population attributable risk for the first factor from 100% and then applied the population attributable risk for the second factor to the remaining proportion that was not attributable to the first factor. We repeated this process in sequential order for all relevant exposures. Results: Overall, an estimated 40.8% of cancer cases in Alberta in 2012 were attributable to modifiable lifestyle and environmental risk factors. The largest proportion of cancers were estimated to be attributable to tobacco smoking, physical inactivity and excess body weight. The summary population attributable risk estimate was slightly higher among women (42.4%) than among men (38.7%). Interpretation: About 41% of cancer cases in Alberta may be attributable to known modifiable lifestyle and environmental risk factors. Reducing the prevalence of these factors in the Alberta population has the potential to substantially reduce the provincial cancer burden. PMID:28687643

Urolithiasis in dogs. II: Breed prevalence, and interrelations of breed, sex, age, and mineral composition.

PubMed

Ling, G V; Franti, C E; Ruby, A L; Johnson, D L

1998-05-01

To analyze selected breed-related data for canine urinary calculi. 11,000 specimens: 5,781 from female dogs, 5,215 from males, and 4 from dogs of unrecorded sex. Information was compiled for all canine urinary calculi submitted between July 1981 and January 1994. Results for a mixed-breed group and 26 of the most common breeds of stone-forming dogs were analyzed. Interrelations of breed, sex, and age of affected dogs and mineral composition of the specimens were determined. Prevalence of 5 specific mineral types was significantly correlated between the sexes of 27 common breed groups: struvite, calcium phosphate (apatite), calcium oxalate, brushite, and urate. Struvite-containing calculi were seen in high proportions in both sexes of 7 breeds, and in low proportions in both sexes of 7 other breeds. Male and female Lhasa Apsos, Cairn Terriers, and 5 other breeds had high proportions of oxalate-containing calculi; values in males were substantially higher. Low numbers of oxalate-containing calculi were seen in both sexes of 7 breeds; Dalmatians had the lowest numbers. Males and females of 6 breeds had high numbers of urate-containing calculi, Dalmatians and English Bulldogs had the highest numbers. Low amounts of urate were found in calculi from males and females of 6 breeds, Samoyeds had the lowest numbers. Highest proportions of cystine-containing calculi were seen in male Dachshunds, English Bulldogs, and Chihuahuas. Males of 8 breeds had no specimens that contained cystine; only 2 such specimens were obtained from females. Prevalence of uroliths differs among breed, age, and sex of affected dogs. Breed, sex, and age of dogs; mineral types of calculi in males versus females; and their anatomic location within the tract are important considerations for clinicians when evaluating risk in dogs with urolithiasis and in identifying areas that need further in-depth applied or clinical investigation, or both.

Implications from Under-reporting at Lifetime, Death Certificate Notifications and Trace-back on the Recorded Incidence of a "Newly" Established Population-based Cancer Registry.

PubMed

Holleczek, B; Brenner, H

2016-01-01

Population-based cancer registries (CRs) are powerful tools for measuring cancer burden and progress against cancer. The study's objective was to investigate the effects of under-reporting at lifetime, death certificate notifications, and trace-back on the incidence a newly established population-based CR may record during its initial 15 years of operation. Using cancer data of nine CRs of the SEER programme we performed model calculations to investigate temporal trends of the recorded incidence that might be expected if registration started in 1995 with gradually increasing proportions of cancers reported to the CR. It was assumed that the CR obtains all death certificates providing cancer as the underlying cause of death. Different scenarios with regard to the development of the proportions of cancers reported to the CR and the use of trace-back were evaluated. Our model calculations demonstrated that the inclusion of cancers notified from death certificates which were diagnosed prior to the start of registration and which attribute to the incidence estimates of the year of death ('prevalent' cases) may compensate under-reporting typically observed right after the start of a CR. The recorded incidence may even be overestimated during the first years of registration, if large amounts of prevalent cancers are notified from death certificates (e.g. overestimation of lung cancer incidence by 8% and 21% in the first year of registration, if the proportions of cases reported were 50% and 70% in that year, overestimation of myeloma incidence still exceeding 5% after eight years of registration, if the proportion of cases reported to the CR had reached 97.5% after six years). Trace-back may effectively reduce the recorded surplus cancer cases. During the initial years of registration, the inclusion of prevalent cancers from death certificates may compensate the higher amount of underreporting right after the start of a CR. Accurate incidence estimates may nevertheless be observed for highly fatal cancers if substantial proportions of cancer cases are missed at lifetime, however apparent incidence trends observed in the initial years of registration need to be interpreted with caution.

Examining Minor and Major Depression in Adolescents

ERIC Educational Resources Information Center

Gonzalez-Tejera, Gloria; Canino, Glorisa; Ramirez, Rafael; Chavez, Ligia; Shrout, Patrick; Bird, Hector; Bravo, Milagros; Martinez-Taboas, Alfonso; Ribera, Julio; Bauermeister, Jose

2005-01-01

Background: Research has shown that a large proportion of adolescents with symptoms of depression and substantial distress or impairment fail to meet the diagnostic criteria for a major depressive disorder (MDD). However, many of these undiagnosed adolescents may meet criteria for a residual category of the "Diagnostic and Statistical Manual of…

14 CFR 25.177 - Static lateral-directional stability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Static lateral-directional stability. 25.177 Section 25.177 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... movements and forces must be substantially proportional to the angle of sideslip in a stable sense; and the...

14 CFR 25.177 - Static lateral-directional stability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Static lateral-directional stability. 25.177 Section 25.177 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... movements and forces must be substantially proportional to the angle of sideslip in a stable sense; and the...

A Needs Assessment of Older Persons.

ERIC Educational Resources Information Center

Puglisi, J. Thomas; And Others

In response to a request from the Charlotte-Mecklenburg Council on Aging, structured interviews were conducted with a random sample of 388 older persons in Charlotte, North Carolina, to assess their needs in the areas of health, transportation, housing, nutrition, information referral, and social participation. A substantial proportion of those…

Labor Force Experience of Women from "Generation X."

ERIC Educational Resources Information Center

DiNatale, Marisa; Boraas, Stephanie

2002-01-01

In 2000, women aged 25-34 years participated in the labor force in greater proportions, were more educated, earned more, and enjoyed more labor market benefits than their counterparts 25 years earlier. The earnings gap between young women and men narrowed substantially during the period. (Contains 18 references.) (Author)

School Injury among Ottawa-Area Children: A Population-Based Study

ERIC Educational Resources Information Center

Josse, Jonathan M.; MacKay, Morag; Osmond, Martin H.; MacPherson, Alison K.

2009-01-01

Background: Injuries are the leading cause of death among Canadian children and are responsible for a substantial proportion of hospitalizations and emergency department visits. This investigation sought to identify the factors associated with the likelihood of sustaining an injury at school among Ottawa-area children. Methods: Children presenting…

Finding Funds for Kids.

ERIC Educational Resources Information Center

Shorey, Clyde E., Jr.

Fund raising should be considered a major part of the business of every voluntary organization, even if the organization has relatively small fund raising goals. Voluntary agencies concerned with children should keep in mind the following: (1) public fund raising campaigns can provide a substantial proportion of the funding requirements of many…

Just Who Are These International Students Anyway?

ERIC Educational Resources Information Center

Allameh, Joy

Foreign students enrolled in U.S. colleges and universities form a substantial proportion of the student population. The majority of these students come from Asia and most often choose to study business, management, and engineering. The number of female foreign students is rising. The foreign student population has special educational, social, and…

What Determines Student Acceptance of Politically Controversial Scientific Conclusions?

ERIC Educational Resources Information Center

Walker, J. D.; Wassenberg, Deena; Franta, Gabriel; Cotner, Sehoya

2017-01-01

Certain scientific conclusions are controversial, in that they are rejected by a substantial proportion of nonscientists despite an overwhelming scientific consensus. Science educators are motivated to help students understand the evidence behind the scientific consensus on these matters and to move students' views into alignment with those held…

Correlates of Social Support and Its Association with Physical Activity among Young Adolescents

ERIC Educational Resources Information Center

Gill, Monique; Chan-Golston, Alec M.; Rice, Lindsay N.; Roth, Sarah E.; Crespi, Catherine M.; Cole, Brian L.; Koniak-Griffin, Deborah; Prelip, Michael L.

2018-01-01

Background: A substantial proportion of adolescents, particularly girls and minority youth, fail to meet daily physical activity (PA) recommendations. Social support contributes to adolescent PA, but studies examining this relationship have yielded inconsistent results and rarely focus on diverse, urban populations. Aims: This study examines the…

Gender Differences in Science Career Choice.

ERIC Educational Resources Information Center

Zewotir, Temesgen

Although a number of female students in the entry-level of tertiary education has increased substantially in recent years, the proportion of incoming females in the fields of science and technology is low. Government and non-government organizations encourage females to enter tertiary level education for career development. However, judging by…

An Autistic Dimension: A Proposed Subtype of Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Bejerot, Susanne

2007-01-01

This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive…

Knowledge of Traumatic Brain Injury among Educators

ERIC Educational Resources Information Center

Ernst, William J.; Gallo, Adrienne B.; Sellers, Amanda L.; Mulrine, Jessica; MacNamara, Luciana; Abrahamson, Allison; Kneavel, Meredith

2016-01-01

The purpose of this study is to determine knowledge of traumatic brain injury among educators. Few studies have examined knowledge of traumatic brain injury in this population and fewer still have included a substantial proportion of general education teachers. Examining knowledge of traumatic brain injury in educators is important as the vast…

WIOA: Implications for Low-Scoring Adult Learners

ERIC Educational Resources Information Center

Pickard, Amy

2016-01-01

A substantial proportion of participants in public adult education programs struggle with "basic" academic print literacy skills. According to the 2014-2015 National Reporting System (NRS) data, 48.7% of the national adult basic education/adult secondary education (ABE/ ASE) population tested as reading at or below the "Low…

The Quality of Life in China

ERIC Educational Resources Information Center

Shu, Xiaoling; Zhu, Yifei

2009-01-01

The Asia Barometer Survey of 2,000 respondents reveals that substantial majorities of the Chinese people experience feelings of happiness, enjoyment, and accomplishment. In fact, the proportion experiencing these indicators of a high quality of life are larger in China than in some more prosperous countries. Favorable historical comparison,…

Spatial analysis of the tuberculosis treatment dropout, Buenos Aires, Argentina

PubMed Central

Herrero, María Belén; Arrossi, Silvina; Ramos, Silvina; Braga, Jose Ueleres

2015-01-01

OBJECTIVE Identify spatial distribution patterns of the proportion of nonadherence to tuberculosis treatment and its associated factors. METHODS We conducted an ecological study based on secondary and primary data from municipalities of the metropolitan area of Buenos Aires, Argentina. An exploratory analysis of the characteristics of the area and the distributions of the cases included in the sample (proportion of nonadherence) was also carried out along with a multifactor analysis by linear regression. The variables related to the characteristics of the population, residences and families were analyzed. RESULTS Areas with higher proportion of the population without social security benefits (p = 0.007) and of households with unsatisfied basic needs had a higher risk of nonadherence (p = 0.032). In addition, the proportion of nonadherence was higher in areas with the highest proportion of households with no public transportation within 300 meters (p = 0.070). CONCLUSIONS We found a risk area for the nonadherence to treatment characterized by a population living in poverty, with precarious jobs and difficult access to public transportation. PMID:26270011

Spatial analysis of the tuberculosis treatment dropout, Buenos Aires, Argentina.

PubMed

Herrero, María Belén; Arrossi, Silvina; Ramos, Silvina; Braga, Jose Ueleres

2015-01-01

OBJECTIVE Identify spatial distribution patterns of the proportion of nonadherence to tuberculosis treatment and its associated factors. METHODS We conducted an ecological study based on secondary and primary data from municipalities of the metropolitan area of Buenos Aires, Argentina. An exploratory analysis of the characteristics of the area and the distributions of the cases included in the sample (proportion of nonadherence) was also carried out along with a multifactor analysis by linear regression. The variables related to the characteristics of the population, residences and families were analyzed. RESULTS Areas with higher proportion of the population without social security benefits (p = 0.007) and of households with unsatisfied basic needs had a higher risk of nonadherence (p = 0.032). In addition, the proportion of nonadherence was higher in areas with the highest proportion of households with no public transportation within 300 meters (p = 0.070). CONCLUSIONS We found a risk area for the nonadherence to treatment characterized by a population living in poverty, with precarious jobs and difficult access to public transportation.

Progress and challenges in maternal health in western China: a Countdown to 2015 national case study.

PubMed

Gao, Yanqiu; Zhou, Hong; Singh, Neha S; Powell-Jackson, Timothy; Nash, Stephen; Yang, Min; Guo, Sufang; Fang, Hai; Alvarez, Melisa Martinez; Liu, Xiaoyun; Pan, Jay; Wang, Yan; Ronsmans, Carine

2017-05-01

China is one of the few Countdown countries to have achieved Millennium Development Goal 5 (75% reduction in maternal mortality ratio between 1990 and 2015). We aimed to examine the health systems and contextual factors that might have contributed to the substantial decline in maternal mortality between 1997 and 2014. We chose to focus on western China because poverty, ethnic diversity, and geographical access represent particular challenges to ensuring universal access to maternal care in the region. In this systematic assessment, we used data from national census reports, National Statistical Yearbooks, the National Maternal and Child Health Routine Reporting System, the China National Health Accounts report, and National Health Statistical Yearbooks to describe changes in policies, health financing, health workforce, health infrastructure, coverage of maternal care, and maternal mortality by region between 1997 and 2014. We used a multivariate linear regression model to examine which contextual and health systems factors contributed to the regional variation in maternal mortality ratio in the same period. Using data from a cross-sectional survey in 2011, we also examined equity in access to maternity care in 42 poor counties in western China. Maternal mortality declined by 8·9% per year between 1997 and 2014 (geometric mean ratio for each year 0·91, 95% CI 0·91-0·92). After adjusting for GDP per capita, length of highways, female illiteracy, the number of licensed doctors per 1000 population, and the proportion of ethnic minorities, the maternal mortality ratio was 118% higher in the western region (2·18, 1·44-3·28) and 41% higher in the central region (1·41, 0·99-2·01) than in the eastern region. In the rural western region, the proportion of births in health facilities rose from 41·9% in 1997 to 98·4% in 2014. Underpinning such progress was the Government's strong commitment to long-term strategies to ensure access to delivery care in health facilities-eg, professionalisation of maternity care in large hospitals, effective referral systems for women medically or socially at high risk, and financial subsidies for antenatal and delivery care. However, in the poor western counties, substantial disparity by education level of the mother existed in access to health facility births (44% of illiterate women vs 100% of those with college or higher education), antenatal care (17% vs 69%) had at least four visits), and caesarean section (8% vs 44%). Despite remarkable progress in maternal survival in China, substantial disparities remain, especially for the poor, less educated, and ethnic minority groups in remote areas in western China. Whether China's highly medicalised model of maternity care will be an answer for these populations is uncertain. A strategy modelled after China's immunisation programme, whereby care is provided close to the women's homes, might need to be explored, with township hospitals taking a more prominent role. Government of Canada, UNICEF, and the Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

[A gender comparison of legal and illicit drug consumption].

PubMed

Rodríguez, Jorge; Hernández, Enrique; Fernández, Ana María

2007-04-01

It is possible that men consume a higher amount of legal and illegal drugs than women. This can be assessed using the peer methodology, that is an adaptation of the privileged access interviewers (PAI) method and allows to identify populations in which there may be a tendency to under state a phenomenon (hidden populations) To compare the consumption of legal and illegal drugs by gender. Drug consumption was assessed using a peer methodology in university students between 18 and 26 years of age. A random sample of 56 women (mean age 21.6 years) and 86 men (mean age 21.5 years), was studied. Women tended to report a higher proportion of tobacco consumption than men. Both genders had a similar consumption behavior of alcohol, total legal drugs, marihuana, cocaine, ecstasies and total illegal drugs. Among subjects that recognized the consumption of legal drugs, men have a higher proportion of illicit drug use and women have a higher proportion of smoking. Men have a higher awareness of the damages caused by drug consumption. The results in these small population sample do not support the hypothesis that men have a higher frequency and proportion of illicit drug consumption.

Attaining the canopy in dry and moist tropical forests: strong differences in tree growth trajectories reflect variation in growing conditions

PubMed Central

Zuidema, Pieter A.; Martínez-Ramos, Miguel

2009-01-01

Availability of light and water differs between tropical moist and dry forests, with typically higher understorey light levels and lower water availability in the latter. Therefore, growth trajectories of juvenile trees—those that have not attained the canopy—are likely governed by temporal fluctuations in light availability in moist forests (suppressions and releases), and by spatial heterogeneity in water availability in dry forests. In this study, we compared juvenile growth trajectories of Cedrela odorata in a dry (Mexico) and a moist forest (Bolivia) using tree rings. We tested the following specific hypotheses: (1) moist forest juveniles show more and longer suppressions, and more and stronger releases; (2) moist forest juveniles exhibit wider variation in canopy accession pattern, i.e. the typical growth trajectory to the canopy; (3) growth variation among dry forest juveniles persists over longer time due to spatial heterogeneity in water availability. As expected, the proportion of suppressed juveniles was higher in moist than in dry forest (72 vs. 17%). Moist forest suppressions also lasted longer (9 vs. 5 years). The proportion of juveniles that experienced releases in moist forest (76%) was higher than in dry forest (41%), and releases in moist forests were much stronger. Trees in the moist forest also had a wider variation in canopy accession patterns compared to the dry forest. Our results also showed that growth variation among juvenile trees persisted over substantially longer periods of time in dry forest (>64 years) compared to moist forest (12 years), most probably because of larger persistent spatial variation in water availability. Our results suggest that periodic increases in light availability are more important for attaining the canopy in moist forests, and that spatial heterogeneity in water availability governs long-term tree growth in dry forests. Electronic supplementary material The online version of this article (doi:10.1007/s00442-009-1540-5) contains supplementary material, which is available to authorized users. PMID:20033820

Prevalence and outcome of patients with non-ST segment elevation myocardial infarction with occluded "culprit" artery - a systemic review and meta-analysis.

PubMed

Hung, Chi-Sheng; Chen, Ying-Hsien; Huang, Ching-Chang; Lin, Mao-Shin; Yeh, Chih-Fan; Li, Hung-Yuan; Kao, Hsien-Li

2018-02-09

The aim was to determine the prevalence and impact of an occluded "culprit" artery (OCA) in patients with non-ST segment elevation myocardial infarction (NSTEMI). We searched PubMed, EMBASE, and Web of Science, with no language restrictions, up to 1 Jul. 2016. Observational cohorts or clinical trials of adult NSTEMI were eligible for inclusion to determine the prevalence if the proportion of OCA on coronary angiography was reported. Studies were further eligible for inclusion to determine the outcome if the association between OCA and clinical endpoints was reported. Among the 60,898 patients with NSTEMI enrolled in 25 studies, 17,212 were found to have OCA. The average proportion of OCA in NSTEMI was 34% (95% CI 30-37%). Patients with OCA were more likely to have left circumflex artery as their culprit artery (odds ratio (OR) 1.65, 95% CI 1.15-2.37, p = 0.007), and this was associated with lower left ventricular ejection fraction (standard mean difference -0.29, 95% CI -0.34 to -0.34, p < 0.001), higher peak enzyme level (standard mean difference 0.43, 95% CI 0.27-0.58, p < 0.001), and higher risk for cardiogenic shock (OR 1.66, 95% CI 1.35-2.04, p < 0.001), compared with patients with a non-occlusive culprit artery. Death rate (OR 1.72, 95% CI 1.49-1.98, p < 0.001) and recurrent myocardial infarction (OR 1.7, 95% CI 1.06-2.75, p = 0.029) were also higher in patients with OCA, compared with patients with a non-occlusive culprit artery. Patients with OCA comprised a substantial portion of the NSTEMI population. These patients present with more severe symptoms and worse clinical outcome. Whether these patients should be treated with more aggressive strategy warrants further study.

Family free-play interaction: the role of the patient in the family interaction.

PubMed

Baldwin, C P; Baldwin, A L; Cole, R E; Kokes, R F

1982-01-01

We have discussed the salient features of the family interaction in the free-play situation: the high rate of interaction with the child and general predominance of parental initiations in the parent-child interaction, the high correlation among all dyads on warmth. This led to the selection of three variables for study: rate of patient-child interaction, proportion of parental initiations to the child, and family warmth. There are major age changes: rate and proportion both decline with age. The patient's rate of interaction with the child and his proportion of interaction is lower than the spouse's rate. This holds for the 4- and 10-year-olds separately. We have tried to account for its reversal in the 7-year-old sample. Nonpsychotic patients have a higher rate of interaction, higher proportion of interactions, and higher family warmth than psychotics. Affectivity shows no relationship to these variables. Patients with a low global assessment score have lower rates, lower proportion, and less warmth than patients with a higher score. Patients who have been recently hospitalized have a lower rate of interactions with their sons than those who have been hospitalized longer.

Does Racial Isolation in School Lead to Long-Term Disadvantages? Labor Market Consequences of High School Racial Composition.

PubMed

Gamoran, Adam; Barfels, Sarah; Collares, Ana Cristina

2016-01-01

School racial composition has modest effects on test score gaps, but evidence of a longer-term impact is scarce. Perpetuation theory suggests that blacks who attend schools with higher proportions of white classmates may have better job outcomes. Multilevel analyses of two national longitudinal surveys reveal no effects of high school racial composition on occupational status, employment, or annual earnings for blacks or whites. For other minority groups, attending schools with more whites impedes occupational advancement. For all groups, however, school racial composition predicts workplace racial composition: Whites who attend high schools with higher proportions of white students have higher proportions of white coworkers, while nonwhites who attend schools with higher proportions of whites have fewer same-race coworkers. The findings are modest in size but robust to alternative specifications, and sensitivity analyses support a causal interpretation for same-race coworkers. These results support perpetuation theory for workplace composition but not for stratification outcomes.

Prognostic determinants of community-acquired bloodstream infection in type 2 diabetic patients in ED.

PubMed

Yo, Chia-Hung; Lee, Meng-Tse Gabriel; Gi, Weng-Tein; Chang, Shy-Shin; Tsai, Kuang-Chau; Chen, Shyr-Chyr; Lee, Chien-Chang

2014-12-01

The objective of the study is to describe the epidemiology and outcome of community-acquired bloodstream infection (BSI) in type 2 diabetic patients in emergency department (ED). All patients admitted to the ED of the university hospital from June 2010 to June 2011 with a history of type 2 diabetes mellitus and microbiologically documented BSI were retrospectively enrolled. Demographic characteristics, Charlson comorbidity index, antibiotic therapy, clinical severity, microbiological etiology, and diabetes-related complications were recorded in a standardized form. The major outcome measure was 30-day survival. χ2 Or Student t test was used for univariate analysis, and Cox proportional hazards models were used for multivariate analysis. Among 250 enrolled emergency patients with BSI, the overall 30-day mortality rate was 15.5%. Twenty-seven patients (10.7%) developed diabetic ketoacidosis (DKA), and 22 patients (8.8%) developed hyperosmolar hyperglycemic state. On univariate analysis, DKA rather than hyperosmolar hyperglycemic state was associated with adverse outcome. Other risk factors include higher mean glycated hemoglobin level, presence of underlying malignancy, long-term use of steroids, lower respiratory tract infection, and higher Charlson scores. Multivariate analysis identified 3 independent risk factors for early mortality when severity, comorbidity, age, and sex were under control: DKA (hazard ratio, 3.89; 95% confidence interval, 1.6-8.9), inappropriate antibiotics (2.25, 1.05-4.82), and chronic use of steroid (3.89, 1.1-13.2). In type 2 diabetic patients with BSI, a substantial proportion of patients developed DKA. This condition was probably underrecognized by clinicians and constituted an independent risk factor for short-term mortality. Other identified risk factors are potentially correctable and may allow preventive efforts to individuals at greatest potential benefit. Copyright © 2014 Elsevier Inc. All rights reserved.

Quantifying the mediating effect of body mass index on the relation between a Mediterranean diet and development of maternal pregnancy complications: the Australian Longitudinal Study on Women's Health.

PubMed

Schoenaker, Danielle Ajm; Soedamah-Muthu, Sabita S; Mishra, Gita D

2016-09-01

The contribution of body mass index (BMI) to the observed associations between dietary patterns and risk of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) remains unclear. The objective of this study was to formally quantify the mediating effect of prepregnancy BMI in these associations. Women (aged 25-30 y) participating in the Australian Longitudinal Study on Women's Health were not pregnant at baseline in 2003 and reported ≥1 pregnancy up to 2012. GDM and HDP diagnoses were self-reported for each pregnancy and validated in a subset. A Mediterranean diet score was created by use of a baseline-validated food-frequency questionnaire and dichotomized to reflect low adherence (<25th percentile) and higher adherence (≥25th percentile). A causal inference framework for mediation analysis was used to estimate total, natural direct, and natural indirect effects of the prepregnancy Mediterranean diet on incident GDM and HDP and proportions mediated through prepregnancy BMI. In 3378 women without a history of diabetes, 240 (7.1%) developed GDM. HDP was reported in 273 (8.6%) of 3167 women with no history of hypertension. Low adherence to the Mediterranean diet was associated with higher risk of GDM (OR: 1.35; 95% CI: 1.02, 1.60) and HDP (OR: 1.41; 95% CI: 1.18, 1.56), after adjustment for education, parity, polycystic ovary syndrome, energy intake, and physical activity. Proportions mediated through prepregnancy BMI (per 1-kg/m(2) increase) were 32% and 22% for GDM and HDP, respectively. These findings suggest that prepregnancy BMI as a single mediator contributes substantially to the total effects of the prepregnancy Mediterranean diet on GDM and HDP risk. © 2016 American Society for Nutrition.

The National Practitioner Data Bank: the first 4 years.

PubMed Central

Oshel, R E; Croft, T; Rodak, J

1995-01-01

The National Practitioner Data Bank became operational September 1, 1990, as a flagging system to identify health care practitioners who may have been involved in incidents of medical incompetence. Query volumes have grown substantially over the Data Bank's first 4 years of operation. The greatest increase has come in the number of voluntary queries. By the end of 1994, the Data Bank had processed more than 4.5 million requests for information on practitioners, more than 1.5 million of which were received in 1994 alone. The proportion of queries for which the Data Bank contains information on the practitioner in question has grown as the Data Bank has come to contain more reports. During 1994, 7.9 percent of queries were matched. The Data Bank contained more than 97,500 reports at the end of 1994. More than 82 percent of the reports concerned malpractice payments. Licensure reports made up the bulk of the rest. Physicians predominate in reports, accounting for slightly more than 76 percent of the total. The remainder are related to dentists (16 percent) and all other types of practitioners (8 percent). Since reporting of adverse actions is mandatory only for physicians and dentists, the proportion of reports attributable to these types of practitioners is higher than it would be if adverse action reporting requirements were uniform for all practitioners. State malpractice payment rates and adverse action rates vary widely, but a State's rate in any given year is highly correlated with its rate in any other year. State malpractice rates are not strongly correlated with adverse action rates, neither are the rates for physicians strongly correlated with those for dentists. There is a weak tendency for States with smaller physician populations to have higher levels of licensure and privileging actions. PMID:7638325

CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

PubMed Central

Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

2014-01-01

Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

Association of Acute Radiation Syndrome and Rain after the Bombings in Atomic Bomb Survivors.

PubMed

Ozasa, K; Sakata, R; Cullings, H M; Grant, E J

2016-06-01

Acute radiation-induced symptoms reported in survivors after the atomic bombings in Hiroshima and Nagasaki have been suspected to be associated with rain that fell after the explosions, but this association has not been evaluated in an epidemiological study that considers the effects of the direct dose from the atomic bombs and other factors. The aim of this study was to evaluate this association using information from a fixed cohort, comprised of 93,741 members of the Life Span Study who were in the city at the time of the bombing. Information on acute symptoms and exposure to rain was collected in surveys conducted by interviewers, primarily in the 1950s. The proportion of survivors developing severe epilation was around 60% at levels of direct radiation doses of 3 Gy or higher and less than 0.2% at levels <0.005 Gy regardless of reported rain exposure status. The low prevalence of acute symptoms at low direct doses indicates that the reported fallout rain was not homogeneously radioactive at a level sufficient to cause a substantial probability of acute symptoms. We observed that the proportion of reported acute symptoms was slightly higher among those who reported rain exposure in some subgroups, however, suggestions that rain was the cause of these reported symptoms are not supported by analyses specific to the known areas of radioactive fallout. Misclassification of exposure and outcome, including symptoms due to other causes and recall bias, appears to be a more plausible explanation. However, the insufficient and retrospective nature of the available data limited our ability to quantify the attribution to those possible causes.

Short-term change in physical function and disability: the Women's Health and Aging Study.

PubMed

Mendes de Leon, Carlos F; Guralnik, Jack M; Bandeen-Roche, Karen

2002-11-01

Although measures of physical function are predictive of future disability, little is known about the short-term impact of changes in physical function on disability. Data from 93 of the 102 women who participated in the Weekly Substudy of the Women's Health and Aging Study (WHAS) were used to explore the association of changes in physical function with disability. The WHAS Substudy included 24 weekly assessments of three standard performance tests and self-reported disability in activities of daily living (ADLs) and basic mobility. Using random-effects models, we found small but significant (ps <.01) changes in ADL and mobility disability during weekly follow-up. Baseline performance scores were significantly associated with both ADL and mobility disability (ps <.001), accounting for 27% and 36% of the between-person variability in each type of disability, respectively. After adjustment for baseline scores, change in performance scores was significantly associated with ADL disability (beta = 0.08, p <.01) and mobility disability (beta = 0.12, p <.001), but accounted only for a small proportion (<10%) of the variability in the rate of change in disability outcomes. There was no evidence for an additional effect on either type of disability because of having a single episode of a higher or lower than usual performance score, or because of periods of at least 4 consecutive higher or lower than usual performance test scores. Basic physical functions account for a substantial proportion of the heterogeneity in ADL and mobility disability among older disabled women, but have a relatively small impact on short-term changes in either type of disability. Effective prevention of disability may require attention to a wider array of risk factors than just limitations in basic physical functions.

Thailand's universal coverage scheme and its impact on health-seeking behavior.

PubMed

Paek, Seung Chun; Meemon, Natthani; Wan, Thomas T H

2016-01-01

Thailand's Universal Coverage Scheme (UCS) has improved healthcare access and utilization since its initial introduction in 2002. However, a substantial proportion of beneficiaries has utilized care outside the UCS boundaries. Because low utilization may be an indication of a policy gap between people's health needs and the services available to them, we investigated the patterns of health-seeking behavior and their social/contextual determinants among UCS beneficiaries in the year 2013. The study findings from the outpatient analysis showed that the use of designated facilities for care was significantly higher in low-income, unemployed, and chronic status groups. The findings from the inpatient analysis showed that the use of designated facilities for care was significantly higher in the low-income, older, and female groups. Particularly, for the low-income group, we found that they (1) had greater health care needs, (2) received a larger number of services from designated facilities, and (3) paid the least for both inpatient and outpatient services. This pro-poor impact indicated that the UCS could adequately respond to beneficiaries' needs in terms of vertical equity. However, we also found that a considerable proportion of beneficiaries utilized out-of-network services, which implied a lack of universal access to policy services from a horizontal equity point of view. Thus, the policy should continue expanding and diversifying its service benefits to strengthen horizontal equity. Particularly, private sector involvement for those who are employed as well as the increased unmet health needs of those in rural areas may be important policy priorities for that. Lastly, methodological issues such as severity adjustment and a detailed categorization of health-seeking behaviors need to be further considered for a better understanding of the policy impact.

Potential of genetically modified oilseed rape for biofuels in Austria: Land use patterns and coexistence constraints could decrease domestic feedstock production

PubMed Central

Moser, Dietmar; Eckerstorfer, Michael; Pascher, Kathrin; Essl, Franz; Zulka, Klaus Peter

2013-01-01

Like other EU Member States, Austria will meet the substitution target of the EU European Renewable Energy Directive for transportation almost exclusively by first generation biofuels, primarily biodiesel from oilseed rape (OSR). Genetically modified (GM) plants have been promoted as a new option for biofuel production as they promise higher yield or higher quality feedstock. We tested implications of GM OSR application for biodiesel production in Austria by means of high resolution spatially explicit simulation of 140 different coexistence scenarios within six main OSR cropping regions in Austria (2400 km2). We identified structural land use characteristics such as field size, land use diversity, land holding patterns and the proportion of the target crop as the predominant factors which influence overall production of OSR in a coexistence scenario. Assuming isolation distances of 800 m and non-GM-OSR proportions of at least 10% resulted in a loss of area for cultivation of OSR in all study areas ranging from −4.5% to more than −25%, depending on the percentage of GM farmers and on the region. We could show that particularly the current primary OSR cropping regions are largely unsuitable for coexistence and would suffer from a net loss of OSR area even at isolation distances of 400 or 800 m. Coexistence constraints associated with application of GM OSR are likely to offset possible GM gains by substantially reducing farmland for OSR cultivation, thus contradicting the political aim to increase domestic OSR area to meet the combined demands of food, feed and biofuel production. PMID:26109750

SMARCB1 mutations in schwannomatosis and genotype correlations with rhabdoid tumors.

PubMed

Smith, Miriam J; Wallace, Andrew J; Bowers, Naomi L; Eaton, Helen; Evans, D Gareth R

2014-09-01

Mutations in the SMARCB1 gene are involved in several human tumor-predisposing syndromes. They were established as an underlying cause of the tumor suppressor syndrome schwannomatosis in 2008. There is a much higher rate of mutation detection in familial disease than in sporadic disease. We have performed extensive genetic testing on a cohort of familial and sporadic patients who fulfilled clinical diagnostic criteria for schwannomatosis. In our updated cohort, we identified novel mutations within the SMARCB1 gene as well as several recurrent mutations. Of the schwannomatosis screens reported to date, including those in our updated cohort, SMARCB1 mutations have been found in 45% of familial probands and 9% of sporadic patients. The exon 1 mutation, c.41C>A p.Pro14His (10% in our series), and the 3' untranslated region mutation, c.*82C>T (27%), are the most common changes reported in patients with schwannomatosis to date, indicating the presence of mutation hot spots at both 5' and 3' portions of the gene. Comparison with germline SMARCB1 mutations in patients with rhabdoid tumors showed that the schwannomatosis mutations were significantly more likely to occur at either end of the gene and be nontruncating mutations (P < 0.0001). SMARCB1 mutations are found in a significant proportion of schwannomatosis patients, and an even higher proportion of rhabdoid patients. Whereas SMARCB1 alone seems to account for rhabdoid disease, there is likely to be substantial heterogeneity in schwannomatosis even for familial disease. There is a clear genotype-phenotype correlation, with germline rhabdoid mutations being significantly more likely to be centrally placed, involve multiple exon deletions, and be truncating mutations. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of silane- and MDP-based primers application orders on zirconia-resin adhesion-A ToF-SIMS study.

PubMed

Chuang, Shu-Fen; Kang, Li-Li; Liu, Yi-Chuan; Lin, Jui-Che; Wang, Ching-Cheng; Chen, Hui-Min; Tai, Cheng-Kun

2017-08-01

To evaluate the 3-methacryloyloxypropyltrimethoxysilane (MPS)- and 10-methacryloyloxydecyl-dihydrogen-phosphate (MDP)-base primers, in their single or sequential applications, with regard to modifying zirconia surfaces and improving resin-zirconia adhesion. Zirconia disks received different treatments: without primer (Zr), MPS-base primer (S), MDP-base primer (M), MPS/MDP mixture (SMmix), MPS followed by MDP (SM), and MDP followed by MPS (MS). The compositions and chemical interactions of the coatings to zirconia were analyzed using time-of-flight secondary ion mass spectrometry (ToF-SIMS) and reconstructed 3D ion images. Surface wettability of these coatings to water and resin adhesive was assessed. The shear bond strength (SBS) between resin and the treated zirconia was also examined before and after thermocycling. Groups S and MS presented substantial OH - ions in the coatings and zirconia substrate. PO 2 - and PO 3 - fragments existed in all MDP-treatment groups with various proportions and distributions, while groups M and SM showed higher proportions of PO 3 - and the zirconium phosphate related ions. In 3D ion images, PO 3 - in groups M and SM was denser and segregated to the interface, but was dispersed or overlaid above PO 2 - in SMmix and MS. All the primers increased the surface wettability to water and resin, with M and SM presenting superhydrophilic surfaces. All MDP-treatment groups showed improved SBS before thermocycling, while M and SM retained higher SBS after this. The MDP-base primer shows a relevant function in facilitating POZr bonding and enhancing resin-zirconia bonding. The co-treated MPS impairs the chemical activity of MDP, especially if it is the final coat. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Vector-borne parasitic infections in dogs in the Baltic and Nordic countries: A questionnaire study to veterinarians on canine babesiosis and infections with Dirofilaria immitis and Dirofilaria repens.

PubMed

Tiškina, Valentina; Jokelainen, Pikka

2017-09-15

Canine vector-borne diseases have been spreading northwards in Europe, and canine babesiosis and infections with Dirofilaria immitis (heartworm) and Dirofilaria repens have been diagnosed also in the Baltic and the Nordic countries. We used an online questionnaire to survey how large a proportion of veterinarians in the Baltic (Estonia, Latvia, and Lithuania) and the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) saw canine babesiosis cases and dogs infected with D. immitis and D. repens in 2016. In addition, questions regarding transmission, zoonotic potential, clinical signs, and treatment of the infections were asked. The questionnaire was completed by 122 veterinarians. In 2016, 23% of them had seen at least one case of canine babesiosis, 15% at least one dog with D. immitis infection, and 9% at least one dog with D. repens infection. A veterinarian working in the Baltic countries had 12.2 times higher odds to have seen a canine babesiosis case and 9.3 times higher odds to have seen a dog with D. repens infection than a veterinarian working in the Nordic countries did. While 48% of the veterinarians knew that canine babesiosis is not considered a zoonosis, 26% knew that D. immitis is zoonotic and 34% knew that D. repens is zoonotic. The results suggested that autochthonous cases of the three vector-borne parasitic infections were seen by veterinarians in the Baltic countries, whereas most cases seen by veterinarians in the Nordic countries appeared to be imported. A substantial proportion of the veterinarians did not know whether the parasites are zoonotic. Copyright © 2017 Elsevier B.V. All rights reserved.

Prion protein genotypes of sheep as determined from 3343 samples submitted from Ontario and other provinces of Canada from 2005 to 2012

PubMed Central

Cameron, Colin; Bell-Rogers, Patricia; McDowall, Rebeccah; Rebelo, Ana R.; Cai, Hugh Y.

2014-01-01

This study analyzed sheep prion protein (PrP) genotypes of samples submitted from Ontario and other provinces of Canada to the Animal Health Laboratory at the University of Guelph, Guelph, Ontario, between 2005 and 2012. In Ontario, the proportion of scrapie-resistant sheep increased from 2005 to 2012 as evidenced by an increase in the ARR haplotype. When Canadian provinces (Alberta, Ontario, Quebec, and Nova Scotia) were compared from 2008 to 2012, a high proportion of scrapie-resistant sheep was found in all the provinces. The proportions of resistant sheep were lower in Alberta and Quebec than in Ontario and Nova Scotia. Alberta had higher proportions of susceptible sheep and a higher frequency of VRQ alleles, and Quebec had a higher frequency of the ARQ allele. PMID:25355994

AUTOMATIC LIGHT CONTROL

DOEpatents

Artzt, M.

1957-08-27

A control system for a projection kinescope used in a facsimile scanning system and, in particular, meams for maintaining substantially constant the light emanating from the flying spot on the face of the kinescope are described. In general, the invention provides a feeler member disposed in such a position with respect to a projecting lens as to intercept a portion of the light striking the lens. Suitable circuitry in conjunction with a photomultiplier tube provides a signal proportional to the light intensity of the flying spot. The grid bias on the kinescope is controlled by this signal to maintain the intensity of the spot substantially constant.

Resilience, Stress, Stigma, and Barriers to Mental Healthcare in U.S. Air Force Nursing Personnel.

PubMed

Hernandez, Stephen H A; Morgan, Brenda J; Parshall, Mark B

Stigma may deter military service members from seeking mental health (MH) services. Previously, substantial proportions of U.S. Air Force (USAF) registered nurses and medical technicians reported concerns about stigma with accessing MH services; in particular, that unit members might lose confidence in them or perceive them as weak, unit leadership might treat them differently, or accessing care might affect career advancement. This study assessed the extent to which stigma and barriers to accessing MH services as perceived by USAF nursing personnel are associated with resilience, stress, previous deployment, or demographic characteristics. An anonymous, online survey was administered to active-duty USAF registered nurses and medical technicians at three locations (N = 250). The survey included demographic items, the Stigma and Barriers to Care scales, Conner-Davidson Resilience Scale, and Perceived Stress Questionnaire. Mean resilience was high, and perceived stress was moderate. About half of participants agreed that unit members might have less confidence in me (54%) or unit leadership might treat me differently (58%). Many also had concerns that it would harm my career (47%), I would be seen as weak (47%), or there would be difficulty getting time off work for treatment (45%). Stigma was positively correlated with perceived stress (r = .40, p < .01) and negatively correlated with resilience (r = -.24, p < .01). Officers had significantly higher stigma and resilience scores and lower stress scores compared with enlisted personnel, but those differences were small. This study validated previous findings that substantial percentages of USAF nursing personnel have concerns that accessing MH services may adversely affect their careers and how they are viewed by unit leaders and peers. In addition, higher levels of concern about stigma were associated with higher levels of stress and lower levels of resilience. Limitations included a low response rate (18%) and self-selection biases.

The variation of chemical characteristics of PM2.5 and PM10 and formation causes during two haze pollution events in urban Beijing, China

NASA Astrophysics Data System (ADS)

Gao, Jiajia; Tian, Hezhong; Cheng, Ke; Lu, Long; Zheng, Mei; Wang, Shuxiao; Hao, Jiming; Wang, Kun; Hua, Shenbing; Zhu, Chuanyong; Wang, Yong

2015-04-01

Airborne particles in urban Beijing during haze days and normal days were collected and analyzed in the autumn and winter seasons to reveal the chemical characteristics variations of air pollution. The air quality in haze days was substantially worse than that in normal days. Both the relatively low wind speed and high relative humidity were in favor of the accumulation of pollution species and new formation of secondary PM2.5 in the atmosphere. Elevated concentrations of elements and water-soluble inorganic ions were found on haze days for both PM10 and PM2.5. Particularly, the crustal element, such as Fe, in both PM10 and PM2.5 were substantially higher in autumn normal days and winter haze days than those in autumn haze days and winter normal days, indicating that the abundance of Fe in autumn haze days mainly be originated from crustal dust while in winter haze days it might be primarily emitted from anthropogenic sources (iron and steel smelting) instead of road dust. Secondary ion species (SO42-, NO3-, NH4+) in particles were generated much more during haze episodes, and contributed a higher proportion in PM2.5 than in PM10 during the two sampling periods. Moreover, HYSPLIT model was used to explain the possible transport of airborne particles from distant sources. By comparing with south-type trajectory, west-type trajectory entrained larger amounts of primary crustal pollutants, while, south-type trajectory was comprised of a higher mass of anthropogenic pollution species. The results of back trajectory analysis indicated that the elevated concentration of aerosol and its chemical components during haze days might be caused by the integrated effects of accumulation under stagnant meteorological condition and the transport emissions of pollutants from anthropogenic sources surrounding Beijing city.

Functional macronutritional generalism in a large omnivore, the brown bear.

PubMed

Coogan, Sean C P; Raubenheimer, David; Stenhouse, Gordon B; Coops, Nicholas C; Nielsen, Scott E

2018-02-01

We combine a recently developed framework for describing dietary generalism with compositional data analysis to examine patterns of omnivory in a large widely distributed mammal. Using the brown bear ( Ursus arctos ) as a model species, we collected and analyzed data from the literature to estimate the proportions of macronutrients (protein, carbohydrate, and lipid) in the diets of bear populations. Across their range, bears consumed a diversity of foods that resulted in annual population diets that varied in macronutrient proportions, suggesting a wide fundamental macronutrient niche. The variance matrix of pairwise macronutrient log-ratios indicated that the most variable macronutrient among diets was carbohydrate, while protein and lipid were more proportional or codependent (i.e., relatively more constant log-ratios). Populations that consumed anthropogenic foods, such agricultural crops and supplementary feed (e.g., corn), had a higher geometric mean proportion of carbohydrate, and lower proportion of protein, in annual diets. Seasonally, mean diets were lower in protein and higher in carbohydrate, during autumn compared to spring. Populations with anthropogenic subsidies, however, had higher mean proportions of carbohydrate and lower protein, across seasons compared to populations with natural diets. Proportions of macronutrients similar to those selected in experiments by captive brown bears, and which optimized primarily fat mass gain, were observed among hyperphagic prehibernation autumn diets. However, the majority of these were from populations consuming anthropogenic foods, while diets of natural populations were more variable and typically higher in protein. Some anthropogenic diets were close to the proportions selected by captive bears during summer. Our results suggest that omnivory in brown bears is a functional adaptation enabling them to occupy a diverse range of habitats and tolerate variation in the nutritional composition and availability of food resources. Furthermore, we show that populations consuming human-sourced foods have different dietary macronutrient proportions relative to populations with natural diets.

Breast cancer mortality in African-American and non-Hispanic white women by molecular subtype and stage at diagnosis: a population-based study

PubMed Central

Tao, Li; Gomez, Scarlett Lin; Keegan, Theresa HM; Kurian, Allison W.; Clarke, Christina A.

2015-01-01

Background Higher breast cancer mortality rates for African-American than non-Hispanic white women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients. Methods We obtained data for all invasive breast cancers diagnosed 1/1/2005-12/31/2012 and followed through 12/31/2012 among 93,760 non-Hispanic white and 9,738 African-American women in California. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for breast cancer-specific mortality. Results After adjustment for patient, tumor and treatment characteristics, outcomes were comparable by race for Stage I or IV cancer regardless of subtype, and HR+/HER2+ or HR-/HER2+ cancer regardless of stage. We found substantially higher hazards of breast cancer death among African-American women with Stage II/III HR+/HER2- (HR, 1.31, 95% CI, 1.03-1.65, and HR, 1.39, 95% CI, 1.10-1.75, respectively) and Stage III triple-negative cancers relative to whites. Conclusions There are substantial racial/ethnic disparities among patients with Stages II/III HR+/HER2- and Stage III triple-negative breast cancers but not for other subtype and stage. Impact These data provide insights to assess barriers to targeted treatment (e.g. trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. PMID:25969506

Breast Cancer Mortality in African-American and Non-Hispanic White Women by Molecular Subtype and Stage at Diagnosis: A Population-Based Study.

PubMed

Tao, Li; Gomez, Scarlett Lin; Keegan, Theresa H M; Kurian, Allison W; Clarke, Christina A

2015-07-01

Higher breast cancer mortality rates for African-American than non-Hispanic White women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients. We obtained data for all invasive breast cancers diagnosed between January 1, 2005, and December 31, 2012, and followed through December 31, 2012, among 93,760 non-Hispanic White and 9,738 African-American women in California. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were used to calculate relative hazard (RH) and 95% confidence intervals (CI) for breast cancer-specific mortality. After adjustment for patient, tumor, and treatment characteristics, outcomes were comparable by race for stage I or IV cancer regardless of subtype, and HR(+)/HER2(+) or HR(-)/HER2(+) cancer regardless of stage. We found substantially higher hazards of breast cancer death among African-American women with stage II/III HR(+)/HER2(-) (RH, 1.31; 95% CI, 1.03-1.65; and RH, 1.39; 95% CI, 1.10-1.75, respectively) and stage III triple-negative cancers relative to Whites. There are substantial racial/ethnic disparities among patients with stages II/III HR(+)/HER2(-) and stage III triple-negative breast cancers but not for other subtype and stage. These data provide insights to assess barriers to targeted treatment (e.g., trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. ©2015 American Association for Cancer Research.

Galaxy Zoo: Morphological Classification of Galaxy Images from the Illustris  Simulation

NASA Astrophysics Data System (ADS)

Dickinson, Hugh; Fortson, Lucy; Lintott, Chris; Scarlata, Claudia; Willett, Kyle; Bamford, Steven; Beck, Melanie; Cardamone, Carolin; Galloway, Melanie; Simmons, Brooke; Keel, William; Kruk, Sandor; Masters, Karen; Vogelsberger, Mark; Torrey, Paul; Snyder, Gregory F.

2018-02-01

Modern large-scale cosmological simulations model the universe with increasing sophistication and at higher spatial and temporal resolutions. These ongoing enhancements permit increasingly detailed comparisons between the simulation outputs and real observational data. Recent projects such as Illustris are capable of producing simulated images that are designed to be comparable to those obtained from local surveys. This paper tests the degree to which Illustris achieves this goal across a diverse population of galaxies using visual morphologies derived from Galaxy Zoo citizen scientists. Morphological classifications provided by these volunteers for simulated galaxies are compared with similar data for a compatible sample of images drawn from the Sloan Digital Sky Survey (SDSS) Legacy Survey. This paper investigates how simple morphological characterization by human volunteers asked to distinguish smooth from featured systems differs between simulated and real galaxy images. Significant differences are identified, which are most likely due to the limited resolution of the simulation, but which could be revealing real differences in the dynamical evolution of populations of galaxies in the real and model universes. Specifically, for stellar masses {M}\\star ≲ {10}11 {M}ȯ , a substantially larger proportion of Illustris galaxies that exhibit disk-like morphology or visible substructure, relative to their SDSS counterparts. Toward higher masses, the visual morphologies for simulated and observed galaxies converge and exhibit similar distributions. The stellar mass threshold indicated by this divergent behavior confirms recent works using parametric measures of morphology from Illustris simulated images. When {M}\\star ≳ {10}11 {M}ȯ , the Illustris data set contains substantially fewer galaxies that classifiers regard as unambiguously featured. In combination, these results suggest that comparison between the detailed properties of observed and simulated galaxies, even when limited to reasonably massive systems, may be misleading.

Dropout rates and factors associated with dropout from treatment among elderly patients attending the outpatient services of a tertiary care hospital

PubMed Central

Grover, Sandeep; Dua, Devakshi; Chakrabarti, Subho; Avasthi, Ajit

2018-01-01

Aim: This study aimed to evaluate the “dropout” rates from treatment and associated factors among elderly patients attending a tertiary care psychiatry outpatient facility. Materials and Methods: Data of 1422 patients aged ≥60 years, attending the walk-in clinic were evaluated. Results: Out of 1422 patients, 406 (28.55%) belonged to the “dropout” group. In the “dropout” group, the age of patients was significantly higher than the followed-up group, and a higher proportion of patients were >70 years old. Significantly lower proportion of patients with diagnosis of depressive disorders belonged to the “dropout” group and significantly higher proportion of patients with “other” diagnoses belonged to the dropped out group. In patients with depressive disorders, a higher proportion of the patients in the “dropout” group were Hindu by religion (68.7% vs. 58.7%; χ2 = 4.26; P = 0.03). In patients with bipolar disorder, patients in the “dropout” group had significantly higher income (Rs. 13,323 [standard deviation [SD] = 16,769] vs. 5681 [SD = 9422]; t-test value: 2–25; P = 0.028) and lesser proportion of patients were of the male gender (63.15 vs. 86.95%; Mann–Whitney U value = 257.5; P = 0.039). In the group of other diagnoses, a higher proportion of patients in the “dropout” group were currently single (32.3% vs. 18.7%; χ2 = 4.12; P = 0.042), from rural locality (63.1% vs. 46.72%; χ2 = 4.33; P = 0.037) and were not prescribed medications (40% vs. 22.4%; χ2 = 6.05; P = 0.04). Conclusion: Dropout from treatment among elderly patients is associated with higher age, not being prescribed medications, and diagnosis other than the affective disorders, psychotic disorders, and the cognitive disorders. PMID:29736062

The long-term decline of adult tobacco use in Victoria: changes in smoking initiation and quitting over a quarter of a century of tobacco control.

PubMed

Germain, Daniella; Durkin, Sarah; Scollo, Michelle; Wakefield, Melanie

2012-02-01

To examine changes in regular smoking prevalence among demographic and socioeconomic groups of Victorian adults from 1984 to 2008. Data were drawn from face-to-face and telephone surveys of randomly sampled Victorians conducted annually from 1984 to 2008. Regular smoking in Victoria declined from 33.2% in 1984 to 15.5% in 2008, a relative decline of 53%. This change was largely accounted for by significant drops in 'ever smoking' among 18-29 year olds (from 59% to 35%, a relative decline of 41%) and by increased quitting among those aged 30 and older (from a quit proportion [% of those ever smoked who have quit] of 37% to 61% among 30-49 year olds, a relative increase of 64%; and from 53% to 79% among 50+ years, an increase of 48%). Over time, smoking prevalence became more similar between males and females. Regular smoking declined significantly across all socioeconomic status (SES) groups. Victorians living in low SES areas experienced the greatest relative increase in quit proportions of 75% (from 34% to 60%), helping to reduce the gap between low and higher SES groups in terms of smoking prevalence. Regular smoking in Victoria has declined substantially across all demographic groups. Victorians are taking up smoking at much lower levels than 25 years ago, while quit proportions have more than doubled. The continuation and extension of comprehensive, multi-level approaches to tobacco control is likely to be required for the maintenance of the downward trend in smoking. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

Variations in Mental Health Diagnosis and Prescribing Across Pediatric Primary Care Practices

PubMed Central

Mayne, Stephanie L.; Ross, Michelle E.; Song, Lihai; McCarn, Banita; Steffes, Jennifer; Liu, Weiwei; Margolis, Benyamin; Azuine, Romuladus; Gotlieb, Edward; Grundmeier, Robert W.; Leslie, Laurel K.; Localio, Russell; Wasserman, Richard

2016-01-01

BACKGROUND: Primary care pediatricians increasingly care for children’s mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. METHODS: This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models. RESULTS: Among 294 748 children, 40 932 (15%) received a mental health diagnosis and 39 695 (14%) were prescribed psychotropic medication. Attention deficit/hyperactivity disorder was most commonly diagnosed (1%–16% per practice). The proportion of children receiving any psychotropic medication (4%-26%) and the proportion receiving ≥2 medication classes (1%-12%) varied across practices. Prescribing of specific medication classes also varied (stimulants, 3%–18%; antidepressants, 1%–12%; α-agonists, 0%–8%; second-generation antipsychotics, 0%–5%). Variability was partially explained by community availability of psychiatrists (significantly higher odds of a diagnosis or prescription when not available) but not by colocation of mental health professionals or percentage of children in foster care. CONCLUSIONS: The prevalence of mental health diagnosis and psychotropic medication prescribing varies substantially across practices and is only partially explained by psychiatrist availability. Research is needed to better define the causes of variable practice-level diagnosis and prescribing and implications for child mental health outcomes. PMID:27244791

Efficacy and safety of golimumab in Indian patients with rheumatoid arthritis: Subgroup data from GO-MORE study.

PubMed

Pal, Sarvajeet; Veeravalli, Sarath Chandra Mouli; Das, Siddharth Kumar; Shobha, Vineeta; Uppuluri, Ramakrishna Rao; Dharmanand, B G; Nadkar, Milind; Hsia, Elizabeth; Fei, Kaiyin; Yao, Ruji; Khalifa, Ahmed

2016-11-01

To conduct a subgroup analysis of GO-MORE trial Part 1, comparing efficacy and safety of add-on subcutaneous golimumab therapy in rheumatoid arthritis (RA) patients enrolled from and outside India. GO-MORE was an open-label, multicenter, prospective trial of add-on golimumab in biologic-naïve RA patients, having active disease despite being on conventional DMARD regimen(s). Part 1 of the study was chosen as the focus of this subgroup analysis because a substantial number of Indian patients (106) were enrolled compared to no Indian patients in Part 2. The primary efficacy outcome was proportion of patients achieving good to moderate DAS28-ESR (Disease Activity Score of 28 joints calculated using erythrocyte sedimentation rate) European League Against Rheumatism (EULAR) response at month 6. Efficacy evaluable population comprised of 105 and 3175 patients from India and outside India, respectively. Safety analysis included 106 patients enrolled from India and 3251 from outside India. A higher proportion of Indian patients had a high disease activity as measured by DAS28 ESR than outside India patients. At month 6, the proportion of Indian and non-Indian patients achieving DAS28-ESR, DAS28 - C-reactive protein, simplified disease activity index (SDAI) remission, and EuroQoL Quality-of-Life Questionnaire (EQ-5D) scores were comparable. Incidence of all adverse events was lower in Indian patients. There were no deaths, cases of tuberculosis or malignancy reported in the patients from India at month 6. The efficacy and safety results with add-on golimumab were consistent between RA patients from India and outside India, despite high baseline disease activity in the Indian patients. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Comparison of the Effects of Intermittent Boluses to Simple Continuous Infusion on Patients' Global Perceived Effect in Intrathecal Therapy for Pain: A Randomized Double-Blind Crossover Study.

PubMed

Eldabe, Sam; Duarte, Rui V; Madzinga, Grace; Batterham, Alan M; Brookes, Morag E; Gulve, Ashish P; Perruchoud, Christophe; Raphael, Jon H; Lorenzana, David; Buchser, Eric

2017-05-01

Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration. The primary outcome measure was the Patients' Global Impression of Change (PGIC) scale. The mean proportion of positive responders (at least "minimally improved") was 38.4% in the continuous condition vs 37.3% in the bolus (difference in proportions = 1.1%, 95% confidence interval [CI] = -21.8-24.0%, P  = 0.93). The mean PGIC in the continuous condition was 3.8 vs 3.9 in the bolus (mean difference = -0.1, -0.6-0.4, P  = 0.72). Exploratory analyses revealed a tendency for the mean proportion of positive responders to be higher at low vs high flow rates for both bolus and continuous administrations. Two patients were withdrawn from the study due to adverse events during the bolus phase, both with symptoms of increased pain, and one patient with additional symptoms of numbness and urinary retention. The mean PGIC and proportion of positive responders was not substantially different after intermittent bolus vs continuous administration. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The formation of unsaturated zones within cemented paste backfill mixtures-effects on the release of copper, nickel, and zinc.

PubMed

Hamberg, Roger; Maurice, Christian; Alakangas, Lena

2018-05-13

Flooding of cemented paste backfill (CPB) filled mine workings is, commonly, a slow process and could lead to the formation of unsaturated zones within the CPB fillings. This facilitates the oxidation of sulfide minerals and thereby increases the risk of trace metal leaching. Pyrrhotitic tailings from a gold mine (cyanidation tailing (CT)), containing elevated concentrations of nickel (Ni), copper (Cu), and zinc (Zn), were mixed with cement and/or fly ash (1-3 wt%) to form CT-CPB mixtures. Pyrrhotite oxidation progressed more extensively during unsaturated conditions, where acidity resulted in dissolution of the Ni, Cu, and Zn associated with amorphous Fe precipitates and/or cementitious phases. The establishment of acidic, unsaturated conditions in CT-CBP:s with low fractions (1 wt%) of binders increased the Cu release (to be higher than that from CT), owing to the dissolution of Cu-associated amorphous Fe precipitates. In CT-CPB:s with relatively high proportions of binder, acidity from pyrrhotite oxidation was buffered to a greater extent. At this stage, Zn leaching increased due the occurrence of fly ash-specific Zn species soluble in alkaline conditions. Irrespective of binder proportion and water saturation level, the Ni and Zn release were lower, compared to that in CT. Fractions of Ni, Zn, and Cu associated with acid-soluble phases or amorphous Fe precipitates, susceptible to remobilization under acidic conditions, increased in tandem with binder fractions. Pyrrhotite oxidation occurred irrespective of the water saturation level in the CPB mixtures. That, in turn, poses an environmental risk, whereas a substantial proportion of Ni, Cu, and Zn was associated with acid-soluble phases.

Do attributes of persons with chronic kidney disease differ in low-income and middle-income countries compared with high-income countries? Evidence from population-based data in six countries.

PubMed

Anand, Shuchi; Zheng, Yuanchao; Montez-Rath, Maria E; Wei, Wang Jin; Perico, Norberto; Carminati, Sergio; Narayan, Km Venkat; Tandon, Nikhil; Mohan, Viswanathan; Jha, Vivekanand; Zhang, Luxia; Remuzzi, Giuseppe; Prabahkaran, Dorairaj; Chertow, Glenn M

2017-01-01

Kidney biopsies to elucidate the cause of chronic kidney disease (CKD) are performed in a minority of persons with CKD living in high-income countries, since associated conditions-that is, diabetes mellitus, vascular disease or obesity with pre-diabetes, prehypertension or dyslipidaemia-can inform management targeted at slowing CKD progression in a majority. However, attributes of CKD may differ substantially among persons living in low-income and middle-income countries (LMICs). We used data from population or community-based studies from five LMICs (China, urban India, Moldova, Nepal and Nigeria) to determine what proportion of persons with CKD living in diverse regions fit one of the three major clinical profiles, with data from the US National Health Nutrition and Examination Survey as reference. In the USA, urban India and Moldova, 79.0%-83.9%; in China and Nepal, 62.4%-66.7% and in Nigeria, 51.6% persons with CKD fit one of three established risk profiles. Diabetes was most common in urban India and vascular disease in Moldova (50.7% and 33.2% of persons with CKD in urban India and Moldova, respectively). In Nigeria, 17.8% of persons with CKD without established risk factors had albuminuria ≥300 mg/g, the highest proportion in any country. While the majority of persons with CKD in LMICs fit into one of three established risk profiles, the proportion of persons who have CKD without established risk factors is higher than in the USA. These findings can inform tailored CKD detection and management systems and highlight the importance of studying potential causes and outcomes of CKD without established risk factors in LMICs.

Do attributes of persons with chronic kidney disease differ in low-income and middle-income countries compared with high-income countries? Evidence from population-based data in six countries

PubMed Central

Anand, Shuchi; Zheng, Yuanchao; Montez-Rath, Maria E; Wei, Wang Jin; Perico, Norberto; Carminati, Sergio; Narayan, KM Venkat; Tandon, Nikhil; Mohan, Viswanathan; Jha, Vivekanand; Zhang, Luxia; Remuzzi, Giuseppe; Prabahkaran, Dorairaj; Chertow, Glenn M

2017-01-01

Kidney biopsies to elucidate the cause of chronic kidney disease (CKD) are performed in a minority of persons with CKD living in high-income countries, since associated conditions—that is, diabetes mellitus, vascular disease or obesity with pre-diabetes, prehypertension or dyslipidaemia—can inform management targeted at slowing CKD progression in a majority. However, attributes of CKD may differ substantially among persons living in low-income and middle-income countries (LMICs). We used data from population or community-based studies from five LMICs (China, urban India, Moldova, Nepal and Nigeria) to determine what proportion of persons with CKD living in diverse regions fit one of the three major clinical profiles, with data from the US National Health Nutrition and Examination Survey as reference. In the USA, urban India and Moldova, 79.0%–83.9%; in China and Nepal, 62.4%–66.7% and in Nigeria, 51.6% persons with CKD fit one of three established risk profiles. Diabetes was most common in urban India and vascular disease in Moldova (50.7% and 33.2% of persons with CKD in urban India and Moldova, respectively). In Nigeria, 17.8% of persons with CKD without established risk factors had albuminuria ≥300 mg/g, the highest proportion in any country. While the majority of persons with CKD in LMICs fit into one of three established risk profiles, the proportion of persons who have CKD without established risk factors is higher than in the USA. These findings can inform tailored CKD detection and management systems and highlight the importance of studying potential causes and outcomes of CKD without established risk factors in LMICs. PMID:29071132

Causative Pathogens of Febrile Neutropaenia in Children Treated for Acute Lymphoblastic Leukaemia.

PubMed

Lam, Joyce Cm; Chai, Jie Yang; Wong, Yi Ling; Tan, Natalie Wh; Ha, Christina Tt; Chan, Mei Yoke; Tan, Ah Moy

2015-11-01

Treatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution. Patients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed. There were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%. Febrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.

Unit Support Protects Against Sexual Harassment and Assault among National Guard Soldiers

PubMed Central

Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B.; Calabrese, Joseph; Koenen, Karestan C.

2014-01-01

Objective Despite concerns about increased sexual harassment and assault following 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members’ relationships within their unit, protects against sexual harassment and assault during deployment. Methods Participants were 1674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008-2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Results Approximately 13.2% (n=198) of men and 43.5% (n=74) of women reported sexual harassment, and 1.1% (n=17) of men and 18.8% (n=32) of women reported sexual assault during their most recent deployment. Higher unit support was associated with decreased odds of sexual harassment and assault. Conclusions A substantial proportion of men and women reported sexual harassment/assault. Higher unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has potential to reduce sexual harassment and assault. PMID:25442705

Comparison of solidification/stabilization effects of calcite between Australian and South Korean cements

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

Lee, Dongjin; Waite, T. David; Swarbrick, Gareth

2005-11-15

The differences in the effect of calcite on the strength and stability of Pb-rich wastes solidified and stabilized using Australian and South Korean ordinary Portland cements are examined in this study. Pb-rich waste stabilized using Australian OPC has been shown to possess both substantially higher unconfined compressive strength and lead immobilization ability than South Korean OPC as a result of its higher C{sub 3}S content and the associated enhanced degree of precipitation of lead on the surfaces of silicate phases present. Calcite addition is observed to have an accelerating effect on the OPC-induced solidification/stabilization of Pb-rich wastes as gauged bymore » the unconfined compressive strength and leachability of the solids formed. This effect is observed to be far more dramatic for South Korean OPC than for Australian OPC. Using scanning electron microscopy, waste stabilized with cement and calcite was observed to develop significantly greater proportions of hydrated crystals than wastes stabilized with cement alone. The results of X-ray diffraction studies have shown that the presence of calcite in South Korean OPC results in greater acceleration in the formation of portlandite than is the case for Australian OPC.« less

Subtypes of depression and their overlap in a naturalistic inpatient sample of major depressive disorder.

PubMed

Musil, Richard; Seemüller, Florian; Meyer, Sebastian; Spellmann, Ilja; Adli, Mazda; Bauer, Michael; Kronmüller, Klaus-Thomas; Brieger, Peter; Laux, Gerd; Bender, Wolfram; Heuser, Isabella; Fisher, Robert; Gaebel, Wolfgang; Schennach, Rebecca; Möller, Hans-Jürgen; Riedel, Michael

2018-03-01

Subtyping depression is important in order to further delineate biological causes of depressive syndromes. The aim of this study was to evaluate clinical and outcome characteristics of distinct subtypes of depression and to assess proportion and features of patients fulfilling criteria for more than one subtype. Melancholic, atypical and anxious subtypes of depression were assessed in a naturalistic sample of 833 inpatients using DSM-IV specifiers based on operationalized criteria. Baseline characteristics and outcome criteria at discharge were compared between distinct subtypes and their overlap. A substantial proportion of patients (16%) were classified with more than one subtype of depression, 28% were of the distinct anxious, 7% of the distinct atypical and 5% of the distinct melancholic subtype. Distinct melancholic patients had shortest duration of episode, highest baseline depression severity, but were more often early improvers; distinct anxious patients had higher NEO-Five Factor Inventory (NEO-FFI) neuroticism scores compared with patients with unspecific subtype. Melancholic patients with overlap of anxious features had worse treatment outcome compared to distinct melancholic and distinct anxious subtype. Distinct subtypes differed in only few variables and patients with overlap of depression subtypes may have independent clinical and outcome characteristics. Studies investigating biological causes of subtypes of depression should take influence of features of other subtypes into account. Copyright © 2017 John Wiley & Sons, Ltd.

Placental Abruption and Perinatal Mortality With Preterm Delivery as a Mediator: Disentangling Direct and Indirect Effects

PubMed Central

Ananth, Cande V.; VanderWeele, Tyler J.

2011-01-01

The authors use recent methodology in causal inference to disentangle the direct and indirect effects that operate through a mediator in an exposure-response association paradigm. They demonstrate how total effects can be partitioned into direct and indirect effects even when the exposure and mediator interact. The impact of bias due to unmeasured confounding on the exposure-response association is assessed through a series of sensitivity analyses. These methods are applied to a problem in perinatal epidemiology to examine the extent to which the effect of abruption on perinatal mortality is mediated through preterm delivery. Data on over 26 million US singleton births (1995–2002) were utilized. Risks of mortality among abruption and nonabruption births were 102.7 and 6.2 per 1,000 births, respectively. Risk ratios of the natural direct and indirect (preterm delivery-mediated) effects of abruption on mortality were 10.18 (95% confidence interval: 9.80, 10.58) and 1.35 (95% confidence interval: 1.33, 1.38), respectively. The proportion of increased mortality risk mediated through preterm delivery was 28.1%, with even higher proportions associated with deliveries at earlier gestational ages. Sensitivity analyses underscore that the qualitative conclusions of some mediated effects and substantial direct effects are reasonably robust to unmeasured confounding of a fairly considerable magnitude. PMID:21430195

Prevalence of serious bleeding events and intracranial hemorrhage in patients receiving activated protein C: a systematic review and meta-analysis.

PubMed

Khan, Ajmal; Agarwal, Ritesh; Aggarwal, Ashutosh N; Gupta, Dheeraj

2010-07-01

Activated protein C reduces 28-day mortality in patients with severe sepsis, but its anticoagulant properties entail a risk of bleeding. The aim of this systematic review was to evaluate the prevalence of serious bleeding events in patients receiving activated protein C. We searched the MEDLINE and EMBASE databases for studies that described the prevalence of serious bleeding events and intracranial hemorrhage in patients receiving activated protein C. We calculated the bleeding rates by calculating proportions and 95% CIs for each study, and then pooled the data to derive a pooled proportion and 95% CI. Our search yielded 17 studies, which included 10,679 patients. The occurrence of serious bleeding events in patients receiving activated protein C ranged from 0.5% to 9.6%, and the pooled prevalence was 3.3% (95% CI 2.4-4.4%) by the random effects model. The occurrence of intracranial hemorrhage ranged from 0% to 1.4%, and the pooled prevalence was 0.44% (95% CI 0.31-0.6%). Sensitivity analysis showed a higher prevalence of bleeding in the observational studies than in the randomized controlled trials. There was substantial clinical and statistical heterogeneity, but no evidence of publication bias. Activated protein C is associated with significant risk of bleeding, so strict inclusion and exclusion criteria should be set prior to administering activated protein C.

Comparison of Health Status and Health Behaviors between Female Graduate and Undergraduate College Students

ERIC Educational Resources Information Center

Bulmer, Sandra Minor; Irfan, Syed; Barton, Barbara; Vancour, Michele; Breny, Jean

2010-01-01

Objective: Graduate females represent a substantial and growing proportion of the college student population, yet health promotion research and programming has traditionally focused on undergraduates. This study compared health status and health behaviors of female graduate and undergraduate students at a public university in the northeastern U.S.…

Attrition in Chronic Disease Self-Management Programs and Self-Efficacy at Enrollment

ERIC Educational Resources Information Center

Verevkina, Nina; Shi, Yunfeng; Fuentes-Caceres, Veronica Alejandra; Scanlon, Dennis Patrick

2014-01-01

Among other goals, the Chronic Disease Self-Management Program (CDSMP) is designed to improve self-efficacy of the chronically ill. However, a substantial proportion of the enrollees often leave CDSMPs before completing the program curriculum. This study examines factors associated with program attrition in a CDSMP implemented in a community…

Technical Vocabulary in Specialised Texts.

ERIC Educational Resources Information Center

Chung, Teresa Mihwa; Nation, Paul

2003-01-01

Describes two studies of technical vocabulary, one using an anatomy text and the other an applied linguistics text. Technical vocabulary was found by rating words in the texts on a four-step scale. Found that technical vocabulary made up a very substantial proportion of both the different words and the running words in texts. (Author/VWL)

Quality in Family Child Care: A Focus Group Study with Canadian Providers

ERIC Educational Resources Information Center

Doherty, Gillian

2015-01-01

A substantial proportion of American, Canadian and English preschoolers regularly participate in family child care making its quality of vital importance for the children concerned, their parents, the school system and the society in which they live. This article discusses the seven key caregiver behaviors and physical space characteristics…

The Role of International Medical Graduate Psychiatrists in the United States Healthcare System

ERIC Educational Resources Information Center

Boulet, John Robin; Cassimatis, Emmanuel G.; Opalek, Amy

2012-01-01

Objective: International medical graduates (IMGs) make up a substantial proportion of the United States physician workforce, including psychiatrists in practice. The purpose of this study was to describe, based on current data, the characteristics and qualities of IMG psychiatrists who provide patient care in the US. Method: Physician data from…

The Prevalence of Effective Substance Use Prevention Curricula in the Nation's High Schools

ERIC Educational Resources Information Center

Ringwalt, Chris; Hanley, Sean; Vincus, Amy A.; Ennett, Susan T.; Rohrbach, Louise A.; Bowling, J. Michael

2008-01-01

Despite a substantial proportion of high school students who initiate substance use following middle school, the implementation of universal evidence-based prevention curricula appears to be scant. We report data collected in 2005 from 1392 school district-based drug prevention coordinators, from a national, representative study of school-based…

Alcohol Use. Adolescent Health Highlight. Publication #2012-34

ERIC Educational Resources Information Center

Murphey, David; Vaughn, Brigitte; Barry, Megan; Terzian, Mary

2012-01-01

A substantial proportion of high school students consume alcohol, with nearly a quarter of 12th grade students reporting binge drinking in the past two weeks. Drinking alcohol in adolescence is associated with a variety of other risky behaviors, as well as with an increased likelihood of long-term problems reaching into adulthood. This "Adolescent…

Current Issues in Early Childhood Education.

ERIC Educational Resources Information Center

Katz, Lilian G.

If present trends in family life and education continue into the next decade, most children under five will spend substantial proportions of their early years in various types of early childhood programs, most five- to six-year-olds will attend all-day kindergarten, and during their elementary school years they will spend much of their time before…

Employment and Adjustment of School-Leavers with Mild Retardation in New Zealand.

ERIC Educational Resources Information Center

Wilton, Keri; And Others

1988-01-01

Three studies analyzing the employment status and opportunities of mildly retarded school leavers in West Auckland, New Zealand, indicated that a substantial proportion of subjects were not obtaining/retaining employment, and the situation was attributed to unavailability of jobs rather than lack of awareness of employment opportunities or…

12 CFR 225.17 - Notice procedure for one-bank holding company formations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y... substantially the same proportion, except for changes in shareholders' interests resulting from the exercise of... Change in Bank Control Act of 1978 (12 U.S.C. 1817(j)) by the appropriate federal banking agency for the...

A Framework for Bilingual School Consultation to Facilitate Multitier Systems of Support for English Language Learners

ERIC Educational Resources Information Center

Harris, Bryn; Sullivan, Amanda L.

2017-01-01

Bilingual students comprise a substantial and growing proportion of U.S. school enrollment and often experience unsatisfactory school outcomes attributed to limited opportunities to learn. Bilingual consultants have the unique opportunity to shape school psychological services and general education supports for all bilingual students by working…

Conditional Cash Transfers and School Dropout Rates

ERIC Educational Resources Information Center

Dearden, Lorraine; Emmerson, Carl; Frayne, Christine; Meghir, Costas

2009-01-01

This paper evaluates a United Kingdom pilot study designed to test whether a means-tested conditional cash transfer paid to 16- to 18-year-olds for staying in full-time education is an effective way of reducing the proportion of school dropouts. The transfer's impact is substantial: In the first year, full-time education participation rates…

The Factor Content of Bilateral Trade: An Empirical Test.

ERIC Educational Resources Information Center

Choi, Yong-Seok; Krishna, Pravin

2004-01-01

The factor proportions model of international trade is one of the most influential theories in international economics. Its central standing in this field has appropriately prompted, particularly recently, intense empirical scrutiny. A substantial and growing body of empirical work has tested the predictions of the theory on the net factor content…

Characterizing the isotopic composition of atmospheric ammonia emission sources using passive samplers and a combined oxidation-bacterial denitrifier approach

USDA-ARS?s Scientific Manuscript database

Ammonia (NH3) emissions are a substantial source of nitrogen pollution to sensitive terrestrial, aquatic, and marine ecosystems. Dependable quantification of NH3 sources is of growing importance due to recently observed increases in ammonium (NH4+) deposition rates that are directly proportional to ...

Changes in the Logging Labor Force

Treesearch

Charles H. Wolf; Jean W. Nolley

1977-01-01

Employment in the logging industry dropped 28 percent between 1950 and 1970, while output of industrial roundwood increased 31 percent. Today's loggers are older, better educated, and more skilled. A large proportion are self-employed, many work less than a full year, and a substantial number have incomes below the poverty level. Mechanization of timber harvesting...

"Alternative to Prison" Programs for the Mentally Ill Offender

ERIC Educational Resources Information Center

Schaefer, Nicole J.; Stefancic, Ana

2003-01-01

Mentally ill offenders represent a substantial proportion of jail and prison inmates. Despite the fact that confining mentally ill offenders can and often will exacerbate their mental illness, the quality of mental health services available to them remains poor and insufficient. Up to date, only a few cities and counties have considered a more…

Behind Mathematical Learning Disabilities: What about Visual Perception and Motor Skills?

ERIC Educational Resources Information Center

Pieters, Stefanie; Desoete, Annemie; Roeyers, Herbert; Vanderswalmen, Ruth; Van Waelvelde, Hilde

2012-01-01

In a sample of 39 children with mathematical learning disabilities (MLD) and 106 typically developing controls belonging to three control groups of three different ages, we found that visual perception, motor skills and visual-motor integration explained a substantial proportion of the variance in either number fact retrieval or procedural…

Modes of occurrence of potentially hazardous elements in coal: levels of confidence

USGS Publications Warehouse

Finkelman, R.B.

1994-01-01

The modes of occurrence of the potentially hazardous elements in coal will be of significance in any attempt to reduce their mobilization due to coal combustion. Antimony and selenium may be present in solid solution in pyrite, as minute accessory sulfides dispersed throughout the organic matrix, or in organic association. Because of these modes of occurrence it is anticipated that less than 50% of these elements will be routinely removed by conventional coal cleaning procedures. Arsenic and mercury occur primarily in late-stage coarse-grained pyrite therefore physical coal cleaning procedures should be successful in removing substantial proportions of these elements. Cadmium occurs in sphalerite and lead in galena. Both of these minerals exhibit a wide range of particle sizes and textural relations. Depending on the particle size and textural relations, physical coal cleaning may remove as little as 25% of these elements or as much as 75%. Manganese in bituminous coal occurs in carbonates, especially siderite. Physical coal cleaning should remove a substantial proportion of this element. More information is needed to elucidate the modes of occurrence of beryllium, chromium, cobalt, and nickel. ?? 1994.

Negative symptoms in first episode non-affective psychosis.

PubMed

Malla, Ashok K; Takhar, Jatinder J; Norman, Ross M G; Manchanda, Rahul; Cortese, Leonard; Haricharan, Raj; Verdi, Mary; Ahmed, Rashid

2002-06-01

To determine the prevalence of negative symptoms and to examine secondary sources of influence on negative symptoms and the role of specific negative symptoms in delay associated with seeking treatment in first episode non-affective psychosis. One hundred and ten patients who met Diagnostic Statistical Manual-IV (DSM-IV) criteria for a first episode of schizophrenia spectrum psychoses were rated for assessment of negative, positive, depressive and extrapyramidal symptoms, the premorbid adjustment scale and assessment of demographic and clinical characteristics including duration of untreated psychosis (DUP). Alogia/flat affect and avolition/anhedonia were strongly influenced by parkinsonian and depressive symptoms, respectively. A substantial proportion (26.8%) of patients showed at a least moderate level of negative symptoms not confounded by depression and Parkinsonism. DUP was related only to avolition/anhedonia while flat affect/alogia was related to male gender, diagnosis of schizophrenia, age of onset and the length of the prodrome. Negative symptoms that are independent of the influence of positive symptoms, depression and extra pyramidal symptoms (EPS) are present in a substantial proportion of first episode psychosis patients and delay in seeking treatment is associated mainly with avolition and anhedonia.

Substantial proportion of global streamflow less than three months old

NASA Astrophysics Data System (ADS)

Jasechko, Scott; Kirchner, James W.; Welker, Jeffrey M.; McDonnell, Jeffrey J.

2016-02-01

Biogeochemical cycles, contaminant transport and chemical weathering are regulated by the speed at which precipitation travels through landscapes and reaches streams. Streamflow is a mixture of young and old precipitation, but the global proportions of these young and old components are not known. Here we analyse seasonal cycles of oxygen isotope ratios in rain, snow and streamflow compiled from 254 watersheds around the world, and calculate the fraction of streamflow that is derived from precipitation that fell within the past two or three months. This young streamflow accounts for about a third of global river discharge, and comprises at least 5% of discharge in about 90% of the catchments we investigated. We conclude that, although typical catchments have mean transit times of years or even decades, they nonetheless can rapidly transmit substantial fractions of soluble contaminant inputs to streams. Young streamflow is less prevalent in steeper landscapes, which suggests they are characterized by deeper vertical infiltration. Because young streamflow is derived from less than 0.1% of global groundwater storage, we conclude that this thin veneer of aquifer storage will have a disproportionate influence on stream water quality.

Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met?

PubMed

Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Chang, Rowland W; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Hootman, Jennifer M

2011-11-01

Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA. Copyright © 2011 by the American College of Rheumatology.

Risk Analysis of Prostate Cancer in PRACTICAL, a Multinational Consortium, Using 25 Known Prostate Cancer Susceptibility Loci.

PubMed

Amin Al Olama, Ali; Benlloch, Sara; Antoniou, Antonis C; Giles, Graham G; Severi, Gianluca; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Muir, Kenneth; Schleutker, Johanna; Henderson, Brian E; Haiman, Christopher A; Schumacher, Fredrick R; Pashayan, Nora; Pharoah, Paul D P; Ostrander, Elaine A; Stanford, Janet L; Batra, Jyotsna; Clements, Judith A; Chambers, Suzanne K; Weischer, Maren; Nordestgaard, Børge G; Ingles, Sue A; Sorensen, Karina D; Orntoft, Torben F; Park, Jong Y; Cybulski, Cezary; Maier, Christiane; Doerk, Thilo; Dickinson, Joanne L; Cannon-Albright, Lisa; Brenner, Hermann; Rebbeck, Timothy R; Zeigler-Johnson, Charnita; Habuchi, Tomonori; Thibodeau, Stephen N; Cooney, Kathleen A; Chappuis, Pierre O; Hutter, Pierre; Kaneva, Radka P; Foulkes, William D; Zeegers, Maurice P; Lu, Yong-Jie; Zhang, Hong-Wei; Stephenson, Robert; Cox, Angela; Southey, Melissa C; Spurdle, Amanda B; FitzGerald, Liesel; Leongamornlert, Daniel; Saunders, Edward; Tymrakiewicz, Malgorzata; Guy, Michelle; Dadaev, Tokhir; Little, Sarah J; Govindasami, Koveela; Sawyer, Emma; Wilkinson, Rosemary; Herkommer, Kathleen; Hopper, John L; Lophatonanon, Aritaya; Rinckleb, Antje E; Kote-Jarai, Zsofia; Eeles, Rosalind A; Easton, Douglas F

2015-07-01

Genome-wide association studies have identified multiple genetic variants associated with prostate cancer risk which explain a substantial proportion of familial relative risk. These variants can be used to stratify individuals by their risk of prostate cancer. We genotyped 25 prostate cancer susceptibility loci in 40,414 individuals and derived a polygenic risk score (PRS). We estimated empirical odds ratios (OR) for prostate cancer associated with different risk strata defined by PRS and derived age-specific absolute risks of developing prostate cancer by PRS stratum and family history. The prostate cancer risk for men in the top 1% of the PRS distribution was 30.6 (95% CI, 16.4-57.3) fold compared with men in the bottom 1%, and 4.2 (95% CI, 3.2-5.5) fold compared with the median risk. The absolute risk of prostate cancer by age of 85 years was 65.8% for a man with family history in the top 1% of the PRS distribution, compared with 3.7% for a man in the bottom 1%. The PRS was only weakly correlated with serum PSA level (correlation = 0.09). Risk profiling can identify men at substantially increased or reduced risk of prostate cancer. The effect size, measured by OR per unit PRS, was higher in men at younger ages and in men with family history of prostate cancer. Incorporating additional newly identified loci into a PRS should improve the predictive value of risk profiles. We demonstrate that the risk profiling based on SNPs can identify men at substantially increased or reduced risk that could have useful implications for targeted prevention and screening programs. ©2015 American Association for Cancer Research.

Impact of a financial risk-sharing scheme on budget-impact estimations: a game-theoretic approach.

PubMed

Gavious, Arieh; Greenberg, Dan; Hammerman, Ariel; Segev, Ella

2014-06-01

As part of the process of updating the National List of Health Services in Israel, health plans (the 'payers') and manufacturers each provide estimates on the expected number of patients that will utilize a new drug. Currently, payers face major financial consequences when actual utilization is higher than the allocated budget. We suggest a risk-sharing model between the two stakeholders; if the actual number of patients exceeds the manufacturer's prediction, the manufacturer will reimburse the payers by a rebate rate of α from the deficit. In case of under-utilization, payers will refund the government at a rate of γ from the surplus budget. Our study objective was to identify the optimal early estimations of both 'players' prior to and after implementation of the risk-sharing scheme. Using a game-theoretic approach, in which both players' statements are considered simultaneously, we examined the impact of risk-sharing within a given range of rebate proportions, on players' early budget estimations. When increasing manufacturer's rebate α to be over 50 %, then manufacturers will announce a larger number, and health plans will announce a lower number of patients than they would without risk sharing, thus substantially decreasing the gap between their estimates. Increasing γ changes players' estimates only slightly. In reaction to applying a substantial risk-sharing rebate α on the manufacturer, both players are expected to adjust their budget estimates toward an optimal equilibrium. Increasing α is a better vehicle for reaching the desired equilibrium rather than increasing γ, as the manufacturer's rebate α substantially influences both players, whereas γ has little effect on the players behavior.

Risk Analysis of Prostate Cancer in PRACTICAL, a Multinational Consortium, Using 25 Known Prostate Cancer Susceptibility Loci

PubMed Central

Amin Al Olama, Ali; Benlloch, Sara; Antoniou, Antonis C.; Zeigler-Johnson, Charnita; Stephenson, Robert; Cox, Angela; Southey, Melissa C.; Spurdle, Amanda B.; FitzGerald, Liesel; Leongamornlert, Daniel; Saunders, Edward; Tymrakiewicz, Malgorzata; Guy, Michelle; Dadaev, Tokhir; Little, Sarah J.; Govindasami, Koveela; Sawyer, Emma; Wilkinson, Rosemary; Herkommer, Kathleen; Hopper, John L.; Lophatonanon, Aritaya; Rinckleb, Antje E.; Kote-Jarai, Zsofia; Eeles, Rosalind A.; Easton, Douglas F.

2015-01-01

Background Genome-wide association studies have identified multiple genetic variants associated with prostate cancer (PrCa) risk which explain a substantial proportion of familial relative risk. These variants can be used to stratify individuals by their risk of PrCa. Methods We genotyped 25 PrCa susceptibility loci in 40,414 individuals and derived a polygenic risk score (PRS). We estimated empirical Odds Ratios for PrCa associated with different risk strata defined by PRS and derived age-specific absolute risks of developing PrCa by PRS stratum and family history. Results The PrCa risk for men in the top 1% of the PRS distribution was 30.6 (95% CI 16.4-57.3) fold compared with men in the bottom 1%, and 4.2 (95% CI 3.2-5.5) fold compared with the median risk. The absolute risk of PrCa by age 85 was 65.8% for a man with family history in the top 1% of the PRS distribution, compared with 3.7% for a man in the bottom 1%. The PRS was only weakly correlated with serum PSA level (correlation=0.09). Conclusions Risk profiling can identify men at substantially increased or reduced risk of PrCa. The effect size, measured by OR per unit PRS, was higher in men at younger ages and in men with family history of PrCa. Incorporating additional newly identified loci into a PRS should improve the predictive value of risk profiles. Impact We demonstrate that the risk profiling based on SNPs can identify men at substantially increased or reduced risk that could have useful implications for targeted prevention and screening programs. PMID:25837820

The permafrost carbon inventory on the Tibetan Plateau: a new evaluation using deep sediment cores

NASA Astrophysics Data System (ADS)

Yang, Y.; Ding, J.; Li, F.; Yang, G.; Chen, L.

2016-12-01

The permafrost organic carbon (OC) stock is of global significance because of its large pool size and potential positive feedback to climate warming. However, due to the lack of systematic field observations and appropriate upscaling methodologies, substantial uncertainties exist in the permafrost OC budget, which limits our understanding on the fate of frozen carbon in a warming world. In particular, the lack of comprehensive estimation of OC stock across alpine permafrost means that the current knowledge on this issue remains incomplete. Here we evaluated the pool size and spatial variations of permafrost OC stock to 3 meters depth on the Tibetan Plateau by combining systematic measurements from a substantial number of pedons (i.e., 342 three-meter-deep cores and 177 50-cm-deep pits) with a machine learning technique (i.e., support vector machine, SVM). We also quantified uncertainties in permafrost carbon budget by conducting Monte Carlo simulation. Our results revealed that the combination of systematic measurements with the SVM model allowed spatially explicit estimates. The OC density (OC amount per unit area, OCD) exhibited a decreasing trend from the southeastern to the northwestern plateau, with the exception that OCD in the swamp meadow was substantially higher than that in surrounding regions. Our results also demonstrated that Tibetan permafrost stored a large amount of OC in the top 3 meters, with the median OC pool size being 15.31 Pg C (interquartile range: 13.03-17.77 Pg C). Of them, 44% occurred in deep layers (i.e., 100-300 cm), close to the proportion observed across the northern circumpolar permafrost region. The large carbon pool size, together with significant permafrost thawing implies a risk of carbon emissions and positive climate feedback across the Tibetan alpine permafrost region.

Soil macrofauna webmasters of ecosystem

NASA Astrophysics Data System (ADS)

Frouz, Jan

2015-04-01

The role of plant roots and microflora in shaping many ecosystem processes is generally appreciated in the contrary rho role of soil mcrofauna in this context is assumed to be negligible and rather anecdotic. But more than half of the litter fall is consumed by soil fauna and soil fauna can also consume and or translocation substantial amount of soil. Here we demonstrate on example of post mining chronosequences how site colonization by soil fauna affect composition of whole soil biota community, plant succession and soil formation. Filed and laboratory experiments show that decomposition of fauna feces may be sped up compare to litter at the very beginning but in long term fauna feces decompose slower than litter. This is also supported by micro morphological observation which shows that fauna feces form substantial part of soil. Fauna feces also induce lover or even negative priming effect when introduced in soil in comparison with litter that triggers positive priming effect. Laboratory experiment show that fauna effect is context sensitive and is more pronounced in systems already affected by soil fauna. Soil mixing by soil fauna consequently affect environmental conditions in soils such as water holding capacity or nutrient availability, it also affect composition of decomposer food web including microbial community (fungal bacterial ratio) which feed back in alternation of plant community composition during succession This fauna activity is not constant everywhere the higher effect of fauna activity on litter layer was observed in temperate soils of deciduous forests and with litter having CN between 20-30. In conclusion soil fauna use directly only small proportion of energy in the litter but can substantially affect soil carbon turnover, soil formation, decomposer food web and plant community.

Death certificate only proportions should be age adjusted in studies comparing cancer survival across populations and over time.

PubMed

Brenner, Hermann; Castro, Felipe A; Eberle, Andrea; Emrich, Katharina; Holleczek, Bernd; Katalinic, Alexander; Jansen, Lina

2016-01-01

The proportion of cases notified by death certificate only (DCO) is a commonly used data quality indicator in studies comparing cancer survival across regions and over time. We aimed to assess dependence of DCO proportions on the age structure of cancer patients. Using data from a national cancer survival study in Germany, we determined age specific and overall (crude) DCO proportions for 24 common forms of cancer. We then derived overall (crude) DCO proportions expected in case of shifts of the age distribution of the cancer populations by 5 and 10 years, respectively, assuming age specific DCO proportions to remain constant. Median DCO proportions across the 24 cancers were 2.4, 3.7, 5.5, 8.5 and 23.9% in age groups 15-44, 45-54, 55-64, 65-74, and 75+, respectively. A decrease of ages by 5 and 10 years resulted in decreases of cancer specific crude DCO proportions ranging from 0.4 to 4.8 and from 0.7 to 8.6 percent units, respectively. Conversely, an increase of ages by 5 and 10 years led to increases of cancer specific crude DCO proportions ranging from 0.8 to 4.8 and from 1.8 to 9.6 percent units, respectively. These changes were of similar magnitude (but in opposite direction) as changes in crude 5-year relative survival resulting from the same shifts in age distribution. The age structure of cancer patient populations has a substantial impact on DCO proportions. DCO proportions should therefore be age adjusted in comparative studies on cancer survival across regions and over time. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community violence exposure and severe posttraumatic stress in suburban American youth: risk and protective factors.

PubMed

Löfving-Gupta, Sandra; Lindblad, Frank; Stickley, Andrew; Schwab-Stone, Mary; Ruchkin, Vladislav

2015-04-01

The psychological effects of community violence exposure among inner-city youth are severe, yet little is known about its prevalence and moderators among suburban middle-class youth. This study aimed to assess the prevalence of community violence exposure among suburban American youth, to examine associated posttraumatic stress and to evaluate factors related to severe vs. less severe posttraumatic stress, such as co-existing internalizing and externalizing problems, as well as the effects of teacher support, parental warmth and support, perceived neighborhood safety and conventional involvement in this context. Data were collected from 780 suburban, predominantly Caucasian middle-class high-school adolescents in the Northeastern US during the Social and Health Assessment (SAHA) study. A substantial number of suburban youth were exposed to community violence and 24% of those victimized by community violence developed severe posttraumatic stress. Depressive symptoms were strongly associated with higher levels and perceived teacher support with lower levels of posttraumatic stress. Similar to urban youth, youth living in suburban areas in North American settings may be affected by community violence. A substantial proportion of these youth reports severe posttraumatic stress and high levels of comorbid depressive symptoms. Teacher support may have a protective effect against severe posttraumatic stress and thus needs to be further assessed as a potential factor that can be used to mitigate the detrimental effects of violence exposure.

Refined assessment of associations between drinking water residence time and emergency department visits for gastrointestinal illness in Metro Atlanta, Georgia.

PubMed

Levy, Karen; Klein, Mitchel; Sarnat, Stefanie Ebelt; Panwhar, Samina; Huttinger, Alexandra; Tolbert, Paige; Moe, Christine

2016-08-01

Recent outbreak investigations suggest that a substantial proportion of waterborne disease outbreaks are attributable to water distribution system issues. In this analysis, we examine the relationship between modeled water residence time (WRT), a proxy for probability of microorganism intrusion into the distribution system, and emergency department visits for gastrointestinal (GI) illness for two water utilities in Metro Atlanta, USA during 1993-2004. We also examine the association between proximity to the nearest distribution system node, based on patients' residential address, and GI illness using logistic regression models. Comparing long (≥90th percentile) with intermediate WRTs (11th to 89th percentile), we observed a modestly increased risk for GI illness for Utility 1 (OR = 1.07, 95% CI: 1.02-1.13), which had substantially higher average WRT than Utility 2, for which we found no increased risk (OR = 0.98, 95% CI: 0.94-1.02). Examining finer, 12-hour increments of WRT, we found that exposures >48 h were associated with increased risk of GI illness, and exposures of >96 h had the strongest associations, although none of these associations was statistically significant. Our results suggest that utilities might consider reducing WRTs to <2-3 days or adding booster disinfection in areas with longer WRT, to minimize risk of GI illness from water consumption.

Refined Assessment of Associations between Drinking Water Residence Time and Emergency Department Visits for Gastrointestinal Illness in Metro Atlanta, Georgia

PubMed Central

Levy, Karen; Klein, Mitchell; Sarnat, Stefanie Ebelt; Panwhar, Samina; Huttinger, Alexandra; Tolbert, Paige; Moe, Christine

2017-01-01

Recent outbreak investigations suggest that a substantial proportion of waterborne disease outbreaks are attributable to water distribution system issues. In this analysis, we examine the relationship between modeled water residence time (WRT), a proxy for probability of microorganism intrusion into the distribution system, and emergency department visits for gastrointestinal (GI) illness for two water utilities in Metro Atlanta, USA during 1993–2004. We also examine the association between proximity to the nearest distribution system node, based on patients' residential address, and GI illness using logistic regression models. Comparing long (≥90th percentile) to intermediate WRTs (11th to 89th percentile), we observed a modestly increased risk for GI illness for Utility 1 (OR=1.07, 95% CI: 1.02–1.13), which had substantially higher average WRT than Utility 2, for which we found no increased risk (OR=0.98, 95% CI: 0.94–1.02). Examining finer, 12-hour increments of WRT, we found that exposures >48 hrs were associated with increased risk of GI illness, and exposures of >96 hrs had the strongest associations, although none of these associations were statistically significant. Our results suggest that utilities might consider reducing WRTs to <2–3 days or add booster disinfection in areas with longer WRT, to minimize risk of GI illness from water consumption. PMID:27441862

All part of the job? The contribution of the psychosocial and physical work environment to health inequalities in Europe and the European health divide.

PubMed

Toch, Marlen; Bambra, Clare; Lunau, Thorsten; van der Wel, Kjetil A; Witvliet, Margot I; Dragano, Nico; Eikemo, Terje A

2014-01-01

This study is the first to examine the contribution of both psychosocial and physical risk factors to occupational inequalities in self-assessed health in Europe. Data from 27 countries were obtained from the 2010 European Working Conditions Survey for men and women aged 16 to 60 (n = 21,803). Multilevel logistic regression analyses (random intercept) were applied, estimating odds ratios of reporting less than good health. Analyses indicate that physical working conditions account for a substantial proportion of occupational inequalities in health in both Central/Eastern and Western Europe. Physical, rather than psychosocial, working conditions seem to have the largest effect on self-assessed health in manual classes. For example, controlling for physical working conditions reduced the inequalities in the prevalence of"less than good health" between the lowest (semi- and unskilled manual workers) and highest (higher controllers) occupational groups in Europe by almost 50 percent (Odds Ratio 1.87, 95% Confidence Interval 1.62-2.16 to 1.42, 1.23-1.65). Physical working conditions contribute substantially to health inequalities across "post-industrial" Europe, with women in manual occupations being particularly vulnerable, especially those living in Central/Eastern Europe. An increased political and academic focus on physical working conditions is needed to explain and potentially reduce occupational inequalities in health.

Conversational Entrainment of Vocal Fry in Young Adult Female American English Speakers.

PubMed

Borrie, Stephanie A; Delfino, Christine R

2017-07-01

Conversational entrainment, the natural tendency for people to modify their behaviors to more closely match their communication partner, is examined as one possible mechanism modulating the prevalence of vocal fry in the speech of young American women engaged in spoken dialogue. Twenty young adult female American English speakers engaged in two spoken dialogue tasks-one with a young adult female American English conversational partner who exhibited substantial vocal fry and one with a young adult female American English conversational partner who exhibited quantifiably less vocal fry. Dialogues were analyzed for proportion of vocal fry, by speaker, and two measures of communicative success (efficiency and enjoyment). Participants employed significantly more vocal fry when conversing with the partner who exhibited substantial vocal fry than when conversing with the partner who exhibited quantifiably less vocal fry. Further, greater similarity between communication partners in their use of vocal fry tracked with higher scores of communicative efficiency and communicative enjoyment. Conversational entrainment offers a mechanistic framework that may be used to explain, to some degree, the frequency with which vocal fry is employed by young American women engaged in spoken dialogue. Further, young American women who modulated their vocal patterns during dialogue to match those of their conversational partner gained more efficiency and enjoyment from their interactions, demonstrating the cognitive and social benefits of entrainment. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Willingness to pay for footwear, and associated factors related to podoconiosis in northern Ethiopia

PubMed Central

Tsegay, Girmay; Tamiru, Abreham; Amberbir, Tsige; Davey, Gail; Deribe, Kebede

2016-01-01

Background In Northern Ethiopia, use of footwear by the rural community is limited, and non-governmental organizations provide footwear for school children as a means of preventing podoconiosis. However, this is not a sustainable strategy. This study assessed willingness to pay for footwear among people with and without podoconiosis. Methods A comparative cross-sectional community-based study was conducted in Mecha and Gozamen woredas among randomly selected people with and without podoconiosis. Trained health extension workers collected data using an interviewer-administered structured questionnaire. The data were entered into EPI-Data and exported to SPSS version 16.0 statistical software package for analysis. Results The willingness to pay for footwear among people with and without podoconiosis was 72.3% and 76.7% respectively (p=0.30). People with podoconiosis in the lower quintiles of economic status were less likely to be willing to pay for footwear than those in the higher quintiles. Conclusions There is substantial willingness to pay for footwear. The expressed willingness to pay indicates demand for footwear in the community, suggesting an opportunity for shoe companies. There are still a substantial proportion of individuals not willing to pay for footwear. This requires intensified public education and social transformation to bring about change in behavior towards footwear use if elimination of podoconiosis within our generation is to be achieved. PMID:27620919

Willingness to pay for footwear, and associated factors related to podoconiosis in northern Ethiopia.

PubMed

Tsegay, Girmay; Tamiru, Abreham; Amberbir, Tsige; Davey, Gail; Deribe, Kebede

2016-09-01

In Northern Ethiopia, use of footwear by the rural community is limited, and non-governmental organizations provide footwear for school children as a means of preventing podoconiosis. However, this is not a sustainable strategy. This study assessed willingness to pay for footwear among people with and without podoconiosis. A comparative cross-sectional community-based study was conducted in Mecha and Gozamen woredas among randomly selected people with and without podoconiosis. Trained health extension workers collected data using an interviewer-administered structured questionnaire. The data were entered into EPI-Data and exported to SPSS version 16.0 statistical software package for analysis. The willingness to pay for footwear among people with and without podoconiosis was 72.3% and 76.7% respectively (p=0.30). People with podoconiosis in the lower quintiles of economic status were less likely to be willing to pay for footwear than those in the higher quintiles. There is substantial willingness to pay for footwear. The expressed willingness to pay indicates demand for footwear in the community, suggesting an opportunity for shoe companies. There are still a substantial proportion of individuals not willing to pay for footwear. This requires intensified public education and social transformation to bring about change in behavior towards footwear use if elimination of podoconiosis within our generation is to be achieved. © The Author 2016. Published by Oxford University Press Royal Society of Tropical Medicine and Hygiene.

Subjects harboring presenilin familial Alzheimer’s disease mutations exhibit diverse white matter biochemistry alterations

PubMed Central

Roher, Alex E; Maarouf, Chera L; Malek-Ahmadi, Michael; Wilson, Jeffrey; Kokjohn, Tyler A; Daugs, Ian D; Whiteside, Charisse M; Kalback, Walter M; Macias, MiMi P; Jacobson, Sandra A; Sabbagh, Marwan N; Ghetti, Bernardino; Beach, Thomas G

2013-01-01

Alzheimer’s disease (AD) dementia impacts all facets of higher order cognitive function and is characterized by the presence of distinctive pathological lesions in the gray matter (GM). The profound alterations in GM structure and function have fostered the view that AD impacts are primarily a consequence of GM damage. However, the white matter (WM) represents about 50% of the cerebrum and this area of the brain is substantially atrophied and profoundly abnormal in both sporadic AD (SAD) and familial AD (FAD). We examined the WM biochemistry by ELISA and Western blot analyses of key proteins in 10 FAD cases harboring mutations in the presenilin genes PSEN1 and PSEN2 as well as in 4 non-demented control (NDC) individuals and 4 subjects with SAD. The molecules examined were direct substrates of PSEN1 such as Notch-1 and amyloid precursor protein (APP). In addition, apolipoproteins, axonal transport molecules, cytoskeletal and structural proteins, neurotrophic factors and synaptic proteins were examined. PSEN-FAD subjects had, on average, higher amounts of WM amyloid-beta (Aβ) peptides compared to SAD, which may play a role in the devastating dysfunction of the brain. However, the PSEN-FAD mutations we examined did not produce uniform increases in the relative proportions of Aβ42 and exhibited substantial variability in total Aβ levels. These observations suggest that neurodegeneration and dementia do not depend solely on enhanced Aβ42 levels. Our data revealed additional complexities in PSEN-FAD individuals. Some direct substrates of γ-secretase, such as Notch, N-cadherin, Erb-B4 and APP, deviated substantially from the NDC group baseline for some, but not all, mutation types. Proteins that were not direct γ-secretase substrates, but play key structural and functional roles in the WM, likewise exhibited varied concentrations in the distinct PSEN mutation backgrounds. Detailing the diverse biochemical pathology spectrum of PSEN mutations may offer valuable insights into dementia progression and the design of effective therapeutic interventions for both SAD and FAD. PMID:24093083

Extended family medicine training: Measuring training flows at a time of substantial pedagogic change.

PubMed

Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F

2016-12-01

To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Canada. All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS-Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of extended family medicine training programs. Copyright© the College of Family Physicians of Canada.

The demand for physician services. Evidence from a natural experiment.

PubMed

Cockx, Bart; Brasseur, Carine

2003-11-01

This study exploits a natural experiment in Belgium to estimate the effect of copayment increases on the demand for physician services. It shows how a differences-in-differences (DD) estimator of the price effects can be decomposed into effects induced by the common average proportional price increase (income effects) and by the change in relative prices (substitution effects). The price elasticity of a uniform proportional price increase is relatively small (-0.13 for men and -0.03 for women). Substitution effects are large, especially for women, but imprecisely estimated. Despite the substantial price increases, the efficiency gain of the reform, if any, is modest.

School Segregation of Children Who Migrate to the U.S. from Puerto Rico.

ERIC Educational Resources Information Center

Laosa, Luis M.

2001-01-01

Examined patterns of school segregation and other ecological characteristics of 89 schools attended by Puerto Rican students who migrated to the mainland United States (New Jersey). Correlations show that the higher the proportion of Hispanics/Latinos, the higher the student body's proportion of students from economically impoverished households…

Hotspots of inefficiency: Mapping the difference between crop production and food calorie delivery

NASA Astrophysics Data System (ADS)

Cassidy, E. S.; Foley, J. A.

2012-12-01

Meeting growing demands for food calories will be a substantial challenge. One place to search for solutions is in how we allocate the world's crops, and finding ways to feed more people with current crop production. Currently, a substantial proportion of crop calories are used as animal feed, and only a small fraction of those feed calories ultimately contribute to human diets. Countries like the United States and China, which together produce over a third of the world's meat, eggs and dairy, lose a substantial portion of calories and protein to the feed-to-animal conversion process. This study looks at global croplands that have a large difference between calories grown, and the food calories available for consumption. These hotspots have the potential to feed more people, while reducing environmental impacts of agriculture.;

Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education.

PubMed

Volken, T; Wieber, F; Rüesch, P; Huber, M; Crawford, R J

2017-09-01

Our study aimed to describe the temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland, with a view to identifying groups at risk for declining health. Secondary analysis of population-based cross-sectional health surveys. Data were collected from the cross-sectional, population-based, five-year Swiss Health Survey, from 1997, 2002, 2007 and 2012. A total of 63,861 individuals' data were included. Multilevel mixed-effect logistic regression analysis was employed to estimate the probability of very good and good health within the framework of a hierarchical cross-classified age-period-cohort model (HAPC), adjusting for education level, gender, civil status, smoking status and body mass index. Individuals with higher education were substantially more likely than those with primary education to report good SRH (OR = 2.12; 95% CI = 1.93-2.33 for secondary education and OR = 3.79; 95% CI = 3.39-4.23 for tertiary education). The education effect depended on birth cohort and age: higher proportions of good SRH were reported by secondary (8%-17%) and tertiary (10%-22%) compared with primary educated individuals from the 1940 birth cohort onward; the proportion of secondary/tertiary (compared to primary) educated people reporting good SRH increased with age (by 10/11% at 45-50 years and 25/36% at 80-84 years). Gender health equality was achieved by the 1955 (primary educated) and 1960 (secondary educated) birth cohorts, while these women overtook men in reporting good SRH from the 1975 birth cohort onward. Tertiary educated younger women were significantly less likely to report good SRH than men but parity was achieved at around pension age. Similarly, gender inequality in those with primary and secondary education reduced in the younger ages to not be significant at around age 55, with women overtaking men from age 65. Younger birth cohorts with lower education levels appear most vulnerable in terms of their SRH. The education effect cumulatively increases when attaining incrementally higher education levels. While women report lower health than men, gender inequality in SRH has declined and even reversed over time and is substantially linked to differences in educational status. Swiss public health strategies should particularly target the younger adults with only primary school education of both genders; for women, to combat health burdens in their early life, and men, to mitigate issues in their later life. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A Novel Tool Improves Existing Estimates of Recent Tuberculosis Transmission in Settings of Sparse Data Collection.

PubMed

Kasaie, Parastu; Mathema, Barun; Kelton, W David; Azman, Andrew S; Pennington, Jeff; Dowdy, David W

2015-01-01

In any setting, a proportion of incident active tuberculosis (TB) reflects recent transmission ("recent transmission proportion"), whereas the remainder represents reactivation. Appropriately estimating the recent transmission proportion has important implications for local TB control, but existing approaches have known biases, especially where data are incomplete. We constructed a stochastic individual-based model of a TB epidemic and designed a set of simulations (derivation set) to develop two regression-based tools for estimating the recent transmission proportion from five inputs: underlying TB incidence, sampling coverage, study duration, clustered proportion of observed cases, and proportion of observed clusters in the sample. We tested these tools on a set of unrelated simulations (validation set), and compared their performance against that of the traditional 'n-1' approach. In the validation set, the regression tools reduced the absolute estimation bias (difference between estimated and true recent transmission proportion) in the 'n-1' technique by a median [interquartile range] of 60% [9%, 82%] and 69% [30%, 87%]. The bias in the 'n-1' model was highly sensitive to underlying levels of study coverage and duration, and substantially underestimated the recent transmission proportion in settings of incomplete data coverage. By contrast, the regression models' performance was more consistent across different epidemiological settings and study characteristics. We provide one of these regression models as a user-friendly, web-based tool. Novel tools can improve our ability to estimate the recent TB transmission proportion from data that are observable (or estimable) by public health practitioners with limited available molecular data.

Salinity alters the protein composition of rice endosperm and the physicochemical properties of rice flour.

PubMed

Baxter, Graeme; Zhao, Jian; Blanchard, Christopher

2011-09-01

Salinity is one of the major threats to production of rice and other agricultural crops worldwide. Although numerous studies have shown that salinity can severely reduce rice yield, little is known about its impact on the chemical composition, processing and sensory characteristics of rice. The objective of the current study was to investigate the effect of salinity on the pasting and textural properties of rice flour as well as on the protein content and composition of rice endosperm. Rice grown under saline conditions had significantly lower yields but substantially higher protein content. The increase in protein content was mainly attributed to increases in the amount of glutelin, with lesser contributions from albumin. Salinity also altered the relative proportions of the individual peptides within the glutelin fraction. Flours obtained from rice grown under saline conditions showed significantly higher pasting temperatures, but lower peak and breakdown viscosities. Rice gels prepared from the flour showed significantly higher hardness and adhesiveness values, compared to the freshwater controls. Salinity can significantly affect the pasting and textural characteristics of rice flour. Although some of the effects could be attributed to changes in protein content of the rice flour, especially the increased glutelin level, the impact of salinity on the physicochemical properties of rice is rather complex and may involve the interrelated effects of other rice components such as starch and lipids. Copyright © 2011 Society of Chemical Industry.

Models of job-related stress and personal achievement among consultant doctors.

PubMed

Deary, I J; Blenkin, H; Agius, R M; Endler, N S; Zealley, H; Wood, R

1996-02-01

The antecedents and outcomes of feelings of job-related stress and personal achievement were studied in a large sample of consultant doctors working in Scotland. In a sample of 333 doctors it was found that a tendency to use emotion-oriented coping strategies and negative appraisals of organizational changes in the practice of medicine mediated the effect of the personality dimension of Neuroticism on reported job stress. Job stress levels predicted the degree of 'burnout' experienced by doctors, i.e. their tendencies to be emotionally exhausted by their work and to dehumanize patients. Higher clinical workloads were related to higher levels of stress but also to higher feelings of personal achievement. A substantial proportion of the variance in many of the variables in the stress model was accounted for by a general tendency to experience negative emotions, closely related to Neuroticism; this general factor appeared to be similar to the recently formulated concepts of 'negative affectivity' and 'somatopsychic distress'. The personality factors of Extraversion and Conscientiousness both contributed to positive feelings of personal achievement (N = 344); the effect of Extraversion was direct, whereas the effect of Conscientiousness was mediated by a tendency to use task-oriented coping strategies. Models of the processes of stress and personal achievement were tested for acceptability using the EQS Structural Equations Program. The implications of the models for transactional theories of stress are discussed.

Estimating the Proportion of True Null Hypotheses Using the Pattern of Observed p-values

PubMed Central

Tong, Tiejun; Feng, Zeny; Hilton, Julia S.; Zhao, Hongyu

2013-01-01

Estimating the proportion of true null hypotheses, π0, has attracted much attention in the recent statistical literature. Besides its apparent relevance for a set of specific scientific hypotheses, an accurate estimate of this parameter is key for many multiple testing procedures. Most existing methods for estimating π0 in the literature are motivated from the independence assumption of test statistics, which is often not true in reality. Simulations indicate that most existing estimators in the presence of the dependence among test statistics can be poor, mainly due to the increase of variation in these estimators. In this paper, we propose several data-driven methods for estimating π0 by incorporating the distribution pattern of the observed p-values as a practical approach to address potential dependence among test statistics. Specifically, we use a linear fit to give a data-driven estimate for the proportion of true-null p-values in (λ, 1] over the whole range [0, 1] instead of using the expected proportion at 1 − λ. We find that the proposed estimators may substantially decrease the variance of the estimated true null proportion and thus improve the overall performance. PMID:24078762

Estimating the Proportion of True Null Hypotheses Using the Pattern of Observed p-values.

PubMed

Tong, Tiejun; Feng, Zeny; Hilton, Julia S; Zhao, Hongyu

2013-01-01

Estimating the proportion of true null hypotheses, π 0 , has attracted much attention in the recent statistical literature. Besides its apparent relevance for a set of specific scientific hypotheses, an accurate estimate of this parameter is key for many multiple testing procedures. Most existing methods for estimating π 0 in the literature are motivated from the independence assumption of test statistics, which is often not true in reality. Simulations indicate that most existing estimators in the presence of the dependence among test statistics can be poor, mainly due to the increase of variation in these estimators. In this paper, we propose several data-driven methods for estimating π 0 by incorporating the distribution pattern of the observed p -values as a practical approach to address potential dependence among test statistics. Specifically, we use a linear fit to give a data-driven estimate for the proportion of true-null p -values in (λ, 1] over the whole range [0, 1] instead of using the expected proportion at 1 - λ. We find that the proposed estimators may substantially decrease the variance of the estimated true null proportion and thus improve the overall performance.

Influence of substrate type and temperature on the developmental morphology of Pandora neoaphidis (Zygomycetes: entomophthorales), a pathogen of the tobacco aphid (Homoptera: aphididae).

PubMed

Dara, S K; Semtner, P J

1998-09-01

Developmental morphology of Pandora neoaphidis was observed on the surfaces of the tobacco aphid, Myzus nicotianae, tobacco leaves (Nicotiana tabacum), and glass coverslips at 13 and 20 degrees C for 12 and 24 h postinoculation. Pandora neoaphidis responded similarly on the two living substrates, but differed on the inert coverslips. The proportions of ellipsoid conidia (primary and secondary) were similar on all substrates. Higher proportions of appressoria and lower proportions of round secondary conidia and germinating conidia occurred on the aphids and leaves than on the coverslips. Appressoria predominated over round secondary conidia and germinating conidia on the living substrates at 20 degrees C, but the opposite was seen at 13 degrees C. The proportions of ellipsoid conidia were similar at both temperatures. On coverslips, the proportions of appressoria and round secondary conidia were similar at both temperatures. However, the proportions of germinating and ellipsoid conidia were higher at 13 and 20 degrees C, respectively. Copyright 1998 Academic Press.

Potential impact of the human papillomavirus vaccine on the incidence proportion of genital warts in French women (EFFICAE study): a multicentric prospective observational study.

PubMed

Judlin, Philippe; Jacquard, Anne-Carole; Carcopino, Xavier; Aubin, François; Dahlab, André; Mistretta, Frédéric; Not, Didier; Boelle, Pierre-Yves; Aynaud, Olivier; Soubeyrand, Benoît

2016-02-01

Background The objective was to evaluate the effect of a HPV vaccination program on the incidence proportion of a proxy, genital warts (GW), in women in France. The number of primary GW cases was prospectively recorded over two 4-month periods before (T0: Dec 2008 to March 2009) and after (T1: Dec 2011 to March 2012) a HPV vaccination program. A total of 160 gynaecologists participated in T0 and 189 in T1. Primary genital herpes (HSV) infection was used as a control. During T0, 39190 15- to 26 year-old women were seen, of whom 176 were diagnosed with GW (incidence proportion: 0.45%) and 155 with primary HSV infection (incidence proportion: 0.39%). During T1, 45628 females were seen [229 with GW (incidence proportion: 0.50%) and 202 with HSV (incidence proportion: 0.44%)]. In the 15-20 years age category, the incidence proportion of primary GW decreased from 0.41% to 0.30% (P=0.128) between T0 and T1, and the proportion of women newly diagnosed with primary genital herpes diseases slightly increased from 0.34% to 0.38% (P=0.620). In the 15-18 years age group, this decrease became significant (0.34% to 0.18%; P=0.048). A trend for a non-significant decreased incidence proportion of GW was observed in young women below 20 years who are more frequently vaccinated. This may be the result of HPV vaccination and suggests that a substantial increase in vaccine coverage could lead to a more pronounced decreased incidence proportion of GW in the future.

The Process of Retirement Planning Scale (PRePS): Development and Validation

ERIC Educational Resources Information Center

Noone, Jack H.; Stephens, Christine; Alpass, Fiona

2010-01-01

Although a substantial proportion of the western population is approaching retirement age, little is known about how they are preparing for the future. Much attention has been paid to the consumption of educational material and retirement wealth in the present literature, but the process of retirement planning has been ignored. S. L. Friedman and…

Modeling the Relationship between Perceptions of Assessment Tasks and Classroom Assessment Environment as a Function of Gender

ERIC Educational Resources Information Center

Alkharusi, Hussain; Aldhafri, Said; Alnabhani, Hilal; Alkalbani, Muna

2014-01-01

A substantial proportion of the classroom time involves exposing students to a variety of assessment tasks. As students process these tasks, they develop beliefs about the importance, utility, value, and difficulty of the tasks. This study aimed at deriving a model describing the multivariate relationship between students' perceptions of the…

The Short-Run Employment Decision and Overtime Behavior in U.S. Industry, 1966.

ERIC Educational Resources Information Center

Ehrenberg, Ronald Gordon

A rational manpower policy must seek to create jobs as well as to provide training for unemployed workers. The creation of new jobs has been hindered, however, by the observed tendency of employers to substitute overtime hours for additional employees, even while substantial unemployment exists. Although a large proportion of overtime hours is due…

Defining the Needs of Patients with Intellectual Disabilities in the High Security Psychiatric Hospitals in England

ERIC Educational Resources Information Center

Thomas, S. D.; Dolan, M.; Johnston, S.; Middleton, H.; Harty, M. A.; Carlisle, J.; Thornicroft, G.; Appleby, L.; Jones, P.

2004-01-01

Previous studies have suggested that a substantial proportion of the patients with intellectual disabilities (ID) in the high security psychiatric hospitals (HSPHs) should be transferred to more appropriate services to cater for their specific needs in the longer term. The individual and placement needs of high secure psychiatric patients detained…

Irlen Colored Filters in the Classroom: A 1-Year Follow-Up

ERIC Educational Resources Information Center

Ritchie, Stuart J.; Della Sala, Sergio; McIntosh, Robert D.

2012-01-01

Colored filters are used to treat Irlen syndrome (IS), a controversial disorder posited to be the cause of a substantial proportion of reading difficulties. Previously, we found that Irlen colored filters do not produce any short-term alleviation of reading difficulties in schoolchildren aged 7-12. Here, we tested whether colored filters show…

Insight into Obsessive-Compulsive Symptoms and Awareness of Illness in Adolescent Schizophrenia Patients with and without OCD

ERIC Educational Resources Information Center

Faragian, Sarit; Kurs, Rena; Poyurovsky, Michael

2008-01-01

A substantial proportion of adolescent schizophrenia patients also has obsessive-compulsive disorder (OCD). As the reliability of OCD identification in schizophrenia has been challenged, we evaluated insight into OCD symptoms and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale and the Scale to Assess Unawareness of Mental…

Adolescents' Responses to Cigarette Advertisements for Five "Youth Brands" and One "Adult Brand."

ERIC Educational Resources Information Center

Arnett, Jeffrey Jensen

2001-01-01

Examined 12- to 17-year-olds' responses to cigarette advertisements. Found that a substantial proportion of adolescents, especially smokers, liked ads for youth brands and believed they made smoking more appealing. Ads for Marlboro brand and new Camel and Winston ads were especially attractive to adolescents. Few adolescents liked the adult brand…

Making Progress Toward Graduation: Evidence from the Talent Development High School Model

ERIC Educational Resources Information Center

Kemple, James J.; Herlihy, Corinne M.; Smith, Thomas J.

2005-01-01

In low-performing public high schools in U.S. cities, high proportions of students drop out, students who stay in school typically do not succeed academically, and efforts to make substantial reforms often meet with little success. The Talent Development High School model is a comprehensive school reform initiative that has been developed to…

Why Does an Adolescent Commit a Crime?

ERIC Educational Resources Information Center

Ziiadova, D.

2004-01-01

In the past few years, Russian adolescents have become a criminally active category of the population. A substantial portion of the contingents of participants in crime consists of students in general education schools. In 2000, their proportion added up to 27 percent of all crimes committed by minors. A study of the structure of the total file of…

Presence, Proximity, and Peer Interactions of Adolescents with Severe Disabilities in General Education Classrooms

ERIC Educational Resources Information Center

Feldman, Rebecca; Carter, Erik W.; Asmus, Jennifer; Brock, Matthew E.

2016-01-01

The authors conducted 324 full-class-length observations of 108 high school students with severe disabilities in general education classes, focusing analyses on how often students were present during class and in proximity to peers without disabilities. Students were not present for a substantial proportion of the classes in which they were…

Rigor, Transparency, and Reporting Social Science Research: Why Guidelines Don't Have to Kill Your Story

ERIC Educational Resources Information Center

Wharton, Tracy

2017-01-01

Dissemination of research is the most challenging aspect of building the evidence base. Despite peer review, evidence suggests that a substantial proportion of papers leave out details that are necessary to judge bias, consider replication, or initiate meta-analyses and systematic reviews. Reporting guidelines were created to ensure minimally…

Financing Basic Education in Bangladesh. CREATE Pathways to Access. Research Monograph No. 12

ERIC Educational Resources Information Center

Al-Samarrai, Samer

2007-01-01

This paper presents education finance trends for Bangladesh since 2000. It shows that while government spending on education as a proportion of national income has stagnated, it has increased in real terms. Real increases in education spending have resulted in substantial increases in per student spending in basic education. At primary, enrolment…

Policy Implications of a Proposed Framework to Improve the Accessibility and Effectiveness of Internships in Accounting

ERIC Educational Resources Information Center

Capka, John; Foltin, Craig

2017-01-01

Accounting internships provide substantial benefits to employers and students alike. However, opportunities for students are not equitable across all populations due to the existing policies that exist for placing interns. This inequity is particularly true for students from community colleges where there is a larger proportion of underrepresented…

Education for Adult English Language Learners in the United States: Trends, Research, and Promising Practices

ERIC Educational Resources Information Center

Schaetzel, Kirsten; Young, Sarah

2010-01-01

Adult English language learners comprise a substantial proportion of the adult education population in the United States. In program year 2006-2007, 46% of participants enrolled in state-administered adult education programs were in English as a second language (ESL) classes. This percentage does not include English language learners enrolled in…

26 CFR 1.46-8 - Requirements for taxpayers electing additional one-percent investment credit (TRASOP's).

Code of Federal Regulations, 2011 CFR

2011-04-01

... issued by the employer. Common stock which meets one of the following tests is “no less favorable”. (i... constructively owned under section 318. (ii) Substantial proportionality test. More than one class of common... one-percent investment credit (TRASOP's). 1.46-8 Section 1.46-8 Internal Revenue INTERNAL REVENUE...

26 CFR 1.46-8 - Requirements for taxpayers electing additional one-percent investment credit (TRASOP's).

Code of Federal Regulations, 2010 CFR

2010-04-01

... issued by the employer. Common stock which meets one of the following tests is “no less favorable”. (i... constructively owned under section 318. (ii) Substantial proportionality test. More than one class of common... one-percent investment credit (TRASOP's). 1.46-8 Section 1.46-8 Internal Revenue INTERNAL REVENUE...

General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators

ERIC Educational Resources Information Center

Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

2006-01-01

Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

Testing Women With Endometrial Cancer for Lynch Syndrome: Should We Test All?

PubMed Central

Ma, Jun; Ledbetter, Nancy; Glenn, Lyn

2013-01-01

Women with Lynch syndrome (LS) are at equal or higher risk for gynecologic cancers compared with their risk for colorectal cancer (CRC). Endometrial cancer (EC) often precedes CRC as patients’ sentinel malignancy. Identifying these patients is believed to reduce their substantial risk for synchronous and metachronous tumors and has profound implications for reducing cancer-related morbidity and mortality in other family members. Routine screening of patients with CRC for LS has become increasingly common, but routine screening for LS in women with EC is rarely performed. Current screening guidelines for identifying LS in women with EC vary but rely heavily on patient age and personal/family history, with or without incorporation of tumor pathology. Because each of these strategies misses a significant proportion of women with LS, more inclusive screening strategies that make good economic and clinical sense are needed. In recent years, emerging medicoeconomic evidence supports the fact that screening EC patients for LS may be cost-effective. Implementation of such a strategy requires multidisciplinary collaboration and partnership. PMID:25032011

Medication-overuse headache: a perspective review

PubMed Central

Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars; Jensen, Rigmor Højland

2016-01-01

Medication-overuse headache (MOH) is a debilitating condition in which frequent and prolonged use of medication for the acute treatment of pain results in the worsening of the headache. The purpose of this paper is to review the most recent literature on MOH and discuss future avenues for research. MOH accounts for a substantial share of the global burden of disease. Prevalence is often reported as 1–2% but can be as high as 7% overall, with higher proportions among women and in those with a low socioeconomic position. Management consists of withdrawing pain medication, focusing on prophylactic and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research in MOH epidemiology, pathophysiology, and neuroimaging. Randomized and long-term follow-up studies on MOH treatment protocols are needed. Further focused research could be of major importance for global health. PMID:27493718

The Current Studies of Education for a Traditional and Complementary Medicine in Malaysia

PubMed Central

Kim, Yun Jin

2017-01-01

The aim of this study is to understand the current tradition and complementary medicine (T&CM) education in Malaysia. We referred to literature regarding to traditional medicine education in Malaysia, and collected the information via website or interview with faculty of T&CM in universities/colleges and Division of T&CM, Ministry of Health, Malaysia. T&CM education in Malaysia has been following China’s T&CM systems for 50 years. Currently, Division of T&CM, Ministry of Health; and Ministry of Higher Education has approved 11 institutions to offer T&CM education. Students may major in Chinese herbal medicine, acupuncture, or other T&CM subjects. Generally, clinical training programs in China, Taiwan, or Australia include substantial proportion of clinical training. We report on the general information of T&CM education in Malaysia. This result would be the first-stage information for the establishment of a strategy regarding the enhancement of T&CM education in Malaysia. PMID:28853309

Tenacious self-reliance in health maintenance may jeopardize late life survival.

PubMed

Hamm, Jeremy M; Chipperfield, Judith G; Perry, Raymond P; Parker, Patti C; Heckhausen, Jutta

2017-11-01

Although an active pursuit of health goals is typically adaptive, there may be circumstances in very late life when it is not. Our 10-year study of community-dwelling individuals (n = 220, 79-98 years-old) examined whether investing substantial effort into personal health (high selective primary control) in the absence of help-seeking strategies (low compensatory primary control) jeopardized survival for very old adults who varied in functional independence (low, high). Cox proportional hazard models showed selective primary control (SPC) predicted 10-year mortality risk for only those with low compensatory primary control (CPC) and high initial functional independence. For these individuals, each standard deviation increase in SPC predicted a 101% higher risk of death. Results are consistent with the lines-of-defense model (Heckhausen et al., 2013) and suggest that, for very old adults with little previous need for help-seeking strategies, tenacious self-reliance (high SPC, low CPC) may have life-shortening consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Content of Structural and Trace Elements in the Knee Joint Tissues.

PubMed

Roczniak, Wojciech; Brodziak-Dopierała, Barbara; Cipora, Elżbieta; Mitko, Krzysztof; Jakóbik-Kolon, Agata; Konieczny, Magdalena; Babuśka-Roczniak, Magdalena

2017-11-23

Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead.

Aquatic Invertebrate Assemblages in Shallow Prairie Lakes: Fish and Environmental Influences

USGS Publications Warehouse

Paukert, C.P.; Willis, D.W.

2003-01-01

We sampled zooplankton and benthic macroinvertebrate assemblages in 30 shallow natural lakes to determine the effects of the environment (i.e., habitat and fish abundance) on invertebrates. Zooplankters were identified to genus, and up to 120 individuals per genus were measured. Macroinvertebrates were identified to order, class, or family. Fish communities were also sampled. Relative abundances of zooplankton and macroinvertebrates were low at increased chlorophyll a concentrations, although mean zooplankton length increased with total phosphorus, possibly because of an increased proportion of microzooplankton (rotifers and copepod nauplii) at higher phosphorus levels. Canonical correspondence analysis revealed that zooplankton and macroinvertebrate abundance was influenced by submersed vegetation coverage, whereas zooplankton abundance and size structure were also related to productivity (i.e., chlorophyll a and total phosphorus). However, relative abundance of fish species or fish feeding guilds was not strongly correlated with zooplankton or macroinvertebrate abundance or zooplankton size structure. Physical habitat (e.g., vegetation coverage) may exert substantial influences on invertebrate assemblages in these lakes, possibly providing a refuge from fish predation.

The Content of Structural and Trace Elements in the Knee Joint Tissues

PubMed Central

Roczniak, Wojciech; Brodziak-Dopierała, Barbara; Cipora, Elżbieta; Mitko, Krzysztof; Jakóbik-Kolon, Agata; Konieczny, Magdalena; Babuśka-Roczniak, Magdalena

2017-01-01

Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead. PMID:29168758

Understanding Racial Differences in Exposure to Violent Areas: Integrating Survey, Smartphone, and Administrative Data Resources.

PubMed

Browning, Christopher R; Calder, Catherine A; Ford, Jodi L; Boettner, Bethany; Smith, Anna L; Haynie, Dana

2017-01-01

Emerging evidence indicates that exposure to violent areas may influence youth wellbeing. We employ smartphone GPS data on youth activity spaces to examine the extent of, and potential explanations for, racial disparities in these exposures. Multilevel models of data from the Adolescent Health and Development in Context study indicate that exposures to violent areas vary significantly across days of the week and between youth who reside in the same neighborhood. African American youth are exposed to areas with substantially higher levels of violence. Residing in a disadvantaged neighborhood is significantly associated with exposure to violent areas and explains a non-trivial proportion of the racial difference in this outcome. However, neighborhood factors are incomplete explanations of the racial disparity. Characteristics of the activity locations at which youth spend time explain the residual racial disparity in exposure to violent areas. These findings highlight the importance of youth activity spaces, above and beyond their neighborhood environments.

Understanding Racial Differences in Exposure to Violent Areas: Integrating Survey, Smartphone, and Administrative Data Resources

PubMed Central

Browning, Christopher R; Calder, Catherine A.; Ford, Jodi L.; Boettner, Bethany; Smith, Anna L.; Haynie, Dana

2017-01-01

Emerging evidence indicates that exposure to violent areas may influence youth wellbeing. We employ smartphone GPS data on youth activity spaces to examine the extent of, and potential explanations for, racial disparities in these exposures. Multilevel models of data from the Adolescent Health and Development in Context study indicate that exposures to violent areas vary significantly across days of the week and between youth who reside in the same neighborhood. African American youth are exposed to areas with substantially higher levels of violence. Residing in a disadvantaged neighborhood is significantly associated with exposure to violent areas and explains a non-trivial proportion of the racial difference in this outcome. However, neighborhood factors are incomplete explanations of the racial disparity. Characteristics of the activity locations at which youth spend time explain the residual racial disparity in exposure to violent areas. These findings highlight the importance of youth activity spaces, above and beyond their neighborhood environments. PMID:28845047

Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities

PubMed Central

Whitty, Christopher JM; Chandler, Clare; Ansah, Evelyn; Leslie, Toby; Staedke, Sarah G

2008-01-01

Following a long period when the effectiveness of existing mono-therapies for antimalarials was steadily declining with no clear alternative, most malaria-endemic countries in Africa and Asia have adopted artemisinin combination therapy (ACT) as antimalarial drug policy. Several ACT drugs exist and others are in the pipeline. If properly targeted, they have the potential to reduce mortality from malaria substantially. The major challenge now is to get the drugs to the right people. Current evidence suggests that most of those who need the drugs do not get them. Simultaneously, a high proportion of those who are given antimalarials do not in fact have malaria. Financial and other barriers mean that, in many settings, the majority of those with malaria, particularly the poorest, do not access formal healthcare, so the provision of free antimalarials via this route has only limited impact. The higher cost of ACT creates a market for fake drugs. Addressing these problems is now a priority. This review outlines current evidence, possible solutions and research priorities. PMID:19091041

Body Esteem and Self–examination in British Men and Women

PubMed Central

Brewer, Gayle; Dewhurst, Anne M.

2013-01-01

Background: Breast and testicular cancers affect a substantial and increasing proportion of the global population. Self-examination encourages early detection and treatment of these cancers, which positively impacts on patient quality of life and survival. Methods: The present study investigated the role of body esteem in breast and testicular self-examination. Men (N = 60) and women (N = 90) recruited from a British University completed the body esteem scale and either the testicular self-examination or breast self-examination questionnaire. Results: Logistic regression models revealed that body esteem predicted women's intention to engage in breast self-examination. Women with higher levels of sexual attractiveness and those with lower levels of weight concern were more likely to report that they would regularly self-examine in the future. Body esteem did not however, distinguish between those women that did or did not currently self-examine or predict men's current or intended testicular self-examination. Conclusion: The findings have implications for the promotion of self-examination and highlight an emerging area of preventive health research. PMID:23930186

Weldment for austenitic stainless steel and method

DOEpatents

Bagnall, Christopher; McBride, Marvin A.

1985-01-01

For making defect-free welds for joining two austenitic stainless steel mers, using gas tungsten-arc welding, a thin foil-like iron member is placed between the two steel members to be joined, prior to making the weld, with the foil-like iron member having a higher melting point than the stainless steel members. When the weld is formed, there results a weld nugget comprising melted and then solidified portions of the joined members with small portions of the foil-like iron member projecting into the solidified weld nugget. The portions of the weld nugget proximate the small portions of the foil-like iron member which project into the weld nugget are relatively rich in iron. This causes these iron-rich nugget portions to display substantial delta ferrite during solidification of the weld nugget which eliminates weld defects which could otherwise occur. This is especially useful for joining austenitic steel members which, when just below the solidus temperature, include at most only a very minor proportion of delta ferrite.

Transitions in Loneliness Among Older Adults: A 5-Year Follow-Up in the National Social Life, Health, and Aging Project.

PubMed

Hawkley, Louise C; Kocherginsky, Masha

2018-04-01

A substantial portion of the older adult population suffers from frequent feelings of loneliness, but a large proportion remains relatively unscathed by loneliness. To date, research examining both protective and risk factors for loneliness has not included data from the United States. The present study used the first two waves of data from the National Social Life, Health, and Aging Project to examine sociodemographic, structural, and functional factors thought to be associated with loneliness in older adults. Functional limitations and low family support were associated with an increase in loneliness frequency (as were more strained friendships) and with transitioning from nonlonely to lonely status. Better self-rated health, higher levels of socializing frequency, and lower family strain were associated with transitioning from lonely to nonlonely status. Interventions that target these factors may be effective in preventing and reducing loneliness and its effects on health and well-being in older adults.

Estimation of occupational cosmic radiation exposure among airline personnel: Agreement between a job-exposure matrix, aggregate, and individual dose estimates.

PubMed

Talibov, Madar; Salmelin, Raili; Lehtinen-Jacks, Susanna; Auvinen, Anssi

2017-04-01

Job-exposure matrices (JEM) are used for exposure assessment in occupational studies, but they can involve errors. We assessed agreement between the Nordic Occupational Cancer Studies JEM (NOCCA-JEM) and aggregate and individual dose estimates for cosmic radiation exposure among Finnish airline personnel. Cumulative cosmic radiation exposure for 5,022 airline crew members was compared between a JEM and aggregate and individual dose estimates. The NOCCA-JEM underestimated individual doses. Intraclass correlation coefficient was 0.37, proportion of agreement 64%, kappa 0.46 compared with individual doses. Higher agreement was achieved with aggregate dose estimates, that is annual medians of individual doses and estimates adjusted for heliocentric potentials. The substantial disagreement between NOCCA-JEM and individual dose estimates of cosmic radiation may lead to exposure misclassification and biased risk estimates in epidemiological studies. Using aggregate data may provide improved estimates. Am. J. Ind. Med. 60:386-393, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Sedimentary organic matter in two Spitsbergen fjords: Terrestrial and marine contributions based on carbon and nitrogen contents and stable isotopes composition

NASA Astrophysics Data System (ADS)

Koziorowska, Katarzyna; Kuliński, Karol; Pempkowiak, Janusz

2016-02-01

The aim of this study was to estimate the spatial variability of organic carbon (Corg) and total nitrogen (Ntot) concentrations, Corg/Ntot ratios, stable isotopes of carbon and nitrogen (δ13Corg, δ15Ntot) and the proportions of autochthonous and allochtonous organic matter within recently deposited sediments of two Spitsbergen fjords: the Hornsund and the Adventfjord, which are affected to a different degree by the West Spitsbergen Current. Corg concentrations ranged from 1.38% to 1.98% in the Hornsund and from 1.73% to 3.85% in the Adventfjord. In both fjords the highest Corg concentrations were measured at the innermost stations and they decreased towards the mouths of the fjords. This suggests fresh water runoff to be an important source of organic matter (OM) for surface sediments. The results showed that both fjords differ significantly in terms of sedimentary organic matter characteristics. The samples from the Hornsund, except those from the innermost station in the Brepollen, had relatively low Corg/Ntot ratios, all within a narrow range (from 9.7 to 11.3). On the other hand significantly higher Corg/Ntot ratios, varying within a broad range (from 14.6 to 33.0), were measured in the Adventfjord. The samples from the Hornsund were characterized by higher δ13Corg (from -24.90‰ to -23.87‰) and δ15Ntot (from 3.02‰ to 4.93‰) than those from the Adventfjord (-25.94‰ to -24.69‰ and from 0.71‰ to 4.00‰, respectively). This is attributed to a larger proportion of marine organic matter. Using the two end-member approach proportions of terrestrial organic matter were evaluated. Terrestrial OM contribution for the Adventfjord was in the range of 82-83%, while in case of the Hornsund the results were in the range of 69-75%, with the exception of the innermost part of the fjord, where terrestrial organic matter contribution ranged from 80 to 82%. The strong positive correlation between δ13Corg and δ15Ntot was revealed. This was taken as an indicator that fresh, labile organic matter is the base of the trophic pyramid. The conclusion regarding a more complex food web in the Horsund, based on larger δ15Ntot values, is further substantiated by the larger proportion of autochthonous, labile organic matter found in the Hornsund's sediments.

Living arrangements among older people: an overview of trends in Europe and the USA.

PubMed

Tomassini, Cecilia; Glaser, Karen; Wolf, Douglas A; Broese van Groenou, Marjolein I; Grundy, Emily

2004-01-01

This article compares the trends in living arrangements of older people in several European countries and in the United States. Trends and cross-country variability in several factors that could account for these cross-national differences, including marital status, fertility, labour force participation and attitudes, are also examined. In most countries the proportion of older people living alone increased substantially between 1970 and 1990. However the increase in living alone stabilised or even declined between 1990 and 2000 in most of the countries analysed indicating a possible reversal in the trend. Increases in proportions of older women who are married and reductions in the proportions childless may partially explain this. Considerable variability in both trends and levels of older people's living arrangements was seen especially between north-western and southern European countries. These variations mirrored contrasts in attitudes towards residential care and parent-child coresidence between the countries.

Estimating the changes in energy flux that characterize the rise in obesity prevalence

USDA-ARS?s Scientific Manuscript database

The daily energy imbalance gap associated with the current population weight gain in the obesity epidemic is relatively small. However, the substantially higher body weights of populations that have accumulated over several years are associated with a substantially higher total energy expenditure (T...

Socioeconomic differences in purchases of more vs. less healthy foods and beverages: Analysis of over 25,000 British households in 2010☆

PubMed Central

Pechey, Rachel; Jebb, Susan A.; Kelly, Michael P.; Almiron-Roig, Eva; Conde, Susana; Nakamura, Ryota; Shemilt, Ian; Suhrcke, Marc; Marteau, Theresa M.

2013-01-01

Socioeconomic inequalities in diet-related health outcomes are well-recognised, but are not fully explained by observational studies of consumption. We provide a novel analysis to identify purchasing patterns more precisely, based on data for take-home food and beverage purchases from 25,674 British households in 2010. To examine socioeconomic differences (measured by occupation), we conducted regression analyses on the proportion of energy purchased from (a) each of 43 food or beverage categories and (b) major nutrients. Results showed numerous small category-level socioeconomic differences. Aggregation of the categories showed lower SES groups generally purchased a greater proportion of energy from less healthy foods and beverages than those in higher SES groups (65% and 60%, respectively), while higher SES groups purchased a greater proportion of energy from healthier food and beverages (28% vs. 24%). At the nutrient-level, socioeconomic differences were less marked, although higher SES was associated with purchasing greater proportions of fibre, protein and total sugars, and smaller proportions of sodium. The observed pattern of purchasing across SES groups contributes to the explanation of observed health differences between groups and highlights targets for interventions to reduce health inequalities. PMID:23849275

Improved quality of care for cardiovascular disease for Latinos seen in high proportion Latino vs low proportion Latino clinics.

PubMed

López, Lenny; Cook, Nakela; Hicks, Leroi

2015-01-01

Primary care practices that concentrate linguistically and culturally appropriate services for Latinos may result in higher cardiology consultation rates and improved process measure performance for patients with coronary artery disease (CAD) and congestive heart failure (CHF). Multivariable Cox proportional-hazards regression was used to assess differences in referral at high proportion (HP) vs low proportion (LP) practices. Multivariable Poisson regression was used to assess the frequency of follow-up consultation. Among the 9,761 patients, 9,168 had CAD, 4,444 had CHF, and 3,851 had both conditions. Latinos comprised 11% of the CAD cohort and 11% of the CHF cohort. Multivariable analyses showed higher consultation rates for Latinos at HP practices for CAD and CHF. Blacks and Whites at HP practices had no significant differences in rates of consultation compared to those in LP practices. Latinos at HP practices had 25% more consultations for CAD and 23% more consultations for CHF than Latinos at LP practices. Latinos at HP clinics had higher overall mean quality performance on clinical measures for both CAD and CHF. Latinos at an LP clinic had the largest improvement in quality performance with consultation. Among Latinos with CAD or CHF receiving care within a single large academic care network, Latino patients at HP practices have higher rates of cardiologist consultation and performance on CVD process measures compared to Latino patients at LP practices. Elucidating the essential components of individual practice environments that provide higher quality of care for Latinos will allow for well designed systems to reduce health care disparities.

Comparison of text messaging data collection vs face-to-face interviews for public health surveys: a cluster randomized crossover study of care-seeking for childhood pneumonia and diarrhoea in rural China

PubMed Central

van Velthoven, Michelle Helena; Wang, Wei; Wu, Qiong; Li, Ye; Scherpbier, Robert W; Du, Xiaozhen; Chen, Li; Zhang, Yanfeng; Car, Josip; Rudan, Igor

2018-01-01

Background To compare text messaging and face-to-face interviews to conduct a survey on childhood diarrhoea and pneumonia. Methods Caregivers of young children able to send text messages in Zhao County in rural China were included in this crossover study. Villages (clusters) were randomized into two groups using the ratio 1:1.6 to account for an expected higher drop-out in group 2. In group 1, participants first completed the face-to-face and then text messaging survey; this order was reversed in group 2. We determined data equivalence of 17 questions that were answered by participants who were the same person in both surveys. For the text messaging survey, we assessed the overall and item response rate. Results We included 1014 participants between 16 and 28 March 2013: 371 in 15 villages in group 1 and 643 in 27 villages in group 2. A total of 662 (65.3%) out of 1014 participants responded (first text message question) and a significantly higher proportion who did not respond were from rural areas (P = 0.005). Of 651 participants willing to participate, 356 (54.7%) completed the text messaging survey, which was marginally significantly different between the groups (P = 0.05). In total, 409 participants took part in both surveys: 183 in group 1 and 226 in group 2. There was a significantly higher proportion of caregivers from rural areas in Zhao County in the non-responder group compared to the responder group (P = 0.004). Kappas were substantial for six (0.61–0.80), moderate for two (0.58 and 0.60), and fair for three questions (0.31, 0.35 and 0.37). The proportion of agreement was >90% for five questions; 80.0%-90.0% for five questions; 70.0%, 65.0% and 45.5%. The remaining questions had too small numbers to calculate these values. Conclusions This study shows that text messaging data collection produces data similar to data from face-to-face interviews in a middle-income setting, but the response rate was insufficient for use in public health surveys. Improving the response rate is important, because text message surveys could be of greater value in rural remote areas due to the cost-saving potential. PMID:29899982

Education and employment outcomes of young adults with a history of developmental language disorder.

PubMed

Conti-Ramsden, Gina; Durkin, Kevin; Toseeb, Umar; Botting, Nicola; Pickles, Andrew

2018-03-01

Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes. To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age-matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes? Participants included 84 individuals with DLD (67% males) and 88 age-matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income. Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age-matched peers was in work full time. Participants with DLD were much more likely to be in non-professional occupations. However, when examining pay in relation to types of occupation, the groups' incomes were broadly comparable. At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD. © 2017 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Statewide Divorce Rates and Wives' Participation in the Labor Market.

ERIC Educational Resources Information Center

Yeh, Bijou Y.; Lester, David

1987-01-01

Analyzed the relationship between the participation of married women in the labor market and divorce rates in the continental states of the United States in 1980. Results showed the higher the proportion of married women working full time and the lower the proportion of married women working part time, the higher the divorce rate of the state.…

Area-level poverty, race/ethnicity & dialysis star ratings.

PubMed

Kshirsagar, Abhijit V; Manickam, Raj N; Mu, Yi; Flythe, Jennifer E; Chin, Andrew I; Bang, Heejung

2017-01-01

The Centers for Medicare and Medicaid Services recently released a five star rating system as part of 'Dialysis Facility Compare' to help patients identify and choose high performing clinics in the US. Eight dialysis-related measures determine ratings. Little is known about the association between surrounding community sociodemographic characteristics and star ratings. Using data from the U.S. Census and over 6000 dialysis clinics across the country, we examined the association between dialysis clinic star ratings and characteristics of the local population: 1) proportion of population below the federal poverty level (FPL); 2) proportion of black individuals; and 3) proportion of Hispanic individuals, by correlation and regression analyses. Secondary analyses with Quality Incentive Program (QIP) scores and population characteristics were also performed. We observed a negligible correlation between star ratings and the proportion of local individuals below FPL; Spearman coefficient, R = -0.09 (p<0.0001), and a stronger correlation between star ratings and the proportion of black individuals; R = -0.21 (p<0.0001). Ordered logistic regression analyses yielded adjusted odds ratio of 0.91 (95% confidence interval [0.80-1.30], p = 0.12) and 0.55 ([0.48-0.63], p<0.0001) for high vs. low level of proportion below FPL and proportion of black individuals, respectively. In contrast, a near-zero correlation was observed between star ratings and the proportion of Hispanic individuals. Correlations varied substantially by country region, clinic profit status and clinic size. Analyses using clinic QIP scores provided similar results. Sociodemographic characteristics of the surrounding community, factors typically outside of providers' direct control, have varying levels of association with clinic dialysis star ratings.

A Novel Tool Improves Existing Estimates of Recent Tuberculosis Transmission in Settings of Sparse Data Collection

PubMed Central

Kasaie, Parastu; Mathema, Barun; Kelton, W. David; Azman, Andrew S.; Pennington, Jeff; Dowdy, David W.

2015-01-01

In any setting, a proportion of incident active tuberculosis (TB) reflects recent transmission (“recent transmission proportion”), whereas the remainder represents reactivation. Appropriately estimating the recent transmission proportion has important implications for local TB control, but existing approaches have known biases, especially where data are incomplete. We constructed a stochastic individual-based model of a TB epidemic and designed a set of simulations (derivation set) to develop two regression-based tools for estimating the recent transmission proportion from five inputs: underlying TB incidence, sampling coverage, study duration, clustered proportion of observed cases, and proportion of observed clusters in the sample. We tested these tools on a set of unrelated simulations (validation set), and compared their performance against that of the traditional ‘n-1’ approach. In the validation set, the regression tools reduced the absolute estimation bias (difference between estimated and true recent transmission proportion) in the ‘n-1’ technique by a median [interquartile range] of 60% [9%, 82%] and 69% [30%, 87%]. The bias in the ‘n-1’ model was highly sensitive to underlying levels of study coverage and duration, and substantially underestimated the recent transmission proportion in settings of incomplete data coverage. By contrast, the regression models’ performance was more consistent across different epidemiological settings and study characteristics. We provide one of these regression models as a user-friendly, web-based tool. Novel tools can improve our ability to estimate the recent TB transmission proportion from data that are observable (or estimable) by public health practitioners with limited available molecular data. PMID:26679499

Proportion of US adults potentially affected by the 2014 hypertension guideline.

PubMed

Navar-Boggan, Ann Marie; Pencina, Michael J; Williams, Ken; Sniderman, Allan D; Peterson, Eric D

2014-04-09

The new 2014 blood pressure (BP) guideline released by the panel members appointed to the Eighth Joint National Committee (JNC 8; 2014 BP guideline) proposed less restrictive BP targets for adults aged 60 years or older and for those with diabetes and chronic kidney disease. To estimate the proportion of US adults potentially affected by recent changes in recommendations for management of hypertension. Cross-sectional, nationally representative survey. Using data from the National Health and Nutrition Examination Survey between 2005 and 2010 (n = 16,372), we evaluated hypertension control and treatment recommendations for US adults. Proportion of adults estimated to meet guideline-based BP targets under the 2014 BP guideline and under the previous seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline. The proportion of younger adults (18-59 years) with treatment-eligible hypertension under the JNC 7 guideline was 20.3% (95% CI, 19.1%-21.4%) and decreased to 19.2% (95% CI, 18.1%-20.4%) under the 2014 BP guideline. Larger declines were observed among older adults (≥60 years), decreasing from 68.9% (95% CI, 66.9%-70.8%) under JNC 7 to 61.2% (95% CI, 59.3%-63.0%) under the 2014 BP guideline. The proportion of adults with treatment-eligible hypertension who met BP goals increased slightly for younger adults, from 41.2% (95% CI, 38.1%-44.3%) under JNC 7 to 47.5% (95% CI, 44.4%-50.6%) under the 2014 BP guideline, and more substantially for older adults, from 40.0% (95% CI, 37.8%-42.3%) under JNC 7 to 65.8% (95% CI, 63.7%-67.9%) under the 2014 BP guideline. Overall, 1.6% (95% CI, 1.3%-1.9%) of US adults aged 18-59 years and 27.6% (95% CI, 25.9%-29.3%) of adults aged 60 years or older were receiving BP-lowering medication and meeting more stringent JNC 7 targets. These patients may be eligible for less stringent or no BP therapy with the 2014 BP guideline. Compared with the JNC 7 guideline, the 2014 BP guideline from the panel members appointed to the JNC 8 was associated with a reduction in the proportion of US adults recommended for hypertension treatment and a substantial increase in the proportion of adults considered to have achieved goal BP, primarily in older adults.

Predominance of new G9P[8] rotaviruses closely related to Turkish strains in Nizhny Novgorod (Russia).

PubMed

Sashina, T A; Morozova, O V; Epifanova, N V; Novikova, N A

2017-08-01

Genotype G9P[8] rotaviruses are rare in the territory of Russia. They were found in Nizhny Novgorod only in 2011-2012 for the first time, when their proportion was 25.9%. During the next two seasons, G9P[8] strains were detected in only 1.8% of cases. Their proportion substantially increased again in 2014, and they became predominant in the city by 2016. Phylogenetic analysis on the basis of gene VP7 nucleotide sequences showed that this increase was accompanied by the emergence of new strains in the population. These isolates were related to Turkish strains, but not to Russian ones detected earlier.

The Impact of Cost Sharing on Internal Efficiency of Public Secondary Schools in Ndivisi Division, Bungoma District Kenya

ERIC Educational Resources Information Center

Kiveu, Noah Murumba; Mayio, Julius

2009-01-01

Adoption of cost sharing policy in education has witnessed the return to communities and parents a substantial proportion of financial responsibility for schooling. With increased poverty levels, many parents and communities have not been able to meet the cost requirements under cost sharing policy. Thus their investment in education and support…

Cognitive Skill, Skill Demands of Jobs, and Earnings among Young European American, African American, and Mexican American Workers.

ERIC Educational Resources Information Center

Farkas, George; And Others

1997-01-01

Analyses of National Longitudinal Survey data indicate that cognitive skill level affects access to high-skill occupations and earnings. Lower cognitive skill levels for African Americans and U.S.-born Mexican Americans explain a substantial proportion of income differences between these groups and European Americans but not the gender gap in pay…

The Narrowing Gap in New York City Teacher Qualifications and Its Implications for Student Achievement in High-Poverty Schools

ERIC Educational Resources Information Center

Boyd, Donald; Lankford, Hamilton; Loeb, Susanna; Rockoff, Jonah; Wyckoff, James

2008-01-01

Understanding what makes an effective teacher, as well as how teachers sort by their effectiveness across schools, is central to understanding and addressing student achievement gaps. Prior studies have found substantial sorting of teachers across schools, with the schools with the highest proportions of poor, non-white, and low-scoring students…

"A Very Fine Line": Parents' Experiences of Using Restraint with Their Adult Son/Daughter with Intellectual Disabilities

ERIC Educational Resources Information Center

Elford, Helen; Beail, Nigel; Clarke, Zara

2010-01-01

Background: Restraint is sometimes used on people with intellectual disabilities who display challenging behaviours, and may be justifiable as a last resort to prevent harm. A substantial proportion of such people are cared for within the family home. The aim of this paper is to explore parents' experiences of using restraint with their…

Cultural Exclusion in China: State Education, Social Mobility and Cultural Difference. Comparative Development and Policy in Asia

ERIC Educational Resources Information Center

Yi, Lin

2012-01-01

Ethnic minorities form a very substantial proportion of the population of China, with over 100 million people in 55 formally designated minority groups inhabiting over 60% of the country's land area. Poverty and economic inequality of minority groups are widely-recognised problems. However, as this book, based on extensive original research,…

The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

ERIC Educational Resources Information Center

Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

2006-01-01

Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

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

Conway, R.

This article describes a petrol (gasoline) engine development project to combine the duel technologies of an Otto cycle engine with a modified cooling system and a high-tech processor-controlled bottoming cycle to harness not only the waste heat from the exhaust gases but also a significant proportion of the heat lost by a conventional petrol engine to the water coolant, resulting in a very substantial increase in energy conversion efficiency.

Hydrogen peroxide kinetics in water radiolysis

NASA Astrophysics Data System (ADS)

Iwamatsu, Kazuhiro; Sundin, Sara; LaVerne, Jay A.

2018-04-01

The kinetics of the formation and reaction of hydrogen peroxide in the long time γ- radiolysis of water is examined using a combination of experiment with model calculations. Escape yields of hydrogen peroxide on the microsecond time scale are easily measured with added radical scavengers even with substantial amounts of initial added hydrogen peroxide. The γ-radiolysis of aqueous hydrogen peroxide solutions without added radical scavengers reach a steady state limiting concentration of hydrogen peroxide with increasing dose, and that limit is directly proportional to the initial concentration of added hydrogen peroxide. The dose necessary to reach that limiting hydrogen peroxide concentration is also proportional to the initial concentration, but dose rate has a very small effect. The addition of molecular hydrogen to aqueous solutions of hydrogen peroxide leads to a decrease in the high dose limiting hydrogen peroxide concentration that is linear with the initial hydrogen concentration, but the amount of decrease is not stoichiometric. Proton irradiations of solutions with added hydrogen peroxide and hydrogen are more difficult to predict because of the decreased yields of radicals; however, with a substantial increase in dose rate there is a sufficient decrease in radical yields that hydrogen addition has little effect on hydrogen peroxide decay.

Role of selected polymorphisms in determining muscle fiber composition in Japanese men and women.

PubMed

Kumagai, Hiroshi; Tobina, Takuro; Ichinoseki-Sekine, Noriko; Kakigi, Ryo; Tsuzuki, Takamasa; Zempo, Hirofumi; Shiose, Keisuke; Yoshimura, Eiichi; Kumahara, Hideaki; Ayabe, Makoto; Higaki, Yasuki; Yamada, Ryo; Kobayashi, Hiroyuki; Kiyonaga, Akira; Naito, Hisashi; Tanaka, Hiroaki; Fuku, Noriyuki

2018-05-01

Genetic polymorphisms and sex differences are suggested to affect muscle fiber composition; however, no study has investigated the effects of genetic polymorphisms on muscle fiber composition with respect to sex differences. Therefore, the present study examined the effects of genetic polymorphisms on muscle fiber composition with respect to sex differences in the Japanese population. The present study included 211 healthy Japanese individuals (102 men and 109 women). Muscle biopsies were obtained from the vastus lateralis to determine the proportion of myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, and MHC-IIx). Moreover, we analyzed polymorphisms in α-actinin-3 gene ( ACTN3; rs1815739 ), angiotensin-converting enzyme gene ( ACE; rs4341 ), hypoxia-inducible factor 1 α gene ( rs11549465 ), vascular endothelial growth factor receptor 2 gene ( rs1870377 ), and angiotensin II receptor, type 2 gene ( rs11091046 ), by TaqMan single-nucleotide polymorphism genotyping assays. The proportion of MHC-I was 9.8% lower in men than in women, whereas the proportion of MHC-IIa and MHC-IIx was higher in men than in women (5.0 and 4.6%, respectively). Men with the ACTN3 RR + RX genotype had a 4.8% higher proportion of MHC-IIx than those with the ACTN3 XX genotype. Moreover, men with the ACE ID + DD genotype had a 4.7% higher proportion of MHC-I than those with the ACE II genotype. Furthermore, a combined genotype of ACTN3 R577X and ACE insertion/deletion (I/D) was significantly correlated with the proportion of MHC-I ( r = -0.23) and MHC-IIx ( r = 0.27) in men. In contrast, no significant correlation was observed between the examined polymorphisms and muscle fiber composition in women. These results suggest that the ACTN3 R577X and ACE I/D polymorphisms independently affect the proportion of human skeletal muscle fibers MHC-I and MHC-IIx in men but not in women. NEW & NOTEWORTHY In men, the RR + RX genotype of the α-actinin-3 gene ( ACTN3) R577X polymorphism was associated with a higher proportion of myosin heavy chain (MHC)-IIx. The ID + DD genotype of the angiotensin-converting enzyme gene ( ACE) insertion/deletion (I/D) polymorphism, in contrast to a previous finding, was associated with a higher proportion of MHC-I in men. In addition, the combined genotype of these polymorphisms was correlated with the proportion of MHC-I and MHC-IIx in men. Thus ACTN3 R577X and ACE I/D polymorphisms influence the muscle fiber composition in Japanese men.

Suppression of Biodynamic Interference by Adaptive Filtering

NASA Technical Reports Server (NTRS)

Velger, M.; Merhav, S. J.; Grunwald, A. J.

1984-01-01

Preliminary experimental results obtained in moving base simulator tests are presented. Both for pursuit and compensatory tracking tasks, a strong deterioration in tracking performance due to biodynamic interference is found. The use of adaptive filtering is shown to substantially alleviate these effects, resulting in a markedly improved tracking performance and reduction in task difficulty. The effect of simulator motion and of adaptive filtering on human operator describing functions is investigated. Adaptive filtering is found to substantially increase pilot gain and cross-over frequency, implying a more tight tracking behavior. The adaptive filter is found to be effective in particular for high-gain proportional dynamics, low display forcing function power and for pursuit tracking task configurations.

Initiating or changing to a fixed-dose combination of Fluticasone propionate/Formoterol over Fluticasone propionate/Salmeterol: A real-life effectiveness and cost impact evaluation.

PubMed

Wan Yau Ming, Simon; Haughney, John; Small, Iain; Wolfe, Stephanie; Hamill, John; Gruffydd-Jones, Kevin; Daly, Cathal; Soriano, Joan B; Gardener, Elizabeth; Skinner, Derek; Stagno d'Alcontres, Martina; Price, David B

2017-08-01

Asthma has a substantial impact on quality of life and health care resources. The identification of a more cost-effective, yet equally efficacious, treatment could positively influence the economic burden of this disease. Fluticasone propionate/Formoterol (FP/FOR) may be as effective as Fluticasone Salmeterol (FP/SAL). We evaluated non-inferiority of asthma control in terms of the proportion of patients free from exacerbations, and conducted a cost impact analysis. This historical, matched cohort database study evaluated two treatment groups in the Optimum Patient Care Research Database in the UK: 1) an FP/FOR cohort of patients initiating treatment with FP/FOR or changing from FP/SAL to FP/FOR and; 2) an FP/SAL cohort comprising patients initiating, or remaining on FP/SAL pMDI combination therapy. The main outcome evaluated non-inferiority of effectiveness (defined as prevention of severe exacerbations, lower limit of the 95% confidence interval (CI) of the mean difference between groups in patient proportions with no exacerbations is -3.5% or higher) in patients treated with FP/FOR versus FP/SAL. After matching 1:3, we studied a total of 2472 patients: 618 in the FP/FOR cohort (174 patients initiated on FP/FOR and 444 patients changed to FP/FOR) and 1854 in the FP/SAL cohort (522 patients initiated FP/SAL and 1332 continued FP/SAL). The percentage of patients prescribed FP/FOR met non-inferiority as the adjusted mean difference in proportion of no severe exacerbations (95%CI) was 0.008 (-0.032, 0.047) between the two cohorts. No other significant differences were observed except acute respiratory event rates, which were lower for patients prescribed FP/FOR (rate ratio [RR] 0.82, 95% CI 0.71, 0.94). Changing to, or initiating FP/FOR combination therapy, is associated with a non-inferior proportion of patients who are severe exacerbation-free at a lower average annual cost compared with continuing or initiating treatment with FP/SAL. Copyright © 2017 Elsevier Ltd. All rights reserved.

Host age and Plasmodium falciparum multiclonality are associated with gametocyte prevalence: a 1-year prospective cohort study.

PubMed

Adomako-Ankomah, Yaw; Chenoweth, Matthew S; Tocker, Aaron M; Doumbia, Saibou; Konate, Drissa; Doumbouya, Mory; Keita, Abdoul S; Anderson, Jennifer M; Fairhurst, Rick M; Diakite, Mahamadou; Miura, Kazutoyo; Long, Carole A

2017-11-21

Since Plasmodium falciparum transmission relies exclusively on sexual-stage parasites, several malaria control strategies aim to disrupt this step of the life cycle. Thus, a better understanding of which individuals constitute the primary gametocyte reservoir within an endemic population, and the temporal dynamics of gametocyte carriage, especially in seasonal transmission settings, will not only support the effective implementation of current transmission control programmes, but also inform the design of more targeted strategies. A 1-year prospective cohort study was initiated in June 2013 with the goal of assessing the longitudinal dynamics of P. falciparum gametocyte carriage in a village in Mali with intense seasonal malaria transmission. A cohort of 500 individuals aged 1-65 years was recruited for this study. Gametocyte prevalence was measured monthly using Pfs25-specific RT-PCR, and analysed for the effects of host age and gender, seasonality, and multiclonality of P. falciparum infection over 1 year. Most P. falciparum infections (51-89%) in this population were accompanied by gametocytaemia throughout the 1-year period. Gametocyte prevalence among P. falciparum-positive individuals (proportion of gametocyte positive infections) was associated with age (p = 0.003) but not with seasonality (wet vs. dry) or gender. The proportion of gametocyte positive infections were similarly high in children aged 1-17 years (74-82% on median among 5 age groups), while older individuals had relatively lower proportion, and those aged > 35 years (median of 43%) had significantly lower than those aged 1-17 years (p < 0.05). Plasmodium falciparum-positive individuals with gametocytaemia were found to have significantly higher P. falciparum multiclonality than those without gametocytaemia (p < 0.033 in two different analyses). Taken together, these results suggest that a substantial proportion of Pf-positive individuals carries gametocytes throughout the year, and that age is a significant determinant of gametocyte prevalence among these P. falciparum-positive individuals. Furthermore, the presence of multiple P. falciparum genotypes in an infection, a common feature of P. falciparum infections in high transmission areas, is associated with gametocyte prevalence.

Home composting using different ratios of bulking agent to food waste.

PubMed

Guidoni, Lucas Lourenço Castiglioni; Marques, Roger Vasques; Moncks, Rodrigo Bilhalva; Botelho, Fabiana Torma; da Paz, Matheus Francisco; Corrêa, Luciara Bilhalva; Corrêa, Érico Kunde

2018-02-01

The negative environmental impacts associated with home composting may be due to the absence of a defined operation criteria for the degradation process. In addition to the potentially low environmental impact in terms of energy and water usage, which is minimal to the manufacture of the composting unit and avoiding the processing and transportation of waste or byproduct, composting at home can also promote a reduction in the emission of unpleasant gases. The proportion of the food waste and bulking agents in the composting mixture may be decisive to fulfill good practices of waste stabilization. The aim of this study was to investigate how different ratios of bulking agent and organic household waste can affect the progress and outcome of the composting process. Three treatments, varying in the ratio of rice husk: raw fruit and vegetable leftovers (70:30, 50:50, 30:70; v:v) were used in a home composting system on a pilot scale. Results show that the proportion of starting materials used in the composting mixture influenced the degradation of organic matter, nitrogen dynamics of the process and its toxicity on germinating plants. The proportions with greater amounts of food waste had higher concentrations of mineral matter, higher peak temperature, and a better initial carbon-to-nitrogen ratio, while the proportion containing 70% of bulking agent lacked odors and leachate generation and showed a low nitrogen loss. A higher proportion of food waste presented better conditions for microbiological development and less time to obtain characteristics of matured composts. A higher proportion of bulking agents resulted in favorable conditions for household handling and less potential for environmental impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Willingness to pay for the social health insurance in Iran.

PubMed

Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Akbari Sari, Ali; Mahdavi, Ghadir; Moeini, Maryam

2014-05-30

The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households' Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society.

Disability Divides in India: Evidence from the 2011 Census.

PubMed

Saikia, Nandita; Bora, Jayanta Kumar; Jasilionis, Domantas; Shkolnikov, Vladimir M

2016-01-01

Understanding the socioeconomic and regional divides in disability prevalence in India has considerable relevance for designing public health policies and programs. The aim of the present study is to quantify the prevalence of disability by gender, region (rural and urban; states and districts), and caste. We also examine the association between disability prevalence and the major socio-demographic and socioeconomic characteristics of the districts in India. Age-standardized disability prevalence (ASDP) was calculated using 2011 census data and applying the WHO World Standard Population. A regression analysis was carried out to examine the association between disability prevalence and demographic and socioeconomic characteristics across districts of India. The study found that ASDP varies substantially across districts and is higher among women, rural dwellers, and members of scheduled tribes (STs) and scheduled castes (SCs). The regression model showed that the disability rate in districts rises with increasing proportions of the population who are urban dwellers, aged 65 or older, members of STs, and living in dilapidated housing; and that the disability prevalence decreases with increasing proportions of the female population who are literate, and of the general population who are working and have access to safe drinking water. As the burden of disability falls disproportionately across geographic regions and socioeconomic groups, public health policies in India should take this variation into account. The definition of disability used in the census should be modified to generate internationally comparable estimates of disability prevalence.

The Effects of Item Format and Cognitive Domain on Students' Science Performance in TIMSS 2011

NASA Astrophysics Data System (ADS)

Liou, Pey-Yan; Bulut, Okan

2017-12-01

The purpose of this study was to examine eighth-grade students' science performance in terms of two test design components, item format, and cognitive domain. The portion of Taiwanese data came from the 2011 administration of the Trends in International Mathematics and Science Study (TIMSS), one of the major international large-scale assessments in science. The item difficulty analysis was initially applied to show the proportion of correct items. A regression-based cumulative link mixed modeling (CLMM) approach was further utilized to estimate the impact of item format, cognitive domain, and their interaction on the students' science scores. The results of the proportion-correct statistics showed that constructed-response items were more difficult than multiple-choice items, and that the reasoning cognitive domain items were more difficult compared to the items in the applying and knowing domains. In terms of the CLMM results, students tended to obtain higher scores when answering constructed-response items as well as items in the applying cognitive domain. When the two predictors and the interaction term were included together, the directions and magnitudes of the predictors on student science performance changed substantially. Plausible explanations for the complex nature of the effects of the two test-design predictors on student science performance are discussed. The results provide practical, empirical-based evidence for test developers, teachers, and stakeholders to be aware of the differential function of item format, cognitive domain, and their interaction in students' science performance.

Conservation of streptococcal CRISPRs on human skin and saliva.

PubMed

Robles-Sikisaka, Refugio; Naidu, Mayuri; Ly, Melissa; Salzman, Julia; Abeles, Shira R; Boehm, Tobias K; Pride, David T

2014-06-06

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) are utilized by bacteria to resist encounters with their viruses. Human body surfaces have numerous bacteria that harbor CRISPRs, and their content can provide clues as to the types and features of viruses they may have encountered. We investigated the conservation of CRISPR content from streptococci on skin and saliva of human subjects over 8-weeks to determine whether similarities existed in the CRISPR spacer profiles and whether CRISPR spacers were a stable component of each biogeographic site. Most of the CRISPR sequences identified were unique, but a small proportion of spacers from the skin and saliva of each subject matched spacers derived from previously sequenced loci of S. thermophilus and other streptococci. There were significant proportions of CRISPR spacers conserved over the entire 8-week study period for all subjects, and salivary CRISPR spacers sampled in the mornings showed significantly higher levels of conservation than any other time of day. We also found substantial similarities in the spacer repertoires of the skin and saliva of each subject. Many skin-derived spacers matched salivary viruses, supporting that bacteria of the skin may encounter viruses with similar sequences to those found in the mouth. Despite the similarities between skin and salivary spacer repertoires, the variation present was distinct based on each subject and body site. The conservation of CRISPR spacers in the saliva and the skin of human subjects over the time period studied suggests a relative conservation of the bacteria harboring them.

Do health and medical workforce shortages explain the lower rate of rural consumers' complaints to Victoria's Health Services Commissioner?

PubMed

Jones, Judith A; Humphreys, John S; Wilson, Beth

2005-12-01

To identify which explanations account for lower rural rates of complaint about health services--(i) fear of consequences where there is little choice of alternative provider; (ii) a higher complaint threshold for rural consumers; (iii) lack of access to complaint mechanisms; or (iv) reduced access to services about which to complain. Ecological study incorporating consumer complaint, population and workforce distribution data sources. All health care providers practising in Victoria. De-identified records of all closed consumer complaints made to the Health Services Commissioner, Victoria, between March 1988 and April 2001 by Victorian residents (13 856 records). Differences in the percentage of under-representation in complaint rates in total and for each of four categories of health services providers for different size communities. No consistent relationship was observed between community size and either degree of under-representation of complaints against any category of provider, or the proportion of serious or substantial complaints. Rural under-representation was highest (41%) for dentists, the provider category with the lowest proportion working in rural areas (17%), and lowest (18%) for hospitals, with the highest representation in rural areas (28% of beds). More rural complaints were about access issues (10.7% rural and 8.4% metropolitan). Reduced opportunity to use health services due to rural health and medical workforce shortages was the best-supported explanation for the lower rural complaint rate. Workforce shortages impact on the quality of rural health services and on residents' opportunities to improve their health status.

Conservation of streptococcal CRISPRs on human skin and saliva

PubMed Central

2014-01-01

Background Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) are utilized by bacteria to resist encounters with their viruses. Human body surfaces have numerous bacteria that harbor CRISPRs, and their content can provide clues as to the types and features of viruses they may have encountered. Results We investigated the conservation of CRISPR content from streptococci on skin and saliva of human subjects over 8-weeks to determine whether similarities existed in the CRISPR spacer profiles and whether CRISPR spacers were a stable component of each biogeographic site. Most of the CRISPR sequences identified were unique, but a small proportion of spacers from the skin and saliva of each subject matched spacers derived from previously sequenced loci of S. thermophilus and other streptococci. There were significant proportions of CRISPR spacers conserved over the entire 8-week study period for all subjects, and salivary CRISPR spacers sampled in the mornings showed significantly higher levels of conservation than any other time of day. We also found substantial similarities in the spacer repertoires of the skin and saliva of each subject. Many skin-derived spacers matched salivary viruses, supporting that bacteria of the skin may encounter viruses with similar sequences to those found in the mouth. Despite the similarities between skin and salivary spacer repertoires, the variation present was distinct based on each subject and body site. Conclusions The conservation of CRISPR spacers in the saliva and the skin of human subjects over the time period studied suggests a relative conservation of the bacteria harboring them. PMID:24903519

Meat quality, oxidative stability and blood parameters from Graylag geese offered alternative fiber sources in growing period.

PubMed

He, L W; Meng, Q X; Li, D Y; Zhang, Y W; Ren, L P

2015-04-01

The effects of dietary fiber sources on the meat quality, oxidative stability, and blood parameters of growing Graylag geese (28-112d) were investigated. The birds were randomly allocated into 4 treatments, of which dietary fiber was mainly from corn straw silage (CSS), steam-exploded corn straw (SECS), steam-exploded wheat straw (SEWS), and steam-exploded rice straw (SERS). No influence (P>0.05) on the basic chemical components, oxidative stability, or organoleptic traits of muscle were observed, except that birds fed SECS had a higher (P<0.05) protein proportion than those fed CSS or SERS, and CSS increased (P<0.01) the cholesterol content when compared to SEWS or SERS. Regarding fatty acid profile in meat, CSS and SECS increased (P<0.01) the proportion of C18:2n6t and decreased that of C21:0 and C22:0 when compared to the others. The birds fed SERS had a higher (P<0.05) proportion of C20:0 and C22:0 than the others, a higher proportion of C20:5n3, n-3 fatty acids, Δ-9 desaturase (18) index compared to those fed CSS or SECS, and a lower (P<0.01) proportion of C20:1n9 than those fed SECS or SEWS. Additionally, SEWS resulted in a higher (P<0.01) proportion of C20:2 when compared to the others. In conclusion, these fibers affect just the protein proportion, cholesterol content, and fatty acid profile of breast muscle, along with the concentration of TG and MDA in blood, but not the other characteristics. No superior fiber source exists with respect to meat quality, suggesting that Graylag geese feeding should make the most economically of the convenient fiber source with appropriate pretreatment. © 2015 Poultry Science Association Inc.

The impact of dog walking on leisure-time physical activity: results from a population-based survey of Michigan adults.

PubMed

Reeves, Mathew J; Rafferty, Ann P; Miller, Corinne E; Lyon-Callo, Sarah K

2011-03-01

The extent to which dog walking promotes leisure-time physical activity (LTPA) remains unresolved. We describe the characteristics of people who walk their dog, and assess the impact on LTPA. Information on dog ownership, dog walking patterns, total walking activity and LTPA were assessed in the 2005 Michigan Behavioral Risk Factor Survey. Multiple logistic regression was used to generate adjusted odds ratios (AOR) for the effect of dog walking on total walking and LTPA. Of 5902 respondents 41% owned a dog, and of these, 61% walked their dog for at least 10 minutes at a time. However, only 27% walked their dog at least 150 minutes per week. Dog walking was associated with a significant increase in walking activity and LTPA. Compared with non-dog owners, the odds of obtaining at least 150 minutes per week of total walking were 34% higher for dog walkers (AOR = 1.34, 95% CI = 1.13 to 1.59), and the odds of doing any LTPA were 69% higher (AOR = 1.69, 95% CI = 1.33 to 2.15). Dog walking was associated with more walking and LTPA, however a substantial proportion of dog owners do not walk their dog. The promotion of dog walking could help increase LTPA.

The Role of Race/Ethnicity in Alcohol-attributable Injury in the United States

PubMed Central

Keyes, Katherine M.; Liu, Xianfang C.; Cerda, Magdalena

2012-01-01

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns. PMID:21930592

Disparities in survival after Hodgkin lymphoma: a population-based study

PubMed Central

Keegan, Theresa H.M.; Clarke, Christina A.; Chang, Ellen T.; Shema, Sarah J.; Glaser, Sally L.

2009-01-01

Survival after Hodgkin lymphoma (HL) is generally favorable, but may vary by patient demographic characteristics. The authors examined HL survival according to race/ethnicity and neighborhood socioeconomic status (SES), determined from residential census block group at diagnosis. For 12,492 classical HL patients ≥15 years diagnosed in California during 1988-2006 and followed through 2007, we determined risk of overall and HL-specific death using Cox proportional hazards regression; analyses were stratified by age and Ann Arbor stage. Irrespective of disease stage, patients with lower neighborhood SES had worse overall and HL-specific survival than patients with higher SES. Patients with the lowest quintile of neighborhood SES had a 64% (patients aged 15-44 years) and 36% (≥45 years) increased risk of HL-death compared to patients with the highest quintile of SES; SES results were similar for overall survival. Even after adjustment for neighborhood SES, blacks and Hispanics had increased risks of HL-death 74% and 43% (15-44 years) and 40% and 17% (≥45 years), respectively, higher than white patients. The racial/ethnic differences in survival were evident for all stages of disease. These data provide evidence for substantial, and probably remediable, racial/ethnic and neighborhood SES disparities in HL outcomes. PMID:19557531

The Role of Race/Ethnicity in Alcohol-attributable Injury in the United States

PubMed Central

Keyes, Katherine M.; Liu, Xianfang C.; Cerda, Magdalena

2017-01-01

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns. PMID:23441581

Benthic Crustacea from tropical and temperate reef locations: differences in assemblages and their relationship with habitat structure

NASA Astrophysics Data System (ADS)

Kramer, Michael J.; Bellwood, David R.; Taylor, Richard B.; Bellwood, Orpha

2017-09-01

Tropical and temperate marine habitats have long been recognised as fundamentally different system, yet comparative studies are rare, particularly for small organisms such as Crustacea. This study investigates the ecological attributes (abundance, biomass and estimated productivity) of benthic Crustacea in selected microhabitats from a tropical and a temperate location, revealing marked differences in the crustacean assemblages. In general, microhabitats from the tropical location (dead coral, the epilithic algal matrix [algal turfs] and sand) supported high abundances of small individuals (mean length = 0.53 mm vs. 0.96 mm in temperate microhabitats), while temperate microhabitats (the brown seaweed Carpophyllum sp., coralline turf and sand) had substantially greater biomasses of crustaceans and higher estimated productivity rates. In both locations, the most important microhabitats for crustaceans (per unit area) were complex structures: tropical dead coral and temperate Carpophyllum sp. It appears that the differences between microhabitats are largely driven by the size and relative abundance of key crustacean groups. Temperate microhabitats have a higher proportion of relatively large Peracarida (Amphipoda and Isopoda), whereas tropical microhabitats are dominated by small detrital- and microalgal-feeding crustaceans (harpacticoid copepods and ostracods). These differences highlight the vulnerability of tropical and temperate systems to the loss of complex benthic structures and their associated crustacean assemblages.

Effects of livestock exclusion on density, survival and biomass of the perennial sagebrush grass Hymenachne pernambucense (Poaceae) from a temperate fluvial wetland

NASA Astrophysics Data System (ADS)

Magnano, Andrea L.; Nanni, Analía S.; Krug, Pamela; Astrada, Elizabeth; Vicari, Ricardo; Quintana, Rubén D.

2018-01-01

In Argentina, the intensification of soybean production has displaced a substantial proportion of cattle ranching to fluvial wetlands such as those in the Delta of the Paraná River. Cattle grazing affects structure and dynamics of native forage plants but there is little information on this impact in populations from fluvial wetlands. This study addresses the effect of cattle ranching on density, survival, mean life-span and aerial biomass of Hymenachne pernambucense (Poaceae), an important forage species in the region. The study was carried out monthly for one year in permanents plots subject to continuous grazing and plots excluded from grazing in the Middle Delta of the Paraná River. In plots excluded from grazing, tillers showed significantly higher population density and survival, and a two-fold increase in mean life-span, while continuous grazing decreased survival of cohorts. The largest contribution to tiller density in ungrazed and grazed populations was made by spring and summer cohorts, respectively. Total and green biomass were significantly higher in the ungrazed population, with highest differences in late spring-early summer. Cattle grazing affected the relationship between tiller density and green biomass suggesting that cattle prefer sprouts because they are more palatable and nutritious than older tissue.

Trends in lung cancer incidence in Lebanon by gender and histological type over the period 2005-2008.

PubMed

Temraz, Sally; Charafeddine, Maya; Mukherji, Deborah; Shamseddine, Ali

2017-09-01

Lung cancer incidence rates, overall and by histologic subtypes, vary substantially by gender and smoking. This study's aim was to review data regarding trends in the number of cases of different lung-cancer histologies and relate these to smoking habits by gender in Lebanon. Lung cancer data using ICD-O, 3rd edition, from the Lebanese National Cancer Registry from 2005 to 2008 were stratified by gender for histology type for patients aged over 18years. Lung cancer cases among males were 2.5 times higher than those in females. The most common lung cancer histology type for males and females was adenocarcinoma for all observed years. The proportion of squamous cell carcinoma in incident cases was significantly higher in males than in females for the total period from 2005 to 2008, P=0.032, but not in individual years. The ratio of adenocarcinoma to squamous cell carcinoma in incident cases between 2005 and 2008 was 2:45 for males and 3:15 for females. Lung cancer histology in Lebanon is following a pattern similar to that found in most countries of North America and in Europe, where adenocarcinoma is the most prevalent subtype among both males and females. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Role of Intracellular Lipid Logistics in the Preferential Usage of Very Long Chain-Ceramides in Glucosylceramide.

PubMed

Yamaji, Toshiyuki; Horie, Aya; Tachida, Yuriko; Sakuma, Chisato; Suzuki, Yusuke; Kushi, Yasunori; Hanada, Kentaro

2016-10-21

Ceramide is a common precursor of sphingomyelin (SM) and glycosphingolipids (GSLs) in mammalian cells. Ceramide synthase 2 (CERS2), one of the six ceramide synthase isoforms, is responsible for the synthesis of very long chain fatty acid (C20-26 fatty acids) (VLC)-containing ceramides (VLC-Cer). It is known that the proportion of VLC species in GSLs is higher than that in SM. To address the mechanism of the VLC-preference of GSLs, we used genome editing to establish three HeLa cell mutants that expressed different amounts of CERS2 and compared the acyl chain lengths of SM and GSLs by metabolic labeling experiments. VLC-sphingolipid expression was increased along with that of CERS2, and the proportion of VLC species in glucosylceramide (GlcCer) was higher than that in SM for all expression levels of CERS2. This higher proportion was still maintained even when the proportion of C16-Cer to the total ceramides was increased by disrupting the ceramide transport protein (CERT)-dependent C16-Cer delivery pathway for SM synthesis. On the other hand, merging the Golgi apparatus and the endoplasmic reticulum (ER) by Brefeldin A decreased the proportion of VLC species in GlcCer probably due to higher accessibility of UDP-glucose ceramide glucosyltransferase (UGCG) to C16-rich ceramides. These results suggest the existence of a yet-to-be-identified mechanism rendering VLC-Cer more accessible than C16-Cer to UGCG, which is independent of CERT.

Gender differences in abused children with and without disabilities.

PubMed

Sobsey, D; Randall, W; Parrila, R K

1997-08-01

Two questions were posed: (1) What are the proportions of boys and girls in various categories of substantiated child abuse? (2) Do the gender proportions differ for children with and without disabilities? Data collected by previous researchers from a demographically representative sample of U.S. child abuse reporting districts was analyzed. This included 1,249 case files involving 1,834 children. The number of girls and boys who did and did not have disabilities was identified for three age categories and for several categories of abuse. Chi-square analyses were used to determine whether there was a relationship between disability and gender for the various age and abuse categories. More boys were physically abused and neglected, but more girls were sexually abused. Boys with disabilities, however, were over-represented in all categories of abuse. Moreover, gender proportions among abused children with disabilities differed significantly from those found among other abused children. Although slightly more than half of abused children without disabilities were girls, 65% of abused children with disabilities were boys. Boys represented a significantly larger proportion of physically abused, sexually abused, and neglected children with disabilities than would be expected from their respective proportion of abused and neglected children without disabilities. Several possible explanations for the observed gender and disability status interaction are discussed.

Myoelectric control system and task-specific characteristics affect voluntary use of simultaneous control

PubMed Central

Smith, Lauren H.; Kuiken, Todd A.; Hargrove, Levi J.

2015-01-01

Clinically available myoelectric control does not enable simultaneous proportional control of prosthetic degrees of freedom. Multiple studies have proposed systems that provide simultaneous control, though few have investigated whether subjects voluntarily use simultaneous control or how they implement it. Additionally, few studies have explicitly evaluated the effect of providing proportional velocity control. The objective of this study was to evaluate factors influencing when and how subjects use simultaneous myoelectric control, including the ability to proportionally control the velocity and the required task precision. Five able-bodied subjects used simultaneous myoelectric control systems with and without proportional velocity control in a virtual Fitts’ Law task. Though subjects used simultaneous control to a substantial degree when proportional velocity control was present, they used very little simultaneous control when using constant-velocity control. Furthermore, use of simultaneous control varied significantly with target distance and width, reflecting a strategy of using simultaneous control for gross cursor positioning and sequential control for fine corrective movements. These results provide insight into how users take advantage of simultaneous control and highlight the need for real-time evaluation of simultaneous control algorithms, as the potential benefit of providing simultaneous control may be affected by other characteristics of the myoelectric control system. PMID:25769167

The Impact of Ownership on Hospice Service Use, 2005–2011

PubMed Central

Stevenson, David G.; Grabowski, David C.; Keating, Nancy L.; Huskamp, Haiden A.

2016-01-01

Background/Objectives For-profit agencies comprise the majority of all United States hospice agencies, prompting concerns about aggressive enrollment practices and deficient care. Using detailed administrative data from 2005–2011, we sought to assess differences in patient populations and service use by hospice ownership, chain status, and agency size. Design/Participants Retrospective cohort study of 5,405,526 Medicare beneficiaries age 65+ enrolled in hospice during 2005–2011. Hospice use by ownership category (for-profit non-chain and chain, not-for-profit non-chain and chain, government) and agency size (0–50 patients, 51–200, 201–400, 401+). Mean length-of-use, stays ≤3 days, stays ending with live discharge, and decedents receiving no general inpatient care (GIP) or continuous home care (CHC) level hospice in the last 7 days of life. Results After adjusting for patient and geographic differences, for-profit non-chain and chain agencies had longer mean lengths-of-use (84.5 and 91.2 days, respectively) than other agency types (66.3–72.5 days); higher rates of live discharge (21.0% and 20.2% versus 14.6%–15.9%); and lower proportions of stays of ≤3 days (13.9% and 14.7% versus 16.6%–17.5%) (all p-values<0.001). The proportion of decedents not receiving GIP/CHC level care before death was highest among for-profit chains (75.9%) and lowest among not-for-profit non-chains (63.2%). Across ownership categories, smaller agencies had longer mean lengths-of-use, higher live discharge rates, lower rates of stays ≤3 days, and higher rates of patients receiving no GIP/CHC level care. Considerable variation in patient traits and unadjusted service use existed among the nation’s largest chains. Conclusion Although for-profit and not-for-profit hospice agencies differ along key dimensions, our results convey substantial heterogeneity within these categories, highlighting the need to consider factors such as agency size and chain affiliation in understanding variations in Medicare beneficiaries’ hospice care. PMID:27131344

Mortality among British Columbians testing for hepatitis C antibody.

PubMed

Yu, Amanda; Spinelli, John J; Cook, Darrel A; Buxton, Jane A; Krajden, Mel

2013-04-02

Hepatitis C virus (HCV) infection is a major preventable and treatable cause of morbidity and mortality. The ability to link population based centralized laboratory HCV testing data with administrative databases provided a unique opportunity to compare mortality between HCV seronegative and seropositive individuals. Through the use of laboratory testing patterns and results, the objective of this study was to differentiate the viral effects of mortality due to HCV infection from risk behaviours/activities that are associated with acquisition of HCV infection. Serological testing data from the British Columbia (BC) Centre for Disease Control Public Health Microbiology and Reference Laboratory from 1992-2004 were linked to the BC Vital Statistics Agency death registry. Four groups of HCV testers were defined by their HCV antibody (anti-HCV) testing patterns: single non-reactive (SNR); serial multiple tested non-reactive (MNR); reactive at initial testing (REAC); and seroconverter (SERO) (previously seronegative followed by reactive, a marker for incident infection). Standardized mortality ratios (SMRs) were calculated to compare the relative risk of all cause and disease specific mortality to that of the BC population for each serological group. Time dependent Cox proportional hazard regression was used to compare hazard ratios (HRs) among HCV serological groups. All anti-HCV testers had higher SMRs than the BC population. Referent to the SNR group, the REAC group had higher risks for liver (HR: 9.62; 95% CI=8.55-10.87) and drug related mortality (HR: 13.70; 95% CI=11.76-16.13). Compared to the REAC group, the SERO group had a lower risk for liver (HR: 0.53; 95% CI=0.24-0.99), but a higher risk for drug related mortality (HR: 1.54; 95% CI=1.12-2.05). These findings confirm that individuals who test anti-HCV positive have increased mortality related to progressive liver disease, and that a substantial proportion of the mortality is attributable to drug use and risk behaviours/activities associated with HCV acquisition. Mortality reduction in HCV infected individuals will require comprehensive prevention programming to reduce the harms due to behaviours/activities which relate to HCV acquisition, as well as HCV treatment to prevent progression of chronic liver disease.

Influence of Oxygen Tension on Dopaminergic Differentiation of Human Fetal Stem Cells of Midbrain and Forebrain Origin

PubMed Central

Krabbe, Christina; Bak, Sara Thornby; Jensen, Pia; von Linstow, Christian; Martínez Serrano, Alberto; Hansen, Claus; Meyer, Morten

2014-01-01

Neural stem cells (NSCs) constitute a promising source of cells for transplantation in Parkinson's disease (PD), but protocols for controlled dopaminergic differentiation are not yet available. Here we investigated the influence of oxygen on dopaminergic differentiation of human fetal NSCs derived from the midbrain and forebrain. Cells were differentiated for 10 days in vitro at low, physiological (3%) versus high, atmospheric (20%) oxygen tension. Low oxygen resulted in upregulation of vascular endothelial growth factor and increased the proportion of tyrosine hydroxylase-immunoreactive (TH-ir) cells in both types of cultures (midbrain: 9.1±0.5 and 17.1±0.4 (P<0.001); forebrain: 1.9±0.4 and 3.9±0.6 (P<0.01) percent of total cells). Regardless of oxygen levels, the content of TH-ir cells with mature neuronal morphologies was higher for midbrain as compared to forebrain cultures. Proliferative Ki67-ir cells were found in both types of cultures, but the relative proportion of these cells was significantly higher for forebrain NSCs cultured at low, as compared to high, oxygen tension. No such difference was detected for midbrain-derived cells. Western blot analysis revealed that low oxygen enhanced β-tubulin III and GFAP expression in both cultures. Up-regulation of β-tubulin III was most pronounced for midbrain cells, whereas GFAP expression was higher in forebrain as compared to midbrain cells. NSCs from both brain regions displayed less cell death when cultured at low oxygen tension. Following mictrotransplantation into mouse striatal slice cultures predifferentiated midbrain NSCs were found to proliferate and differentiate into substantial numbers of TH-ir neurons with mature neuronal morphologies, particularly at low oxygen. In contrast, predifferentiated forebrain NSCs microtransplanted using identical conditions displayed little proliferation and contained few TH-ir cells, all of which had an immature appearance. Our data may reflect differences in dopaminergic differentiation capacity and region-specific requirements of NSCs, with the dopamine-depleted striatum cultured at low oxygen offering an attractive micro-environment for midbrain NSCs. PMID:24788190

Prevalence of antisocial personality disorder among Chinese individuals receiving treatment for heroin dependence: a meta-analysis

PubMed Central

ZHONG, Baoliang; XIANG, Yutao; CAO, Xiaolan; LI, Yan; ZHU, Junhong; CHIU, Helen F. K.

2014-01-01

Background Studies from Western countries consistently report very high rates of comorbid Antisocial Personality Disorder (ASPD) among individuals with heroin addiction, but the reported proportion of Chinese individuals with heroin addiction who have co-morbid ASPD varies widely, possibly because Chinese clinicians do not consider personality issues when treating substance abuse problems. Aim Conduct a meta-analysis of studies that assessed the proportion of Chinese individuals with heroin dependence who have comorbid ASPD. Methods We searched for relevant studies in both Chinese databases (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Taiwan Electronic Periodical Services) and western databases (PubMed, EMBASE, and PsycInfo). Two authors independently retrieved the literature, identified studies that met pre-defined inclusion and exclusion criteria, assessed the quality of included studies, and extracted the data used in the analysis. Statistical analysis was performed using StatsDirect 3.0 and R software. Results The search yielded 15 eligible studies with a total of 3692 individuals with heroin dependence. Only 2 of the studies were rated as high-quality studies. All studies were conducted in rehabilitation centers or hospitals. The pooled lifetime prevalence of ASPD in these subjects was 30% (95%CI: 23%-38%), but the heterogeneity of results across studies was great (I2 =95%, p<0.001). Men had a higher prevalence than women (44% vs. 21%), and injection heroin users had higher prevalence than those who smoked heroin (44% vs. 27%). Studies that were methodologically stronger had higher reported prevalence of ASPD among heroin dependent individuals. Conclusions There are substantial methodological problems in the available literature about ASPD in Chinese individuals receiving treatment for heroin dependence, but we estimate that about one-third of them meet criteria for ASPD. Further work is needed to increase clinicians’ awareness of this issue; to compare the pathogenesis, treatment responsiveness and recidivism of those with and without ASPD; and to develop and test targeted interventions for this difficult-to-treat subgroup of individuals with heroin dependence. PMID:25477719

Growing challenges for HIV programmes in Asia: clinic population trends, 2003-2013.

PubMed

De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Ly, Penh Sun; Ng, Oon Tek; Nguyen, Kinh Van; Merati, Tuti Parwati; Lee, Man Po; Do, Cuong Duy; Choi, Jun Yong; Ross, Jeremy L; Law, Matthew G

2017-10-01

The scale-up of antiretroviral therapy (ART) has led to a substantial change in the clinical population of HIV-positive patients receiving care. We describe the temporal trends in the demographic and clinical characteristics of HIV-positive patients initiating ART in 2003-13 within an Asian regional cohort. All HIV-positive adult patients that initiated ART between 2003 and 2013 were included. We summarized ART regimen use, age, CD4 cell count, HIV viral load, and HIV-related laboratory monitoring rates during follow-up by calendar year. A total of 16 962 patients were included in the analysis. Patients in active follow-up increased from 695 patients at four sites in 2003 to 11,137 patients at eight sites in 2013. The proportion of patients receiving their second or third ART regimen increased over time (5% in 2003 to 29% in 2013) along with patients aged ≥50 years (8% in 2003 to 18% in 2013). Concurrently, CD4 monitoring has remained stable in recent years, whereas HIV viral load monitoring, although varied among the sites, is increasing. There have been substantial changes in the clinical and demographic characteristics of HIV-positive patients receiving ART in Asia. HIV programmes will need to anticipate the clinical care needs for their aging populations, expanded viral load monitoring, and, the eventual increase in second and third ART regimens that will lead to higher costs and more complex drug procurement needs.

Who has housing affordability problems? Disparities in Housing Cost burden by Race, Nativity and Legal Status in Los Angeles

PubMed Central

McConnell, Eileen Diaz

2013-01-01

Housing costs are a substantial component of U.S. household expenditures. Those who allocate a large proportion of their income to housing often have to make difficult financial decisions with significant short-term and long-term implications for adults and children. This study employs cross-sectional data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS) collected between 2000 and 2002 to examine the most common U.S. standard of housing affordability, the likelihood of spending thirty percent or more of income on shelter costs. Multivariate analyses of a low-income sample of U.S. born Latinos, Whites, African Americans, authorized Latino immigrants and unauthorized Latino immigrants focus on baseline and persistent differences in the likelihood of being cost burdened by race, nativity and legal status. Nearly half or more of each group of low-income respondents experience housing affordability problems. The results suggest that immigrants’ legal status is the primary source of disparities among those examined, with the multivariate analyses revealing large and persistent disparities for unauthorized Latino immigrants relative to most other groups. Moreover, the higher odds of housing cost burden observed for unauthorized immigrants compared with their authorized immigrant counterparts remains substantial, accounting for traditional indicators of immigrant assimilation. These results are consistent with emerging scholarship regarding the role of legal status in shaping immigrant outcomes in the United States. PMID:24077641

How Compliance Measures, Behavior Modification, and Continuous Quality Improvement Led to Routine HIV Screening in an Emergency Department in Brooklyn, New York.

PubMed

Isaac, Jermel Kyri; Sanchez, Travis H; Brown, Emily H; Thompson, Gina; Sanchez, Christina; Fils-Aime, Stephany; Maria, Jose

2016-01-01

New York State adopted a new HIV testing law in 2010 requiring medical providers to offer an HIV test to all eligible patients aged 13-64 years during emergency room or ambulatory care visits. Since then, Wyckoff Heights Medical Center (WHMC) in Brooklyn, New York, began implementing routine HIV screening organization-wide using a compliance, behavior-modification, and continuous quality-improvement process. WHMC first implemented HIV screening in the emergency department (ED) and evaluated progress with the following monthly indicators: HIV tests offered, HIV tests accepted, HIV tests ordered (starting in December 2013), HIV tests administered, positive HIV tests, and linkage to HIV care. Compliance with the delivery of HIV testing was determined by the proportion of patients who, after accepting a test, received one. During August 2013 through July 2014, of 57,852 eligible patients seen in the WHMC ED, a total of 31,423 (54.3%) were offered an HIV test. Of those, 8,229 (26.2%) patients accepted a test. Of those, 6,114 (74.3%) underwent a test. A total of 26 of the 6,114 patients tested (0.4%) had a positive test, and 24 of the 26 HIV-positive patients were linked to HIV medical care. By July 2014, the monthly proportion of patients offered a test was 62%; the proportion of those offered a test who had a test ordered was 98%, and the proportion of those with a test ordered who were tested was 81%. Testing compliance increased substantially at the WHMC ED, from 77% in December 2013 to >98% in July 2014. Using compliance-monitoring, behavior-modification, and continuous quality-improvement processes produced substantial increases in offers and HIV test completion. WHMC is replicating this approach across departments, and other hospitals implementing routine HIV screening programs should consider this approach as well.

COPD in Never Smokers

PubMed Central

McBurnie, Mary Ann; Vollmer, William M.; Gudmundsson, Gunnar; Welte, Tobias; Nizankowska-Mogilnicka, Ewa; Studnicka, Michael; Bateman, Eric; Anto, Josep M.; Burney, Peter; Mannino, David M.; Buist, Sonia A.

2011-01-01

Background: Never smokers comprise a substantial proportion of patients with COPD. Their characteristics and possible risk factors in this population are not yet well defined. Methods: We analyzed data from 14 countries that participated in the international, population-based Burden of Obstructive Lung Disease (BOLD) study. Participants were aged ≥ 40 years and completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. A diagnosis of COPD was based on the postbronchodilator FEV1/FVC ratio, according to current GOLD (Global Initiative for Obstructive Lung Disease) guidelines. In addition to this, the lower limit of normal (LLN) was evaluated as an alternative threshold for the FEV1/FVC ratio. Results: Among 4,291 never smokers, 6.6% met criteria for mild (GOLD stage I) COPD, and 5.6% met criteria for moderate to very severe (GOLD stage II+) COPD. Although never smokers were less likely to have COPD and had less severe COPD than ever smokers, never smokers nonetheless comprised 23.3% (240/1,031) of those classified with GOLD stage II+ COPD. This proportion was similar, 20.5% (171/832), even when the LLN was used as a threshold for the FEV1/FVC ratio. Predictors of COPD in never smokers include age, education, occupational exposure, childhood respiratory diseases, and BMI alterations. Conclusion: This multicenter international study confirms previous evidence that never smokers comprise a substantial proportion of individuals with COPD. Our data suggest that, in addition to increased age, a prior diagnosis of asthma and, among women, lower education levels are associated with an increased risk for COPD among never smokers. PMID:20884729

Prospective association between self-reported life satisfaction and mortality: results from the MONICA/KORA Augsburg S3 survey cohort study.

PubMed

Lacruz, Maria E; Emeny, Rebecca T; Baumert, Jens; Ladwig, Karl H

2011-07-20

To identify factors which determine high life satisfaction (LS) and to analyse the prognostic influence of LS on mortality. Data collection was conducted on 2,675 participants, age 25-74 years, as part of the MONICA Augsburg Project 1994-95. Multivariate logistic regression analyses were used to determine factors associated with high LS (measured with one item, 6-level Likert scale, where "high" = very satisfied/most of the time very satisfied with ones personal life). After 12 years mean follow-up, a total of 245 deaths occurred. We calculated age- and sex-adjusted incident mortality rates per 10,000. Hazard ratios (HRs) were estimated from Cox proportional hazards models. Independent determinants of LS were income, health-perception, and social support, as well as somatisation, anger or depressive symptoms (all p < 0.05). Participants with higher LS (n = 721, 27%) benefited the most with respect to absolute mortality risk reduction (higher LS = 67; mid = 98; low = 140 per 10,000). The sex-stratified analyses indicated an independent association of higher LS and survival for men (HR 0.55; 95% CI 0.37 - 0.81) but not for women. Baseline assessment demonstrated that psychological, social and life-style factors, but not somatic co-morbidities, were relevant determinants of LS. Moreover, the analysis showed that men with higher LS have a substantial long-term survival benefit. The observed association between LS and mortality may be attributed to common underlying causes such as social network integration and/or self-rated health.

Prospective association between self-reported life satisfaction and mortality: Results from the MONICA/KORA Augsburg S3 survey cohort study

PubMed Central

2011-01-01

Background To identify factors which determine high life satisfaction (LS) and to analyse the prognostic influence of LS on mortality. Methods Data collection was conducted on 2,675 participants, age 25-74 years, as part of the MONICA Augsburg Project 1994-95. Multivariate logistic regression analyses were used to determine factors associated with high LS (measured with one item, 6-level Likert scale, where "high" = very satisfied/most of the time very satisfied with ones personal life). After 12 years mean follow-up, a total of 245 deaths occurred. We calculated age- and sex-adjusted incident mortality rates per 10,000. Hazard ratios (HRs) were estimated from Cox proportional hazards models. Results Independent determinants of LS were income, health-perception, and social support, as well as somatisation, anger or depressive symptoms (all p < 0.05). Participants with higher LS (n = 721, 27%) benefited the most with respect to absolute mortality risk reduction (higher LS = 67; mid = 98; low = 140 per 10,000). The sex-stratified analyses indicated an independent association of higher LS and survival for men (HR 0.55; 95% CI 0.37 - 0.81) but not for women. Conclusions Baseline assessment demonstrated that psychological, social and life-style factors, but not somatic co-morbidities, were relevant determinants of LS. Moreover, the analysis showed that men with higher LS have a substantial long-term survival benefit. The observed association between LS and mortality may be attributed to common underlying causes such as social network integration and/or self-rated health. PMID:21774793

Topical adenosine increases the proportion of thick hair in Caucasian men with androgenetic alopecia.

PubMed

Iwabuchi, Tokuro; Ideta, Ritsuro; Ehama, Ritsuko; Yamanishi, Haruyo; Iino, Masato; Nakazawa, Yosuke; Kobayashi, Takashi; Ohyama, Manabu; Kishimoto, Jiro

2016-05-01

Adenosine is an effective treatment for androgenetic alopecia (AGA) in Japanese men and women. Adenosine exerts its effects by significantly increasing the proportion of thick hair. In this study, we assessed the clinical outcome of adenosine treatment for 6 months in 38 Caucasian men. The change in proportion of thick hair (≥60 μm) compared with baseline in the adenosine group was significantly higher than that in the placebo group (P < 0.0001). The change in vellus hair proportion (<40 μm) was significantly lower in the adenosine group than that in the placebo group (P = 0.0154). The change in hair density compared with baseline of the adenosine group was also significantly higher compared with that of the placebo group (P = 0.0470). No adverse effects due to treatment were noted during this study by dermatological evaluation. Adenosine is effective in increasing the proportion of thick hair in Caucasian men with AGA as well as in Japanese men and women. © 2015 Japanese Dermatological Association.

The planetary positions and relationships at the dates of birth of a cohort of Nigerian schizophrenics.

PubMed

Ohaeri, J U

1997-01-01

Some astrological hypotheses related to predisposition to severe mental illness were tested by analysing the zodiacal signs, the interactions between planetary qualities (aspects), and the occurrence of full and new moon dates, on the dates of birth of 221 schizophrenics, compared with 112 normal subjects. The sun signs of the schizophrenics were significantly more likely to be in the signs associated with introversion, while those of the control population were significantly more likely to be in the outgoing signs. A significantly higher proportion of schizophrenics had their Mars (i.e., symbol of aggressiveness) in the outgoing signs than the normal population. A significantly higher proportion of control subjects fulfilled operational criteria for adequacy of number of aspects between the sun and the other planets. The tendency for a higher proportion of schizophrenics to have "difficult" aspects just failed to reach significance. A significantly higher proportion of control subjects had aspects between the sun and mars; and also a significantly higher proportion of control subjects had "soft" (helpful) aspects between the sun and mars. These findings are in keeping with the well-known oddity of schizophrenia (schiz = split; phren = mind); such that, a group which collectively is characterised by an "introverted" self (i.e. sun sign), has a coexisting aggressive tendency (i.e. strong mars) and poor integration between the elements of the psyche and the self (i.e. inadequacy of aspects between Sun and other planets). However, the findings give only partial support to key astrological postulates because there was a non-significant trend for more schizophrenics to be born in "water" signs and on full moon dates.

T cells in chronic lymphocytic leukemia display dysregulated expression of immune checkpoints and activation markers.

PubMed

Palma, Marzia; Gentilcore, Giusy; Heimersson, Kia; Mozaffari, Fariba; Näsman-Glaser, Barbro; Young, Emma; Rosenquist, Richard; Hansson, Lotta; Österborg, Anders; Mellstedt, Håkan

2017-03-01

Chronic lymphocytic leukemia is characterized by impaired immune functions largely due to profound T-cell defects. T-cell functions also depend on co-signaling receptors, inhibitory or stimulatory, known as immune checkpoints, including cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) and programmed death-1 (PD-1). Here we analyzed the T-cell phenotype focusing on immune checkpoints and activation markers in chronic lymphocytic leukemia patients (n=80) with different clinical characteristics and compared them to healthy controls. In general, patients had higher absolute numbers of CD3 + cells and the CD8 + subset was particularly expanded in previously treated patients. Progressive patients had higher numbers of CD4 + and CD8 + cells expressing PD-1 compared to healthy controls, which was more pronounced in previously treated patients ( P =0.0003 and P =0.001, respectively). A significant increase in antigen-experienced T cells was observed in patients within both the CD4 + and CD8 + subsets, with a significantly higher PD-1 expression. Higher numbers of CD4 + and CD8 + cells with intracellular CTLA-4 were observed in patients, as well as high numbers of proliferating (Ki67 + ) and activated (CD69 + ) CD4 + and CD8 + cells, more pronounced in patients with active disease. The numbers of Th1, Th2, Th17 and regulatory T cells were substantially increased in patients compared to controls ( P <0.05), albeit decreasing to low levels in pre-treated patients. In conclusion, chronic lymphocytic leukemia T cells display increased expression of immune checkpoints, abnormal subset distribution, and a higher proportion of proliferating cells compared to healthy T cells. Disease activity and previous treatment shape the T-cell profile of chronic lymphocytic leukemia patients in different ways. Copyright© Ferrata Storti Foundation.

Coronary Heart Disease and Stroke Attributable to Major Risk Factors is Similar in Argentina and the United States: the Coronary Heart Disease Policy Model

PubMed Central

Moran, Andrew; DeGennaro, Vincent; Ferrante, Daniel; Coxson, Pamela G.; Palmas, Walter; Mejia, Raul; Perez-Stable, Eliseo J.; Goldman, Lee

2011-01-01

Background Cardiovascular disease is the leading cause of death in Argentina and the U.S. Argentina is 92% urban, with cardiovascular disease risk factor levels approximating the U.S. Methods The Coronary Heart Disease (CHD) Policy Model is a national-scale computer model of CHD and stroke. Risk factor data were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America Study (2003–04), Argentina National Risk Factor Survey (2005) and U.S. national surveys. Proportions of cardiovascular events over 2005–2015 attributable to risk factors were simulated by setting risk factors to optimal exposure levels [systolic blood pressure (SBP) 115 mm Hg, low-density lipoprotein cholesterol (LDL) 2.00 mmol/l (78 mg/dl), high-density lipoprotein cholesterol (HDL) 1.03 mmol/l (60 mg/dl), absence of diabetes, and smoking]. Cardiovascular disease attributable to body mass index (BMI) > 21 kg/m2 was assumed mediated through SBP, LDL, HDL, and diabetes. Results Cardiovascular disease attributable to major risk factors was similar between Argentina and the U.S., except for elevated SBP in men (CHD 8 % points higher in Argentine men, 6% higher for stroke). CHD attributable to BMI > 21 kg/m2 was substantially higher in the U.S. (men 10–11 % points higher; women CHD 13–14% higher). Conclusions Projected cardiovascular disease attributable to major risk factors appeared similar in Argentina and the U.S., though elevated BMI may be responsible for more of U.S. cardiovascular disease. A highly urbanized middle-income nation can have cardiovascular disease rates and risk factor levels comparable to a high income nation, but fewer resources for fighting the epidemic. PMID:21550675

Change in joint space width: hyaline articular cartilage loss or alteration in meniscus?

PubMed

Hunter, D J; Zhang, Y Q; Tu, X; Lavalley, M; Niu, J B; Amin, S; Guermazi, A; Genant, H; Gale, D; Felson, D T

2006-08-01

To explore the relative contribution of hyaline cartilage morphologic features and the meniscus to the radiographic joint space. The Boston Osteoarthritis of the Knee Study is a natural history study of symptomatic knee osteoarthritis (OA). Baseline and 30-month followup assessments included knee magnetic resonance imaging (MRI) and fluoroscopically positioned weight-bearing knee radiographs. Cartilage and meniscal degeneration were scored on MRI in the medial and lateral tibiofemoral joints using a semiquantitative grading system. Meniscal position was measured to the nearest millimeter. The dependent variable was joint space narrowing (JSN) on the plain radiograph (possible range 0-3). The predictor variables were MRI cartilage score, meniscal degeneration, and meniscal position measures. We first conducted a cross-sectional analysis using multivariate regression to determine the relative contribution of meniscal factors and cartilage morphologic features to JSN, adjusting for body mass index (BMI), age, and sex. The same approach was used for change in JSN and change in predictor variables. We evaluated 264 study participants with knee OA (mean age 66.7 years, 59% men, mean BMI 31.4 kg/m(2)). The results from the models demonstrated that meniscal position and meniscal degeneration each contributed to prediction of JSN, in addition to the contribution by cartilage morphologic features. For change in medial joint space, both change in meniscal position and change in articular cartilage score contributed substantially to narrowing of the joint space. The meniscus (both its position and degeneration) accounts for a substantial proportion of the variance explained in JSN, and the change in meniscal position accounts for a substantial proportion of change in JSN.

Evolution of the global use of unsafe medical injections, 2000-2010.

PubMed

Pépin, Jacques; Abou Chakra, Claire Nour; Pépin, Eric; Nault, Vincent

2013-01-01

Since 1999, substantial efforts have been made by the international community to reduce the risks associated with unsafe injections, through ministries of health, international donors, the World Health Organization and the Safe Injection Global Network. The present study attempted to measure the progress, or lack thereof, made over the 2000-2010 decade in reducing unsafe injections in ten regions of the world corresponding to developing and transitional economies. Data about the number of injections per person per year and the proportion of re-use of syringes and needles were obtained for 2010, mainly from population surveys, and compared with previous estimates for 2000 which had used various sources of information including injection safety assessments, population surveys and published studies on injection practices. From 2000 to 2010, in developing countries and transitional economies, the average number of injections per person per year decreased from 3.40 to 2.88, while the proportion of re-use of injection devices dropped from 39.8% to 5.5%. Combining both factors the number of unsafe injections per person per year decreased from 1.35 to 0.16. Even if substantial progress has been made, the Eastern Mediterranean region remains problematic, with 0.57 unsafe injections per person per year. In sub-Saharan Africa and Latin America, people now receive on average only 0.04-0.05 unsafe injections per year. Substantial progress has been made in reducing the number of unsafe injections in developing countries and transitional economies, essentially through a reduction in the re-use of injection devices. In some regions, elimination of unsafe injections might become a reasonable goal.

Effect of urbanization on population structure in U.A.R.

PubMed

Husein, H M; Sarhan, A E

1970-06-01

Census data from Egypt in 1927, 1937, 1947, and 1960 indicate slow urbanization through 1937 and more rapid urbanization thereafter. There is a higher proportion of working age (15-44) people in urban areas and a higher proportion of males. Both fertility and mortality rates are higher in rural than in urban areas, but the rate of overall population growth is greater in urban areas. Figures from 4 recently industrialized urban areas (El-Mahalla, Kafr el-Dawar, Helwan, and Aswan) bear out the conclusions drawn from the general census figures.

Modeling ecological traps for the control of feral pigs

PubMed Central

Dexter, Nick; McLeod, Steven R

2015-01-01

Ecological traps are habitat sinks that are preferred by dispersing animals but have higher mortality or reduced fecundity compared to source habitats. Theory suggests that if mortality rates are sufficiently high, then ecological traps can result in extinction. An ecological trap may be created when pest animals are controlled in one area, but not in another area of equal habitat quality, and when there is density-dependent immigration from the high-density uncontrolled area to the low-density controlled area. We used a logistic population model to explore how varying the proportion of habitat controlled, control mortality rate, and strength of density-dependent immigration for feral pigs could affect the long-term population abundance and time to extinction. Increasing control mortality, the proportion of habitat controlled and the strength of density-dependent immigration decreased abundance both within and outside the area controlled. At higher levels of these parameters, extinction was achieved for feral pigs. We extended the analysis with a more complex stochastic, interactive model of feral pig dynamics in the Australian rangelands to examine how the same variables as the logistic model affected long-term abundance in the controlled and uncontrolled area and time to extinction. Compared to the logistic model of feral pig dynamics, the stochastic interactive model predicted lower abundances and extinction at lower control mortalities and proportions of habitat controlled. To improve the realism of the stochastic interactive model, we substituted fixed mortality rates with a density-dependent control mortality function, empirically derived from helicopter shooting exercises in Australia. Compared to the stochastic interactive model with fixed mortality rates, the model with the density-dependent control mortality function did not predict as substantial decline in abundance in controlled or uncontrolled areas or extinction for any combination of variables. These models demonstrate that pest eradication is theoretically possible without the pest being controlled throughout its range because of density-dependent immigration into the area controlled. The stronger the density-dependent immigration, the better the overall control in controlled and uncontrolled habitat combined. However, the stronger the density-dependent immigration, the poorer the control in the area controlled. For feral pigs, incorporating environmental stochasticity improves the prospects for eradication, but adding a realistic density-dependent control function eliminates these prospects. PMID:26045954

Clinical features and prognosis of patients with acute aortic dissection in China

PubMed Central

Zhao, Lujing; Chai, Yanfen

2017-01-01

Objective To evaluate the clinical features, risk factors, and prognostic significance of different Stanford types of acute aortic dissection (AAD). Methods We retrospectively analyzed the clinical data and prognostic predictors in 105 patients with AAD (37 with Stanford type A and 68 with Stanford type B) at Tianjin Medical University General Hospital and Tianjin 4th Central Hospital from January 2014 to November 2015. Results Patients with Marfan syndrome and bicuspid aortic valve constituted 24.3% and 8.1%, respectively, of patients with type A AAD; these proportions were significantly higher than those of patients with type B AAD (7.4% and 0.0%, respectively). The proportion of iatrogenic causes of type A AAD (8.1%) was significantly higher than that of type B AAD (0.0%). Computed tomography angiography showed that the proportion of involvement of the aortic arch and pericardial effusion (86.5% and 18.9%, respectively) in patients with type A AAD were higher than those in patients with type B AAD (23.5% and 5.9%, respectively). Endovascular treatment was performed in a higher proportion of patients with type B than A AAD (70.6% vs. 5.4%, respectively). Conclusion Systolic blood pressure, pericardial effusion, periaortic hematoma, conservative treatment, and open surgery were independent predictors of increased mortality in patients with AAD. PMID:28345421

High School Pupils' Understanding of Peer Counselling and Willingness to Use it for Different Types of Bullying

ERIC Educational Resources Information Center

Boulton, Michael John

2014-01-01

Bullying affects a substantial proportion of school pupils, and peer counselling services have been established to help tackle this problem. The present study aimed to further the understanding of why affected pupils do or do not choose to utilise this form of social support. Pupils ("N" = 99, aged 12-16 years) from the UK were asked…

Beyond the Dualism between Lifelong Employment and Job Insecurity: Some New Career Promises for Young Scientists

ERIC Educational Resources Information Center

Dany, F.; Mangematin, Vincent

2004-01-01

This article analyses the early careers of young scientists in France. Since training and early career management are designed to cater almost exclusively for an academic career, a substantial proportion of PhDs lack support to design their training in relation to the job they will look for after graduation. Even if most young scientists manage to…

Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology

ERIC Educational Resources Information Center

Rønholt, Stine; Karsberg, Sidsel; Elklit, Ask

2013-01-01

Background: In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 3½ years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 3½ years after the…

Effects of a Cross-Age Peer Learning Program on the Vocabulary and Comprehension of English Learners and Non-English Learners in Elementary School

ERIC Educational Resources Information Center

Silverman, Rebecca D.; Martin-Beltran, Melinda; Peercy, Megan M.; Hartranft, Anna M.; McNeish, Daniel M.; Artzi, Lauren; Nunn, Stephanie

2017-01-01

This study evaluated the effects of a cross-age peer learning program targeting vocabulary and comprehension in kindergarten and fourth-grade classrooms with substantial proportions of English Learners (ELs). The study followed a quasi-experimental design with 12 classrooms (6 kindergarten and 6 fourth grade) in the intervention group and 12…

"I Can Read Further and There's More Meaning While I Read": An Exploratory Study Investigating the Impact of a Rhythm-Based Music Intervention on Children's Reading

ERIC Educational Resources Information Center

Long, Marion

2014-01-01

A substantial proportion of children underachieve in reading (Brooks & Tough, 2006; Doubek & Cooper, 2007; Tymms & Merrill, 2007). This paper builds on the existing evidence base for the link between reading and rhythm, presenting findings of an investigation into a rhythm-based music intervention. Following participation in the…

Birth order and hospitalization for alcohol and narcotics use in Sweden.

PubMed

Barclay, Kieron; Myrskylä, Mikko; Tynelius, Per; Berglind, Daniel; Rasmussen, Finn

2016-10-01

Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings. Before age 20 we find that later born siblings are hospitalized for alcohol use at a higher rate than first-borns, and there is a monotonic increase in the hazard of hospitalization with increasing birth order. Second-borns are hospitalized at a rate 47% higher than first-borns, and third-borns at a rate 65% higher. Similar patterns are observed for hospitalization for narcotics use. After age 20 the pattern is similar, but the association is weaker. These patterns are consistent across various sibling group sizes. Later born siblings are more likely to be hospitalized for both alcohol and narcotics use in Sweden. These birth order effects are substantial in size, and larger than the estimated sex differences for the risk of hospitalization related to alcohol and drug use before age 20, and previous estimates for socioeconomic status differences in alcohol and drug abuse. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys

PubMed Central

Krill, Patrick R.; Johnson, Ryan; Albert, Linda

2016-01-01

Objectives: Rates of substance use and other mental health concerns among attorneys are relatively unknown, despite the potential for harm that attorney impairment poses to the struggling individuals themselves, and to our communities, government, economy, and society. This study measured the prevalence of these concerns among licensed attorneys, their utilization of treatment services, and what barriers existed between them and the services they may need. Methods: A sample of 12,825 licensed, employed attorneys completed surveys, assessing alcohol use, drug use, and symptoms of depression, anxiety, and stress. Results: Substantial rates of behavioral health problems were found, with 20.6% screening positive for hazardous, harmful, and potentially alcohol-dependent drinking. Men had a higher proportion of positive screens, and also younger participants and those working in the field for a shorter duration (P < 0.001). Age group predicted Alcohol Use Disorders Identification Test scores; respondents 30 years of age or younger were more likely to have a higher score than their older peers (P < 0.001). Levels of depression, anxiety, and stress among attorneys were significant, with 28%, 19%, and 23% experiencing symptoms of depression, anxiety, and stress, respectively. Conclusions: Attorneys experience problematic drinking that is hazardous, harmful, or otherwise consistent with alcohol use disorders at a higher rate than other professional populations. Mental health distress is also significant. These data underscore the need for greater resources for lawyer assistance programs, and also the expansion of available attorney-specific prevention and treatment interventions. PMID:26825268

Geographical variation in the incidence of childhood leukaemia in Manitoba.

PubMed

Torabi, Mahmoud; Singh, Harminder; Galloway, Katie; Israels, Sara J

2015-11-01

Identification of geographical areas and ecological factors associated with higher incidence of childhood leukaemias can direct further study for preventable factors and location of health services to manage such individuals. The aim of this study was to describe the geographical variation and the socio-demographic factors associated with childhood leukaemia in Manitoba. Information on childhood leukaemia incidence between 1992 and 2008 was obtained from the Canadian Cancer Registry and the socio-demographic characteristics for the area of residence from the 2006 Canadian Census. Bayesian spatial Poisson mixed models were used to describe the geographical variation of childhood leukaemia and to determine the association between childhood leukaemia and socio-demographic factors. The south-eastern part of the province had a higher incidence of childhood leukaemia than other parts of the province. In the age and sex-adjusted Poisson regression models, areas with higher proportions of visible minorities and immigrant residents had higher childhood leukaemia incidence rate ratios. In the saturated Poisson regression model, the childhood leukaemia rates were higher in areas with higher proportions of immigrant residents. Unemployment rates were not a significant factor in leukaemia incidence. In Manitoba, areas with higher proportions of immigrants experience higher incidence rates of childhood leukaemia. We have identified geographical areas with higher incidence, which require further study and attention. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Status and Perspectives of Clinical Modes in Surgical Patients With Lung Cancer: A Retrospective Study.

PubMed

Lai, Yutian; Du, Heng; Wang, Xin; Shen, Cheng; Huang, Jian; Li, Weiming; Che, Guowei

2016-01-01

To investigate the association between the clinical characteristics and clinical modes of surgically treated lung cancer patients, we conducted a retrospective study with 1097 lung cancer patients receiving pulmonary resection between 2012 and 2013.A physical examination or screening (PES) group (n = 267) and a symptomatic (SY) group (n = 830) were established depending on the new clinical mode (sequence of physical examination, early detection and sequential medical treatment) and the conventional mode (hospitalization due to occurrence of relevant symptoms), respectively.A higher proportion of patients referred to our unit directly form a junior medical unit is found in PES group (43.8%, 117/267 vs 13.6%, 113/830) (P < 0.001) and 37.5% (100/267) patients in PES group spent <1 months from detection or first medical visit to diagnosis compared with 15.4% (128/830) patient in SY group (P < 0.001). A significantly higher proportion of PES patients versus SY patients received video-assisted thoracoscopic surgery (VATS) resection (67.8%, 183/267 vs 42.6%, 352/830; P < 0.001). A significantly higher proportion of PES patients versus SY patients chose sublobar resection (16.9%, 45/267 vs 7.6%, 63/830; P < 0.001). A significantly higher proportion of PES patients versus SY patients are at stage 0 or I (64.4%, 172/267 vs 40.7%, 338/830; P < 0.000). The postoperative incidence rate of complications in 30 days is significantly higher in SY group than in PES group (34.9% vs 27.3%; P = 0.022).Helping to early diagnosis and surgical treatment, early tumor detection via PES may contribute to significantly higher proportions of early-stage lung cancer, use of VATS pulmonary resection, and sublobectomy as well as lower complication rate.

The metrics and correlates of physician migration from Africa.

PubMed

Arah, Onyebuchi A

2007-05-17

Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration. Ranking and correlational analyses were conducted on African physician migration data adjusted for bilateral net flows, and supplemented with developmental, economic and health system data. The setting was the 53 African birth countries of African-born physicians working in nine wealthier destination countries. Three metrics of physician migration were used: total number of physician émigrés; emigration fraction defined as the proportion of the potential physician pool working in destination countries; and physician migration density defined as the number of physician émigrés per 1000 population of the African source country. Rankings based on any of the migration metrics differed substantially from those based on the other two metrics. Although the emigration fraction and physician migration density metrics gave proportionality to the migration crisis, only the latter was consistently associated with source countries' workforce capacity, health, health spending, economic and development characteristics. As such, higher physician migration density was seen among African countries with relatively higher health workforce capacity (0.401 < or = r < or = 0.694, p < or = 0.011), health status, health spending, and development. The perceived magnitude of physician migration is sensitive to the choice of metrics. Complementing the emigration fraction, the physician migration density is a metric which gives a different but proportionate picture of which African countries stand to lose relatively more of its physicians with unchecked migration. The nature of health policies geared at health-worker migration can be expected to depend on the choice of migration metrics.

Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study.

PubMed

Granerod, Julia; Ambrose, Helen E; Davies, Nicholas Ws; Clewley, Jonathan P; Walsh, Amanda L; Morgan, Dilys; Cunningham, Richard; Zuckerman, Mark; Mutton, Ken J; Solomon, Tom; Ward, Katherine N; Lunn, Michael Pt; Irani, Sarosh R; Vincent, Angela; Brown, David Wg; Crowcroft, Natasha S

2010-12-01

Encephalitis has many causes, but for most patients the cause is unknown. We aimed to establish the cause and identify the clinical differences between causes in patients with encephalitis in England. Patients of all ages and with symptoms suggestive of encephalitis were actively recruited for 2 years (staged start between October, 2005, and November, 2006) from 24 hospitals by clinical staff. Systematic laboratory testing included PCR and antibody assays for all commonly recognised causes of infectious encephalitis, investigation for less commonly recognised causes in immunocompromised patients, and testing for travel-related causes if indicated. We also tested for non-infectious causes for acute encephalitis including autoimmunity. A multidisciplinary expert team reviewed clinical presentation and hospital tests and directed further investigations. Patients were followed up for 6 months after discharge from hospital. We identified 203 patients with encephalitis. Median age was 30 years (range 0-87). 86 patients (42%, 95% CI 35-49) had infectious causes, including 38 (19%, 14-25) herpes simplex virus, ten (5%, 2-9) varicella zoster virus, and ten (5%, 2-9) Mycobacterium tuberculosis; 75 (37%, 30-44) had unknown causes. 42 patients (21%, 15-27) had acute immune-mediated encephalitis. 24 patients (12%, 8-17) died, with higher case fatality for infections from M tuberculosis (three patients; 30%, 7-65) and varicella zoster virus (two patients; 20%, 2-56). The 16 patients with antibody-associated encephalitis had the worst outcome of all groups-nine (56%, 30-80) either died or had severe disabilities. Patients who died were more likely to be immunocompromised than were those who survived (OR = 3·44). Early diagnosis of encephalitis is crucial to ensure that the right treatment is given on time. Extensive testing substantially reduced the proportion with unknown cause, but the proportion of cases with unknown cause was higher than that for any specific identified cause. The Policy Research Programme, Department of Health, UK. Copyright © 2010 Elsevier Ltd. All rights reserved.

Changes in characteristics, risk factors, and in-hospital mortality among patients with acute myocardial infarction in the capital of China over 40 years.

PubMed

Zhao, Qinghao; Yang, Yuejin; Chen, Zaijia; Yu, Hongwei; Xu, Haiyan

2018-08-15

Acute myocardial infarction (AMI) has sharply increased and become a major cause of hospitalization and mortality in China over the past few decades, with the rapid economic development and substantial life-style changes. We compared the characteristics, risk factors, and in-hospital outcomes among 1314 patients with AMI from Beijing Collaborative Group data in 1972 and 1973, and 2200 patients in Beijing from China AMI registry in 2013 and 2014. The proportions of patients with <30 and >70 years old in 2010s were significantly higher than those in 1970s (1970s vs 2010s: 0.2% vs 0.9% and 15.8% vs 25.6%, respectively, p < 0.05). The proportion of male patients was higher in 2010s (75.6%) than that (68.3%) in 1970s (p < 0.001). Rural population with AMI markedly increased (1970s vs 2010s: 6.5% vs 14.5%, p < 0.001). Patients with AMI in 2010s were more likely to have a history of diabetes mellitus (DM), prior stroke and myocardial infarction (MI) than those in 1970s (1970s vs 2010s: DM 6.2% vs 27.6%; prior stroke 6.2% vs 10.5%; prior MI 9.5% vs 11.9%; all p < 0.05). The in-hospital mortality was significantly lower in 2010s (2.6%) than that in 1970s (24%; p < 0.05). Age, gender, rural population, diabetes, prior stroke and MI history as well as in-hospital mortality were significantly different among patients with AMI in Beijing over 40 years. The patterns most likely reflect big lifestyle changes, improved socioeconomic status, less targeted heart disease prevention programs, and advance in medical therapies. Copyright © 2018 Elsevier B.V. All rights reserved.

Fertility in adult women with classic galactosemia and primary ovarian insufficiency.

PubMed

van Erven, Britt; Berry, Gerard T; Cassiman, David; Connolly, Geraldine; Forga, Maria; Gautschi, Matthias; Gubbels, Cynthia S; Hollak, Carla E M; Janssen, Mirian C; Knerr, Ina; Labrune, Philippe; Langendonk, Janneke G; Õunap, Katrin; Thijs, Abel; Vos, Rein; Wortmann, Saskia B; Rubio-Gozalbo, M Estela

2017-07-01

To study pregnancy chance in adult women with classic galactosemia and primary ovarian insufficiency. Despite dietary treatment, >90% of women with classic galactosemia develop primary ovarian insufficiency, resulting in impaired fertility. For many years, chance of spontaneous conception has not been considered, leading to counseling for infertility. But an increasing number of reports on pregnancies in this group questions whether current counseling approaches are correct. Multicenter retrospective observational study. Metabolic centers. Adult women (aged >18 y) with confirmed classic galactosemia and primary ovarian insufficiency were included. Participants and medical records were consulted to obtain study data in a standardized manner with the use of a questionnaire. Conception opportunities, time to pregnancy, pregnancy outcome, hormone replacement therapy use, fertility counseling, and the participants' vision of fertility were evaluated. Potential predictive factors for increased pregnancy chance were explored. Eighty-five women with classic galactosemia and primary ovarian insufficiency participated. Twenty-one women actively attempted to conceive or did not take adequate contraceptive precautions. Of these 21 women, nine became pregnant spontaneously (42.9%). This was higher than reported in primary ovarian insufficiency due to other causes (5%-10%). After a period of 12 months, a cumulative proportion of 27.8% of couples had conceived, which increased to 48.4% after 24 months and 61.3% after 27 months. Predictive factors could not be identified. A considerable miscarriage rate of 30% was observed (6 of 20 pregnancies). Although a substantial proportion of women expressed a child-wish (n = 28/53; 52.8%), the vast majority of participants (n = 43/57; 75.4%) considered conceiving to be highly unlikely, owing to negative counseling in the past. The pregnancy rate in women with classic galactosemia and primary ovarian insufficiency was higher than for women with primary ovarian insufficiency of any cause. This shifting paradigm carries significant implications for fertility counseling and potential application of fertility preservation techniques. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Comparing Utilization and Costs of Care in Freestanding Emergency Departments, Hospital Emergency Departments, and Urgent Care Centers.

PubMed

Ho, Vivian; Metcalfe, Leanne; Dark, Cedric; Vu, Lan; Weber, Ellerie; Shelton, George; Underwood, Howard R

2017-12-01

We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type. Prices for the top 20 diagnoses and procedures by facility type are compared. Texans use hospital-based EDs and urgent care centers much more than freestanding EDs, but freestanding ED utilization increased 236% between 2012 and 2015. The average price per visit was lower for freestanding EDs versus hospital-based EDs in 2012 ($1,431 versus $1,842), but prices in 2015 were comparable ($2,199 versus $2,259). Prices for urgent care centers were only $164 and $168 in 2012 and 2015. Out-of-pocket liability for consumers for all these facilities increased slightly from 2012 to 2015. There was 75% overlap in the 20 most common diagnoses at freestanding EDs versus urgent care centers and 60% overlap for hospital-based EDs and urgent care centers. However, prices for patients with the same diagnosis were on average almost 10 times higher at freestanding and hospital-based EDs relative to urgent care centers. Utilization of freestanding EDs is rapidly expanding in Texas. Higher prices at freestanding and hospital-based EDs relative to urgent care centers, despite substantial overlap in services delivered, imply potential inefficient use of emergency facilities. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Estimating Minimum Adult HIV Prevalence: A Cross-Sectional Study to Assess the Characteristics of People Living with HIV in Italy

PubMed Central

Raimondo, Mariangela; Dorrucci, Maria; Regine, Vincenza; Salfa, Maria Cristina; Suligoi, Barbara

2015-01-01

Abstract In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load. PMID:25432098

Foliar pH as a new plant trait: can it explain variation in foliar chemistry and carbon cycling processes among subarctic plant species and types?

PubMed

Cornelissen, J H C; Quested, H M; van Logtestijn, R S P; Pérez-Harguindeguy, N; Gwynn-Jones, D; Díaz, S; Callaghan, T V; Press, M C; Aerts, R

2006-03-01

Plant traits have become popular as predictors of interspecific variation in important ecosystem properties and processes. Here we introduce foliar pH as a possible new plant trait, and tested whether (1) green leaf pH or leaf litter pH correlates with biochemical and structural foliar traits that are linked to biogeochemical cycling; (2) there is consistent variation in green leaf pH or leaf litter pH among plant types as defined by nutrient uptake mode and higher taxonomy; (3) green leaf pH can predict a significant proportion of variation in leaf digestibility among plant species and types; (4) leaf litter pH can predict a significant proportion of variation in leaf litter decomposability among plant species and types. We found some evidence in support of all four hypotheses for a wide range of species in a subarctic flora, although cryptogams (fern allies and a moss) tended to weaken the patterns by showing relatively poor leaf digestibility or litter decomposability at a given pH. Among seed plant species, green leaf pH itself explained only up to a third of the interspecific variation in leaf digestibility and leaf litter up to a quarter of the interspecific variation in leaf litter decomposability. However, foliar pH substantially improved the power of foliar lignin and/or cellulose concentrations as predictors of these processes when added to regression models as a second variable. When species were aggregated into plant types as defined by higher taxonomy and nutrient uptake mode, green-specific leaf area was a more powerful predictor of digestibility or decomposability than any of the biochemical traits including pH. The usefulness of foliar pH as a new predictive trait, whether or not in combination with other traits, remains to be tested across more plant species, types and biomes, and also in relation to other plant or ecosystem traits and processes.

Patterns of Sexual Behavior in Lowland Thai Youth and Ethnic Minorities Attending High School in Rural Chiang Mai, Thailand.

PubMed

Aurpibul, Linda; Tangmunkongvorakul, Arunrat; Musumari, Patou Masika; Srithanaviboonchai, Kriengkrai; Tarnkehard, Surapee

2016-01-01

The rural areas of Northern Thailand are home to a large cultural diversity of ethnic minority groups. Previous studies have shown that young people in rural Thailand have low levels of knowledge on HIV/AIDS and high sexual risks. We compared sexual behaviors between the lowland Thai youth and the youth from ethnic minority groups. This is a cross-sectional quantitative study conducted among high-school Thai and ethnic students in Chiang Mai. From a total 1215 participants, 487 (40.1%) were lowland Thai and 728 (59.9%) were from ethnic minorities. Overall, 17.9% of respondents reported "ever had sex." Lowland Thai adolescents were more likely to have ever had sex compared with ethnic minority adolescents (AOR, 1.61; CI, 1.06-2.45; P< 0.01). A higher proportion of lowland Thai respondents reported having ≥ 2 lifetime sexual partners (51.9% vs. 33.3%, P = 0.003), or currently having a boy/girlfriend (59.9% vs. 45.3%, P< 0.001) compared to ethnic minority adolescents. Consistent condom use was low in both groups (22.6%). The common significant factors associated with "ever had sex" in both groups were "ever drunk alcohol in the past year" and "currently having a boy/girlfriend." Specifically, for lowland Thai youth, being around the age of 17 or 18 years and "ever used methamphetamine in the past year" were associated with increased odds of "ever had sex". For ethnic minority adolescents, being female and belonging to religions other than Buddhism were associated with decreased odds of "ever had sex". A substantially higher proportion of lowland Thai engage in risky sexual behaviors when compared to ethnic minorities. However, both groups remained vulnerable to HIV and other sexually transmitted infections. To minimize sexual risks, education program and school-based interventions are warranted to increase awareness of young people about risky behaviors and to promote essential life skills.

Admixture in Hispanic Americans: its impact on ITGAM association and implications for admixture mapping in SLE.

PubMed

Molineros, J E; Kim-Howard, X; Deshmukh, H; Jacob, C O; Harley, J B; Nath, S K

2009-07-01

Systemic Lupus Erythematosus (SLE) disproportionately affects minorities, such as Hispanic Americans (HA). Prevalence of SLE is 3-5 times higher in HA than in European-derived populations and have more active disease at the time of diagnosis, with more serious organ system involvement. HA is an admixed population, it is possible that there is an effect of admixture on the relative risk of the disease. This admixture can create substantial increase of linkage disequilibrium (LD) in both magnitude and range, which can provide a unique opportunity for admixture mapping. The main objectives of this study are to (a) estimate hidden population structure in HA individuals; (b) estimate individual ancestry proportions and its impact on SLE risk; (c) assess impact of admixture on ITGAM association, a recently identified SLE susceptibility gene; and (d) estimate power of admixture mapping in HA. Our dataset contained 1125 individuals, of whom 884 (657 SLE cases and 227 controls) were self-classified as HA. Using 107 unlinked ancestry informative markers (AIMs), we estimated hidden population structure and individual ancestry in HA. Out of 5671 possible pairwise LD, 54% were statistically significant, indicating recent population admixture. The best-fitted model for HA was a four-population model with average ancestry of European (48%), American-Indian (AI) (40%), African (8%) and a fourth population (4%) with unknown ancestry. We also identified significant higher risk associated with AI ancestry (odds ratio (OR)=4.84, P=0.0001, 95% CI (confidence interval)=2.14-10.95) on overall SLE. We showed that ITGAM is associated as a risk factor for SLE (OR=2.06, P=8.74 x 10(-5), 95% CI=1.44-2.97). This association is not affected by population substructure or admixture. We have shown that HA have great potential and are an appropriate population for admixture mapping. As expected, the case-only design is more powerful than case-control design, for any given admixture proportion or ancestry risk ratio.

Flow regulation manipulates contemporary seasonal sedimentary dynamics in the reservoir fluctuation zone of the Three Gorges Reservoir, China.

PubMed

Tang, Qiang; Bao, Yuhai; He, Xiubin; Fu, Bojie; Collins, Adrian L; Zhang, Xinbao

2016-04-01

Since the launch of the Three Gorges Dam on the Yangtze River, a distinctive reservoir fluctuation zone has been created and significantly modified by regular dam operations. Sediment redistribution within this artificial landscape differs substantially from that in natural fluvial riparian zones, due to a specific hydrological regime comprising steps of water impoundment with increasing magnitudes and seasonal water level fluctuation holding a range of sediment fluxes. This study reinterpreted post-dam sedimentary dynamics in the reservoir fluctuation zone by stratigraphy determination of a 345-cm long sediment core, and related it to impact of the hydrological regime. Seasonality in absolute grain-size composition of suspended sediment was applied as a methodological basis for stratigraphic differentiation. Sedimentary laminations with relatively higher proportions of sandy fractions were ascribed to sedimentation during the dry season when proximal subsurface bank erosion dominates source contributions, while stratigraphy with a lower proportion of sandy fractions is possibly contributed by sedimentation during the wet season when distal upstream surface erosion prevails. Chronology determination revealed non-linear and high annual sedimentation rates ranging from 21.7 to 152.1cm/yr. Although channel geomorphology may primarily determine the spatial extent of sedimentation, seasonal sedimentary dynamics was predominantly governed by the frequency, magnitude, and duration of flooding. Summer inundation by natural floods with enhanced sediment loads produced from upstream basins induced higher sedimentation rates than water impoundment during the dry season when distal sediment supply was limited. We thus conclude that flow regulation manipulates contemporary seasonal sedimentary dynamics in the reservoir fluctuation zone, though little impact on total sediment retention rate was detected. Ongoing reductions in flow and sediment supply under human disturbance may have profound implications in affecting sedimentary equilibrium in the reservoir fluctuation zone. The results herein provide insights of how big dams have disrupted the sediment conveyance processes of large scale fluvial systems. Copyright © 2016 Elsevier B.V. All rights reserved.

Achievement of optimal medical therapy goals for U.S. adults with coronary artery disease: results from the REGARDS Study (REasons for Geographic And Racial Differences in Stroke).

PubMed

Brown, Todd M; Voeks, Jenifer H; Bittner, Vera; Brenner, David A; Cushman, Mary; Goff, David C; Glasser, Stephen; Muntner, Paul; Tabereaux, Paul B; Safford, Monika M

2014-04-29

In a nonclinical trial setting, we sought to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation) trial. In the COURAGE trial, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. The REGARDS (REasons for Geographic And Racial Differences in Stroke) study is a national prospective cohort study of 30,239 African-American and white community-dwelling individuals older than 45 years of age who enrolled in 2003 through 2007. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on the COURAGE trial: 1) aspirin use; 2) systolic blood pressure <130 mm Hg and diastolic blood pressure <85 mm Hg (<80 mm Hg if diabetic); 3) low-density lipoprotein cholesterol <85 mg/dl, high-density lipoprotein cholesterol >40 mg/dl, and triglycerides <150 mg/dl; 4) fasting glucose <126 mg/dl; 5) nonsmoking status; 6) body mass index <25 kg/m(2); and 7) exercise ≥4 days per week. The mean age of participants was 69 ± 9 years; 33% were African American and 35% were female. Overall, the median number of goals met was 4. Less than one-fourth met ≥5 of the 7 goals, and 16% met all 3 goals for aspirin, blood pressure, and low-density lipoprotein cholesterol. Older age, white race, higher income, more education, and higher physical functioning were independently associated with meeting more goals. There is substantial room for improvement in risk factor reduction among U.S. individuals with CAD. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Report on the first government-funded opioid substitution programme for heroin users in the Western Cape Province, South Africa.

PubMed

Michie, Graeme; Hoosain, Shuaib; Macharia, Muiruri; Weich, Lize

2017-05-24

Although pharmacological opioid substitution treatment (OST) is a well-established treatment modality for heroin addiction, it is a relatively recent introduction in low- and middle-income countries. To report on a pilot OST programme initiated in 2013 that was the only public-funded programme in South Africa (SA) at the time. Participants were offered standard care only (n=68) or, for the OST group (n=67), standard care plus Suboxone (Reckitt Benckiser), a synthetic partial opioid agonist, in a 12-week clinician-monitored programme. Clinical records of 135 participants in the rehabilitation programme at Sultan Bahu Rehabilitation Centre in Mitchell's Plain, Cape Town, SA, from 1 January to 31 December 2014 were reviewed. Data collected included demographics and duration in treatment (retention) as well as number of urine samples provided, positive tests or self-reported use events and dates of first positive/negative tests. Significantly more participants in the OST group (65.7%) than controls (44.1%) completed the treatment (p=0.019). Among the non-completers, retention was higher in the OST group than in the standard care group (48.2 v. 30.1 days; p=0.001). The groups did not differ in respect of number of missed appointments and time to first positive test. However, the proportion of participants testing positive was higher in the OST group (80.6%) than in the standard care group (61.8%), although the former were tested nearly three times (18.3 v. 6.6 times) more. Consequently, the positive rate (proportion of positive tests) was substantially lower in the OST group (16.8%) than in the standard care group (23.3%). The results demonstrate modest success of this pilot OST programme in terms of completion and retention and should argue for a move to increase availability of and accessibility to OSTs for the management of opioid use disorder.

Early Literacy Instruction and Intervention

PubMed Central

Al Otaiba, Stephanie; Foorman, Barbara

2014-01-01

The purpose of this paper is to describe the efficacy of early literacy interventions and to discuss possible roles for volunteer tutors in helping prevent reading difficulties within the Response to Intervention process. First, we describe a landmark study that evaluated the impact of primary classroom instruction on reducing the proportion of students at risk for reading failure, and a more recent series of studies exploring the effects of individualizing classroom reading instruction based on students’ initial skills. Second, we review studies of more intensive early intervention to demonstrate how these interventions substantially reduce the proportion of students at risk. Third, we examine effective tutoring models that utilize volunteers. Finally, we discuss the potential role of community tutors in supporting primary classroom instruction and secondary interventions. PMID:25221452

Likelihood Ratio, Optimal Decision Rules, and Relationship between Proportion Correct and d' in the Dual-Pair AB vs BA identification Paradigm

PubMed Central

Micheyl, Christophe; Dai, Huanping

2010-01-01

The equal-variance Gaussian signal-detection-theory (SDT) decision model for the dual-pair change-detection (or “4IAX”) paradigm has been described in earlier publications. In this note, we consider the equal-variance Gaussian SDT model for the related dual-pair AB vs BA identification paradigm. The likelihood ratios, optimal decision rules, receiver operating characteristics (ROCs), and relationships between d' and proportion-correct (PC) are analyzed for two special cases: that of statistically independent observations, which is likely to apply in constant-stimuli experiments, and that of highly correlated observations, which is likely to apply in experiments where stimuli are roved widely across trials or pairs. A surprising outcome of this analysis is that although these two situations lead to different optimal decision rules, the predicted ROCs and proportions of correct responses (PCs) for these two cases are not substantially different, and are either identical or similar to those observed in the basic Yes-No paradigm. PMID:19633356

Analysis of crash proportion by vehicle type at traffic analysis zone level: A mixed fractional split multinomial logit modeling approach with spatial effects.

PubMed

Lee, Jaeyoung; Yasmin, Shamsunnahar; Eluru, Naveen; Abdel-Aty, Mohamed; Cai, Qing

2018-02-01

In traffic safety literature, crash frequency variables are analyzed using univariate count models or multivariate count models. In this study, we propose an alternative approach to modeling multiple crash frequency dependent variables. Instead of modeling the frequency of crashes we propose to analyze the proportion of crashes by vehicle type. A flexible mixed multinomial logit fractional split model is employed for analyzing the proportions of crashes by vehicle type at the macro-level. In this model, the proportion allocated to an alternative is probabilistically determined based on the alternative propensity as well as the propensity of all other alternatives. Thus, exogenous variables directly affect all alternatives. The approach is well suited to accommodate for large number of alternatives without a sizable increase in computational burden. The model was estimated using crash data at Traffic Analysis Zone (TAZ) level from Florida. The modeling results clearly illustrate the applicability of the proposed framework for crash proportion analysis. Further, the Excess Predicted Proportion (EPP)-a screening performance measure analogous to Highway Safety Manual (HSM), Excess Predicted Average Crash Frequency is proposed for hot zone identification. Using EPP, a statewide screening exercise by the various vehicle types considered in our analysis was undertaken. The screening results revealed that the spatial pattern of hot zones is substantially different across the various vehicle types considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

Problems Associated with the Microchip Data of Stray Dogs and Cats Entering RSPCA Queensland Shelters

PubMed Central

Lancaster, Emily; Rand, Jacquie; Collecott, Sheila; Paterson, Mandy

2015-01-01

Simple Summary Microchip identification has become an important tool to reunite stray dogs and cats with their owners, and is now compulsory in most states of Australia. Improvement of the microchipping system in Australia is limited by a lack of published Australian data documenting the problems experienced by shelter staff when using microchip data to contact the owner of a stray animal. In this study we determine the character and frequency of inaccurate microchip data to identify weaknesses in the current microchipping system. This information could be used to develop strategies that increase the accuracy of microchip data that will increase the reclaiming of stray animals. Abstract A lack of published information documenting problems with the microchip data for the reclaiming of stray animals entering Australian shelters limits improvement of the current microchipping system. A retrospective study analysing admission data for stray, adult dogs (n = 7258) and cats (n = 6950) entering the Royal Society for the Prevention of Cruelty to Animals (RSPCA) Queensland between January 2012 and December 2013 was undertaken to determine the character and frequency of microchip data problems and their impact on outcome for the animal. Only 28% of dogs and 9% of cats were microchipped, and a substantial proportion (37%) had problems with their data, including being registered to a previous owner or organisation (47%), all phone numbers incorrect/disconnected (29%), and the microchip not registered (14%). A higher proportion of owners could be contacted when the microchip had no problems, compared to those with problems (dogs, 93% vs. 70%; cats, 75% vs. 41%). The proportion of animals reclaimed declined significantly between microchipped animals with no data problems, microchipped animals with data problems and non-microchipped animals—87%, 69%, and 37%, respectively, for dogs and 61%, 33%, and 5%, respectively, for cats. Strategies are needed to increase the accuracy of microchip data to facilitate the reclaiming of stray dogs and cats. PMID:26479238

Accreditation Status and Geographic Location of Outpatient Echocardiographic Testing Facilities Among Medicare Beneficiaries: The VALUE-ECHO Study.

PubMed

Brown, Scott C; Wang, Kefeng; Dong, Chuanhui; Yi, Li; Marinovic Gutierrez, Carolina; Di Tullio, Marco R; Farrell, Mary Beth; Burgess, Pamela; Gornik, Heather L; Hamburg, Naomi M; Needleman, Laurence; Orsinelli, David; Robison, Susana; Rundek, Tatjana

2018-02-01

Accreditation of echocardiographic testing facilities by the Intersocietal Accreditation Commission (IAC) is supported by the American College of Cardiology and American Society of Echocardiography. However, limited information exists on the accreditation status and geographic distribution of echocardiographic facilities in the United States. Our study aimed to identify (1) the proportion of outpatient echocardiography facilities used by Medicare beneficiaries that are IAC accredited, (2) their geographic distribution, and (3) variations in procedure type and volume by accreditation status. As part of the VALUE-ECHO (Value of Accreditation, Location, and Utilization Evaluation-Echocardiography) study, we examined the proportion of IAC-accredited echocardiographic facilities performing outpatient echocardiography in the 2013 Centers for Medicare and Medicaid Services outpatient limited data set (100% sample) and their geographic distribution using geocoding in ArcGIS (ESRI, Redlands, CA). Among 4573 outpatient facilities billing Medicare for echocardiographic testing in 2013, 99.6% (n = 4554) were IAC accredited (99.7% in the 50 US states and 86.2% in Puerto Rico). The proportion IAC-accredited echocardiographic facilities varied by region, with 98.7%, 99.9%, 99.9%, 99.5%, and 86.2% of facilities accredited in the Northeast, South, Midwest, West, and Puerto Rico, respectively (P < .01, Fisher exact test). Of all echocardiographic outpatient procedures conducted (n = 1,890,156), 99.8% (n = 1,885,382) were performed in IAC-accredited echocardiographic facilities. Most procedures (90.9%) were transthoracic echocardiograms, of which 99.7% were conducted in IAC-accredited echocardiographic facilities. Almost all outpatient echocardiographic facilities billed by Medicare are IAC accredited. This accreditation rate is substantially higher than previously reported for US outpatient vascular testing facilities (13% IAC accredited). The uniformity of imaging and interpretation protocols from a single accrediting body is important to facilitate optimal cardiovascular care. © 2017 by the American Institute of Ultrasound in Medicine.

Characterization of the genome and transcriptome of the blue tit Cyanistes caeruleus: polymorphisms, sex-biased expression and selection signals.

PubMed

Mueller, Jakob C; Kuhl, Heiner; Timmermann, Bernd; Kempenaers, Bart

2016-03-01

Decoding genomic sequences and determining their variation within populations has potential to reveal adaptive processes and unravel the genetic basis of ecologically relevant trait variation within a species. The blue tit Cyanistes caeruleus--a long-time ecological model species--has been used to investigate fitness consequences of variation in mating and reproductive behaviour. However, very little is known about the underlying genetic changes due to natural and sexual selection in the genome of this songbird. As a step to bridge this gap, we assembled the first draft genome of a single blue tit, mapped the transcriptome of five females and five males to this reference, identified genomewide variants and performed sex-differential expression analysis in the gonads, brain and other tissues. In the gonads, we found a high number of sex-biased genes, and of those, a similar proportion were sex-limited (genes only expressed in one sex) in males and females. However, in the brain, the proportion of female-limited genes within the female-biased gene category (82%) was substantially higher than the proportion of male-limited genes within the male-biased category (6%). This suggests a predominant on-off switching mechanism for the female-limited genes. In addition, most male-biased genes were located on the Z-chromosome, indicating incomplete dosage compensation for the male-biased genes. We called more than 500,000 SNPs from the RNA-seq data. Heterozygote detection in the single reference individual was highly congruent between DNA-seq and RNA-seq calling. Using information from these polymorphisms, we identified potential selection signals in the genome. We list candidate genes which can be used for further sequencing and detailed selection studies, including genes potentially related to meiotic drive evolution. A public genome browser of the blue tit with the described information is available at http://public-genomes-ngs.molgen.mpg.de. © 2015 John Wiley & Sons Ltd.

Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006.

PubMed

Rogers, William J; Frederick, Paul D; Stoehr, Edna; Canto, John G; Ornato, Joseph P; Gibson, C Michael; Pollack, Charles V; Gore, Joel M; Chandra-Strobos, Nisha; Peterson, Eric D; French, William J

2008-12-01

Although ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction (AMI) have been the focus of intense clinical investigation, limited information exists on characteristics and hospital mortality of patients not enrolled in clinical trials. Previous large databases have reported declining mortality of patients with STEMI but have not noted substantial mortality change among those with NSTEMI. The National Registry of Myocardial Infarction enrolled 2,515,106 patients at 2,157 US hospitals from 1990 to 2006. Of these, we evaluated 1,950,561 with diagnoses reflecting acute myocardial ischemia on admission. From 1990 to 2006, the proportion of NSTEMI increased from 14.2% to 59.1% (P < .0001), whereas the proportion of STEMI decreased. Mean age increased (from 64.1 to 66.4 years, P < .0001) as did the proportion of females (from 32.4% to 37.0%, P < .0001). Patients were less likely to report prior angina, prior AMI, or family history of coronary artery disease but more likely to report history of diabetes, hypertension, current smoking, heart failure, prior revascularization, stroke, and hyperlipidemia. From 1994 to 2006, hospital mortality fell among all patients (10.4% to 6.3%), STEMI (11.5% to 8.0%), and NSTEMI (7.1% to 5.2%), (all P < .0001). After adjustment for baseline covariates, hospital mortality fell among all patients by 23.6% (odds ratio [OR] 0.764, 95% CI 0.744-0.785), STEMI by 24.2% (OR 0.758, 0.732-0.784), and NSTEMI by 22.6% (OR 0.774, 0.741-0.809), all P < .001. This large, observational database from 1990 to 2006 shows increasing prevalence of NSTEMI and, despite higher risk profile on presentation, falling risk-adjusted hospital mortality in patients with either STEMI or NSTEMI.

Diet of the invasive Cuban treefrog (Osteopilus septentrionalis) in pine rockland and mangrove habitats in South Florida

USGS Publications Warehouse

Glorioso, B.M.; Waddle, J.H.; Crockett, M.E.; Rice, K.G.; Percival, H.F.

2012-01-01

Native to Cuba, the Bahamas and the Cayman Islands, the Cuban Treefrog (CTF) is an invasive species in Florida, with the ability to inflict serious ecological damage to invaded habitats. By examining the diet of the CTF, a known predator of native frogs, better predictions may be made of the impacts on native species and ecosystems. From 2002 - 2003, CTF diet was investigated in south Florida at four sites, two each within pine rockland and mangrove habitat. Within each habitat, one site exhibited a low density of CTFs and the other a high density of CTFs. CTFs were captured in PVC pipes attached to trees and stomach contents were examined after euthanasia. Beetles were the most numerous and widely consumed prey item among sites; roaches, orthopterans, spiders, ants, and caterpillars were also major dietary components. There were significant differences in the proportion of taxa consumed by CTFs between low and high density populations within each habitat, with the low density site in every instance having the higher proportion. Across habitats, ants comprised a significantly higher proportion of the diet in mangroves, whereas beetles, orthopterans, and snails comprised a significantly higher proportion of the diet in pine rocklands. Approximately 3.5% of all stomachs examined contained anuran remains. Though not significant, CTFs from low density sites consumed a higher proportion of frogs than those at high density sites. Corroborating previous research, the data show the CTF to be a generalist feeder, consuming a wide variety of invertebrate prey, with anurans playing only a minor role in the overall diet.

Variability in the measurement of hospital-wide mortality rates.

PubMed

Shahian, David M; Wolf, Robert E; Iezzoni, Lisa I; Kirle, Leslie; Normand, Sharon-Lise T

2010-12-23

Several countries use hospital-wide mortality rates to evaluate the quality of hospital care, although the usefulness of this metric has been questioned. Massachusetts policymakers recently requested an assessment of methods to calculate this aggregate mortality metric for use as a measure of hospital quality. The Massachusetts Division of Health Care Finance and Policy provided four vendors with identical information on 2,528,624 discharges from Massachusetts acute care hospitals from October 1, 2004, through September 30, 2007. Vendors applied their risk-adjustment algorithms and provided predicted probabilities of in-hospital death for each discharge and for hospital-level observed and expected mortality rates. We compared the numbers and characteristics of discharges and hospitals included by each of the four methods. We also compared hospitals' standardized mortality ratios and classification of hospitals with mortality rates that were higher or lower than expected, according to each method. The proportions of discharges that were included by each method ranged from 28% to 95%, and the severity of patients' diagnoses varied widely. Because of their discharge-selection criteria, two methods calculated in-hospital mortality rates (4.0% and 5.9%) that were twice the state average (2.1%). Pairwise associations (Pearson correlation coefficients) of discharge-level predicted mortality probabilities ranged from 0.46 to 0.70. Hospital-performance categorizations varied substantially and were sometimes completely discordant. In 2006, a total of 12 of 28 hospitals that had higher-than-expected hospital-wide mortality when classified by one method had lower-than-expected mortality when classified by one or more of the other methods. Four common methods for calculating hospital-wide mortality produced substantially different results. This may have resulted from a lack of standardized national eligibility and exclusion criteria, different statistical methods, or fundamental flaws in the hypothesized association between hospital-wide mortality and quality of care. (Funded by the Massachusetts Division of Health Care Finance and Policy.).

Trends in Hospital Volume and Operative Mortality for High-Risk Surgery

PubMed Central

Finks, Jonathan F.; Osborne, Nicholas H.; Birkmeyer, John D.

2011-01-01

BACKGROUND There were numerous efforts in the United States during the previous decade to concentrate selected surgical procedures in high-volume hospitals. It remains unknown whether referral patterns for high-risk surgery have changed as a result and how operative mortality has been affected. METHODS We used national Medicare data to study patients undergoing one of eight different cancer and cardiovascular operations from 1999 through 2008. For each procedure, we examined trends in hospital volume and market concentration, defined as the proportion of Medicare patients undergoing surgery in the top decile of hospitals by volume per year. We used regression-based techniques to assess the effects of volume and market concentration on mortality over time, adjusting for case mix. RESULTS Median hospital volumes of four cancer resections (lung, esophagus, pancreas, and bladder) and of repair of abdominal aortic aneurysm (AAA) rose substantially. Depending on the procedure, higher hospital volumes were attributable to an increasing number of cases nationwide, an increasing market concentration, or both. Hospital volumes rose slightly for aortic-valve replacement but fell for coronary-artery bypass grafting and carotid endarterectomy. Operative mortality declined for all eight procedures, ranging from a relative decline of 8% for carotid endarterectomy (1.3% mortality in 1999 and 1.2% in 2008) to 36% for AAA repair (4.4% in 1999 and 2.8% in 2008). Higher hospital volumes explained a large portion of the decline in mortality for pancreatectomy (67% of the decline), cystectomy (37%), and esophagectomy (32%), but not for the other procedures. CONCLUSIONS Operative mortality with high-risk surgery fell substantially during the previous decade. Although increased market concentration and hospital volume have contributed to declining mortality with some high-risk cancer operations, declines in mortality with other procedures are largely attributable to other factors. (Funded by the National Institute on Aging.) PMID:21631325

Association of temporomandibular disorder pain with awake and sleep bruxism in adults.

PubMed

Sierwald, Ira; John, Mike T; Schierz, Oliver; Hirsch, Christian; Sagheri, Darius; Jost-Brinkmann, Paul-Georg; Reissmann, Daniel R

2015-07-01

Parafunctional habits such as clenching or grinding (bruxism) during daytime and at night are considered to have a great impact on the etiopathogenesis of temporomandibular disorders (TMD). However, the size of the effect and how daytime activities interact with nocturnal activities is not yet clear. The aim of this study was to assess the association of TMD pain with both awake and sleep bruxism in adults. In this case-control study, data of a consecutive sample of 733 TMD patients (cases; mean age ± SD: 41.4 ± 16.3 years; 82% women) with at least one pain-related TMD diagnosis according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD) and of a community-based probability sample of 890 subjects (controls; mean age ± SD: 40.4 ± 11.8 years; 57% female) without TMD were evaluated. Clenching or grinding while awake and/or asleep was assessed with self-reports. Association of TMD pain with awake and sleep bruxism was analyzed using multiple logistic regression analyses and controlled for potential confounders. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated. While 11.2% of the controls reported clenching or grinding while awake, this proportion was significantly higher in TMD patients (33.9%; p < 0.001). Nocturnal clenching or grinding was reported by 23.5% of the controls and 49.4% of the TMD patients (p < 0.001). Risk for TMD pain did not differ substantially for the separate reports of awake (OR 1.7; CI 1.0-2.7) or sleep bruxism (OR 1.8; CI 1.4-2.4). However, risk for TMD pain substantially increased in cases of simultaneous presence of awake and sleep bruxism (OR 7.7; CI 5.4-11.1). When occurring separately, awake and sleep bruxism are significant risk factors for TMD pain. In case of simultaneous presence, the risk for TMD pain is even higher.

Determinants of mobile phone output power in a multinational study: implications for exposure assessment.

PubMed

Vrijheid, M; Mann, S; Vecchia, P; Wiart, J; Taki, M; Ardoino, L; Armstrong, B K; Auvinen, A; Bédard, D; Berg-Beckhoff, G; Brown, J; Chetrit, A; Collatz-Christensen, H; Combalot, E; Cook, A; Deltour, I; Feychting, M; Giles, G G; Hepworth, S J; Hours, M; Iavarone, I; Johansen, C; Krewski, D; Kurttio, P; Lagorio, S; Lönn, S; McBride, M; Montestrucq, L; Parslow, R C; Sadetzki, S; Schüz, J; Tynes, T; Woodward, A; Cardis, E

2009-10-01

The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure for epidemiological studies, we assessed determinants of mobile phone output power in a multinational study. More than 500 volunteers in 12 countries used Global System for Mobile communications software-modified phones (GSM SMPs) for approximately 1 month each. The SMPs recorded date, time, and duration of each call, and the frequency band and output power at fixed sampling intervals throughout each call. Questionnaires provided information on the typical circumstances of an individual's phone use. Linear regression models were used to analyse the influence of possible explanatory variables on the average output power and the percentage call time at maximum power for each call. Measurements of over 60,000 phone calls showed that the average output power was approximately 50% of the maximum, and that output power varied by a factor of up to 2 to 3 between study centres and network operators. Maximum power was used during a considerable proportion of call time (39% on average). Output power decreased with increasing call duration, but showed little variation in relation to reported frequency of use while in a moving vehicle or inside buildings. Higher output powers for rural compared with urban use of the SMP were observed principally in Sweden where the study covered very sparsely populated areas. Average power levels are substantially higher than the minimum levels theoretically achievable in GSM networks. Exposure indices could be improved by accounting for average power levels of different telecommunications systems. There appears to be little value in gathering information on circumstances of phone use other than use in very sparsely populated regions.

Combined biocidal action of silver nanoparticles and ions against Chlorococcales (Scenedesmus quadricauda, Chlorella vulgaris) and filamentous algae (Klebsormidium sp.).

PubMed

Zouzelka, Radek; Cihakova, Pavlina; Rihova Ambrozova, Jana; Rathousky, Jiri

2016-05-01

Despite the extensive research, the mechanism of the antimicrobial and biocidal performance of silver nanoparticles has not been unequivocally elucidated yet. Our study was aimed at the investigation of the ability of silver nanoparticles to suppress the growth of three types of algae colonizing the wetted surfaces or submerged objects and the mechanism of their action. Silver nanoparticles exhibited a substantial toxicity towards Chlorococcales Scenedesmus quadricauda, Chlorella vulgaris, and filamentous algae Klebsormidium sp., which correlated with their particle size. The particles had very good stability against agglomeration even in the presence of multivalent cations. The concentration of silver ions in equilibrium with nanoparticles markedly depended on the particle size, achieving about 6 % and as low as about 0.1 % or even less for the particles 5 nm in size and for larger ones (40-70 nm), respectively. Even very limited proportion of small particles together with larger ones could substantially increase concentration of Ag ions in solution. The highest toxicity was found for the 5-nm-sized particles, being the smallest ones in this study. Their toxicity was even higher than that of silver ions at the same silver concentration. When compared as a function of the Ag(+) concentration in equilibrium with 5-nm particles, the toxicity of ions was at least 17 times higher than that obtained by dissolving silver nitrite (if not taking into account the effect of nanoparticles themselves). The mechanism of the toxicity of silver nanoparticles was found complex with an important role played by the adsorption of silver nanoparticles and the ions released from the particles on the cell surface. This mechanism could be described as some sort of synergy between nanoparticles and ions. While our study clearly showed the presence of this synergy, its detailed explanation is experimentally highly demanding, requiring a close cooperation between materials scientists, physical chemists, and biologists.

Population size estimation in Yellowstone wolves with error-prone noninvasive microsatellite genotypes.

PubMed

Creel, Scott; Spong, Goran; Sands, Jennifer L; Rotella, Jay; Zeigle, Janet; Joe, Lawrence; Murphy, Kerry M; Smith, Douglas

2003-07-01

Determining population sizes can be difficult, but is essential for conservation. By counting distinct microsatellite genotypes, DNA from noninvasive samples (hair, faeces) allows estimation of population size. Problems arise because genotypes from noninvasive samples are error-prone, but genotyping errors can be reduced by multiple polymerase chain reaction (PCR). For faecal genotypes from wolves in Yellowstone National Park, error rates varied substantially among samples, often above the 'worst-case threshold' suggested by simulation. Consequently, a substantial proportion of multilocus genotypes held one or more errors, despite multiple PCR. These genotyping errors created several genotypes per individual and caused overestimation (up to 5.5-fold) of population size. We propose a 'matching approach' to eliminate this overestimation bias.

Simulation Suggests That Medical Group Mergers Won’t Undermine The Potential Utility Of Health Information Exchanges

PubMed Central

Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.

2013-01-01

Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665

Investigation of total and hexavalent chromium in filtered and unfiltered groundwater samples at the Tucson International Airport Superfund Site

USGS Publications Warehouse

Tillman, Fred; McCleskey, R. Blaine; Hermosillo, Edyth

2016-01-01

Potential health effects from hexavalent chromium in groundwater have recently become a concern to regulators at the Tucson International Airport Area Superfund site. In 2016, the U.S. Geological Survey sampled 46 wells in the area to characterize the nature and extent of chromium in groundwater, to understand what proportion of total chromium is in the hexavalent state, and to determine if substantial differences are present between filtered and unfiltered chromium concentrations. Results indicate detectable chromium concentrations in all wells, over 75 % of total chromium is in the hexavalent state in a majority of wells, and filtered and unfiltered results differ substantially in only a few high-turbidity total chromium samples.

Investigation of Total and Hexavalent Chromium in Filtered and Unfiltered Groundwater Samples at the Tucson International Airport Superfund Site.

PubMed

Tillman, Fred D; McCleskey, R Blaine; Hermosillo, Edyth

2016-10-01

Potential health effects from hexavalent chromium in groundwater have recently become a concern to regulators at the Tucson International Airport Area Superfund site. In 2016, the U.S. Geological Survey sampled 46 wells in the area to characterize the nature and extent of chromium in groundwater, to understand what proportion of total chromium is in the hexavalent state, and to determine if substantial differences are present between filtered and unfiltered chromium concentrations. Results indicate detectable chromium concentrations in all wells, over 75 % of total chromium is in the hexavalent state in a majority of wells, and filtered and unfiltered results differ substantially in only a few high-turbidity total chromium samples.

Sonora exploratory study for the detection of wheat-leaf rust

NASA Technical Reports Server (NTRS)

Payne, R. W. (Principal Investigator)

1980-01-01

The applicability of LANDSAT remote sensing technology to the detection of a wheat-leaf-rust epidemic in Sonora, Mexico, during 1977 was investigated. LANDSAT data acquired during crop years 1975-76 and 1976-77 were clustered, classified, and analyzed in order to detect agricultural changes. Analysis of 1977 data indicates a significant proportion of the identified wheat is stressed (potentially rust-infected). Additional analyses show a significant increase in fallowing during the year, as well as a substantial decrease in reservoir levels in the Sonora agricultural region. Ground observations are required to substantiate these analyses. The possibility exists that heat-rust is not LANDSAT detectable and that the clusters identified as containing stressed signatures represent different varieties of wheat or perhaps nonwheat crops.

Higher Education: Information on Incentive Compensation Violations Substantiated by the U.S. Department of Education. GAO-10-370R

ERIC Educational Resources Information Center

Iritani, Katherine M.

2010-01-01

The Higher Education Opportunity Act (HEOA) mandated that GAO conduct a study on Education's enforcement of the incentive compensation ban in light of the safe harbors and report on the number of violations substantiated by the Secretary of Education since 1998, the nature of these violations, and the names of the institutions involved. This…

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The permafrost carbon inventory on the Tibetan Plateau: a new evaluation using deep sediment cores.

PubMed

Ding, Jinzhi; Li, Fei; Yang, Guibiao; Chen, Leiyi; Zhang, Beibei; Liu, Li; Fang, Kai; Qin, Shuqi; Chen, Yongliang; Peng, Yunfeng; Ji, Chengjun; He, Honglin; Smith, Pete; Yang, Yuanhe

2016-08-01

The permafrost organic carbon (OC) stock is of global significance because of its large pool size and the potential positive feedback to climate warming. However, due to the lack of systematic field observations and appropriate upscaling methodologies, substantial uncertainties exist in the permafrost OC budget, which limits our understanding of the fate of frozen carbon in a warming world. In particular, the lack of comprehensive estimates of OC stocks across alpine permafrost means that current knowledge on this issue remains incomplete. Here, we evaluated the pool size and spatial variations of permafrost OC stock to 3 m depth on the Tibetan Plateau by combining systematic measurements from a substantial number of pedons (i.e. 342 three-metre-deep cores and 177 50-cm-deep pits) with a machine learning technique (i.e. support vector machine, SVM). We also quantified uncertainties in permafrost carbon budget by conducting Monte Carlo simulations. Our results revealed that the combination of systematic measurements with the SVM model allowed spatially explicit estimates to be made. The OC density (OC amount per unit area, OCD) exhibited a decreasing trend from the south-eastern to the north-western plateau, with the exception that OCD in the swamp meadow was substantially higher than that in surrounding regions. Our results also demonstrated that Tibetan permafrost stored a large amount of OC in the top 3 m, with the median OC pool size being 15.31 Pg C (interquartile range: 13.03-17.77 Pg C). 44% of OC occurred in deep layers (i.e. 100-300 cm), close to the proportion observed across the northern circumpolar permafrost region. The large carbon pool size together with significant permafrost thawing suggests a risk of carbon emissions and positive climate feedback across the Tibetan alpine permafrost region. © 2016 John Wiley & Sons Ltd.

Ternary boride product and process

NASA Technical Reports Server (NTRS)

Clougherty, Edward V. (Inventor)

1976-01-01

A hard, tough, strong ceramic body is formed by hot pressing a mixture of a powdered metal and a powdered metal diboride. The metal employed is zirconium, titanium or hafnium and the diboride is the diboride of a different member of the same group of zirconium, titanium or hafnium to form a ternary composition. During hot pressing at temperatures above about 2,000.degree.F., a substantial proportion of acicular ternary monoboride is formed.

Do Poverty Dynamics Explain the Shift to an Informal Private Schooling System in the Wake of Free Public Primary Education in Nairobi Slums?

ERIC Educational Resources Information Center

Oketch, Moses; Mutisya, Maurice; Sagwe, Jackline

2012-01-01

With the introduction of free primary education (FPE) in Kenya in 2003, it was expected that the burden on poor households in financing primary education would be reduced substantially. This in turn would increase enrolment in public schools and lead to universal primary education. However, studies have shown that a considerable proportion of…

Population Size, Growth, and Environmental Justice Near Oil and Gas Wells in Colorado.

PubMed

McKenzie, Lisa M; Allshouse, William B; Burke, Troy; Blair, Benjamin D; Adgate, John L

2016-11-01

We evaluated population size and factors influencing environmental justice near oil and gas (O&G) wells. We mapped nearest O&G well to residential properties to evaluate population size, temporal relationships between housing and O&G development, and 2012 housing market value distributions in three major Colorado O&G basins. We reviewed land use, building, real estate, and state O&G regulations to evaluate distributive and participatory justice. We found that by 2012 at least 378,000 Coloradans lived within 1 mile of an active O&G well, and this population was growing at a faster rate than the overall population. In the Denver Julesburg and San Juan basins, which experienced substantial O&G development prior to 2000, we observed a larger proportion of lower value homes within 500 feet of an O&G well and that most O&G wells predated houses. In the Piceance Basin, which had not experienced substantial prior O&G development, we observed a larger proportion of high value homes within 500 feet of an O&G well and that most houses predated O&G wells. We observed economic, rural, participatory, and/or distributive injustices that could contribute to health risk vulnerabilities in populations near O&G wells. We encourage policy makers to consider measures to reduce these injustices.

Fatty acid composition of minced meat, longissimus muscle and omental fat from Small East African goats finished on different levels of concentrate supplementation.

PubMed

Mushi, D E; Thomassen, M S; Kifaro, G C; Eik, L O

2010-10-01

Effects of supplementing Small East African (SEA) goats with concentrate diets on fatty acids composition of minced meat, M. longissimus dorsi (LD) and omental fat were assessed using 23 animals (14.5 months old and 20.1 kg body weight). Goats were subjected to four levels of concentrate supplementation: ad libitum concentrate allowance (T100), 66% (T66), 33% (T33) and 0% (T0) of ad libitum concentrate allowance. All goats were slaughtered after 90 days of experimental period. Minced meat from concentrate-supplemented goats had higher (P<0.05) proportions of unsaturated fatty acids (UFA), monounsaturated fatty acids (MUFA) and desirable fatty acid (DFA) than that of non-supplemented ones (T0). Minced meat from T00 and T66 goats had similar proportions of polyunsaturated fatty acids (PUFA) and n-6 PUFA that were higher (P<0.05) than that of other dietary groups. There was limited variation in fatty acids composition of LD attributable to concentrate supplementation. Trans-vaccenic and linoleic acids were in higher (P<0.05) proportion in omental fat from concentrate-supplemented goats whereas margaric and arachidonic acids were in higher (P<0.05) proportion in omental fat from non-supplemented goats. Overall, LD was associated with PUFA, omental fat with saturated fatty acids (SFA), minced meat with MUFA. It is concluded that finishing SEA goats on concentrate diets will increase the proportion of DFA in meat from them. In addition, the proportion of PUFA in meat from such goats will peak at concentrate supplementation equivalent to 66% of their ad libitum intake. Consumers should avoid high intake of internal fat due to their richness in SFA. Copyright (c) 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

Greenspace, urbanity and health: relationships in England

PubMed Central

Mitchell, Richard; Popham, Frank

2007-01-01

Objectives To determine the association between the percentage of greenspace in an area and the standardised rate of self‐reported “not good” health, and to explore whether this association holds for areas exhibiting different combinations of urbanity and income deprivation. Design and setting Cross‐sectional, ecological study in England. Participants All residents of England as at the 2001 Census. Main outcome measures Age and sex standardised rate of reporting “not good” health status. Results A higher proportion of greenspace in an area was generally associated with better population health. However, this association varied according to the combination of area income deprivation and urbanity. There was no significant association between greenspace and health in higher income suburban and higher income rural areas. In suburban lower income areas, a higher proportion of greenspace was associated with worse health. Conclusions Although, in general, higher proportion of greenspace in an area is associated with better health, the association depends on the degree of urbanity and level of income deprivation in an area. One interpretation of these analyses is that quality as well as quantity of greenspace may be significant in determining health benefits. PMID:17630365

Foodborne listeriosis acquired in hospitals.

PubMed

Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

2014-08-15

Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Soft X-ray spectrum of BL Lacertae object AO 0235+164 as a tracer of elemental abundances at z approximately 0.5

NASA Technical Reports Server (NTRS)

Madejski, Greg

1994-01-01

We report the soft X-ray spectrum of BL Lac object AO 0235+164, observed with the Einstein Observatory Imaging Proportional Counter (IPC). This object (z = 0.94) has an intervening galaxy (or a protogalactic disk) at z = 0.524 present in the line of sight, producing both radio and optical absorption lines in the background BL Lac continuum. The X-ray spectrum exhibits a substantial soft X-ray cutoff, corresponding to several times that expected from our own Galaxy; we interpret that excess cutoff as due to the intervening galaxy. The comparison of the hydrogen column density inferred from the 21 cm radio data and the X-ray absorption allows, in principle, the determination of the elemental abundances in the intervening galaxy. However, the uncertainties in both the H I spin temperature and X-ray spectral parameters only loosely restrict these abundances to be 2 +/- 1 solar, which even at the lower limit appears higher than that inferred from studies of samples of optical absoprtion-line systems.

Prevalence and correlates of human immunodeficiency virus testing and posttest counseling among outpatients with serious mental illness.

PubMed

Desai, Mayur M; Rosenheck, Robert A; Desai, Rani A

2007-09-01

This study examined the prevalence and correlates of receipt of human immunodeficiency virus (HIV) testing, test results, and posttest counseling among outpatients with serious mental illness at 3 public-sector facilities in Connecticut (N = 487). A substantial proportion (41.9%) reported never having been tested for HIV, including fully one-third of those who were "very afraid" of getting acquired immune deficiency syndrome. Independent correlates of HIV testing included younger age, felony criminal history, stronger therapeutic alliance with one's primary clinician, and increased drug problems and psychological distress. Of those tested, nearly all (96.5%) reported receiving the test results; however, only half (50.5%) reported receiving any posttest counseling. Independent correlates of posttest counseling included higher educational level, felony criminal history, and receipt of community-based case management services. Greater efforts are needed to increase HIV testing and counseling among persons with serious mental illness to better identify and care for HIV-positive individuals and potentially reduce future transmission of the virus in this vulnerable, at-risk population.

Educational inequalities in mortality by cause of death: first national data for the Netherlands.

PubMed

Kulhánová, Ivana; Hoffmann, Rasmus; Eikemo, Terje A; Menvielle, Gwenn; Mackenbach, Johan P

2014-10-01

Using new facilities for linking large databases, we aimed to evaluate for the first time the magnitude of relative and absolute educational inequalities in mortality by sex and cause of death in the Netherlands. We analyzed data from Dutch Labour Force Surveys (1998-2002) with mortality follow-up 1998-2007 among people aged 30-79 years. We calculated hazard ratios using Cox proportional hazards model, age-standardized mortality rates and partial life expectancy by education. We compared results for the Netherlands with those for other European countries. The relative risk of dying was about two times higher among primary educated men and women as compared to their tertiary educated counterparts, leading to a gap in partial life expectancy of 3.4 years (men) and 2.4 years (women). Inequalities in mortality are similar to those in other countries in North-Western Europe, but inequalities in lung cancer mortality are substantially larger in the Netherlands, particularly among men. The Netherlands has large inequalities in mortality, especially for smoking-related causes of death. These large inequalities require the urgent attention of policy makers.

Substantial changes in hemocyte parameters of Manila clam Ruditapes philippinarum two years after the Hebei Spirit oil spill off the west coast of Korea.

PubMed

Hong, Hyun-Ki; Donaghy, Ludovic; Kang, Chang-Keun; Kang, Hyun-Sil; Lee, Hee-Jung; Park, Heung-Sik; Choi, Kwang-Sik

2016-07-15

Two years after the Hebei Spirit oil spill occurred off the west coast of Korea, we determined sub-lethal effects of the spilled oil on hemocyte parameters of Ruditapes philippinarum in the damaged areas. Clams in the spilled sites displayed unusually high proportion of granulocytes, which may result in higher phagocytosis capacity and reactive oxygen species production. Hemocytes in clams from the polluted sites also displayed less DNA damage and mortality than in the control site, possibly due to a faster phagocytosis of the impaired cells. Glycogen, the major energetic reserve, was depleted in clams from the spilled sites, potentially due to energetic consumption for maintenance of a large pool of granulocytes, detoxification processes and oxidative stress. Modified hemocyte parameters in clams in the spilled area, may reflect sub-lethal physiological stresses caused by the residual oils in the sediment, in conjunction with environmental modifications such as food availability and pathogens pattern. Copyright © 2016 Elsevier Ltd. All rights reserved.

Regulatory Enforcement and Fiscal Impact in Local Health Agencies

PubMed Central

Rabarison, Kristina M.; Rabarison, Monika K.

2015-01-01

Objectives. We used a cross-sectional, retrospective study design to analyze the association between local health agency regulatory activities and revenues from nonclinical fees and fines (NFF). Methods. We extracted data from the 2010 National Association of County and City Health Officials (NACCHO) Profile Survey, the most recent report including NFF information, and used 2-part multivariable regression models to identify relationships between regulatory activities and revenue. We also interviewed LHD directors on access to revenue from fines. Results. NFFs generated substantial revenue for most LHDs, increasing in scope and amount with jurisdiction size for all but the largest municipalities. The greatest proportion of net revenue came from public pools, campgrounds and recreational vehicles, and solid waste disposal. For small and mid-sized LHDs, enforcement activities generated revenue in a dose–response pattern, with higher returns for increased activities. LHDs in decentralized governance states collected more NFF revenue than those in centralized states. States vary regarding LHD access to revenue from sanctions. Conclusions. The fiscal impact of changes in regulatory activity needs careful assessment to avoid unanticipated consequences of applicable law. PMID:25689178

Irrigation, risk aversion, and water right priority under water supply uncertainty

NASA Astrophysics Data System (ADS)

Li, Man; Xu, Wenchao; Rosegrant, Mark W.

2017-09-01

This paper explores the impacts of a water right's allocative priority—as an indicator of farmers' risk-bearing ability—on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right-truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to 141.4 acre-1 or 55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority-based water sharing mechanism.

Irrigation, risk aversion, and water right priority under water supply uncertainty.

PubMed

Li, Man; Xu, Wenchao; Rosegrant, Mark W

2017-09-01

This paper explores the impacts of a water right's allocative priority-as an indicator of farmers' risk-bearing ability-on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right-truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to $141.4 acre -1 or $55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority-based water sharing mechanism.

Differences in acoustic features of vocalizations produced by killer whales cross-socialized with bottlenose dolphins.

PubMed

Musser, Whitney B; Bowles, Ann E; Grebner, Dawn M; Crance, Jessica L

2014-10-01

Limited previous evidence suggests that killer whales (Orcinus orca) are capable of vocal production learning. However, vocal contextual learning has not been studied, nor the factors promoting learning. Vocalizations were collected from three killer whales with a history of exposure to bottlenose dolphins (Tursiops truncatus) and compared with data from seven killer whales held with conspecifics and nine bottlenose dolphins. The three whales' repertoires were distinguishable by a higher proportion of click trains and whistles. Time-domain features of click trains were intermediate between those of whales held with conspecifics and dolphins. These differences provided evidence for contextual learning. One killer whale spontaneously learned to produce artificial chirps taught to dolphins; acoustic features fell within the range of inter-individual differences among the dolphins. This whale also produced whistles similar to a stereotyped whistle produced by one dolphin. Thus, results provide further support for vocal production learning and show that killer whales are capable of contextual learning. That killer whales produce similar repertoires when associated with another species suggests substantial vocal plasticity and motivation for vocal conformity with social associates.

Irrigation, risk aversion, and water right priority under water supply uncertainty

PubMed Central

Xu, Wenchao; Rosegrant, Mark W.

2017-01-01

Abstract This paper explores the impacts of a water right's allocative priority—as an indicator of farmers' risk‐bearing ability—on land irrigation under water supply uncertainty. We develop and use an economic model to simulate farmers' land irrigation decision and associated economic returns in eastern Idaho. Results indicate that the optimal acreage of land irrigated increases with water right priority when hydroclimate risk exhibits a negatively skewed or right‐truncated distribution. Simulation results suggest that prior appropriation enables senior water rights holders to allocate a higher proportion of their land to irrigation, 6 times as much as junior rights holders do, creating a gap in the annual expected net revenue reaching up to $141.4 acre−1 or $55,800 per farm between the two groups. The optimal irrigated acreage, expected net revenue, and shadow value of a water right's priority are subject to substantial changes under a changing climate in the future, where temporal variation in water supply risks significantly affects the profitability of agricultural land use under the priority‐based water sharing mechanism. PMID:29200529

The use of the ion probe mass spectrometer in the measurement of hydrogen concentration gradients in Monel K 500

NASA Technical Reports Server (NTRS)

Truhan, J. J., Jr.; Hehemann, R. F.

1974-01-01

The ion probe mass spectrometer was used to measure hydrogen concentration gradients in cathodically charged Monel K 500. Initial work with the ion probe involved the calibration of the instrument and the establishment of a suitable experimental procedure for this application. Samples of Monel K 500 were cathodically charged in a weak sulfuric acid solution. By varying the current density, different levels of hydrogen were introduced into the samples. Hydrogen concentration gradients were taken by ion sputtering on the surface of these samples and monitoring the behavior of the hydrogen mass peak as a function of time. An attempt was made to determine the relative amounts of hydrogen in the bulk and grain boundaries by analyzing a fresh fracture surface with a higher proportion of grain boundary area. It was found that substantially more hydrogen was detected in the grain boundaries than in the bulk, confirming the predictions of previous workers. A sputter rate determination was made in order to establish the rate of erosion.

Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey

PubMed Central

Johansen, Ingrid Hjulstad; Baste, Valborg; Rosta, Judith; Aasland, Olaf G; Morken, Tone

2017-01-01

Objectives The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. Design Repeated cross-sectional survey. Setting All healthcare levels and medical specialties in Norway. Participants Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158). Main outcome measures Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty. Results There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95). Conclusions A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors’ education and within work settings. PMID:28801441

Antibiotic Use in Small Community Hospitals.

PubMed

Stenehjem, Edward; Hersh, Adam L; Sheng, Xiaoming; Jones, Peter; Buckel, Whitney R; Lloyd, James F; Howe, Stephen; Evans, R Scott; Greene, Tom; Pavia, Andrew T

2016-11-15

 Antibiotic use and misuse is driving drug resistance. Much of US healthcare takes place in small community hospitals (SCHs); 70% of all US hospitals have <200 beds. Antibiotic use in SCHs is poorly described. We evaluated antibiotic use using data from the National Healthcare and Safety Network antimicrobial use option from the Centers for Disease Control and Prevention.  We used Intermountain Healthcare's monthly antibiotic use reports for 19 hospitals from 2011 to 2013. Hospital care units were categorized as intensive care, medical/surgical, pediatric, or miscellaneous. Antibiotics were categorized based on spectrum of coverage. Antibiotic use rates, expressed as days of therapy per 1000 patient-days (DOT/1000PD), were calculated for each SCH and compared with rates in large community hospitals (LCHs). Negative-binomial regression was used to relate antibiotic use to predictor variables.  Total antibiotic use rates varied widely across the 15 SCHs (median, 436 DOT/1000PD; range, 134-671 DOT/1000PD) and were similar to rates in 4 LCHs (509 DOT/1000PD; 406-597 DOT/1000PD). The proportion of patient-days spent in the respective unit types varied substantially within SCHs and had a large impact on facility-level rates. Broad-spectrum antibiotics accounted for 26% of use in SCHs (range, 8%-36%), similar to the proportion in LCHs (32%; range, 26%-37%). Case mix index, proportion of patient-days in specific unit types, and season were significant predictors of antibiotic use.  There is substantial variation in patterns of antibiotic use among SCHs. Overall usage in SCHs is similar to usage in LCHs. Small hospitals need to become a focus of stewardship efforts. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Use of a Unique Farmers' Market Program Targeting Lower-Income Community Members.

PubMed

Lawrence, Brittany; Greer, Anna E; Zimeri, Anne Marie; Hernandez, Daphne C; Ahn, SangNam; Jones, Shaakira; Smith, Matthew Lee

2018-06-01

We examined use of a farmers' market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and reasons for market use, financial support received, and how attendees had learned about the market. Ordinal regression was used to identify household characteristics associated with increased market attendance. Although the proportion of lower-income attendees declined over the study period, a substantial proportion of households in 2014 (69.1%) and 2015 (54.6%) were below the poverty threshold. We identified significant differences in attendees' reasons for market use and ways attendees heard about the market from 2014 to 2015. The most frequently reported reason for 2014 market use was retirement/fixed income (P < 0.001) and in 2015 was low-income (P < 0.001). Most attendees heard about the market through flyers (P < 0.001) and word of mouth (P ≤ 0.001) in 2014 and through local, non-profit services (P < 0.001) in 2015. In the ordinal regression, households with an older person registering the household for the market used the market more times per year (P < 0.001). Impoverished households (P = 0.020) and households receiving more financial support services (P < 0.001) used the market fewer times per year. While a substantial proportion of lower-income persons used the free-produce market, frequency of use was still lowest among this group indicating a need to address barriers beyond produce cost.

Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

PubMed

Jenson, Alexander; Roter, Debra L; Mkocha, Harran; Munoz, Beatriz; West, Sheila

2018-06-01

Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. Copyright © 2018 Elsevier B.V. All rights reserved.

Association of Dietary Proportions of Macronutrients with Visceral Adiposity Index: Non-Substitution and Iso-Energetic Substitution Models in a Prospective Study.

PubMed

Moslehi, Nazanin; Ehsani, Behnaz; Mirmiran, Parvin; Hojjat, Parvane; Azizi, Fereidoun

2015-10-26

We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (ΔVAI). The study included 1254 adults (18-74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with ΔVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher ΔVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with ΔVAI and risk of VAD.

Evolution of the Global Use of Unsafe Medical Injections, 2000–2010

PubMed Central

Pépin, Jacques; Abou Chakra, Claire Nour; Pépin, Eric; Nault, Vincent

2013-01-01

Objective Since 1999, substantial efforts have been made by the international community to reduce the risks associated with unsafe injections, through ministries of health, international donors, the World Health Organization and the Safe Injection Global Network. The present study attempted to measure the progress, or lack thereof, made over the 2000–2010 decade in reducing unsafe injections in ten regions of the world corresponding to developing and transitional economies. Methods Data about the number of injections per person per year and the proportion of re-use of syringes and needles were obtained for 2010, mainly from population surveys, and compared with previous estimates for 2000 which had used various sources of information including injection safety assessments, population surveys and published studies on injection practices. Results From 2000 to 2010, in developing countries and transitional economies, the average number of injections per person per year decreased from 3.40 to 2.88, while the proportion of re-use of injection devices dropped from 39.8% to 5.5%. Combining both factors the number of unsafe injections per person per year decreased from 1.35 to 0.16. Even if substantial progress has been made, the Eastern Mediterranean region remains problematic, with 0.57 unsafe injections per person per year. In sub-Saharan Africa and Latin America, people now receive on average only 0.04–0.05 unsafe injections per year. Conclusion Substantial progress has been made in reducing the number of unsafe injections in developing countries and transitional economies, essentially through a reduction in the re-use of injection devices. In some regions, elimination of unsafe injections might become a reasonable goal. PMID:24324650

Linking river nutrient concentrations to land use and rainfall in a paddy agriculture-urban area gradient watershed in southeast China.

PubMed

Xia, Yongqiu; Ti, Chaopu; She, Dongli; Yan, Xiaoyuan

2016-10-01

The effects of land use and land-use changes on river nutrient concentrations are not well understood, especially in the watersheds of developing countries that have a mixed land use of rice paddy fields and developing urban surfaces. Here, we present a three-year study of a paddy agricultural-urban area gradient watershed in southeast China. The annual anthropogenic nitrogen (N) input from the agricultural region to the urban region was high, yet the results showed that the monthly nutrient concentrations in the river were low in the rainy seasons. The nutrient concentrations decreased continuously as the river water passed through the traditional agriculture region (TAR; paddy rice and wheat rotation) and increased substantially in the city region (CR). The traditional agricultural reference region exported most of the nutrient loads at high flows (>1mmd(-1)), the intensified agricultural region (IAR, aquaculture and poultry farming) exported most of the nutrient loads at moderate flows (between 0.5 and 1mmd(-1)), and the CR reference area exported most of the nutrient loads under low to moderate flows. We developed a statistical model to link variations in the nutrient concentrations to the proportion of land-use types and rainfall. The statistical results showed that impervious surfaces, which we interpret as a proxy for urban activities including sewage disposal, were the most important drivers of nutrient concentrations, whereas water surfaces accounted for a substantial proportion of the nutrient sinks. Therefore, to efficiently reduce water pollution, sewage from urban areas must be addressed as a priority, although wetland restoration could also achieve substantial pollutant removal. Copyright © 2016. Published by Elsevier B.V.

The burden of attending a pediatric surgical clinic and family preferences toward telemedicine.

PubMed

Bator, Eli X; Gleason, Joseph M; Lorenzo, Armando J; Kanaroglou, Niki; Farhat, Walid A; Bägli, Darius J; Koyle, Martin A

2015-10-01

Indirect expenses for accessing health care may place significant fiscal strain on Canadian families. Telemedicine alternatives, using email, telephone, and video conferencing, can mitigate such financial burdens by reducing travel and related costs. Our objectives were to assess costs that families incur visiting an outpatient pediatric surgical clinic, and family attitudes toward telemedicine alternatives. A survey was offered pre-consult to all families who attended pediatric urology and general surgery outpatient clinics over a three-month period. A total of 1032 of 1574 families screened participated (66.0%). Less than half (18.5%) of participants traveled over 200 km, and 32.9% spent over 4 hours in transit, round-trip. The proportion of participants who spent over $50 on travel and ancillary expenses was 33.0%. In 74.0% of families, 1 or more adults missed work. The proportion of families who perceived costs as somewhat high or high was 29.1%. Perceived cost was positively correlated to distance traveled, money spent, and missed work (p<0.01). Most were comfortable with medical communication using technology; and 34.3%-42.7% would avoid an in-person clinic visit utilizing email, telephone, and video conferencing. Higher perceived cost (p<0.001) and distance traveled (p<0.01) were only weakly associated with greater willingness to substitute a clinic visit with video conferencing. Many families face high costs related to routine outpatient clinical visits, and there is a substantial willingness by them to access telemedicine alternatives, rather than the traditional face-to-face clinical visit. Copyright © 2015 Elsevier Inc. All rights reserved.

Increasing girls' physical activity during a short-term organized youth sport basketball program: A randomized controlled trial.

PubMed

Guagliano, Justin M; Lonsdale, Chris; Kolt, Gregory S; Rosenkranz, Richard R; George, Emma S

2015-07-01

To evaluate the short-term efficacy of coach education on basketball players' physical activity (PA) intensity during practices. Intervention effects on players' motivation were also investigated. Randomized controlled trial. This study took place over the course of a 5-day organized youth sport (OYS) basketball program in 2 sports centres in Greater Western Sydney, Australia (September, 2013). A convenience sample of 76 players and 8 coaches were recruited. Players were girls aged 9 to 12 years. Following the first 2 days of the basketball program, coaches allocated into the intervention condition attended 2 coach education sessions where strategies to increase moderate-to-vigorous physical activity (MVPA) and decrease inactivity were discussed. Each coach education session lasted approximately 2h. Compared to the control group, players in the intervention group spent a significantly higher proportion of practice time in MVPA (mean difference [MD]=14.6%; standard error [SE]=2.2%), vigorous PA (VPA; MD=12.6%; SE=1.9%), moderate PA (MD=2.0%; SE=0.5%) and a significantly lower proportion of practice time inactive (MD=-14.5%; SE=2.3%) from baseline to follow-up. There were no significant changes in motivation from baseline to follow-up in either group. Brief coach education sessions can increase MVPA and decrease inactivity without deleterious effects on players' motivation. Also, substantial increases in VPA were found, which is an important finding because VPA has been associated with health benefits, over and above benefits accrued from lower-intensity activity. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Social inequalities in residential exposure to road traffic noise: an environmental justice analysis based on the RECORD Cohort Study.

PubMed

Havard, Sabrina; Reich, Brian J; Bean, Kathy; Chaix, Basile

2011-05-01

To explore social inequalities in residential exposure to road traffic noise in an urban area. Environmental injustice in road traffic noise exposure was investigated in Paris, France, using the RECORD Cohort Study (n = 2130) and modelled noise data. Associations were assessed by estimating noise exposure within the local area around participants' residence, considering various socioeconomic variables defined at both individual and neighbourhood level, and comparing different regression models attempting or not to control for spatial autocorrelation in noise levels. After individual-level adjustment, participants' noise exposure increased with neighbourhood educational level and dwelling value but also with proportion of non-French citizens, suggesting seemingly contradictory findings. However, when country of citizenship was defined according to its human development level, noise exposure in fact increased and decreased with the proportions of citizens from advantaged and disadvantaged countries, respectively. These findings were consistent with those reported for the other socioeconomic characteristics, suggesting higher road traffic noise exposure in advantaged neighbourhoods. Substantial collinearity between neighbourhood explanatory variables and spatial random effects caused identifiability problems that prevented successful control for spatial autocorrelation. Contrary to previous literature, this study shows that people living in advantaged neighbourhoods were more exposed to road traffic noise in their residential environment than their deprived counterparts. This case study demonstrates the need to systematically perform sensitivity analyses with multiple socioeconomic characteristics to avoid incorrect inferences about an environmental injustice situation and the complexity of effectively controlling for spatial autocorrelation when fixed and random components of the model are correlated.

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk.

PubMed

Pettersson, David; Bottai, Matteo; Mathiesen, Tiit; Prochazka, Michaela; Feychting, Maria

2015-01-01

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

Characterization of virgin olive oils produced with autochthonous Galician varieties.

PubMed

Reboredo-Rodríguez, Patricia; González-Barreiro, Carmen; Cancho-Grande, Beatriz; Valli, Enrico; Bendini, Alessandra; Gallina Toschi, Tullia; Simal-Gandara, Jesus

2016-12-01

The interest of Galician oil producers (NW Spain) in recovering the ancient autochthonous olive varieties Brava and Mansa has increased substantially in recent years. Virgin olive oils produced by co-crushing both varieties in two different proportions, reflecting the usual and most common practice adopted in this region, have gradually emerged for the production of virgin olive oils. Herein, the sensory and chemical characteristics of such oils were characterized by quality and genuineness-related parameters. The results of chemical analysis are discussed in terms of their effective contribution to the sensory profile, which suggests useful recommendations for olive oil producers to improve the quality of oils. Antioxidant compounds, together with aromas and coloured pigments were determined, and their contribution in determining the functional value and the sensory properties of oils was investigated. In general, given the high levels of phenolic compounds (ranging between 254 and 375mg/kg oil), tocopherols (about 165mg/kg oil) and carotenoids (10-12mg/kg oil); these are oils with long stability, especially under dark storage conditions, because stability is reinforced with the contribution of chlorophylls (15-22mg/kg oil). A major content of phenolic compounds, as well as a predominance of trans-2-hexen-1-al within odor-active compounds (from 897 to 1645μg/kg oil), responsible for bitter sensory notes. This characterization allows to developing new antioxidant-rich and flavour-rich VOOs, when co-crushing with a higher proportion of Brava olives, satisfying the consumers' demand in having access to more healthy dishes and peculiar sensory attributes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Willingness To Pay for Social Health Insurance in Iran

PubMed Central

Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Sari, Ali Akbari; Mahdavi, Ghadir; Moeini, Maryam

2014-01-01

Objective: The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. Method: The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. Result: The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. Conclusions: From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households’ Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society. PMID:25168979

Epidemiology of diabetes mellitus and associated cardiovascular risk factors: focus on human immunodeficiency virus and psychiatric disorders.

PubMed

Zimmet, Paul

2005-04-01

Type 2 diabetes mellitus and obesity have reached epidemic proportions in many developing and developed nations, leading to talk of the "twin epidemics." The latest projections from the International Diabetes Federation suggest that 190 million people worldwide currently have type 2 diabetes. In addition, > or = 300 million people worldwide have impaired glucose tolerance (IGT). These statistics represent an epidemic of major proportions--possibly the largest epidemic in human history--in terms of glucose intolerance and cardiovascular disease (CVD) risk because individuals with IGT are at substantially higher risk for diabetes and CVD than are members of the general population. Along with IGT, the metabolic syndrome comprises other major CVD risk factors, including insulin resistance, central obesity, and dyslipidemia; insulin resistance has been implicated as the single most common cause of the syndrome. Although the exact prevalence of the metabolic syndrome is unknown, the syndrome is widespread among adults in developed nations, becoming more prevalent with age. Epidemiologic data suggest that in patients with schizophrenia or affective disorders, both diabetes and obesity are 1.5 to 2.0 times more prevalent than in the general population. Furthermore, because adverse effects of certain therapies for human immunodeficiency virus (HIV) infection and psychiatric disorders increase the risk for developing diabetes, obesity, and the metabolic syndrome, such therapies should be carefully chosen, particularly considering CVD risk. Appropriate therapy may be determined via screening of patients for levels of fasting blood glucose and lipids, as well as other CVD risk factors, before initiating use of second-generation antipsychotic agents or highly active antiretroviral therapy.

Explaining individual differences in alcohol intake in adults: evidence for genetic and cultural transmission?

PubMed

van Beek, Jenny H D A; de Moor, Marleen H M; Geels, Lot M; Willemsen, Gonneke; Boomsma, Dorret I

2014-03-01

The current study aimed to describe what proportion of variation in adult alcohol intake is attributable to genetic differences among individuals and what proportion to differences in environmental experiences individuals have been exposed to. Effects of age, gender, spousal resemblance, and cultural transmission of alcohol intake from parents to offspring were taken into account. In a twin-family design, the effects of genetic and cultural transmission and shared and nonshared environment on alcohol intake were estimated with genetic structural equation models. Data originated from adult twins, their siblings, parents (n = 12,587), and spouses (n = 429) registered with the population-based Netherlands Twin Register (63.5% female; ages 18-97 years). Alcohol intake (grams per day) was higher among men than women and increased with age. Broad-sense heritability estimates were similar across sex and age (53%). Spousal resemblance was observed (r = .39) but did not significantly affect the heritability estimates. No effects of cultural transmission were detected. In total, 23% of the variation in alcohol intake was explained by additive genetic effects, 30% by dominant (nonadditive) gene action, and 47% by environmental effects that were not shared among family members. Individual differences in adult alcohol intake are explained by genetic and individual-specific environmental effects. The same genes are expressed in males and females and in younger and older participants. A substantial part of the heritability of alcohol intake is attributable to nonadditive gene action. Effects of cultural transmission that have been reported in adolescence are not present in adulthood.

Longitudinal study of objective and subjective cognitive performance and psychological distress in OEF/OIF Veterans with and without traumatic brain injury.

PubMed

Donnelly, Kerry; Donnelly, James P; Warner, Gary C; Kittleson, C James; King, Paul R

2018-04-01

To describe changes in post-deployment objective and subjective cognitive performance in combat Veterans over 18 months, relative to traumatic brain injury (TBI) status and psychological distress. This prospective cohort study examined 500 Veterans from Upstate New York at four time points, six months apart. TBI status was determined by a structured clinical interview. Neuropsychological instruments focused on attention, memory, and executive functions. Subjective cognitive complaints were assessed with the Neurobehavioral Symptom Inventory (NSI). A psychological distress composite included measures of post-traumatic stress disorder (PTSD), depression, and generalized anxiety. Forty-four percent of the sample was found to have sustained military-related TBI, 97% of which were classified as mild (mTBI), with a mean time since injury of 41 months. Veterans with TBI endorsed moderate cognitive symptoms on the NSI. In contrast to these subjective complaints, mean cognitive test performance was within normal limits at each time point in all domains, regardless of TBI status. Multilevel models examined effects of TBI status, time, and psychological distress. Psychological distress was a strong predictor of all cognitive domains, especially the subjective domain. Substantial proportions of both TBI+ and TBI- groups remained in the clinically significant range at the initial and final assessment for all three distress measures, but the TBI+ group had higher proportions of clinically significant cases. Objective cognitive performance was generally within normal limits for Veterans with mTBI across all assessments. Psychological distress was elevated and significantly related to both objective and subjective cognitive performance.

Shock anxiety among implantable cardioverter defibrillator recipients with recent tachyarrhythmia.

PubMed

Morken, Ingvild M; Isaksen, Kjetil; Karlsen, Bjørg; Norekvål, Tone M; Bru, Edvin; Larsen, Alf Inge

2012-11-01

Shock anxiety has been documented irrespective of shock exposure in implantable cardioverter defibrillator (ICD) recipients. The presence of tachyarrhythmia may lead to an anticipation of receiving a shock and thereby give rise to shock anxiety. The aims were to assess: (1) the level of shock anxiety in a sample of ICD recipients, (2) the relationship between such anxiety and shock exposure, and (3) the relationship between recent tachyarrhythmia and shock anxiety. ICD recipients (n = 167) completed the Florida Shock Anxiety Scale measure of shock anxiety. The recipients were divided into three groups: (1) Recipients with no documented tachyarrhythmia over the previous 12 months (n = 56), (2) recipients with documented tachyarrhythmia over the previous twelve months (n = 54), and (3) recipients with any history of shocks (n = 57). Of the recipients, 44% experienced some form of shock anxiety, whereas 15% reported general shock anxiety. Analyses of covariance revealed that recipients with recent tachyarrhythmia (F = 7.675 df = 9/100, P = 0.007) as well as recipients with a shock history (F = 9.976, df = 9/103, P = 0.002) reported higher levels of shock anxiety than recipients with no recent tachyarrhythmia. This study indicates that although a substantial proportion of the ICD recipients experienced some form of shock anxiety, only a relatively small proportion reported general shock anxiety. ICD recipients with recent tachyarrhythmia, in addition to recipients with shock history, appear to be at greater risk for development of shock anxiety. This implies that these recipients may profit from clinical-based strategies and interventions targeting shock anxiety. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

Health characteristics of women beginning postmenopausal hormone therapy: have they changed since the publication of the Women's Health Initiative?

PubMed

Fournier, Agnès; Fritel, Xavier; Panjo, Henri; Zins, Marie; Ringa, Virginie

2014-07-01

After we demonstrated a substantial drop in postmenopausal hormone therapy (HT) in France after 2002, we sought to compare health characteristics assessed before menopause and reasons for beginning treatment among women who started postmenopausal HT before and after this year. Among participants of the GAZEL (GAZ and ELectricité) cohort of employees of the French national power company, we studied 1,229 women who reached menopause before 2002 and 562 women who reached menopause after 2002. We analyzed HT use among these newly postmenopausal women before and after 2002 and its relations to self-rated health, simple and troublesome hot flushes, and various other symptoms before menopause. After 2002, compared with before 2002, women starting HT were more likely to have reported troublesome hot flushes before menopause (odds ratio, 2.3; 95% CI, 1.0-5.4). The groups of new HT users did not differ significantly except for health characteristics. Significantly higher proportions of women starting HT reported using it for hot flushes (68.1% vs 52.9%, P = 0.02) and sleep disorders (11.1% vs 2.8%, P = 0.001) and a significantly lower proportion of women starting HT reported using it for osteoporosis prevention (12.5% vs 43.9%, P < 0.001) after 2002 than before 2002. After 2002, HT tended to be prescribed for more severe hot flushes, but almost one third of prescriptions were still written for reasons not linked to hot flushes. Doctors seem to be following recommendations to not use HT as a first-line treatment of osteoporosis.

Substantial variation in the acceptance of medically complex live kidney donors across US renal transplant centers

PubMed Central

Reese, PP; Feldman, HI; McBride, MA; Anderson, K; Asch, DA; Bloom, RD

2008-01-01

Concern exists about accepting live kidney donation from “medically complex donors” -those with risk factors for future kidney disease. This study’s aim was to examine variation in complex kidney donor use across United States (US) transplant centers. We conducted a retrospective cohort study of live kidney donors using Organ Procurement and Transplantation Network data. Donors with hypertension, obesity, or estimated glomerular filtration rate (eGFR) <60 ml/minute/1.73m2 were considered medically complex. Among 9319 donors, 2254 (24.2%) were complex: 1194 (12.8%) were obese, 956 (10.3%) hypertensive, and 392 (4.2%) had low eGFR. The mean proportion of medically complex donors at a center was 24% (range 0 – 65%.) In multivariate analysis, donor characteristics associated with medical complexity included spousal relationship to the recipient (OR 1.29, CI 1.06-1.56, p<0.01), low education (OR 1.19, CI 1.04-1.37, p=0.01), older age (OR 1.01 per year, CI 1.01-1.02, p<0.01), and non-US citizenship (OR 0.70, CI 0.51-0.97, p=0.01). Renal transplant centers with the highest transplant volume (OR 1.26, CI 1.02-1.57, p=0.03), and with a higher proportion of (living donation)/(all kidney transplants) (OR 1.97, CI 1.23-3.16, p<0.01) were more likely to use medically complex donors. Though controversial, the use of medically complex donors is widespread and varies widely across centers. PMID:18727695

Quantifying components of the hydrologic cycle in Virginia using chemical hydrograph separation and multiple regression analysis

USGS Publications Warehouse

Sanford, Ward E.; Nelms, David L.; Pope, Jason P.; Selnick, David L.

2012-01-01

This study by the U.S. Geological Survey, prepared in cooperation with the Virginia Department of Environmental Quality, quantifies the components of the hydrologic cycle across the Commonwealth of Virginia. Long-term, mean fluxes were calculated for precipitation, surface runoff, infiltration, total evapotranspiration (ET), riparian ET, recharge, base flow (or groundwater discharge) and net total outflow. Fluxes of these components were first estimated on a number of real-time-gaged watersheds across Virginia. Specific conductance was used to distinguish and separate surface runoff from base flow. Specific-conductance data were collected every 15 minutes at 75 real-time gages for approximately 18 months between March 2007 and August 2008. Precipitation was estimated for 1971–2000 using PRISM climate data. Precipitation and temperature from the PRISM data were used to develop a regression-based relation to estimate total ET. The proportion of watershed precipitation that becomes surface runoff was related to physiographic province and rock type in a runoff regression equation. Component flux estimates from the watersheds were transferred to flux estimates for counties and independent cities using the ET and runoff regression equations. Only 48 of the 75 watersheds yielded sufficient data, and data from these 48 were used in the final runoff regression equation. The base-flow proportion for the 48 watersheds averaged 72 percent using specific conductance, a value that was substantially higher than the 61 percent average calculated using a graphical-separation technique (the USGS program PART). Final results for the study are presented as component flux estimates for all counties and independent cities in Virginia.

Impact of referral letters on scheduling of hospital appointments: a randomised control trial.

PubMed

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-07-01

Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ(2) and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. © British Journal of General Practice 2014.

Higher B-cell activating factor levels at birth are positively associated with maternal dairy farm exposure and negatively related to allergy development.

PubMed

Lundell, Anna-Carin; Hesselmar, Bill; Nordström, Inger; Adlerberth, Ingegerd; Wold, Agnes E; Rudin, Anna

2015-10-01

A high proportion of circulating immature/naive CD5(+) B cells during early infancy is a risk factor for allergy development. B-cell activating factor (BAFF) is an important cytokine for B-cell maturation. We sought to investigate whether BAFF levels are related to environmental exposures during pregnancy and early childhood and whether BAFF levels are associated with postnatal B-cell maturation and allergic disease. In the FARMFLORA study, including both farming and nonfarming families, we measured BAFF levels in plasma from mothers and their children at birth and at 1, 4, 18, and 36 months of age. Infants' blood samples were also analyzed for B-cell numbers and proportions of CD5(+) and CD27(+) B cells. Allergic disease was clinically evaluated at 18 and 36 months of age. Circulating BAFF levels were maximal at birth, and farmers' children had higher BAFF levels than nonfarmers' children. Higher BAFF levels at birth were positively associated with proportions of CD27(+) memory B cells among farmers' children and inversely related to proportions of CD5(+) immature/naive B cells among nonfarmers' children. Children with allergic disease at 18 months of age had lower cord blood BAFF levels than nonallergic children. At birth, girls had higher BAFF levels and lower proportions of CD5(+) B cells than boys. Farm exposure during pregnancy appears to induce BAFF production in the newborn child, and high neonatal BAFF levels were associated with more accelerated postnatal B-cell maturation, which lend further strength to the role of B cells in the hygiene hypothesis. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

[Study on the characteristics of serology and sexual behavior among drug users at the HIV sentinel surveillance sites in 2012].

PubMed

Ge, Lin; Cui, Yan; Wang, Lu; Li, Dongmin; Guo, Wei; Ding, Zhengwei; Wang, Lan

2014-02-01

To analyze the serological results and sexual behavior among different types of drug users (DUS) at the HIV sentinel surveillance sites. Sentinel surveillance programs were conducted between April and June annually. DUS were those involved in custodes, living at the communities and those attending the methadone maintenance treatment clinics but with positive urine tests one month before blood sampling collected and questionnaire survey started. 116 279 drug abusers were included in the analysis. The prevalence rates of HIV, Syphilis and HCV among traditional drug (heroin, etc.)users were 5.0%, 4.4% and 49.4%, while the prevalence rates of new narcotic (meth, etc.) users were 0.5%, 4.6%, 15.2%, respectively. The prevalence rates of HIV, syphilis among traditional drug uses were higher than the new narcotic users (P < 0.01). The proportion of sexual behavior in last month and the proportion of sexual behavior with casual and commercial sexual partners were 46.3%, 87.2% and 28.1% among the new narcotic users, respectively, which were higher than those among traditional drug users (40.7% , 82.8% and 22.2%). The proportion of using condom in last sexual contact with casual sexual partner was 33.3% among the new narcotic users which was less than traditional drug users (36.2%). The proportion of condom use in the last commercial sexual contact was 65.1% which was higher than those traditional drug users (62.9%). The proportion of never using condom with casual and commercial sexual partners in the past year was 43.2% and 19.0% among the traditional drug users, which were higher than those among new narcotic users (41.3%, 15.3%). Compared with the traditional drug abusers, the sexual behavior of new narcotic users seemed more active, less engaging in condom use but with higher risk of HIV transmission through sexual contact.

Light scattering from laser induced pit ensembles on high power laser optics

DOE PAGES

Feigenbaum, Eyal; Elhadj, Selim; Matthews, Manyalibo J.

2015-01-01

Far-field light scattering characteristics from randomly arranged shallow Gaussian-like shaped laser induced pits, found on optics exposed to high energy laser pulses, is studied. Closed-form expressions for the far-field intensity distribution and scattered power are derived for individual pits and validated using numerical calculations of both Fourier optics and FDTD solutions to Maxwell’s equations. It is found that the scattered power is proportional to the square of the pit width and approximately also to the square of the pit depth, with the proportionality factor scaling with pit depth. As a result, the power scattered from shallow pitted optics is expectedmore » to be substantially lower than assuming complete scattering from the total visible footprint of the pits.« less

NMR characterization of functional groups: 9--isomer ratios of available chloromethylstyrene mixtures

NASA Technical Reports Server (NTRS)

Manatt, S. L.; Khune, G. D.; Khatri, N. A.

1985-01-01

From the assignments of the 1H and 13C 11.7 tesla NMR spectra of available mixtures of m- and p-chloromethylstyrene, the proportion of the meta and para compounds are easily determined. For these materials from two common commercial sources, proportions of 72 and 28% and 68 and 32% were found. These concentrations are substantially different from the often assumed 60 and 40% for the meta and para compounds, respectively. The influence of this difference on the desired properties of copolymers made from such mixtures is discussed. An alternative quantitative procedure for determining the chloromethyl group isomer ratios is also described which employs silver trifluoroacetate in acetone displacement of chloride and 19F NMR examination of the resulting ester mixture with a 2.3 tesla spectrometer.

[Malaria and HIV infection: clinical and biological aspects at Donka National Hospital in Conakry, Guinea].

PubMed

Bald, I; Camara, A; Baldé, O; Magassouba, N F; Bah, M S; Makanéra, A; Gamy, E P

2010-08-01

Malaria and HIV/AIDS are two of the most widespread infectious diseases encountered in sub-Saharan Africa. Even minor interactions between these two diseases could have substantial effects on public health. The purpose of this study was to investigate associations between malaria and HIV infection. Study was carried out over an 8-month period (April 1, 2003 to November 30, 2003) in the Tropical and Infectious Diseases Department of the Donka National Hospital in Conakry, Guinea. A total of 89 malaria patients including 41 cases with HIV infection and 48 controls without HIV infection were included. All patients were hospitalized during the study and provided informed consent. Results showed that malaria affected all age groups in the same proportion. Mean patient age was 34 years (range, 15 and 76 years). Males were more frequently infected with a sex ratio of 1.05. The average number of malaria episodes was higher in cases (malaria with HIV-infection than in controls (malaria without HIV infection). Hyperthermia was observed in most cases (68.29%) and controls (77.08%). Severe anemia was observed in 26.82% of cases versus 10.41% of controls. Low parasite density was observed in 73.17% of cases as compared to 68.75% of controls. The recovery rate was higher in the control group than in case group: 27.08% versus 14.63%. The death rate was higher in the case group than in the control group: 21.95% versus 6.25%. These findings demonstrate a link between malaria and HIV. The frequency of malaria episodes was higher in patients with HIV infection than patients without HIV infection and the outcome of malarial episodes was better in patients without HIV infection.

Fermentation profiles of Manzanilla-Aloreña cracked green table olives in different chloride salt mixtures.

PubMed

Bautista-Gallego, J; Arroyo-López, F N; Durán-Quintana, M C; Garrido-Fernández, A

2010-05-01

NaCl plays an important role in table olive processing affecting the flavour and microbiological stability of the final product. However, consumers demand foods low in sodium, which makes necessary to decrease levels of this mineral in fruits. In this work, the effects of diverse mixtures of NaCl, CaCl(2) and KCl on the fermentation profiles of cracked directly brined Manzanilla-Aloreña olives, were studied by means of response surface methodology based in a simplex lattice mixture design with constrains. All salt combinations led to lactic acid processes. The growth of Enterobacteriaceae populations was always limited and partially inhibited by the presence of CaCl(2). Only time to reach half maximum populations and decline rates of yeasts, which were higher as concentrations of NaCl or KCl increased, were affected, and correspondingly modelled, as a function of salt mixtures. However, lactic acid bacteria growth parameters could not be related to initial environmental conditions. They had a longer lag phase, slower growth and higher population levels than yeasts. Overall, the presence of CaCl(2) led to a slower Enterobacteriaceae and lactic acid bacteria growth than the traditional NaCl brine but to higher yeast activity. The presence of CaCl(2) in the fermentation brines also led to higher water activity, lower pH and combined acidity as well as a faster acidification while NaCl and KCl had fairly similar behaviours. Apparently, NaCl may be substituted in diverse proportions with KCl or CaCl(2) without substantially disturbing water activity or the usual fermentation profiles while producing olives with lower salt content. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

High prevalence of underweight and undernutrition in Japanese inpatients with schizophrenia: a nationwide survey

PubMed Central

Sugai, Takuro; Suzuki, Yutaro; Yamazaki, Manabu; Shimoda, Kazutaka; Mori, Takao; Ozeki, Yuji; Matsuda, Hiroshi; Sugawara, Norio; Yasui-Furukori, Norio; Minami, Yoshitake; Okamoto, Kurefu; Sagae, Toyoaki; Someya, Toshiyuki

2015-01-01

Objectives To clarify the prevalence of underweight and overweight/obesity, and laboratory data for nutritional status in Japanese outpatients and inpatients with schizophrenia. Design Cross-sectional study. Setting A questionnaire conducted in inpatient and outpatient facilities in Japan. Participants The population of adult patients with schizophrenia in Japan (N=23 116). Main outcome measures The prevalence of underweight and undernutrition in Japanese inpatients and outpatients with schizophrenia. Results We conducted a large-scale investigation of the prevalence of underweight and undernutrition in 520 outpatient facilities and 247 inpatient facilities belonging to the Japan Psychiatric Hospitals Association between January 2012 and July 2013. There were 7655 outpatients and 15 461 inpatients with schizophrenia. There was a significant difference in the distribution of three body mass index levels between outpatients and inpatients (p<0.001). The proportion of underweight inpatients with schizophrenia was significantly higher than that among outpatients (p<0.001). Age-specific analysis revealed that the proportion of underweight individuals aged ≥40 years was higher in inpatients than in outpatients and in the general Japanese population. The proportion of individuals with hypocholesterolaemia was significantly higher in inpatients with schizophrenia than in outpatients (p<0.001). There was a significant difference in the severity of underweight between outpatients and inpatients with schizophrenia; the proportion of severe underweight in inpatients was twofold higher than in outpatients. Conclusions The prevalence of underweight and undernutrition in Japanese inpatients with schizophrenia was higher than in outpatients and the general population. Therefore, the physical risk of inpatients should be carefully considered in clinical practice. PMID:26656016

Postpartum depressive symptoms and maternal sensitivity: an exploration of possible social media-based measures.

PubMed

Dáu, Ana Luísa B T; Callinan, Laura S; Mayes, Linda C; Smith, Megan V

2017-02-01

This study examined the relationship between self-reported depressive symptoms, directly observed maternal sensitivity, and the content and themes of pictures posted on a mobile application. Data on 20 participants were analyzed. Results suggested that mothers' scoring as more intrusive on the maternal sensitivity scale tended to post a higher proportion of photos of themselves interacting with their babies. An association between higher levels of maternal depressive symptoms and a lower proportion of posts of baby smiling photos was also suggested.

Causal Effects of Single-Sex Schools on College Entrance Exams and College Attendance: Random Assignment in Seoul High Schools

PubMed Central

Park, Hyunjoon; Behrman, Jere R.; Choi, Jaesung

2012-01-01

Despite the voluminous literature on the potentials of single-sex schools, there is no consensus on the effects of single-sex schools because of student selection of school types. We exploit a unique feature of schooling in Seoul—the random assignment of students into single-sex versus coeducational high schools—to assess causal effects of single-sex schools on college entrance exam scores and college attendance. Our validation of the random assignment shows comparable socioeconomic backgrounds and prior academic achievement of students attending single-sex schools and coeducational schools, which increases the credibility of our causal estimates of single-sex school effects. The three-level hierarchical model shows that attending all-boys schools or all-girls schools, rather than coeducational schools, is significantly associated with higher average scores on Korean and English test scores. Applying the school district fixed-effects models, we find that single-sex schools produce a higher percentage of graduates who attended four-year colleges and a lower percentage of graduates who attended two-year junior colleges than do coeducational schools. The positive effects of single-sex schools remain substantial, even after we take into account various school-level variables, such as teacher quality, the student-teacher ratio, the proportion of students receiving lunch support, and whether the schools are public or private. PMID:23073751

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

PubMed

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

2011-09-01

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

Seasonal variability in size-segregated airborne bacterial particles and their characterization at different source-sites.

PubMed

Agarwal, Smita

2017-05-01

Size-segregated aerosol samplings were carried out near the potential sources of airborne biological particles i.e. at a landfill site, an agricultural field and a road side restaurant-cluster site in winter, spring and summer seasons during 2013-2015 in New Delhi. The culturable airborne bacterial (CAB) concentrations showed significant seasonal variation from higher to moderate in spring and winter seasons and lowest during summer. Highest CAB concentrations were observed at the Okhla landfill site followed by restaurant-cluster area and agriculture site. The CAB particles showed bimodal size distribution, abundant in the size ranges of 1.1-2.1, 2.1-3.3 and 4.7-5.8 μm. However, substantial concentrations were also observed in the size bins of 0.43-0.65 and <0.43 μm, which are important for cloud condensation nuclei (CCN) activity of aerosols in addition to their adverse health effects. In spring, bacterial particles were also maximized in size ranges between 5.8 and >9.0 μm. Fine mode proportions of CAB were found to be higher in winter than other two seasons. Bacterial identification was done by 16s rDNA sequencing, and most abundant identified strains were Bacillus cereus (16%), Bacillus licheniformis (11%), Bacillus thuringiensis (9%), Micrococcus sp. (7%) and Acinetobacter sp. (9%).

Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

PubMed

Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

2016-08-01

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

A financial ratio analysis of for-profit and non-profit rural referral centers.

PubMed

McCue, Michael J; Nayar, Preethy

2009-01-01

National financial data show that rural referral center (RRC) hospitals have performed well financially. RRC hospitals' median cash flow margin ratio was 10.04% in 2002 and grew to 11.04% in 2004. The aim of this study is to compare the ratio analysis of key operational and financial performance measures of for-profit RRCs to those of private, non-profit RRCs. To control for accounting aberrations within a given year, we selected RRCs that reported 3 consecutive fiscal years of Centers for Medicare and Medicaid Services (CMS) cost report data, starting with fiscal year 2004 and ending with fiscal year 2006. Given a limited sample size of 28 for-profit RRCs and 127 non-profits, we used the non-parametric median test to assess median differences in operational and key financial measures between the 2 groups. For-profit RRCs treated less complex cases and reported fewer discharges per bed and fewer occupied beds than did non-profits. However, for-profit RRCs staffed their beds with fewer full-time-equivalent (FTE) personnel and served a higher proportion of Medicaid patients. For-profit RRCs generated operating cash flow margins in excess of 19%, compared to only 8.1% for non-profits, and maintained newer plant and equipment. For-profit RRCs generated a substantially higher cash flow margin by controlling their operating costs.

High statistical heterogeneity is more frequent in meta-analysis of continuous than binary outcomes.

PubMed

Alba, Ana C; Alexander, Paul E; Chang, Joanne; MacIsaac, John; DeFry, Samantha; Guyatt, Gordon H

2016-02-01

We compared the distribution of heterogeneity in meta-analyses of binary and continuous outcomes. We searched citations in MEDLINE and Cochrane databases for meta-analyses of randomized trials published in 2012 that reported a measure of heterogeneity of either binary or continuous outcomes. Two reviewers independently performed eligibility screening and data abstraction. We evaluated the distribution of I(2) in meta-analyses of binary and continuous outcomes and explored hypotheses explaining the difference in distributions. After full-text screening, we selected 671 meta-analyses evaluating 557 binary and 352 continuous outcomes. Heterogeneity as assessed by I(2) proved higher in continuous than in binary outcomes: the proportion of continuous and binary outcomes reporting an I(2) of 0% was 34% vs. 52%, respectively, and reporting an I(2) of 60-100% was 39% vs. 14%. In continuous but not binary outcomes, I(2) increased with larger number of studies included in a meta-analysis. Increased precision and sample size do not explain the larger I(2) found in meta-analyses of continuous outcomes with a larger number of studies. Meta-analyses evaluating continuous outcomes showed substantially higher I(2) than meta-analyses of binary outcomes. Results suggest differing standards for interpreting I(2) in continuous vs. binary outcomes may be appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

Personality Traits of Suicidality Are Associated with Premenstrual Syndrome and Premenstrual Dysphoric Disorder in a Suicidal Women Sample.

PubMed

Ducasse, Déborah; Jaussent, Isabelle; Olié, Emilie; Guillaume, Sébastien; Lopez-Castroman, Jorge; Courtet, Philippe

2016-01-01

Both Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) might increase the risk of suicidal behavior. The aim of this study was to assess the relationship between personality dimensions specifically involved in suicidal vulnerability and PMS/PMDD. We collected data from 232 women consecutively hospitalized after a suicide attempt. We examined the relationship between impulsivity, aggressiveness/hostility, hopelessness, trait anger, affect intensity, emotional lability, and PMS/PMDD. Notably, we created an algorithm from the shortened Premenstrual Assessment form in order to assess PMDD status. The proportions of PMS and PMDD among female suicide attempters were 50% and 23% respectively. Women with PMS or PMDD were more likely to endorse most of these personality traits to than those without even after controlling for potential confounders. We found an impulsive-aggressive pattern of personality in women with PMS or PMDD, independently from the time of the menstrual cycle. Interestingly, trait anger remained associated with both PMS and PMDD independently of every other personality traits. The higher the anger level, the higher the risk was to suffer from both PMS and PMDD. This study demonstrates a strong, independent association between PMS/PMDD and trait anger among a representative sample of female suicide attempters. It is of major interest for clinicians in view of addressing a substantial public health problem among women of reproductive age.

Personality Traits of Suicidality Are Associated with Premenstrual Syndrome and Premenstrual Dysphoric Disorder in a Suicidal Women Sample

PubMed Central

Ducasse, Déborah; Jaussent, Isabelle; Olié, Emilie; Guillaume, Sébastien; Lopez-Castroman, Jorge; Courtet, Philippe

2016-01-01

Objective Both Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) might increase the risk of suicidal behavior. The aim of this study was to assess the relationship between personality dimensions specifically involved in suicidal vulnerability and PMS/PMDD. Method We collected data from 232 women consecutively hospitalized after a suicide attempt. We examined the relationship between impulsivity, aggressiveness/hostility, hopelessness, trait anger, affect intensity, emotional lability, and PMS/PMDD. Notably, we created an algorithm from the shortened Premenstrual Assessment form in order to assess PMDD status. Results The proportions of PMS and PMDD among female suicide attempters were 50% and 23% respectively. Women with PMS or PMDD were more likely to endorse most of these personality traits to than those without even after controlling for potential confounders. We found an impulsive-aggressive pattern of personality in women with PMS or PMDD, independently from the time of the menstrual cycle. Interestingly, trait anger remained associated with both PMS and PMDD independently of every other personality traits. The higher the anger level, the higher the risk was to suffer from both PMS and PMDD. Conclusions This study demonstrates a strong, independent association between PMS/PMDD and trait anger among a representative sample of female suicide attempters. It is of major interest for clinicians in view of addressing a substantial public health problem among women of reproductive age. PMID:26863007

Trends in the Inactive Kidney Transplant Waitlist and Implications for Candidate Survival

PubMed Central

Grams, Morgan E.; Massie, Allan B.; Schold, Jesse D.; Chen, B. Po-Han; Segev, Dorry L.

2014-01-01

In November 2003, OPTN policy was amended to allow kidney transplant (KT) candidates to accrue waiting time while registered as status 7, or inactive. We evaluated trends in inactive listings and the association of inactive status with transplantation and survival, studying 262,824 adult first-time KT candidates listed between 2000–2011. The proportion of waitlist candidates initially listed as inactive increased from 2.3% pre-policy change to 31.4% in 2011. Candidates initially listed as inactive were older, more often female, African-American, and with higher body mass index. Post-policy change, conversion from initially inactive to active status generally occurred early if at all: at one year after listing, 52.7% of initially inactive candidates had been activated; at 3 years, only 66.3% had been activated. Inactive status was associated with a substantially higher waitlist mortality (aHR 2.21, 95%CI:2.15–2.28, p<0.001) and lower rates of eventual transplantation (aRR 0.68, 95%CI:0.67–0.70, p<0.001). In summary, waitlist practice has changed significantly since November 2003, with a sharp increase in the number of inactive candidates. Using the full waitlist to estimate organ shortage or as a comparison group in transplant outcome studies is less appropriate in the current era. PMID:23399028