User acceptance of observation and response charts with a track and trigger system: a multisite staff survey.

PubMed

Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

2016-08-01

To examine user acceptance with a new format of charts for recording observations and as a prompt for responding to episodes of clinical deterioration in adult medical-surgical patients. Improving recognition and response to clinical deterioration remains a challenge for acute healthcare institutions globally. Five chart templates were developed in Australia, combining human factors design principles with a track and trigger system for escalation of care. Two chart templates were previously tested in simulations, but none had been evaluated in clinical practice. Prospective multisite survey of user acceptance of the charts in practice. New observation and response charts were trialled in parallel with existing charts for 24 hours across 36 adult acute medical-surgical wards, covering 108 shifts, in five Australian states. Surveys were completed by 477 staff respondents, with open-ended comments and narrative from short informal feedback groups providing elaboration and context of user experiences. Respondents were broadly supportive of the chart format and content for monitoring patients, and as a prompt for escalating care. Some concerns were noted for chart size and style, use of ranges to graph vital signs and with specific human factors design features. Information and training issues were identified to improve usability and adherence to chart guidelines and to support improved detection and response for patients with clinical deterioration. This initial evaluation demonstrated that the charts were perceived as appropriate for documenting observations and as a prompt to detect clinical deterioration. Further evaluation after some minor modifications to the chart is recommended. Explicit training on the principles and rationale of human factors chart design, use of embedded change management strategies and addressing practical issues will improve authentic engagement, staff acceptance and adoption by all clinical users when implementing a similar observation and response chart into practice. © 2016 John Wiley & Sons Ltd.

Prospective surveillance pilot of rivaroxaban safety within the US Food and Drug Administration Sentinel System.

PubMed

Chrischilles, Elizabeth A; Gagne, Joshua J; Fireman, Bruce; Nelson, Jennifer; Toh, Sengwee; Shoaibi, Azadeh; Reichman, Marsha E; Wang, Shirley; Nguyen, Michael; Zhang, Rongmei; Izem, Rima; Goulding, Margie R; Southworth, Mary Ross; Graham, David J; Fuller, Candace; Katcoff, Hannah; Woodworth, Tiffany; Rogers, Catherine; Saliga, Ryan; Lin, Nancy D; McMahill-Walraven, Cheryl N; Nair, Vinit P; Haynes, Kevin; Carnahan, Ryan M

2018-03-01

The US Food and Drug Administration's Sentinel system developed tools for sequential surveillance. In patients with non-valvular atrial fibrillation, we sequentially compared outcomes for new users of rivaroxaban versus warfarin, employing propensity score matching and Cox regression. A total of 36 173 rivaroxaban and 79 520 warfarin initiators were variable-ratio matched within 2 monitoring periods. Statistically significant signals were observed for ischemic stroke (IS) (first period) and intracranial hemorrhage (ICH) (second period) favoring rivaroxaban, and gastrointestinal bleeding (GIB) (second period) favoring warfarin. In follow-up analyses using primary position diagnoses from inpatient encounters for increased definition specificity, the hazard ratios (HR) for rivaroxaban vs warfarin new users were 0.61 (0.47, 0.79) for IS, 1.47 (1.29, 1.67) for GIB, and 0.71 (0.50, 1.01) for ICH. For GIB, the HR varied by age: <66 HR = 0.88 (0.60, 1.30) and 66+ HR = 1.49 (1.30, 1.71). This study demonstrates the capability of Sentinel to conduct prospective safety monitoring and raises no new concerns about rivaroxaban safety. Copyright © 2018 John Wiley & Sons, Ltd.

Examining the ethical and social issues of health technology design through the public appraisal of prospective scenarios: a study protocol describing a multimedia-based deliberative method

PubMed Central

2014-01-01

Background The design of health technologies relies on assumptions that affect how they will be implemented, such as intended use, complexity, impact on user autonomy, and appropriateness. Those who design and implement technologies make several ethical and social assumptions on behalf of users and society more broadly, but there are very few tools to examine prospectively whether such assumptions are warranted and how the public define and appraise the desirability of health innovations. This study protocol describes a three-year study that relies on a multimedia-based prospective method to support public deliberations that will enable a critical examination of the social and ethical issues of health technology design. Methods The first two steps of our mixed-method study were completed: relying on a literature review and the support of our multidisciplinary expert committee, we developed scenarios depicting social and technical changes that could unfold in three thematic areas within a 25-year timeframe; and for each thematic area, we created video clips to illustrate prospective technologies and short stories to describe their associated dilemmas. Using this multimedia material, we will: conduct four face-to-face deliberative workshops with members of the public (n = 40) who will later join additional participants (n = 25) through an asynchronous online forum; and analyze and integrate three data sources: observation, group deliberations, and a self-administered participant survey. Discussion This study protocol will be of interest to those who design and assess public involvement initiatives and to those who examine the implementation of health innovations. Our premise is that using user-friendly tools in a deliberative context that foster participants’ creativity and reflexivity in pondering potential technoscientific futures will enable our team to analyze a range of normative claims, including some that may prove problematic and others that may shed light over potentially more valuable design options. This research will help fill an important knowledge gap; intervening earlier in technological development could help reduce undesirable effects and inform the design and implementation of more appropriate innovations. PMID:24952582

Examining the ethical and social issues of health technology design through the public appraisal of prospective scenarios: a study protocol describing a multimedia-based deliberative method.

PubMed

Lehoux, Pascale; Gauthier, Philippe; Williams-Jones, Bryn; Miller, Fiona A; Fishman, Jennifer R; Hivon, Myriam; Vachon, Patrick

2014-06-21

The design of health technologies relies on assumptions that affect how they will be implemented, such as intended use, complexity, impact on user autonomy, and appropriateness. Those who design and implement technologies make several ethical and social assumptions on behalf of users and society more broadly, but there are very few tools to examine prospectively whether such assumptions are warranted and how the public define and appraise the desirability of health innovations. This study protocol describes a three-year study that relies on a multimedia-based prospective method to support public deliberations that will enable a critical examination of the social and ethical issues of health technology design. The first two steps of our mixed-method study were completed: relying on a literature review and the support of our multidisciplinary expert committee, we developed scenarios depicting social and technical changes that could unfold in three thematic areas within a 25-year timeframe; and for each thematic area, we created video clips to illustrate prospective technologies and short stories to describe their associated dilemmas. Using this multimedia material, we will: conduct four face-to-face deliberative workshops with members of the public (n=40) who will later join additional participants (n=25) through an asynchronous online forum; and analyze and integrate three data sources: observation, group deliberations, and a self-administered participant survey. This study protocol will be of interest to those who design and assess public involvement initiatives and to those who examine the implementation of health innovations. Our premise is that using user-friendly tools in a deliberative context that foster participants' creativity and reflexivity in pondering potential technoscientific futures will enable our team to analyze a range of normative claims, including some that may prove problematic and others that may shed light over potentially more valuable design options. This research will help fill an important knowledge gap; intervening earlier in technological development could help reduce undesirable effects and inform the design and implementation of more appropriate innovations.

Metabolic effects of the contraceptive skin patch and subdermal contraceptive implant in Mexican women: A prospective study

PubMed Central

2014-01-01

Background The contraceptive skin patch (CSP) accepted by the U.S. FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is also approved by the FDA. In Mexico, both are now widely used for contraception but their effects on Mexican population are unknown. The objective of the study was to evaluate if these treatments induce metabolic changes in a sample of indigenous and mestizo Mexican women. Methods An observational, prospective, longitudinal, non-randomized study of women between 18 and 35 years of age assigned to CSP or SCI. We performed several laboratory tests: clinical chemistry, lipid profile, and liver and thyroid function tests. Also, serum levels of insulin, C-peptide, IGF-1, leptin, adiponectin, and C reactive protein were assayed. Results Sixty-two women were enrolled, 25 used CSP (0 indigenous; 25 mestizos) and 37 used SCI (18 indigenous; 19 mestizos). Clinical symptoms were relatively more frequent in the SCI group. Thirty-four contraceptive users gained weight without other clinical significant changes. After 4 months of treatment, significant changes were found in some biochemical parameters in both treatment groups. Most were clinically irrelevant. Interestingly, the percentage of users with an abnormal atherogenic index diminished from 75% to 41.6% after follow-up. Conclusions The CSP slightly modified the metabolic variables. Most changes were nonsignificant, whereas for SCI users changes were more evident and perhaps beneficial. Results of this attempt to evaluate the effects of contraceptives in mestizo and native-American populations show that clinical symptoms are frequent in Mexican users of CSP and SCI. Although these medications may affect some metabolic variables, these changes seem clinically irrelevant. Induction of abnormalities in other physiological pathways cannot be ruled out. PMID:24767248

Prospective memory, everyday cognitive failure and central executive function in recreational users of Ecstasy.

PubMed

Heffernan, T. M.; Jarvis, H.; Rodgers, J.; Scholey, A. B.; Ling, J.

2001-12-01

Chronic use of MDMA (3,4-methylenedioxymethamphetamine), or Ecstasy, is believed to lead to impaired psychological performance, including well-documented decrements in laboratory and field tests of retrospective memory. Less is known about the impact of Ecstasy on aspects of 'everyday' memory, despite obvious concerns about such effects. The three studies reported here focused on the impact of chronic Ecstasy use on prospective memory (PM), associated central executive function and other aspects of day-to-day cognition. In study 1 46 regular Ecstasy users were compared with 46 Ecstasy-free controls using the Prospective Memory Questionnaire (PMQ). Ecstasy users reported significantly more errors in PM (remembering to do something in the future); these findings persisted after controlling for other drug use and the number of strategies used to aid memory. No difference was found between representative subgroups on the Lies Scale of the Eysenck Personality Questionnaire. In study 2 a different group of 30 regular Ecstasy users and 37 Ecstasy-free controls was assessed on the PMQ and on a central executive task comprising verbal fluency measures. The results confirmed the significant impairments in long- and short-term PM and revealed corresponding impairments in verbal fluency. In study 3 15 Ecstasy users, 15 cannabis users and 15 non-drug users were assessed using the Cognitive Failures Questionnaire, which requires participants to provide ratings of the frequency of various day-to-day cognitive slips. The results indicate that the Ecstasy users did not perceive their general cognitive performance to be worse than that of controls. Taken together, these results suggest that Ecstasy users have impaired PM that cannot be explained by an increased propensity to exaggerate cognitive failures. These may be attributable, in part, to central executive deficits that are due to frontal lobe damage associated with Ecstasy use. Copyright 2001 John Wiley & Sons, Ltd.

Prospective Memory Deficits in Ecstasy Users: Effects of Longer Ongoing Task Delay Interval

PubMed Central

WEINBORN, MICHAEL; WOODS, STEVEN PAUL; NULSEN, CLAIRE; PARK, KATHERINE

2011-01-01

Ecstasy use has been associated with neurotoxicity and neurocognitive impairment in a variety of domains, including prospective memory (ProM), which involves the delayed execution of a previously encoded intention in response to a specific cue. The present study adopted the multiprocess theory of ProM to evaluate the hypothesis that ecstasy users would evidence differentially impaired ProM on longer versus shorter ongoing task delays. Ecstasy (n = 31) users, high-risk alcohol users (n = 21) and healthy nonusers (n = 31) completed the short (2-min) and long (15-min) delay ProM scales of the Memory for Intentions Screening Test. Results showed a significant group by ProM delay interaction, such that ecstasy users performed comparably to the comparison groups on short-delay trials, but were impaired on long-delay ProM, particularly for time-based cues. Among the ecstasy users, long-delay ProM was positively associated with risky decision-making, but not with retrospective memory or other aspects of executive functions. These findings suggest that ecstasy users may be particularly susceptible to deficits in strategic target monitoring and maintenance of cue-intention pairings over longer ProM delays. Findings are discussed in the context of their potential everyday functioning (e.g., academic, vocational) and treatment implications for ecstasy users. PMID:22047194

Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP): Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women.

PubMed

Modi, Ankita; Ebeling, Peter R; Lee, Mel S; Min, Yong-Ki; Mithal, Ambrish; Yang, Xiaoqin; Sajjan, Shiva

2015-12-01

The burden of osteoporosis in the Asia-Pacific region is not well characterized. The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP) was designed to better understand the association of gastrointestinal events with patient-reported outcomes in postmenopausal women of this region. MUSIC OS-AP is a prospective, multinational, observational cohort study of postmenopausal women ≥ 50 years of age diagnosed with osteoporosis. The study was conducted in five Asia-Pacific countries: Australia, New Zealand, Taiwan, Korea, and India. MUSIC OS-AP has three components: a physician questionnaire, a retrospective chart review, and a prospective cohort study. The physician questionnaire investigated the role of gastrointestinal events in physicians' pharmacologic management of osteoporosis. The retrospective chart review, also completed by physicians, recorded rate of osteoporosis treatment and the types of osteoporosis medications prescribed to osteoporosis patients. The prospective cohort study investigated the associations between gastrointestinal events and patient-reported outcomes among patients taking oral medications for osteoporosis as well as reasons for non-treatment in patients who remained untreated. The prospective cohort study enrolled two groups of patients: untreated, and treated with oral osteoporosis medications. Untreated patients completed only the baseline surveys, providing information on gastrointestinal event rates, quality of life, health care resource use, and reasons for non-treatment. Treated patients, who were either new to osteoporosis medication or continuing an ongoing medication course, completed surveys at baseline and 3, 6, and 12 months post-baseline. The evaluations recorded patient characteristics, gastrointestinal events, health-related and osteoporosis-specific quality of life, health care resource use, medication adherence, and satisfaction with treatment. Physicians at 59 sites completed the physician questionnaire, and data for 300 patients from 26 sites were abstracted for the retrospective chart review. Enrollment and baseline data collection for the prospective cohort study were conducted between July 2013 and August 2014 for 301 untreated and 3287 treated patients, of whom 1416 were new users and 1871 were experienced users of oral osteoporosis medications. The results of MUSIC OS-AP will highlight the association of gastrointestinal events with patient-reported outcomes among postmenopausal women with osteoporosis and elucidate physicians' management of gastrointestinal events among this patient population in the Asia-Pacific region.

Verbal learning and memory in adolescent cannabis users, alcohol users and non-users.

PubMed

Solowij, Nadia; Jones, Katy A; Rozman, Megan E; Davis, Sasha M; Ciarrochi, Joseph; Heaven, Patrick C L; Lubman, Dan I; Yücel, Murat

2011-07-01

Long-term heavy cannabis use can result in memory impairment. Adolescent users may be especially vulnerable to the adverse neurocognitive effects of cannabis. In a cross-sectional and prospective neuropsychological study of 181 adolescents aged 16-20 (mean 18.3 years), we compared performance indices from one of the most widely used measures of learning and memory--the Rey Auditory Verbal Learning Test--between cannabis users (n=52; mean 2.4 years of use, 14 days/month, median abstinence 20.3 h), alcohol users (n=67) and non-user controls (n=62) matched for age, education and premorbid intellectual ability (assessed prospectively), and alcohol consumption for cannabis and alcohol users. Cannabis users performed significantly worse than alcohol users and non-users on all performance indices. They recalled significantly fewer words overall (p<0.001), demonstrating impaired learning (p<0.001), retention (p<0.001) and retrieval (p<0.05) (Cohen's d 0.43-0.84). The degree of impairment was associated with the duration, quantity, frequency and age of onset of cannabis use, but was unrelated to alcohol exposure or other drug use. No gender effects were detected and the findings remained after controlling for premorbid intellectual ability. An earlier age of onset of regular cannabis use was associated with worse memory performance after controlling for extent of exposure to cannabis. Despite relatively brief exposure, adolescent cannabis users relative to their age-matched counterparts demonstrated similar memory deficits to those reported in adult long-term heavy users. The results indicate that cannabis adversely affects the developing brain and reinforce concerns regarding the impact of early exposure.

15 CFR Supplement No. 8 to Part 748 - Information Required in Requests for Validated End-User (Veu) Authorization

Code of Federal Regulations, 2010 CFR

2010-01-01

... overview of any business activity or corporate relationship that the entity has with either government or... structure, ownership and business of the prospective validated end-user. Include a description of the entity...-site reviews by U.S. Government officials to verify the end-user's compliance with the conditions of...

Mileage-Based User Fees : Prospects and Challenges

DOT National Transportation Integrated Search

2012-06-01

This report reviews the current research regarding mileage-based user fees for vehicle travel (MBUF), possibly as a replacement or supplement to fuel taxes, which is currently the primary source of transportation revenues in New York State and the na...

First results concerning the safety, walking, and satisfaction with an innovative, microprocessor-controlled four-axes prosthetic foot.

PubMed

Hahn, Andreas; Sreckovic, Ivana; Reiter, Sebastian; Mileusnic, Milana

2018-06-01

The microprocessor-controlled foot Meridium is a prosthetic component with adjustable stance-phase characteristics. To investigate subjects' and prosthetists' perception of safety, walking, and satisfaction during first routine fittings. Multicenter, prospective, observational cohort study. Data regarding demographics, fitting process, safety, daily life activities, and satisfaction were obtained through questionnaires. The follow-up period was 7 months. In all, 89% of 70 users were satisfactorily fitted within the first two visits. Compared to previous feet, users reported improvements in walking on level ground (54% of subjects), uneven ground (82%), ascending (97%), and descending ramps (91%). More than 45% of the users perceived an improvement in safety and stability while standing and walking. No difference was observed in concentration, exertion, and pain. Overall user satisfaction with Meridium was 50% and the foot was preferred by 40% of users. Amputation level, age and mobility grade did not influence subjects' preference. Prosthetists recommended Meridium for 59% of subjects. A correlation analysis revealed that transfemoral amputees fitted with Genium and/or having a long residual limb strongly preferred Meridium ( p < 0.05). Meridium was appreciated by amputees with a preference for natural walking and requirement to safely and comfortably negotiate uneven terrain and slopes. Clinical relevance Amputees preferring Meridium perceive benefits with safe, comfortable, and natural walking. While the perception of benefits regarding the negotiation of uneven terrain and slopes is very high, the correlation to product preference is moderate. Individual assessment and trial fitting might be essential to identify patients who benefit greatly.

Clinical information transfer and data capture in the acute myocardial infarction pathway: an observational study.

PubMed

Kesavan, Sujatha; Kelay, Tanika; Collins, Ruth E; Cox, Benita; Bello, Fernando; Kneebone, Roger L; Sevdalis, Nick

2013-10-01

Acute myocardial infarctions (MIs) or heart attacks are the result of a complete or an incomplete occlusion of the lumen of the coronary artery with a thrombus. Prompt diagnosis and early coronary intervention results in maximum myocardial salvage, hence time to treat is of the essence. Adequate, accurate and complete information is vital during the early stages of admission of an MI patient and can impact significantly on the quality and safety of patient care. This study aimed to record how clinical information between different clinical teams during the journey of a patient in the MI care pathway is captured and to review the flow of information within this care pathway. A prospective, descriptive, structured observational study to assess (i) current clinical information systems (CIS) utilization and (ii) real-time information availability within an acute cardiac care setting was carried out. Completeness and availability of patient information capture across four key stages of the MI care pathway were assessed prospectively. Thirteen separate information systems were utilized during the four phases of the MI pathway. Observations revealed fragmented CIS utilization, with users accessing an average of six systems to gain a complete set of patient information. Data capture was found to vary between each pathway stage and in both patient cohort risk groupings. The highest level of information completeness (100%) was observed only in the discharge stage of the MI care pathway. The lowest level of information completeness (58%) was observed in the admission stage. The study highlights fragmentation, CIS duplication, and discrepancies in the current clinical information capture and data transfer across the MI care pathway in an acute cardiac care setting. The development of an integrated and user-friendly electronic data capture and transfer system would reduce duplication and would facilitate efficient and complete information provision at the point of care. © 2012 John Wiley & Sons Ltd.

Statin use and incident frailty in women aged 65 years or older: prospective findings from the Women's Health Initiative Observational Study.

PubMed

LaCroix, Andrea Z; Gray, Shelly L; Aragaki, Aaron; Cochrane, Barbara B; Newman, Anne B; Kooperberg, Charles L; Black, Henry; Curb, J David; Greenland, Philip; Woods, Nancy F

2008-04-01

Inflammatory biomarkers have shown consistent associations with disability and frailty in older adults. Statin medications may reduce the incidence the frailty because of their anti-inflammatory effects. This study examines associations between current use, duration, and potency of statin medications and incident frailty in initially nonfrail women 65 years old or older. The authors conducted a prospective analysis of data from the Women's Health Initiative Observational Study (WHI-OS) conducted at 40 clinical centers in the United States. Eligible women were nonfrail and 65-79 years old at baseline (n = 25,378). Current statin use at baseline was ascertained through direct inspection of medicine containers during clinic visits. Frailty was ascertained through self-reported indicators and physical measurements at baseline and 3-year clinic contacts. Components of frailty included self-reported low physical function, exhaustion, low physical activity, and unintended weight loss. Multinomial logistic regression models were used to adjust for covariates predicting incident frailty. Among the 25,378 eligible women, 3453 (13.6%) developed frailty by the 3-year follow-up contact. Current statin use had no association with incident frailty (multivariate-adjusted odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.85-1.16). Duration and potency of statin use were also not significantly associated with incident frailty. Among low potency statin users, longer duration of use was associated with reduced risk of frailty (p for trend =.02). A similar pattern of results was observed when frailty was studied in the absence of intervening, incident cardiovascular events. Overall, incidence of frailty was similar in current statin users and nonusers.

Estimation of toll road users value of time

DOT National Transportation Integrated Search

2008-02-01

This research examines a new methodology for prospectively estimating the willingness of travelers to use a toll road by combining travel time saved with the income of the prospective customer base. The purpose of the research is to facilitate networ...

Effects of prospective-user factors and sign design features on guessability of pharmaceutical pictograms.

PubMed

Chan, Alan H S; Chan, Ken W L

2013-02-01

To examine the associations between the guessing performance of 25 pharmaceutical pictograms and five sign features for naïve participants. The effect of prospective-user factors on guessing performance was also investigated. A total of 160 Hong Kong Chinese people, drawn largely from a young student population, guessed the meanings of 25 pharmaceutical pictograms that were generally not familiar to them. Participants then completed a questionnaire about their drug buying and drug label reading habits, and their demographics and medication history. Finally they rated five features (familiarity, concreteness, complexity, meaningfulness, and semantic distance) of the pharmaceutical pictograms using 0-100 scales. For all pharmaceutical pictograms, mean and standard deviation of guessability score were 64.8 and 17.1, respectively. Prospective-user factors of 'occupation', 'age' and 'education level' significantly affected guessing performance. For sign features, semantic closeness was the best predictor of guessability score, followed by simplicity, concreteness, meaningfulness and familiarity. User characteristics and sign features are critical for pharmaceutical pictograms. To be effective, pharmaceutical pictograms should have obvious and direct connections with familiar things and it is recommended that pharmaceutical pictograms should be designed with consideration of the five sign features investigated here. This study provides useful information and recommendations to assist interface designers to create and evaluate icons for pharmaceutical products and to design more user-friendly pharmaceutical pictograms. However, further work is needed to see how older people respond to such pharmaceutical pictograms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Smart learning services based on smart cloud computing.

PubMed

Kim, Svetlana; Song, Su-Mi; Yoon, Yong-Ik

2011-01-01

Context-aware technologies can make e-learning services smarter and more efficient since context-aware services are based on the user's behavior. To add those technologies into existing e-learning services, a service architecture model is needed to transform the existing e-learning environment, which is situation-aware, into the environment that understands context as well. The context-awareness in e-learning may include the awareness of user profile and terminal context. In this paper, we propose a new notion of service that provides context-awareness to smart learning content in a cloud computing environment. We suggest the elastic four smarts (E4S)--smart pull, smart prospect, smart content, and smart push--concept to the cloud services so smart learning services are possible. The E4S focuses on meeting the users' needs by collecting and analyzing users' behavior, prospecting future services, building corresponding contents, and delivering the contents through cloud computing environment. Users' behavior can be collected through mobile devices such as smart phones that have built-in sensors. As results, the proposed smart e-learning model in cloud computing environment provides personalized and customized learning services to its users.

Modulating the neural bases of persuasion: why/how, gain/loss, and users/non-users

PubMed Central

Katzman, Perri L.; Ames, Daniel L.; Falk, Emily B.; Lieberman, Matthew D.

2017-01-01

Abstract Designing persuasive content is challenging, in part because people can be poor predictors of their actions. Medial prefrontal cortex (MPFC) activation during message exposure reliably predicts downstream behavior, but past work has been largely atheoretical. We replicated past results on this relationship and tested two additional framing effects known to alter message receptivity. First, we examined gain- vs. loss-framed reasons for a health behavior (sunscreen use). Consistent with predictions from prospect theory, we observed greater MPFC activity to gain- vs. loss-framed messages, and this activity was associated with behavior. This relationship was stronger for those who were not previously sunscreen users. Second, building on theories of action planning, we compared neural activity during messages regarding how vs. why to enact the behavior. We observed rostral inferior parietal lobule and posterior inferior frontal gyrus activity during action planning (“how” messages), and this activity was associated with behavior; this is in contrast to the relationship between MPFC activity during the “why” (i.e., gain and loss) messages and behavior. These results reinforce that persuasion occurs in part via self-value integration—seeing value and incorporating persuasive messages into one's self-concept—and extend this work to demonstrate how message framing and action planning may influence this process. PMID:27521303

Improving Institutional Report Card Indicators

ERIC Educational Resources Information Center

McGowan, Veronica

2016-01-01

Institutional report cards are increasingly being used by higher educational institutions to present academic outcomes to external audiences of prospective students and parents, as well as program and institutional evaluators. While some prospective students are served by national transparency measures most users mine information from the…

Review of modern biometric user authentication and their development prospects

NASA Astrophysics Data System (ADS)

Boriev, Z. V.; Sokolov, S. S.; Nyrkov, A. P.

2015-09-01

This article discusses the possibility of using biometric information technologies in management. Made a brief overview of access control and time attendance. Analyzed biometrics and identification system user. Recommendations on the use of various systems depending on the specific tasks.

A pilot study of loss aversion for drug and non-drug commodities in cocaine users.

PubMed

Strickland, Justin C; Beckmann, Joshua S; Rush, Craig R; Stoops, William W

2017-11-01

Numerous studies in behavioral economics have demonstrated that individuals are more sensitive to the prospect of a loss than a gain (i.e., loss aversion). Although loss aversion has been well described in "healthy" populations, little research exists in individuals with substance use disorders. This gap is notable considering the prominent role that choice and decision-making play in drug use. The purpose of this pilot study was to evaluate loss aversion in active cocaine users. Current cocaine users (N=38; 42% female) participated in this within-subjects laboratory pilot study. Subjects completed a battery of tasks designed to assess loss aversion for drug and non-drug commodities under varying risk conditions. Standardized loss aversion coefficients (λ) were compared to theoretically and empirically relevant normative values (i.e., λ=2). Compared to normative loss aversion coefficient values, a precise and consistent decrease in loss aversion was observed in cocaine users (sample λ≈1). These values were observed across drug and non-drug commodities as well as under certain and risky conditions. These data represent the first systematic study of loss aversion in cocaine-using populations and provide evidence for equal sensitivity to losses and gains or loss equivalence. Futures studies should evaluate the specificity of these effects to a history of cocaine use as well as the impact of manipulations of loss aversion on drug use to determine how this phenomenon may contribute to intervention development efforts. Copyright © 2017 Elsevier B.V. All rights reserved.

Postmenopausal hormone therapy and changes in mammographic density.

PubMed

van Duijnhoven, Fränzel J B; Peeters, Petra H M; Warren, Ruth M L; Bingham, Sheila A; van Noord, Paulus A H; Monninkhof, Evelyn M; Grobbee, Diederick E; van Gils, Carla H

2007-04-10

Hormone therapy (HT) use has been associated with an increased breast cancer risk. We explored the underlying mechanism further by determining the effects of HT on mammographic density, a measure of dense tissue in the breast and a consistent breast cancer risk factor. A total of 620 HT users and 620 never users from the Dutch Prospect-European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and 175 HT users and 161 never users from the United Kingdom EPIC-Norfolk cohort were included. For HT users, one mammogram before and one mammogram during HT use was included. For never users, mammograms with similar time intervals were included. Mammographic density was assessed using a computer-assisted method. Changes in density were analyzed using linear regression. The median time between mammograms was 3.0 years and the median duration of HT use was 1 year. The absolute mean decline in percent density was larger in never users (7.3%) than in estrogen therapy users (6.4%; P = .22) and combined HT users (3.5%; P < .01). The effect of HT appeared to be high in a small number of women, whereas most women were unaffected. Our results suggest that HT use, and especially estrogen and progestin use, slows the changes from dense patterns to more fatty patterns that are normally seen in women with increasing age. Given that it is postulated that lifetime cumulative exposure to high density may be related to breast cancer risk, a delay in density decline in HT users potentially could explain their increased breast cancer risk.

Human Resources Planning for Office Automation.

ERIC Educational Resources Information Center

Munoz, Judith T.

1985-01-01

Examination of the transition to automated offices revealed that the prospect can be anxiety-producing for potential users, most users did not receive adequate training, lack of training may cause equipment underutilization, administrators are often not prepared to manage the change, and most experienced job satisfaction after automation. (MSE)

High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators.

PubMed

Forslund, Emelie Butler; Jørgensen, Vivien; Franzén, Erika; Opheim, Arve; Seiger, Åke; Ståhle, Agneta; Hultling, Claes; Stanghelle, Johan K; Roaldsen, Kirsti Skavberg; Wahman, Kerstin

2017-01-31

To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury. Prospective multi-centre study. One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway. Inclusion criteria: wheelchair users ≥ 18 years old with traumatic spinal cord injury ≥ 1 year post-injury. individuals with motor complete injuries above C5. Falls were prospectively reported by text message every second week for one year and were followed-up by telephone interviews. Outcomes were: fall incidence, risk indicators for recurrent (> 2) falls and fall-related injuries. Independent variables were: demographic data, quality of life, risk willingness, functional independence, and exercise habits. Of the total sample (n = 149), 96 (64%) participants fell, 45 (32%) fell recurrently, 50 (34%) were injured, and 7 (5%) severely injured. Multivariate logistic regression analysis showed that reporting recurrent falls the previous year increased the odds ratio (OR) of recurrent falls (OR 10.2, p < 0.001). Higher quality of life reduced the OR of fall-related injuries (OR 0.86, p = 0.037). Previous recurrent falls was a strong predictor of future falls. The incidence of falls, recurrent falls and fall-related injuries was high. Hence, prevention of falls and fall-related injuries is important.

Mobile phone use and risk of brain neoplasms and other cancers: prospective study.

PubMed

Benson, Victoria S; Pirie, Kirstin; Schüz, Joachim; Reeves, Gillian K; Beral, Valerie; Green, Jane

2013-06-01

Results from some retrospective studies suggest a possible increased risk of glioma and acoustic neuroma in users of mobile phones. The relation between mobile phone use and incidence of intracranial central nervous system (CNS) tumours and other cancers was examined in 791,710 middle-aged women in a UK prospective cohort, the Million Women Study. Cox regression models were used to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs). Women reported mobile phone use in 1999 to 2005 and again in 2009. During 7 years' follow-up, 51,680 incident invasive cancers and 1,261 incident intracranial CNS tumours occurred. Risk among ever vs never users of mobile phones was not increased for all intracranial CNS tumours (RR = 1.01, 95% CI = 0.90-1.14, P = 0.82), for specified CNS tumour types nor for cancer at 18 other specified sites. For long-term users compared with never users, there was no appreciable association for glioma (10+ years: RR = 0.78, 95% CI = 0.55-1.10, P = 0.16) or meningioma (10+ years: RR = 1.10, 95% CI = 0.66-1.84, P = 0.71). For acoustic neuroma, there was an increase in risk with long term use vs never use (10+ years: RR = 2.46, 95% CI = 1.07-5.64, P = 0.03), the risk increasing with duration of use (trend among users, P = 0.03). In this large prospective study, mobile phone use was not associated with increased incidence of glioma, meningioma or non-CNS cancers.

Presence for design: conveying atmosphere through video collages.

PubMed

Keller, I; Stappers, P J

2001-04-01

Product designers use imagery for inspiration in their creative design process. To support creativity, designers apply many tools and techniques, which often rely on their ability to be inspired by found and previously made visual material and to experience the atmosphere of the user environment. Computer tools and developments in VR offer perspectives to support this kind of imagery and presence in the design process. But currently these possibilities come at too high a technological overhead and price to be usable in the design practice. This article proposes an expressive and technically lightweight approach using the possibilities of VR and computer tools, by creating a sketchy environment using video collages. Instead of relying on highly realistic or even "hyperreal" graphics, these video collages use lessons learned from theater and cinema to get a sense of atmosphere across. Product designers can use these video collages to reexperience their observations in the environment in which a product is to be used, and to communicate this atmosphere to their colleagues and clients. For user-centered design, video collages can also provide an environmental context for concept testing with prospective user groups.

Body weight and composition in users of levonorgestrel-releasing intrauterine system.

PubMed

Dal'Ava, Natália; Bahamondes, Luis; Bahamondes, M Valeria; de Oliveira Santos, Allan; Monteiro, Ilza

2012-10-01

There is little information about body weight and body composition (BC) among users of the levonorgestrel-releasing intrauterine system (LNG-IUS). The aim of this study was to evaluate body weight and BC in LNG-IUS users compared to users of the TCu380A intrauterine device (IUD). A prospective study was done with 76 new users of both contraceptive methods. Women were paired by age (±2 years) and body mass index (BMI, kg/m², ±2). Body weight and BC (% lean mass and % fat mass) were evaluated by a trained professional at baseline and at 1 year of contraceptive use. The BC measurements were obtained using Lunar DXA equipment. Weight and BC were evaluated in each woman at baseline and at 12 months and analyzed as the mean change within each woman. Then, the changes in weight and BC for each woman were calculated and then compared between LNG-IUS and TCu380A IUD users (paired data for each woman). The central-to-peripheral fat ratio was calculated by dividing trunk fat by the upper and lower limb fat. There were no significant differences at time of IUD insertion between LNG-IUS and TCu380A IUD users regarding age (mean±SD) (34.4±7.5 vs. 33.9±8.0 years), BMI (25.3±4.1 vs. 25.9±4.1) and number of pregnancies (1.9±0.2 vs. 1.7±0.2), respectively. Mean body weight gain of 2.9 kg was observed among LNG-IUS users at 12 months (p=.0012), whereas the body weight of TCu380A IUD users only increased by 1.4 kg (p=.067). There was no significant difference in body weight change between the two groups of users at 12 months. The variation in the central-to-peripheral fat ratio was the same between the two groups (-1.6% vs. -0.2%; p=.364). LNG-IUS users showed a 2.5% gain in fat mass (p=.0009) and a 1.4% loss of lean mass, whereas TCu380A IUD users showed a loss of 1.3% of fat mass (p=.159) and gain of 1.0% of lean mass (p=.120). TCu380A IUD users gained more lean mass than LNG-IUS users (p=.0270), although there was no significant difference between the two groups after 12 months of use. Although an increase in mean fat mass among LNG-IUS users at 12 months of use was observed, it should be noted that an increase of body weight was also observed in both groups after 1 year of insertion of the device. However, a study with a larger number of women and long-term evaluation is necessary to evaluate these body changes. Copyright © 2012 Elsevier Inc. All rights reserved.

49 CFR 1152.29 - Prospective use of rights-of-way for interim trail use and rail banking.

Code of Federal Regulations, 2011 CFR

2011-10-01

... liability arising out of the use of the right-of-way (unless the user is immune from liability, in which... arising out of the transfer or use of (unless the user is immune from liability, in which case it need...

Patterns of drug use and the influence of gender on self-reports of memory ability in ecstasy users: a web-based study.

PubMed

Rodgers, J; Buchanan, T; Scholey, A B; Heffernan, T M; Ling, J; Parrott, A C

2003-12-01

Research indicates that the use of recreational drugs, including MDMA ('ecstasy') can result in impairments in cognitive functioning. Recent evidence, based on accounts of 'on drug' effects and cortical binding ratios suggests that women may be more susceptible to the effects of MDMA; however, no research has explored whether there are differences in the long-term behavioural sequelae of the drug between men and women. In addition, little is known about the profile of functioning of the 'typical' user. The present investigation accessed a large sample of recreational drug users, using the Internet, to obtain self-reports of memory functioning with a view to exploring any differences in self-reported ability amongst male and female users, and the level of difficulty reported by the 'typical' ecstasy user. A web site (www.drugresearch.org.uk) was developed and used for data collection. Prospective memory ability was assessed using the Prospective Memory Questionnaire. Self-report of day-to-day memory performance was investigated using the Everyday Memory Questionnaire. The UEL Drug Questionnaire assessed the use of other substances. The number of mistakes made while completing the questionnaires was also taken as an objective measure of performance errors. Findings, based on datasets submitted from 763 respondents, indicate no differences in self-reports of functioning between male and female participants. An overall dissociation between the effects of cannabis and ecstasy on self-reported memory functioning and on the likelihood of making an error during the completion of the questionnaire was found. Typical ecstasy users were found to report significantly more difficulties in long-term prospective memory and to make more completion errors than users of other substances and drug naive controls. Whilst taking into account the fact that participants were recruited via the World Wide Web and that a number of stringent exclusion criteria were applied to the data, a number of conclusions can be drawn. Recreational drug users perceive their memory ability to be impaired compared to non-users. The type of memory difficulties reported varies depending upon the drug of choice. These difficulties are exacerbated in ecstasy users. Individuals reporting average levels of use of ecstasy are more likely to report memory problems than non-ecstasy drug users or drug free individuals. The deleterious effects of ecstasy are therefore not restricted to heavy or chronic users. No gender differences were detected, suggesting that there may be a dissociation between cognitive impairment and cortical binding worthy of further exploration.

The association of pattern of lifetime alcohol use and cause of death in the European prospective investigation into cancer and nutrition (EPIC) study.

PubMed

Bergmann, Manuela M; Rehm, Jürgen; Klipstein-Grobusch, Kerstin; Boeing, Heiner; Schütze, Madlen; Drogan, Dagmar; Overvad, Kim; Tjønneland, Anne; Halkjær, Jytte; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Teucher, Birgit; Kaaks, Rudolph; Trichopoulou, Antonia; Benetou, Vassiliki; Trichopoulos, Dimitrios; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Beulens, Joline Wj; Redondo, Maria Luisa; Duell, Eric J; Molina-Montes, Esther; Navarro, Carmen; Barricarte, Aurelio; Arriola, Larraitz; Allen, Naomi E; Crowe, Francesca L; Khaw, Kay-Tee; Wareham, Nick; Romaguera, Dora; Wark, Petra A; Romieu, Isabelle; Nunes, Luciana; Riboli, Elio; Ferrari, Pietro

2013-12-01

There is limited evidence for an association between the pattern of lifetime alcohol use and cause-specific risk of death. Multivariable hazard ratios were estimated for different causes of death according to patterns of lifetime alcohol consumption using a competing risks approach: 111 953 men and 268 442 women from eight countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included. Self-reported alcohol consumption at ages 20, 30, 40 or 50 years and at enrollment were used for the analysis; 26 411 deaths were observed during an average of 12.6 years of follow-up. The association between lifetime alcohol use and death from cardiovascular diseases was different from the association seen for alcohol-related cancers, digestive, respiratory, external and other causes. Heavy users (>5 drinks/day for men and >2.5 drinks/day for women), regardless of time of cessation, had a 2- to 5-times higher risk of dying due to alcohol-related cancers, compared with subjects with lifetime light use (≤1 and ≤0.5 drink/week for men and women, respectively). Compared with lifetime light users, men who used <5 drinks/day throughout their lifetime had a 24% lower cardiovascular disease mortality (95% confidence interval 2-41). The risk of death from coronary heart disease was also found to be 34-46% lower among women who were moderate to occasionally heavy alcohol users compared with light users. However, this relationship was only evident among men and women who had no chronic disease at enrollment. Limiting alcohol use throughout life is associated with a lower risk of death, largely due to cardiovascular disease but also other causes. However, the potential health benefits of alcohol use are difficult to establish due to the possibility of selection bias and competing risks related to diseases occurring later in life.

The association of pattern of lifetime alcohol use and cause of death in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

PubMed Central

Bergmann, Manuela M; Rehm, Jürgen; Klipstein-Grobusch, Kerstin; Boeing, Heiner; Schütze, Madlen; Drogan, Dagmar; Overvad, Kim; Tjønneland, Anne; Halkjær, Jytte; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Teucher, Birgit; Kaaks, Rudolph; Trichopoulou, Antonia; Benetou, Vassiliki; Trichopoulos, Dimitrios; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Beulens, Joline WJ; Redondo, Maria Luisa; Duell, Eric J; Molina-Montes, Esther; Navarro, Carmen; Barricarte, Aurelio; Arriola, Larraitz; Allen, Naomi E; Crowe, Francesca L; Khaw, Kay-Tee; Wareham, Nick; Romaguera, Dora; Wark, Petra A; Romieu, Isabelle; Nunes, Luciana; Riboli, Elio; Ferrari, Pietro

2013-01-01

Background There is limited evidence for an association between the pattern of lifetime alcohol use and cause-specific risk of death. Methods Multivariable hazard ratios were estimated for different causes of death according to patterns of lifetime alcohol consumption using a competing risks approach: 111 953 men and 268 442 women from eight countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study were included. Self-reported alcohol consumption at ages 20, 30, 40 or 50 years and at enrolment were used for the analysis; 26 411 deaths were observed during an average of 12.6 years of follow-up. Results The association between lifetime alcohol use and death from cardiovascular diseases was different from the association seen for alcohol-related cancers, digestive, respiratory, external and other causes. Heavy users (>5 drinks/day for men and >2.5 drinks/day for women), regardless of time of cessation, had a 2- to 5-times higher risk of dying due to alcohol-related cancers, compared with subjects with lifetime light use (≤1 and ≤0.5 drink/week for men and women, respectively). Compared with lifetime light users, men who used <5 drinks/day throughout their lifetime had a 24% lower cardiovascular disease mortality (95% confidence interval 2-41). The risk of death from coronary heart disease was also found to be 34–46% lower among women who were moderate to occasionally heavy alcohol users compared with light users. However, this relationship was only evident among men and women who had no chronic disease at enrolment. Conclusions Limiting alcohol use throughout life is associated with a lower risk of death, largely due to cardiovascular disease but also other causes. However, the potential health benefits of alcohol use are difficult to establish due to the possibility of selection bias and competing risks related to diseases occurring later in life. PMID:24415611

Burden of arrhythmia in recreational marijuana users.

PubMed

Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

2018-08-01

Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2018 Elsevier B.V. All rights reserved.

CIAO: CHANDRA/X-RAY DATA ANALYSIS FOR EVERYONE

NASA Astrophysics Data System (ADS)

McDowell, Jonathan; CIAO Team

2018-01-01

Eighteen years after the launch of Chandra, the archive is full of scientifically rich data and new observations continue. Improvements in recent years to the data analysis package CIAO (Chandra Interactive Analysis of Observations) and its extensive accompanying documentation make it easier for astronomers without a specialist background in high energy astrophysics to take advantage of this resource.The CXC supports hundreds of CIAO users around the world at all levels of training from high school and undergraduate students to the most experienced X-ray astronomers. In general, we strive to provide a software system which is easy for beginners, yet powerful for advanced users.Chandra data cover a range of instrument configurations and types of target (pointlike, extended and moving), requiring a flexible data analysis system. In addition to CIAO tools using the familiar FTOOLS/IRAF-style parameter interface, CIAO includes applications such as the Sherpa fitting engine which provide access to the data via Python scripting.In this poster we point prospective (and existing!) users to the high level Python scripts now provided to reprocess Chandra or other X-ray mission data, determine source fluxes and upper limits, and estimate backgrounds; and to the latest documentation including the CIAO Gallery, a new entry point featuring the system's different capabilities.This work has been supported by NASA under contract NAS 8-03060 to the Smithsonian Astrophysical Observatory for operation of the Chandra X-ray Center.

Modulating the neural bases of persuasion: why/how, gain/loss, and users/non-users.

PubMed

Vezich, I Stephanie; Katzman, Perri L; Ames, Daniel L; Falk, Emily B; Lieberman, Matthew D

2017-02-01

Designing persuasive content is challenging, in part because people can be poor predictors of their actions. Medial prefrontal cortex (MPFC) activation during message exposure reliably predicts downstream behavior, but past work has been largely atheoretical. We replicated past results on this relationship and tested two additional framing effects known to alter message receptivity. First, we examined gain- vs. loss-framed reasons for a health behavior (sunscreen use). Consistent with predictions from prospect theory, we observed greater MPFC activity to gain- vs. loss-framed messages, and this activity was associated with behavior. This relationship was stronger for those who were not previously sunscreen users. Second, building on theories of action planning, we compared neural activity during messages regarding how vs. why to enact the behavior. We observed rostral inferior parietal lobule and posterior inferior frontal gyrus activity during action planning ("how" messages), and this activity was associated with behavior; this is in contrast to the relationship between MPFC activity during the "why" (i.e., gain and loss) messages and behavior. These results reinforce that persuasion occurs in part via self-value integration-seeing value and incorporating persuasive messages into one's self-concept-and extend this work to demonstrate how message framing and action planning may influence this process. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

SOURCE EXPLORER: Towards Web Browser Based Tools for Astronomical Source Visualization and Analysis

NASA Astrophysics Data System (ADS)

Young, M. D.; Hayashi, S.; Gopu, A.

2014-05-01

As a new generation of large format, high-resolution imagers come online (ODI, DECAM, LSST, etc.) we are faced with the daunting prospect of astronomical images containing upwards of hundreds of thousands of identifiable sources. Visualizing and interacting with such large datasets using traditional astronomical tools appears to be unfeasible, and a new approach is required. We present here a method for the display and analysis of arbitrarily large source datasets using dynamically scaling levels of detail, enabling scientists to rapidly move from large-scale spatial overviews down to the level of individual sources and everything in-between. Based on the recognized standards of HTML5+JavaScript, we enable observers and archival users to interact with their images and sources from any modern computer without having to install specialized software. We demonstrate the ability to produce large-scale source lists from the images themselves, as well as overlaying data from publicly available source ( 2MASS, GALEX, SDSS, etc.) or user provided source lists. A high-availability cluster of computational nodes allows us to produce these source maps on demand and customized based on user input. User-generated source lists and maps are persistent across sessions and are available for further plotting, analysis, refinement, and culling.

17 CFR Appendix C - Demonstration of Compliance That a Contract Is Not Readily Susceptible to Manipulation

Code of Federal Regulations, 2014 CFR

2014-04-01

... contract market. When designing a futures contract, the designated contract market should conduct market research so that the contract design meets the risk management needs of prospective users and promotes... users to obtain their views and opinions during the contract design process to ensure the contract's...

Relative User Ratings of MMPI-2 Computer-Based Test Interpretations

ERIC Educational Resources Information Center

Williams, John E.; Weed, Nathan C.

2004-01-01

There are eight commercially available computer-based test interpretations (CBTIs) for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), of which few have been empirically evaluated. Prospective users of these programs have little scientific data to guide choice of a program. This study compared ratings of these eight CBTIs. Test users…

Educational Behavior Apps and Wearable Devices: Current Research and Prospects

ERIC Educational Resources Information Center

Lowe, Heather

2016-01-01

Dartmouth and MIT have developed educational behavior apps and wearable devices that collect contiguous streams of data from student users. Given the consent of the user, the app collects information about a student's physical activity, sleep patterns, and location to form conjectures about social and academic behavior. These apps have the…

Participatory Design of Learning Media: Designing Educational Computer Games with and for Teenagers

ERIC Educational Resources Information Center

Danielsson, Karin; Wiberg, Charlotte

2006-01-01

This paper reports on how prospective users may be involved in the design of entertaining educational computer games. The paper illustrates an approach, which combines traditional Participatory Design methods in an applicable way for this type of design. Results illuminate the users' important contribution during game development, especially when…

[Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

PubMed

Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

2013-03-01

Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow-up revealed that about two thirds of the OSA patients did not use the CPAP machine. Older age, higher scores on the ESS questionnaire and lower 02 saturation levels on the polysomnogram (PSG) predict better adherence to treatment with the CPAP machine. In light of our findings and high treatment costs, we suggest a better selection process for prescribing CPAP treatment based on the above mentioned criteria. Other treatment modalities may be considered for patients not compliant with CPAP treatment or those who refuse to use it. Ongoing medical and social support is needed in order to maintain good compliance.

Do Selective Serotonin Reuptake Inhibitors (SSRIs) Cause Fractures?

PubMed

Warden, Stuart J; Fuchs, Robyn K

2016-10-01

Recent meta-analyses report a 70 % increase in fracture risk in selective serotonin reuptake inhibitor (SSRI) users compared to non-users; however, included studies were observational and limited in their ability to establish causality. Here, we use the Bradford Hill criteria to explore causality between SSRIs and fractures. We found a strong, consistent, and temporal relationship between SSRIs and fractures, which appears to follow a biological gradient. However, specificity and biological plausibility remain concerns. In terms of specificity, the majority of available data have limitations due to either confounding by indication or channeling bias. Self-controlled case series address some of these limitations and provide relatively strong observational evidence for a causal relationship between SSRIs and fracture. In doing so, they suggest that falls contribute to fractures in SSRI users. Whether there are also underlying changes in skeletal properties remains unresolved. Initial studies provide some evidence for skeletal effects of SSRIs; however, the pathways involved need to be established before biological plausibility can be accepted. As the link between SSRIs and fractures is based on observational data and not evidence from prospective trials, there is insufficient evidence to definitively determine a causal relationship and it appears premature to label SSRIs as a secondary cause of osteoporosis. SSRIs appear to contribute to fracture-inducing falls, and addressing any fall risk associated with SSRIs may be an efficient approach to reducing SSRI-related fractures. As fractures stemming from SSRI-induced falls are more likely in individuals with compromised bone health, it is worth considering bone density testing and intervention for those presenting with risk factors for osteoporosis.

Prospective memory deficits in illicit polydrug users are associated with the average long-term typical dose of ecstasy typically consumed in a single session.

PubMed

Gallagher, Denis T; Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Robinson, Sarita J; Judge, Jeannie

2014-01-01

Neuroimaging evidence suggests that ecstasy-related reductions in SERT densities relate more closely to the number of tablets typically consumed per session rather than estimated total lifetime use. To better understand the basis of drug related deficits in prospective memory (p.m.) we explored the association between p.m. and average long-term typical dose and long-term frequency of use. Study 1: Sixty-five ecstasy/polydrug users and 85 nonecstasy users completed an event-based, a short-term and a long-term time-based p.m. task. Study 2: Study 1 data were merged with outcomes on the same p.m. measures from a previous study creating a combined sample of 103 ecstasy/polydrug users, 38 cannabis-only users, and 65 nonusers of illicit drugs. Study 1: Ecstasy/polydrug users had significant impairments on all p.m. outcomes compared with nonecstasy users. Study 2: Ecstasy/polydrug users were impaired in event-based p.m. compared with both other groups and in long-term time-based p.m. compared with nonillicit drug users. Both drug using groups did worse on the short-term time-based p.m. task compared with nonusers. Higher long-term average typical dose of ecstasy was associated with poorer performance on the event and short-term time-based p.m. tasks and accounted for unique variance in the two p.m. measures over and above the variance associated with cannabis and cocaine use. The typical ecstasy dose consumed in a single session is an important predictor of p.m. impairments with higher doses reflecting increasing tolerance giving rise to greater p.m. impairment.

Reviewing long-term antidepressants can reduce drug burden: a prospective observational cohort study

PubMed Central

Johnson, Chris F; Macdonald, Hector J; Atkinson, Pauline; Buchanan, Alasdair I; Downes, Noreen; Dougall, Nadine

2012-01-01

Background Antidepressant prescribing continues to rise. Contributing factors are increased long-term prescribing and possibly the use of higher selective serotonin re-uptake inhibitor (SSRI) doses. Aim To review general practice patients prescribed the same antidepressant long-term (≥2 years) and evaluate prescribing and management pre and post-review. Design and setting Prospective observational cohort study using routine data from 78 urban general practices, Scotland. Method All patients prescribed antidepressants (excluding amitriptyline) for ≥2 years were identified from records November 2009 to March 2010. GPs selected patients for face-to-face review of clinical condition and medication, December 2009 to September 2010. Pre- and post-review data were collected; average antidepressant doses and changes in prescribed daily doses were calculated. Onward referral to support services was recorded. Results 8.6% (33 312/388 656) of all registered patients were prescribed an antidepressant, 47.1% (15 689) were defined as long-term users and 2849 (18.2%) were reviewed. 811 (28.5%) patients reviewed had a change in antidepressant therapy: 7.0% stopped, 12.8% reduced dose, 5.3% increased dose, and 3.4% changed antidepressant, resulting in 9.5% (95% CI = 9.1% to 9.8% P<0.001) reduction in prescribed daily dose and 8.1% reduction in prescribing costs. 6.3% were referred onwards, half to NHS Mental Health Services. Pre-review SSRI doses were 10–30% higher than previously reported. Conclusion Almost half of all people prescribed antidepressants were long-term users. Appropriate reductions in prescribing can be achieved by reviewing patients. Higher SSRI doses may be contributing to current antidepressant growth. PMID:23211181

Rationale, design, and cohort enrolment of a prospective observational study of the clinical performance of the new contraceptive implant (Femplant) in Pakistan.

PubMed

Azmat, Syed Khurram; Hameed, Waqas; Lendvay, Anja; Shaikh, Babar Tasneem; Mustafa, Ghulam; Siddiqui, Muhammad Ahmed; Brohi, Sajid; Karim, Asif; Ishaque, Muhammad; Hussain, Wajahat; Bilgrami, Mohsina; Feldblum, Paul J

2014-01-01

The use of hormonal implants has gained positive traction in family planning programs in recent times. Compared to other popular methods, such as long-term reversible intrauterine devices, the use of hormonal implants as a family planning method has distinct advantages in terms of long-term efficiency and better user compliance and availability. This paper presents a study protocol to document and evaluate the efficacy, safety, and acceptability of Femplant (contraceptive implant) in Pakistan during the first year of its use among married women of reproductive age (18-44 years) at clinics in two provinces of Pakistan (Sindh and Punjab). A total of 724 married women were enrolled in a noncomparative prospective observational study. The study involved six government clinics from the Population Welfare Department in Sindh Province and 13 clinics run by the Marie Stopes Society (a local nongovernmental organization) in both provinces. The participation of women was subject to voluntary acceptance and medical eligibility. All respondents were interviewed at baseline and subsequently at each scheduled visit during the study period. Side effects, complications and adverse events, if any, were recorded for every participant at each visit to the facility. Over the next 5-year period (2013-2018), 27 million hormonal implants will be made available in lower- to middle-income countries by international donors and agencies. The evidence generated from this study will identify factors affecting the acceptability and satisfaction of end users with Femplant (Sino-implant II). This will help to guide policies to enhance access to and the use of long-acting contraceptive implants in Pakistan and similar developing countries.

Characterizing longitudinal health state transitions among heroin, cocaine, and methamphetamine users

PubMed Central

Nosyk, B; Li, L; Evans, E; Huang, D; Min, J; Kerr, T; Brecht, ML; Hser, YI

2014-01-01

Aims Characterize longitudinal patterns of drug use careers and identify determinants of drug use frequency across cohorts of primary heroin, methamphetamine (MA) and cocaine users. Design Pooled analysis of prospective cohort studies. Settings Illicit drug users recruited from community, criminal justice and drug treatment settings in California, USA. Participants We used longitudinal data on from five observational cohort studies featuring primary users of heroin (N=629), cocaine (N=694) and methamphetamine (N=474). The mean duration of follow-up was 20.9 years. Measurements Monthly longitudinal data was arranged according to five health states (incarceration, drug treatment, abstinence, non-daily and daily use). We fitted proportional hazards (PH) frailty models to determine independent differences in successive episode durations. We then executed multi-state Markov (MSM) models to estimate probabilities of transitioning between health states, and the determinants of these transitions. Findings Across primary drug use types, PH frailty models demonstrated durations of daily use diminished in successive episodes over time. MSM models revealed primary stimulant users had more erratic longitudinal patterns of drug use, transitioning more rapidly between periods of treatment, abstinence, non-daily and daily use. MA users exhibited relatively longer durations of high-frequency use. Criminal engagement had a destabilizing effect on health state durations across drug types. Longer incarceration histories were associated with delayed transitions towards cessation. Conclusions PH frailty and MSM modeling techniques provided complementary information on longitudinal patterns of drug abuse. This information can inform clinical practice and policy, and otherwise be used in health economic simulation models, designed to inform resource allocation decisions. PMID:24837584

21 CFR 801.421 - Hearing aid devices; conditions for sale.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Informs the prospective user that the exercise of the waiver is not in the user's best health interest... that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish...

21 CFR 801.421 - Hearing aid devices; conditions for sale.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Informs the prospective user that the exercise of the waiver is not in the user's best health interest... that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish...

21 CFR 801.421 - Hearing aid devices; conditions for sale.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Informs the prospective user that the exercise of the waiver is not in the user's best health interest... that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish...

21 CFR 801.421 - Hearing aid devices; conditions for sale.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Informs the prospective user that the exercise of the waiver is not in the user's best health interest... that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish...

21 CFR 801.421 - Hearing aid devices; conditions for sale.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Informs the prospective user that the exercise of the waiver is not in the user's best health interest... that my best health interest would be served if I had a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. I do not wish...

The Developmental Significance of Late Adolescent Substance Use for Early Adult Functioning

ERIC Educational Resources Information Center

Englund, Michelle M.; Siebenbruner, Jessica; Oliva, Elizabeth M.; Egeland, Byron; Chung, Chu-Ting; Long, Jeffrey D.

2013-01-01

This study examines the predictive significance of late adolescent substance use groups (i.e., abstainers, experimental users, at-risk users, and abusers) for early adult adaptation. Participants (N = 159) were drawn from a prospective longitudinal study of first-born children of low-income mothers. At 17.5 years of age, participants were assigned…

Space Station Freedom user's guide

NASA Technical Reports Server (NTRS)

1992-01-01

This guide is intended to inform prospective users of the accommodations and resources provided by the Space Station Freedom program. Using this information, they can determine if Space Station Freedom is an appropriate laboratory or facility for their research objectives. The steps that users must follow to fly a payload on Freedom are described. This guide covers the accommodations and resources available on the Space Station during the Man-Tended Capability (MTC) period, scheduled to begin the end of 1996, and a Permanently Manned Capability (PMC) beginning in late 1999.

Getting the Books Off the Shelves. Making the Most of Your Congregation's Library. Revised Edition. CSLA Guide No. 12.

ERIC Educational Resources Information Center

Smith, Ruth S.

This guide provides guidelines for promoting and attracting users to a church library. The first of six chapters, "Promoting Library Use," discusses stages of promotion, methods of attracting the attention and interest of prospective users, and how to involve members of the congregation in library activities; the second chapter, "Publicizing the…

Calcium Nutrition Perceptions among Food Bank Users: A Canadian Case Study

ERIC Educational Resources Information Center

Johnson, Shanthi; Hawkins, Nicki

2010-01-01

The present study examined the differences in the food bank users' perceptions related to calcium nutrition across sex and employment status using a cross-sectional, prospective design at a large food bank in Canada. A total of 197 individuals participated for a response rate of 97%. A structured survey was developed and pilot tested before it was…

Inputs requested from earth resources remote sensing data users regarding LANDSAT-C mission requirements and data needs

NASA Technical Reports Server (NTRS)

1976-01-01

Inputs from prospective LANDSAT-C data users are requested to aid NASA in defining LANDSAT-C mission and data requirements and in making decisions regarding the scheduling of satellite operations and ground data processing operations. Design specifications, multispectral band scanner performance characteristics, satellite schedule operations, and types of available data products are briefly described.

Non-Dependent and Dependent Daily Cannabis Users Differ in Mental Health but Not Prospective Memory Ability

PubMed Central

Braidwood, Ruth; Mansell, Samantha; Waldron, Jon; Rendell, Peter G.; Kamboj, Sunjeev K.; Curran, H. Valerie

2018-01-01

Research suggests that daily cannabis users have impaired memory for past events, but it is not clear whether they are also impaired in prospective memory (PM) for future events. The present study examined PM in daily cannabis users who were either dependent (n = 18) or non-dependent (n = 18), and compared them with non-using controls (n = 18). The effect of future event simulation (FES) on PM performance was also examined. Participants were matched across groups on age, gender, and highest level of education. The virtual week (VW) was used to objectively assess PM abilities, both at baseline and following FES. Other measures used were: cannabis use variables, immediate and delayed prose recall, phonemic and category fluency, spot-the-word test (premorbid intelligence), Beck Depression Inventory, Beck Anxiety Inventory, and a measure of schizotypy (Oxford-Liverpool Inventory of Feelings and Experiences: unusual experiences subscale). No group differences were found in PM performance on the VW, and FES did not improve PM performance in any group. Dependent cannabis users scored higher on depression, anxiety, and schizotypy than both other groups with non-dependent cannabis users scoring at a similar level to controls. There were no group differences in alcohol use. Findings suggest that when carefully matched on baseline variables, and not differing in premorbid IQ or alcohol use, young, near-daily cannabis users do not differ from non-using controls in PM performance. PMID:29636705

Vitamin A levels and human immunodeficiency virus load in injection drug users.

PubMed Central

Semba, R D; Farzadegan, H; Vlahov, D

1997-01-01

Although low plasma vitamin A levels are associated with increased mortality and higher vertical transmission during human immunodeficiency virus (HIV) infection, it is unknown whether plasma low vitamin A levels are a marker for circulating HIV load. We conducted a cross-sectional study within a prospective cohort study of injection drug users in order to evaluate the relationship between plasma vitamin A levels and HIV viral load. Plasma vitamin A level was measured by high-performance liquid chromatography. Infectious viral load was measured by quantitative microculture of serial fivefold dilutions of 10(6) peripheral blood mononuclear cells. A total of 284 HIV-infected adults (79 women, 205 men) were studied. Plasma vitamin A levels consistent with deficiency were found in 28.9% of adults. A total of 38.0% of women and 25.3% of men had vitamin A deficiency (P < 0.04). The median infectious viral load for the entire study population was 8 infectious units per million cells. No significant relationship between plasma vitamin A levels and infectious viral load was observed in these injection drug users. This study suggests that there is no correlation between HIV viral load and plasma vitamin A levels in injection drug users, and these variables may represent independent risk factors during HIV infection. HIV-infected adult women appear to be at higher risk of developing vitamin A deficiency. PMID:9008289

Mortality among young injection drug users in San Francisco: a 10-year follow-up of the UFO study.

PubMed

Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly

2012-02-15

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.

Mortality Among Young Injection Drug Users in San Francisco: A 10-Year Follow-up of the UFO Study

PubMed Central

Evans, Jennifer L.; Tsui, Judith I.; Hahn, Judith A.; Davidson, Peter J.; Lum, Paula J.; Page, Kimberly

2012-01-01

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO (“U Find Out”) Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths. PMID:22227793

Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: a WHO-coordinated, prospective, international, observational cohort study.

PubMed

Kleinschmidt, Immo; Bradley, John; Knox, Tessa Bellamy; Mnzava, Abraham Peter; Kafy, Hmooda Toto; Mbogo, Charles; Ismail, Bashir Adam; Bigoga, Jude D; Adechoubou, Alioun; Raghavendra, Kamaraju; Cook, Jackie; Malik, Elfatih M; Nkuni, Zinga José; Macdonald, Michael; Bayoh, Nabie; Ochomo, Eric; Fondjo, Etienne; Awono-Ambene, Herman Parfait; Etang, Josiane; Akogbeto, Martin; Bhatt, Rajendra M; Chourasia, Mehul Kumar; Swain, Dipak K; Kinyari, Teresa; Subramaniam, Krishanthi; Massougbodji, Achille; Okê-Sopoh, Mariam; Ogouyemi-Hounto, Aurore; Kouambeng, Celestin; Abdin, Mujahid Sheikhedin; West, Philippa; Elmardi, Khalid; Cornelie, Sylvie; Corbel, Vincent; Valecha, Neena; Mathenge, Evan; Kamau, Luna; Lines, Jonathan; Donnelly, Martin James

2018-04-09

Scale-up of insecticide-based interventions has averted more than 500 million malaria cases since 2000. Increasing insecticide resistance could herald a rebound in disease and mortality. We aimed to investigate whether insecticide resistance was associated with loss of effectiveness of long-lasting insecticidal nets and increased malaria disease burden. This WHO-coordinated, prospective, observational cohort study was done at 279 clusters (villages or groups of villages in which phenotypic resistance was measurable) in Benin, Cameroon, India, Kenya, and Sudan. Pyrethroid long-lasting insecticidal nets were the principal form of malaria vector control in all study areas; in Sudan this approach was supplemented by indoor residual spraying. Cohorts of children from randomly selected households in each cluster were recruited and followed up by community health workers to measure incidence of clinical malaria and prevalence of infection. Mosquitoes were assessed for susceptibility to pyrethroids using the standard WHO bioassay test. Country-specific results were combined using meta-analysis. Between June 2, 2012, and Nov 4, 2016, 40 000 children were enrolled and assessed for clinical incidence during 1·4 million follow-up visits. 80 000 mosquitoes were assessed for insecticide resistance. Long-lasting insecticidal net users had lower infection prevalence (adjusted odds ratio [OR] 0·63, 95% CI 0·51-0·78) and disease incidence (adjusted rate ratio [RR] 0·62, 0·41-0·94) than did non-users across a range of resistance levels. We found no evidence of an association between insecticide resistance and infection prevalence (adjusted OR 0·86, 0·70-1·06) or incidence (adjusted RR 0·89, 0·72-1·10). Users of nets, although significantly better protected than non-users, were nevertheless subject to high malaria infection risk (ranging from an average incidence in net users of 0·023, [95% CI 0·016-0·033] per person-year in India, to 0·80 [0·65-0·97] per person year in Kenya; and an average infection prevalence in net users of 0·8% [0·5-1·3] in India to an average infection prevalence of 50·8% [43·4-58·2] in Benin). Irrespective of resistance, populations in malaria endemic areas should continue to use long-lasting insecticidal nets to reduce their risk of infection. As nets provide only partial protection, the development of additional vector control tools should be prioritised to reduce the unacceptably high malaria burden. Bill & Melinda Gates Foundation, UK Medical Research Council, and UK Department for International Development. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

The asthma mobile health study, smartphone data collected using ResearchKit.

PubMed

Chan, Yu-Feng Yvonne; Bot, Brian M; Zweig, Micol; Tignor, Nicole; Ma, Weiping; Suver, Christine; Cedeno, Rafhael; Scott, Erick R; Gregory Hershman, Steven; Schadt, Eric E; Wang, Pei

2018-05-22

Widespread adoption of smart mobile platforms coupled with a growing ecosystem of sensors including passive location tracking and the ability to leverage external data sources create an opportunity to generate an unprecedented depth of data on individuals. Mobile health technologies could be utilized for chronic disease management as well as research to advance our understanding of common diseases, such as asthma. We conducted a prospective observational asthma study to assess the feasibility of this type of approach, clinical characteristics of cohorts recruited via a mobile platform, the validity of data collected, user retention patterns, and user data sharing preferences. We describe data and descriptive statistics from the Asthma Mobile Health Study, whereby participants engaged with an iPhone application built using Apple's ResearchKit framework. Data from 6346 U.S. participants, who agreed to share their data broadly, have been made available for further research. These resources have the potential to enable the research community to work collaboratively towards improving our understanding of asthma as well as mobile health research best practices.

Multi-parameter brain tissue microsensor and interface systems: calibration, reliability and user experiences of pressure and temperature sensors in the setting of neurointensive care.

PubMed

Childs, Charmaine; Wang, Li; Neoh, Boon Kwee; Goh, Hok Liok; Zu, Mya Myint; Aung, Phyo Wai; Yeo, Tseng Tsai

2014-10-01

The objective was to investigate sensor measurement uncertainty for intracerebral probes inserted during neurosurgery and remaining in situ during neurocritical care. This describes a prospective observational study of two sensor types and including performance of the complete sensor-bedside monitoring and readout system. Sensors from 16 patients with severe traumatic brain injury (TBI) were obtained at the time of removal from the brain. When tested, 40% of sensors achieved the manufacturer temperature specification of 0.1 °C. Pressure sensors calibration differed from the manufacturers at all test pressures in 8/20 sensors. The largest pressure measurement error was in the intraparenchymal triple sensor. Measurement uncertainty is not influenced by duration in situ. User experiences reveal problems with sensor 'handling', alarms and firmware. Rigorous investigation of the performance of intracerebral sensors in the laboratory and at the bedside has established measurement uncertainty in the 'real world' setting of neurocritical care.

Traditional fertility regulation methods among the Yoruba of southwestern Nigeria. II. A prospective study of use-effectiveness.

PubMed

Jinadu, M K; Ajuwon, B

1997-03-01

This study investigated the effectiveness of traditional contraceptives commonly used by Yoruba women, and the attitudes of users and non-users towards family planning services and contraceptives in Nigeria. One hundred forty-two married women aged 19 to 40 years were followed for 18 months. Seventy-two of the women were identified as current users of four types of traditional contraceptives (ring, incision, soup, and waistband types), and 70 women did not use any type of contraceptive. The users and non-users were matched on socio-demographic characteristics. Attitudes of the users and non-users towards fertility regulation were investigated using focus group discussions. The study found that 5.6 percent of the users and 34.5 percent of the non-users became pregnant during the follow-up period. Contraceptive failure was experienced by users of the waistband and ring methods. The main barriers to the use of modern contraceptives as described by women were the negative attitudes of men and the fear of side effects.

Shuttle operations simulation model programmers'/users' manual

NASA Technical Reports Server (NTRS)

Porter, D. G.

1972-01-01

The prospective user of the shuttle operations simulation (SOS) model is given sufficient information to enable him to perform simulation studies of the space shuttle launch-to-launch operations cycle. The procedures used for modifying the SOS model to meet user requirements are described. The various control card sequences required to execute the SOS model are given. The report is written for users with varying computer simulation experience. A description of the components of the SOS model is included that presents both an explanation of the logic involved in the simulation of the shuttle operations cycle and a description of the routines used to support the actual simulation.

Directivity and noise reduction in hearing aids: speech perception and benefit.

PubMed

Quintino, Camila Angélica; Mondelli, Maria Fernanda Capoani Garcia; Ferrari, Déborah Viviane

2010-01-01

Hearing aid. To compare the performance, benefit and satisfaction of users of ITE, CIC and BTE digital hearing aid with noise reduction and omnidirectional and directional microphones. 34 users of hearing aid were evaluated by means of speech perception in noise tests and APHAB and IOI self assessment questionnaires. Prospective study. Better results were obtained by users of ITE, CIC and directional hearing aids, however, no statistical significance was found between the groups. Directivity improved speech perception in noise and benefit in daily life situations.

Teaching Pediatric Peritoneal Dialysis Globally through Virtual Simulation.

PubMed

Olszewski, Aleksandra E; Daniel, Dennis A; Stein, Deborah R; McCulloch, Mignon I; Su, Sharon W; Hames, Daniel L; Wolbrink, Traci A

2018-05-02

Despite the increasing prevalence of childhood kidney disease worldwide, there is a shortage of clinicians trained to provide peritoneal dialysis (PD). E-learning technologies may provide a solution to improve knowledge in PD. We describe the development of a virtual PD simulator and report the first 22 months of online usage. The PD simulator was developed and released on OPENPediatrics in January of 2016. A prospective study of international, multidisciplinary healthcare providers was conducted from January of 2016 through October of 2017. User action data were analyzed with descriptive statistics and linear regression. Paired t tests compared user pre- and post-test scores. User satisfaction was assessed by survey. The simulator was accessed by 1066 users in 70 countries. Users spent a median of 35 minutes (interquartile range [IQR] 14-84) in the simulator. Users who completed the structured learning curriculum ( n =300) spent a median of 85 minutes (IQR 46-95), and those who completed the entire simulator ( n =63) spent a median of 122 minutes (IQR 69-195). Users who completed the simulator were more likely to scroll through text and access the simulator in multiple sessions. The 300 users that completed testing showed statistically significant increases in the post- versus pretest scores, with a mean increase of 36.4 of 100 points, SD 19.9 (95% confidence interval, 34.1 to 38.6, P <0.001). Eighty-seven percent (20 of 23) of survey respondents felt the simulator was relevant to their clinical practice, and 78% (18 of 23) would recommend it to others. This is the first reported virtual PD simulator. Increased test scores were observed between pre- and post-tests by clinicians who completed testing, across disciplines, training levels, and resource settings. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_05_02_CJASNPodcast_18_6_O.mp3. Copyright © 2018 by the American Society of Nephrology.

Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.

PubMed

Havers, Fiona; Bramley, Anna M; Finelli, Lyn; Reed, Carrie; Self, Wesley H; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Courtney, D Mark; Girard, Timothy D; Anderson, Evan J; Grijalva, Carlos G; Edwards, Kathryn M; Wunderink, Richard G; Jain, Seema

2016-06-15

Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study

PubMed Central

Meyer, Brett C.; Raman, Rema; Hemmen, Thomas; Obler, Richard; Zivin, Justin A.; Rao, Ramesh; Thomas, Ronald G.; Lyden, Patrick D.

2009-01-01

Background To increase effective use of rt-PA for acute stroke, vascular neurology expertise must be disseminated more widely. We prospectively assessed whether telemedicine (real-time, 2 way audio/video and DICOM interpretation) or telephone was superior for decision-making in acute telemedicine consultations. Methods Acute stroke patients were randomized to telemedicine or telephone consultation. Primary outcome measure was whether the thrombolytic treatment decision was correct, as determined by central adjudication. Secondary outcomes included rt-PA use-rate, 90 day functional outcomes, hemorrhages, and technical observations. Findings Two hundred thirty-four patients were prospectively evaluated. Mean NIHSS score was 9.5 (11.4±8.7 telemedicine, 7.7±7.0 telephone; p=0.0020). One telemedicine consult (0.9%) was aborted for technical reasons, though was included in intention-to-treat analyses. Correct treatment decision was made more often in telemedicine (98.2% telemedicine, 82% telephone; OR 10.9; 95%CI 2.7-44.6; p=0.0009). IV rt-PA use-rate was 25% (28% telemedicine, 23% telephone; OR 1.3; 95%CI 0.7-2.5; p=0.4248). Ninety day functional outcomes were not different for BI(95–100) (OR 0.6; 95%CI 0.4-1.1; p=0.1268) or for mRS (OR 0.6; 95%CI 0.3-1.1; p=0.0898). There was no mortality difference (OR 1.6; 95%CI 0.8-3.4; p=0.2690). Post-rt-PA ICH rates were not different (7% telemedicine, 8% telephone; OR 0.8; 95%CI 0.1-6.3; p=1.0). There was a difference noted for amount of non-completed data (3.1% telemedicine, 12.0% telephone; OR 0.2; 95%CI 0.1-0.3; p<0.001). Interpretation This trial reports that stroke telemedicine consultations result in more accurate decision making, compared to telephone, and can serve as a model for the effective use of telemedicine in other medical fields. The more appropriate decisions, high rt-PA userates, improved data collection, low ICH rates, low technical complications, and favorable time requirements all support telemedicine’s efficacy, most specifically for decision-making, and may enable more practitioners to use telemedicine in daily stroke care. PMID:18676180

A pilot prospective feasibility study of organ-at-risk definition using Target Contour Testing/Instructional Computer Software (TaCTICS), a training and evaluation platform for radiotherapy target delineation.

PubMed

Kalpathy-Cramer, Jayashree; Bedrick, Steven D; Boccia, Kelly; Fuller, Clifton D

2011-01-01

Target volume delineation is a critical, but time-consuming step in the creation of radiation therapy plans used in the treatment of many types of cancer. However, variability in target volume definitions can introduce substantial differences in resulting doses to tumors and critical structures. We developed TaCTICS, a web-based educational training software application targeted towards non-expert users. We report on a small, prospective study to evaluate the utility of this online tool in improving conformance of regions-of-interest (ROIs) with a reference set. Eight residents contoured a set of structures for a head-and-neck cancer case. Subsequently, they were provided access to TaCTICS as well as contouring atlases to allow evaluation of their contours in reference to other users as well as reference ROIs. The residents then contoured a second case using these resources. Volume overlap metrics between the users showed a substantial improvement following the intervention. Additionally, 66% of users reported that they found TaCTICS to be a useful educational tool and all participants reported they would like to use TaCTICS to track their contouring skills over the course of their residency.

Design and architecture of retailapp: an application to support conventional retailers

NASA Astrophysics Data System (ADS)

Jaya, I.; Tarigan, J. T.; Hardi, S. M.; Nasution, M. K. M.

2018-03-01

Over the last few years, the preference on shopping over internet application, usually called online shopping or e-shopping, has increased significantly. One of the major advantage of online shopping is the capability to use digital content to support the marketing process. Prospective buyers can conveniently browse and look to a certain object and find the information needed with a few clicks. Moreover, the use of multimedia (such as images, sound, and movies) may help prospective buyers to make a decision faster than conventional shopping at retailers. However, shoppers still consider that conventional shopping is the best way to perform shopping due to the ability to make a physical contact to the object. Our objective is to merge these experiences by enabling user to find digital content that relate to nearby retailers. In this research, we built a mobile application that collects data from nearby retailers and shows it to its user. By using this application, it will be easier to users to find the location of the object and to find nearby promotion.

Antithrombotic drug use, cerebral microbleeds, and intracerebral hemorrhage: a systematic review of published and unpublished studies.

PubMed

Lovelock, Caroline E; Cordonnier, Charlotte; Naka, Hiromitsu; Al-Shahi Salman, Rustam; Sudlow, Cathie L M; Sorimachi, Takatoshi; Werring, David J; Gregoire, Simone M; Imaizumi, Toshio; Lee, Seung-Hoon; Briley, Dennis; Rothwell, Peter M

2010-06-01

Cerebral microbleeds (MB) are potential risk factors for intracerebral hemorrhage (ICH), but it is unclear if they are a contraindication to using antithrombotic drugs. Insights could be gained by pooling data on MB frequency stratified by antithrombotic use in cohorts with ICH and ischemic stroke (IS)/transient ischemic attack (TIA). We performed a systematic review of published and unpublished data from cohorts with stroke or TIA to compare the presence of MB in: (1) antithrombotic users vs nonantithrombotic users with ICH; (2) antithrombotic users vs nonusers with IS/TIA; and (3) ICH vs ischemic events stratified by antithrombotic use. We also analyzed published and unpublished follow-up data to determine the risk of ICH in antithrombotic users with MB. In a pooled analysis of 1460 ICH and 3817 IS/TIA, MB were more frequent in ICH vs IS/TIA in all treatment groups, but the excess increased from 2.8 (odds ratio; range, 2.3-3.5) in nonantithrombotic users to 5.7 (range, 3.4-9.7) in antiplatelet users and 8.0 (range, 3.5-17.8) in warfarin users (P difference=0.01). There was also an excess of MB in warfarin users vs nonusers with ICH (OR, 2.7; 95% CI, 1.6-4.4; P<0.001) but none in warfarin users with IS/TIA (OR, 1.3; 95% CI, 0.9-1.7; P=0.33; P difference=0.01). There was a smaller excess of MB in antiplatelet users vs nonusers with ICH (OR, 1.7; 95% CI, 1.3-2.3; P<0.001), but findings were similar for antiplatelet users with IS/TIA (OR, 1.4; 95% CI, 1.2-1.7; P<0.001; P difference=0.25). In pooled follow-up data for 768 antithrombotic users, presence of MB at baseline was associated with a substantially increased risk of subsequent ICH (OR, 12.1; 95% CI, 3.4-42.5; P<0.001). The excess of MB in warfarin users with ICH compared to other groups suggests that MB increase the risk of warfarin-associated ICH. Limited prospective data corroborate these findings, but larger prospective studies are urgently required.

Human-Centered Design Study: Enhancing the Usability of a Mobile Phone App in an Integrated Falls Risk Detection System for Use by Older Adult Users

PubMed Central

Harte, Richard; Glynn, Liam; Rodríguez-Molinero, Alejandro; Baker, Paul MA; Scharf, Thomas; ÓLaighin, Gearóid

2017-01-01

Background Design processes such as human-centered design (HCD), which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of HCD can often conflict with the necessary rapid product development life-cycles associated with the competitive connected health industry. Objective The aim of this study was to apply a structured HCD methodology to the development of a smartphone app that was to be used within a connected health fall risk detection system. Our methodology utilizes so called discount usability engineering techniques to minimize the burden on resources during development and maintain a rapid pace of development. This study will provide prospective designers a detailed description of the application of a HCD methodology. Methods A 3-phase methodology was applied. In the first phase, a descriptive “use case” was developed by the system designers and analyzed by both expert stakeholders and end users. The use case described the use of the app and how various actors would interact with it and in what context. A working app prototype and a user manual were then developed based on this feedback and were subjected to a rigorous usability inspection. Further changes were made both to the interface and support documentation. The now advanced prototype was exposed to user testing by end users where further design recommendations were made. Results With combined expert and end-user analysis of a comprehensive use case having originally identified 21 problems with the system interface, we have only seen and observed 3 of these problems in user testing, implying that 18 problems were eliminated between phase 1 and 3. Satisfactory ratings were obtained during validation testing by both experts and end users, and final testing by users shows the system requires low mental, physical, and temporal demands according to the NASA Task Load Index (NASA-TLX). Conclusions From our observation of older adults’ interactions with smartphone interfaces, there were some recurring themes. Clear and relevant feedback as the user attempts to complete a task is critical. Feedback should include pop-ups, sound tones, color or texture changes, or icon changes to indicate that a function has been completed successfully, such as for the connection sequence. For text feedback, clear and unambiguous language should be used so as not to create anxiety, particularly when it comes to saving data. Warning tones or symbols, such as caution symbols or shrill tones, should only be used if absolutely necessary. Our HCD methodology, designed and implemented based on the principles of the International Standard Organizaton (ISO) 9241-210 standard, produced a functional app interface within a short production cycle, which is now suitable for use by older adults in long term clinical trials. PMID:28559227

Low Soluble Fms-Like Tyrosine Kinase-1, Endoglin, and Endothelin-1 Levels in Women With Confirmed or Suspected Preeclampsia Using Proton Pump Inhibitors.

PubMed

Saleh, Langeza; Samantar, Raaho; Garrelds, Ingrid M; van den Meiracker, Anton H; Visser, Willy; Danser, A H Jan

2017-09-01

Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement. Measurements were only made once, at study entry between weeks 20 and 41 (median 33 weeks). PPI use was associated with lower sFlt-1 levels, with no change in placental growth factor levels, both when compared with all non-PPI users and with 80 gestational age-matched controls selected from the non-PPI users. No sFlt-1/placental growth factor alterations were observed in women using ferrous fumarate or macrogol while, as expected, women using antihypertensive medication displayed higher sFlt-1 levels and lower placental growth factor levels. The PPI use-associated decrease in sFlt-1 was independent of the application of antihypertensive drugs and also occurred when restricting our analysis to patients with hypertensive disease of pregnancy at study entry. PPI users displayed more cases with preexisting proteinuria, less gestational hypertension, and a lower number of neonatal sepsis cases. Finally, their plasma endoglin and endothelin-1 levels were lower while sFlt-1 levels correlated positively with both. In conclusion, PPI use associates with low sFlt-1, endoglin, and endothelin-1 levels, warranting prospective trials to investigate the therapeutic potential of PPIs in preeclampsia. © 2017 American Heart Association, Inc.

Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: an interrupted time series analysis

PubMed Central

Socías, M. Eugenia; Wood, Evan; McNeil, Ryan; Kerr, Thomas; Dong, Huiru; Shoveller, Jean; Montaner, Julio; Milloy, M-J

2018-01-01

Background In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. Methods Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted time series analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrollment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015. Results A total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed. Conclusions We observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies. PMID:28454044

Unintended impacts of regulatory changes to British Columbia Methadone Maintenance Program on addiction and HIV-related outcomes: An interrupted time series analysis.

PubMed

Socías, M Eugenia; Wood, Evan; McNeil, Ryan; Kerr, Thomas; Dong, Huiru; Shoveller, Jean; Montaner, Julio; Milloy, M-J

2017-07-01

In February 2014, several regulatory reforms were introduced to the methadone maintenance treatment (MMT) program in British Columbia, Canada, including a switch to a ten-times more concentrated methadone formulation and restrictions in pharmacy delivery services. We evaluated possible unintended effects of these changes on illicit drug use patterns and HIV treatment outcomes among HIV-positive opioid users. Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive people who use illicit drugs in Vancouver, Canada. Interrupted Time Series Analyses were used to evaluate impacts of the policy change on monthly rates of MMT enrolment, illicit heroin injection, antiretroviral therapy (ART) adherence, and HIV viral suppression among HIV-positive opioid users between November 2012 and May 2015. A total of 331 HIV-positive opioid users were included. The MMT policy change led to a significant immediate 11.5% increase in heroin injection, and 15.9% drop in optimal ART adherence. A gradual increase in the prevalence of MMT enrolment after the policy change was also documented (0.9% per month). No changes in viral suppression rates were observed. We observed immediate increases in illicit heroin injection and decreases in ART adherence in the wake of regulatory changes to the local MMT program. These findings underscore the need to consider potential unintended effects of altering health programmes for vulnerable populations, the need to develop appropriate mitigation strategies, as well as to involve all relevant stakeholders in the planning and implementations of new policies. Copyright © 2017 Elsevier B.V. All rights reserved.

Identification of influential spreaders in online social networks using interaction weighted K-core decomposition method

NASA Astrophysics Data System (ADS)

Al-garadi, Mohammed Ali; Varathan, Kasturi Dewi; Ravana, Sri Devi

2017-02-01

Online social networks (OSNs) have become a vital part of everyday living. OSNs provide researchers and scientists with unique prospects to comprehend individuals on a scale and to analyze human behavioral patterns. Influential spreaders identification is an important subject in understanding the dynamics of information diffusion in OSNs. Targeting these influential spreaders is significant in planning the techniques for accelerating the propagation of information that is useful for various applications, such as viral marketing applications or blocking the diffusion of annoying information (spreading of viruses, rumors, online negative behaviors, and cyberbullying). Existing K-core decomposition methods consider links equally when calculating the influential spreaders for unweighted networks. Alternatively, the proposed link weights are based only on the degree of nodes. Thus, if a node is linked to high-degree nodes, then this node will receive high weight and is treated as an important node. Conversely, the degree of nodes in OSN context does not always provide accurate influence of users. In the present study, we improve the K-core method for OSNs by proposing a novel link-weighting method based on the interaction among users. The proposed method is based on the observation that the interaction of users is a significant factor in quantifying the spreading capability of user in OSNs. The tracking of diffusion links in the real spreading dynamics of information verifies the effectiveness of our proposed method for identifying influential spreaders in OSNs as compared with degree centrality, PageRank, and original K-core.

Entering a New Energy Age

ERIC Educational Resources Information Center

Fowler, John M.

1975-01-01

Discusses the oil embargo and its effects on the United States. Also assesses the present energy situation, sources and users of energy, threats to the environment, and the prospect of nuclear energy for the future. (CP)

Semantic Data Access Services at NASA's Atmospheric Science Data Center

NASA Astrophysics Data System (ADS)

Huffer, E.; Hertz, J.; Kusterer, J.

2012-12-01

The corpus of Earth Science data products at the Atmospheric Science Data Center at NASA's Langley Research Center comprises a widely heterogeneous set of products, even among those whose subject matter is very similar. Two distinct data products may both contain data on the same parameter, for instance, solar irradiance; but the instruments used, and the circumstances under which the data were collected and processed, may differ significantly. Understanding the differences is critical to using the data effectively. Data distribution services must be able to provide prospective users with enough information to allow them to meaningfully compare and evaluate the data products offered. Semantic technologies - ontologies, triple stores, reasoners, linked data - offer functionality for addressing this issue. Ontologies can provide robust, high-fidelity domain models that serve as common schema for discovering, evaluating, comparing and integrating data from disparate products. Reasoning engines and triple stores can leverage ontologies to support intelligent search applications that allow users to discover, query, retrieve, and easily reformat data from a broad spectrum of sources. We argue that because of the extremely complex nature of scientific data, data distribution systems should wholeheartedly embrace semantic technologies in order to make their data accessible to a broad array of prospective end users, and to ensure that the data they provide will be clearly understood and used appropriately by consumers. Toward this end, we propose a distribution system in which formal ontological models that accurately and comprehensively represent the ASDC's data domain, and fully leverage the expressivity and inferential capabilities of first order logic, are used to generate graph-based representations of the relevant relationships among data sets, observational systems, metadata files, and geospatial, temporal and scientific parameters to help prospective data consumers navigate directly to relevant data sets and query, subset, retrieve and compare the measurement and calculation data they contain. A critical part of developing semantically-enabled data distribution capabilities is developing an ontology that adequately describes 1) the data products - their structure, their content, and any supporting documentation; 2) the data domain - the objects and processes that the products denote; and 3) the relationship between the data and the domain. The ontology, in addition, should be machine readable and capable of integrating with the larger data distribution system to provide an interactive user experience. We will demonstrate how a formal, high-fidelity, queriable ontology representing the atmospheric science domain objects and data products, together with a robust set of inference rules for generating interactive graphs, allows researchers to navigate quickly and painlessly through the large volume of data at the ASDC. Scientists will be able to discover data products that exactly meet their particular criteria, link to information about the instruments and processing methods that generated the data; and compare and contrast related products.

EMPTAC (Electromagnetic Pulse Test Aircraft) user's guide

NASA Astrophysics Data System (ADS)

Cleaveland, Dale R.; Burkhard, Avery

1988-04-01

This guide was established to give test managers a way to familiarize themselves with the Air Force Weapons Laboratory's electromagnetic pulse (EMP) test aircraft program located at Kirtland Air Force Base (KAFB), New Mexico. Brief descriptions of the available EMP test facilities at KAFB are also included. This guide should give prospective customers (users) adequate information to scope the magnitude of their test effort and to accomplish general planning without extensive involvement in test execution details.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit.

PubMed

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-04-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care.

The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol

PubMed Central

Peikert, Mona Leandra; Inhestern, Laura; Bergelt, Corinna

2017-01-01

Introduction For ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment. Methods and analysis This prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4–6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis. Ethics and dissemination This study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences. PMID:28801389

NASA technology transfer network communications and information system: TUNS user survey

NASA Technical Reports Server (NTRS)

1992-01-01

Applied Expertise surveyed the users of the deployed Technology Utilization Network System (TUNS) and surveyed prospective new users in order to gather background information for developing the Concept Document of the system that will upgrade and replace TUNS. Survey participants broadly agree that automated mechanisms for acquiring, managing, and disseminating new technology and spinoff benefits information can and should play an important role in meeting NASA technology utilization goals. However, TUNS does not meet this need for most users. The survey describes a number of systematic improvements that will make it easier to use the technology transfer mechanism, and thus expedite the collection and dissemination of technology information. The survey identified 26 suggestions for enhancing the technology transfer system and related processes.

The CORALIE study: improving patient education to help new users better understand their oral contraceptive.

PubMed

de Reilhac, Pia; Plu-Bureau, Geneviève; Serfaty, David; Letombe, Brigitte; Gondry, Jean; Christin-Maitre, Sophie

2016-10-01

Combined oral contraceptives (COCs) are the most widely used contraceptive method in Europe. Paradoxically, rates of unintended pregnancy and abortion are still remarkably high. A lack of knowledge about COCs is often reported to lead to poor adherence, suggesting an unmet need for adequate contraceptive counselling. Our objective was to investigate the impact on the knowledge level of users of a structured approach to deliver contraceptive information for a first COC prescription. The Oral Contraception Project to Optimise Patient Information (CORALIE) is a multicentre, prospective, randomised study conducted in France between March 2009 and January 2013. The intervention involved providing either an 'essential information' checklist or unstructured counselling to new COC users. The outcome measure was a questionnaire that assessed whether the information provided to the new user by the gynaecologist had been correctly understood. One hundred gynaecologists and an expert committee used the Delphi method to develop an 'essential information' checklist, after which 161 gynaecologists were randomised to two groups. Group I (n = 81) used the checklist with 324 new COC users and group II (n = 80) delivered unstructured information to 307 new COC users. The average score for understanding the information delivered during the visit was significantly higher in women in group I than in the women in group II, even after adjustment for age and previous history of pregnancy: 16.48/20 vs 14.27/20 (p < 0.0001). Delivering structured information for a first COC prescription is beneficial for understanding contraception. Our tool could ultimately contribute to increased adherence and should be investigated in a prospective study of long-term outcomes.

Approach-bias predicts development of cannabis problem severity in heavy cannabis users: results from a prospective FMRI study.

PubMed

Cousijn, Janna; Goudriaan, Anna E; Ridderinkhof, K Richard; van den Brink, Wim; Veltman, Dick J; Wiers, Reinout W

2012-01-01

A potentially powerful predictor for the course of drug (ab)use is the approach-bias, that is, the pre-reflective tendency to approach rather than avoid drug-related stimuli. Here we investigated the neural underpinnings of cannabis approach and avoidance tendencies. By elucidating the predictive power of neural approach-bias activations for future cannabis use and problem severity, we aimed at identifying new intervention targets. Using functional Magnetic Resonance Imaging (fMRI), neural approach-bias activations were measured with a Stimulus Response Compatibility task (SRC) and compared between 33 heavy cannabis users and 36 matched controls. In addition, associations were examined between approach-bias activations and cannabis use and problem severity at baseline and at six-month follow-up. Approach-bias activations did not differ between heavy cannabis users and controls. However, within the group of heavy cannabis users, a positive relation was observed between total lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover, approach-bias activations in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) independently predicted cannabis problem severity after six months over and beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during cannabis approach trials, but lower activity during cannabis avoidance trials were associated with decreases in cannabis problem severity. These findings suggest that cannabis users with deficient control over cannabis action tendencies are more likely to develop cannabis related problems. Moreover, the balance between cannabis approach and avoidance responses in the DLPFC and ACC may help identify individuals at-risk for cannabis use disorders and may be new targets for prevention and treatment.

Evaluation of the Tear Function Tests and the Ocular Surface in First-Time Users of Silicone Hydrogel Contact Lenses.

PubMed

Yildiz Tasci, Yelda; Gürdal, Canan; Sarac, Ozge; Onusever, Aykut

2017-07-01

To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (balafilcon A, senofilcon A, and comfilcon A) on tear function tests, corneal thickness, and ocular surface cytology in first time contact lens users. In this prospective study, 120 eyes of 60 subjects were evaluated. Balafilcon A users were designated as group 1, senofilcon A users as group 2, and comfilcon A users as group 3. In all cases, before and after 6 months of contact lens wear, ocular surface disease index score (OSDI), tear breakup time (TBUT), Schirmer 1 test, central corneal thickness (CCT), central corneal epithelium thickness (CCET), and conjunctival impression cytology samples were evaluated. In group 1, 40 eyes of the 20 patients, in group 2, 40 eyes of the 20 patients, and in group 3, 40 eyes of the 20 patients were evaluated. The mean OSDI scores did not differ between the three groups after contact lens wear (p > 0.05). In group 1 and group 2, significant decrease was found in the mean TBUT 6 months after contact lens wear (p = 0.04, p < 0.001, respectively). In group 3, after 6 months of contact lens wear, the mean Schirmer 1 tear test was decreased significantly (p = 0.021). In all 3 groups, no significant change was observed in the mean CCT and CCET after contact lens wear (p > 0.05). After 6 months, the morphological changes in temporal and superior conjunctival epithelial cells were found to be significant in all groups (p < 0.001). Six months after SHCL wear, marked morphological changes occurred in the conjunctival epithelium. Tear function tests were also affected, while corneal thickness did not show any significant difference.

Approach-Bias Predicts Development of Cannabis Problem Severity in Heavy Cannabis Users: Results from a Prospective FMRI Study

PubMed Central

Cousijn, Janna; Goudriaan, Anna E.; Ridderinkhof, K. Richard; van den Brink, Wim; Veltman, Dick J.; Wiers, Reinout W.

2012-01-01

A potentially powerful predictor for the course of drug (ab)use is the approach-bias, that is, the pre-reflective tendency to approach rather than avoid drug-related stimuli. Here we investigated the neural underpinnings of cannabis approach and avoidance tendencies. By elucidating the predictive power of neural approach-bias activations for future cannabis use and problem severity, we aimed at identifying new intervention targets. Using functional Magnetic Resonance Imaging (fMRI), neural approach-bias activations were measured with a Stimulus Response Compatibility task (SRC) and compared between 33 heavy cannabis users and 36 matched controls. In addition, associations were examined between approach-bias activations and cannabis use and problem severity at baseline and at six-month follow-up. Approach-bias activations did not differ between heavy cannabis users and controls. However, within the group of heavy cannabis users, a positive relation was observed between total lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover, approach-bias activations in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) independently predicted cannabis problem severity after six months over and beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during cannabis approach trials, but lower activity during cannabis avoidance trials were associated with decreases in cannabis problem severity. These findings suggest that cannabis users with deficient control over cannabis action tendencies are more likely to develop cannabis related problems. Moreover, the balance between cannabis approach and avoidance responses in the DLPFC and ACC may help identify individuals at-risk for cannabis use disorders and may be new targets for prevention and treatment. PMID:22957019

Development of the teaching simulator based on animated film to strengthening pedagogical competencies of prospective teachers

NASA Astrophysics Data System (ADS)

Fatimah, Siti; Setiawan, Wawan; Kusnendar, Jajang; Rasim, Junaeti, Enjun; Anggraeni, Ria

2017-05-01

Debriefing of pedagogical competence through both theory and practice which became a requirement for prospective teachers were through micro teaching and teaching practice program. But, some reports from the partner schools stated that the participants of teaching practice program have not well prepared on implementing the learning in the classroom because of lacking the debriefing. In line with the development of information technology, it is very possible to develop a media briefing of pedagogical competencies for prospective teachers through an application so that they can use it anytime and anywhere. This study was one answer to the problem of unpreparedness participants of the teaching practice program. This study developed a teaching simulator, which was an application for learning simulation with the animated film to enhance the professional pedagogical competence prospective teachers. By the application of this teaching simulator, students as prospective teacher could test their own pedagogic competence through learning models with different varied characteristics of students. Teaching Simulator has been equipped with features that allow users to be able to explore the quality of teaching techniques that they employ for the teaching and learning activities in the classroom. These features included the election approaches, the student's character, learning materials, questioning techniques, discussion, and evaluation. Teaching simulator application provided the ease of prospective teachers or teachers in implementing the development of lessons for practice in the classroom. Applications that have been developed to apply simulation models allow users to freely manage a lesson. Development of teaching simulator application was passed through the stages which include needs assessment, design, coding, testing, revision, improvement, grading, and packaging. The application of teaching simulator was also enriched with some real instructional video as a comparison for the user. Based on the two experts, the media expert and education expert, stated that the application of teaching simulator is feasible to be used as an instrument for the debriefing of students as potential participants of the teaching practice program. The results of the use of the application to the students as potential participants of teaching practice program, showed significant increases in the pedagogic competence. This study was presented at an international seminar and in the process of publishing in international reputated journals. Applications teaching simulator was in the process of registration to obtain the copyright of the Ministry of Justice and Human Rights. Debriefing for prospective teachers to use teaching simulator application could improve the mastery of pedagogy, give clear feedback, and perform repetitions at anytime.

The use of online word of mouth opinion in online learning: a questionnaire survey.

PubMed

Sandars, John; Walsh, Kieran

2009-04-01

There is increasing use of online word of mouth opinion (user feedback) systems for general services but its use in online learning has not been previously investigated. To understand why users of BMJ Learning provide and read word of mouth feedback, and whether this feedback influences uptake of modules by prospective users. Online questionnaire of users of BMJ Learning who had completed online user feedback. 109 questionnaires were completed (response rate 25%). The main motivation to contribute was to influence the authors of the module (66%), and 43% stated that they wanted to help other users to make an informed choice. 16% stated that they wanted to develop an online community of learners. The main motivation to read the user feedback was to see if they agreed with the comments (56%). Online word of mouth opinion (user feedback) appears to be useful for online learners. There are also system design considerations since the attempt to create an online community of learners that is desired by some users will not be appreciated by others. Further research with a larger number of users is recommended to confirm the findings.

Solar Disinfection Improves Drinking Water Quality to Prevent Diarrhea in Under-Five Children in Sikkim, India

PubMed Central

Rai, BB; Pal, Ranabir; Kar, Sumit; Tsering, Dechen C

2010-01-01

Background: Solar radiations improve the microbiological quality of water and offer a method for disinfection of drinking water that requires few resources and no expertise and may reduce the prevalence of diarrhea among under-five children. Aims and Objectives: To find out the reduction in the prevalence of diarrhea in the under-five children after consumption of potable water treated with solar disinfection method. Materials and Methods: This was a population-based interventional prospective study in the urban slum area of Mazegoan, Jorethang, south Sikkim, during the period 1st May 2007 to 30th November 2007 on 136 children in the under-five age group in 102 households selected by random sampling. Main outcome measure was the assessment of the reduction of the prevalence of diarrhea among under-five children after consumption of potable water treated with solar disinfection method practiced by the caregivers in the intervention group keeping water in polyethylene terephthalate (PET) bottles as directed by the investigators. The data were collected by the interview method using a pre-tested questionnaire prepared on the basis of socio-demographics and prevalence of diarrhea. The data were subjected to percentages and chi-square tests, which were used to find the significance. Results: After four weeks of intervention among the study group, the diarrhea prevalence was 7.69% among solar disinfection (SODIS) users, while 31.82% prevalence was observed among non-users in that period; the reduction in prevalence of diarrhea was 75.83%. After eight weeks of intervention, the prevalence of diarrhea was 7.58% among SODIS users and 31.43% among non-users; the reduction in diarrhea was 75.88% in the study group. The findings were found to be statistically significant. Conclusions: In our study, we observed that the prevalence of diarrhea decreased significantly after solar disinfection of water was practiced by the caregivers keeping potable water in PET bottles in the intervention group. PMID:20927281

Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

PubMed

Park, Song-Yi; Wilkens, Lynne R; Kolonel, Laurence N; Monroe, Kristine R; Haiman, Christopher A; Marchand, Loïc Le

2017-02-01

Evidence has accumulated that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer. We tested whether the inverse associations between NSAIDs and colorectal cancer is similarly observed across sexes and five racial/ethnic groups (Japanese, Latino, African American, Native Hawaiian, and white) in the Multiethnic Cohort (MEC) Study. During a mean follow-up of 16.1 years, we identified 4,882 invasive incident colorectal cancer cases among 183,199 eligible participants. Cox proportional hazards models were used to calculate HRs and 95% confidence intervals (CI). Use of aspirin and other NSAIDs was associated with a lower incidence of colorectal cancer in men (HR = 0.77; 95% CI, 0.69-0.86 for current vs. never users of aspirin) but not in women (P interaction = 0.005). Among male current users, a reduced risk was observed with ≥6 years of aspirin or total NSAID use. The inverse association with current NSAID use in men was observed in all racial/ethnic groups, except for Native Hawaiians, and was stronger in whites. Our findings suggest that the benefit of NSAIDs for colorectal cancer may be strongest for white men and generalizes to African American, Japanese, and Latino, but not to Native Hawaiian men. The lack of inverse association observed in women and Native Hawaiian men in the MEC should be interpreted with caution. As only very few ethnic/racial groups are likely to be represented in trials of NSAIDs and colorectal cancer, it is important to conduct prospective observational studies in various populations to test the generalizability of their results. Cancer Epidemiol Biomarkers Prev; 26(2); 162-9. ©2016 AACR. ©2016 American Association for Cancer Research.

Effect of statins on disease-related outcomes in patients with idiopathic pulmonary fibrosis.

PubMed

Kreuter, Michael; Bonella, Francesco; Maher, Toby M; Costabel, Ulrich; Spagnolo, Paolo; Weycker, Derek; Kirchgaessler, Klaus-Uwe; Kolb, Martin

2017-02-01

Data are conflicting regarding the possible effects of statins in patients with idiopathic pulmonary fibrosis (IPF). This post hoc analysis assessed the effects of statin therapy on disease-related outcomes in IPF. Patients randomised to placebo (n=624) in three controlled trials of pirfenidone in IPF (CAPACITY 004 and 006, ASCEND) were categorised by baseline statin use. Outcomes assessed during the 1-year follow-up included disease progression, mortality, hospitalisation and composite outcomes of death or ≥10% absolute decline in FVC and death or ≥50 m decline in 6-minute walk distance (6MWD). At baseline, 276 (44%) patients were statin users versus 348 (56%) non-users. Baseline characteristics were similar between groups, except statin users were older and had higher prevalence of cardiovascular disease and risk factors. In multivariate analyses adjusting for differences in baseline characteristics, statin users had lower risks of death or 6MWD decline (HR 0.69; 95% CI 0.48 to 0.99, p=0.0465), all-cause hospitalisation (HR 0.58; 95% CI 0.35 to 0.94, p=0.0289), respiratory-related hospitalisation (HR 0.44; 95% CI 0.25 to 0.80, p=0.0063) and IPF-related mortality (HR 0.36; 95% CI 0.14 to 0.95, p=0.0393) versus non-users. Non-significant treatment effects favouring statin use were observed for disease progression (HR 0.75; 95% CI 0.52 to 1.07, p=0.1135), all-cause mortality (HR 0.54; 95% CI 0.24 to 1.21, p=0.1369) and death or FVC decline (HR 0.71; 95% CI 0.48 to 1.07, p=0.1032). This post hoc analysis supports the hypothesis that statins may have a beneficial effect on clinical outcomes in IPF. Prospective clinical trials are required to validate these observations. NCT01366209, NCT00287729 and NCT00287716. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Mobile phones and social structures: an exploration of a closed user group in rural Ghana

PubMed Central

2013-01-01

Background In the Millennium Villages Project site of Bonsaaso, Ghana, the Health Team is using a mobile phone closed user group to place calls amongst one another at no cost. Methods In order to determine the utilization and acceptability of the closed user group amongst users, social network analysis and qualitative methods were used. Key informants were identified and interviewed. The key informants also kept prospective call journals. Billing statements and de-identified call data from the closed user group were used to generate data for analyzing the social structure revealed by the network traffic. Results The majority of communication within the closed user group was personal and not for professional purposes. The members of the CUG felt that the group improved their efficiency at work. Conclusions The methods used present an interesting way to investigate the social structure surrounding communication via mobile phones. In addition, the benefits identified from the exploration of this closed user group make a case for supporting mobile phone closed user groups amongst professional groups. PMID:24007331

An international prospective cohort study of mobile phone users and health (Cosmos): design considerations and enrolment.

PubMed

Schüz, Joachim; Elliott, Paul; Auvinen, Anssi; Kromhout, Hans; Poulsen, Aslak Harbo; Johansen, Christoffer; Olsen, Jørgen H; Hillert, Lena; Feychting, Maria; Fremling, Karin; Toledano, Mireille; Heinävaara, Sirpa; Slottje, Pauline; Vermeulen, Roel; Ahlbom, Anders

2011-02-01

There is continuing public and scientific interest in the possibility that exposure to radiofrequency (RF) electromagnetic fields (EMF) from mobile telephones or other wireless devices and applications might increase the risk of certain cancers or other diseases. The interest is amplified by the rapid world-wide penetration of such technologies. The evidence from epidemiological studies published to date have not been consistent and, in particular, further studies are required to identify whether longer term (well beyond 10 years) RF exposure might pose some health risk. The "Cosmos" study described here is a large prospective cohort study of mobile telephone users (ongoing recruitment of 250,000 men and women aged 18+ years in five European countries - Denmark, Finland, Sweden, The Netherlands, UK) who will be followed up for 25+ years. Information on mobile telephone use is collected prospectively through questionnaires and objective traffic data from network operators. Associations with disease risks will be studied by linking cohort members to existing disease registries, while changes in symptoms such as headache and sleep quality and of general well-being are assessed by baseline and follow-up questionnaires. A prospective cohort study conducted with appropriate diligence and a sufficient sample size, overcomes many of the shortcomings of previous studies. Its major advantages are exposure assessment prior to the diagnosis of disease, the prospective collection of objective exposure information, long-term follow-up of multiple health outcomes, and the flexibility to investigate future changes in technologies or new research questions. Copyright © 2010 Elsevier Ltd. All rights reserved.

The relationship between risk networks' patterns of crack cocaine and alcohol consumption and HIV-related sexual behaviors among adult injection drug users: a prospective study.

PubMed

Latkin, C A; Mandell, W; Vlahov, D

1996-11-01

Social context may be an important determinant of drug and alcohol consumption and HIV-related behaviors. To assess the influence of peers on drug users' risk behaviors this study examined the association between individual level and group level behaviors. This analysis reports on the prospective association between baseline self-reported drug and alcohol use of the network members of injection drug users, and self-reported sexual behaviors and alcohol use at 5-month follow-up. Participants were a nontreatment sample of inner-city injection drug users who volunteered for a network-oriented HIV preventive intervention. They were predominantly unemployed, African American males. Of the 71 index participants who completed both the baseline and follow-up interviews, 227 of their drug network members were enrolled in the study. At baseline indexes' sexual risk behaviors were significantly associated with their drug network members' level of crack cocaine use. At follow-up higher levels of alcohol and crack use among drug network members were associated with indexes' reports of multiple sex partners and increased alcohol consumption. Higher levels of crack use among the drug network members were associated with the indexes' reporting casual sex partners at follow-up. These results highlight the importance of studying the role of peer group influence and the social context of risk behaviors.

Using a social marketing framework to evaluate recruitment of a prospective study of genetic counseling and testing for the deaf community.

PubMed

Kobayashi, Yoko; Boudreault, Patrick; Hill, Karin; Sinsheimer, Janet S; Palmer, Christina G S

2013-11-25

Recruiting deaf and hard-of-hearing participants, particularly sign language-users, for genetics health service research is challenging due to communication barriers, mistrust toward genetics, and researchers' unfamiliarity with deaf people. Feelings of social exclusion and lack of social cohesion between researchers and the Deaf community are factors to consider. Social marketing is effective for recruiting hard-to-reach populations because it fosters social inclusion and cohesion by focusing on the targeted audience's needs. For the deaf population this includes recognizing their cultural and linguistic diversity, their geography, and their systems for information exchange. Here we use concepts and language from social marketing to evaluate our effectiveness to engage a U.S. deaf population in a prospective, longitudinal genetic counseling and testing study. The study design was interpreted in terms of a social marketing mix of Product, Price, Place, and Promotion. Price addressed linguistic diversity by including a variety of communication technologies and certified interpreters to facilitate communication; Place addressed geography by including community-based participation locations; Promotion addressed information exchange by using multiple recruitment strategies. Regression analyses examined the study design's effectiveness in recruiting a culturally and linguistically diverse sample. 271 individuals were enrolled, with 66.1% American Sign Language (ASL)-users, 19.9% ASL + English-users, 12.6% English-users. Language was significantly associated with communication technology, participation location, and recruitment. Videophone and interpreters were more likely to be used for communication between ASL-users and researchers while voice telephone and no interpreters were preferred by English-users (Price). ASL-users were more likely to participate in community-based locations while English-users preferred medically-based locations (Place). English-users were more likely to be recruited through mass media (Promotion) while ASL-users were more likely to be recruited through community events and to respond to messaging that emphasized inclusion of a Deaf perspective. This study design effectively engaged the deaf population, particularly sign language-users. Results suggest that the deaf population's cultural and linguistic diversity, geography, and forms of information exchange must be taken into account in study designs for successful recruitment. A social marketing approach that incorporates critical social determinants of health provides a novel and important framework for genetics health service research targeting specific, and hard-to-reach, underserved groups.

Using a social marketing framework to evaluate recruitment of a prospective study of genetic counseling and testing for the deaf community

PubMed Central

2013-01-01

Background Recruiting deaf and hard-of-hearing participants, particularly sign language-users, for genetics health service research is challenging due to communication barriers, mistrust toward genetics, and researchers’ unfamiliarity with deaf people. Feelings of social exclusion and lack of social cohesion between researchers and the Deaf community are factors to consider. Social marketing is effective for recruiting hard-to-reach populations because it fosters social inclusion and cohesion by focusing on the targeted audience’s needs. For the deaf population this includes recognizing their cultural and linguistic diversity, their geography, and their systems for information exchange. Here we use concepts and language from social marketing to evaluate our effectiveness to engage a U.S. deaf population in a prospective, longitudinal genetic counseling and testing study. Methods The study design was interpreted in terms of a social marketing mix of Product, Price, Place, and Promotion. Price addressed linguistic diversity by including a variety of communication technologies and certified interpreters to facilitate communication; Place addressed geography by including community-based participation locations; Promotion addressed information exchange by using multiple recruitment strategies. Regression analyses examined the study design’s effectiveness in recruiting a culturally and linguistically diverse sample. Results 271 individuals were enrolled, with 66.1% American Sign Language (ASL)-users, 19.9% ASL + English-users, 12.6% English-users. Language was significantly associated with communication technology, participation location, and recruitment. Videophone and interpreters were more likely to be used for communication between ASL-users and researchers while voice telephone and no interpreters were preferred by English-users (Price). ASL-users were more likely to participate in community-based locations while English-users preferred medically-based locations (Place). English-users were more likely to be recruited through mass media (Promotion) while ASL-users were more likely to be recruited through community events and to respond to messaging that emphasized inclusion of a Deaf perspective. Conclusions This study design effectively engaged the deaf population, particularly sign language-users. Results suggest that the deaf population’s cultural and linguistic diversity, geography, and forms of information exchange must be taken into account in study designs for successful recruitment. A social marketing approach that incorporates critical social determinants of health provides a novel and important framework for genetics health service research targeting specific, and hard-to-reach, underserved groups. PMID:24274380

[Goals, possibilities and limits of quality evaluation of guidelines. A background report on the user manual of the "Methodological Quality of Guidelines" check list].

PubMed

Helou, A; Ollenschläger, G

1998-06-01

Recently a German appraisal instrument for clinical guidelines was published that could be used by various parties in formal evaluation of guidelines. An user's guide to the appraisal instrument was designed that contains a detailed explanation for each question to ensure that the instrument is interpreted consistently. This paper describes the purposes, format and contents of the user's guide, and reviews the key factors influencing the validity of guidelines. Taking into account international experiences, the purposes, chances and methodological limitations of a prospective assessment of clinical practice guidelines are discussed.

A multicenter prospective cohort study on camera navigation training for key user groups in minimally invasive surgery.

PubMed

Graafland, Maurits; Bok, Kiki; Schreuder, Henk W R; Schijven, Marlies P

2014-06-01

Untrained laparoscopic camera assistants in minimally invasive surgery (MIS) may cause suboptimal view of the operating field, thereby increasing risk for errors. Camera navigation is often performed by the least experienced member of the operating team, such as inexperienced surgical residents, operating room nurses, and medical students. The operating room nurses and medical students are currently not included as key user groups in structured laparoscopic training programs. A new virtual reality laparoscopic camera navigation (LCN) module was specifically developed for these key user groups. This multicenter prospective cohort study assesses face validity and construct validity of the LCN module on the Simendo virtual reality simulator. Face validity was assessed through a questionnaire on resemblance to reality and perceived usability of the instrument among experts and trainees. Construct validity was assessed by comparing scores of groups with different levels of experience on outcome parameters of speed and movement proficiency. The results obtained show uniform and positive evaluation of the LCN module among expert users and trainees, signifying face validity. Experts and intermediate experience groups performed significantly better in task time and camera stability during three repetitions, compared to the less experienced user groups (P < .007). Comparison of learning curves showed significant improvement of proficiency in time and camera stability for all groups during three repetitions (P < .007). The results of this study show face validity and construct validity of the LCN module. The module is suitable for use in training curricula for operating room nurses and novice surgical trainees, aimed at improving team performance in minimally invasive surgery. © The Author(s) 2013.

Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women's health initiative

PubMed Central

McGinn, A. P.; Budrys, N.; Chlebowski, R.; Ho, G. Y.; Johnson, K. C.; Lane, D. S.; Li, W.; Neuhouser, M. L.; Saquib, J.; Shikany, J. M.; Song, Y.; Thomson, C.

2014-01-01

Multivitamin use is common in the United States. It is not known whether multivitamins with minerals supplements (MVM) used by women already diagnosed with invasive breast cancer would affect their breast cancer mortality risk. To determine prospectively the effects of MVM use on breast cancer mortality in postmenopausal women diagnosed with invasive breast cancer, a prospective cohort study was conducted of 7,728 women aged 50–79 at enrollment in the women's health initiative (WHI) in 40 clinical sites across the United States diagnosed with incident invasive breast cancer during WHI and followed for a mean of 7.1 years after breast cancer diagnosis. Use of MVM supplements was assessed at WHI baseline visit and at visit closest to breast cancer diagnosis, obtained from vitamin pill bottles brought to clinic visit. Outcome was breast cancer mortality. Hazard ratios and 95 % confidence intervals (CIs) for breast cancer mortality comparing MVM users to non-users were estimated using Cox proportional hazard regression models. Analyses using propensity to take MVM were done to adjust for potential differences in characteristics of MVM users versus non-users. At baseline, 37.8 % of women reported MVM use. After mean post-diagnosis follow-up of 7.1 ± 4.1 (SD) years, there were 518 (6.7 %) deaths from breast cancer. In adjusted analyses, breast cancer mortality was 30 % lower in MVM users as compared to non-users (HR = 0.70; 95 % CI 0.55, 0.91). This association was highly robust and persisted after multiple adjustments for potential confounding variables and in propensity score matched analysis (HR = 0.76; 95 % CI 0.60–0.96). Postmenopausal women with invasive breast cancer using MVM had lower breast cancer mortality than non-users. The results suggest a possible role for daily MVM use in attenuating breast cancer mortality in women with invasive breast cancer but the findings require confirmation. PMID:24104882

Human-Centered Design Study: Enhancing the Usability of a Mobile Phone App in an Integrated Falls Risk Detection System for Use by Older Adult Users.

PubMed

Harte, Richard; Quinlan, Leo R; Glynn, Liam; Rodríguez-Molinero, Alejandro; Baker, Paul Ma; Scharf, Thomas; ÓLaighin, Gearóid

2017-05-30

Design processes such as human-centered design (HCD), which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of HCD can often conflict with the necessary rapid product development life-cycles associated with the competitive connected health industry. The aim of this study was to apply a structured HCD methodology to the development of a smartphone app that was to be used within a connected health fall risk detection system. Our methodology utilizes so called discount usability engineering techniques to minimize the burden on resources during development and maintain a rapid pace of development. This study will provide prospective designers a detailed description of the application of a HCD methodology. A 3-phase methodology was applied. In the first phase, a descriptive "use case" was developed by the system designers and analyzed by both expert stakeholders and end users. The use case described the use of the app and how various actors would interact with it and in what context. A working app prototype and a user manual were then developed based on this feedback and were subjected to a rigorous usability inspection. Further changes were made both to the interface and support documentation. The now advanced prototype was exposed to user testing by end users where further design recommendations were made. With combined expert and end-user analysis of a comprehensive use case having originally identified 21 problems with the system interface, we have only seen and observed 3 of these problems in user testing, implying that 18 problems were eliminated between phase 1 and 3. Satisfactory ratings were obtained during validation testing by both experts and end users, and final testing by users shows the system requires low mental, physical, and temporal demands according to the NASA Task Load Index (NASA-TLX). From our observation of older adults' interactions with smartphone interfaces, there were some recurring themes. Clear and relevant feedback as the user attempts to complete a task is critical. Feedback should include pop-ups, sound tones, color or texture changes, or icon changes to indicate that a function has been completed successfully, such as for the connection sequence. For text feedback, clear and unambiguous language should be used so as not to create anxiety, particularly when it comes to saving data. Warning tones or symbols, such as caution symbols or shrill tones, should only be used if absolutely necessary. Our HCD methodology, designed and implemented based on the principles of the International Standard Organizaton (ISO) 9241-210 standard, produced a functional app interface within a short production cycle, which is now suitable for use by older adults in long term clinical trials. ©Richard Harte, Leo R Quinlan, Liam Glynn, Alejandro Rodríguez-Molinero, Paul MA Baker, Thomas Scharf, Gearóid ÓLaighin. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.05.2017.

Do heroin overdose patients require observation after receiving naloxone?

PubMed

Willman, Michael W; Liss, David B; Schwarz, Evan S; Mullins, Michael E

2017-02-01

Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses. There are concerns about the outcomes and safety of this practice as well. To search the medical literature related to the following questions: (1) What are the medical risks to a heroin user who refuses ambulance transport after naloxone? (2) If the heroin user is treated in the emergency department with naloxone, how long must they be observed prior to discharge? (3) How effective in heroin users is naloxone administered by first responders and bystanders? Are there risks associated with naloxone distribution programs? We searched PubMed and GoogleScholar with search terms related to each of the questions listed above. The search was limited to English language and excluded patents and citations. The search was last updated on September 31, 2016. The articles found were reviewed for relevance to our objective questions. Eight out of 1020 citations were relevant to the first 2 questions, 5 of 707 were relevant to the third question and 15 of 287 were relevant to the fourth question. In the prehospital environment, does a heroin user revived with naloxone always require ambulance transport and what are the medical risks if ambulance transport is refused after naloxone? The eight articles were all observational studies done either prospectively or retrospectively. Two studies focused on heroin overdoses and included 1069 patients not transported to the hospital. No deaths occurred in this group. In counting the patients from all eight studies, some of which included non-heroin opioid overdoses, there were 5443 patients treated without transport and four deaths from rebound opioid toxicity. The number needed to transport to save one life (NNT) is 1361. Adverse effects were mostly related to opioid withdrawal. If a heroin user is treated in the ED, how long must the patient stay under observation before being safe for discharge? Five articles addressing the duration of ED observation required for patients treated with naloxone for opioid overdoses. Although a wide range of observation durations were reported, one study supported observing patients for one hour. If after this period the patient mobilizes as usual, has normal vital signs, and a Glasgow Coma Scale of 15, they can be discharged safely. What are the likely risks in heroin users following naloxone use by lay bystanders or first responders? Of the 15 relevant papers, a systematic review reported a 100% survival rate in eleven studies and a range of 96-99% survival in the remaining four. Two other studies suffered from poor follow-up and had lower success rates of 83% and 89%. Few if any risks were associated with opioid overdose prevention programs in which lay people were trained to administer naloxone. Patients revived with naloxone after heroin overdose may be safely released without transport to the hospital if they have normal mentation and vital signs. In the absence of co-intoxicants and further opioid use there is very low risk of death from rebound opioid toxicity. For those patients treated in the ED for opioid overdose, an observation period of one hour is sufficient if they ambulate as usual, have normal vital signs and a Glasgow Coma Scale of 15. Patients suffering opioid toxicity can be administered naloxone safely by first responders and trained lay people. Programs that train these individuals are likely safe and beneficial, however further research is necessary.

User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study.

PubMed

Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

2017-12-01

To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Electronic Cigarette Use in US Adults at Risk for or with COPD: Analysis from Two Observational Cohorts.

PubMed

Bowler, Russell P; Hansel, Nadia N; Jacobson, Sean; Graham Barr, R; Make, Barry J; Han, MeiLan K; O'Neal, Wanda K; Oelsner, Elizabeth C; Casaburi, Richard; Barjaktarevic, Igor; Cooper, Chris; Foreman, Marilyn; Wise, Robert A; DeMeo, Dawn L; Silverman, Edwin K; Bailey, William; Harrington, Kathleen F; Woodruff, Prescott G; Drummond, M Bradley

2017-12-01

Electronic cigarettes (e-cigarettes) are battery-operated nicotine-delivery devices used by some smokers as a cessation tool as well as by never smokers. To determine the usage of e-cigarettes in older adults at risk for or with chronic obstructive pulmonary disease (COPD). Prospective cohorts. COPDGene (N = 3536) and SPIROMICS (N = 1060) subjects who were current or former smokers aged 45-80. Participants were surveyed to determine whether e-cigarette use was associated with longitudinal changes in COPD progression or smoking habits. From 2010 to 2016, participants who had ever used e-cigarettes steadily increased to 12-16%, but from 2014 to 2016 current use was stable at ~5%. E-cigarette use in African-Americans (AA) and whites was similar; however, AA were 1.8-2.9 times as likely to use menthol-flavored e-cigarettes. Current e-cigarette and conventional cigarette users had higher nicotine dependence and consumed more nicotine than those who smoked only conventional cigarettes. E-cigarette users had a heavier conventional cigarette smoking history and worse respiratory health, were less likely to reduce or quit conventional cigarette smoking, had higher nicotine dependence, and were more likely to report chronic bronchitis and exacerbations. Ever e-cigarette users had more rapid decline in lung function, but this trend did not persist after adjustment for persistent conventional cigarette smoking. E-cigarette use, which is common in adults with or at risk for COPD, was associated with worse pulmonary-related health outcomes, but not with cessation of smoking conventional cigarettes. Although this was an observational study, we find no evidence supporting the use of e-cigarettes as a harm reduction strategy among current smokers with or at risk for COPD.

Human factors approach to evaluate the user interface of physiologic monitoring.

PubMed

Fidler, Richard; Bond, Raymond; Finlay, Dewar; Guldenring, Daniel; Gallagher, Anthony; Pelter, Michele; Drew, Barbara; Hu, Xiao

2015-01-01

As technology infiltrates more of our personal and professional lives, user expectations for intuitive design have driven many consumer products, while medical equipment continues to have high training requirements. Not much is known about the usability and user experience associated with hospital monitoring equipment. This pilot project aimed to better understand and describe the user interface interaction and user experience with physiologic monitoring technology. This was a prospective, descriptive, mixed-methods quality improvement project to analyze perceptions and task analyses of physiologic monitors. Following a survey of practice patterns and perceived abilities to accomplish key tasks, 10 voluntary experienced physician and nurse subjects were asked to perform a series of tasks in 7 domains of monitor operations on GE Monitoring equipment in a single institution. For each task analysis, data were collected on time to complete the task, the number of button pushes or clicks required to accomplish the task, economy of motion, and observed errors. Although 60% of the participants reported incorporating monitoring data into patient care, 80% of participants preferred to receive monitoring data at the point of care (bedside). Average perceived central station usability is 5.3 out of 10 (ten is easiest). High variability exists in monitoring station interaction performance among those participating in this project. Alarms were almost universally silenced without cognitive recognition of the alarm state. Education related to monitoring operations appeared largely absent in this sample. Most users perceived the interface to not be intuitive, complaining of multiple layers and steps for data retrieval. These clinicians report real-time monitoring helpful for abrupt changes in condition like arrhythmias; however, reviewing alarms is not prioritized as valuable due to frequent false alarms. Participants requested exporting monitoring data to electronic medical records. Much research is needed to develop best practices for display of real-time information, organization and filtering of meaningful data, and simplified ways to find information. Published by Elsevier Inc.

Menstrual and reproductive factors and gastric cancer risk in a large prospective study of women.

PubMed

Freedman, Neal D; Chow, Wong-Ho; Gao, Yu-Tang; Shu, Xiao-Ou; Ji, Bu-Tian; Yang, Gong; Lubin, Jay H; Li, Hong-Lan; Rothman, Nathaniel; Zheng, Wei; Abnet, Christian C

2007-12-01

Gastric cancer incidence rates are consistently lower in women than men in both high and low-risk regions worldwide. Sex hormones, such as progesterone and estrogen, may protect women against gastric cancer. To investigate the association of menstrual and reproductive factors and gastric cancer risk. These associations were prospectively investigated in 73 442 Shanghai women. After 419 260 person-years of follow-up, 154 women were diagnosed with gastric cancer. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models adjusted for age, body mass index, education, income, and cigarette use. No associations were observed between gastric cancer risk and age of menarche, number of children, breast feeding, or oral contraceptive use. In contrast, associations were observed with age of menopause (HR 0.80 per five-year increase in menopausal age, 95% CI 0.66-0.97), years of fertility (participants with less than 30 years of fertility were at increased risk compared with those with 30-36 years of fertility, HR 1.90, 95% CI 1.25-2.90), years since menopause (HR 1.26 per five years, 95% CI 1.03-1.53), and intrauterine device use (HR for users 1.61, 95% CI 1.08-2.39). These results support the hypothesis that female hormones play a protective role in gastric cancer risk.

Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users.

PubMed

Wang, Michael T M; Chan, Evon; Ea, Linda; Kam, Clifford; Lu, Yvonne; Misra, Stuti L; Craig, Jennifer P

2017-11-01

Dry eye is a frequently reported problem among computer users. Low relative humidity environments are recognized to exacerbate signs and symptoms of dry eye, yet are common in offices of computer operators. Desktop USB-powered humidifiers are available commercially, but their efficacy for dry eye relief has not been established. This study aims to evaluate the potential for a desktop USB-powered humidifier to improve tear-film parameters, ocular surface characteristics, and subjective comfort of computer users. Forty-four computer users were enrolled in a prospective, masked, randomized crossover study. On separate days, participants were randomized to 1 hour of continuous computer use, with and without exposure to a desktop humidifier. Lipid-layer grade, noninvasive tear-film breakup time, and tear meniscus height were measured before and after computer use. Following the 1-hour period, participants reported whether ocular comfort was greater, equal, or lesser than that at baseline. The desktop humidifier effected a relative difference in humidity between the two environments of +5.4 ± 5.0% (P < .001). Participants demonstrated no significant differences in lipid-layer grade and tear meniscus height between the two environments (all P > .05). However, a relative increase in the median noninvasive tear-film breakup time of +4.0 seconds was observed in the humidified environment (P < .001), which was associated with a higher proportion of subjects reporting greater comfort relative to baseline (36% vs. 5%, P < .001). Even with a modest increase in relative humidity locally, the desktop humidifier shows potential to improve tear-film stability and subjective comfort during computer use.Trial registration no: ACTRN12617000326392.

The use of electric bed heaters and the risk of clinically recognized spontaneous abortion.

PubMed

Lee, G M; Neutra, R R; Hristova, L; Yost, M; Hiatt, R A

2000-07-01

We conducted a prospective cohort study to evaluate the relation of spontaneous abortion and electric bed heater use during the first trimester of pregnancy. Compared with non-users, rates of spontaneous abortion were lower for women who used electric bed heaters. The adjusted odds ratio and 95% confidence interval (CI) for the two major devices used, electric blankets (N = 524) and waterbeds (N = 796), were, respectively, 0.8 (95% CI = 0.5-1.1) and 0.9 (95% CI = 0.7-1.2). An increase of risk with increasing intensity (setting-duration combination) of use was not observed. Users of electric blankets at low settings for most of the night (N = 171) had lower risks of spontaneous abortion than non-users (adjusted odds ratio = 0.5; 95% CI = 0.3-1.0). Twenty women who used electric blankets at a high setting for 1 hour or less had an adjusted odds ratio of 3.0 (95% CI = 1.1-8.3), but we found no spontaneous abortions among the few women (N = 13) who used a high setting for 2 or more hours. We found that exposure rankings of the magnetic field time-weighted average and a rate of change metric did not correspond monotonically to the pattern of spontaneous abortion risks and that electric blankets contribute less to overnight time-weighted average magnetic fields than has been thought.

Report on Development of CFEA (Collective Front-End Analysis) Procedures: Specification of CFEA Model & Results of the HAWK CFEA

DTIC Science & Technology

1985-03-01

0423 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT, PROJECT, TASK AREA & WORK UNIT NUMBERSApplied Science Associates, Inc. AREAOU U...the workload on the user and help organize the massive amounts of data involved, job aids have been developed for CFEA users. A trial CFEA was conducted...coupled with the complex and massive nature of a CFEA of a battalion-sized [ organization could make the prospect of conducting a CFEA seem a bit over

Bright Idea: Solar Energy Primer.

ERIC Educational Resources Information Center

Missouri State Dept. of Natural Resources, Jefferson City.

This booklet is intended to address questions most frequently asked about solar energy. It provides basic information and a starting point for prospective solar energy users. Information includes discussion of solar space heating, solar water heating, and solar greenhouses. (Author/RE)

Feasibility of assessing the safety and effectiveness of menstrual regulation medications purchased from pharmacies in Bangladesh: a prospective cohort study.

PubMed

Footman, Katharine; Scott, Rachel; Taleb, Fahmida; Dijkerman, Sally; Nuremowla, Sadid; Reiss, Kate; Church, Kathryn

2018-02-01

To assess the feasibility of following up women who purchase mifepristone+misoprostol or misoprostol-only from pharmacies in order to measure the safety and effectiveness of self-administration of menstrual regulation. A prospective cohort study followed women purchasing mifepristone+misoprostol or misoprostol-only from pharmacies in Bangladesh. Participants were recruited by pharmacy workers either in person or indirectly via the purchaser of the drugs. End users were contacted by phone 2 weeks after recruitment, screened and interviewed. Study recruitment rates by pharmacy workers were low (30%, 109 of 642 women informed about the study), but 2-week follow-up rates were high (87%). Of the 109 end users interviewed, 87 purchased mifepristone+misoprostol and 20 misoprostol-only, while 2 women did not know what drugs they had purchased. Mean self-reported number of weeks of pregnancy was 5.7 weeks. Information provision by pharmacy workers was inadequate (40.4% received none, 8.7% received written information or pictures). A total of 80.5% of mifepristone+misoprostol users were sold the correct regimen versus 9 out of 20 misoprostol-only users. A total of 68.8% did not report experiencing any complications (70.0% misoprostol-only; 69.0% mifepristone+misoprostol users, p=1.0). A total of 94.3% of mifepristone+misoprostol users and 75% of misoprostol-only users reported that they were not pregnant at day 15 (p=.020). However, 7.3% of all users sought additional treatment. Challenges in assessing outcomes of self-managed menstrual regulation medications purchased from pharmacies must be overcome through further development of this methodology. Interventions are urgently needed to ensure that women have access to correct dosages, accurate information and necessary referrals. This paper assesses the outcomes of women who self-manage menstrual regulation medications purchased from pharmacies. The methodology requires further development, but our study provides preliminary positive evidence on the safety and effectiveness of self-management despite low information provision from pharmacy workers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

ENVIRONMENTAL TECHNOLOGY VERIFICATION PROGRAM - ADVANCED MONITORING SYSTEMS OUTREACH

EPA Science Inventory

Technology performance information must be effectively communicated if it is to be of value to prospective users. The U.S. Environmental Protection Agency has provided funding to the Environmental Technology Verification (ETV) program to provide a plan to verify the environmen...

Nearest private query based on quantum oblivious key distribution

NASA Astrophysics Data System (ADS)

Xu, Min; Shi, Run-hua; Luo, Zhen-yu; Peng, Zhen-wan

2017-12-01

Nearest private query is a special private query which involves two parties, a user and a data owner, where the user has a private input (e.g., an integer) and the data owner has a private data set, and the user wants to query which element in the owner's private data set is the nearest to his input without revealing their respective private information. In this paper, we first present a quantum protocol for nearest private query, which is based on quantum oblivious key distribution (QOKD). Compared to the classical related protocols, our protocol has the advantages of the higher security and the better feasibility, so it has a better prospect of applications.

Improvement of Workwear Clothing for Army

NASA Astrophysics Data System (ADS)

Belakova, D.; Dabolina, I.; Baltina, I.; Zommere, G.

2017-10-01

The two main tasks of combat clothes are soldier's physical protection and freedom of movements [1]. This requirement shall be made with the provision of protective clothing appearance and fit, as well as a suitable choice of material [2]. The aim of the research described in an article is to find out what issues the potential end user meets with during product using (field uniform trousers and jackets) and how it would be possible to avoid it. To reach the aim, end user were interviewed using survey, prospective users were measured by non-contact Human Body 3D scanning combat clothing prototypes (field uniforms) constructive and technological solutions and properties of fabrics were analysed during research.

Body composition and bone mineral density in users of the etonogestrel-releasing contraceptive implant.

PubMed

Modesto, Waleska; Dal Ava, Natália; Monteiro, Ilza; Bahamondes, Luis

2015-12-01

There is scarce information about bone mineral density (BMD) and body composition (BC) among users of the etonogestrel (ENG)-releasing implant. To evaluate BC and BMD in ENG-releasing implant users as compared to copper intrauterine device (Cu-IUD)-users. A prospective study was conducted on 75 users of both contraceptive methods. BMD was evaluated at femoral neck (FN) and lumbar spine (LS) (L1-L4) and BC at baseline and at 12 months after insertion. The mean (±SD) age was 30.4 ± 6.8 and 29.8 ± 8.4 years and body mass index (kg/m(2)) was 24.9 ± 4.1 and 24.6 ± 3.5 in ENG-releasing implant- and Cu-IUD-users, respectively. ENG-releasing implant users did not show significant differences on BMD at the LS and FN at 12 months of use. Furthermore, ENG-implant users had an increase in body weight at 12 months (p < 0.001) and an increase of 2 % in the percentage of body fat, when compared with Cu-IUD users. There was a significant increase in lean mass in ENG-implant users at 12 months (p = 0.020). No significant changes of BMD were seen after the first year of use among the ENG-releasing implant-users, albeit an increase of weight and fat mass was seen when compared to Cu-IUD users.

Rationale, design, and baseline data of a cross-national randomized trial on the effect of built shade in public parks for sun protection.

PubMed

Buller, David B; Dobbinson, Suzanne; English, Dallas R; Wakefield, Melanie; Buller, Mary Klein

2017-04-01

Environments can be structured to reduce solar ultraviolet radiation (UV) exposure to prevent skin cancer. A prospective randomized trial is being conducted to test whether introducing shade sails in passive recreation areas (PRAs) in public parks will increase use and decrease UV exposure in the shaded compared to unshaded PRAs. Shade effects will be compared between Melbourne, Australia and Denver, USA. The trial enrolled 145 public parks with PRAs suitable for shade construction and randomized parks to intervention or control in a 1:3 ratio. Use of PRAs and UV levels were recorded at each park by trained observers during 30-minute periods on four weekend days in each of two summers (pretest and posttest). Shade sails were constructed between the summers. Given low numbers of users at pretest, the outcome measure was modified to use of the PRA (use vs. no use) and unit of analysis to the individual observation. Observations (n=580) occurred on average 29days from the summer solstice and 55min from solar noon in warm weather (mean=26.2°C) with some cloud cover but only slight or no wind. Typically, PRAs had benches and picnic tables and were located near playgrounds. PRAs were in use during 13.3% of observations (mean=0.41 users). UV over 30-minutes at the PRA boundary (mean=3.2 standard erythemal dose [SED]) and center (mean=3.3 SED) was high. Shade for skin cancer prevention has been understudied. This study will address this gap by determining whether purpose-built shade structures promote greater use of shaded areas within public parks. Copyright © 2017 Elsevier Inc. All rights reserved.

Inter-observer agreement for diagnostic classification of esophageal motility disorders defined in high-resolution manometry.

PubMed

Fox, M R; Pandolfino, J E; Sweis, R; Sauter, M; Abreu Y Abreu, A T; Anggiansah, A; Bogte, A; Bredenoord, A J; Dengler, W; Elvevi, A; Fruehauf, H; Gellersen, S; Ghosh, S; Gyawali, C P; Heinrich, H; Hemmink, M; Jafari, J; Kaufman, E; Kessing, K; Kwiatek, M; Lubomyr, B; Banasiuk, M; Mion, F; Pérez-de-la-Serna, J; Remes-Troche, J M; Rohof, W; Roman, S; Ruiz-de-León, A; Tutuian, R; Uscinowicz, M; Valdovinos, M A; Vardar, R; Velosa, M; Waśko-Czopnik, D; Weijenborg, P; Wilshire, C; Wright, J; Zerbib, F; Menne, D

2015-01-01

High-resolution esophageal manometry (HRM) is a recent development used in the evaluation of esophageal function. Our aim was to assess the inter-observer agreement for diagnosis of esophageal motility disorders using this technology. Practitioners registered on the HRM Working Group website were invited to review and classify (i) 147 individual water swallows and (ii) 40 diagnostic studies comprising 10 swallows using a drop-down menu that followed the Chicago Classification system. Data were presented using a standardized format with pressure contours without a summary of HRM metrics. The sequence of swallows was fixed for each user but randomized between users to avoid sequence bias. Participants were blinded to other entries. (i) Individual swallows were assessed by 18 practitioners (13 institutions). Consensus agreement (≤ 2/18 dissenters) was present for most cases of normal peristalsis and achalasia but not for cases of peristaltic dysmotility. (ii) Diagnostic studies were assessed by 36 practitioners (28 institutions). Overall inter-observer agreement was 'moderate' (kappa 0.51) being 'substantial' (kappa > 0.7) for achalasia type I/II and no lower than 'fair-moderate' (kappa >0.34) for any diagnosis. Overall agreement was somewhat higher among those that had performed >400 studies (n = 9; kappa 0.55) and 'substantial' among experts involved in development of the Chicago Classification system (n = 4; kappa 0.66). This prospective, randomized, and blinded study reports an acceptable level of inter-observer agreement for HRM diagnoses across the full spectrum of esophageal motility disorders for a large group of clinicians working in a range of medical institutions. Suboptimal agreement for diagnosis of peristaltic motility disorders highlights contribution of objective HRM metrics. © 2014 International Society for Diseases of the Esophagus.

Rationale, Design, and Baseline Data of a Cross-national Randomized Trial on the Effect of Built Shade in Public Parks for Sun Protection

PubMed Central

Buller, David B.; Dobbinson, Suzanne; English, Dallas R.; Wakefield, Melanie; Buller, Mary Klein

2017-01-01

Environments can be structured to reduce solar ultraviolet radiation (UV) exposure to prevent skin cancer. A prospective randomized trial is being conducted to test whether introducing shade sales in passive recreation areas (PRAs) in public parks will increase use and decrease UV exposure in the shaded compared to unshaded PRAs. Shade effects will be compared between Melbourne, Australia and Denver, USA. The trial enrolled 144 public parks with PRAs suitable for shade construction and randomized parks to intervention or control in a 1:3 ratio. Use of PRAs and UV levels were recorded at each park by trained observers during 30-minute periods on four weekend days in each of two summers (pretest and posttest). Shade sails were constructed between the summers. Given low numbers of users at pretest, the outcome measure was modified to use of the PRA (use v. no use) and unit of analysis to the individual observation. Observations (n=580) occurred on average 29 days from the summer solstice and 55 minutes from solar noon in warm weather (mean=26.2°C) with some cloud cover but only slight or no wind. Typically, PRAs had benches and picnic tables and were located near playgrounds. PRAs were in use during 13.3% of observations (mean=0.41 users). UV over 30-minutes at the PRA boundary (mean=3.2 standard erythemal dose [SED]) and center (mean=3.3 SED) was high. Shade for skin cancer prevention has been understudied. This study will address this gap by determining whether purpose-built shade structures promote greater use of shaded areas within public parks. PMID:28185996

Non-HACEK gram-negative bacillus endocarditis.

PubMed

Morpeth, Susan; Murdoch, David; Cabell, Christopher H; Karchmer, Adolf W; Pappas, Paul; Levine, Donald; Nacinovich, Francisco; Tattevin, Pierre; Fernández-Hidalgo, Núria; Dickerman, Stuart; Bouza, Emilio; del Río, Ana; Lejko-Zupanc, Tatjana; de Oliveira Ramos, Auristela; Iarussi, Diana; Klein, John; Chirouze, Catherine; Bedimo, Roger; Corey, G Ralph; Fowler, Vance G

2007-12-18

Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. 61 hospitals in 28 countries. Hospitalized patients with definite endocarditis. Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

Contraindications to progestin-only oral contraceptive pills among reproductive aged women

PubMed Central

White, Kari; Potter, Joseph E.; Hopkins, Kristine; Fernández, Leticia; Amastae, Jon; Grossman, Daniel

2012-01-01

Background Progestin-only oral contraceptive pills (POPs) have fewer contraindications to use compared to combined pills. However, the overall prevalence of contraindications to POPs among reproductive aged women has not been assessed. Study Design We collected information on contraindications to POPs in two studies: 1) the Self-Screening Study, a sample of 1,267 reproductive aged women in the general population in El Paso, Texas, and 2) the Prospective Study of Oral Contraceptive (OC) Users, a sample of current OC users who obtained their pills in El Paso clinics (n=532) or over the counter (OTC) in Mexican pharmacies (n=514). In the Self-Screening Study, we also compared women’s self-assessment of contraindications using a checklist to a clinician’s evaluation. Results Only 1.6% of women in the Self-Screening Study were identified as having at least one contraindication to POPs. The sensitivity of the checklist for identifying women with at least one contraindication was 75.0% (95% CI: 50.6–90.4%), and the specificity was 99.4% (95% CI: 98.8–99.7%). In total, 0.6% of women in the Prospective Study of OC Users reported having any contraindication to POPs. There were no significant differences between clinic and OTC users. Conclusion The prevalence of contraindications to POPs was very low in these samples. POPs may be the best choice for the first OTC oral contraceptive in the US. PMID:22364816

Prospective Postmarketing Surveillance of Acute Myocardial Infarction in New Users of Saxagliptin: A Population-Based Study.

PubMed

Toh, Sengwee; Reichman, Marsha E; Graham, David J; Hampp, Christian; Zhang, Rongmei; Butler, Melissa G; Iyer, Aarthi; Rucker, Malcolm; Pimentel, Madelyn; Hamilton, Jack; Lendle, Samuel; Fireman, Bruce H

2018-01-01

The cardiovascular safety of saxagliptin, a dipeptidyl-peptidase 4 inhibitor, compared with other antihyperglycemic treatments is not well understood. We prospectively examined the association between saxagliptin use and acute myocardial infarction (AMI). We identified patients aged ≥18 years, starting from the approval date of saxagliptin in 2009 and continuing through August 2014, using data from 18 Mini-Sentinel data partners. We conducted seven sequential assessments comparing saxagliptin separately with sitagliptin, pioglitazone, second-generation sulfonylureas, and long-acting insulin, using disease risk score (DRS) stratification and propensity score (PS) matching to adjust for potential confounders. Sequential testing kept the overall chance of a false-positive signal below 0.05 (one-sided) for each pairwise comparison. We identified 82,264 saxagliptin users and more than 1.5 times as many users of each comparator. At the end of surveillance, the DRS-stratified hazard ratios (HRs) (95% CI) were 1.08 (0.90-1.28) in the comparison with sitagliptin, 1.11 (0.87-1.42) with pioglitazone, 0.79 (0.64-0.98) with sulfonylureas, and 0.57 (0.46-0.70) with long-acting insulin. The corresponding PS-matched HRs were similar. Only one interim analysis of 168 analyses met criteria for a safety signal: the PS-matched saxagliptin-pioglitazone comparison from the fifth sequential analysis, which yielded an HR of 1.63 (1.12-2.37). This association diminished in subsequent analyses. We did not find a higher AMI risk in saxagliptin users compared with users of other selected antihyperglycemic agents during the first 5 years after U.S. Food and Drug Administration approval of the drug. © 2017 by the American Diabetes Association.

Adolescents’ Prescription Stimulant Use and Adult Functional Outcomes: A National Prospective Study

PubMed Central

McCabe, Sean Esteban; Veliz, Philip; Wilens, Timothy E.; Schulenberg, John E.

2017-01-01

Objective To assess the prospective 17-year relationship between the medical and nonmedical use of prescription stimulants during adolescence (age 18) and educational attainment and substance use disorder (SUD) symptoms in adulthood (age 35). Method A survey was self-administered by nationally representative probability samples of U.S. high school seniors from the Monitoring the Future study; 8,362 of these individuals were followed longitudinally from adolescence (age 18, high school senior years of 1976–1996) to adulthood (age 35, 1993–2013). Results An estimated 8.1% reported medical use of prescription stimulants while 16.7% reported nonmedical use of prescription stimulants by age 18. Approximately 43% of adolescent medical users of prescription stimulants had also engaged in nonmedical use of prescription stimulants during adolescence. Among past-year adolescent nonmedical users of prescription stimulants, 97.3% had used at least one other substance during the past-year. Medical users of prescription stimulants without any history of nonmedical use during adolescence did not differ significantly from population controls (i.e., non-attention-deficit/hyperactivity disorder (ADHD) and non-stimulant medicated ADHD during adolescence) in educational attainment and SUD symptoms in adulthood. In contrast, adolescent nonmedical users of prescription stimulants (with or without medical use) had lower educational attainment and more SUD symptoms in adulthood, compared to population controls and medical users of prescription stimulants without nonmedical use during adolescence. Conclusions Nonmedical use of prescription stimulants is common among adolescents prescribed these medications. The findings indicate youth should be carefully monitored for nonmedical use because this behavior is associated with lower educational attainment and more SUD symptoms in adulthood. PMID:28219488

Music enjoyment with cochlear implantation.

PubMed

Prevoteau, Charlotte; Chen, Stephanie Y; Lalwani, Anil K

2018-10-01

Since the advent of cochlear implant (CI) surgery in the 1960s, there have been remarkable technological and surgical advances enabling excellent speech perception in quiet with many CI users able to use the telephone. However, many CI users struggle with music perception, particularly with the pitch-based and melodic elements of music. Yet remarkably, despite poor music perception, many CI users enjoy listening to music based on self-report questionnaires, and prospective studies have suggested a disassociation between music perception and enjoyment. Music enjoyment is arguably a more functional measure of one's listening experience, and thus enhancing one's listening experience is a worthy goal. Recent studies have shown that re-engineering music to reduce its complexity may enhance enjoyment in CI users and also delineate differences in musical preferences from normal hearing listeners. Copyright © 2017 Elsevier B.V. All rights reserved.

One year quality of life measured with SEC-QoL in levonorgestrel 52 mg IUS users.

PubMed

Cristobal, Ignacio; Lete, Luis Ignacio; Viuda, Esther de la; Perulero, Nuria; Arbat, Agnes; Canals, Ignasi

2016-04-01

The present study aims to prospectively evaluate quality of life (QoL) of women using 52-mg levonorgestrel intrauterine system (LNG-IUS) for contraception determined through the Sociedad Española de Contracepción (Spanish contraception Society) (SEC)-QoL, a questionnaire specifically designed to assess the impact of contraceptive methods on QoL of fertile women. We conducted a prospective observational multicenter study of 201 reproductive age women who initiated the LNG-IUS for contraception. Sociodemographic and clinical data were collected at baseline and 12 months afterwards. Participants filled in the SEC-QoL questionnaire at both visits. SEQ-QoL scores range from 0 (worst QoL) to 100 (best QoL). Participants claimed an increased QoL 12 months after insertion in all five dimensions of SEC-QoL due to its high contraceptive efficacy and its capability to reduce other menstrual symptoms (e.g., heavy menstrual bleeding or dysmenorrhoea), overall exerting a positive impact on user's satisfaction. SEC-QoL general overall score went from a mean (S.D.) score of 46.3 (17.3) at baseline to 72.2 (14.8) 12 months afterwards (p<.001). Overall, 94.6% of women claimed having found additional benefits other than contraception. No pregnancies were reported during the 12 months of study duration, and only 14 women discontinued use of LNG-IUS (only two of them due to an adverse event), representing a continuation rate of 93%. Women using LNG-IUS for contraception have an increased QoL after 12 months of use, demonstrated by the increased score in all dimensions of the SEC-QoL questionnaire. The present study prospectively evaluated QoL of women using LNG-IUS for contraception through the SEC-QoL questionnaire. Participants claimed increased QoL 12 months afterwards, implying that women using LNG-IUS for contraception in usual clinical practise also benefit from the reduction of period-related symptoms, overall leading to very low discontinuation rates. Copyright © 2016 Elsevier Inc. All rights reserved.

A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users.

PubMed

Silins, Edmund; Swift, Wendy; Slade, Tim; Toson, Barbara; Rodgers, Bryan; Hutchinson, Delyse M

2017-09-01

The extent to which young adult former cannabis users fare better than infrequent users is unclear. We investigated the association between cannabis use status at age 23 and substance use and mental health outcomes at age 27. Data were from the 20+ year cohort of the PATH Through Life Study. Lifetime cannabis users (n = 1410) at age 23 were classified as former/occasional/regular users. Multivariable logistic regression was used to estimate the association between cannabis use status at age 23 and six outcomes assessed at age 27. Compared with occasional cannabis users: (i) former users had odds of subsequent tobacco use [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.52-0.85], illicit drug use (cannabis, OR = 0.22, 95% CI 0.17-0.28; other illicit drugs, OR = 0.29, 95% CI 0.22-0.39) and mental health impairment (OR = 0.71, 95% CI 0.55-0.92) that were 29-78% lower; and (ii) regular users had odds of subsequent frequent alcohol use (OR = 2.34, 95% CI 0.67-1.34), tobacco use (OR = 3.67, 95% CI 2.54-5.30), cannabis use (OR = 11.73, 95% CI 6.81-20.21) and dependence symptoms (OR = 12.60, 95% CI 8.38-18.94), and other illicit drug use (OR = 2.95, 95% CI 2.07-4.21) that were 2-13 times greater. Associations attenuated after covariate adjustment, and most remained significant. Clear associations exist between cannabis use status in young adulthood and subsequent mental health and substance use. While early intervention remains important to prevent regular cannabis use and the associated harms, experimentation with cannabis use in the years leading into young adulthood may not necessarily determine an immutable pathway to mental health problems and illicit substance use. [Silins E, Swift W, Slade T, Toson B, Rodgers B, Hutchinson DM. A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

[Substance use and risk behaviors of out-of-treatment cocaine base paste and cocaine hydrochloride users].

PubMed

Santis B, Rodrigo; Hidalgo C, Carmen Gloria; Hayden C, Viviana; Anselmo M, Enzo; Rodríguez T, Jorge; Cartajena de la M, Fernando; Dreyse D, Jorge; Torres B, Rafael

2007-01-01

In Chile, cocaine base paste (CBP) is the illegal substance that produces the highest rate of addiction. Nonetheless, a marginal number of users receive treatment each year. To compare the consumption patterns and risk behavior of CBP and cocaine hydrochloride (CH) users who do not attend rehabilitation services. In a prospective research design, through a study methodology called Privileged Access Interview of hidden populations, 28 surveyors recruited 231 CBP users (group 1) and 236 CH users (group 2). The Risk Behavior Questionnaire was applied in four communities of Metropolitan Santiago, that have the highest prevalence of PBC and CH use. CBP users showed higher schools drop-out and unemployment rates. Subjects of both groups were predominantly polysubstance and polyaddicted users. The severity of addiction to CBP of group 1 was significantly higher than the severity of addiction to CH of group 2 (5.5 versus 5.1: p<0.001). CBP users showed significantly higher rates of sexual risk behaviors, antisocial behavior, self infliction of injuries, suicide attempt and child neglect. A higher vulnerability was shown for users of CBP than those of CH. Attention is drawn to the need for developing community interventions in order to alter substance abuse and the risk behavior of these vulnerable groups.

Feasibility of using recipients of health promotional newsletters for post-marketing surveillance.

PubMed

Mead, L A; Ford, D E; Roht, L H; Beach, C L; Klag, M J

2000-06-01

Achieving an adequate sample size is one of the major difficulties in performing post-marketing observational studies of health outcomes in persons taking specific drug preparations. We assessed the feasibility of recruiting participants for such a study of Cardizem CD from approximately 400,000 U.S. recipients of a health promotion newsletter. A three-page questionnaire was sent to a 2.5% random sample (n = 10,000) of recipients, stratified by geographic region. After two mailings, 2779 (28%) returned the questionnaire. Of the 2779 respondents, 2132 (77%) reported having high blood pressure. Eighty-seven percent indicated a willingness to participate in a long-term prospective study. In a multivariate model, calcium channel blocker (CCB) use was associated with a history of coronary heart disease, duration of hypertension medication use greater than 1 year, a rating of good or excellent hypertension care, higher systolic blood pressure, higher education level, family history of cardiovascular disease, and history of smoking. These results indicate that self-reported CCB users may be at greater risk of cardiovascular heart disease and that it is feasible to use health promotion newsletters as a source of participants in prospective studies of cardiovascular disease.

No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC).

PubMed

Bergmann, M M; Hernandez, V; Bernigau, W; Boeing, H; Chan, S S M; Luben, R; Khaw, K-T; van Schaik, F; Oldenburg, B; Bueno-de-Mesquita, B; Overvad, K; Palli, D; Masala, G; Carbonnel, F; Boutron-Ruault, M-C; Olsen, A; Tjonneland, A; Kaaks, R; Katzke, V; Riboli, E; Hart, A R

2017-04-01

The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD. Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (⩽0.5 and 1 drink per week), below the recommended limits (BRL) (⩽1 and 2 drinks per day), moderate (⩽2.5 and 5 drinks per day), or heavy use (>2.5 and >5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference. Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios. There was no evidence of associations between alcohol use and the odds of developing either UC or CD.

PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain.

PubMed

Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A

2007-07-01

Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

A prospective approach to coastal geography from satellite. [technological forecasting

NASA Technical Reports Server (NTRS)

Munday, J. C., Jr.

1981-01-01

A forecasting protocol termed the "prospective approach' was used to examine probable futures relative to coastal applications of satellite data. Significant variables include the energy situation, the national economy, national Earth satellite programs, and coastal zone research, commercial activity, and regulatory activity. Alternative scenarios for the period until 1986 are presented. Possible response by state/local remote sensing centers include operational applications for users, input to geo-base information systems (GIS), development of decision-making algorithms using GIS data, and long term research programs for coastal management using merged satellite and traditional data.

SatCam: A mobile application for coordinated ground/satellite observation of clouds and validation of satellite-derived cloud mask products.

NASA Astrophysics Data System (ADS)

Gumley, L.; Parker, D.; Flynn, B.; Holz, R.; Marais, W.

2011-12-01

SatCam is an application for iOS devices that allows users to collect observations of local cloud and surface conditions in coordination with an overpass of the Terra, Aqua, or NPP satellites. SatCam allows users to acquire images of sky conditions and ground conditions at their location anywhere in the world using the built-in iPhone or iPod Touch camera at the same time that the satellite is passing overhead and viewing their location. Immediately after the sky and ground observations are acquired, the application asks the user to rate the level of cloudiness in the sky (Completely Clear, Mostly Clear, Partly Cloudy, Overcast). For the ground observation, the user selects their assessment of the surface conditions (Urban, Green Vegetation, Brown Vegetation, Desert, Snow, Water). The sky condition and surface condition selections are stored along with the date, time, and geographic location for the images, and the images are uploaded to a central server. When the MODIS (Terra and Aqua) or VIIRS (NPP) imagery acquired over the user location becomes available, a MODIS or VIIRS true color image centered at the user's location is delivered back to the SatCam application on the user's iOS device. SSEC also proposes to develop a community driven SatCam website where users can share their observations and assessments of satellite cloud products in a collaborative environment. SSEC is developing a server side data analysis system to ingest the SatCam user observations, apply quality control, analyze the sky images for cloud cover, and collocate the observations with MODIS and VIIRS satellite products (e.g., cloud mask). For each observation that is collocated with a satellite observation, the server will determine whether the user scored a "hit", meaning their sky observation and sky assessment matched the automated cloud mask obtained from the satellite observation. The hit rate will be an objective assessment of the accuracy of the user's sky observations. Users with high hit rates will be identified automatically and their observations will be used globally to evaluate the performance of the MODIS cloud mask algorithm for Terra and Aqua and the VIIRS cloud mask algorithm for NPP. The user's assessment of the ground conditions will also be used to evaluate the cloud mask accuracy in selecting the correct surface type at the user's location, which is an important element in the decision path used internally by the cloud mask algorithm. This presentation will describe the SatCam application, how it is used, and show examples of SatCam observations.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit

PubMed Central

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-01-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care. PMID:28288104

Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

PubMed

Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

2016-10-01

To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Auditory Speech Perception Tests in Relation to the Coding Strategy in Cochlear Implant.

PubMed

Bazon, Aline Cristine; Mantello, Erika Barioni; Gonçales, Alina Sanches; Isaac, Myriam de Lima; Hyppolito, Miguel Angelo; Reis, Ana Cláudia Mirândola Barbosa

2016-07-01

The objective of the evaluation of auditory perception of cochlear implant users is to determine how the acoustic signal is processed, leading to the recognition and understanding of sound. To investigate the differences in the process of auditory speech perception in individuals with postlingual hearing loss wearing a cochlear implant, using two different speech coding strategies, and to analyze speech perception and handicap perception in relation to the strategy used. This study is prospective cross-sectional cohort study of a descriptive character. We selected ten cochlear implant users that were characterized by hearing threshold by the application of speech perception tests and of the Hearing Handicap Inventory for Adults. There was no significant difference when comparing the variables subject age, age at acquisition of hearing loss, etiology, time of hearing deprivation, time of cochlear implant use and mean hearing threshold with the cochlear implant with the shift in speech coding strategy. There was no relationship between lack of handicap perception and improvement in speech perception in both speech coding strategies used. There was no significant difference between the strategies evaluated and no relation was observed between them and the variables studied.

The vocal load of Reform Jewish cantors in the USA.

PubMed

Hapner, Edie; Gilman, Marina

2012-03-01

Jewish cantors comprise a subset of vocal professionals that is not well understood by vocal health professionals. This study aimed to document the vocal demands, vocal training, reported incidence of voice problems, and treatment-seeking behavior of Reform Jewish cantors. The study used a prospective observational design to anonymously query Reform Jewish cantors using a 35-item multiple-choice survey distributed online. Demographic information, medical history, vocal music training, cantorial duties, history of voice problems, and treatment-seeking behavior were addressed. Results indicated that many of the commonly associated risk factors for developing voice disorders were present in this population, including high vocal demands, reduced vocal downtime, allergies, and acid reflux. Greater than 65% of the respondents reported having had a voice problem that interfered with their ability to perform their duties at some time during their careers. Reform Jewish cantors are a population of occupational voice users who may be currently unidentified and underserved by vocal health professionals. The results of the survey suggest that Reform Jewish cantors are occupational voice users and are at high risk for developing voice disorders. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

A decade of neural networks: Practical applications and prospects

NASA Technical Reports Server (NTRS)

Kemeny, Sabrina (Editor); Thakoor, Anil (Editor)

1994-01-01

On May 11-13, 1994, JPL's Center for Space Microelectronics Technology (CSMT) hosted a neural network workshop entitled, 'A Decade of Neural Networks: Practical Applications and Prospects,' sponsored by DOD and NASA. The past ten years of renewed activity in neural network research has brought the technology to a crossroads regarding the overall scope of its future practical applicability. The purpose of the workshop was to bring together the sponsoring agencies, active researchers, and the user community to formulate a vision for the next decade of neural network research and development prospects, with emphasis on practical applications. Of the 93 participants, roughly 15% were from government agencies, 30% were from industry, 20% were from universities, and 35% were from Federally Funded Research and Development Centers (FFRDC's).

AIM - Agile Instrumented Monitoring for Improving User Experience of Participation in HealthIT Development.

PubMed

Pitkänen, Janne; Nieminen, Marko

2017-01-01

Participation of healthcare professionals in information technology development has emerged as an important challenge. As end-users, the professionals are willing to participate in the development activities, but their experiences on the current methods of participation remain mostly negative. There is lack of applicable methods for meeting the needs of agile development approach and scaling up to the largest implementation projects, while maintaining the interest of the professional users to participate in development activities and keeping up their ability to continue working in a productive manner. In this paper, we describe the Agile Instrumented Monitoring as a methodology, based on the methods of instrumented usability evaluation, for improving user experience in HealthIT development. The contribution of the proposed methodology is analyzed in relation to activities of whole iteration cycle and chosen usability evaluation methods, while the user experience of participation is addressed regarding healthcare professionals. Prospective weak and strong market tests for AIM are discussed in the conclusions for future work.

Synfuel program analysis. Volume 2: VENVAL users manual

NASA Astrophysics Data System (ADS)

Muddiman, J. B.; Whelan, J. W.

1980-07-01

This volume is intended for program analysts and is a users manual for the VENVAL model. It contains specific explanations as to input data requirements and programming procedures for the use of this model. VENVAL is a generalized computer program to aid in evaluation of prospective private sector production ventures. The program can project interrelated values of installed capacity, production, sales revenue, operating costs, depreciation, investment, dent, earnings, taxes, return on investment, depletion, and cash flow measures. It can also compute related public sector and other external costs and revenues if unit costs are furnished.

MDMA, serotonergic neurotoxicity, and the diverse functional deficits of recreational 'Ecstasy' users.

PubMed

Parrott, Andrew C

2013-09-01

Serotonergic neurotoxicity following MDMA is well-established in laboratory animals, and neuroimaging studies have found lower serotonin transporter (SERT) binding in abstinent Ecstasy/MDMA users. Serotonin is a modulator for many different psychobiological functions, and this review will summarize the evidence for equivalent functional deficits in recreational users. Declarative memory, prospective memory, and higher cognitive skills are often impaired. Neurocognitive deficits are associated with reduced SERT in the hippocampus, parietal cortex, and prefrontal cortex. EEG and ERP studies have shown localised reductions in brain activity during neurocognitive performance. Deficits in sleep, mood, vision, pain, psychomotor skill, tremor, neurohormonal activity, and psychiatric status, have also been demonstrated. The children of mothers who take Ecstasy/MDMA during pregnancy have developmental problems. These psychobiological deficits are wide-ranging, and occur in functions known to be modulated by serotonin. They are often related to lifetime dosage, with light users showing slight changes, and heavy users displaying more pronounced problems. In summary, abstinent Ecstasy/MDMA users can show deficits in a wide range of biobehavioral functions with a serotonergic component. Copyright © 2013 Elsevier Ltd. All rights reserved.

Relationship between cannabis and psychosis: Reasons for use and associated clinical variables.

PubMed

Mané, Anna; Fernández-Expósito, Miguel; Bergé, Daniel; Gómez-Pérez, Laura; Sabaté, Agnés; Toll, Alba; Diaz, Laura; Diez-Aja, Cristobal; Perez, Victor

2015-09-30

The mechanism underneath the relationship between cannabis and psychosis remains controversial, for which several hypotheses have been proposed, including cannabis as self-medication and cannabis as a risk for the development of psychosis. The aim of this work was to study the relationship between cannabis and psychosis in first-episode psychosis cannabis users and non-users, and non-psychotic cannabis users. The age at the first psychotic episode, duration of untreated psychosis, psychopathology and reasons for cannabis use were assessed. First-episode psychosis cannabis users showed an earlier age at psychosis onset than non-user patients. No significant differences in symptomatology were found. The distinguishing reasons to use cannabis for patients with first-episode psychosis with respect to non-psychotic users were to arrange their thoughts and deal with hallucinations and suspiciousness. These findings are in agreement with both hypotheses: self-medication and secondary psychosis hypothesis. However, longitudinal prospective cohort studies assessing reasons for cannabis use are needed to investigate both hypotheses and their complementarity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Research on water management system based on Android

NASA Astrophysics Data System (ADS)

Li, Dongjiang; Hu, Songlin

2018-04-01

With the rapid development of Smart city, Smart water is an important part of Smart city, which is paid more and more attention. It obtains and deals with urban water information through information technology. It can effectively manage urban water supply, The sale of water and other processes. At the same time, due to the popularity of Smartphones, Smartphone applications have covered every aspect of life and become an indispensable part of people's daily life. Through the Smartphone applications, the user can achieve online mobile water purchase, query the water situation, water quality and other basic situation, greatly facilitate the use of the user, for wisdom water construction is of great significance. In this paper, the water management system based on Android is designed and implemented according to the user's needs. It includes intelligent water meter terminal, monitoring center server, Smartphone application and wireless communication network. The user can use the Smartphone at any time and at any place to view the user's water information in real time providing great convenience for users. So its application prospect is very broad as an important part of smart city.

Computer Education and Training Reference Guide.

ERIC Educational Resources Information Center

Edumatics Corp., Oceanport, NJ.

Intended for use by educators, educational administrators, and directors of training within industry, this guide lists commercially available products and services in the field of computers and education. It contains descriptive information wherever possible and comparison charts designed to enable the prospective user to make a preliminary…

Identifying new patient prospects: efficacy of usage segmentation. For some health care services, usage-based segmentation schemes can be wasteful and ineffective.

PubMed

Sarel, D; Marmorstein, H

1996-01-01

Even though there is intuitive appeal in identifying the user profile for a given service and then targeting similar nonusers, this approach can be very misleading when marketing health care services with low market penetration. If usage segmentation is employed without checking other indicators of latent demand and perceived barriers to use, significant misallocation of marketing resources is likely to occur. Confidentiality and embarrassment can be significant barriers to use by segments that are excellent patient prospects. In this study of mental and behavioral care, females and non-whites were found to be more concerned with confidentiality than were members of the user group. Lack of awareness can be a much bigger impediment to adoption than negative attitudes. Health care marketers need to design communications that not only increase awareness and familiarity for services with low market penetration, but also address other issues of concern to highly receptive segments.

Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women's health initiative.

PubMed

Wassertheil-Smoller, S; McGinn, A P; Budrys, N; Chlebowski, R; Ho, G Y; Johnson, K C; Lane, D S; Li, W; Neuhouser, M L; Saquib, J; Shikany, J M; Song, Y; Thomson, C

2013-10-01

Multivitamin use is common in the United States. It is not known whether multivitamins with minerals supplements (MVM) used by women already diagnosed with invasive breast cancer would affect their breast cancer mortality risk. To determine prospectively the effects of MVM use on breast cancer mortality in postmenopausal women diagnosed with invasive breast cancer, a prospective cohort study was conducted of 7,728 women aged 50-79 at enrollment in the women's health initiative (WHI) in 40 clinical sites across the United States diagnosed with incident invasive breast cancer during WHI and followed for a mean of 7.1 years after breast cancer diagnosis. Use of MVM supplements was assessed at WHI baseline visit and at visit closest to breast cancer diagnosis, obtained from vitamin pill bottles brought to clinic visit. Outcome was breast cancer mortality. Hazard ratios and 95 % confidence intervals (CIs) for breast cancer mortality comparing MVM users to non-users were estimated using Cox proportional hazard regression models. Analyses using propensity to take MVM were done to adjust for potential differences in characteristics of MVM users versus non-users. At baseline, 37.8 % of women reported MVM use. After mean post-diagnosis follow-up of 7.1 ± 4.1 (SD) years, there were 518 (6.7 %) deaths from breast cancer. In adjusted analyses, breast cancer mortality was 30 % lower in MVM users as compared to non-users (HR = 0.70; 95 % CI 0.55, 0.91). This association was highly robust and persisted after multiple adjustments for potential confounding variables and in propensity score matched analysis (HR = 0.76; 95 % CI 0.60-0.96). Postmenopausal women with invasive breast cancer using MVM had lower breast cancer mortality than non-users. The results suggest a possible role for daily MVM use in attenuating breast cancer mortality in women with invasive breast cancer but the findings require confirmation.

Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins

PubMed Central

Danaei, Goodarz; Tavakkoli, Mohammad; Hernán, Miguel A.

2012-01-01

Randomized clinical trials (RCTs) are usually the preferred strategy with which to generate evidence of comparative effectiveness, but conducting an RCT is not always feasible. Though observational studies and RCTs often provide comparable estimates, the questioning of observational analyses has recently intensified because of randomized-observational discrepancies regarding the effect of postmenopausal hormone replacement therapy on coronary heart disease. Reanalyses of observational data that excluded prevalent users of hormone replacement therapy led to attenuated discrepancies, which begs the question of whether exclusion of prevalent users should be generally recommended. In the current study, the authors evaluated the effect of excluding prevalent users of statins in a meta-analysis of observational studies of persons with cardiovascular disease. The pooled, multivariate-adjusted mortality hazard ratio for statin use was 0.77 (95% confidence interval (CI): 0.65, 0.91) in 4 studies that compared incident users with nonusers, 0.70 (95% CI: 0.64, 0.78) in 13 studies that compared a combination of prevalent and incident users with nonusers, and 0.54 (95% CI: 0.45, 0.66) in 13 studies that compared prevalent users with nonusers. The corresponding hazard ratio from 18 RCTs was 0.84 (95% CI: 0.77, 0.91). It appears that the greater the proportion of prevalent statin users in observational studies, the larger the discrepancy between observational and randomized estimates. PMID:22223710

Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

PubMed Central

Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

2014-01-01

Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

Long Term Use of Aspirin and the Risk of Gastrointestinal Bleeding

PubMed Central

Huang, Edward S.; Strate, Lisa L.; Ho, Wendy W.; Lee, Salina S.; Chan, Andrew T.

2011-01-01

Background In short-term trials, aspirin is associated with gastrointestinal bleeding. However, the effect of dose and duration of aspirin use on risk remains unclear. Methods We conducted a prospective study of 87,680 women enrolled in the Nurses' Health Study in 1990 who provided biennial data on aspirin use. We examined the relative risk (RR) of major gastrointestinal bleeding requiring hospitalization or blood transfusion. Results Over a 24-year follow-up, 1537 women reported a major gastrointestinal bleeding. Among women who used aspirin regularly (≥2 standard [325-mg] tablets/week), the multivariate RR of gastrointestinal bleeding was 1.43 (95% confidence interval [CI], 1.29-1.59) compared with non-regular users. Compared with women who denied any aspirin use, the multivariate RRs of gastrointestinal bleeding were 1.03 (95% CI, 0.85-1.24) for women who used 0.5 to 1.5 standard aspirin tablets/week, 1.30 (95% CI, 1.07-1.58) for 2 to 5 tablets/week, 1.77 (95% CI, 1.44-2.18) for 6-14 tablets/week, and 2.24 (95% CI, 1.66-3.03) for >14 tablets/week (Ptrend<.001). Similar dose-response relationships were observed among short-terms users (≤ 5 years; Ptrend<.001) and long-term users (>5 years; Ptrend<.001). In contrast, after adjustments were made for dose, increasing duration of use did not confer greater risk of bleeding (Ptrend=0.28). Conclusions Regular aspirin use is associated with gastrointestinal bleeding. Risk appears more strongly related to dose than duration of aspirin use. Efforts to minimize adverse effects of aspirin therapy should emphasize using the lowest effective dose among both short-term and long-term users. PMID:21531232

Hormone therapy use and physical quality of life in postmenopausal women with multiple sclerosis.

PubMed

Bove, Riley; White, Charles C; Fitzgerald, Kathryn C; Chitnis, Tanuja; Chibnik, Lori; Ascherio, Alberto; Munger, Kassandra L

2016-10-04

To determine the association between hormone therapy (HT) and physical quality of life (QOL) in postmenopausal women with multiple sclerosis (MS). We included female participants from the prospective Nurses' Health Study, with a diagnosis of definite or probable MS, who had completed a physical functioning assessment (PF10; subscale of the 36-Item Short-Form Health Survey QOL survey) at a time point between 3 and 10 years after their final menstrual period (early postmenopause). We assessed the association between HT use at this time point (never vs at least 12 months of systemic estrogen with/without progestin) and both PF10 and the 36-Item Short-Form Health Survey Physical Component Scale. We used a linear regression model adjusting for age, MS duration, menopause type and duration, and further for additional covariates (only ancestry was significant). Among 95 participants meeting all inclusion criteria at their first postmenopausal assessment, 61 reported HT use and 34 reported none. HT users differed from non-HT users in MS duration (p = 0.02) and menopause type (p = 0.01) but no other clinical or demographic characteristics. HT users had average PF10 scores that were 23 points higher than non-HT users (adjusted p = 0.004) and average Physical Component Scale scores that were 9.1 points higher in the 59 women with these available (adjusted p = 0.02). Longer duration of HT use was also associated with higher PF10 scores (p = 0.02, adjusted p = 0.06). Systemic HT use was associated with better physical QOL in postmenopausal women with MS in this observational study. Further studies are necessary to investigate causality. © 2016 American Academy of Neurology.

Bayesian neural adjustment of inhibitory control predicts emergence of problem stimulant use.

PubMed

Harlé, Katia M; Stewart, Jennifer L; Zhang, Shunan; Tapert, Susan F; Yu, Angela J; Paulus, Martin P

2015-11-01

Bayesian ideal observer models quantify individuals' context- and experience-dependent beliefs and expectations about their environment, which provides a powerful approach (i) to link basic behavioural mechanisms to neural processing; and (ii) to generate clinical predictors for patient populations. Here, we focus on (ii) and determine whether individual differences in the neural representation of the need to stop in an inhibitory task can predict the development of problem use (i.e. abuse or dependence) in individuals experimenting with stimulants. One hundred and fifty-seven non-dependent occasional stimulant users, aged 18-24, completed a stop-signal task while undergoing functional magnetic resonance imaging. These individuals were prospectively followed for 3 years and evaluated for stimulant use and abuse/dependence symptoms. At follow-up, 38 occasional stimulant users met criteria for a stimulant use disorder (problem stimulant users), while 50 had discontinued use (desisted stimulant users). We found that those individuals who showed greater neural responses associated with Bayesian prediction errors, i.e. the difference between actual and expected need to stop on a given trial, in right medial prefrontal cortex/anterior cingulate cortex, caudate, anterior insula, and thalamus were more likely to exhibit problem use 3 years later. Importantly, these computationally based neural predictors outperformed clinical measures and non-model based neural variables in predicting clinical status. In conclusion, young adults who show exaggerated brain processing underlying whether to 'stop' or to 'go' are more likely to develop stimulant abuse. Thus, Bayesian cognitive models provide both a computational explanation and potential predictive biomarkers of belief processing deficits in individuals at risk for stimulant addiction. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Female reproductive factors, menopausal hormone use, and Parkinson’s disease

PubMed Central

Liu, Rui; Baird, Donna; Park, Yikyung; Freedman, Neal D.; Huang, Xuemei; Hollenbeck, Albert; Blair, Aaron; Chen, Honglei

2014-01-01

Objective To examine the associations of reproductive factors and exogenous hormone use with risk of Parkinson’s disease (PD) among postmenopausal women. Methods The study comprised 119,166 postmenopausal women ages 50–71 years in the NIH-AARP Diet and Health Study, who completed a baseline questionnaire in 1995–1996 and a follow-up survey in 2004–2006. A total of 410 self-reported PD diagnoses were identified between 1995 and 2006. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were derived from logistic regression models. Results PD risk was not significantly associated with female reproductive factors including age at menarche, age at first live birth, parity, and age at menopause. For example, compared with women with natural menopause at ages 50–54 years, the ORs were 1.18, (95% CI 0.78–1.79) for women with natural menopause at ages <45, 1.19 (0.88–1.61) for ages 45–49, and 1.33 (0.91–1.93) for ages 55 or later. We found that oral contraceptive use for ≥10 years (vs. never use) was associated with lower PD risk (OR=0.59; 0.38–0.92) but shorter use showed no association. Use of menopausal hormone therapy showed inconsistent results. Compared with non-hormone users at baseline, current hormone users of <5 years showed a higher risk of PD (OR=1.52; 1.11–2.08). However, no associations were observed for past hormone users or current users of ≥5 years. Conclusions Overall, this large prospective study provides little support for an association between female reproductive factors and PD risk. Our findings on long-term oral contraceptive use and current hormone therapy warrant further investigations. PMID:24352877

Location and Modality Effects in Online Dating: Rich Modality Profile and Location-Based Information Cues Increase Social Presence, While Moderating the Impact of Uncertainty Reduction Strategy.

PubMed

Jung, Soyoung; Roh, Soojin; Yang, Hyun; Biocca, Frank

2017-09-01

This study investigates how different interface modality features of online dating sites, such as location awareness cues and modality of profiles, affect the sense of social presence of a prospective date. We also examined how various user behaviors aimed at reducing uncertainty about online interactions affect social presence perceptions and are affected by the user interface features. Male users felt a greater sense of social presence when exposed to both location and accessibility cues (geographical proximity) and a richer medium (video profiles). Viewing a richer medium significantly increased the sense of social presence among female participants whereas location-based information sharing features did not directly affect their social presence perception. Augmented social presence, as a mediator, contributed to users' greater intention to meet potential dating partners in a face-to-face setting and to buy paid memberships on online dating sites.

User satisfaction with realtime teleneurology.

PubMed

Craig, J; Russell, C; Patterson, V; Wootton, R

1999-01-01

User satisfaction (i.e. that of patients, medical staff at a remote hospital and medical staff at a neurological centre) with realtime teleneurology consultations was studied prospectively. Twenty-five patients with neurological problems admitted to a hospital without permanent neurological cover were assessed from a neurological centre by specialist neurologists using realtime video-links transmitting at 384 kbit/s. All users reported high levels of satisfaction with the technical aspects of the consultations. Patients, almost universally, reported confidence in teleneurology as a means of dealing with their presenting complaints. Similarly, medical staff at either site felt confident in managing patients using teleneurology and almost always felt that a telephone consultation would not have achieved as good an outcome. No major organizational problems were identified. These findings suggest overall user satisfaction with realtime teleneurology for managing patients with neurological problems admitted to hospitals that do not have resident neurologists.

The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol.

PubMed

Peikert, Mona Leandra; Inhestern, Laura; Bergelt, Corinna

2017-08-11

For ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment. This prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4-6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis. This study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Non-melanoma skin cancer and NSAID use in women with a history of skin cancer in the Women's Health Initiative.

PubMed

Wysong, Ashley; Ally, Mina S; Gamba, Christina S; Desai, Manisha; Swetter, Susan M; Seiffert-Sinha, Kristina; Sinha, Animesh A; Stefanick, Marcia L; Tang, Jean Y

2014-12-01

Evidence for the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on non-melanoma skin cancer (NMSC) risk is inconsistent. We prospectively examined whether regular, inconsistent, or no/low-use of NSAIDs is associated with lower NMSC risk among 54,728 postmenopausal Caucasian women in the Women's Health Initiative Observational Study enrolled between 1993 and 1998. Logistic regression models were used to assess odds of NMSC after adjusting for skin type, sun exposure history and indication for NSAID use. There were 7652 incident cases of NMSC (median follow-up: 6.9years). There was no association between regular NSAID-use and NMSC risk relative to no/low-users. However, in a subgroup analysis of 5325 women with a history of skin cancer (incident NMSC: 1897), odds of NMSC were lower among regular NSAID users whether <5years (OR 0.82, 95% CI: 0.70-0.95) or ≥5years (OR 0.82, 95% CI: 0.69-0.98) of use compared to no/low-users. Inconsistent NSAID use and acetaminophen use were not associated with NMSC risk. Overall, NSAID use was not associated with NMSC risk. However, in women with a history of skin cancer, regular NSAID use was associated with 18% lower odds of NMSC. Future studies on potential chemopreventative effects of NSAIDs should focus on subjects with prior history of NMSC. Copyright © 2014 Elsevier Inc. All rights reserved.

Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.

PubMed

Turok, David K; Jacobson, Janet C; Dermish, Amna I; Simonsen, Sara E; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A

2014-03-01

We investigated the 1-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 intrauterine device (IUD) or oral levonorgestrel (LNG) for EC. This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Of the 542 women who presented for EC, agreed to participate in the trial and met the inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG [hazard ratio (HR) 0.53, 95% confidence interval (CI): 0.29-0.97, p=.041]. By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users (HR 0.42, 95% CI: 0.20-0.85, p=.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26-0.96, p=.037). One year after presenting for EC, women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. Compared to EC users who choose oral levonorgestrel, those who select the copper IUD have lower rates of pregnancy in the next year. Greater use of the copper IUD for EC may lower rates of unintended pregnancy in high-risk women. Copyright © 2014 Elsevier Inc. All rights reserved.

17 CFR 38.1201 - Additional sources for compliance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... designing a futures contract, the designated contract market should conduct market research so that the contract design meets the risk management needs of prospective users and promotes price discovery of the... and opinions during the contract design process to ensure the contract's term and conditions reflect...

The Renewable Energy Data Explorer: Mapping Our Renewable Energy Future

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

The Renewable Energy (RE) Data Explorer, developed by the National Renewable Energy Laboratory, is an innovative web-based platform that allows users to visualize and analyze renewable energy potential. The RE Data Explorer informs prospecting, integrated planning, and policymaking to enable low emission development.

NASA Laser Light Scattering Advanced Technology Development Workshop, 1988

NASA Technical Reports Server (NTRS)

Meyer, William V. (Editor)

1989-01-01

The major objective of the workshop was to explore the capabilities of existing and prospective laser light scattering hardware and to assess user requirements and needs for a laser light scattering instrument in a reduced gravity environment. The workshop addressed experimental needs and stressed hardware development.

Nine Steps to Prepare for Electricity Deregulation.

ERIC Educational Resources Information Center

Robertson, Wayne

1997-01-01

Discusses the prospects of electricity deregulation and highlights nine steps school districts can take to reassess and update their plans for maximizing the benefits of deregulation. Suggestions include forming an energy management team, seeking discounts and rate incentives, getting involved in competitive user groups, and aggressively seeking…

Improving Archives-Library Relations: User-Centered Solutions to a Sibling Rivalry.

ERIC Educational Resources Information Center

Maher, William J.

1990-01-01

Examines the sources of tension between academic archives and academic libraries, prospects for improved relations based on common ground, and factors that might limit improved relations. Areas where cooperation might occur are discussed, including mutual fund raising efforts, documentation strategies, administrative information services, and…

Increased alcohol consumption, nonmedical prescription drug use, and illicit drug use are associated with energy drink consumption among college students

PubMed Central

Arria, Amelia M.; Caldeira, Kimberly M.; Kasperski, Sarah J.; O’Grady, Kevin E.; Vincent, Kathryn B.; Griffiths, Roland R.; Wish, Eric D.

2009-01-01

Objectives This longitudinal study examined the prevalence and correlates of energy drink use among college students, and investigated its possible prospective associations with subsequent drug use, including nonmedical prescription drug use. Methods Participants were 1,060 undergraduates from a large, public university who completed three annual interviews, beginning in their first year of college. Use of energy drinks, other caffeinated products, tobacco, alcohol, and other illicit and prescription drugs were assessed, as well as demographic and personality characteristics. Results Annual weighted prevalence of energy drink use was 22.6%wt and 36.5%wt in the second and third year of college, respectively. Compared to energy drink non-users, energy drink users had heavier alcohol consumption patterns, and were more likely to have used other drugs, both concurrently and in the preceding assessment. Regression analyses revealed that Year 2 energy drink use was significantly associated with Year 3 nonmedical use of prescription stimulants and prescription analgesics, but not with other Year 3 drug use, holding constant demographics, prior drug use, and other factors. Conclusions A substantial and rapidly-growing proportion of college students use energy drinks. Energy drink users tend to have greater involvement in alcohol and other drug use and higher levels of sensation-seeking, relative to non-users of energy drinks. Prospectively, energy drink use has a unique relationship with nonmedical use of prescription stimulants and analgesics. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance use problems. PMID:20729975

The association of aspirin use with age-related macular degeneration.

PubMed

Liew, Gerald; Mitchell, Paul; Wong, Tien Yin; Rochtchina, Elena; Wang, Jie Jin

2013-02-25

To determine whether regular aspirin use is associated with a higher risk for developing age-related macular degeneration (AMD) by using analyzed data from a 15-year prospective cohort. A prospective analysis was conducted of data from an Australian population-based cohort with 4 examinations during a 15-year period (1992-1994 to 2007-2009). Participants completed a detailed questionnaire at baseline assessing aspirin use, cardiovascular disease status, and AMD risk factors. Age-related macular degeneration was graded side-by-side from retinal photographs taken at each study visit to assess the incidence of neovascular (wet) AMD and geographic atrophy (dry AMD) according to the international AMD classification. Of 2389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of the 2389 developed neovascular AMD. Persons who were regular aspirin users were more likely to have incident neovascular AMD: the 15-year cumulative incidence was 9.3% in users and 3.7% in nonusers. After adjustment for age, sex, smoking, history of cardiovascular disease, systolic blood pressure, and body mass index, persons who were regular aspirin users had a higher risk of developing neovascular AMD (odds ratio [OR], 2.46; 95% CI, 1.25-4.83). The association showed a dose-response effect (multivariate-adjusted P = .01 for trend). Aspirin use was not associated with the incidence of geographic atrophy (multivariate-adjusted OR, 0.99; 95% CI, 0.59-1.65). Regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.

Herschel Space Observatory - Overview and Observing Opportunities

NASA Astrophysics Data System (ADS)

Pilbratt, G. L.

2005-12-01

The Herschel Space Observatory is the fourth cornerstone mission in the European Space Agency (ESA) science programme. It will perform imaging photometry and spectroscopy in the far infrared and submillimetre part of the spectrum, covering approximately the 55-650 micron range. The key science objectives emphasize current questions connected to the formation and evolution of galaxies, stars, and our own planetary system. However, Herschel will offer unique observing capabilities available to the entire astronomical community. Herschel will carry a 3.5 metre diameter passively cooled telescope. The science payload complement - two cameras/medium resolution spectrometers (PACS and SPIRE) and a very high resolution heterodyne spectrometer (HIFI) - will be housed in a superfluid helium cryostat. The ground segment will be jointly developed by the ESA, the three instrument teams, and NASA/IPAC. Once operational in orbit around L2 sometime in 2008, Herschel will offer a minimum of 3 years of routine observations; roughly 2/3 of the available observing time is open to the general astronomical community through a standard competitive proposal procedure. I will report on the current implementation status of the various elements that together make up the Herschel mission, introduce the mission from the perspective of the prospective user of this major facility, and describe the plans for announcing observing opportunities.

Influence of kidney function on risk of supratherapeutic international normalized ratio-related hemorrhage in warfarin users: a prospective cohort study

USDA-ARS?s Scientific Manuscript database

Background: Anticoagulation management is difficult in chronic kidney disease, with frequent supratherapeutic international normalized ratios (INRs >/= 4) increasing hemorrhagic risk. We evaluated whether the interaction of INR and lower estimated glomerular filtration rate (eGFR) increases hemorrha...

School Finance Equalization Management System: An Overview.

ERIC Educational Resources Information Center

Educational Testing Service, Princeton, NJ. Education Policy Research Institute.

This overview acquaints prospective users with the School Finance Equalization Management System (SFEMS), a computer-based system designed to answer questions about state aid distribution. SFEMS can determine such things as the current pattern of aid distribution, the current pattern of tax effort, or the effect of alternative expenditure and…

Spinoff, 1985

NASA Technical Reports Server (NTRS)

Haggerty, J. J.

1986-01-01

Mainline NASA programs, whose challenging objectives necessitate advances across a diverse scientific/technological spectrum are summarized. A representative selection of spinoff products and processes are presented and the NASA technology from which these transfers are derived, are described. The mechanisms NASA employs to foster technology utilization and stimulate interest among prospective users of the technology are detailed.

Does a Mobile Phone Depression-Screening App Motivate Mobile Phone Users With High Depressive Symptoms to Seek a Health Care Professional's Help?

PubMed

BinDhim, Nasser F; Alanazi, Eman M; Aljadhey, Hisham; Basyouni, Mada H; Kowalski, Stefan R; Pont, Lisa G; Shaman, Ahmed M; Trevena, Lyndal; Alhawassi, Tariq M

2016-06-27

The objective of disease screening is to encourage high-risk subjects to seek health care diagnosis and treatment. Mobile phone apps can effectively screen mental health conditions, including depression. However, it is not known how effective such screening methods are in motivating users to discuss the obtained results of such apps with health care professionals. Does a mobile phone depression-screening app motivate users with high depressive symptoms to seek health care professional advice? This study aimed to address this question. This was a single-cohort, prospective, observational study of a free mobile phone depression app developed in English and released on Apple's App Store. Apple App Store users (aged 18 or above) in 5 countries, that is, Australia, Canada, New Zealand (NZ), the United Kingdom (UK), and the United States (US), were recruited directly via the app's download page. The participants then completed the Patient Health Questionnaire (PHQ-9), and their depression screening score was displayed to them. If their score was 11 or above and they had never been diagnosed with depression before, they were advised to take their results to their health care professional. They were to follow up after 1 month. A group of 2538 participants from the 5 countries completed PHQ-9 depression screening with the app. Of them, 322 participants were found to have high depressive symptoms and had never been diagnosed with depression, and received advice to discuss their results with health care professionals. About 74% of those completed the follow-up; approximately 38% of these self-reported consulting their health care professionals about their depression score. Only positive attitude toward depression as a real disease was associated with increased follow-up response rate (odds ratio (OR) 3.2, CI 1.38-8.29). A mobile phone depression-screening app motivated some users to seek a depression diagnosis. However, further study should investigate how other app users use the screening results provided by such apps.

Comparison of combined hormonal vaginal ring and low dose combined oral hormonal pill for the treatment of idiopathic chronic pelvic pain: a randomised trial.

PubMed

Priya, Khushboo; Rajaram, Shalini; Goel, Neerja

2016-12-01

To compare the efficacy and acceptability of combined hormonal vaginal ring with combined oral hormonal pill in women with idiopathic chronic pelvic pain. Randomised prospective interventional trial conducted in 60 women with idiopathic chronic pelvic pain. Women were randomised into two groups of 30 each. In each group, treatment was given for 84 days using either combined vaginal ring or combined oral hormonal pill. Hormonal vaginal ring releases 15mcg of ethinyl estradiol and 120mcg of the etonogestrel per day while the hormonal pill contained 30mcg of ethinyl estradiol and 150mcg of levonorgestrel. There was no ring or pill free week. After every 28 days, pain relief was measured using visual analogue scale (VAS), and verbal rating score (VRS) calculated by summing dysmenorrhea, non-cyclic pelvic pain (NCCP) and deep dyspareunia scores. Side effects, compliance, satisfaction, and user acceptability were also measured. Data was analyzed using various parametric and non-parametric tests. Reduction in mean VAS score at end of treatment in ring group was 6.23 (95% confidence interval [CI], 5.45-7.01; p<0.001) as compared to 5.53 in pill group (95% CI, 4.83-6.23; p<0.001). Reduction in mean VRS score was 5.63 in ring users (95% CI, 4.84-6.42; p<0.001) versus 4.36 in pill users (95% CI, 3.63-5.10; p<0.001). A significantly higher persistent relief in NCPP score was observed in vaginal ring group as compared to oral pill group at end of one month after stopping treatment. Compliance, satisfaction, and user acceptability were higher in ring users (80%) than pill users (70%) and a higher incidence of nausea was seen in pill group. Present study demonstrates for first time that both vaginal and oral hormonal therapy are effective in treatment of idiopathic chronic pelvic pain and vaginal ring may be a better choice with higher satisfaction rate and fewer side effects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prospect Theory for Online Financial Trading

NASA Astrophysics Data System (ADS)

Liu, Yang-Yu; Nacher, Jose C.; Ochiai, Tomoshiro; Martino, Mauro; Altshuler, Yaniv

2014-03-01

Prospect theory is widely viewed as the best available descriptive model of how people evaluate risk in experimental settings. According to prospect theory, people make decisions based on the potential value of losses and gains rather than the final outcome. People are risk-averse with respect to gains and risk-seeking with respect to losses, a phenomenon called ``loss aversion''. Despite of the fact that prospect theory has been well studied in behavioral economics at the theoretical level, there exist very few empirical research and most of them has been undertaken with micro-panel data. Here we analyze the trading activities of over 1.5 million members of an online financial trading community over 28 months, aiming to explore the large-scale empirical aspect of prospect theory. By analyzing and comparing the behaviour of ``winners'' and ``losers'', i.e., traders with positive or negative final net profit, we find clear evidence of the loss aversion phenomenon, an essence in prospect theory. This work demonstrates an unprecedented large-scale empirical evidence of prospect theory. It has immediate implication in financial trading, e.g., developing new trading strategies by minimizing the effect of loss aversion. It also provides opportunity to augment online social trading, where users are allowed to watch and follow the trading activity of others, by predicting potential winners based on their historical trading behaviour.

Earth Observing System (EOS) Snow and Ice Products for Observation and Modeling

NASA Technical Reports Server (NTRS)

Hall, D.; Kaminski, M.; Cavalieri, D.; Dickinson, R.; Marquis, M.; Riggs, G.; Robinson, D.; VanWoert, M.; Wolfe, R.

2005-01-01

Snow and ice are the key components of the Earth's cryosphere, and their influence on the Earth's energy balance is very significant due at least in part to the large areal extent and high albedo characterizing these features. Large changes in the cryosphere have been measured over the last century and especially over the past decade, and remote sensing plays a pivotal role in documenting these changes. Many of NASA's Earth Observing System (EOS) products derived from instruments on the Terra, Aqua, and Ice, Cloud and land Elevation Satellite (ICESat) satellites are useful for measuring changes in features that are associated with climate change. The utility of the products is continually enhanced as the length of the time series increases. To gain a more coherent view of the cryosphere and its historical and recent changes, the EOS products may be employed together, in conjunction with other sources of data, and in models. To further this goal, the first EOS Snow and Ice Products Workshop was convened. The specific goals of the workshop were to provide current and prospective users of EOS snow and ice products up-to-date information on the products, their validation status and future enhancements, to help users utilize the data products through hands-on demonstrations, and to facilitate the integration of EOS products into models. Oral and poster sessions representing a wide variety of snow and ice topics were held; three panels were also convened to discuss workshop themes. Panel discussions focused on data fusion and assimilation of the products into models. Approximately 110 people attended, representing a wide array of interests and organizations in the cryospheric community.

A single dose of cocaine enhances prospective memory performance.

PubMed

Hutten, Nadia Rpw; Kuypers, Kim Pc; van Wel, Janelle Hp; Theunissen, Eef L; Toennes, Stefan W; Verkes, Robbert-Jan; Ramaekers, Johannes G

2018-06-01

Prospective memory is the ability to recall intended actions or events at the right time or in the right context. While cannabis is known to impair prospective memory, the acute effect of cocaine is unknown. In addition, it is not clear whether changes in prospective memory represent specific alterations in memory processing or result from more general effects on cognition that spread across multiple domains such as arousal and attention. The main objective of the study was, therefore, to determine whether drug-induced changes in prospective memory are memory specific or associated with more general drug-induced changes in attention and arousal. A placebo-controlled, three-way, cross-over study including 15 regular poly-drug users was set up to test the influence of oral cocaine (300 mg) and vaporised cannabis (300+150 'booster' µg/kg bodyweight) on an event-based prospective memory task. Attentional performance was assessed using a divided attention task and subjective arousal was assessed with the Profile of Mood States questionnaire. Results showed that cocaine enhanced prospective memory, attention and arousal. Mean performance of prospective memory and attention, as well as levels of arousal were lowest during treatment with cannabis as compared with placebo and cocaine as evinced by a significantly increased trend across treatment conditions. Prospective memory performance was only weakly positively associated to measures of attention and arousal. Together, these results indicate that cocaine enhancement of prospective memory performance cannot be fully explained by parallel changes in arousal and attention levels, and is likely to represent a direct change in the neural network underlying prospective memory.

Prevalence of helmet use by users of bicycles, push scooters, inline skates and skateboards in Toronto and the surrounding area in the absence of comprehensive legislation: an observational study.

PubMed

Page, Jessica L; Macpherson, Alison K; Middaugh-Bonney, Tara; Tator, Charles H

2012-04-01

Legislation in the province of Ontario, Canada, mandates users under the age of 18 to wear a helmet when they ride a bicycle, and legislation has been shown to significantly increase rates of bicycle helmet use. Legislation does not exist in Ontario for older bicyclists or for users of other non-motorised modes of transportation, and there are no current data available regarding rates of helmet use in these categories. This study was designed to determine the prevalence of helmet use among users of bicycles, skateboards, push scooters and inline skates in Toronto, Ontario, and the surrounding area. Further analysis was performed to examine factors associated with helmet use. We performed a cross-sectional, observational study. Three trained, stationary observers captured 6038 users of bicycles (5783), skateboards (77), inline skates (165) and push scooters (13) in the summer of 2009. Observations were separated into three time periods capturing commuters, midday users and recreational users. A general linear model was used to assess the factors associated with helmet use among bicyclists. Helmets were worn by 48.9% of all users observed and 50.0% of all bicyclists. Among bicyclists, females were more likely to wear helmets than males (prevalence ratio 1.27, 95% CI 1.17 to 1.36), while children were significantly more likely to wear helmets than adults (prevalence ratio 1.17, 95% CI 1.37 to 2.15). Significant behavioural variation was observed among users during the three observation periods (p<0.001), with commuters being the most likely to wear a helmet. In the absence of comprehensive legislation encompassing all ages of users, only half of users of non-motorised, wheeled transportation devices are choosing to wear a helmet to protect against traumatic brain injury. Implementation of evidence-based strategies to increase helmet use, such as the introduction of legislation encompassing all ages and all equipment, is required.

Cognitive Functioning of Adolescent and Young Adult Cannabis Users in the Philadelphia Neurodevelopmental Cohort

PubMed Central

Scott, J. Cobb; Wolf, Daniel H.; Calkins, Monica E.; Bach, Emily C.; Weidner, Jennifer; Ruparel, Kosha; Moore, Tyler M.; Jones, Jason D.; Jackson, Chad T.; Gur, Raquel E.; Gur, Ruben C.

2017-01-01

Cannabis use in youth is rising and has been linked to deficits in cognitive functioning. However, cognitive findings have primarily been based on small samples of users seeking treatment, and few studies have evaluated cognition in occasional cannabis users. Here, we examined 4,568 adolescents and young adults (ages 14–21) drawn from the Philadelphia Neurodevelopmental Cohort, a prospective, population-based study. Participants were classified as cannabis Non-Users (n=3,401), Occasional Users (twice per week or less; n=940), or Frequent Users (>3 times per week; n=227). Mixed-model analyses examined main effects of cannabis use and interactions between age and cannabis use on cognitive functioning. There was a significant interaction between cannabis group and age, such that adolescent (but not young adult) Frequent Users performed worse than Non-Users on measures of executive control (p=0.002). Earlier age of cannabis use was associated with worse performance in executive control in Occasional Users (p=0.04). Unexpectedly, Occasional Users exhibited better executive control, memory, and social cognition than Non-Users (ps<.05). Although mild executive control deficits in adolescent frequent users and a relation between early cannabis initiation and cognitive performance are partially consistent with prior research, cognitive deficits were not found in other hypothesized domains in this community-based sample. Moreover, occasional cannabis users displayed equivalent or even slightly better executive control, social cognitive, and memory abilities compared to non-users, suggesting complex relationships between cannabis use and cognition in youth. Longitudinal studies with community samples are needed to identify variables affecting risk and resilience to cognitive deficits associated with cannabis. PMID:28414475

Crowdsourcing quality control for Dark Energy Survey images

DOE PAGES

Melchior, P.

2016-07-01

We have developed a crowdsourcing web application for image quality control employed by the Dark Energy Survey. Dubbed the "DES exposure checker", it renders science-grade images directly to a web browser and allows users to mark problematic features from a set of predefined classes. Users can also generate custom labels and thus help identify previously unknown problem classes. User reports are fed back to hardware and software experts to help mitigate and eliminate recognized issues. We report on the implementation of the application and our experience with its over 100 users, the majority of which are professional or prospective astronomersmore » but not data management experts. We discuss aspects of user training and engagement, and demonstrate how problem reports have been pivotal to rapidly correct artifacts which would likely have been too subtle or infrequent to be recognized otherwise. We conclude with a number of important lessons learned, suggest possible improvements, and recommend this collective exploratory approach for future astronomical surveys or other extensive data sets with a sufficiently large user base. We also release open-source code of the web application and host an online demo versionat http://des-exp-checker.pmelchior.net« less

Crowdsourcing quality control for Dark Energy Survey images

NASA Astrophysics Data System (ADS)

Melchior, P.; Sheldon, E.; Drlica-Wagner, A.; Rykoff, E. S.; Abbott, T. M. C.; Abdalla, F. B.; Allam, S.; Benoit-Lévy, A.; Brooks, D.; Buckley-Geer, E.; Carnero Rosell, A.; Carrasco Kind, M.; Carretero, J.; Crocce, M.; D'Andrea, C. B.; da Costa, L. N.; Desai, S.; Doel, P.; Evrard, A. E.; Finley, D. A.; Flaugher, B.; Frieman, J.; Gaztanaga, E.; Gerdes, D. W.; Gruen, D.; Gruendl, R. A.; Honscheid, K.; James, D. J.; Jarvis, M.; Kuehn, K.; Li, T. S.; Maia, M. A. G.; March, M.; Marshall, J. L.; Nord, B.; Ogando, R.; Plazas, A. A.; Romer, A. K.; Sanchez, E.; Scarpine, V.; Sevilla-Noarbe, I.; Smith, R. C.; Soares-Santos, M.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Vikram, V.; Walker, A. R.; Wester, W.; Zhang, Y.

2016-07-01

We have developed a crowdsourcing web application for image quality control employed by the Dark Energy Survey. Dubbed the "DES exposure checker", it renders science-grade images directly to a web browser and allows users to mark problematic features from a set of predefined classes. Users can also generate custom labels and thus help identify previously unknown problem classes. User reports are fed back to hardware and software experts to help mitigate and eliminate recognized issues. We report on the implementation of the application and our experience with its over 100 users, the majority of which are professional or prospective astronomers but not data management experts. We discuss aspects of user training and engagement, and demonstrate how problem reports have been pivotal to rapidly correct artifacts which would likely have been too subtle or infrequent to be recognized otherwise. We conclude with a number of important lessons learned, suggest possible improvements, and recommend this collective exploratory approach for future astronomical surveys or other extensive data sets with a sufficiently large user base. We also release open-source code of the web application and host an online demo version at http://des-exp-checker.pmelchior.net.

Crowdsourcing quality control for Dark Energy Survey images

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

Melchior, P.

We have developed a crowdsourcing web application for image quality control employed by the Dark Energy Survey. Dubbed the "DES exposure checker", it renders science-grade images directly to a web browser and allows users to mark problematic features from a set of predefined classes. Users can also generate custom labels and thus help identify previously unknown problem classes. User reports are fed back to hardware and software experts to help mitigate and eliminate recognized issues. We report on the implementation of the application and our experience with its over 100 users, the majority of which are professional or prospective astronomersmore » but not data management experts. We discuss aspects of user training and engagement, and demonstrate how problem reports have been pivotal to rapidly correct artifacts which would likely have been too subtle or infrequent to be recognized otherwise. We conclude with a number of important lessons learned, suggest possible improvements, and recommend this collective exploratory approach for future astronomical surveys or other extensive data sets with a sufficiently large user base. We also release open-source code of the web application and host an online demo versionat http://des-exp-checker.pmelchior.net« less

The GEOSS User Requirement Registry (URR): A Cross-Cutting Service-Oriented Infrastructure Linking Science, Society and GEOSS

NASA Astrophysics Data System (ADS)

Plag, H.-P.; Foley, G.; Jules-Plag, S.; Ondich, G.; Kaufman, J.

2012-04-01

The Group on Earth Observations (GEO) is implementing the Global Earth Observation System of Systems (GEOSS) as a user-driven service infrastructure responding to the needs of users in nine interdependent Societal Benefit Areas (SBAs) of Earth observations (EOs). GEOSS applies an interdisciplinary scientific approach integrating observations, research, and knowledge in these SBAs in order to enable scientific interpretation of the collected observations and the extraction of actionable information. Using EOs to actually produce these societal benefits means getting the data and information to users, i.e., decision-makers. Thus, GEO needs to know what the users need and how they would use the information. The GEOSS User Requirements Registry (URR) is developed as a service-oriented infrastructure enabling a wide range of users, including science and technology (S&T) users, to express their needs in terms of EOs and to understand the benefits of GEOSS for their fields. S&T communities need to be involved in both the development and the use of GEOSS, and the development of the URR accounts for the special needs of these communities. The GEOSS Common Infrastructure (GCI) at the core of GEOSS includes system-oriented registries enabling users to discover, access, and use EOs and derived products and services available through GEOSS. In addition, the user-oriented URR is a place for the collection, sharing, and analysis of user needs and EO requirements, and it provides means for an efficient dialog between users and providers. The URR is a community-based infrastructure for the publishing, viewing, and analyzing of user-need related information. The data model of the URR has a core of seven relations for User Types, Applications, Requirements, Research Needs, Infrastructure Needs, Technology Needs, and Capacity Building Needs. The URR also includes a Lexicon, a number of controlled vocabularies, and

Quantifying the bystander-effect of 2.5G mobile telephones on the speech perception of digital hearing aid users.

PubMed

Vlastarakos, P V; Nikolopoulos, T P; Manolopoulos, L; Stamou, A; Halkiotis, K K; Ferekidis, E; Georgiou, E

2012-01-01

To quantify the bystander-effect of 2.5G mobile telephones (2.5G-MTs) on the speech perception of digital hearing-aid (dHA) users. Differences in the susceptibility of behind-the-ear (BTE) compared to in-to-the-ear (ITE) dHAs were also assessed. Prospective-comparative study conducted at a tertiary referral centre (ENT Department) and a HA-fitting laboratory. Key-word recognition scores from open-sentence lists were calculated. Power-analysis determined that a minimum of 60 subjects with SNHL (30 in each group), using either BTE or ITE dHAs, were required for reliable study outcomes. Sixty-four adults were tested with a functioning 2.5G-MT at almost physical contact with their ear; thirty subjects used BTE and 34 ITE dHAs. Aided word recognition score differences between studied groups and within each group, while a 2.5G-MT was activated. Cut-off inclusion criterion regarding baseline aided word recognition score was 75%. Baseline aided word recognition scores for ITE dHAs were better compared to BTE ones (p < 0.01). Following the 2.5G-MT activation, this difference disappeared. No statistically significant difference in word recognition was observed between the examined groups, or within the BTE group, from the bystander-effect of the 2.5G-MT. ITE dHAs proved more susceptible to electromagnetic interference (p < 0.05). The bystander-effect of 2.5G-MTs on the speech perception of dHA users is either minimal, or not significant. The observed compatibility has a positive impact on the lives of millions of people worldwide. The long-standing theory of more interference in BTE compared to ITE HAs is not confirmed by the results of the present study. EBM level of evidence: 2c.

Effects of four-month handbike training under free-living conditions on physical fitness and health in wheelchair users.

PubMed

Hoekstra, Sven; Valent, Linda; Gobets, David; van der Woude, Lucas; de Groot, Sonja

2017-08-01

Recognizing the encouraging effect of challenging events, the HandbikeBattle (HBB) was created to promote exercise among wheelchair users. The purpose of this study was to reveal the effects on physical fitness and health outcomes of four-month handbike training under free-living conditions in preparation for the event. In this prospective cohort study, 59 relatively inexperienced handyclists participated in the HBB of 2013 or 2014. Incremental exercise tests were conducted, respiratory function was tested and anthropometrics were measured before and after the preparation period. Main outcome measures were peak power output (POpeak), peak oxygen uptake (VO2peak) and waist circumference, of which the changes were tested using repeated measures ANOVA. To detect possible determinants of changes in physical fitness, a linear regression analysis was conducted with personal characteristics, executed training volume and upper-extremity complaints during the training period as independent variables. POpeak, VO2peak and waist circumference improved significantly with 17%, 7% and 4.1%, respectively. None of the included variables were significant determinants for the changes in POpeak found as a result of the training. A challenging event such as the HBB provokes training regimes among participants of sufficient load to realize substantial improvements in physical fitness and health outcomes. Implications for Rehabilitation Due to the often impaired muscle function in the lower-limbs and an inactive lifestyle, wheelchair users generally show considerably lower levels of fitness compared to able-bodied individuals. This prospective cohort study showed that four months of handbike training under free-living conditions in preparation for this event resulted in substantial improvements in physical fitness and health outcomes in wheelchair users. The creation of a challenging event such as the HandbikeBattle as part of a follow-up rehabilitation practice can therefore be a useful tool to help wheelchair users initiate or keep training to improve their physical fitness and health.

Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study

DTIC Science & Technology

2006-12-01

Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study Robert M. Perkins,*† Matthew C. Aboudara,* Kevin C. Abbott,*† and...Surgical Research, San Antonio, Texas The trauma patient is exposed to physiologic processes and life-saving interventions that predispose to hyperkalemia ...in the care of the massively traumatized patient may or may not increase the risk for hyperkalemia . This prospective, observational study was

Motivation Mining: Prospecting the Web.

ERIC Educational Resources Information Center

Small, Ruth V.; Arnone, Marilyn P.

1999-01-01

Describes WebMAC instruments, which differ from other Web-evaluation instruments because they have a theoretical base, are user-centered, are designed for students in grades 7 through 12, and assess the motivational quality of Web sites. Examples are given of uses of WebMAC Middle and WebMAC Senior in activities to promote evaluation and…

36 CFR 228.4 - Plan of operations-notice of intent-requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... used and maintained for National Forest System purposes; (ii) Prospecting and sampling which will not... disturbance which is substantially different than that caused by other users of the National Forest System who... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Plan of operations-notice of...

47 CFR 24.238 - Emission limitations for Broadband PCS equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provided the measured power is integrated over the full required measurement bandwidth (i.e. 1 MHz or 1... files and disclose it to prospective assignees or transferees and, upon request, to the FCC. (d... results in interference to users of another radio service, the FCC may require a greater attenuation of...

Dissemination Activities Report

ERIC Educational Resources Information Center

Barclay, Hanna; Batatia, Hudj; Bauters, Merja; Ben Ami, Zvi; Drachman, Raul; Flouris, Giorgos; Jadin, Tanja; Jalonen, Satu; Karlgren, Klas; Karpati, Andrea; Kotzinos, Dimitris; Lakkala, Minna; Lallimo, Jiri; Moen, Anne; Nygard, Kathrine; Paavola, Sami; Padiglia, Sheila; Scapolla, Marina; Sins, Patrick; Vasileva, Tania

2008-01-01

In the first 24 months of the project, KP-Lab members were highly dedicated to dissemination and were engaged in various dissemination activities that contributed to the prime objective of the KP-Lab dissemination efforts which is "to make the project widely known to a variety of prospective users and, at a later stage, to promote the…

The World of Science: What's Ahead for the 1980's?

ERIC Educational Resources Information Center

USA Today, 1980

1980-01-01

Various articles on science and technology in the 1980s focus on solar eruptions and climatic changes, Antarctic warming, new theories of the universe's beginnings, analyzing lunar samples, the planets, space products, genetic research, using ozone to purify water, techniques to track illegal users of explosives, energy prospects, and use of waste…

Let ABE Do It. Basic Education in the Workplace.

ERIC Educational Resources Information Center

Mark, Jorie Lester, Ed.

This publication highlights business, industry, union, and Job Training Partnership Act (JTPA)-supported efforts to provide public and private employees, as well as some prospective employees, with the basic literacy skills they need to perform in the workplace. Basic or remedial education users listed in this directory include 198 companies or…

Intrauterine contraception in nulliparous women: a prospective survey.

PubMed

Hall, Alexandra M; Kutler, Beth A

2016-01-01

Intrauterine contraception is a first-line option for young women, yet relatively few prospective studies have been performed in nulliparous women using currently available devices, and many providers are still reluctant to provide this option. Between January 2012 and June 2014, 109 nulliparous women, aged 18-30 years, who had an intrauterine device (IUD) placed at a student health clinic [88 levonorgestrel-intrauterine system (LNG-IUS) users and 21 Cu T 380A (IUD) users] were surveyed at 1, 6, 12 and 18 months after insertion. Overall satisfaction was high; at follow-up survey 83% of 100 women (mean use 13.4 months) were 'happy' or 'very happy' with their IUD, and there were no differences in satisfaction between the two IUD types. Some 75% of participants stated that the insertion procedure went 'very well', despite 78% rating insertion pain as moderate to severe, and 46% experiencing vasovagal symptoms. The 12-month continuation rate was 89%, with discontinuations for expulsion (3%), side effects (6%), lack of anticipated benefit (1%) and pregnancy (1%). Users of the Cu T 380A were more likely to have heavy menses (74% vs 2%; p<0.0001) or moderate to severe cramping (68% vs 20%; p=0.0002) compared with LNG-IUS users. There were no uterine perforations or diagnoses of pelvic inflammatory disease. The rate of failed insertions during the study period was 6.2%. Despite significant symptoms with insertion, intrauterine contraception is safe, effective and ultimately well tolerated in nulliparous women and should be provided to this population in both university and community health settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Intrauterine contraception in nulliparous women: a prospective survey

PubMed Central

Kutler, Beth A

2016-01-01

Background Intrauterine contraception is a first-line option for young women, yet relatively few prospective studies have been performed in nulliparous women using currently available devices, and many providers are still reluctant to provide this option. Methods Between January 2012 and June 2014, 109 nulliparous women, aged 18–30 years, who had an intrauterine device (IUD) placed at a student health clinic [88 levonorgestrel-intrauterine system (LNG-IUS) users and 21 Cu T 380A (IUD) users] were surveyed at 1, 6, 12 and 18 months after insertion. Results Overall satisfaction was high; at follow-up survey 83% of 100 women (mean use 13.4 months) were ‘happy’ or ‘very happy’ with their IUD, and there were no differences in satisfaction between the two IUD types. Some 75% of participants stated that the insertion procedure went ‘very well’, despite 78% rating insertion pain as moderate to severe, and 46% experiencing vasovagal symptoms. The 12-month continuation rate was 89%, with discontinuations for expulsion (3%), side effects (6%), lack of anticipated benefit (1%) and pregnancy (1%). Users of the Cu T 380A were more likely to have heavy menses (74% vs 2%; p<0.0001) or moderate to severe cramping (68% vs 20%; p=0.0002) compared with LNG-IUS users. There were no uterine perforations or diagnoses of pelvic inflammatory disease. The rate of failed insertions during the study period was 6.2%. Conclusions Despite significant symptoms with insertion, intrauterine contraception is safe, effective and ultimately well tolerated in nulliparous women and should be provided to this population in both university and community health settings. PMID:25854550

Internet and Social Media Use After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study.

PubMed

Baker-Sparr, Christina; Hart, Tessa; Bergquist, Thomas; Bogner, Jennifer; Dreer, Laura; Juengst, Shannon; Mellick, David; OʼNeil-Pirozzi, Therese M; Sander, Angelle M; Whiteneck, Gale G

To characterize Internet and social media use among adults with moderate to severe traumatic brain injury (TBI) and to compare demographic and socioeconomic factors associated with Internet use between those with and without TBI. Ten Traumatic Brain Injury Model Systems centers. Persons with moderate to severe TBI (N = 337) enrolled in the TBI Model Systems National Database and eligible for follow-up from April 1, 2014, to March 31, 2015. Prospective cross-sectional observational cohort study. Internet usage survey. The proportion of Internet users with TBI was high (74%) but significantly lower than those in the general population (84%). Smartphones were the most prevalent means of Internet access for persons with TBI. The majority of Internet users with TBI had a profile account on a social networking site (79%), with more than half of the sample reporting multiplatform use of 2 or more social networking sites. Despite the prevalence of Internet use among persons with TBI, technological disparities remain in comparison with the general population. The extent of social media use among persons with TBI demonstrates the potential of these platforms for social engagement and other purposes. However, further research examining the quality of online activities and identifying potential risk factors of problematic use is recommended.

Salivary α-amylase and cortisol after exercise in menopause: influence of long-term HRT.

PubMed

Patacchioli, F R; Ghiciuc, C M; Bernardi, M; Dima-Cozma, L C; Fattorini, L; Squeo, M R; Galoppi, P; Brunelli, R; Ferrante, F; Pasquali, V; Perrone, G

2015-01-01

This observational prospective study analyzed the effect of an incremental cardiopulmonary exercise test (CPET) on the secretion of salivary biomarkers of the adrenergic nervous system and hypothalamus-pituitary-adrenal (HPA) axis activity by measuring salivary α-amylase and cortisol diurnal trajectories in the setting of long-term hormone replacement therapy (HRT). Fifteen healthy sedentary postmenopausal women who were current HRT users and 15 women who had never used HRT were consecutively recruited. α-Amylase and cortisol were measured in salivary samples collected on the CPET day and on a rest day. Cardiovascular and respiratory fitness parameters were recorded during the CPET challenge. The participants had very homogeneous somatic characteristics, and they were all in generally good health. The postmenopausal never-HRT users presented an abnormal diurnal pattern of α-amylase at baseline and a flattened response to CPET. In contrast, women on HRT had a physiological α-amylase diurnal pattern and increased salivary α-amylase production during the CPET-induced challenge. The CPET challenge physiologically activated the HPA axis activity, as shown by the increase in the concentration of salivary cortisol during the effort test. HPA axis activity was not affected by long-term HRT. Postmenopausal women using HRT exhibited a cardiorespiratory functional capacity that was significantly (p < 0.05) higher than that of non-users. Our findings show that healthy postmenopausal women present an asymmetry between adrenergic nervous system and HPA axis activities under both basal and stress conditions. HRT was able to modify the abnormal adrenergic nervous system activity, most likely by reducing the sympathetic hyperactivity that characterizes menopause.

Female-initiated barrier methods for the prevention of STI/HIV: where are we now? Where should we go?

PubMed

Latka, M

2001-12-01

The female condom has been on the US market for over 8 years and was hailed as a method that would allow women greater control in protecting themselves against unwanted pregnancy and sexually transmitted infections. However, since its launch, promotion of the female condom has met with challenges that vary from provider bias against the device, concerns about efficacy, and doubts about whether it will be used. While daunting, many of these challenges are not unique to the female condom. In fact, they parallel those of the tampon when it was first promoted in the US for menstrual hygiene in the early 1930s. Many providers were initially opposed to the tampon; early users found the tampon inadequate. Ten years after the introduction of the tampon and despite mass marketing, acceptability was mixed and use was modest (25% prevalence in a 26-city survey). Similar to female condom use observed in current-day prospective studies, users did not use the tampon exclusively or even predominantly. The story of the tampon demonstrates that a method does not have to be adopted by all users immediately to play an important role, and that even initially controversial methods can become widely accepted as mainstream. The early history of the tampon sheds perspective, and hope, on where we stand with the female condom. While much-needed work is under way to develop microbicides, we should take advantage of the fact that the female condom is already available and promote it to those in need now.

Economic impact of and satisfaction with a high resolution thyroid nodule clinic at the endocrinology department.

PubMed

Díaz-Soto, Gonzalo; Torres, Beatriz; López Gómez, Juan Jose; Gómez Hoyos, Emilia; Villar, Aurelia; Romero, Enrique; de Luis, Daniel A

2016-10-01

No conclusive data exist on the value of a high resolution thyroid nodule clinic for management of nodular thyroid disease. The aim of this study was to evaluate the economic impact of and user satisfaction with a high resolution thyroid nodule clinic (HRTNC) in coordination with primary care. A prospective, observational, descriptive study was conducted to analyze data from 3,726 patients (mean age 61±12 years; 85% women) evaluated at an HRTNC during 2014 and 2015. Demographic data (sex and age), number of ultrasound examinations and fine needle aspiration cytologies (FNAC), referral center and consultation type were assessed. In 2014 and 2015, 3,726 neck ultrasound examinations and 926 FNACs (3.8% rated as non-diagnostic) were performed. Among the 1,227 patients evaluated for the first time, 21.5% did not require a second endocrine appointment, which resulted in mean estimated savings of 14,354.55 euros. Of all patients, 41.1% were referred from primary care, 33.4% from endocrinology, and 26.5% from other specialties. As compared to 2013, the number of thyroid ultrasound examinations requested decreased by 65.3% and 59.7% in 2014 and 2015 respectively, with mean estimated savings of 137,563.92 euros. Mean user satisfaction assessed was 4.0 points (95% confidence interval, 3.7-4.3) on a 5-point scale. HRTNCs at endocrinology departments, coordinated with primary care, are a viable, cost-effective alternative with a positive user perception. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Multicenter User Evaluation of ACCU-CHEK® Combo, an Integrated System for Continuous Subcutaneous Insulin Infusion

PubMed Central

Kerr, David; Hoogma, Roel P.L.M; Buhr, Andreas; Petersen, Bettina; Storms, Fred E.M.G

2010-01-01

Background The aim of this study was to evaluate a newly developed system for insulin delivery incorporating a multifunctional blood glucose meter and a remotely controlled insulin pump (ACCU-CHEK® Combo system) in established pump users with type 1 diabetes. The technology was assessed both from device performance and subject usability perspectives. Method A multicenter, prospective, single group study was carried out in five centers in the Netherlands and four centers in the United Kingdom for more than 6 months. The study was divided into two phases: Phase 1 (4 weeks) for device validation purposes and phase 2 (22 weeks) to observe the impact of the system on metabolic control, patient satisfaction [using the Diabetes Treatment Satisfaction Questionnaire (DTSQ)] and device safety. Results Eighty subjects completed the planned study period. There were no unexpected device errors. Treatment satisfaction was high at baseline and further increased to study end (DTSQ change version: sum score, 10.6 ± 7.2; scale score range, -18 to +18, p < 0.0001). Hemoglobin A1c improved continuously over time, from 7.9% (±0.9%) to 7.7% (±0.8%) at month 3 (p < 0.001) and 7.6% (±0.8%) at month 6 (p < 0.0001). The frequency of severe hypoglycemia was 0.08 per patient years. There was no case of ketoacidosis. Conclusions The new system was evaluated by experienced continuous subcutaneous insulin infusion users as safe in daily practice and associated with favorable treatment satisfaction and a modest improvement in glycemic control. PMID:21129336

Effects of marijuana on visuospatial working memory: an fMRI study in young adults.

PubMed

Smith, Andra M; Longo, Carmelinda A; Fried, Peter A; Hogan, Matthew J; Cameron, Ian

2010-06-01

The effects of marijuana use on visuospatial working memory were investigated in 19-21-year-olds using functional magnetic resonance imaging (fMRI). Participants were members of the Ottawa Prenatal Prospective Study, a longitudinal study that collected a unique body of information on participants from infancy to young adulthood including: prenatal drug history, detailed cognitive/behavioral performance, and current and past drug usage. This information allowed for the measurement of an unprecedented number of potentially confounding drug exposure variables including: prenatal marijuana, nicotine, alcohol, and caffeine exposure and offspring alcohol, marijuana, and nicotine use. Ten marijuana users and 14 nonusing controls performed a visuospatial 2-back task while fMRI blood oxygen level-dependent response was examined. Despite similar task performance, marijuana users had significantly greater activation in the inferior and middle frontal gyri, regions of the brain normally associated with visuospatial working memory. Marijuana users also had greater activation in the right superior temporal gyrus, a region of the brain not typically associated with visuospatial working memory tasks. These results suggest that marijuana use leads to altered neural functioning during visuospatial working memory after controlling for other prenatal and current drug use. This alteration appears to be compensated for by the recruitment of blood flow in additional brain regions. It is possible that this compensation may not be sufficient in more real-life situations where this type of processing is required and thus deficits may be observed. Awareness of these neural physiological effects of marijuana in youth is critical.

A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer

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

Moran, Meena S., E-mail: meena.moran@yale.edu; Department of Radiation Therapy, William W. Backus Hospital, Norwich, Connecticut; Ma Shuangge

Purpose: Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation. Materials/Methods: A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers. Results: CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reportedmore » activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017). Conclusion: This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast cancer.« less

A Computer Code for Swirling Turbulent Axisymmetric Recirculating Flows in Practical Isothermal Combustor Geometries

NASA Technical Reports Server (NTRS)

Lilley, D. G.; Rhode, D. L.

1982-01-01

A primitive pressure-velocity variable finite difference computer code was developed to predict swirling recirculating inert turbulent flows in axisymmetric combustors in general, and for application to a specific idealized combustion chamber with sudden or gradual expansion. The technique involves a staggered grid system for axial and radial velocities, a line relaxation procedure for efficient solution of the equations, a two-equation k-epsilon turbulence model, a stairstep boundary representation of the expansion flow, and realistic accommodation of swirl effects. A user's manual, dealing with the computational problem, showing how the mathematical basis and computational scheme may be translated into a computer program is presented. A flow chart, FORTRAN IV listing, notes about various subroutines and a user's guide are supplied as an aid to prospective users of the code.

Rotary engine performance computer program (RCEMAP and RCEMAPPC): User's guide

NASA Technical Reports Server (NTRS)

Bartrand, Timothy A.; Willis, Edward A.

1993-01-01

This report is a user's guide for a computer code that simulates the performance of several rotary combustion engine configurations. It is intended to assist prospective users in getting started with RCEMAP and/or RCEMAPPC. RCEMAP (Rotary Combustion Engine performance MAP generating code) is the mainframe version, while RCEMAPPC is a simplified subset designed for the personal computer, or PC, environment. Both versions are based on an open, zero-dimensional combustion system model for the prediction of instantaneous pressures, temperature, chemical composition and other in-chamber thermodynamic properties. Both versions predict overall engine performance and thermal characteristics, including bmep, bsfc, exhaust gas temperature, average material temperatures, and turbocharger operating conditions. Required inputs include engine geometry, materials, constants for use in the combustion heat release model, and turbomachinery maps. Illustrative examples and sample input files for both versions are included.

The host response in critically ill sepsis patients on statin therapy: a prospective observational study.

PubMed

Wiewel, Maryse A; Scicluna, Brendon P; van Vught, Lonneke A; Hoogendijk, Arie J; Zwinderman, Aeilko H; Lutter, René; Horn, Janneke; Cremer, Olaf L; Bonten, Marc J; Schultz, Marcus J; van der Poll, Tom

2018-01-18

Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis. We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of these, 351 patients (33%) were on statin therapy before admission. The host response was evaluated by measuring 23 biomarkers providing insight into key pathways implicated in sepsis pathogenesis and by analyzing whole-blood leukocyte transcriptomes in samples obtained within 24 h after ICU admission. To account for indication bias, a propensity score-matched cohort was created (N = 194 in both groups for protein biomarkers and N = 95 in both groups for gene expression analysis). Prior statin use was not associated with an altered mortality up to 90 days after admission (38.0 vs. 39.7% in the non-statin users in the propensity-matched analysis). Statin use did not modify systemic inflammatory responses, activation of the vascular endothelium or the coagulation system. The blood leukocyte genomic response, characterized by over-expression of genes involved in inflammatory and innate immune signaling pathways as well as under-expression of genes associated to T cell function, was not different between patients with and without prior statin use. Statin therapy is not associated with a modified host response in sepsis patients on admission to the ICU.

Feasibility of aerosol drug delivery to sleeping infants: a prospective observational study.

PubMed

Amirav, Israel; Newhouse, Michael T; Luder, Anthony; Halamish, Asaf; Omar, Hamza; Gorenberg, Miguel

2014-03-26

Delivery of inhaled medications to infants is usually very demanding and is often associated with crying and mask rejection. It has been suggested that aerosol administration during sleep may be an attractive alternative. Previous studies in sleeping children were disappointing as most of the children awoke and rejected the treatment. The SootherMask (SM) is a new, gentle and innovative approach for delivering inhaled medication to infants and toddlers. The present pilot study describes the feasibility of administering inhaled medications during sleep using the SM. Prospective observational study. Out patients. 13 sleeping infants with recurrent wheezing who regularly used pacifiers and were <12 months old. Participants inhaled technetium99mDTPA-labelled normal saline aerosol delivered via a Respimat Soft Mist Inhaler (SMI) (Boehringer-Ingelheim, Germany) and SM + InspiraChamber (IC; InspiRx Inc, New Jersey, USA). The two major outcomes were the acceptability of the treatment and the lung deposition (per cent of emitted dose). All infants who fulfilled the inclusion criteria successfully received the SM treatment during sleep without difficulty. Mean lung deposition (±SD) averaged 1.6±0.5% in the right lung. This study demonstrated that the combination of Respimat, IC and SM was able to administer aerosol therapy to all the sleeping infants who were regular pacifier users with good lung deposition. Administration of aerosols during sleep is advantageous since all the sleeping children accepted the mask and ensuing aerosol therapy under these conditions, in contrast to previous studies in which there was frequent mask rejection using currently available devices. NCT01120938.

Recommendations and settings of word prediction software by health-related professionals for patients with spinal cord injury: a prospective observational study.

PubMed

Pouplin, Samuel; Roche, Nicolas; Hugeron, Caroline; Vaugier, Isabelle; Bensmail, Djamel

2016-02-01

For people with cervical spinal cord injury (SCI), access to computers can be difficult, thus several devices have been developed to facilitate their use. However, text input speed remains very slow compared to users who do not have a disability, even with these devices. Several methods have been developed to increase text input speed, such as word prediction software (WPS). Health-related professionals (HRP) often recommend this type of software to people with cervical SCI. WPS can be customized using different settings. It is likely that the settings used will influence the effectiveness of the software on text input speed. However, there is currently a lack of literature regarding professional practices for the setting of WPS as well as the impact for users. To analyze word prediction software settings used by HRP for people with cervical SCI. Prospective observational study. Garches, France; health-related professionals who recommend Word Prediction Software. A questionnaire was submitted to HRP who advise tetraplegic people regarding the use of communication devices. A total of 93 professionals responded to the survey. The most frequently recommended software was Skippy, a commercially available software. HRP rated the importance of the possibility to customise the settings as high. Moreover, they rated some settings as more important than others (P<0.001). However, except for the number of words displayed, each setting was configured by less than 50% of HRP. The results showed that there was a difference between the perception of the importance of some settings and data in the literature regarding the optimization of settings. Moreover, although some parameters were considered as very important, they were rarely specifically configured. Confidence in default settings and lack of information regarding optimal settings seem to be the main reasons for this discordance. This could also explain the disparate results of studies which evaluated the impact of WPS on text input speed in people with cervical SCI. The results showed that there was a difference between the perception of the importance of some settings and data in the literature regarding the optimization of settings. Moreover, although some parameters were considered as very important, they were rarely specifically configured. Confidence in default settings and lack of information regarding optimal settings seem to be the main reasons for this discordance. This could also explain the disparate results of studies which evaluated the impact of WPS on text input speed in people with cervical SCI. Professionals tend to have confidence in default settings, despite the fact they are not always appropriate for users. It thus seems essential to develop information networks and training to disseminate the results of studies and in consequence possibly improve communication for people with cervical SCI who use such devices.

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan: a study protocol and participants' profile.

PubMed

Azmat, Syed Khurram; Hameed, Waqas; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Khan, Omar Farooq; Abbas, Ghazunfer; Munroe, Erik

2015-03-18

Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users. A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate. The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system.

Multimodal observational assessment of quality and productivity benefits from the implementation of wireless technology for out of hours working

PubMed Central

Blakey, John D; Guy, Debbie; Simpson, Carl; Fearn, Andrew; Cannaby, Sharon; Wilson, Petra

2012-01-01

Objectives The authors investigated if a wireless system of call handling and task management for out of hours care could replace a standard pager-based system and improve markers of efficiency, patient safety and staff satisfaction. Design Prospective assessment using both quantitative and qualitative methods, including interviews with staff, a standard satisfaction questionnaire, independent observation, data extraction from work logs and incident reporting systems and analysis of hospital committee reports. Setting A large teaching hospital in the UK. Participants Hospital at night co-ordinators, clinical support workers and junior doctors handling approximately 10 000 tasks requested out of hours per month. Outcome measures Length of hospital stay, incidents reported, co-ordinator call logging activity, user satisfaction questionnaire, staff interviews. Results Users were more satisfied with the new system (satisfaction score 62/90 vs 82/90, p=0.0080). With the new system over 70 h/week of co-ordinator time was released, and there were fewer untoward incidents related to handover and medical response (OR=0.30, p=0.02). Broad clinical measures (cardiac arrest calls for peri-arrest situations and length of hospital stay) improved significantly in the areas covered by the new system. Conclusions The introduction of call handling software and mobile technology over a medical-grade wireless network improved staff satisfaction with the Hospital at Night system. Improvements in efficiency and information flow have been accompanied by a reduction in untoward incidents, length of stay and peri-arrest calls. PMID:22466035

Statin Prescriptions and Breast Cancer Recurrence Risk: A Danish Nationwide Prospective Cohort Study

PubMed Central

Pedersen, Lars; Tarp, Maja; Cronin-Fenton, Deirdre P.; Garne, Jens Peter; Silliman, Rebecca A.; Sørensen, Henrik Toft; Lash, Timothy L.

2011-01-01

Background Accumulating evidence suggests that statins affect diseases other than cardiovascular disease, including cancer, and that these effects may depend on the lipid solubility of specific statins. Though many studies have reported an association between statin use and breast cancer incidence, the relationship between statin use and breast cancer recurrence has not been well studied. Methods We conducted a nationwide, population-based prospective cohort study of all female residents in Denmark diagnosed with stage I–III invasive breast carcinoma who were reported to the Danish Breast Cancer Cooperative Group registry between 1996 and 2003 (n = 18 769). Women were followed for a median of 6.8 years after diagnosis. Prescriptions for lipophilic and hydrophilic statins were ascertained from the national electronic pharmacy database. Associations between statin prescriptions and breast cancer recurrence were estimated with generalized linear models and Cox proportional hazards regression with adjustment for age and menopausal status at diagnosis; histological grade; estrogen receptor status; receipt of adjuvant therapy; type of primary surgery received; pre-diagnosis hormone replacement therapy; and co-prescriptions of aspirin, angiotensin-converting enzyme inhibitors, nonsteroidal anti-inflammatory drugs, or anticoagulants. All statistical tests were two-sided. Results Most prescriptions for lipophilic statins in the study population were for simvastatin. Exclusive simvastatin users experienced approximately 10 fewer breast cancer recurrences per 100 women after 10 years of follow-up (adjusted 10-year risk difference = −0.10, 95% confidence interval = −0.11 to −0.08), compared with women who were not prescribed a statin. Exclusive hydrophilic statin users had approximately the same risk of breast cancer recurrence as women not prescribed a statin over follow-up (adjusted 10-year risk difference = 0.05, 95% confidence interval = −0.01 to 0.11). Conclusions Simvastatin, a highly lipophilic statin, was associated with a reduced risk of breast cancer recurrence among Danish women diagnosed with stage I–III breast carcinoma, whereas no association between hydrophilic statin use and breast cancer recurrence was observed. PMID:21813413

Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study.

PubMed

McKetin, Rebecca; Lubman, Dan I; Baker, Amanda L; Dawe, Sharon; Ali, Robert L

2013-03-01

Methamphetamine is associated with psychotic phenomena, but it is not clear to what extent this relationship is due to premorbid psychosis among people who use the drug. To determine the change in the probability of psychotic symptoms occurring during periods of methamphetamine use. Longitudinal prospective cohort study. A fixed-effects analysis of longitudinal panel data, consisting of 4 noncontiguous 1-month observation periods, was used to examine the relationship between changes in methamphetamine use and the risk of experiencing psychotic symptoms within individuals over time. Sydney and Brisbane, Australia. A total of 278 participants 16 years of age or older who met DSM-IV criteria for methamphetamine dependence on entry to the study but who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Clinically significant psychotic symptoms in the past month, defined as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations, or unusual thought content. The number of days of methamphetamine use in the past month was assessed using the Opiate Treatment Index. There was a 5-fold increase in the likelihood of psychotic symptoms during periods of methamphetamine use relative to periods of no use (odds ratio [OR], 5.3 [95% CI, 3.4-8.3]; P < .001), this increase being strongly dose-dependent (1-15 days of methamphetamine use vs abstinence in the past month: OR, 4.0 [95% CI, 2.5-6.5]; ≥16 days of methamphetamine use vs abstinence in the past month: OR, 11.2 [95% CI, 5.9-21.1]). Frequent cannabis and/or alcohol use (≥16 days of use in the past month) further increased the odds of psychotic symptoms (cannabis: OR, 2.0 [95% CI, 1.1-3.5]; alcohol: OR, 2.1 [95% CI, 1.1-4.2]). There was a large dose-dependent increase in the occurrence of psychotic symptoms during periods of methamphetamine use among users of the drug.

Improvements in HIV treatment outcomes among indigenous and non-indigenous people who use illicit drugs in a Canadian setting

PubMed Central

Milloy, M-J; King, Alexandra; Kerr, Thomas; Adams, Evan; Samji, Hasina; Guillemi, Silvia; Wood, Evan; Montaner, Julio

2016-01-01

Introduction In many settings worldwide, members of indigenous groups experience a disproportionate burden of HIV. In Canada, there is an urgent need to improve HIV treatment outcomes for indigenous people living with HIV (IPLWH), to not only reduce HIV/AIDS-associated morbidity and mortality but also curb elevated rates of viral transmission. Thus, by comparing indigenous and non-indigenous participants in an ongoing longitudinal cohort of HIV-positive people who use illicit drugs, we sought to investigate longitudinal changes in three HIV treatment indicators for IPLWH who use illicit drugs during a community-wide treatment-as-prevention (TasP) initiative in British Columbia, Canada. Methods We used data from the ACCESS study, an ongoing observational prospective cohort of HIV-positive illicit drug users recruited from community settings in Vancouver, British Columbia. Cohort data are linked to comprehensive retrospective and prospective clinical records in a setting of no-cost HIV/AIDS treatment and care. We used multivariable generalized estimating equations (GEE) to evaluate longitudinal changes in the proportion of participants with exposure to antiretroviral therapy (ART) in the previous 180 days, optimal adherence to ART (i.e. ≥95% vs. <95%) and non-detectable HIV-1 RNA viral load (VL <50 copies/mL plasma). Results Between 2005 and 2014, 845 individuals were recruited, including 326 (39%) self-reporting any indigenous ancestry, and contributed 6732 interviews and 13,495 VL measurements. Among indigenous participants, the proportion with recent ART increased from 51 to 94% and non-detectable VL from 23 to 65%. In multivariable models, later interview period was positively associated with recent ART (adjusted odds ratio (AOR)=1.16 per interview period, 95% confidence interval (CI): 1.11 to 1.20) and non-detectable VL (AOR=1.07, 95% CI: 1.04 to 1.10). In adjusted models comparing indigenous and non-indigenous participants, we did not observe differences between the two groups (all p>0.1). Conclusions In this large and long-term study involving community-recruited HIV-positive illicit drug users, we observed a substantial and increasing proportion of indigenous participants reach several important thresholds in HIV care at rates indistinguishable from non-indigenous participants. The current findings highlight the important role of TasP on vulnerable populations in this setting and contribute to the evidence base supporting the immediate scale-up of ART to address HIV/AIDS-associated morbidity, mortality and viral transmission. PMID:27094914

Improvements in HIV treatment outcomes among indigenous and non-indigenous people who use illicit drugs in a Canadian setting.

PubMed

Milloy, M-J; King, Alexandra; Kerr, Thomas; Adams, Evan; Samji, Hasina; Guillemi, Silvia; Wood, Evan; Montaner, Julio

2016-01-01

In many settings worldwide, members of indigenous groups experience a disproportionate burden of HIV. In Canada, there is an urgent need to improve HIV treatment outcomes for indigenous people living with HIV (IPLWH), to not only reduce HIV/AIDS-associated morbidity and mortality but also curb elevated rates of viral transmission. Thus, by comparing indigenous and non-indigenous participants in an ongoing longitudinal cohort of HIV-positive people who use illicit drugs, we sought to investigate longitudinal changes in three HIV treatment indicators for IPLWH who use illicit drugs during a community-wide treatment-as-prevention (TasP) initiative in British Columbia, Canada. We used data from the ACCESS study, an ongoing observational prospective cohort of HIV-positive illicit drug users recruited from community settings in Vancouver, British Columbia. Cohort data are linked to comprehensive retrospective and prospective clinical records in a setting of no-cost HIV/AIDS treatment and care. We used multivariable generalized estimating equations (GEE) to evaluate longitudinal changes in the proportion of participants with exposure to antiretroviral therapy (ART) in the previous 180 days, optimal adherence to ART (i.e. ≥ 95% vs. < 95%) and non-detectable HIV-1 RNA viral load (VL <50 copies/mL plasma). Between 2005 and 2014, 845 individuals were recruited, including 326 (39%) self-reporting any indigenous ancestry, and contributed 6732 interviews and 13,495 VL measurements. Among indigenous participants, the proportion with recent ART increased from 51 to 94% and non-detectable VL from 23 to 65%. In multivariable models, later interview period was positively associated with recent ART (adjusted odds ratio (AOR) = 1.16 per interview period, 95% confidence interval (CI): 1.11 to 1.20) and non-detectable VL (AOR = 1.07, 95% CI: 1.04 to 1.10). In adjusted models comparing indigenous and non-indigenous participants, we did not observe differences between the two groups (all p>0.1). In this large and long-term study involving community-recruited HIV-positive illicit drug users, we observed a substantial and increasing proportion of indigenous participants reach several important thresholds in HIV care at rates indistinguishable from non-indigenous participants. The current findings highlight the important role of TasP on vulnerable populations in this setting and contribute to the evidence base supporting the immediate scale-up of ART to address HIV/AIDS-associated morbidity, mortality and viral transmission.

Critical Review of NOAA's Observation Requirements Process

NASA Astrophysics Data System (ADS)

LaJoie, M.; Yapur, M.; Vo, T.; Templeton, A.; Bludis, D.

2017-12-01

NOAA's Observing Systems Council (NOSC) maintains a comprehensive database of user observation requirements. The requirements collection process engages NOAA subject matter experts to document and effectively communicate the specific environmental observation measurements (parameters and attributes) needed to produce operational products and pursue research objectives. User observation requirements documented using a structured and standardized manner and framework enables NOAA to assess its needs across organizational lines in an impartial, objective, and transparent manner. This structure provides the foundation for: selecting, designing, developing, acquiring observing technologies, systems and architectures; budget and contract formulation and decision-making; and assessing in a repeatable fashion the productivity, efficiency and optimization of NOAA's observing system enterprise. User observation requirements are captured independently from observing technologies. Therefore, they can be addressed by a variety of current or expected observing capabilities and allow flexibility to be remapped to new and evolving technologies. NOAA's current inventory of user observation requirements were collected over a ten-year period, and there have been many changes in policies, mission priorities, and funding levels during this time. In light of these changes, the NOSC initiated a critical, in-depth review to examine all aspects of user observation requirements and associated processes during 2017. This presentation provides background on the NOAA requirements process, major milestones and outcomes of the critical review, and plans for evolving and connecting observing requirements processes in the next year.

Music perception and appraisal: cochlear implant users and simulated cochlear implant listening.

PubMed

Wright, Rose; Uchanski, Rosalie M

2012-05-01

The inability to hear music well may contribute to decreased quality of life for cochlear implant (CI) users. Researchers have reported recently on the generally poor ability of CI users to perceive music, and a few researchers have reported on the enjoyment of music by CI users. However, the relation between music perception skills and music enjoyment is much less explored. Only one study has attempted to predict CI users' enjoyment and perception of music from the users' demographic variables and other perceptual skills (Gfeller et al, 2008). Gfeller's results yielded different predictive relationships for music perception and music enjoyment, and the relationships were weak, at best. The first goal of this study is to clarify the nature and relationship between music perception skills and musical enjoyment for CI users, by employing a battery of music tests. The second goal is to determine whether normal hearing (NH) subjects, listening with a CI simulation, can be used as a model to represent actual CI users for either music enjoyment ratings or music perception tasks. A prospective, cross-sectional observational study. Original music stimuli (unprocessed) were presented to CI users, and music stimuli processed with CI-simulation software were presented to 20 NH listeners (CIsim). As a control, original music stimuli were also presented to five other NH listeners. All listeners appraised 24 musical excerpts, performed music perception tests, and filled out a musical background questionnaire. Music perception tests were the Appreciation of Music in Cochlear Implantees (AMICI), Montreal Battery for Evaluation of Amusia (MBEA), Melodic Contour Identification (MCI), and University of Washington Clinical Assessment of Music Perception (UW-CAMP). Twenty-five NH adults (22-56 yr old), recruited from the local and research communities, participated in the study. Ten adult CI users (46-80 yr old), recruited from the patient population of the local adult cochlear implant program, also participated in this study. Musical excerpts were appraised using a seven-point rating scale, and music perception tests were scored as designed. Analysis of variance was performed on appraisal ratings, perception scores, and questionnaire data with listener group as a factor. Correlations were computed between musical appraisal ratings and perceptual scores on each music test. Music is rated as more enjoyable by CI users than by the NH listeners hearing music through a simulation (CIsim), and the difference is statistically significant. For roughly half of the music perception tests, there are no statistically significant differences between the performance of the CI users and of the CIsim listeners. Generally, correlations between appraisal ratings and music perception scores are weak or nonexistent. NH adults listening to music that has been processed through a CI-simulation program are a reasonable model for actual CI users for many music perception skills, but not for rating musical enjoyment. For CI users, the apparent independence of music perception skills and music enjoyment (as assessed by appraisals) indicates that music enjoyment should not be assumed and should be examined explicitly. American Academy of Audiology.

Perceptions of the Harm and Addictiveness of Conventional Cigarette Smoking Among Adolescent E-Cigarette Users.

PubMed

Owotomo, Olusegun; Maslowsky, Julie; Loukas, Alexandra

2018-01-01

Although existing evidence indicates that e-cigarette use is a risk factor for cigarette smoking initiation, mechanisms of this association are not yet known. E-cigarette users perceive e-cigarette use to be less harmful relative to conventional cigarettes, but their absolute perceptions of addictiveness of conventional cigarette smoking are unknown. This study examines how e-cigarette users compare with nonusers (non-e-cigarette users/nonconventional cigarette smokers), conventional cigarette smokers, and dual users on perceptions of harm and the addictiveness of conventional cigarette smoking and on other known predictors of cigarette smoking such as peer smoking, influence of antismoking ads, and risk-taking propensity. National samples of 8th- and 10th-grade students from 2014 and 2015 (N = 14,151) were obtained from the Monitoring the Future Study. Multivariate logistic regression models were used to examine relationships between adolescent smoking status and perceptions of harm and the addictiveness of conventional cigarette smoking while controlling for potential confounders. E-cigarette users had lower perceptions of the addictiveness of conventional cigarette smoking compared with nonusers but higher than cigarette smokers and dual users. E-cigarette users reported lower influence by antismoking ads, more conventional cigarette-smoking peers, and greater risk-taking propensity than nonusers. E-cigarette users and cigarette smokers did not differ in their perceived harm of conventional cigarette smoking or in their risk-taking propensity. E-cigarette users' attitudes and perceptions regarding conventional cigarette smoking may leave them vulnerable to becoming conventional cigarette smokers. Future studies should explore the prospective relationship between smoking-related perceptions of conventional cigarette smoking among e-cigarette users and the onset of cigarette smoking. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

RISK REDUCTION WITH A FUZZY EXPERT EXPLORATION TOOL

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

Robert S. Balch; Ron Broadhead

2005-03-01

Incomplete or sparse data such as geologic or formation characteristics introduce a high level of risk for oil exploration and development projects. ''Expert'' systems developed and used in several disciplines and industries have demonstrated beneficial results when working with sparse data. State-of-the-art expert exploration tools, relying on a database, and computer maps generated by neural networks and user inputs, have been developed through the use of ''fuzzy'' logic, a mathematical treatment of imprecise or non-explicit parameters and values. Oil prospecting risk has been reduced with the use of these properly verified and validated ''Fuzzy Expert Exploration (FEE) Tools.'' Through themore » course of this project, FEE Tools and supporting software were developed for two producing formations in southeast New Mexico. Tools of this type can be beneficial in many regions of the U.S. by enabling risk reduction in oil and gas prospecting as well as decreased prospecting and development costs. In today's oil industry environment, many smaller exploration companies lack the resources of a pool of expert exploration personnel. Downsizing, volatile oil prices, and scarcity of domestic exploration funds have also affected larger companies, and will, with time, affect the end users of oil industry products in the U.S. as reserves are depleted. The FEE Tools benefit a diverse group in the U.S., allowing a more efficient use of scarce funds, and potentially reducing dependence on foreign oil and providing lower product prices for consumers.« less

Poppers use and Sexual Partner Concurrency Increase the HIV Incidence of MSM: a 24-month Prospective Cohort Survey in Shenyang, China.

PubMed

Chu, Zhen-Xing; Xu, Jun-Jie; Zhang, Yong-Hui; Zhang, Jing; Hu, Qing-Hai; Yun, Ke; Wang, Hong-Yi; Jiang, Yong-Jun; Geng, Wen-Qing; Shang, Hong

2018-01-08

The use of poppers is highly prevalent in MSM, but little is known about the association between their use and HIV incidence in China. A prospective cohort study was conducted from 2011 to 2013 in MSM in Shenyang. 475(79.6%) of eligible HIV-negative MSM participated in this prospective survey and near one fourth MSM (23.4%) ever used poppers. About one-third of the participants had condomless anal intercourse, half had multiple sexual partners and 10.5% were syphilis positive. The HIV incidence densities were15.5 (95% CI:9.4-23.4)/100 PY[person-years]) and 4.6 (95% CI:2.9-7.0)/100 PY in poppers-users and non-poppers-users, respectively. Predictors of HIV seroconversion included poppers-using-behavior, having had more than two male partners, practicing group sex, unprotected anal intercourse(UAI) with male partners, and baseline syphilis positivity (all P < 0.05). In conclusion, the use of poppers, high-risk-sexual behaviors and syphilis infection significantly increase the HIV incidence among Shenyang MSM. It is essential for policy makers to add poppers to the official controlled illicit drug list to reduce HIV transmission among the MSM community. A comprehensive strategy should also be implemented to control both their high-risk-sexual behaviors and risk of syphilis infection, since these may represent novel ways to prevent new HIV infections in these MSM.

Social Media in Health Professional Education: A Student Perspective on User Levels and Prospective Applications

ERIC Educational Resources Information Center

Maloney, Stephen; Moss, Alan; Ilic, Dragan

2014-01-01

Social Networking Sites (SNS) have seen exponential growth in recent years. The high utilisation of SNS by tertiary students makes them an attractive tool for educational institutions. This study aims to identify health professional students' use and behaviours with SNS, including students' perspectives on potential applications within…

The Case for Implementing the Levels of Prevention Model: Opiate Abuse on American College Campuses

ERIC Educational Resources Information Center

Daniels-Witt, Quri; Thompson, Amy; Glassman, Tavis; Federman, Sara; Bott, Katie

2017-01-01

Opiate abuse in the United States is on the rise among the college student population. This public health crisis requires immediate action from professionals and stakeholders who are committed to addressing the needs of prospective, current, and recovering opiate users using comprehensive prevention methods. Such approaches have been used to…

Descriptive Analysis of Selected Data Referral Networks.

ERIC Educational Resources Information Center

MAXIMA Corp., Silver Spring, MD.

The National Environmental Data Referral Service (NEDRES) is being developed in response to a national need to improve the awareness of and access to a broad range of environmental data files. Two studies were conducted in support of this effort: a survey of prospective users confirming the need for and willingness to pay fees for the service and…

Technology Review: Website Usability Testing Software-Improving User Experience and Satisfaction with Community College Websites

ERIC Educational Resources Information Center

Dishman, Marcie

2015-01-01

The Internet is a critical tool for higher education institutions as they rely upon their web presence for interaction with multiple stakeholders, including current and prospective students, parents, faculty and staff, and the community (Hong & Kiousis, 2007). As colleges count upon their websites to serve as the primary medium for presenting…

Proceedings of the 16th LAMPF Users-Group Meeting

NASA Astrophysics Data System (ADS)

Bradbury, J. N.; Ruminer, K.; Talley, B.

1983-04-01

The status and operation of the Los Alamos Meson Physics Facility are discussed as well as prospects for future activities in U.S. nuclear science. Other topics covered include low energy strong interactions; parity violations in nuclei and other results from the pion spectrometer. The Triumpf kaon factory plans, and physics at the facility are also explored.

Market study: 3-D eyetracker

NASA Technical Reports Server (NTRS)

1977-01-01

A market study of a proposed version of a 3-D eyetracker for initial use at NASA's Ames Research Center was made. The commercialization potential of a simplified, less expensive 3-D eyetracker was ascertained. Primary focus on present and potential users of eyetrackers, as well as present and potential manufacturers has provided an effective means of analyzing the prospects for commercialization.

The Impact of Using Youtube in EFL Classroom on Enhancing EFL Students' Content Learning

ERIC Educational Resources Information Center

Alwehaibi, Huda Omar

2015-01-01

Information technology has opened up prospects for rich and innovative approaches to tackle educational issues and provide solutions to the increasing demands for learning resources. YouTube, a video-sharing website that allows users to upload, view, and share video clips, offers access to new and dynamic opportunities for effective and…

40 CFR 211.204-3 - Label location and type.

Code of Federal Regulations, 2010 CFR

2010-07-01

... packaging if the label complying with § 211.204-3(a)(1) is not visible at the point of ultimate purchase or...) If the protector is individually packaged and so displayed at the point of ultimate purchase or... the protector is displayed at the point of ultimate purchase or distribution to prospective users in a...

Through Efficient Use of LORs: Prospective Teachers' Views on Operational Aspects of Learning Object Repositories

ERIC Educational Resources Information Center

Yalcinalp, Serpil; Emiroglu, Bulent

2012-01-01

Although many developments have been made in the design and development of learning object repositories (LORs), the efficient use of such systems is still questionable. Without realising the functional use of such systems or considering the involvement of their dynamic users, these systems would probably become obsolete. This study includes both…

An Information-Systems Program for the Language Sciences. Final Report on Survey-and-Analysis Stage, 1967-1968.

ERIC Educational Resources Information Center

Freeman, Robert R.; And Others

The main results of the survey-and-analysis stage include a substantial collection of preliminary data on the language-sciences information user community, its professional specialties and information channels, its indexing tools, and its terminologies. The prospects and techniques for the development of a modern, discipline-based information…

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

The ISO Data Archive and Interoperability with Other Archives

NASA Astrophysics Data System (ADS)

Salama, Alberto; Arviset, Christophe; Hernández, José; Dowson, John; Osuna, Pedro

The ESA's Infrared Space Observatory (ISO), an unprecedented observatory for infrared astronomy launched in November 1995, successfully made nearly 30,000 scientific observations in its 2.5-year mission. The ISO data can be retrieved from the ISO Data Archive, available at ISO Data Archive , and comprised of about 150,000 observations, including parallel and serendipity mode observations. A user-friendly Java interface permits queries to the database and data retrieval. The interface currently offers a wide variety of links to other archives, such as name resolution with NED and SIMBAD, access to electronic articles from ADS and CDS/VizieR, and access to IRAS data. In the past year development has been focused on improving the IDA interoperability with other astronomical archives, either by accessing other relevant archives or by providing direct access to the ISO data for external services. A mechanism of information transfer has been developed, allowing direct query to the IDA via a Java Server Page, returning quick look ISO images and relevant, observation-specific information embedded in an HTML page. This method has been used to link from the CDS/Vizier Data Centre and ADS, and work with IPAC to allow access to the ISO Archive from IRSA, including display capabilities of the observed sky regions onto other mission images, is in progress. Prospects for further links to and from other archives and databases are also addressed.

Oral contraceptive use and psychiatric disorders in a nationally representative sample of women.

PubMed

Cheslack-Postava, Keely; Keyes, Katherine M; Lowe, Sarah R; Koenen, Karestan C

2015-02-01

The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20-39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR) = 0.34, 95 % CI 0.14-0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health.

Mediating the Cognitive Walkthrough with Patient Groups to achieve Personalized Health in Chronic Disease Self-Management System Evaluation.

PubMed

Georgsson, Mattias; Kushniruk, Andre

2016-01-01

The cognitive walkthrough (CW) is a task-based, expert inspection usability evaluation method involving benefits such as cost effectiveness and efficiency. A drawback of the method is that it doesn't involve the user perspective from real users but instead is based on experts' predictions about the usability of the system and how users interact. In this paper, we propose a way of involving the user in an expert evaluation method by modifying the CW with patient groups as mediators. This along with other modifications include a dual domain session facilitator, specific patient groups and three different phases: 1) a preparation phase where suitable tasks are developed by a panel of experts and patients, validated through the content validity index 2) a patient user evaluation phase including an individual and collaborative process part 3) an analysis and coding phase where all data is digitalized and synthesized making use of Qualitative Data Analysis Software (QDAS) to determine usability deficiencies. We predict that this way of evaluating will utilize the benefits of the expert methods, also providing a way of including the patient user of these self-management systems. Results from this prospective study should provide evidence of the usefulness of this method modification.

Evaluating nicotine dependence levels in e-cigarette users.

PubMed

González Roz, Alba; Secades Villa, Roberto; Weidberg, Sara

2017-01-11

Despite the fact that electronic cigarettes (e-cigarettes) are rapidly growing in popularity and use worldwide, there is scarce scientific data on abuse liability among e-cigarette users, and about whether e-cigarette use is related to nicotine dependence or not. The aim of this study is to explore nicotine dependence levels in a sample of experienced e-cigarette users (n= 39) and to compare them with current tobacco cigarette smokers (n=42). We conducted several face-to-face interviews in order to assess sociodemographic and dependence related characteristics in both e-cigarette users and in smokers. Adapted versions of both the Fagerström test for nicotine dependence (FTND) and the nicotine dependence syndrome scale (NDSS) were used to analyze nicotine dependence in each of the groups. Biochemical markers of carbon monoxide and urinary cotinine analysis were also collected. Results showed that e-cigarette users scored lower than cigarette smokers in both FTND and all NDSS subscales. Our findings extend previous research on e-cigarette use and nicotine addiction and suggest that e-cigarette users are less dependent on nicotine than current tobacco cigarette smokers. Further prospective studies are needed to better ascertain their addictiveness potential, comparing those smokers who switched to e-cigarettes from smoking cigarettes, and those who had never been tobacco cigarette smokers.

Memory-related hippocampal functioning in ecstasy and amphetamine users: a prospective fMRI study.

PubMed

Becker, Benjamin; Wagner, Daniel; Koester, Philip; Bender, Katja; Kabbasch, Christoph; Gouzoulis-Mayfrank, Euphrosyne; Daumann, Jörg

2013-02-01

Recreational use of ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) has been associated with memory impairments. Functional neuroimaging studies with cross-sectional designs reported altered memory-related hippocampal functioning in ecstasy-polydrug users. However, differences might be pre-existing or related to the concomitant use of amphetamine. To prospectively investigate the specific effects of ecstasy on memory-related hippocampal functioning. We used an associative memory task and functional magnetic resonance imaging (fMRI) in 40 ecstasy and/or amphetamine users at baseline (t1) and after 12 months (t2). At t1, all subjects had very limited amphetamine and/or ecstasy experience (less than 5 units lifetime dose). Based on the reported drug use at t2, subjects with continued ecstasy and/or amphetamine use (n = 17) were compared to subjects who stopped use after t1 (n = 12). Analysis of repeated measures revealed that encoding-related activity in the left parahippocampal gyrus changed differentially between the groups. Activity in this region increased in abstinent subjects from t1 to t2, however, decreased in subjects with continued use. Decreases within the left parahippocampal gyrus were associated with the use of ecstasy, but not amphetamine, during the follow-up period. However, there were no significant differences in memory performance. The current findings suggest specific effects of ecstasy use on memory-related hippocampal functioning. However, alternative explanations such as (sub-)acute cannabis effects are conceivable.

Prospective clinical evaluation of the Polyperf® Safe, a safety Huber needle, in cancer patients.

PubMed

Goossens, Godelieve A; Moons, Philip; Jérôme, Martine; Stas, Marguerite

2011-01-01

Evaluation of the Polyperf® Safe (PPS) needle on safety and user-friendliness, as experienced by first-time and non-first-time users of the device. A prospective, descriptive study was carried out at the University Hospitals Leuven, Belgium. Five hundred PPS needles were individually evaluated in cancer patients. Different aspects of the PPS were assessed: packaging, needle insertion, and needle removal. Nurses were asked whether they had previously inserted or removed this type of needle. We compared the PPS needle with the standard Gripper® needle in terms of safety, ease of use, and ease of training. Three hundred sixty-six evaluation forms were available for analysis (73.2%). Packaging and access evaluations were scored positively, except for two aspects: (1) needle stability, and (2) ease of dressing. Ease of removal was scored unsatisfactory in up to 22.4% of the registrations. Pain at insertion was reported in about 20% registrations, and blood contact was reported by 2.5% of non-first-time users. Safety was scored as good, although ease of use and ease in training scored 25.4% and 43.8%, respectively, lower than the Gripper®. In general, nurses evaluated the PPS positively, with the exception of needle stability, ease of dressing, and ease of removal. No needlestick accidents were recorded. Aspects of ease of use and ease of training for PPS needles scored less than those for the Gripper® needles in up to one-third of the registrations.

A NEO population generation and observation simulation software tool

NASA Astrophysics Data System (ADS)

Müller, Sven; Gelhaus, Johannes; Hahn, Gerhard; Franco, Raffaella

One of the main targets of ESA's Space Situational Awareness (SSA) program is to build a wide knowledge base about objects that can potentially harm Earth (Near-Earth Objects, NEOs). An important part of this effort is to create the Small Bodies Data Centre (SBDC) which is going to aggregate measurement data from a fully-integrated NEO observation sensor network. Until this network is developed, artificial NEO measurement data is needed in order to validate SBDC algorithms. Moreover, to establish a functioning NEO observation sensor network, it has to be determined where to place sensors, what technical requirements have to be met in order to be able to detect NEOs and which observation strategies work the best. Because of this, a sensor simulation software was needed. This paper presents a software tool which allows users to create and analyse NEO populations and to simulate and analyse population observations. It is a console program written in Fortran and comes with a Graphical User Interface (GUI) written in Java and C. The tool can be distinguished into the components ``Population Generator'' and ``Observation Simulator''. The Population Generator component is responsible for generating and analysing a NEO population. Users can choose between creating fictitious (random) and synthetic populations. The latter are based on one of two models describing the orbital and size distribution of observed NEOs: The existing socalled ``Bottke Model'' (Bottke et al. 2000, 2002) and the new ``Granvik Model'' (Granvik et al. 2014, in preparation) which has been developed in parallel to the tool. Generated populations can be analysed by defining 2D, 3D and scatter plots using various NEO attributes. As a result, the tool creates the appropiate files for the plotting tool ``gnuplot''. The tool's Observation Simulator component yields the Observation Simulation and Observation Analysis functions. Users can define sensor systems using ground- or space-based locations as well as optical or radar sensors and simulate observation campaigns. The tool outputs field-of-view crossings and actual detections of the selected NEO population objects. Using the Observation Analysis users are able to process and plot the results of the Observation Simulation. In order to enable end-users to handle the tool in a user-intuitive and comfortable way, a GUI has been created based on the modular Eclipse Rich Client Platform (RCP) technology. Through the GUI users can easily enter input data for the tool, execute it and view its output data in a clear way. Additionally, the GUI runs gnuplot to create plot pictures and presents them to the user. Furthermore, users can create projects to organise executions of the tool.

Endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors.

PubMed

Camilo, Sílvia Maria Perrone; Almeida, Élia Cláudia de Souza; Miranzi, Benito André Silveira; Silva, Juliano Carvalho; Nomelini, Rosemary Simões; Etchebehere, Renata Margarida

2015-01-01

Proton-pump inhibitors have been used for at least two decades. They are among the most commonly sold drugs in the world. However, some controversy remains about the indications for their use and the consequences of their prolonged use. To evaluate and compare the endoscopic and histopathologic gastric changes in chronic users of proton-pump inhibitors to changes in non-users. A prospective study performed at a tertiary Public Hospital involving 105 patients undergoing upper-gastrointestinal endoscopy. Subjects included 81 proton-pump inhibitor users and 24 non-users (control group). Biopsies of the antral-type mucosa, the antral-fundic transition, and the fundus were evaluated by the Sydney System. The presence of erosion or ulceration, lymphatic follicles, reactive gastropathy, and polypoid or epithelial hyperplasia was also determined. Serum levels of gastrin were measured. We found two polyps, one in each group, both of which were negative for Helicobacter pylori. There were two cases of parietal cell hyperplasia in users of proton-pump inhibitors. Gastrin was elevated in 28 users of proton-pump inhibitors and in four members of the control group. We did not find statistically significant differences in the endoscopic or histopathologic findings between the two groups. Chronic use of proton-pump inhibitors for the duration examined was not associated with significant gastric changes. An interesting finding was that the 4 chronic users of proton-pump inhibitors who had serum gastrin levels above 500 pg/mL also had positive serology for Chagas disease.

Explanation of fields used in the Alaska Resource Data File of mines, prospects, and mineral occurrences in Alaska

USGS Publications Warehouse

,

1996-01-01

Descriptions of mines, prospects, and mineral occurrences in the Alaska Resource Data File (ARDF) are published for individual U.S. Geological Survey 1:250,000 scale quadrangles in Alaska (see accompanying map) and are available for downloading from USGS World Wide Web site: http://www-rnrs-ak.wr.usgs.gov/ardf.These descriptions are divided into a number of fields which describe features of each mine, prospect, or mineral occurrence. These descriptions were complied from published literature and from unpublished reports and data from industry, the U.S. Bureau of Mines, and the U.S. Geological Survey and other sources. Compilation of this database is an ongoing process and each report is essentially a progress report. The authors of the individual quadrangle reports would appreciate any corrections or additional information that users may be able to contribute.

Support of surgical process modeling by using adaptable software user interfaces

NASA Astrophysics Data System (ADS)

Neumuth, T.; Kaschek, B.; Czygan, M.; Goldstein, D.; Strauß, G.; Meixensberger, J.; Burgert, O.

2010-03-01

Surgical Process Modeling (SPM) is a powerful method for acquiring data about the evolution of surgical procedures. Surgical Process Models are used in a variety of use cases including evaluation studies, requirements analysis and procedure optimization, surgical education, and workflow management scheme design. This work proposes the use of adaptive, situation-aware user interfaces for observation support software for SPM. We developed a method to support the modeling of the observer by using an ontological knowledge base. This is used to drive the graphical user interface for the observer to restrict the search space of terminology depending on the current situation. In the evaluation study it is shown, that the workload of the observer was decreased significantly by using adaptive user interfaces. 54 SPM observation protocols were analyzed by using the NASA Task Load Index and it was shown that the use of the adaptive user interface disburdens the observer significantly in workload criteria effort, mental demand and temporal demand, helping him to concentrate on his essential task of modeling the Surgical Process.

The prevalence of traditional herbal medicine use among hypertensives living in South African communities.

PubMed

Hughes, Gail D; Aboyade, Oluwaseyi M; Clark, Bobby L; Puoane, Thandi R

2013-02-18

In South Africa, over 6 million people are hypertensive and the burden of disease shows that cardiovascular diseases (CVDs) are the leading cause of death among adults. Although treatments exist, few people comply or adhere to recommended treatment due to side effects or costs of the drugs, hence the reliance on alternative forms of treatment. Traditional herbal medicines (THM) are used for the management of hypertension but the prevalence of its use among hypertensive patients living in South African communities is not sufficiently known. This was a cross-sectional descriptive study to determine the prevalence of THM use for hypertension, among 135 purposefully selected South African participants of the Prospective Urban and Rural Epidemiological (PURE) study, who are THM users. Data on THM use were collected by way of face to face interviews using structured questionnaires administered by trained field workers. Standard descriptive measures were used to characterize the study sample and responses to the questionnaire. Chi-square test was used when making comparisons between groups. There were 135 THM users, 21% of whom used THM to treat hypertension. Majority (82.1%) of the hypertensive THM users were females, only 29% were married or co-habitating, virtually all (96%) were unemployed and 86% were Christians. More than half (56%) of the respondents were aged between 55 and 64 years. THM was occasionally used (51.9%) as a combination of tea and other mixtures (63%) and prescribed by family/ friends/self-administered. There was a significant difference in the age, marital and employment status, as well as the form and frequency of THM use of hypertensive THM users compared to other THM users. The study gives an insight into the prevalence of THM use by hypertensive patients in selected South African communities. The practice of self-medication was also observed which raises concern regarding the safety of medications taken by the participants. Health care providers should however be more aware of THM use and counsel patients regarding the combination of prescribed treatment regimen and herbal medicines and the potential of herb-drug interactions.

Evaluation of problematic psychoactive substances use in people placed in police custody.

PubMed

Gérardin, Marie; Guigand, Gabriel; Wainstein, Laura; Jolliet, Pascale; Victorri-Vigneau, Caroline; Clément, Renaud

2017-07-01

In France, the law states that any person held in custody could be examined by a doctor. The main objective of the medical examination is to give medical evidence of health compatibility with custody. This review identifies health risks such as addictive behaviour. We wanted to know which psychoactive substances are used in this particular population, and how problematic these uses are. A prospective, monocentric, open-ended study conducted via a structured questionnaire was carried out on detainees who reported having taken drugs or illegal substances. Practitioners investigated desired effects for each substance, and characteristics of use, by means of the dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994). Problematic use was assessed when at least 3 items of the DSM IV were positive. 604 questionnaires were examined. 90.7% of questionnaires reported tobacco use, 76.2% cannabis, 57.3% alcohol, 12.5% psychostimulants, 10.0% opiates and 0.7% benzodiazepines or Z-drugs. The frequency of problematic use was 74.6% for opiates, 44.9% for cocaine and 25.3% for cannabis. Compared to non-problematic users, problematic users were older, more likely to be jobless without financial means, more likely to have a medical history, including a greater likelihood of mental illness, and more chance of undergoing prescribed medical treatment. They included more women and more homeless people. These results show characteristics of psychoactive substance use in a sample of people in custody. Psychoactive substances mentioned by respondents are not different from those observed in the general population, but for certain users, the desired effects are far from the pharmacologically expected ones. For some, taking substances seems to be part of their way of life, for others it is a means to compensate for an underlying feeling of uneasiness. Furthermore, problematic users present severity criteria which seem to be greater than in psychoactive substance users in the general population. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative

PubMed Central

2013-01-01

Background Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density [BMD] have not previously been investigated. Methods This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (≥2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI. Results Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval [CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake. Conclusion These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use. PMID:23635086

Addressing the stimulant treatment gap: A call to investigate the therapeutic benefits potential of cannabinoids for crack-cocaine use.

PubMed

Fischer, Benedikt; Kuganesan, Sharan; Gallassi, Andrea; Malcher-Lopes, Renato; van den Brink, Wim; Wood, Evan

2015-12-01

Crack-cocaine use is prevalent in numerous countries, yet concentrated primarily - largely within urban contexts - in the Northern and Southern regions of the Americas. It is associated with a variety of behavioral, physical and mental health and social problems which gravely affect users and their environments. Few evidence-based treatments for crack-cocaine use exist and are available to users in the reality of street drug use. Numerous pharmacological treatments have been investigated but with largely disappointing results. An important therapeutic potential for crack-cocaine use may rest in cannabinoids, which have recently seen a general resurgence for varied possible therapeutic usages for different neurological diseases. Distinct potential therapeutic benefits for crack-cocaine use and common related adverse symptoms may come specifically from cannabidiol (CBD) - one of the numerous cannabinoid components found in cannabis - with its demonstrated anxiolytic, anti-psychotic, anti-convulsant effects and potential benefits for sleep and appetite problems. The possible therapeutic prospects of cannabinoids are corroborated by observational studies from different contexts documenting crack-cocaine users' 'self-medication' efforts towards coping with crack-cocaine-related problems, including withdrawal and craving, impulsivity and paranoia. Cannabinoid therapeutics offer further benefits of being available in multiple formulations, are low in adverse risk potential, and may easily be offered in community-based settings which may add to their feasibility as interventions for - predominantly marginalized - crack-cocaine user populations. Supported by the dearth of current therapeutic options for crack-cocaine use, we are advocating for the implementation of a rigorous research program investigating the potential therapeutic benefits of cannabinoids for crack-cocaine use. Given the high prevalence of this grave substance use problem in the Americas, opportunities for such research should urgently be created and facilitated there. Copyright © 2015 Elsevier B.V. All rights reserved.

Ribavirin and abacavir drug interaction in HIV-HCV coinfected patients: fact or fiction?

PubMed

Solas, Caroline; Pambrun, Elodie; Winnock, Maria; Salmon, Dominique; Poizot-Martin, Isabelle; Dominguez, Stéphanie; Bani-Sadr, Firouzé; Izopet, Jacques; Garraffo, Rodolphe; Peytavin, Gilles

2012-11-13

To examine the impact of ribavirin and abacavir coadministration on hepatitis C virus (HCV) virological response and trough ribavirin plasma concentration (Cmin) in HIV-HCV coinfected patients. Pharmacokinetic substudy on patients from the ANRS CO-13 HEPAVIH cohort. Patients receiving ribavirin-pegylated interferon for whom a ribavirin steady state Cmin was prospectively determined were included. Rapid virological response (RVR), early virological response (EVR) and sustained virological response (SVR) as well as HCV-RNA decline were evaluated. Overall, 124 HIV-HCV coinfected patients (95% on antiretroviral therapy) were enrolled. Of these patients, 22% received abacavir. The overall median (interquartile range) ribavirin Cmin was 1.6 mg/l (1.2-2.2) with no statistical difference between abacavir users and nonusers [1.5 mg/l (0.99-2.1) and 1.7 (1.2-2.3), P = 0.15]. RVR and EVR were 52 and 72%, respectively. There was no difference observed in the proportion of abacavir users vs. nonusers achieving RVR (respectively 59 vs. 50%, P = 0.40) or EVR (72 vs. 73%, P = 0.94), or in the HCV-RNA decline at week 4 [-2.24 log(10) IU/ml, (-3.58; -0.81) and -1.27 (-2.8; -0.47) P = 0.28] or at week 12 [-1.76 log(10) IU/ml (-3.67; -0.35) and -1.85 (-3.13; -1.13) (P = 0.58)]. The SVR rate was 45% for abacavir users and 24% for abacavir nonusers, but the difference was not statistically significant (P = 0.059). In our study, there was no evidence that abacavir affected HCV treatment outcomes and the ribavirin Cmin was similar in abacavir users and nonusers, confirming the absence of pharmacokinetic interaction between abacavir and ribavirin. An abacavir-containing regimen is, therefore, a well tolerated treatment alternative for coinfected patients starting HCV treatment.

A prospective cohort study on sustained effects of low-dose ecstasy use on the brain in new ecstasy users.

PubMed

de Win, Maartje M L; Reneman, Liesbeth; Jager, Gerry; Vlieger, Erik-Jan P; Olabarriaga, Sílvia D; Lavini, Cristina; Bisschops, Ivo; Majoie, Charles B L M; Booij, Jan; den Heeten, Gerard J; van den Brink, Wim

2007-02-01

It is debated whether ecstasy use has neurotoxic effects on the human brain and what the effects are of a low dose of ecstasy use. We prospectively studied sustained effects (>2 weeks abstinence) of a low dose of ecstasy on the brain in ecstasy-naive volunteers using a combination of advanced MR techniques and self-report questionnaires on psychopathology as part of the NeXT (Netherlands XTC Toxicity) study. Outcomes of proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), and questionnaires on depression, impulsivity, and sensation seeking were compared in 30 subjects (12M, 21.8+/-3.1 years) in two sessions before and after first ecstasy use (1.8+/-1.3 tablets). Interval between baseline and follow-up was on average 8.1+/-6.5 months and time between last ecstasy use and follow-up was 7.7+/-4.4 weeks. Using 1H-MRS, no significant changes were observed in metabolite concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), and creatine (Cr), nor in ratios of NAA, Cho, and mI relative to Cr. However, ecstasy use was followed by a sustained 0.9% increase in fractional anisotropy (FA) in frontoparietal white matter, a 3.4% decrease in apparent diffusion (ADC) in the thalamus and a sustained decrease in relative regional cerebral blood volume (rrCBV) in the thalamus (-6.2%), dorsolateral frontal cortex (-4.0%), and superior parietal cortex (-3.0%) (all significant at p<0.05, paired t-tests). After correction for multiple comparisons, only the rrCBV decrease in the dorsolateral frontal cortex remained significant. We also observed increased impulsivity (+3.7% on the Barratt Impulsiveness Scale) and decreased depression (-28.0% on the Beck Depression Inventory) in novel ecstasy users, although effect sizes were limited and clinical relevance questionable. As no indications were found for structural neuronal damage with the currently used techniques, our data do not support the concern that incidental ecstasy use leads to extensive axonal damage. However, sustained decreases in rrCBV and ADC values may indicate that even low ecstasy doses can induce prolonged vasoconstriction in some brain areas, although it is not known whether this effect is permanent. Additional studies are needed to replicate these findings.

Validation of the Ottawa knee rules in an emergency teaching centre.

PubMed

Ketelslegers, Etienne; Collard, Xavier; Vande Berg, Bruno; Danse, Etienne; El-Gariani, Abdulwahed; Poilvache, Pascal; Maldague, Baudouin

2002-05-01

Our objective was to determine the value of the Ottawa knee rules when applied by users with different levels of clinical training. We used a prospective patient survey by the medical students and surgery residents of a European university trauma centre. The study group consisted of 261 eligible patients who presented with acute knee trauma during a 6-month period. Radiography or follow-up was obtained for each patient. Data were separately analysed according to the degree of qualification of the initial examiner. The Ottawa knee rules had a sensitivity and a negative predictive value of 1.00. Variable degree of medical competence of the users did not alter the accuracy of the rules. Application of the rules would have reduced knee radiography requests by 25%. The Ottawa knee rules remain highly sensitive when applied by medical users with different levels of qualification, such as encountered in a teaching setting.

One-year prospective prediction of marijuana use cessation among youth at continuation high schools.

PubMed

Sussman, S; Dent, C W

1999-01-01

This article reports a large-scale study of the prediction of marijuana use cessation among adolescents who were regular users at baseline. Social, attitude, intrapersonal, violence-related, drug-use-related, and demographic baseline measures served as predictors of whether or not 566 current marijuana users reported having quit use 1 year later. Quitting was defined as having not used marijuana in the last 30 days and having no intention to use marijuana in the future (31% of the baseline users). Those who were slightly older, who reported receiving relatively less approval for using drugs, who held relatively unfavorable attitudes about the acceptability of drug use, and who reported relatively less victimization in the last year were relatively likely to quit. Implications of these results include the need to increase unacceptability of marijuana use to help increase efforts at self-initiated quitting.

Development and Evaluation of Disaster Information Management System Using Digital Pens and Tabletop User Interfaces

NASA Astrophysics Data System (ADS)

Fukada, Hidemi; Kobayashi, Kazue; Satou, Kenji; Kawana, Hideyuki; Masuda, Tomohiro

Most traditional disaster information systems are necessary to post expert staff with high computer literacy to operate the system quickly and correctly in the tense situation when a disaster occurs. However, in the current disaster response system of local governments, it is not easy for local governments to post such expert staff because they are struggling with staff cuts due to administrative and fiscal reform. In this research, we propose a disaster information management system that can be easily operated, even under the disorderly conditions of a disaster, by municipal personnel in charge of disaster management. This system achieves usability enabling easy input of damage information, even by local government staff with no expertise, by using a digital pen and tabletop user interface. Evaluation was conducted by prospective users using a prototype, and the evaluation results are satisfactory with regard to the function and operationality of the proposed system.

Tobacco use in HPV-positive advanced oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence

PubMed Central

Maxwell, Jessica Hooton; Kumar, Bhavna; Feng, Felix Y.; Worden, Francis P.; Lee, Julia; Eisbruch, Avraham; Wolf, Gregory T.; Prince, Mark E.; Moyer, Jeffrey S.; Teknos, Theodoros N.; Chepeha, Douglas B.; McHugh, Jonathan B.; Urba, Susan; Stoerker, Jay; Walline, Heather; Kurnit, David; Cordell, Kitrina G.; Davis, Samantha J.; Ward, Preston D.; Bradford, Carol R.; Carey, Thomas E.

2009-01-01

Purpose The goal of this study was to examine the effect of tobacco use on disease recurrence (local/regional recurrence, distant metastasis, or second primary) among HPV-positive patients with squamous cell carcinoma of the oropharynx (SCCOP) following a complete response to chemoradiation therapy. Experimental Design Between 1999 and 2007, 124 patients with advanced SCCOP (86% with stage IV) and adequate tumor tissue for HPV analysis who were enrolled in one of two consecutive University of Michigan treatment protocols were prospectively included in this study. Patients were categorized as never, former, or current tobacco users. The primary end-points were risk of disease recurrence and time to recurrence; secondary end-points were disease-specific survival and overall survival. Results One hundred and two patients (82.3%) had HPV-positive tumors. Over two-thirds (68%) of patients with HPV-positive tumors were tobacco users. Among HPV-positive patients, current tobacco users were at significantly higher risk of disease recurrence than never-tobacco users (hazard ratio = 5.2; confidence interval [1.1-24.4]; p=0.038). Thirty-five percent of HPV-positive ever tobacco users recurred compared to only 6% of HPV-positive never users and 50% of HPV-negative patients. All HPV-negative patients were tobacco users and had significantly shorter times to recurrence (p=0.002) and reduced disease-specific survival (p=0.004) and overall survival (p<0.001) compared to HPV-positive patients. Compared to HPV-positive never-tobacco users, those with a tobacco history showed a trend for reduced disease-specific survival (p=0.064) but not overall survival (p=0.221). Conclusion Current tobacco users with advanced, HPV-positive SCCOP are at higher risk of disease recurrence compared to never-tobacco users. PMID:20145161

Association of Short-term Bleeding and Cramping Patterns with Long-Acting Reversible Contraceptive Method Satisfaction

PubMed Central

Diedrich, Justin T.; Desai, Sanyukta; Zhao, Qiuhong; Secura, Gina; Madden, Tessa; Peipert, Jeffrey F.

2014-01-01

Objectives To examine the short-term (3 and 6-month), self-reported bleeding and cramping patterns with intrauterine devices (IUDs) and the contraceptive implant, and the association of these symptoms with method satisfaction. Study Design We analyzed 3 and 6-month survey data from IUD and implant users in the Contraceptive CHOICE Project, a prospective cohort study. Participants who received a long-acting reversible contraceptive (LARC) method (levonorgestrel intrauterine system (LNG-IUS), copper IUD, or the etonogestrel implant) and completed their 3- and 6-month surveys were included. Univariable and multivariable analyses were performed to examine the association of bleeding and cramping patterns with short-term satisfaction. Results Our analytic sample included 5,011 CHOICE participants: 3001 LNG-IUS users, 826 copper IUD users, and 1184 implant users. At 3 months, over 65% of LNG-IUS and implant users reported no change or decreased cramping, while 63% of copper IUD users reported increased menstrual cramping. Lighter bleeding was reported by 67% of LNG-IUS users, 58% of implant users, and 8% of copper IUD users. Satisfaction of all LARC methods was high (≥90%) and significantly higher than non-LARC methods (p<0.001). LARC users with increased menstrual cramping (HR 0.96, 95% CI 0.92 – 0.99), heavier bleeding (HR 0.91, 95% CI 0.87 – 0.96), and increased bleeding frequency (HR 0.92, 95% CI 0.89 – 0.96) were less likely to report being very satisfied at 6 months. Conclusion Regardless of the LARC method, satisfaction at 3 and 6 months is very high. Changes in self-reported bleeding and cramping are associated with short-term LARC satisfaction. PMID:25046805

Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction.

PubMed

Diedrich, Justin T; Desai, Sanyukta; Zhao, Qiuhong; Secura, Gina; Madden, Tessa; Peipert, Jeffrey F

2015-01-01

We sought to examine the short-term (3- and 6-month), self-reported bleeding and cramping patterns with intrauterine devices (IUDs) and the contraceptive implant, and the association of these symptoms with method satisfaction. We analyzed 3- and 6-month survey data from IUD and implant users in the Contraceptive CHOICE Project, a prospective cohort study. Participants who received a long-acting reversible contraceptive (LARC) method (levonorgestrel-releasing intrauterine system [LNG-IUS], copper IUD, or the etonogestrel implant) and completed their 3- and 6-month surveys were included. Univariable and multivariable analyses were performed to examine the association of bleeding and cramping patterns with short-term satisfaction. Our analytic sample included 5011 Contraceptive CHOICE Project participants: 3001 LNG-IUS users, 826 copper IUD users, and 1184 implant users. At 3 months, >65% of LNG-IUS and implant users reported no change or decreased cramping, while 63% of copper IUD users reported increased menstrual cramping. Lighter bleeding was reported by 67% of LNG-IUS users, 58% of implant users, and 8% of copper IUD users. Satisfaction of all LARC methods was high (≥90%). LARC users with increased menstrual cramping (relative risk adjusted [RRadj], 0.78; 95% confidence interval [CI], 0.72-0.85), heavier bleeding (RRadj, 0.83; 95% CI, 0.76-0.92), and increased bleeding frequency (RRadj, 0.73; 95% CI, 0.67-0.80) were less likely to report being very satisfied at 6 months. Regardless of the LARC method, satisfaction at 3 and 6 months is very high. Changes in self-reported bleeding and cramping are associated with short-term LARC satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

Exposing the Strategies that can Reduce the Obstacles: Improving the Science User Experience

NASA Astrophysics Data System (ADS)

Lindsay, F. E.; Brennan, J.; Behnke, J.; Lynnes, C.

2017-12-01

It is now well established that pursuing generic solutions to what seem are common problems in Earth science data access and use can often lead to disappointing results for both system developers and the intended users. This presentation focuses on real-world experience of managing a large and complex data system, NASA's Earth Science Data and Information Science System (EOSDIS), whose mission is to serve both broad user communities and those in smaller niche applications of Earth science data and services. In the talk, we focus on our experiences with known data user obstacles characterizing EOSDIS approaches, including various technological techniques, for engaging and bolstering, where possible, user experiences with EOSDIS. For improving how existing and prospective users discover and access NASA data from EOSDIS we introduce our cross-archive tool: Earthdata Search. This new search and order tool further empowers users to quickly access data sets using clever and intuitive features. The Worldview data visualization tool is also discussed highlighting how many users are now performing extensive data exploration without necessarily downloading data. Also, we explore our EOSDIS data discovery and access webinars, data recipes and short tutorials, targeted technical and data publications, user profiles and and social media as additional tools and methods used for improving our outreach and communications to a diverse user community. These efforts have paid substantial dividends for our user communities by allowing us to target discipline specific community needs. The desired take-away from this presentation will be an improved understanding of how EOSDIS has approached, and in several instances achieved, removing or lowering the barriers to data access and use. As we look ahead to more complex Earth science missions, EOSDIS will continue to focus on our user communities, both broad and specialized, so that our overall data system can continue to serve the needs of science and applications users.

Exposing the Strategies that Can Reduce the Obstacles: Improving the Science User Experience

NASA Technical Reports Server (NTRS)

Lindsay, Francis E.; Brennan, Jennifer; Behnke, Jeanne; Lynnes, Chris

2017-01-01

It is now well established that pursuing generic solutions to what seem are common problems in Earth science data access and use can often lead to disappointing results for both system developers and the intended users. This presentation focuses on real-world experience of managing a large and complex data system, NASAs Earth Science Data and Information Science System (EOSDIS), whose mission is to serve both broad user communities and those in smaller niche applications of Earth science data and services. In the talk, we focus on our experiences with known data user obstacles characterizing EOSDIS approaches, including various technological techniques, for engaging and bolstering, where possible, user experiences with EOSDIS. For improving how existing and prospective users discover and access NASA data from EOSDIS we introduce our cross-archive tool: Earthdata Search. This new search and order tool further empowers users to quickly access data sets using clever and intuitive features. The Worldview data visualization tool is also discussed highlighting how many users are now performing extensive data exploration without necessarily downloading data. Also, we explore our EOSDIS data discovery and access webinars, data recipes and short tutorials, targeted technical and data publications, user profiles and social media as additional tools and methods used for improving our outreach and communications to a diverse user community. These efforts have paid substantial dividends for our user communities by allowing us to target discipline specific community needs. The desired take-away from this presentation will be an improved understanding of how EOSDIS has approached, and in several instances achieved, removing or lowering the barriers to data access and use. As we look ahead to more complex Earth science missions, EOSDIS will continue to focus on our user communities, both broad and specialized, so that our overall data system can continue to serve the needs of science and applications users.

RE Data Explorer: Informing Variable Renewable Energy Grid Integration for Low Emission Development

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

Cox, Sarah L

The RE Data Explorer, developed by the National Renewable Energy Laboratory, is an innovative web-based analysis tool that utilizes geospatial and spatiotemporal renewable energy data to visualize, execute, and support analysis of renewable energy potential under various user-defined scenarios. This analysis can inform high-level prospecting, integrated planning, and policy making to enable low emission development.

Library Automation at the University for Development Studies: Challenges and Prospects

ERIC Educational Resources Information Center

Thompson, Edwin S.; Pwadura, Joana

2014-01-01

The automation of a library that basically aims at improving the management of the library's resources and increasing access to these same resources by users has caught on so well in the western world that virtually all academic libraries in that part of the world have automated most of their services. In Africa, however, several challenges are…

Advanced Optical Technologies in NASA's Space Communication Program: Status, Challenges, and Future Plans

NASA Technical Reports Server (NTRS)

Pouch, John

2004-01-01

A goal of the NASA Space Communications Project is to enable broad coverage for high-data-rate delivery to the users by means of ground, air, and space-based assets. The NASA Enterprise need will be reviewed. A number of optical space communications technologies being developed by NASA will be described, and the prospective applications will be discussed.

Analysis and critical assessment of the current and near future plans of the Brazilian satellite applications program and its role in the global space program

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator)

1983-01-01

Brazilian programs using satellites for remote sensing, meteorology and communications are analyzed including their current status and near future plans. The experience gained and available information are used to critically discuss some aspects of great importance for the existing and prospective user countries.

Smart Learning Services Based on Smart Cloud Computing

PubMed Central

Kim, Svetlana; Song, Su-Mi; Yoon, Yong-Ik

2011-01-01

Context-aware technologies can make e-learning services smarter and more efficient since context-aware services are based on the user’s behavior. To add those technologies into existing e-learning services, a service architecture model is needed to transform the existing e-learning environment, which is situation-aware, into the environment that understands context as well. The context-awareness in e-learning may include the awareness of user profile and terminal context. In this paper, we propose a new notion of service that provides context-awareness to smart learning content in a cloud computing environment. We suggest the elastic four smarts (E4S)—smart pull, smart prospect, smart content, and smart push—concept to the cloud services so smart learning services are possible. The E4S focuses on meeting the users’ needs by collecting and analyzing users’ behavior, prospecting future services, building corresponding contents, and delivering the contents through cloud computing environment. Users’ behavior can be collected through mobile devices such as smart phones that have built-in sensors. As results, the proposed smart e-learning model in cloud computing environment provides personalized and customized learning services to its users. PMID:22164048

Reproduction of auditory and visual standards in monochannel cochlear implant users.

PubMed

Kanabus, Magdalena; Szelag, Elzbieta; Kolodziejczyk, Iwona; Szuchnik, Joanna

2004-01-01

The temporal reproduction of standard durations ranging from 1 to 9 seconds was investigated in monochannel cochlear implant (CI) users and in normally hearing subjects for the auditory and visual modality. The results showed that the pattern of performance in patients depended on their level of auditory comprehension. Results for CI users, who displayed relatively good auditory comprehension, did not differ from that of normally hearing subjects for both modalities. Patients with poor auditory comprehension significantly overestimated shorter auditory standards (1, 1.5 and 2.5 s), compared to both patients with good comprehension and controls. For the visual modality the between-group comparisons were not significant. These deficits in the reproduction of auditory standards were explained in accordance with both the attentional-gate model and the role of working memory in prospective time judgment. The impairments described above can influence the functioning of the temporal integration mechanism that is crucial for auditory speech comprehension on the level of words and phrases. We postulate that the deficits in time reproduction of short standards may be one of the possible reasons for poor speech understanding in monochannel CI users.

The drug-user husband and his wife: attachment styles, family cohesion, and adaptability.

PubMed

Finzi-Dottan, Ricky; Cohen, Orna; Iwaniec, Dorota; Sapir, Yaffa; Weizman, Abraham

2003-01-01

This study which assesses the association between the attachment styles of drug-user husbands (n = 56) and their wives (n = 56) and their perceptions of family dynamics was conducted in 1998. The population study included heroin (52.9%) and multidrug detoxified outpatients. All subjects completed the Adult Attachment Style Scale and the FACES III. Results indicated that the perceptions of family adaptability and cohesion among the drug-user husbands and their wives did not differ from the Israeli norm. Most of the drug users (60.7%) were characterized by the avoidant attachment style, followed by the secure style (26.8%), and the anxious/ambivalent style (12.5%). Half the wives (53.6%) were characterized by the secure style, followed by the avoidant style (42.9%) and the anxious/ambivalent style (3.6%). A secure style in husband and wife was associated with higher levels of family cohesion and adaptability, and the anxious/ambivalent style with a lower perception of family cohesion and adaptability. These findings have important implications for rehabilitation prospects and for planning intervention programs.

A home automation based environmental sound alert for people experiencing hearing loss.

PubMed

Mielke, Matthias; Bruck, Rainer

2016-08-01

Different assistive technologies are available for deaf people (i.e. deaf, deafened, and hard of hearing). Besides the well-known hearing aid, devices for detection of sound events that occur at home or at work (e.g. doorbell, telephone) are available. Despite the technological progress in the last years and resulting new possibilities, the basic functions and concepts of such devices have not changed. The user still needs special assistive technology that is bound to the home or work environment. In this contribution a new concept for awareness of events in buildings is presented. In contrast to state-of-the-art assistive devices, it makes use of modern Information and Communication and home automation technology, and thus offers the prospect of cheap implementation and higher comfort for the user. In this concept events are indicated by notifications that are send over a Bluetooth Low Energy mesh network from a source to the user. The notifications are received by the user's smartwatch and the event is indicated by vibration and an icon representing its source.

Internet Competency Predicts Practical Hearing Aid Knowledge and Skills in First-Time Hearing Aid Users.

PubMed

Maidment, David; Brassington, William; Wharrad, Heather; Ferguson, Melanie

2016-10-01

The purpose of the study was to assess whether Internet competency predicted practical hearing aid knowledge and handling skills in first-time hearing aid users. The design was a prospective, randomized controlled trial of a multimedia educational intervention consisting of interactive video tutorials (or reusable learning objects [RLOs]). RLOs were delivered through DVD for TV or PC, and online. Internet competency was measured at the hearing aid fitting appointment, whereas hearing aid knowledge and practical handling skills were assessed 6 weeks postfitting. Internet competency predicted practical hearing aid knowledge and handling skills, controlling for age, hearing sensitivity, educational status, and gender for the group that received the RLOs. Internet competency was inversely related to the number of times the RLOs were watched. Associations between Internet competency and practical hearing aid knowledge, handling skills, and watching the RLOs fewer times may have arisen because of improved self-efficacy. Therefore, first-time hearing aid users who are more competent Internet users may be better equipped to apply newly learned information to effectively manage their hearing loss.

Genomics of Extinct and Endangered Species (2011 JGI User Meeting)

ScienceCinema

Shuster, Stephen

2018-02-13

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Stephen Shuster of Penn State University gives a presentation on "Genomics of Extinct and Endangered Species" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.

Optimel: Software for selecting the optimal method

NASA Astrophysics Data System (ADS)

Popova, Olga; Popov, Boris; Romanov, Dmitry; Evseeva, Marina

Optimel: software for selecting the optimal method automates the process of selecting a solution method from the optimization methods domain. Optimel features practical novelty. It saves time and money when conducting exploratory studies if its objective is to select the most appropriate method for solving an optimization problem. Optimel features theoretical novelty because for obtaining the domain a new method of knowledge structuring was used. In the Optimel domain, extended quantity of methods and their properties are used, which allows identifying the level of scientific studies, enhancing the user's expertise level, expand the prospects the user faces and opening up new research objectives. Optimel can be used both in scientific research institutes and in educational institutions.

Gen IV Materials Handbook Functionalities and Operation (4A) Handbook Version 4.0

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

Ren, Weiju

2013-09-01

This document is prepared for navigation and operation of the Gen IV Materials Handbook, with architecture description and new user access initiation instructions. Development rationale and history of the Handbook is summarized. The major development aspects, architecture, and design principles of the Handbook are briefly introduced to provide an overview of its past evolution and future prospects. Detailed instructions are given with examples for navigating the constructed Handbook components and using the main functionalities. Procedures are provided in a step-by-step fashion for Data Upload Managers to upload reports and data files, as well as for new users to initiate Handbookmore » access.« less

Cloud-based robot remote control system for smart factory

NASA Astrophysics Data System (ADS)

Wu, Zhiming; Li, Lianzhong; Xu, Yang; Zhai, Jingmei

2015-12-01

With the development of internet technologies and the wide application of robots, there is a prospect (trend/tendency) of integration between network and robots. A cloud-based robot remote control system over networks for smart factory is proposed, which enables remote users to control robots and then realize intelligent production. To achieve it, a three-layer system architecture is designed including user layer, service layer and physical layer. Remote control applications running on the cloud server is developed on Microsoft Azure. Moreover, DIV+ CSS technologies are used to design human-machine interface to lower maintenance cost and improve development efficiency. Finally, an experiment is implemented to verify the feasibility of the program.

Operational research as implementation science: definitions, challenges and research priorities.

PubMed

Monks, Thomas

2016-06-06

Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature. To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users. Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.

Gastrointestinal side effects in postmenopausal women using osteoporosis therapy: 1-year findings in the POSSIBLE US study.

PubMed

Woo, Claudine; Gao, Guozhi; Wade, Sally; Hochberg, Marc C

2010-04-01

To characterize gastrointestinal side effects (GI SEs) and its associations with medication discontinuation, health-related quality of life (HRQoL), and treatment) satisfaction in postmenopausal women prescribed osteoporosis (OP) therapies. Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US*) participants enrolled October 27, 2004 - January 25, 2007 and complete questionnaires for up to 3 years. GI SEs for women new to or stable on therapy at entry were characterized at 6 and 12 months. Adjusted odds of experiencing GI SEs; mean HRQoL and treatment satisfaction scores; and risk of discontinuing therapy for bisphosphonate (BP) versus non-BP users were compared with logistic and generalized linear models. About 20% of women reported >or=1 GI SE at entry. GI SEs at month 6 were more common in BP than non-BP users (new: OR = 1.5, 95% CI: 1.2-2.0; stable: OR = 1.7, 95% CI: 1.3-2.1). Women new to OP therapy with GI SEs at month 6 had lower LS Mean HRQoL (OPAQ-SV Emotional Status: 72.3 vs. 78.2, p = 0.005) and treatment satisfaction scores (SEs: 71.4 vs. 82.9; 58.6 vs. 65.6; Global: 55.0 vs. 64.4; all p

Can intrauterine contraceptive devices lead to VulvoVaginal Candidiasis (VVC) and Anemia in Iranian new users?

PubMed

Behboudi-Gandevani, Samira; Imani, Somaieh; Moghaddam-Banaem, Lida; Roudbar-Mohammadi, Shahla

2015-03-01

To assess the prevalence of anemia and VulvoVaginal Candidiasis (VVC) in women before and 3 months after copper Intra Uterine Device (IUD) insertion. Longitudinal prospective study was performed with 101 women aged 15-45 year who wanted to use the IUD at six health centers in Tehran, Iran from November 2011 to August 2012. The pattern of bleeding, Hemoglobin and Hematocirt levels, and Candida colony count/cultures in the women were assessed before and after 3 months of IUD insertion. Data analysis was performed by descriptive and analytical statistics using the SPSS software for Windows. At the end of 3 months, a significant increase in menstrual blood loss and a significant decrease of Hb and HCT (P=0.047 and 0.001, respectively) were reported. Moreover, no difference in the prevalence of anemia before and after IUD insertion was observed. The mean±SD Candida colony counts significantly increased (P=0.001), but positive Candida cultures were not significantly different before and 3 months after IUD insertion. Also, no clinical VVC was reported 3 months after IUD insertion. While BMI≥29 had a positive relationship with Candida colony counts, the results remained unchanged after adjusting for potential risk factors. Despite an increase in bleeding and Candida colony counts in copper IUD users in this study, clinical VVC or anemia cases were not increased, which indicates relative safety of this contraception method. The study findings can be helpful to healthcare professionals and midwives to counsel women who want to start using IUD and also current users who are contemplating IUD removal due to its complications. Copyright © 2014 Elsevier B.V. All rights reserved.

Antiretroviral Use Among Active Injection-Drug Users: The Role of Patient–Provider Engagement and Structural Factors

PubMed Central

Arnsten, Julia H.; Eldred, Lois J.; Wilkinson, James D.; Shade, Starley B.; Bohnert, Amy S.; Yang, Cui; Wissow, Lawrence S.; Purcell, David W.

2010-01-01

Abstract HIV-seropositive, active injection-drug users (IDUs), compared with other HIV populations, continue to have low rates of highly active antiretroviral therapy (HAART) use, contributing to disparities in their HIV health outcomes. We sought to identify individual-level, interpersonal, and structural factors associated with HAART use among active IDUs to inform comprehensive, contextually tailored intervention to improve the HAART use of IDUs. Prospective data from three semiannual assessments were combined, and logistic general estimating equations were used to identify variables associated with taking HAART 6 months later. Participants were a community sample of HIV-seropositive, active IDUs enrolled in the INSPIRE study, a U.S. multisite (Baltimore, Miami, New York, San Francisco) prevention intervention. The analytic sample included 1,225 observations, and comprised 62% males, 75% active drug users, 75% non-Hispanic blacks, and 55% with a CD4 count <350; 48% reported HAART use. Adjusted analyses indicated that the later HAART use of IDUs was independently predicted by patient–provider engagement, stable housing, medical coverage, and more HIV primary care visits. Significant individual factors included not currently using drugs and a positive attitude about HAART benefits even if using illicit drugs. Those who reported patient-centered interactions with their HIV primary care provider had a 45% greater odds of later HAART use, and those with stable housing had twofold greater odds. These findings suggest that interventions to improve the HIV treatment of IDUs and to reduce their HIV health disparities should be comprehensive, promoting better patient–provider engagement, stable housing, HAART education with regard to illicit drug use, and integration of drug-abuse treatment with HIV primary care. PMID:20578910

The use of a kiosk-model bilingual self-triage system in the pediatric emergency department.

PubMed

Sinha, Madhumita; Khor, Kai-Ning; Amresh, Ashish; Drachman, David; Frechette, Alan

2014-01-01

Streamlining the triage process is the key in improving emergency department (ED) workflow. Our objective was to determine if parents of pediatric ED patients in, low-literacy, inner-city hospital, who used the audio-assisted bilingual (English/Spanish) self-triage kiosk, were able to enter their child's medical history data using a touch screen panel with greater speed and accuracy than routine nurse-initiated triage. Parent/child dyads visiting the pediatric ED for nonurgent conditions (February to April 2012) were randomized prospectively to self-triage kiosk group (n = 200) and standard nurse triage group (n = 200). Both groups underwent routine nurse-initiated triage that included verbal elicitation of basic medical history and manual entry into patients' electronic medical records. The kiosk user was a parent in 88.5% of the cases, a patient (range, 11-17 years) in 9.5% of the cases, and a proxy user (sibling or friend) in 2% of the cases. Language choice for kiosk use was equally distributed (English vs Spanish, 50.5% vs 49.5%). The mean (SD) time to enter medical history data by the kiosk group was significantly shorter than the standard nurse triage group (94.38 [38.61] vs 126.72 [62.61] seconds; P < 0.001). Significant inverse relationship was observed between parent education level and kiosk usage time (r = -0.26; P < 0.001). The mean inaccuracies were significantly lower for kiosk group (P < 0.05) in areas of medical, medication and immunization histories, and total discrepancy score. Kiosk triage enabled users to enter basic medical triage history data quickly and accurately in an ED setting with future potential for its wider use in improving ED workflow efficiency.

Effect of Lifestyle Modification Using a Smartphone Application on Obesity With Obstructive Sleep Apnea: A Short-term, Randomized Controlled Study.

PubMed

Cho, Sung-Woo; Wee, Jee Hye; Yoo, Sooyoung; Heo, Eunyoung; Ryu, Borim; Kim, Yoojung; Lee, Joong Seek; Kim, Jeong-Whun

2018-01-30

To investigate the short-term effects of a lifestyle modification intervention based on a mobile application (app) linked to a hospital electronic medical record (EMR) system on weight reduction and obstructive sleep apnea (OSA). We prospectively enrolled adults (aged >20 years) with witnessed snoring or sleep apnea from a sleep clinic. The patients were randomized into the app user (n=24) and control (n=23) groups. The mobile app was designed to collect daily lifestyle data by wearing a wrist activity tracker and reporting dietary intake. A summary of the lifestyle data was displayed on the hospital EMR and was reviewed. In the control group, the lifestyle modification was performed as per usual practice. All participants underwent peripheral arterial tonometry (WatchPAT) and body mass index (BMI) measurements at baseline and after 4 weeks of follow-up. Age and BMI did not differ significantly between the two groups. While we observed a significant decrease in the BMI of both groups, the decrease was greater in the app user group (P <0.001). Apnea-hypopnea index, respiratory distress index, and oxygenation distress index did not change significantly in both groups. However, the proportion of sleep spent snoring at >45 dB was significantly improved in the app user group alone (P =0.014). In either group, among the participants with successful weight reduction, the apnea-hypopnea index was significantly reduced after 4 weeks (P =0.015). Multiple regression analyses showed that a reduction in the apnea-hypopnea index was significantly associated with BMI. Although a short-term lifestyle modification approach using a mobile app was more effective in achieving weight reduction, improvement in OSA was not so significant. Long-term efficacy of this mobile app should be evaluated in the future studies.

Usability and Acceptance of the Librarian Infobutton Tailoring Environment: An Open Access Online Knowledge Capture, Management, and Configuration Tool for OpenInfobutton.

PubMed

Jing, Xia; Cimino, James J; Del Fiol, Guilherme

2015-11-30

The Librarian Infobutton Tailoring Environment (LITE) is a Web-based knowledge capture, management, and configuration tool with which users can build profiles used by OpenInfobutton, an open source infobutton manager, to provide electronic health record users with context-relevant links to online knowledge resources. We conducted a multipart evaluation study to explore users' attitudes and acceptance of LITE and to guide future development. The evaluation consisted of an initial online survey to all LITE users, followed by an observational study of a subset of users in which evaluators' sessions were recorded while they conducted assigned tasks. The observational study was followed by administration of a modified System Usability Scale (SUS) survey. Fourteen users responded to the survey and indicated good acceptance of LITE with feedback that was mostly positive. Six users participated in the observational study, demonstrating average task completion time of less than 6 minutes and an average SUS score of 72, which is considered good compared with other SUS scores. LITE can be used to fulfill its designated tasks quickly and successfully. Evaluators proposed suggestions for improvements in LITE functionality and user interface.

Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study

PubMed Central

Vychytil, Andreas; Remón, César; Michel, Catherine; Williams, Paul; Rodríguez-Carmona, Ana; Marrón, Belén; Vonesh, Ed; van der Heyden, Synke; Filho, Jose C. Divino

2008-01-01

Background. Icodextrin is a glucose polymer derived by hydrolysis of cornstarch. The different biocompatibility profile of icodextrin-containing peritoneal dialysis (PD) solutions may have a positive influence on peritoneal host defence. Furthermore, cases of sterile peritonitis potentially associated with icodextrin have been reported. Methods. The primary objective of this multicentre, longitudinal, observational, non-interventional, prospective cohort study, which included 722 PD patients, was to evaluate the incidence of overall peritonitis in patients treated with icodextrin-containing PD solutions (Extraneal™) used during one long-dwell exchange/day compared with those treated with non-icodextrin-containing PD solutions. The secondary objective was to determine if culture-negative peritonitis rates differed between patients treated with icodextrin from two independent manufacturers. All peritonitis episodes were assessed by a Steering Committee in a blind manner. Results. There was no significant difference between icodextrin-treated and control patients in the adjusted overall, culture-positive or culture-negative peritonitis rates. When stratified by the icodextrin supplier, there was no significant difference in the adjusted rate of culture-negative peritonitis episodes between groups. Conclusion. Subjects receiving icodextrin as part of their PD regimen experienced neither a higher rate of culture-negative peritonitis nor a lower rate of infectious peritonitis compared with non-icodextrin users. There was no significant influence of the icodextrin raw material supplier on peritonitis rates. PMID:18556747

Technology pedagogy: Six teacher candidates' developing pedagogical models for the use of computers in science instruction

NASA Astrophysics Data System (ADS)

Myhre, Oddmund Reidar

1997-12-01

This study investigated how teacher candidates' developing pedagogical beliefs and knowledge of technology influenced their perception of such tools in the teaching of subject matter as they complete the initial course work of their professional program. The purpose of the study was to conceptualize more clearly the relationship between prospective teachers' thinking about computer technology and the content of their professional education. A case study methodology was used to investigate changes in six pre-service secondary science teachers' thinking about technology as a pedagogical tool. Two of the teachers had extensive experience with technology upon entering the teacher preparation course-work, whereas the other four were novice computer users. Data included three semi structured interviews and non-participant observations during the technology course-work. Additional data were collected in the form of interviews with university faculty and cooperating teachers. Analysis of these data indicated that prospective candidates entered teacher education viewing technology as a tool that supports a teacher centered classroom. As the candidates explored more student centered approaches to teaching, they found less room for technology in their images of their future practice. The data also indicated that the technology course-work was isolated from the rest of the teacher education program and many of the misconceptions about technology that the candidates brought to their professional preparation were left unchallenged.

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Chronic Hepatitis C Treatment in Patients with Drug Injection History: Findings of the INTEGRATE Prospective, Observational Study.

PubMed

Robaeys, Geert; Christensen, Stefan; Lucidarme, Damien; Arain, Amber; Bruggmann, Philip; Kunkel, Jan; Keim, Sofia; Jäkel, Martin; DeMasi, Ralph; Liu, Chris; Lonjon-Domanec, Isabelle; Foster, Graham R

2017-06-01

People who inject drugs represent an under-treated chronic hepatitis C virus (HCV)-infected patient population. INTEGRATE was a prospective, observational study investigating the effectiveness, safety, and adherence in routine clinical practice to telaprevir in combination with peg-interferon and ribavirin (Peg-IFN/RBV) in patients with history of injecting drug use chronically infected with genotype 1 HCV. A total of 46 patients were enrolled and included in the intent-to-treat (ITT) population. Among heroin and/or cocaine users (n = 37; 80%), 22% reported use in the past month; 74% (34/46) of patients were on opioid substitution therapy in the pre-treatment phase, and 43% (20/46) discontinued HCV treatment prematurely. Sustained virologic response rate was 54% (25/46) in the ITT population and 74% (25/34) in the per protocol (evaluable-for-effectiveness) population. The main reason for failure in the ITT analysis was loss to follow-up (n = 8; 17%). Adverse events occurred in 91% (42/46) of patients. Mean patient-reported adherence to study drugs was >89% at Week 4, Week 12 and end of treatment. Despite a high rate of treatment discontinuation (including loss to follow-up), self-reported adherence to treatment was good and virologic cure rates were similar to those reported in large real-world cohorts. Our findings suggest that people with a history of injecting drug use should be considered for treatment of chronic HCV infection, and highlight the need for improvements in patient support to boost retention in care and, in turn, help to prevent reinfection and transmission. Clinicaltrials.gov identifier, NCT01980290. Janssen Pharmaceuticals.

Ethics of Engagement: User-Centered Design and Rhetorical Methodology.

ERIC Educational Resources Information Center

Salvo, Michael J.

2001-01-01

Explores the shift from observation of users to participation with users, describing and investigating three examples of user-centered design practice in order to consider the new ethical demands being made of technical communicators. Explores Pelle Ehn's participatory design method, Roger Whitehouse's design of tactile signage for blind users,…

Enhanced identification of eligibility for depression research using an electronic medical record search engine.

PubMed

Seyfried, Lisa; Hanauer, David A; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C

2009-12-01

Electronic medical records (EMRs) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and clinical accuracy of a medical record search engine vs. manual review of the EMR. Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic medical record search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving clinical accuracy. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information.

Enhanced Identification of Eligibility for Depression Research Using an Electronic Medical Record Search Engine

PubMed Central

Seyfried, Lisa; Hanauer, David; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C.

2009-01-01

Purpose Electronic medical records (EMR) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and accuracy of electronic search engine vs. manual review of the EMR. Methods Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Results Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Conclusions Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving reliability. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information. PMID:19560962

Comparison of prospective daily diaries and retrospective recall to measure oral contraceptive adherence.

PubMed

Huber, Larissa R Brunner; Broel, Elizabeth C; Mitchelides, Ashley N; Dmochowski, Jacek; Dulin, Michael; Scholes, Delia

2013-10-01

The purpose of this study was to determine if retrospective recall of oral contraceptive (OC) adherence provides data that are similar to data collected via daily diaries over the same time period. Factors associated with inconsistent agreement between prospective and retrospective measurements of adherence also were explored. A total of 185 women participated in a longitudinal, prospective cohort of OC users, and 113 of these women provided complete information on OC adherence during follow-ups. Concordance beyond chance was assessed using weighted kappa statistics, and logistic regression was used to identify factors associated with inconsistent reporting of adherence. There was substantial agreement between prospective and retrospective adherence information (weighted kappa=0.64; 95% CI: 0.52-0.77). Participants with a high school education or less and those who had problems with feeling sad while using OCs had increased odds of inconsistent reporting of adherence (OR=4.38, 95% CI: 1.41-13.61 and OR=3.52, 95% CI: 1.25-9.94, respectively). While prospective data collection via diaries may improve accuracy, the added expense and burden on study participants may not be necessary. However, the use of retrospective recall may not be appropriate for all study populations. Copyright © 2013 Elsevier Inc. All rights reserved.

Proton pump inhibitor use for 12 months is not associated with changes in serum magnesium levels: a prospective open label comparative study.

PubMed

Bahtiri, Elton; Islami, Hilmi; Hoxha, Rexhep; Gashi, Afrim; Thaçi, Kujtim; Karakulak, Çağla; Thaçi, Shpetim; Qorraj Bytyqi, Hasime

2017-03-01

Proton pump inhibitors (PPIs) are a widely used class of drugs because of a generally acceptable safety profile. Among recently raised safety issues of the long-term use of PPIs is the increased risk of developing hypomagnesemia. As there have been very few prospective studies measuring serum magnesium levels before and after PPI therapy, we aimed to prospectively assess the potential association between PPI therapy for 12 months and the risk of hypomagnesemia as well as the incidence of new-onset hypomagnesemia during the study. In addition, the association of PPI therapy with the risk of hypocalcemia was assessed. The study included 250 patients with normal serum magnesium and total calcium levels, who underwent a long-term PPI treatment. Serum magnesium, total calcium, and parathormone (PTH) levels were measured at baseline and after 12 months. Of the 250 study participants, 209 completed 12 months of treatment and were included in the statistical analysis. The Wilcoxon signed rank test showed no statistically significant differences in serum magnesium levels between measurements at two different time points. However, there were statistically significant differences in serum total calcium and PTH levels in PPI users. Stable serum magnesium levels were demonstrated after 12 months and no association between PPI use and risk of hypomagnesemia was shown in the general population. Significant reductions of serum total calcium levels were demonstrated among PPI users; nevertheless, further research is required before recommending any serum calcium and PTH level monitoring in patients initiated on long-term PPI therapy.

E-Cigarettes and Future Cigarette Use

PubMed Central

Urman, Robert; Berhane, Kiros; Unger, Jennifer B.; Cruz, Tess Boley; Pentz, Mary Ann; Samet, Jonathan M.; Leventhal, Adam M.; McConnell, Rob

2016-01-01

BACKGROUND: There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal. METHODS: The Children’s Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade. RESULTS: Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30–11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37–10.4), including hookah, cigars, or pipes. CONCLUSIONS: E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use. PMID:27296866

E-Cigarettes and Future Cigarette Use.

PubMed

Barrington-Trimis, Jessica L; Urman, Robert; Berhane, Kiros; Unger, Jennifer B; Cruz, Tess Boley; Pentz, Mary Ann; Samet, Jonathan M; Leventhal, Adam M; McConnell, Rob

2016-07-01

There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal. The Children's Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade. Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30-11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37-10.4), including hookah, cigars, or pipes. E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use. Copyright © 2016 by the American Academy of Pediatrics.

Does semi-automatic bone-fragment segmentation improve the reproducibility of the Letournel acetabular fracture classification?

PubMed

Boudissa, M; Orfeuvre, B; Chabanas, M; Tonetti, J

2017-09-01

The Letournel classification of acetabular fracture shows poor reproducibility in inexperienced observers, despite the introduction of 3D imaging. We therefore developed a method of semi-automatic segmentation based on CT data. The present prospective study aimed to assess: (1) whether semi-automatic bone-fragment segmentation increased the rate of correct classification; (2) if so, in which fracture types; and (3) feasibility using the open-source itksnap 3.0 software package without incurring extra cost for users. Semi-automatic segmentation of acetabular fractures significantly increases the rate of correct classification by orthopedic surgery residents. Twelve orthopedic surgery residents classified 23 acetabular fractures. Six used conventional 3D reconstructions provided by the center's radiology department (conventional group) and 6 others used reconstructions obtained by semi-automatic segmentation using the open-source itksnap 3.0 software package (segmentation group). Bone fragments were identified by specific colors. Correct classification rates were compared between groups on Chi 2 test. Assessment was repeated 2 weeks later, to determine intra-observer reproducibility. Correct classification rates were significantly higher in the "segmentation" group: 114/138 (83%) versus 71/138 (52%); P<0.0001. The difference was greater for simple (36/36 (100%) versus 17/36 (47%); P<0.0001) than complex fractures (79/102 (77%) versus 54/102 (53%); P=0.0004). Mean segmentation time per fracture was 27±3min [range, 21-35min]. The segmentation group showed excellent intra-observer correlation coefficients, overall (ICC=0.88), and for simple (ICC=0.92) and complex fractures (ICC=0.84). Semi-automatic segmentation, identifying the various bone fragments, was effective in increasing the rate of correct acetabular fracture classification on the Letournel system by orthopedic surgery residents. It may be considered for routine use in education and training. III: prospective case-control study of a diagnostic procedure. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Hydrophobically modified polymers can minimize skin irritation potential caused by surfactant-based cleansers.

PubMed

Draelos, Zoe; Hornby, Sidney; Walters, Russel M; Appa, Yohini

2013-12-01

The addition of hydrophobically modified polymers (HMPs) to cleansers that contain surfactants can create polymer-surfactant complexes that are less irritating to the skin than commercially available mild cleansers. Our objective was to compare the tolerability and efficacy of a test foaming liquid facial cleanser containing HMPs with a commercial liquid nonfoaming facial cleanser in women with sensitive skin. In this randomized, prospective, double-blind, comparative study, women (n = 20 per group) with mild-to-moderate atopic dermatitis (AD), eczema, acne, or rosacea used a test gentle foaming liquid facial cleanser containing HMPs or a commercial gentle liquid nonfoaming facial cleanser daily for 3 weeks. Investigators assessed irritation and skin condition. Study subjects also assessed their skin properties and the performance of each cleanser. Clinicians as well as study subjects consistently rated the test cleanser as effective or slightly more effective at improving symptoms than the commercial cleanser, although no significant differences between groups were observed. At weeks 1 and 3, respectively, more users of the commercial cleanser reported irritation (20% and 10%) than users of the test cleanser (5% and 5%). In addition, subject self-assessments of skin condition and cleansing properties were slightly more improved with the test cleanser than with the commercial cleanser. Both the test foaming cleanser containing HMPs and the commercial nonfoaming cleanser were effective and well accepted by most women in the study. Improvements were observed by both clinicians and subjects in the group using the test cleanser containing HMPs in all evaluated skin categories. © 2013 The Authors Journal of Cosmetic Dermatology Published by Wiley Periodicals, Inc.

Validation of exposure assessment and assessment of recruitment methods for a prospective cohort study of mobile phone users (COSMOS) in Finland: a pilot study

PubMed Central

2011-01-01

Background The aim of the study was to evaluate the agreement between self-reported and operator-derived estimates of call time based on a three-month monitoring period, as well as the consistency of mobile phone use over time. Alternative approaches to improve participation in a cohort study of mobile phone users were also compared. Methods A total of 5,400 subjects were identified from network operators' subscriber databases for recruitment to the pilot study. Operator and questionnaire data were used to quantify mobile phone use. Operator data were available for a subset of the subjects for a three-month period in three consecutive years. We also evaluated the effect of the length of the questionnaire and one- or two-phase recruitment on participation. Results The average response rate for both questionnaires and recruitment procedures was 12%. The response rate was not affected by the length of the questionnaire or the recruitment method. Operator data were available for 83% of the participants for 2007, the first study year. The agreement between self-reported and operator-derived call times decreased with the level of use among intermediate and heavy mobile phone users. During 2007-2009, mobile phone use increased fairly constantly over time. Conclusions The agreement between self-reported mobile phone use and operator databases was moderate and overestimation of the call time by participants was common. A prospective cohort study would be feasible in Finland, although the potentially low participation rate would increase the resources required for recruitment. PMID:21385407

The effect of vacuum assisted socket suspension on prospective, community-based falls by users of lower limb prostheses.

PubMed

Rosenblatt, Noah J; Ehrhardt, Tess

2017-06-01

Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i.e., "unintentionally came to rest on a lower surface") or stumbled (i.e., lost balance but did not fall) in the prior two weeks. A Chi-squared test was used to compare fall and stumble risk between groups, after stratifying by level of amputation, and the phi coefficient (φ) was used to quantify effect size. While the use of VASS did not affect the rate of falling (i.e., falls per person year) for either persons with transtibial amputation (TTA) or those with transfemoral amputation (TFA), the absolute risk of having multiple falls was reduced by nearly 75% in the former (φ=0.83), which is particularly important given that recurrent falls are associated with more severe injuries. There was no effect of VASS on the risk of falls in TFA. Further work is warranted to demonstrate the persistence of these effects in larger, more controlled samples. Copyright © 2017 Elsevier B.V. All rights reserved.

Cross-sectional and prospective relation of cannabis potency, dosing and smoking behaviour with cannabis dependence: an ecological study.

PubMed

van der Pol, Peggy; Liebregts, Nienke; Brunt, Tibor; van Amsterdam, Jan; de Graaf, Ron; Korf, Dirk J; van den Brink, Wim; van Laar, Margriet

2014-07-01

Increased delta-9-tetrahydrocannabinol (THC) concentrations in cannabis may lead to higher THC exposure, cannabis dependence and treatment need, but users may also adapt the actual intake of THC through reduced inhalation of THC containing smoke (titration). We investigated whether consumers of stronger cannabis use less cannabis per joint or inhale less smoke than those using less potent cannabis and whether these factors predict cannabis dependence severity. Heavy cannabis users (n = 98) brought their own cannabis, rolled a joint and smoked it ad libitum in a naturalistic setting. We analysed the content of the joint, its association with smoking behaviour and the cross-sectional and prospective (1.5-year follow-up) relations between smoking behaviour and cannabis dependence severity (total number of DSM-IV dependence symptoms). THC concentration in cannabis (range 1.10-24.70%) was correlated positively with cannabis dose per joint (b = 0.008, P = 0.01), but the resulting THC concentration per joint (range 0.24-15.72%) was associated negatively with inhalation volume (b = -0.05, P = 0.03). Smoking behaviour measures (number of puffs, inhaled volume, reduction of puff volume and puff duration while smoking) predicted follow-up dependence severity, independently of baseline dependence severity and monthly THC dose (number of joints × cannabis dose × cannabis THC concentration). Monthly THC dose only predicted follow-up dependence severity when unadjusted for baseline severity. Cannabis users titrate their delta-9-tetrahydrocannabinol intake by inhaling lower volumes of smoke when smoking strong joints, but this does not fully compensate for the higher cannabis doses per joint when using strong cannabis. Thus, users of more potent cannabis are generally exposed to more delta-9-tetrahydrocannabinol. Smoking behaviour appears to be a stronger predictor for cannabis dependence severity than monthly delta-9-tetrahydrocannabinol dose. © 2014 Society for the Study of Addiction.

User interaction with the LUCIFER control software

NASA Astrophysics Data System (ADS)

Knierim, Volker; Jütte, Marcus; Polsterer, Kai; Schimmelmann, Jan

2006-06-01

We present the concept and design of the interaction between users and the LUCIFER Control Software Package. The necessary functionality that must be provided to a user depends on and differs greatly for the different user types (i.e., engineers and observers). While engineers want total control over every service provided by the software system, observers are typically only interested in a fault tolerant and efficient user interface that helps them to carry out their observations in the best possible way during the night. To provide the functionality engineers need, direct access to a service is necessary. This may harbor a possible threat to the instrument in the case of a faulty operation by the engineer, but is the only way to test every unit during integration and commissioning of the instrument, and for service time later on. The observer on the other hand should only have indirect access to the instrument, controlled by an instrument manager service that ensures the necessary safety checks so that no harm can be done to the instrument. Our design of the user interaction provides such an approach on a level that is transparent to any interaction component regardless of interface type (i.e., textual or graphical). Using the interface and inheritance concepts of the Java Programming Language and its tools to create graphical user interfaces, it is possible to provide the necessary level of flexibility for the different user types on one side, while ensuring maximum reusability of code on the other side.

Parallel Planes Information Visualization

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

Bush, Brian

2015-12-26

This software presents a user-provided multivariate dataset as an interactive three dimensional visualization so that the user can explore the correlation between variables in the observations and the distribution of observations among the variables.

Clinical Investigation Program Annual Progress Report

DTIC Science & Technology

1988-10-20

Presented: Interna- tional Symposium on Orthopedics, Mexico , September 1987. Publications: In preparation. 147 FAMC A.P.R. (RCS MED 300) Detail Summary...Infection: A Prospective Study. Presented: 2nd Annual Symposium of the Rocky Moun- tain Flow Cytometry Users Group, Albuquerque, New Mexico , 10-11...Podgore, COL, MC (9) Dept/ISvc: Pediatrics (10) Associate Investigators (11) Key Words: Myron J. Levin, M.D. varicella vaccine U Co. HSC (12

E-Recruiting Practices and Trends at Four-Year and Two-Year Institutions, 2010. Noel-Levitz Report on Undergraduate Enrollment Trends

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2010

2010-01-01

This report documents the upward trend in "secret shopping" among today's prospective student Web users, along with the latest changes in electronic communications technologies used by college and university admissions offices. The report is based on a survey of college and university enrollment and admissions officers across the U.S. in March…

The Reality of National Computer Networking for Higher Education. Proceedings of the 1978 EDUCOM Fall Conference. EDUCOM Series in Computing and Telecommunications in Higher Education 3.

ERIC Educational Resources Information Center

Emery, James C., Ed.

A comprehensive review of the current status, prospects, and problems of computer networking in higher education is presented from the perspectives of both computer users and network suppliers. Several areas of computer use are considered including applications for instruction, research, and administration in colleges and universities. In the…

Condom use and sexuality communication with adults: a study among high school students in South Africa and Tanzania

PubMed Central

2013-01-01

Background Fostering adolescents’ communication on sexuality issues with their parents and other significant adults is often assumed to be an important component of intervention programmes aimed at promoting healthy adolescent sexual practices. However, there are few studies describing the relationship between such communication and sexual practices, particularly in sub-Saharan Africa. This study examined the relationships between adolescents’ communication with significant adults and their condom use in three sites in this region. Methods Data stem from a multi-site randomized controlled trial of a school-based HIV prevention intervention implemented in Cape Town and Mankweng, South Africa and Dar es Salaam, Tanzania. Only data from comparison schools were used. The design is therefore a prospective panel study with three waves of data collections. Data were collected in 2004 from 6,251 participants in 40 schools. Associations between adolescents’ communication with adults about sexuality issues and their use of condoms were analysed cross-sectionally using analysis of variance, as well as prospectively using multiple ordinal logistic regression analysis. Results Cross-sectional analyses showed that consistent condom users had significantly higher mean scores on communication (across topics and communication partners) than both occasional users and never-users, who had the lowest scores. After controlling for condom use at the first data collection occasion in each model as well as for possible confounders, communication scores significantly predicted consistent condom use prospectively in all three ordinal logistic regression models (Model R2 = .23 to .31). Conclusion The findings are consistent with the assertion that communication on sexuality issues between adolescents and significant adults results in safer sexual practices, as reflected by condom use, among in-school adolescents. The associations between communication variables and condom use might have been stronger if we had measured additional aspects of communication such as whether or not it was initiated by the adolescents themselves, the quality of advice provided by adults, and if it took place in a context of positive adult-adolescent interaction. Studies with experimental designs are needed in order to provide stronger evidence of causality. PMID:24053420

The Group for High Resolution Sea Surface Temperature: Past, Present and Future.

NASA Astrophysics Data System (ADS)

Donlon, Craig; Casey, Kenneth; Minnett, Peter; Corlett, Gary

2014-05-01

In the last decade, satellite Agencies, science, operational user/producer and Sea Surface Temperature practitioner communities have come together within the Group for High Resolution SST (GHRSST) to create a new framework for generation, delivery and application of improved common format high-resolution (~1-10 km) satellite SST datasets for the benefit of society. The GHRSST data system is a mature, robust, and highly reliable near real time and delayed mode data system known as the GHRSST Regional/Global Task Sharing framework (R/GTS) and has operated in NRT since 2006. It consists of distributed Regional Data Assembly Centers (RDACs) around the world that submit their data to a Global Data Assembly Center (GDAC) maintained at the NASA Jet Propulsion Laboratory Physical Oceanography Distributed Active Archive Center (JPL PO.DAAC), where all the data are available for 30 days. After that they are transferred to the GHRSST Long Term Stewardship and Reanalysis Facility (LTSRF) at the U.S. National Oceanographic Data Center (NODC) for long-term preservation and distribution. The extensive user base includes many operational meteorological services, the scientific community, industry and Government. Since the R/GTS has operated, statistics show over 72,000 users have accessed the R/GTS in NRT, accessing over 100 million files amounting to more than 232 Tb of information. GHRSST has an organisation structure that has both fixed and flexible components allowing it to respond effectively and efficiently to new and emerging challenges. GHRSST has often been cited as a model for other Virtual Communities/Constellations. GHRSST is underpinned by an international Science Team and International Project Office together. Long-standing GHRSST Technical Advisory Groups (TAG) and ad hoc Working Groups (WG) are typically at the "cutting edge" of international SST activities delivering real coordination in space-based Earth observations for societal benefit through the prioritized activities. Most recently, GHRSST has formed a strategic alliance with the Committee for Earth Observation Satellites (CEOS) SST Virtual Constellation further strengthening the important and active international GHRSST Community. This paper reviews the development of GHRSST since its early inception in 2000 its evolution and future prospects.

User Driven Data Mining, Visualization and Decision Making for NOAA Observing System and Data Investments

NASA Astrophysics Data System (ADS)

Austin, M.

2016-12-01

The National Oceanic and Atmospheric Administration (NOAA) observing system enterprise represents a $2.4B annual investment. Earth observations from these systems are foundational to NOAA's mission to describe, understand, and predict the Earth's environment. NOAA's decision makers are charged with managing this complex portfolio of observing systems to serve the national interest effectively and efficiently. The Technology Planning & Integration for Observation (TPIO) Office currently maintains an observing system portfolio for NOAA's validated user observation requirements, observing capabilities, and resulting data products and services. TPIO performs data analytics to provide NOAA leadership business case recommendations for making sound budgetary decisions. Over the last year, TPIO has moved from massive spreadsheets to intuitive dashboards that enable Federal agencies as well as the general public the ability to explore user observation requirements and environmental observing systems that monitor and predict changes in the environment. This change has led to an organizational data management shift to analytics and visualizations by allowing analysts more time to focus on understanding the data, discovering insights, and effectively communicating the information to decision makers. Moving forward, the next step is to facilitate a cultural change toward self-serve data sharing across NOAA, other Federal agencies, and the public using intuitive data visualizations that answer relevant business questions for users of NOAA's Observing System Enterprise. Users and producers of environmental data will become aware of the need for enhancing communication to simplify information exchange to achieve multipurpose goals across a variety of disciplines. NOAA cannot achieve its goal of producing environmental intelligence without data that can be shared by multiple user communities. This presentation will describe where we are on this journey and will provide examples of these visualizations, promoting a better understanding of NOAA's environmental sensing capabilities that enable improved communication to decision makers in an effective and intuitive manner.

Users Do the Darndest Things: True Stories from the CyLab Usable Privacy and Security Laboratory

NASA Astrophysics Data System (ADS)

Cranor, Lorrie Faith

How can we make security and privacy software more usable? The first step is to study our users. Ideally, we would watch them interacting with security or privacy software in situations where they face actual risk. But everyday computer users don't sit around fiddling with security software, and subjecting users to actual security attacks raises ethical and legal concerns. Thus, it can be difficult to observe users interacting with security and privacy software in their natural habitat. At the CyLab Usable Privacy and Security Laboratory, we've conducted a wide variety of studies aimed at understanding how users think about security and privacy and how they interact with security and privacy software. In this talk I'll give a behind the scenes tour of some of the techniques we've used to study users both in the laboratory and in the wild. I'll discuss the trials and tribulations of designing and carrying out security and privacy user studies, and highlight some of our surprising observations. Find out what privacy-sensitive items you can actually get study participants to purchase, how you can observe users' responses to a man-in-the-middle attack without actually conducting such an attack, why it's hard to get people to use high tech cell phones even when you give them away, and what's actually in that box behind the couch in my office.

Mobile App Usage Patterns of Patients Prescribed a Smoking Cessation Medicine: Prospective Observational Study

PubMed Central

2018-01-01

Background Cigarette smoking is the leading preventable cause of death and is responsible for more than 480,000 deaths per year in the United States. Smoking cessation is challenging for many patients. Regardless of available treatment options, most quit attempts are unaided, and it takes multiple attempts before a patient is successful. With the ever-increasing use of smartphones, mobile apps hold promise in supporting cessation efforts. This study evaluates the ease of use and user satisfaction with the Pfizer Meds app to support smoking cessation among patients prescribed varenicline (Chantix). Objective Study participants included varenicline users who downloaded and used the app on their personal smartphone. The main objectives were to report mobile app download frequency and usage details and to describe the participant-reported satisfaction with and usefulness of the app over the 14-week follow-up study period. Methods Adults aged 18 years or older who had been prescribed varenicline were identified from the Express Scripts Incorporated pharmacy claims database. After meeting privacy restrictions, subjects were sent an invitation letter and second reminder letter with instructions on how to download the Pfizer Meds mobile app. Participants received a push notification to complete a smartphone-enabled survey regarding the utility of the app 12 weeks after downloading the app. Descriptive statistics summarized sociodemographics, use of varenicline, and details of use and satisfaction with the mobile app. Results Of the 38,129 varenicline users who were sent invitation letters, 1281 participants (3.35%) downloaded the Pfizer Meds app. Of the 1032 users with demographic and other data, 585 (56.68%) were females, and 446 (43.22%) were males; mean age was 46.4 years (SD 10.8). The mean number of app sessions per participant was 4.0 (SD 6.8). The end-of-study survey was completed by 131 survey respondents (10.23%, 131/1281); a large number of participants (117/131, 89.3%) reported being extremely, very, or moderately satisfied with the app. A total of 97 survey respondents (97/131, 74.0%) reported setting up a quit date in the app. Of those, 74 (74/97, 76%) reported quitting on their quit date. Conclusions Positive patient engagement was observed in this study based on app download and usage. This study quantified how the Pfizer Meds app performed in an observational real-world data setting. The findings demonstrate the willingness of participants to set a quit date and use the app for support in medication adherence, refill reminders, and information regarding how to take the medication. This study provides real-world evidence of the contribution apps can make to the continued encouragement of smokers to improve their health by smoking cessation. PMID:29666043

A Decade of Neural Networks: Practical Applications and Prospects

NASA Technical Reports Server (NTRS)

Kemeny, Sabrina E.

1994-01-01

The Jet Propulsion Laboratory Neural Network Workshop, sponsored by NASA and DOD, brings together sponsoring agencies, active researchers, and the user community to formulate a vision for the next decade of neural network research and application prospects. While the speed and computing power of microprocessors continue to grow at an ever-increasing pace, the demand to intelligently and adaptively deal with the complex, fuzzy, and often ill-defined world around us remains to a large extent unaddressed. Powerful, highly parallel computing paradigms such as neural networks promise to have a major impact in addressing these needs. Papers in the workshop proceedings highlight benefits of neural networks in real-world applications compared to conventional computing techniques. Topics include fault diagnosis, pattern recognition, and multiparameter optimization.

Market definition studies for photovoltaic highway applications

NASA Technical Reports Server (NTRS)

1978-01-01

Prospects for solar electric power in applications related to highways within the continental United States are examined. Principal prospective users are found to be the highway departments of the various states. Economic analysis is employed to demonstrate that suitable applications can occur when powering apparatus such as signs, crossing signals, or instruments which consume less than 100 watts on the average, provided they are located at least one-half mile from existing utility power. Such applications are projected to occur two or three times per state per year. Attitudes of highway officials toward possible use of solar power are sampled and described. Although falling photovoltaic cell prices are expected to have little effect on sales potential here, methods for federal stimulation of this market are discussed.

Evaluating the prospects for sustainable energy development in a sample of Chinese villages.

PubMed

Mortimer, Nigel D; Grant, John F

2008-04-01

This paper describes the methods used to evaluate the potential for achieving sustainable energy development in six Chinese villages included in the Sustainable Users' Concepts for China Engaging Scientific Scenarios (SUCCESS) Project by examining energy efficiency potential and local renewable energy prospects. The approaches needed to obtain and analyse information on possible energy efficiency measures and renewable energy resources are summarised. Results are presented in terms of cumulative net savings in primary energy consumption, as an indicator of energy resource depletion, and associated carbon dioxide emissions, as an indicator of global climate change. Options for sustainable energy development are ranked in order of likely implementation and practical actions which could be considered in each village are identified.

Music Perception and Appraisal: Cochlear Implant Users and Simulated CI Listening

PubMed Central

Wright, Rose; Uchanski, Rosalie M.

2012-01-01

Background The inability to hear music well may contribute to decreased quality of life for cochlear implant (CI) users. Researchers have reported recently on the generally poor ability of CI users’ to perceive music, and a few researchers have reported on the enjoyment of music by CI users. However, the relation between music perception skills and music enjoyment is much less explored. Only one study has attempted to predict CI users’ enjoyment and perception of music from the users’ demographic variables and other perceptual skills (Gfeller et al., 2008). Gfeller’s results yielded different predictive relationships for music perception and music enjoyment, and the relationships were weak, at best. Purpose The first goal of this study is to clarify the nature and relationship between music perception skills and musical enjoyment for CI users, by employing a battery of music tests. The second goal is to determine whether normal hearing (NH) subjects, listening with a CI-simulation, can be used as a model to represent actual CI users for either music enjoyment ratings or music perception tasks. Research Design A prospective, cross-sectional observational study. Original music stimuli (unprocessed) were presented to CI users, and music stimuli processed with CI-simulation software were presented to twenty NH listeners (CIsim). As a control, original music stimuli were also presented to five other NH listeners. All listeners appraised twenty-four musical excerpts, performed music perception tests, and filled out a musical background questionnaire. Music perception tests were the Appreciation of Music in Cochlear Implantees (AMICI), Montreal Battery for Evaluation of Amusia (MBEA), Melodic Contour Identification (MCI), and University of Washington Clinical Assessment of Music Perception (UW-CAMP). Study Sample Twenty-five NH adults (22 – 56 years old), recruited from the local and research communities, participated in the study. Ten adult CI users (46 – 80 years old), recruited from the patient population of the local adult cochlear implant program, also participated in this study. Data Collection and Analysis Musical excerpts were appraised using a 7-point rating scale and music perception tests were scored as designed. Analysis of variance was performed on appraisal ratings, perception scores, and questionnaire data with listener group as a factor. Correlations were computed between musical appraisal ratings and perceptual scores on each music test. Results Music is rated as more enjoyable by CI users than by the NH listeners hearing music through a simulation (CIsim), and the difference is statistically significant. For roughly half of the music perception tests, there are no statistically significant differences between the performance of the CI users and of the CIsim listeners. Generally, correlations between appraisal ratings and music perception scores are weak or non-existent. Conclusions NH adults listening to music that has been processed through a CI-simulation program are a reasonable model for actual CI users for many music perception skills, but not for rating musical enjoyment. For CI users, the apparent independence of music perception skills and music enjoyment (as assessed by appraisals), indicates that music enjoyment should not be assumed and should be examined explicitly. PMID:22533978

Anabolic androgenic steroids--use and correlates among gym users--an assessment study using questionnaires and observations at gyms in the Stockholm region.

PubMed

Leifman, Håkan; Rehnman, Charlotta; Sjöblom, Erika; Holgersson, Stefan

2011-07-01

The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods.

Does tobacco use cause psychosis? Systematic review and meta-analysis

PubMed Central

Gurillo, Pedro; Jauhar, Sameer; Murray, Robin M; MacCabe, James H

2015-01-01

Summary Background Although the association between psychotic illness and cigarette smoking is well known, the reasons are unclear why people with psychosis are more likely to smoke than are the general population. We aimed to test several hypotheses. First, that daily tobacco use is associated with an increased risk of psychotic illness in both case-control and prospective studies. Second, that smoking is associated with an earlier age at onset of psychotic illness. Finally, that an earlier age at initiation of smoking is associated with an increased risk of psychosis. We also aimed to derive an estimate of the prevalence of smoking in patients presenting with their first episode of psychosis. Methods We searched Embase, Medline, and PsycINFO and selected observational studies in which rates of smoking were reported in people with psychotic disorders, compared with controls. We calculated the weighted mean difference for age at onset of psychosis and age at initiation of smoking. For categorical outcomes, we calculated odds ratios from cross-sectional studies and risk ratios from prospective studies. Findings Of 3717 citations retrieved, 61 studies comprising 72 samples met inclusion criteria. The overall sample included 14 555 tobacco users and 273 162 non-users. The prevalence of smoking in patients presenting with their first episode of psychosis was 0·57 (95% CI 0·52–0·62; p<0·0001). In case-control studies, the overall odds ratio for the first episode of psychosis in smokers versus non-smokers was 3·22 (95% CI 1·63–6·33), with some evidence of publication bias (Egger's test p=0·018, Begg's test p=0·007). For prospective studies, we calculated an overall relative risk of new psychotic disorders in daily smokers versus non-smokers of 2·18 (95% CI 1·23–3·85). Daily smokers developed psychotic illness at an earlier age than did non-smokers (weighted mean difference −1·04 years, 95% CI −1·82 to −0·26). Those with psychosis started smoking at a non-significantly earlier age than did healthy controls (−0·44 years, 95% CI −1·21 to 0·34). Interpretation Daily tobacco use is associated with increased risk of psychosis and an earlier age at onset of psychotic illness. The possibility of a causal link between tobacco use and psychosis merits further examination. Funding NIHR Maudsley Biomedical Research Centre. PMID:26249303

Genomics of Extinct and Endangered Species (2011 JGI User Meeting)

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

Shuster, Stephen

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Stephen Shuster of Penn State University gives a presentation on "Genomics of Extinct and Endangeredmore » Species" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.« less

Building Communities: The Community Sequencing Program at JGI (2011 JGI User Meeting)

ScienceCinema

Bristow, Jim

2018-01-22

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy Environment Meeting held March 22-24, 2011 in Walnut Creek, CA. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. DOE JGI Deputy Director Jim Bristow gives a presentation on the Community Sequencing Program at the 6th annual Genomics of Energy and Environment Meeting on March 23, 2011.

Genomic Speciation and Adaptation in Aquilegia (2011 JGI User Meeting)

ScienceCinema

Hodges, Scott

2018-02-14

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Scott Hodges of the University of California, Santa Barbara gives a presentation on Genomic Speciation and Adaptation in Aquilegia at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.

The Gulf Oil Spill: Ecogenomics and Ecoresilience (Keynote - 2011 JGI User Meeting)

ScienceCinema

Hazen, Terry [LBNL

2018-04-25

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Berkeley Lab microbial ecologist Terry Hazen delivers a keynote on "The Gulf Oil Spill: Ecogenomics and Ecoresilience" at the 6th Genomics of Energy & Environment Meeting on March 22, 2011.

Association Genetics of Populus trichocarpa or Resequencing in Populus: Towards Genome Wide Association Genetics (2011 JGI User Meeting)

ScienceCinema

Tuskan, Gerry

2018-02-13

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Gerry Tuskan of Oak Ridge National Laboratory on Resequencing in Populus: Towards Genome Wide Association Genetics at the 6th annual Genomics of Energy Environment Meeting on March 23, 2011.

Designing Biological Systems for Sustainability and Programmed Environmental Interface (2011 JGI User Meeting)

ScienceCinema

Silver, Pamela

2018-02-13

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Pam Silver of Harvard University gives a presentation on "Designing Biological Systems for Sustainability and Programmed Environmental Interface" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.

Spatially and Temporally Resolved Studies of the Human Microbiome (2011 JGI User Meeting)

ScienceCinema

Knight, Rob

2018-04-26

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Rob Knight of the University of Colorado gives a presentation on "Spatially and Temporally Resolved Studies of the Human Microbiome" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.

Data Access System for Hydrology

NASA Astrophysics Data System (ADS)

Whitenack, T.; Zaslavsky, I.; Valentine, D.; Djokic, D.

2007-12-01

As part of the CUAHSI HIS (Consortium of Universities for the Advancement of Hydrologic Science, Inc., Hydrologic Information System), the CUAHSI HIS team has developed Data Access System for Hydrology or DASH. DASH is based on commercial off the shelf technology, which has been developed in conjunction with a commercial partner, ESRI. DASH is a web-based user interface, developed in ASP.NET developed using ESRI ArcGIS Server 9.2 that represents a mapping, querying and data retrieval interface over observation and GIS databases, and web services. This is the front end application for the CUAHSI Hydrologic Information System Server. The HIS Server is a software stack that organizes observation databases, geographic data layers, data importing and management tools, and online user interfaces such as the DASH application, into a flexible multi- tier application for serving both national-level and locally-maintained observation data. The user interface of the DASH web application allows online users to query observation networks by location and attributes, selecting stations in a user-specified area where a particular variable was measured during a given time interval. Once one or more stations and variables are selected, the user can retrieve and download the observation data for further off-line analysis. The DASH application is highly configurable. The mapping interface can be configured to display map services from multiple sources in multiple formats, including ArcGIS Server, ArcIMS, and WMS. The observation network data is configured in an XML file where you specify the network's web service location and its corresponding map layer. Upon initial deployment, two national level observation networks (USGS NWIS daily values and USGS NWIS Instantaneous values) are already pre-configured. There is also an optional login page which can be used to restrict access as well as providing a alternative to immediate downloads. For large request, users would be notified via email with a link to their data when it is ready.

Personal Electronic Health Records: Understanding User Requirements and Needs in Chronic Cancer Care

PubMed Central

Winkler, Eva; Kamradt, Martina; Längst, Gerda; Eckrich, Felicitas; Heinze, Oliver; Bergh, Bjoern; Szecsenyi, Joachim; Ose, Dominik

2015-01-01

Background The integration of new information and communication technologies (ICTs) is becoming increasingly important in reorganizing health care. Adapting ICTs as supportive tools to users' needs and daily practices is vital for adoption and use. Objective In order to develop a Web-based personal electronic health record (PEPA), we explored user requirements and needs with regard to desired information and functions. Methods A qualitative study across health care sectors and health professions was conducted in a regional health care setting in Germany. Overall, 10 semistructured focus groups were performed, collecting views of 3 prospective user groups: patients with colorectal cancer (n=12) and representatives from patient support groups (n=2), physicians (n=17), and non-medical HCPs (n=16). Data were audio- and videotaped, transcribed verbatim, and thematically analyzed using qualitative content analysis. Results For both patients and HCPs, it was central to have a tool representing the chronology of illness and its care processes, for example, patients wanted to track their long-term laboratory findings (eg, tumor markers). Designing health information in a patient accessible way was highlighted as important. Users wanted to have general and tumor-specific health information available in a PEPA. Functions such as filtering information and adding information by patients (eg, on their well-being or electronic communication with HCPs via email) were discussed. Conclusions In order to develop a patient/user centered tool that is tailored to user needs, it is essential to address their perspectives. A challenge for implementation will be how to design PEPA’s health data in a patient accessible way. Adequate patient support and technical advice for users have to be addressed. PMID:25998006

Shell stability analysis in a computer aided engineering (CAE) environment

NASA Technical Reports Server (NTRS)

Arbocz, J.; Hol, J. M. A. M.

1993-01-01

The development of 'DISDECO', the Delft Interactive Shell DEsign COde is described. The purpose of this project is to make the accumulated theoretical, numerical and practical knowledge of the last 25 years or so readily accessible to users interested in the analysis of buckling sensitive structures. With this open ended, hierarchical, interactive computer code the user can access from his workstation successively programs of increasing complexity. The computational modules currently operational in DISDECO provide the prospective user with facilities to calculate the critical buckling loads of stiffened anisotropic shells under combined loading, to investigate the effects the various types of boundary conditions will have on the critical load, and to get a complete picture of the degrading effects the different shapes of possible initial imperfections might cause, all in one interactive session. Once a design is finalized, its collapse load can be verified by running a large refined model remotely from behind the workstation with one of the current generation 2-dimensional codes, with advanced capabilities to handle both geometric and material nonlinearities.

The AAS Working Group on Accessibility and Disability (WGAD): progress, current projects, and prospects for making astronomy accessible to all

NASA Astrophysics Data System (ADS)

Aarnio, Alicia; Diaz-Merced, Wanda; Monkiewicz, Jacqueline; Knierman, Karen; AAS WGAD

2018-01-01

Representation of astronomers with disabilities is low at the earliest career stages and losses compound with career stage thereafter; single-digit and lower percentage representation statistics are in large part due to systemic barriers to access and failure to accommodate the needs of users of a wide range of abilities. In this presentation, we discuss the barriers currently inhibiting broad access to astronomical publications, databases, and conferences. The WGAD was formed in January of 2016 to work toward removal of these barriers to make our field inclusive of astronomers with disabilities at all career stages. We have productively engaged with publishers and accessibility audits have been performed. Database accessibility evaluation is underway, and we are working with the AAS and other professional organizations on conference accessibility. We are keeping users centrally focused via surveys and user test groups, and holding paramount the overarching idea that meeting present accessibility standards is a necessary but insufficient condition for full access.

Methodological challenges of validating a clinical decision-making tool in the practice environment.

PubMed

Brennan, Caitlin W; Daly, Barbara J

2015-04-01

Validating a measurement tool intended for use in the practice environment poses challenges that may not be present when validating a tool intended solely for research purposes. The aim of this article is to describe the methodological challenges of validating a clinical decision-making tool, the Oncology Acuity Tool, which nurses use to make nurse assignment and staffing decisions prospectively each shift. Data were derived from a larger validation study, during which several methodological challenges arose. Revisions to the tool, including conducting iterative feedback cycles with end users, were necessary before the validation study was initiated. The "true" value of patient acuity is unknown, and thus, two approaches to inter-rater reliability assessment were used. Discordant perspectives existed between experts and end users. Balancing psychometric rigor with clinical relevance may be achieved through establishing research-practice partnerships, seeking active and continuous feedback with end users, and weighing traditional statistical rules of thumb with practical considerations. © The Author(s) 2014.

Bio-Inspired Distributed Transmission Power Control Considering QoS Fairness in Wireless Body Area Sensor Networks

PubMed Central

2017-01-01

Recently, the development of wireless body area sensor network (WBASN) has accelerated due to the rapid development of wireless technology. In the WBASN environment, many WBASNs coexist where communication ranges overlap with each other, resulting in the possibility of interference. Although nodes in a WBASN typically operate at a low power level, to avoid adversely affecting the human body, high transmission rates may be required to support some applications. In addition to this, since many varieties of applications exist in the WBASN environment, each prospective user may have different quality of service (QoS) requirements. Hence, the following issues should be considered in the WBASN environment: (1) interference between adjacent WBASNs, which influences the performance of a specific system, and (2) the degree of satisfaction on the QoS of each user, i.e., the required QoS such as user throughput should be considered to ensure that all users in the network are provided with a fair QoS satisfaction. Thus, in this paper, we propose a transmission power adjustment algorithm that addresses interference problems and guarantees QoS fairness between users. First, we use a new utility function to measure the degree of the satisfaction on the QoS for each user. Then, the transmission power of each sensor node is calculated using the Cucker–Smale model, and the QoS satisfaction of each user is synchronized dispersively. The results of simulations show that the proposed algorithm performs better than existing algorithms, with respect to QoS fairness and energy efficiency. PMID:29036924

Bio-Inspired Distributed Transmission Power Control Considering QoS Fairness in Wireless Body Area Sensor Networks.

PubMed

Lee, Chan-Jae; Jung, Ji-Young; Lee, Jung-Ryun

2017-10-14

Recently, the development of wireless body area sensor network (WBASN) has accelerated due to the rapid development of wireless technology. In the WBASN environment, many WBASNs coexist where communication ranges overlap with each other, resulting in the possibility of interference. Although nodes in a WBASN typically operate at a low power level, to avoid adversely affecting the human body, high transmission rates may be required to support some applications. In addition to this, since many varieties of applications exist in the WBASN environment, each prospective user may have different quality of service (QoS) requirements. Hence, the following issues should be considered in the WBASN environment: (1) interference between adjacent WBASNs, which influences the performance of a specific system, and (2) the degree of satisfaction on the QoS of each user, i.e., the required QoS such as user throughput should be considered to ensure that all users in the network are provided with a fair QoS satisfaction. Thus, in this paper, we propose a transmission power adjustment algorithm that addresses interference problems and guarantees QoS fairness between users. First, we use a new utility function to measure the degree of the satisfaction on the QoS for each user. Then, the transmission power of each sensor node is calculated using the Cucker-Smale model, and the QoS satisfaction of each user is synchronized dispersively. The results of simulations show that the proposed algorithm performs better than existing algorithms, with respect to QoS fairness and energy efficiency.

Crack-cocaine use accelerates HIV disease progression in a cohort of HIV-positive drug users.

PubMed

Baum, Marianna K; Rafie, Carlin; Lai, Shenghan; Sales, Sabrina; Page, Bryan; Campa, Adriana

2009-01-01

HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users. A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months. Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to

The Mechanics of Atmospheric Systems Derived Through Vertical and Horizontal Analysis of Parametric Data

NASA Technical Reports Server (NTRS)

Turner, R. E.

1977-01-01

For 36 hours during April 1975, an atmospheric variability experiment was conducted. This research effort supported an observational program in which rawinsonde data, radar data, and satellite data were collected from a network of 42 stations east of the Rocky Mountains at intervals of 3 hours. This program presents data with a high degree of time resolution over a spatially and temporally extensive network. Reduction of the experiment data is intended primarily as a documentation of the checking and processing of the data and should be useful to prospective users. Various flow diagrams of the data processing procedures are described, and a complete summary of the formulas used in the data processing is provided. A wind computation scheme designed to extract as much detailed wind information as possible from the unique experiment data set is discussed. The accuracy of the thermodynamic and wind data were estimated. Errors in the thermodynamic and wind data are given.

Improving self-esteem in women diagnosed with Turner syndrome: results of a pilot intervention.

PubMed

Chadwick, Paul M; Smyth, Arlene; Liao, Lih-Mei

2014-06-01

To evaluate a brief intervention to improve the self esteem of women diagnosed with Turner syndrome (TS). Prospective observational study. Turner Syndrome Support Society, UK. 30 women aged 18-60 years. A 1-day psychology workshop targeting problems of self-esteem in women diagnosed with TS. The workshop drew on cognitive-behavioral therapy and narrative therapy skills and emphasized increased self-awareness of interpersonal difficulties and improved capacity for self-management. Rosenberg Self-esteem Scale (RSS); Hospital Anxiety and Depression Scale (HADS); bespoke user experiences questionnaire. All 30 women provided baseline data, 27/30 provided immediate post-intervention data and 22/30 provided follow-up data at 3 months. The intervention improved RSS and HADS scores at 3 months. Generic skills-based psychological interventions have the potential to be adapted to provide brief and low-cost interventions to improve self-esteem and reduce psychological distress in women diagnosed with TS. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

[Influence of waiting time on patient and companion satisfaction].

PubMed

Fontova-Almató, A; Juvinyà-Canal, D; Suñer-Soler, R

2015-01-01

To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Prospective, observational study. Hospital de Figueres Emergency Department (Girona, Spain). sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). Perceived waiting time and the information about estimated waiting time determined overall satisfaction. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Implementation of enterprise resource planning using Odoo module sales and CRM. Case study: PT Ecosains Hayati

NASA Astrophysics Data System (ADS)

Terminanto, A.; Hidayat, R.; Hidayanto, A. N.

2017-12-01

Marketing is the most important part of PT Ecosains Hayati as a distributor company. Sales looking for prospective buyers and provide product price quotations. Quotations are made by accessing various data in a separate document. It makes the work process less efficient. Implementation of ERP system could improve the efficiency of sales work. It used RAD method that faster than other methods. The selected ERP system is Odoo, which contains various business application programs. Gap and efficiency analysis were performed to compare business processes before and after using Odoo. User Acceptance Test (UAT) is conducted to determine user acceptance of the applications and features available in Odoo module. After implementation of Odoo, there was an increase in the efficiency of the quotations business process by 63% in numberf of activity and by 50% in number of the actors involved. Odoo customization is done on 26 of the 41 module menus used. Based on UAT results, the implementation of Odoo meets the usability aspect with the overall average value 3.7. This indicates that users have a good level of understanding in the use of Odoo, and the features on Odoo can meet the needs of users.

The national- and international-wide prospects of future improvements of position location and time synchronization systems and aids

NASA Technical Reports Server (NTRS)

Gouzhva, Yuri G.; Balyasnikov, Boris N.; Korniyenko, Vladimir V.; Pushkina, Irina G.; Shebshayevich, Valentin S.; Denisov, Vladimir I.; Reutov, Alexander P.

1990-01-01

The concept being designed by the Leningrad Scientific Research Radio Technical Institute (LSRRI) of united positioning and timing service on the basis of the utilization of long-range and global radionavigation and common time systems and aids for different users is described. The estimate of its utilization on the national as well as on international scale is given.

Assessing repository technology. Where do we go from here?

NASA Technical Reports Server (NTRS)

Eichmann, David

1992-01-01

Three sample information retrieval systems, archie, autoLib, and Wide Area Information Service (WAIS), are compared with regard to their expressiveness and usefulness, first in the general context of information retrieval, and then as prospective software reuse repositories. While the representational capabilities of these systems are limited, they provide a useful foundation for future repository efforts, particularly from the perspective of repository distribution and coherent user interface design.

Prospects for Near Ultraviolet Astronomical Observations from the Lunar Surface — LUCI

NASA Astrophysics Data System (ADS)

Mathew, J.; Kumar, B.; Sarpotdar, M.; Suresh, A.; Nirmal, K.; Sreejith, A. G.; Safonova, M.; Murthy, J.; Brosch, N.

2018-04-01

We have explored the prospects for UV observations from the lunar surface and developed a UV telescope (LUCI-Lunar Ultraviolet Cosmic Imager) to put on the Moon, with the aim to detect bright UV transients such as SNe, novae, TDE, etc.

Cannabis use in early psychosis is associated with reduced glutamate levels in the prefrontal cortex.

PubMed

Rigucci, Silvia; Xin, Lijing; Klauser, Paul; Baumann, Philipp S; Alameda, Luis; Cleusix, Martine; Jenni, Raoul; Ferrari, Carina; Pompili, Maurizio; Gruetter, Rolf; Do, Kim Q; Conus, Philippe

2018-01-01

Recent studies have shown that cannabis may disrupt glutamate (Glu) signaling depressing Glu tone in frequent users. Current evidence have also consistently reported lower Glu-levels in various brain regions, particularly in the medial prefrontal cortex (mPFC) of chronic schizophrenia patients, while findings in early psychosis (EP) are not conclusive. Since cannabis may alter Glu synaptic plasticity and its use is a known risk factor for psychosis, studies focusing on Glu signaling in EP with or without a concomitant cannabis-usage seem crucial. We investigate the effect of cannabis use on prefrontal Glu-levels in EP users vs. both EP non-users and healthy controls (HC). Magnetic resonance spectroscopy was used to measure [Glu mPFC ] of 35 EP subjects (18 of whom were cannabis users) and 33 HC. For correlative analysis, neuropsychological performances were scored by the MATRICS-consensus cognitive battery. [Glu mPFC ] was lower in EP users comparing to both HC and EP non-users (p < 0.001 and p = 0.01, respectively), while no differences were observed between EP non-users and HC. A greater [Glu mPFC ]-decline with age was observed in EP users (r = -.46; p = 0.04), but not in EP non-users or HC. Among neuropsychological outcomes, working memory was the only domain that differentiates patients depending on their cannabis use, with users having poorer performances. Cannabis use is associated with reduced prefrontal [Glu mPFC ] and with a stronger Glu-levels decline with age. Glutamatergic abnormalities might influence the cognitive impairment observed in users and have some relevance for the progression of the disease.

Cod liver oil supplement consumption and health: cross-sectional results from the EPIC-Norfolk cohort study.

PubMed

Lentjes, Marleen A H; Welch, Ailsa A; Mulligan, Angela A; Luben, Robert N; Wareham, Nicholas J; Khaw, Kay-Tee

2014-10-16

Supplement users (SU) make healthy lifestyle choices; on the other hand, SU report more medical conditions. We hypothesised that cod liver oil (CLO) consumers are similar to non-supplement users, since CLO use might originate from historical motives, i.e., rickets prevention, and not health consciousness. CLO consumers were studied in order to identify possible confounders, such as confounding by indication. The European Prospective Investigation into Cancer (EPIC) investigates causes of chronic disease. The participants were 25,639 men and women, aged 40-79 years, recruited from general practices in Norfolk, East-Anglia (UK). Participants completed questionnaires and a health examination between 1993 and 1998. Supplement use was measured using 7-day diet diaries. CLO was the most common supplement used, more prevalent among women and associated with not smoking, higher physical activity level and more favourable eating habits. SU had a higher occurrence of benign growths and bone-related diseases, but CLO was negatively associated with cardiovascular-related conditions. Although the results of SU characteristics in EPIC-Norfolk are comparable with studies worldwide, the CLO group is different from SU in general. Confounding by indication takes place and will need to be taken into account when analysing prospective associations of CLO use with fracture risk and cardiovascular diseases.

Oral contraceptives and venous thromboembolism: pill scares and public health.

PubMed

Reid, Robert L

2011-11-01

Post-marketing surveillance of combined oral contraceptives (COCs) for rare complications such as venous thromboembolism (VTE) presents unique challenges. Prospective studies, which are costly and time consuming, have to date been undertaken by only a few contraceptive manufacturers willing to commit to full evaluation of product safety. Often such studies are conducted with the approval of regulatory authorities as a precondition for marketing. Alternatively, independent investigators with access to large databases have conducted retrospective studies to compare the incidence of VTE between new and older products. Such studies, however, run the risk of erroneous conclusions if they cannot ensure comparable risk profiles for users of these different products. Often database studies are unable to access information on important confounders, and medical records may not be available to validate the actual diagnosis of VTE. "Pill scares" generated following publication and media dissemination of worrisome findings, when the conclusions are in doubt and not corroborated by stronger prospective study designs, are frequently damaging to public health. From a review of recent publications on the VTE risk with drospirenone-containing COCs, it can be concluded that the best quality evidence does not support a difference in risk between users of COCs containing drospirenone and those of COCs containing levonorgestrel.

Cortical thickness in adolescent marijuana and alcohol users: A three-year prospective study from adolescence to young adulthood.

PubMed

Jacobus, Joanna; Squeglia, Lindsay M; Meruelo, Alejandro D; Castro, Norma; Brumback, Ty; Giedd, Jay N; Tapert, Susan F

2015-12-01

Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ+ALC, n=30) and controls (CON, n=38) with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ+ALC showed thicker cortical estimates across the brain (23 regions), particularly in frontal and parietal lobes (ps<.05). More cumulative marijuana use was associated with increased thickness estimates by 3-year follow-up (ps<.05). Heavy marijuana use during adolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use. Published by Elsevier Ltd.

Pelvic infection: a comparison of the Dalkon shield and three other intrauterine devices.

PubMed Central

Snowden, R; Pearson, B

1984-01-01

A detailed analysis was undertaken of reports of possible pelvic infection in relation to the use of four commonly fitted intrauterine contraceptive devices during 1971 to 1978 in the United Kingdom. The four devices were the Dalkon shield, Lippes loops 3C and 2D, and the Gravigard (copper 7), and data used were those collected systematically through the UK intrauterine device research network. Prospective reports that the Dalkon shield was uniquely related to high levels of infection when compared with other intrauterine devices were not substantiated in this prospective study among 13 349 users. Though some factors such as social class and previous experience of abortion appeared to influence the rate of infection, the type of intrauterine device being worn did not appear to be a significant factor. Various methods of analysis were used including life table, regression, and discriminant analysis, using information relating to the type of intrauterine device worn, the characteristics of the user, the fitting centre, and the pattern of diagnosis and treatment of reported or suspected pelvic infection. The results of this study suggest that fears that the Dalkon shield may be associated with a higher incidence of pelvic infection than other intrauterine devices may have been unjustified. PMID:6426647

Overrepresentation of seat belt non-users in traffic crashes

DOT National Transportation Integrated Search

1988-04-01

This study used observations of driver belt use linked with driver history information to conclude that non-users of belts are overrepresented in traffic crashes. Examining average numbers of accidents and violations per observed belted and unbelted ...

Understanding USGS user needs and Earth observing data use for decision making

NASA Astrophysics Data System (ADS)

Wu, Z.

2016-12-01

US Geological Survey (USGS) initiated the Requirements, Capabilities and Analysis for Earth Observations (RCA-EO) project in the Land Remote Sensing (LRS) program, collaborating with the National Oceanic and Atmospheric Administration (NOAA) to jointly develop the supporting information infrastructure - The Earth Observation Requirements Evaluation Systems (EORES). RCA-EO enables us to collect information on current data products and projects across the USGS and evaluate the impacts of Earth observation data from all sources, including spaceborne, airborne, and ground-based platforms. EORES allows users to query, filter, and analyze usage and impacts of Earth observation data at different organizational level within the bureau. We engaged over 500 subject matter experts and evaluated more than 1000 different Earth observing data sources and products. RCA-EO provides a comprehensive way to evaluate impacts of Earth observing data on USGS mission areas and programs through the survey of 345 key USGS products and services. We paid special attention to user feedback about Earth observing data to inform decision making on improving user satisfaction. We believe the approach and philosophy of RCA-EO can be applied in much broader scope to derive comprehensive knowledge of Earth observing systems impacts and usage and inform data products development and remote sensing technology innovation.

Cumulative estrogen exposure and prospective memory in older women.

PubMed

Hesson, Jacqueline

2012-10-01

This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to influence estrogen levels across the life span, and performance on prospective and retrospective memory measures in a group of 50 postmenopausal women (mean age=69.3years) who, if they were current or former users of estrogen therapy, had started therapy within 5years of menopause. The ICEE was found to be a significant predictor of performance on the Prospective Memory task (F(1)=4.21, p=.046, η(p)(2)=.084). No significant relationship was noted between the ICEE and performance on measures of retrospective memory. The results suggest that the level of cumulative lifetime exposure to estrogen a woman has influences her prospective memory performance later in life and that the influence of reproductive and biological markers of endogenous estrogen exposure are relevant factors to consider when studying the effect of estrogen therapy on cognitive functioning in postmenopausal women. In addition, the finding that performance on a measure of prospective memory, but not performance on measures of retrospective memory, was associated with the ICEE adds further support to the theory that the frontal cortex may be especially sensitive to estrogen. Copyright © 2012 Elsevier Inc. All rights reserved.

Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study.

PubMed

Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Wells, Helene; Legosz, Margot; Kemp, Robert

2013-10-01

To examine prospectively the contribution of the recreational social environment to ecstasy initiation. Population-based retrospective/prospective cohort study. Data from screening an Australian young adult population to obtain samples of users and non-users of ecstasy. A sample of 204 ecstasy-naive participants aged 19-23 years was obtained, and a 6-month follow-up identified those who initiated ecstasy use. We assessed a range of predictors of ecstasy initiation, including elements of participants' social environment, such as ecstasy-using social contacts and involvement in recreational settings. More than 40% of ecstasy-naive young adults reported ever receiving ecstasy offers. Ecstasy initiation after 6 months was predicted independently by having, at recruitment, many ecstasy-using social contacts [adjusted relative risk (ARR) 3.15, 95% confidence interval (CI): 1.57, 6.34], attending electronic/dance music events (ARR 6.97, 95% CI: 1.99, 24.37), receiving an ecstasy offer (ARR 4.02, 95% CI: 1.23, 13.10), early cannabis use (ARR 4.04, 95% CI: 1.78, 9.17) and psychological distress (ARR 5.34, 95% CI: 2.31, 12.33). Adjusted population-attributable fractions were highest for ecstasy-using social contacts (17.7%) and event attendance (15.1%). In Australia, ecstasy initiation in early adulthood is associated predominantly with social environmental factors, including ecstasy-using social contacts and attendance at dance music events, and is associated less commonly with psychological distress and early cannabis use, respectively. A combination of universal and targeted education programmes may be appropriate for reducing rates of ecstasy initiation and associated harms. © 2013 Society for the Study of Addiction.

Low-dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5-y prospective cohort study.

PubMed

Liu, Jun; Pan, Yu; Chen, Lei; Qiao, Qing Yan; Wang, Jing; Pan, Li Hua; Gu, Yan Hong; Gu, Hui Fang; Fu, Shun Kun; Jin, Hui Min

2016-10-01

Introduction Aspirin is an effective antiplatelet drug for preventing cardiovascular events in high-risk subjects. However, for patients with chronic kidney disease and undergoing hemodialysis (HD), its preventive efficacy remains controversial. The present study aimed to determine whether aspirin therapy reduces the risk of cardiovascular disease (CVD) and all-cause mortality in patients on HD. Methods We conducted a 5-y prospective cohort study involving patients on HD. Major exposure variables included prescription of aspirin (100 mg/d) and no aspirin (nonaspirin). The primary outcomes included all-cause death, cardiovascular events, hemorrhage, and ischemic stroke. The secondary outcome included bleeding events defined by the requirement of hospitalization. Findings In this study, 406 patients on regular HD were involved during a 5-y follow-up. Among these, 152 and 254 propensity-matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ 2  = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all-cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR = 1.795, 95% CI 0.666-4.841, P = 0.174). After adjustment for other confounders, aspirin use was also not associated with decreased risk of all-cause mortality and CVD. Discussion The present prospective cohort study suggests that low-dose aspirin use is not associated with a significant decrease in the risks of all-cause mortality, CVD, and stroke in population undergoing HD (ClinicalTrials.gov number, NCT02261025). © 2016 International Society for Hemodialysis.

Physical Activity in Public Parks of High and Low Socioeconomic Status in Colombia Using Observational Methods.

PubMed

Camargo, Diana Marina; Ramírez, Paula Camila; Quiroga, Vanesa; Ríos, Paola; Férmino, Rogério César; Sarmiento, Olga L

2018-03-28

Public parks are an important resource for the promotion of physical activity (PA). This is the first study in Colombia and the fourth in Latin America to describe the characteristics of park users and their levels of PA using objective measures. A systematic observation assessed sex, age, and the level of PA of users of 10 parks in an intermediate-size city in Colombia, classified in low (5 parks) and high (5 parks) socioeconomic status (SES). A total of 10 daily observations were conducted, in 5 days of the week during 3 periods: morning, afternoon, and evening. In total, 16,671 observations were completed, recording 46,047 users. A higher number of users per park, per day, were recorded in high SES (1195) versus low SES (647). More men were observed in low-SES than high-SES parks (70.1% vs 54.2%), as well as more children were observed in low-SES than high-SES parks (30.1% vs 15.9%). Older adults in high-SES parks were more frequent (9.5% vs 5.2%). Moderate to vigorous PA was higher in low-SES parks (71.7% vs 63.2%). Low-SES parks need more green spaces, walk/bike trails, and areas for PA. All parks need new programs to increase the number of users and their PA level, considering sex, age group, and period of the week.

Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

PubMed

Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto

2013-01-01

The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

Insulin pump-associated adverse events in children and adolescents--a prospective study.

PubMed

Wheeler, Benjamin J; Heels, Kristine; Donaghue, Kim C; Reith, David M; Ambler, Geoffrey R

2014-09-01

Intensive insulin regimens are now the mainstay of modern, type 1 diabetes mellitus management. Insulin pumps (CSII) are a key technique used. Although there has been considerable study of outcomes, there are few recent data on CSII-associated adverse events (AEs) and their incidence and characteristics. Phone calls to our 24-h diabetes support service were screened for CSII-associated AEs. Phone interviews were conducted with the parent/patient, within 96 h of the event. Interviews explored AE characteristics and the role of the user, as well as questions relating to outcome and the impact to the family and patient. Comparisons were made with clinic CSII patients not reporting an AE. Over a 16-week study period, 50 confirmed AEs occurred in 45 of 405 (11.1%) patients. This was annualized to an AE incidence of 40 AEs/100 person-years. Pump malfunction and infusion set/site failures were the most common events reported, occurring in 27 (54.0%) and 18 (36.0%) AEs, respectively. A user- or education-related issue was implicated in 22 (44.0%) events. Pump replacement occurred in 19 of 50 occurrences (38.0%). Additionally, 16 (32.0%) reported a hospital admission or emergency department attendance as a consequence. When compared with those on CSII not reporting an AE, AEs were associated with age <10 years (odds ratio=3.2 [95% confidence interval, 1.7-6.1]) but not with gender, glycosylated hemoglobin, diabetes duration, or pumping duration. This is the first prospective study to look at AEs in modern-generation insulin pumps. AEs appear common and should be anticipated. Their origin is multifactorial, with the pump, associated consumables, and the user all being important factors. Ongoing support and anticipatory education are essential to minimize pump-associated AEs and their impact.

Streaming primary urgent care: a prospective approach.

PubMed

Bickerton, Jane; Davies, Jacqueline; Davies, Helen; Apau, Daniel; Procter, Susan

2012-04-01

To identify the appropriate service provider attendees of emergency departments (EDs) and walk-in centres (WiCs) in North East London and to match this to local service provision and patient choice. An anonymous patient survey and a retrospective analysis of a random sample of patient records were performed. A nurse consultant, general practitioner (GP) and pharmacist used the presenting complaints in the patients' records to independently stream the patient to primary care services, non-National Health Services or ED. Statistical analysis of level of agreement was undertaken. A stakeholder focus group reviewed the results. Adult health consumers attending ED and urgent care services in North East London. The health user survey identified younger rather than older users (mean age of 35.6 years--SD 15.5), where 50% had not seen a health professional about their concern, with over 40% unable to obtain a convenient or emergency appointment with their GP. Over a third of the attendees were already receiving treatment and over 40% of these saw their complaint as an emergency. Over half of respondents expected to see a doctor, one-quarter expected to see a nurse and only 1% expected to see a pharmacist across both services, although WiCs are nurse-led services. More respondents expected a prescription from a visit to a WiC, whereas in the ED a third of respondents sought health advice or reassurance. A number of unscheduled care strategies are, or have just been, developed with the emphasis on moving demand into community-based services. Plurality of services provides service users with a range of alternative access points but can cause duplication of services and repeat attendance. Managing continued increase in emergency and unscheduled care is a challenge. The uncertainties in prospective decision making could be used to inform service development and delivery.

User Working Group Charter

Atmospheric Science Data Center

2014-04-29

... Earth Observing System (EOS) Program through the EOS Data Information System (EOSDIS) Project and the Langley ASDC, located at NASA ... of the ASDC user interface, development of the Information Management System (IMS), and ASDC user conferences requirements for and ...

Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe.

PubMed

Freisling, Heinz; Arnold, Melina; Soerjomataram, Isabelle; O'Doherty, Mark George; Ordóñez-Mena, José Manuel; Bamia, Christina; Kampman, Ellen; Leitzmann, Michael; Romieu, Isabelle; Kee, Frank; Tsilidis, Konstantinos; Tjønneland, Anne; Trichopoulou, Antonia; Boffetta, Paolo; Benetou, Vassiliki; Bueno-de-Mesquita, H B As; Huerta, José María; Brenner, Hermann; Wilsgaard, Tom; Jenab, Mazda

2017-05-23

We evaluated the associations of anthropometric indicators of general obesity (body mass index, BMI), an established risk factor of various cancer, and body fat distribution (waist circumference, WC; hip circumference, HC; and waist-to-hip ratio, WHR), which may better reflect metabolic complications of obesity, with total obesity-related and site-specific (colorectal and postmenopausal breast) cancer incidence. This is a meta-analysis of seven prospective cohort studies participating in the CHANCES consortium including 18 668 men and 24 751 women with a mean age of 62 and 63 years, respectively. Harmonised individual participant data from all seven cohorts were analysed separately and alternatively for each anthropometric indicator using multivariable Cox proportional hazards models. After a median follow-up period of 12 years, 1656 first-incident obesity-related cancers (defined as postmenopausal female breast, colorectum, lower oesophagus, cardia stomach, liver, gallbladder, pancreas, endometrium, ovary, and kidney) had occurred in men and women. In the meta-analysis of all studies, associations between indicators of adiposity, per s.d. increment, and risk for all obesity-related cancers combined yielded the following summary hazard ratios: 1.11 (95% CI 1.02-1.21) for BMI, 1.13 (95% CI 1.04-1.23) for WC, 1.09 (95% CI 0.98-1.21) for HC, and 1.15 (95% CI 1.00-1.32) for WHR. Increases in risk for colorectal cancer were 16%, 21%, 15%, and 20%, respectively per s.d. of BMI, WC, HC, and WHR. Effect modification by hormone therapy (HT) use was observed for postmenopausal breast cancer (P interaction <0.001), where never HT users showed an ∼20% increased risk per s.d. of BMI, WC, and HC compared to ever users. BMI, WC, HC, and WHR show comparable positive associations with obesity-related cancers combined and with colorectal cancer in older adults. For postmenopausal breast cancer we report evidence for effect modification by HT use.

NASA Earth Observations (NEO): Data Access for Informal Education and Outreach

NASA Technical Reports Server (NTRS)

Ward, Kevin; Herring, David

2005-01-01

The NEO (NASA Earth Observations) web space is currently under development with the goal of significantly increasing the demand for NASA remote sensing data while dramatically simplifying public access to georeferenced images. NEO will target the unsophisticated, nontraditional data users who are currently underserved by the existing data ordering systems. These users will include formal and informal educators, museum and science center personnel, professional communicators, and citizen scientists and amateur Earth observers. Users will be able to view and manipulate georeferenced browse imagery and, if they desire, download directly or order the source HDF data from the data provider (e.g., NASA DAAC or science team) via a single, integrated interface. NE0 will accomplish this goal by anticipating users expectations and knowledge level, thus providing an interface that presents material to users in a more simplified manner, without relying upon the jargon/technical terminology that make even the identification of the appropriate data set a significant hurdle. NEO will also act as a gateway that manages users expectations by providing specific details about images and data formats, developing tutorials regarding the manipulation of georeferenced imagery and raw data, links to software tools and ensuring that users are able to get the image they want in the format they want as easily as possible.

Analysis of Critical Earth Observation Priorities for Societal Benefit

NASA Astrophysics Data System (ADS)

Zell, E. R.; Huff, A. K.; Carpenter, A. T.; Friedl, L.

2011-12-01

To ensure that appropriate near real-time (NRT) and historical Earth observation data are available to benefit society and meet end-user needs, the Group on Earth Observations (GEO) sponsored a multi-disciplinary study to identify a set of critical and common Earth observations associated with 9 Societal Benefit Areas (SBAs): Agriculture, Biodiversity, Climate, Disasters, Ecosystems, Energy, Health, Water, and Weather. GEO is an intergovernmental organization working to improve the availability, access, and use of Earth observations to benefit society through a Global Earth Observation System of Systems (GEOSS). The study, overseen by the GEO User Interface Committee, focused on the "demand" side of Earth observation needs: which users need what types of data, and when? The methodology for the study was a meta-analysis of over 1,700 publicly available documents addressing Earth observation user priorities, under the guidance of expert advisors from around the world. The result was a ranking of 146 Earth observation parameters that are critical and common to multiple SBAs, based on an ensemble of 4 statistically robust methods. Within the results, key details emerged on NRT observations needed to serve a broad community of users. The NRT observation priorities include meteorological parameters, vegetation indices, land cover and soil property observations, water body and snow cover properties, and atmospheric composition. The results of the study and examples of NRT applications will be presented. The applications are as diverse as the list of priority parameters. For example, NRT meteorological and soil moisture information can support monitoring and forecasting for more than 25 infectious diseases, including epidemic diseases, such as malaria, and diseases of major concern in the U.S., such as Lyme disease. Quickly evolving events that impact forests, such as fires and insect outbreaks, can be monitored and forecasted with a combination of vegetation indices, fuel moisture content, burn scars, and meteorological parameters. Impacts to public health and livelihoods due to food insecurity, algal blooms, and air pollution can be addressed through NRT monitoring of specific events utilizing land cover, atmospheric composition, water quality, and meteorological observations. More broadly, the assessment of water availability for drinking and agriculture and the development of floods and storms rely on continuous feeds of NRT meteorological and atmospheric composition observations. Overall, this multi-disciplinary study of user needs for NRT data and products can inform the design and operation of NRT data systems. Follow-on work for this study will also be presented, focusing on the availability of current and future satellite measurements (including NRT) of the 30 most critical Earth observation priorities, as well as a detailed analysis of users' needs for precipitation data. The results of this study summarize the priorities for critical Earth observations utilized globally for societal benefit.

Uncertainty in Citizen Science observations: from measurement to user perception

NASA Astrophysics Data System (ADS)

Lahoz, William; Schneider, Philipp; Castell, Nuria

2016-04-01

Citizen Science activities concern general public engagement in scientific research activities when citizens actively contribute to science either with their intellectual effort or surrounding knowledge or with their tools and resources. The advent of technologies such as the Internet and smartphones, and the growth in their usage, has significantly increased the potential benefits from Citizen Science activities. Citizen Science observations from low-cost sensors, smartphones and Citizen Observatories, provide a novel and recent development in platforms for observing the Earth System, with the opportunity to extend the range of observational platforms available to society to spatio-temporal scales (10-100s m; 1 hr or less) highly relevant to citizen needs. The potential value of Citizen Science is high, with applications in science, education, social aspects, and policy aspects, but this potential, particularly for citizens and policymakers, remains largely untapped. Key areas where Citizen Science data start to have demonstrable benefits include GEOSS Societal Benefit Areas such as Health and Weather. Citizen Science observations have many challenges, including simulation of smaller spatial scales, noisy data, combination with traditional observational methods (satellite and in situ data), and assessment, representation and visualization of uncertainty. Within these challenges, that of the assessment and representation of uncertainty and its communication to users is fundamental, as it provides qualitative and/or quantitative information that influences the belief users will have in environmental information. This presentation will discuss the challenges in assessment and representation of uncertainty in Citizen Science observations, its communication to users, including the use of visualization, and the perception of this uncertainty information by users of Citizen Science observations.

Bone Mineral Density in Adolescent Females Using Injectable or Oral Contraceptives: A 24 Month Prospective Study

PubMed Central

Cromer, Barbara A.; Bonny, Andrea E.; Stager, Margaret; Lazebnik, Rina; Rome, Ellen; Ziegler, Julie; Camlin-Shingler, Kelly; Secic, Michelle

2008-01-01

Study Objective To determine whether bone mineral density (BMD) is lower in hormonal contraceptive users than that in an untreated, comparison group. Design Observational, prospective cohort; duration: 24 months. Setting Adolescent clinics in a midwestern, metropolitan setting. Patients 433 postmenarcheal girls, aged 12–18 years, on depot medroxyprogesterone acetate (DMPA) [n=58], oral contraceptives (OC) [n=187], or untreated (n=188). Intervention DMPA and OC containing 100 mcg levonorgestrel and 20 mcg ethinyl estradiol. Main Outcome Measure BMD measurements at spine and femoral neck were obtained with dual x-ray absorptiometry (DXA) at baseline and 6-month intervals. Results Over 24 months, mean percent change in spine BMD was: DMPA −1.5%, OC +4.2%, and untreated +6.3%. Mean percent change in femoral neck BMD was: DMPA −5.2%, OC +3.0%, untreated +3.8%. Statistical significance was found between the DMPA group and other two groups (p<.001). In the DMPA group, mean percent change in spine BMD over the first 12 months was −1.4%; the rate of change slowed to −0.1% over the second 12 months. No bone density loss reached the level of osteopenia. Conclusions Adolescent girls receiving DMPA had significant loss in BMD compared with bone gain in the OC and untreated group. However, its clinical significance is mitigated by slowed loss after the first year of DMPA use and general maintenance of bone density values within the normal range. PMID:18222431

User experience of a centralized hyperacute stroke service: a prospective evaluation.

PubMed

Moynihan, Barry; Paul, Selina; Markus, Hugh S

2013-10-01

Centralizing hyperacute stroke unit (HASU) care services allows improved access to thrombolysis but could be associated with worse patient experience, particularly when early repatriation to a local stroke recovery unit occurs as this may result in discontinuity of care. A centralized model of care was introduced in London, United Kingdom, with 8 HASUs providing acute care for the whole 8.3 million population, with repatriation on day 3 to a local stroke recovery unit. The patient and carer experience of this model of care has not been previously reported. We undertook a prospective observational study of the new model of care in the South West London sector. Patient and carer experiences were evaluated using a modified Picker Questionnaire. Separate questionnaires were used for patients discharged directly home from the HASU, those repatriated to local stroke recovery units, and for carers of patients admitted to the HASU. Despite moving from a selected to nonselected admission pattern, thrombolysis rates increased from 6% to 9%. High satisfaction rates were reported among both patients and carers. Patients discharged directly home had higher satisfaction levels than those requiring repatriation to their local stroke unit, who were older and had more severe stroke. A total of 47% of carers expressed anxiety over the repatriation from the HASU back to the local stroke recovery unit, but few patients and carers reported an impact of this move on patient recovery. Centralized HASU care is associated with good levels of patient and carer satisfaction.

Hepatotoxicity by Drugs: The Most Common Implicated Agents

PubMed Central

Björnsson, Einar S.

2016-01-01

Idiosyncratic drug-induced liver injury (DILI) is an underreported and underestimated adverse drug reaction. Information on the documented hepatotoxicity of drugs has recently been made available by a website that can be accessed in the public domain: LiverTox (http://livertox.nlm.nih.gov). According to critical analysis of the hepatotoxicity of drugs in LiverTox, 53% of drugs had at least one case report of convincing reports of liver injury. Only 48 drugs had more than 50 case reports of DILI. Amoxicillin-clavulanate is the most commonly implicated agent leading to DILI in the prospective series. In a recent prospective study, liver injury due to amoxicillin-clavulanate was found to occur in approximately one out of 2300 users. Drugs with the highest risk of DILI in this study were azathioprine and infliximab. PMID:26861310

Prospective of groundwater overexploitation through participatory approaches: Saiss Plain in Morocco

NASA Astrophysics Data System (ADS)

Ameur, Fatah; Lejars, Caroline; Dionnet, Mathieu; Quarouch, Hassan; Kuper, Marcel

2015-04-01

In the Saiss plain, groundwater overexploitation is often explained by two phenomena. The first one is a natural phenomenon (droughts), which seems therefore uncontrollable; the other one is human as groundwater is largely used by the agricultural sector. The main issue of groundwater governance is to find an acceptable balance in the use of the water resource without compromising the socio-economic development generated by this resource. Our study aims to contribute to understanding the differential contribution of different categories of groundwater users and the socio-economic and agrarian dynamics impacted by the overuse of groundwater. We adopted a participatory approach to explore with the different actors involved in the management and use of groundwater to identify the different viewpoints on the issue of overexploitation and to engage prospective and collective thinking of present situation of groundwater overexploitation. We organized multi-stakeholder workshops and designed a role-playing game to identify and qualify the existing links between the water resource, and the economic and social dynamics in order to better understand the human behavior to economic and environmental crises and the adaptive strategies of farmers confronted with an increasingly scarce groundwater resource. Our results showed considerable differences in the viewpoints of different categories of farmers regarding overexploitation. Agricultural investors who arrived over the past 5 years in the area practicing arboriculture consider themselves modern farmers using precise and water-saving irrigation technologies (drip irrigation, especially) who cannot be blamed for overexploitation of groundwater resources. Lessees practicing horticulture put considerable pressure on water resources, but were not interested in debates on overexploitation and the sustainability of groundwater resources. In fact, they did not turn up for the workshops. Finally, the local small-scale farmers who have very limited access to groundwater due to declining groundwater tables were shown to be the most concerned about groundwater overexploitation, especially the youngsters. These results show that not only different categories of users contribute differently to groundwater overexploitation, but also the direct effects of overexploitation are asymmetrically supported by different categories of users. These results can thus provide the basis for a user-oriented debate on groundwater governance involving the different categories of users and public institutions, by making the differential contribution and impacts of groundwater overexploitation visible. Keywords: Participatory approaches, role-playing game, actors, groundwater, overexploitation, Morocco

SpecDB: The AAVSO’s Public Repository for Spectra of Variable Stars

NASA Astrophysics Data System (ADS)

Kafka, Stella; Weaver, John; Silvis, George; Beck, Sara

2018-01-01

SpecDB is the American Association of Variable Star Observers (AAVSO) spectral database. Accessible to any astronomer with the capability to perform spectroscopy, SpecDB provides an unprecedented scientific opportunity for amateur and professional astronomers around the globe. Backed by the Variable Star Index, one of the most utilized variable star catalogs, SpecDB is expected to become one of the world leading databases of its kind. Once verified by a team of expert spectroscopists, an observer can upload spectra of variable stars target easily and efficiently. Uploaded spectra can then be searched for, previewed, and downloaded for inclusion in publications. Close community development and involvement will ensure a user-friendly and versatile database, compatible with the needs of 21st century astrophysics. Observations of 1D spectra are submitted as FITS files. All spectra are required to be preprocessed for wavelength calibration and dark subtraction; Bias and flat are strongly recommended. First time observers are required to submit a spectrum of a standard (non-variable) star to be checked for errors in technique or equipment. Regardless of user validation, FITS headers must include several value cards detailing the observation, as well as information regarding the observer, equipment, and observing site in accordance with existing AAVSO records. This enforces consistency and provides necessary details for follow up analysis. Requirements are provided to users in a comprehensive guidebook and accompanying technical manual. Upon submission, FITS headers are automatically checked for errors and any anomalies are immediately fed back to the user. Successful candidates can then submit at will, including multiple simultaneous submissions. All published observations can be searched and interactively previewed. Community involvement will be enhanced by an associated forum where users can discuss observation techniques and suggest improvements to the database.

Oral bisphosphonate use and lung cancer incidence among postmenopausal women

PubMed Central

Tao, M H; Chen, S; Freudenheim, J L; Cauley, J A; Johnson, K C; Mai, X; Sarto, G E; Wakelee, H; Boffetta, P; Wactawski-Wende, J

2018-01-01

Abstract Background Bisphosphonates are common medications for the treatment of osteoporosis in older populations. Several studies, including the Women’s Health Initiative (WHI), have found inverse associations of bisphosphonate use with risk of breast and endometrial cancer, but little is known about its association with other common malignancies. The objective of this study was to evaluate the association of bisphosphonate use on the incidence of lung cancer in the WHI. Patients and methods The association between oral bisphosphonate use and lung cancer risk was examined in 151 432 postmenopausal women enrolled into the WHI in 1993–1998. At baseline and during follow-up, participants completed an inventory of regularly used medications including bisphosphonates. Results After a mean follow-up of 13.3 years, 2511 women were diagnosed with incident lung cancer. There was no evidence of a difference in lung cancer incidence between oral bisphosphonate users and never users (adjusted hazard ratio = 0.91; 95% confidence intervals, 0.80–1.04; P = 0.16). However, an inverse association was observed among those who were never smokers (hazard ratio = 0.57, 95% confidence interval, 0.39–0.84; P < 0.01). Conclusion In this large prospective cohort of postmenopausal women, oral bisphosphonate use was associated with significantly lower lung cancer risk among never smokers, suggesting bisphosphonates may have a protective effect against lung cancer. Additional studies are needed to confirm our findings. PMID:29617712

Substance use and misuse in burn patients: Testing the classical hypotheses of the interaction between post-traumatic symptomatology and substance use.

PubMed

Eiroa-Orosa, Francisco Jose; Giannoni-Pastor, Anna; Fidel-Kinori, Sara Guila; Argüello, José María

2016-01-01

The authors aimed to test whether the three classical hypotheses of the interaction between post-traumatic symptomatology and substance use (high risk of trauma exposure, susceptibility for post-traumatic symptomatology, and self-medication of symptoms), may be useful in the understanding of substance use among burn patients. Substance use data (nicotine, alcohol, cannabis, amphetamines, cocaine, opiates, and tranquilizers) and psychopathology measures among burn patients admitted to a burn unit and enrolled in a longitudinal observational study were analyzed. Lifetime substance use information (n = 246) was incorporated to analyses aiming to test the high risk hypothesis. Only patients assessed for psychopathology in a 6-month follow-up (n = 183) were included in prospective analyses testing the susceptibility and self-medication hypotheses. Regarding the high risk hypothesis, results show a higher proportion of heroin and tranquilizer users compared to the general population. Furthermore, in line with the susceptibility hypothesis, higher levels of symptomatology were found in lifetime alcohol, tobacco, and drug users during recovery. The self-medication hypothesis could be tested partially due to the hospital stay "cleaning" effect, but severity of symptoms was linked to the amount of caffeine, nicotine, alcohol, and cannabis use after discharge. It was found that the 3 classical hypotheses could be used to understand the link between traumatic experiences and substance use explaining different patterns of burn patient's risk for trauma exposure and emergence of symptomatology.

Week Long Topography Study of Young Adults Using Electronic Cigarettes in Their Natural Environment.

PubMed

Robinson, R J; Hensel, E C; Roundtree, K A; Difrancesco, A G; Nonnemaker, J M; Lee, Y O

2016-01-01

Results of an observational, descriptive study quantifying topography characteristics of twenty first generation electronic nicotine delivery system users in their natural environment for a one week observation period are presented. The study quantifies inter-participant variation in puffing topography between users and the intra-participant variation for each user observed during one week of use in their natural environment. Puff topography characteristics presented for each user include mean puff duration, flow rate and volume for each participant, along with descriptive statistics of each quantity. Exposure characteristics including the number of vaping sessions, total number of puffs and cumulative volume of aerosol generated from ENDS use (e-liquid aerosol) are reported for each participant for a one week exposure period and an effective daily average exposure. Significant inter-participant and intra-participant variation in puff topography was observed. The observed range of natural use environment characteristics is used to propose a set of topography protocols for use as command inputs to drive machine-puffed electronic nicotine delivery systems in a controlled laboratory environment.

Week Long Topography Study of Young Adults Using Electronic Cigarettes in Their Natural Environment

PubMed Central

Roundtree, K. A.; Difrancesco, A. G.; Nonnemaker, J. M.; Lee, Y. O.

2016-01-01

Results of an observational, descriptive study quantifying topography characteristics of twenty first generation electronic nicotine delivery system users in their natural environment for a one week observation period are presented. The study quantifies inter-participant variation in puffing topography between users and the intra-participant variation for each user observed during one week of use in their natural environment. Puff topography characteristics presented for each user include mean puff duration, flow rate and volume for each participant, along with descriptive statistics of each quantity. Exposure characteristics including the number of vaping sessions, total number of puffs and cumulative volume of aerosol generated from ENDS use (e-liquid aerosol) are reported for each participant for a one week exposure period and an effective daily average exposure. Significant inter-participant and intra-participant variation in puff topography was observed. The observed range of natural use environment characteristics is used to propose a set of topography protocols for use as command inputs to drive machine-puffed electronic nicotine delivery systems in a controlled laboratory environment. PMID:27736944

Genomic and Systems Biology Analyses of Social Behavior or Evolutionary Genomic Analyses of Insect Society: Eat, Drink, and Be Scary (2011 JGI User Meeting)

ScienceCinema

Robinson, Gene

2018-02-05

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, CA. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Gene Robinson of the University of Illinois on Genomic and Systems Biology Analyses of Social Behavior at the 6th Annual Genomics of Energy & Environment Meeting on March 23, 2011.

Performance interface document for users of Tracking and Data Relay Satellite System (TDRSS) electromechanically steered antenna systems (EMSAS)

NASA Technical Reports Server (NTRS)

Hockensmith, R.; Devine, E.; Digiacomo, M.; Hager, F.; Moss, R.

1983-01-01

Satellites that use the NASA Tracking and Data Relay Satellite System (TDRSS) require antennas that are crucial for performing and achieving reliable TDRSS link performance at the desired data rate. Technical guidelines are presented to assist the prospective TDRSS medium-and high-data rate user in selecting and procuring a viable, steerable high-gain antenna system. Topics addressed include the antenna gain/transmitter power/data rate relationship; Earth power flux-density limitations; electromechanical requirements dictated by the small beam widths, desired angular coverage, and minimal torque disturbance to the spacecraft; weight and moment considerations; mechanical, electrical and thermal interfaces; design lifetime failure modes; and handling and storage. Proven designs are cited and space-qualified assemblies and components are identified.

The Turn-on of LCLS: the X-Ray Free Electron Laser at SLAC ( Keynote - 2011 JGI User Meeting)

ScienceCinema

Drell, Persis [SLAC National Accelerator Lab., Menlo Park, CA (United States)

2018-06-15

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. SLAC National Laboratory Director Persis Drell gives a keynote talk on "The Turn-on of LCLS: the X-Ray Free-Electron Laser at SLAC" at the 6th Genomics of Energy & Environment Meeting on March 22, 2011

Regulatory Networks Controlling Plant Cold Acclimation or Low Temperature Regulatory Networks Controlling Cold Acclimation in Arabidopsis (2011 JGI User Meeting)

ScienceCinema

Thomashow, Mike

2018-02-06

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Mike Thomashow of Michigan State University gives a presentation on on "Low Temperature Regulatory Networks Controlling Cold Acclimation in Arabidopsis" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011."

Measuring youth exposure to alcohol marketing on social networking sites: challenges and prospects.

PubMed

Jernigan, David H; Rushman, Anne E

2014-02-01

Youth exposure to alcohol marketing has been linked to increased alcohol consumption and problems. On relatively new and highly interactive social networking sites (SNS) that are popular with youth, tools for measuring youth exposure to alcohol marketing in traditional media are inadequate. We critically review the existing policies of Facebook, Twitter, and YouTube designed to keep branded alcohol content away from underage youth. Looking at brand and user activity on Facebook for the 15 alcohol brands most popular among US youth, we found activity has grown dramatically in the past 3 years, and underage users may be accounting for some of this activity. Surveys of youth and adult participation in alcohol marketing on SNS will be needed to inform debate over these marketing practices.

Association Genetics of Populus trichocarpa or Resequencing in Populus: Towards Genome Wide Association Genetics (2011 JGI User Meeting)

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

Tuskan, Gerry

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Gerry Tuskan of Oak Ridge National Laboratory on Resequencing in Populus: Towards Genome Wide Association Geneticsmore » at the 6th annual Genomics of Energy Environment Meeting on March 23, 2011.« less

Host Genetic Control of the Microbiome in Humans and Maize or Relating Host Genetic Variation to the Microbiome (2011 JGI User Meeting)

ScienceCinema

Ley, Ruth E. [Cornell Univ., Ithaca, NY (United States). Cornell Center for Comparative and Population Genomics, Dept. of Microbiology and Dept. of Molecular Biology and Genetics

2018-06-27

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy and Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Ruth Ley of Cornell University gives a presentation on "Relating Host Genetic Variation to the Microbiome" at the 6th annual Genomics of Energy and Environment Meeting on March 23, 2011.

What Do Our Users Want? Perspectives on Understanding and Meeting User Needs for Multi-Mission Data Services

NASA Technical Reports Server (NTRS)

McGuire, Robert E.; Candey, Robert M.; Bilitza, D.

2006-01-01

The Sun-Earth Connection Active Archive (SECAA) project of NASA's Space Physics Data Facility operates a range of unique and heavily used multi-mission data services in support of the large-scale science objectives of the Great Observatory, including services such as CDAWeb, the CDAWeb Plus client, SSCWeb, OMNIweb and the CDF data format. In developing and operating these services, we have encountered and continue to struggle with a wide range of issues such as balancing scope and functionality with simplicity and ease of use, understanding the effectiveness of our choices and identifying areas most important for further improvement. In this paper, we will review our key services and then discuss some of our observations and new approaches to understanding and meeting user data service requirements. Some observations are obvious but may still have substantial implications; e.g. functionality without information content is of little user interest, which has led to our recent emphasis on development of web services interfaces, so the content and functionality we already serve is readily and fully available as a building block for new services. Some observations require careful design and tradeoffs; e.g. users will complain when they are offered interfaces with limited options but users are also easily intimidated and become lost when offered extensive options for customization. Some observations remain highly challenging; e.g. a comprehensive multi-mission, multi-source view of all data and services available easily produces a daunting list, but a more selective view can easily lead users to overlook available and relevant data. It is often difficult to obtain and meaningfully interpret measures of true productive usage and overall user satisfaction, even with a variety of techniques including statistics, citations, case studies, user feedback and advisory committees. Most of these issues will apply to and may even be more acute for distributed implementation architectures.

Following Experts at Work in Their Own Information Spaces: Using Observational Methods To Develop Tools for the Digital Library.

ERIC Educational Resources Information Center

Gorman, Paul; Lavelle, Mary; Delcambre, Lois; Maier, David

2002-01-01

Offers an overview of the authors' experience using several observational methods to better understand one class of users, expert clinicians treating patients in hospital settings. Shows the evolution of understanding of the users and their information-handling tasks based on observations made in the field by a multidisciplinary research team, and…

Rates of bone loss among women initiating antidepressant medication use in midlife.

PubMed

Diem, Susan J; Ruppert, Kristine; Cauley, Jane A; Lian, YinJuan; Bromberger, Joyce T; Finkelstein, Joel S; Greendale, Gail A; Solomon, Daniel H

2013-11-01

Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. We conducted a prospective cohort study at five clinical centers in the United States. The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck.

Maintaining quality of health services after abolition of user fees: A Uganda case study

PubMed Central

Nabyonga-Orem, Juliet; Karamagi, Humphrey; Atuyambe, Lynn; Bagenda, Fred; Okuonzi, Sam A; Walker, Oladapo

2008-01-01

Background It has been argued that quality improvements that result from user charges reduce their negative impact on utilization especially of the poor. In Uganda, because there was no concrete evidence for improvements in quality of care following the introduction of user charges, the government abolished user fees in all public health units on 1st March 2001. This gave us the opportunity to prospectively study how different aspects of quality of care change, as a country changes its health financing options from user charges to free services, in a developing country setting. The outcome of the study may then provide insights into policy actions to maintain quality of care following removal of user fees. Methods A population cohort and representative health facilities were studied longitudinally over 3 years after the abolition of user fees. Quantitative and qualitative methods were used to obtain data. Parameters evaluated in relation to quality of care included availability of drugs and supplies and; health worker variables. Results Different quality variables assessed showed that interventions that were put in place were able to maintain, or improve the technical quality of services. There were significant increases in utilization of services, average drug quantities and stock out days improved, and communities reported health workers to be hardworking, good and dedicated to their work to mention but a few. Communities were more appreciative of the services, though expectations were lower. However, health workers felt they were not adequately motivated given the increased workload. Conclusion The levels of technical quality of care attained in a system with user fees can be maintained, or even improved without the fees through adoption of basic, sustainable system modifications that are within the reach of developing countries. However, a trade-off between residual perceptions of reduced service quality, and the welfare gains from removal of user fees should guide such a policy change. PMID:18471297

Industrial Wireless Sensors: A User's Perspective on the Impact of Standards on Wide-spread Deployment

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

Taft, Cyrus W.; Manges, Wayne W; Sorge, John N

2012-01-01

The role of wireless sensing technologies in industrial instrumentation will undoubtedly become more important in the years ahead. . Deployment of such instrumentation in an industrial setting with its heightened security and robustness criteria hinges on user acceptance of verified performance as well as meeting cost requirements. Today, industrial users face many choices when specifying a wireless sensor network, including radio performance, battery life, interoperability, security, and standards compliance. The potential market for industrial wireless sensors is literally millions of wireless instruments and it is imperative that accurate information for applying the technology to real-world applications be available to themore » end-user so that they can make informed deployment decisions. The majority of industrial wireless automation designs now being deployed or being considered for deployment are based on three different standards . The HART Communications Foundation s WirelessHART (IEC 62591), the International Society of Automation s ISA100.11a, and the offering from the Industrial Wireless Alliance of China known as WIA-PA (IEC 62601). Aside from these industrial automation standards, users must also be cognizant of the underlying wireless network standards IEEE 802.11, IEEE 802.15.4, and IEEE 802.15.3a and their interactions with the three principal industrial automation protocols mentioned previously. The crucial questions being asked by end users revolve around sensor network performance, interoperability, reliability, and security. This paper will discuss potential wireless sensor applications in power plants, barriers to the acceptance of wireless technology, concerns related to standards, and provide an end user prospective on the issues affecting wide-spread deployment of wireless sensors. Finally, the authors conclude with a discussion of a recommended path forward including how standards organizations can better facilitate end user decision making and how end users can locate and use objective information for decision making.« less

Radar Spectrum Engineering and Management (Ingenierie et gestion du spectre radar)

DTIC Science & Technology

2017-04-01

geophysical monitoring of Earth resources from space, automotive safety , severe weather tracking, and surveillance for defence and security. Nearly...With regard to curtailing adjacent-band spectral regrowth of radar emissions, for obvious reasons of national security and public safety , the precise...generated in adjacent bands. It is important, in the interests of safety as well as those of prospective users of the frequency bands 2,500 – 2,690

Work Distribution in a Fully Distributed Processing System.

DTIC Science & Technology

1982-01-01

Institute of Technology Atlanta, Georgia 30332 THE VIEW, OPINIONS, AND/OR FINDINGS CONTAINED IN THIS REPORT ARE THOSE OF THE AUTHOR AND SHOULD NOT BE...opinions, and/or findings contained in this report are those of the author and should not be construed as an official Department of the Navy position...SECTIONO1 Distributed data processing systems are currently being studied by researchers and prospective users because of their potential for improvements

A web service framework for astronomical remote observation in Antarctica by using satellite link

NASA Astrophysics Data System (ADS)

Jia, M.-h.; Chen, Y.-q.; Zhang, G.-y.; Jiang, P.; Zhang, H.; Wang, J.

2018-07-01

Many telescopes are deployed in Antarctica as it offers excellent astronomical observation conditions. However, because Antarctica's environment is harsh to humans, remote operation of telescope is necessary for observation. Furthermore, communication to devices in Antarctica through satellite link with low bandwidth and high latency limits the effectiveness of remote observation. This paper introduces a web service framework for remote astronomical observation in Antarctica. The framework is based on Python Tornado. RTS2-HTTPD and REDIS are used as the access interface to the telescope control system in Antarctica. The web service provides real-time updates through WebSocket. To improve user experience and control effectiveness under the poor satellite link condition, an agent server is deployed in the mainland to synchronize the Antarctic server's data and send it to domestic users in China. The agent server will forward the request of domestic users to the Antarctic master server. The web service was deployed and tested on Bright Star Survey Telescope (BSST) in Antarctica. Results show that the service meets the demands of real-time, multiuser remote observation and domestic users have a better experience of remote operation.

Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures.

PubMed

Lindegård, A; Karlberg, C; Wigaeus Tornqvist, E; Toomingas, A; Hagberg, M

2005-05-01

The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures.

Single-Incision Multiport/Single Port Laparoscopic Abdominal Surgery (SILAP): A Prospective Multicenter Observational Quality Study.

PubMed

Mantke, Rene; Diener, Markus; Kropf, Siegfried; Otto, Ronny; Manger, Thomas; Vestweber, Boris; Mirow, Lutz; Winde, Günther; Lippert, Hans

2016-09-07

Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist. This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients' perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making. The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period. Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year). This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful. German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http://www.webcitation.org/6jK6ZVyUs).

Dynamic image fusion and general observer preference

NASA Astrophysics Data System (ADS)

Burks, Stephen D.; Doe, Joshua M.

2010-04-01

Recent developments in image fusion give the user community many options for ways of presenting the imagery to an end-user. Individuals at the US Army RDECOM CERDEC Night Vision and Electronic Sensors Directorate have developed an electronic system that allows users to quickly and efficiently determine optimal image fusion algorithms and color parameters based upon collected imagery and videos from environments that are typical to observers in a military environment. After performing multiple multi-band data collections in a variety of military-like scenarios, different waveband, fusion algorithm, image post-processing, and color choices are presented to observers as an output of the fusion system. The observer preferences can give guidelines as to how specific scenarios should affect the presentation of fused imagery.

Anabolic Androgenic Steroids—Use and Correlates among Gym Users—An Assessment Study Using Questionnaires and Observations at Gyms in the Stockholm Region

PubMed Central

Leifman, Håkan; Rehnman, Charlotta; Sjöblom, Erika; Holgersson, Stefan

2011-01-01

The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods. PMID:21845151

Who Tweets? Deriving the Demographic Characteristics of Age, Occupation and Social Class from Twitter User Meta-Data

PubMed Central

Sloan, Luke; Morgan, Jeffrey; Burnap, Pete; Williams, Matthew

2015-01-01

This paper specifies, designs and critically evaluates two tools for the automated identification of demographic data (age, occupation and social class) from the profile descriptions of Twitter users in the United Kingdom (UK). Meta-data data routinely collected through the Collaborative Social Media Observatory (COSMOS: http://www.cosmosproject.net/) relating to UK Twitter users is matched with the occupational lookup tables between job and social class provided by the Office for National Statistics (ONS) using SOC2010. Using expert human validation, the validity and reliability of the automated matching process is critically assessed and a prospective class distribution of UK Twitter users is offered with 2011 Census baseline comparisons. The pattern matching rules for identifying age are explained and enacted following a discussion on how to minimise false positives. The age distribution of Twitter users, as identified using the tool, is presented alongside the age distribution of the UK population from the 2011 Census. The automated occupation detection tool reliably identifies certain occupational groups, such as professionals, for which job titles cannot be confused with hobbies or are used in common parlance within alternative contexts. An alternative explanation on the prevalence of hobbies is that the creative sector is overrepresented on Twitter compared to 2011 Census data. The age detection tool illustrates the youthfulness of Twitter users compared to the general UK population as of the 2011 Census according to proportions, but projections demonstrate that there is still potentially a large number of older platform users. It is possible to detect “signatures” of both occupation and age from Twitter meta-data with varying degrees of accuracy (particularly dependent on occupational groups) but further confirmatory work is needed. PMID:25729900

Chronic nephropathies of cocaine and heroin abuse: a critical review.

PubMed

Jaffe, Jared A; Kimmel, Paul L

2006-07-01

Renal disease in cocaine and heroin users is associated with the nephrotic syndrome, acute glomerulonephritis, amyloidosis, interstitial nephritis, and rhabdomyolysis. The pathophysiologic basis of cocaine-related renal injury involves renal hemodynamic changes, glomerular matrix synthesis and degradation, and oxidative stress and induction of renal atherogenesis. Heroin is the most commonly abused opiate in the United States. Previous studies identified a spectrum of renal diseases in heroin users. The predominant renal lesion in black heroin users is focal segmental glomerulosclerosis and in white heroin users is membranoproliferative glomerulonephritis. Although the prevalence of heroin use in the United States has increased, the incidence of "heroin nephropathy" has declined. Because reports of heroin nephropathy predated the surveillance of hepatitis C virus and HIV, the varied findings might be related to the spectrum of viral illnesses that are encountered in injection drug users. Socioeconomic conditions, cultural and behavioral practices, or differences in genetic susceptibilities may be more associated with the development of nephropathy in heroin users than the drug's pharmacologic properties. Administration of cocaine in animal models results in nonspecific glomerular, interstitial, and tubular cell lesions, but there is no animal model of heroin-associated renal disease. The heterogeneity of responses that are associated with heroin is not consistent with a single or simple notion of nephropathogenesis. There are no well-designed, prospective, epidemiologic studies to assess the incidence and the prevalence of renal disease in populations of opiate users and to establish the validity of a syndrome such as heroin nephropathy. It is concluded although there is a paucity of evidence to support a heroin-associated nephropathy, the evidence from in vitro cellular and animal studies to support the existence of cocaine-induced renal changes is more convincing.

Transmissibility of the Campaign for Colorectal Cancer Awareness in Korea Among Twitter Users

PubMed Central

Lee, Keun Chul; Park, Gibeom; Park, SoHyun; Bae, Woo Kyung; Kim, Jin Won; Yoon, Hyuk; Kim, Myung Jo; Kang, Sung-Il; Son, Il Tae; Kim, Duck-Woo; Kang, Sung-Bum

2016-01-01

Purpose The Korean Society of Coloproctology holds its annual colorectal awareness month every September. This study analyzed the users and the contents of Korean tweets regarding colorectal cancer and estimated the transmissibility of the awareness campaign among Twitter users. Methods Prospective data collection was employed to accumulate Korean tweets containing the keywords "colorectal cancer," "colorectal cancer awareness campaign," "gold ribbon," and/or "love handle," from August 1 to September 30, 2014. Twitter users and contents were analyzed, and the credibility of information-sharing tweets throughout the study period was evaluated. Results In total, 10,387 tweets shared by 1,452 unique users were analyzed. As for users, 57.8% were individuals whereas 5.8% were organizations/communities; spambots accounted for a considerable percentage (36.4%). As for content, most tweets were spam (n = 8,736, 84.1%), repetitively advertising unverified commercial folk remedies, followed by tweets that shared information (n = 1,304, 12.6%) and non-information (n = 347, 3.3%). In the credibility assessment, only 80.6% of the information-sharing tweets were medically correct. After spam tweets had been excluded, a significant increase was seen in the percentage of information-sharing tweets (77.1% to 81.1%, P = 0.045) during the awareness campaign month. Conclusion Most Korean tweets regarding colorectal cancer during the study months were commercial spam tweets; informative public tweets accounted for an extremely small percentage. The transmissibility of the awareness campaign among Twitter users was questionable at best. To expand the reach of credible medical information on colorectal cancer, public health institutions and organizations must pay greater attention to social media. PMID:27847789

Body weight and body composition of depot medroxyprogesterone acetate users.

PubMed

Dal'Ava, Natália; Bahamondes, Luis; Bahamondes, M Valeria; Bottura, Bruna F; Monteiro, Ilza

2014-08-01

Weight gain is a concern with the contraceptive depot-medroxyprogesterone acetate (DMPA); however, this issue remains controversial. The objective of this study was to compare body weight (BW) and body composition (BC) in DMPA and copper intrauterine device (IUD) users at baseline and after one year of use. We enrolled new DMPA users and age and weight matched new IUD users into this prospective study. Weight and height were measured, BC (fat and lean mass) was evaluated using dual-energy X-ray absorptiometry, and physical activity was assessed at baseline and at 12 months. Student's paired t test and the Wilcoxon paired test for matched samples were used. Ninety-seven women were enrolled for the study; 26 matched pairs continued using the initial method for at least one year, and completed the baseline and 12 month assessments. An increase of 1.9 kg occurred in BW (p=.02) in DMPA users at 12 months of use, resulting from an increase in fat mass of 1.6 kg (p=.03). Weight remained stable in IUD users; however, there was an increase in lean mass at 12 months of use (p=.001). The number of women practicing physical activity increased in this group. There was a significant difference between the groups regarding the variation in the percentage of central fat (p=.04). Weight gain in the DMPA group after the first year of use resulted from an increase in fat mass. Weight remained stable in the IUD group; however, an increase in lean mass and a reduction in localized abdominal fat mass occurred, possibly because more users were practicing physical activity. There was a greater increase in body weight in DMPA users compared to TCu380A IUD users in the first year of use of the contraceptive method. Furthermore, the weight increase in users of DMPA occurred principally as the result of an increase in fat mass. Physical activity probably could increase the lean mass in the users of TCu380A IUD. Copyright © 2014 Elsevier Inc. All rights reserved.

Differences in harm from legal BZP/TFMPP party pills between North Island and South Island users in New Zealand: a case of effective industry self-regulation?

PubMed

Wilkins, Chris; Sweetsur, Paul

2010-01-01

'Party' pills containing benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) were sold legally in New Zealand until early 2008. Prospective studies of hospital emergency department admissions appeared to suggest that the harm from party pills was greater among South Island than North Island users. The party pill industry association (the Social Tonics Association of New Zealand or STANZ) claimed these differences were due to the voluntary code of practice adopted by their members in the North Island. The aims of this study were to examine differences in harm from party pills between North and South Island users in New Zealand, and to investigate possible reasons for any differences in harm, including the impact of industry self-regulation. A national household survey of BZP/TFMPP party pill use was conducted in New Zealand. Information on the ingredients of party pills was provided by the National Poisons Centre. In a number of instances last year users of party pills from the South Island were more likely than last year users from the North Island to report harm from party pills. There were no differences between the North and South Island users with regard to the mean number of BZP/TFMPP party pills taken, mean total milligrams of BZP/TFMPP ingested or prevalence of use of other drug types in combination with party pills. A minority of users in the South Island reported using extremely high numbers of BZP/TFMPP party pills in a single session and using extremely high potency brands of party pills. Last year party pill users from the South Island were more likely than those from the North Island to be students. A number of factors may have contributed to the greater harm from BZP/TFMPP party pills among South Island users including a higher proportion of student users with higher consumption of alcohol and other drugs. Users from both Islands commonly exceeded the dosage of BZP/TFMPP recommended by STANZ suggesting the STANZ code of conduct was largely ineffective.

Fatal road traffic injuries in Ibadan, using the mortuary as a data source.

PubMed

Eze, Uwom O; Kipsaina, Chebiwot Caroline; Ozanne-Smith, Joan

2013-12-01

Road Traffic Injury (RTI) in Africa represents 14% of global RTI deaths. Lack of timely, reliable data undermines road safety interventions. Available fatality data are aggregated, limited in detail or scarce in surveys. This is the first fatal RTI surveillance study in Nigeria. To pilot a systematic mortuary-based data collection in Ibadan, determine the nature and circumstances of fatal RTI and assess data quality against existing data sources. Using a draft data collection system developed jointly by WHO and Monash University, the detailed information was prospectively collected on RTI University College Hospital mortuary admissions in Ibadan September 2010 to February 2011. Demographics, road user type, counterpart vehicle, intent, manner and medical cause of death were recorded. Mortuary admissions included 80 fatal RTI cases: 81.3% males. By road user category, 28 (35.0%) were pedestrians; 28 (35.0%) motorised 2-wheeler users; 18.8% car occupants; and 11.3% bus occupants. In 70% of cases, medical cause of death was head injury, including 25 of 28 motorised 2-wheeler users (89.3%). Estimates from this study indicate apparent increased mortuary capture of fatal RTI compared with police data. This study demonstrates the feasibility of collecting detailed, timely RTI fatality data through mortuary-based surveillance in Ibadan. While not all RTI deaths are reported to any authority in Ibadan, this large case series complements existing data sources and suggests that pedestrians and motorised 2-wheeler users die most often in road traffic crashes. Frequent head injuries among motorised 2-wheeler users strongly support the need for helmet wearing interventions.

Patient reactions to a web-based cardiovascular risk calculator in type 2 diabetes: a qualitative study in primary care.

PubMed

Nolan, Tom; Dack, Charlotte; Pal, Kingshuk; Ross, Jamie; Stevenson, Fiona A; Peacock, Richard; Pearson, Mike; Spiegelhalter, David; Sweeting, Michael; Murray, Elizabeth

2015-03-01

Use of risk calculators for specific diseases is increasing, with an underlying assumption that they promote risk reduction as users become better informed and motivated to take preventive action. Empirical data to support this are, however, sparse and contradictory. To explore user reactions to a cardiovascular risk calculator for people with type 2 diabetes. Objectives were to identify cognitive and emotional reactions to the presentation of risk, with a view to understanding whether and how such a calculator could help motivate users to adopt healthier behaviours and/or improve adherence to medication. Qualitative study combining data from focus groups and individual user experience. Adults with type 2 diabetes were recruited through website advertisements and posters displayed at local GP practices and diabetes groups. Participants used a risk calculator that provided individualised estimates of cardiovascular risk. Estimates were based on UK Prospective Diabetes Study (UKPDS) data, supplemented with data from trials and systematic reviews. Risk information was presented using natural frequencies, visual displays, and a range of formats. Data were recorded and transcribed, then analysed by a multidisciplinary group. Thirty-six participants contributed data. Users demonstrated a range of complex cognitive and emotional responses, which might explain the lack of change in health behaviours demonstrated in the literature. Cardiovascular risk calculators for people with diabetes may best be used in conjunction with health professionals who can guide the user through the calculator and help them use the resulting risk information as a source of motivation and encouragement. © British Journal of General Practice 2015.

Understanding factors that influence smoking uptake

PubMed Central

Buller, D; Borland, R; Woodall, W; Hall, J; Burris-Woodall, P; Voeks, J

2003-01-01

Objective:To explore relationships between patterns of smoking uptake and social context and attitudinal variables. Design:Cross sectional survey. Setting:Public schools in Tucson, Arizona and Albuquerque, New Mexico. Participants:982 children in grades 6–9 (ages 11–15 years). Main outcome measures:Items measuring smoking history, nicotine dependence and quit attempts, susceptibility to smoking in the future, smoking norms, use of other tobacco products, attitudes toward smoking, and demographic characteristics. Results:Overall, 43% of children had smoked a cigarette and 57% had never used them. Ever smokers lived in social contexts with more smoking and where smoking was normative. Among never users, 25% are susceptible to smoking; these children have positive attitudes toward smoking, do not feel social pressure to stay off cigarettes, and had more friends who smoked. Among ever users, 36% were currently smoking in the past 30 days. Current users also lived in social context with more smoking and had positive attitudes toward smoking. Most users had tried to stop smoking. Only 9% of current users smoked daily; 29% had not smoked a whole cigarette. Greater cigarette consumption was associated with more favourable attitudes toward smoking. Most of past users were in early uptake: 95% had smoked less than 100 cigarettes but 49% were susceptible to smoking again. Conclusions:There is promise in differentiating subgroups among the never, past and current use of cigarettes. Susceptibility within each of these groups was associated with similar patterns of attitudes and social context. These patterns in smoking uptake need to be confirmed prospectively. PMID:14645936

Elderly benzodiazepine users at increased risk of activity limitations: influence of chronicity, indications, and duration of action--the three-city cohort.

PubMed

Carrière, Isabelle; Mura, Thibault; Pérès, Karine; Norton, Joanna; Jaussent, Isabelle; Edjolo, Arlette; Rouaud, Olivier; Berr, Claudine; Ritchie, Karen; Ancelin, Marie Laure

2015-08-01

To examine the cross-sectional and longitudinal associations between benzodiazepine use and daily activity limitations, according to drug indications and duration of action. Prospective cohort study. Population-based three-city study. 6,600 participants aged 65 years and over included between 1999 and 2001 and followed after 2, 4, and 7 years. Benzodiazepine users were separated into hypnotic, short-acting anxiolytic, and long-acting anxiolytic users and compared with non users. Three outcomes were examined assessing restrictions in mobility, instrumental activities of daily living (IADLs) and social participation. In multivariate simple or mixed logistic models adjusted for sociodemographic variables, impairments and comorbidity, and for anxiety, insomnia, and depression, hypnotic benzodiazepines were moderately associated with mobility limitation prevalence and IADL limitation incidence. Short-acting and long-acting anxiolytics were associated with IADL limitation prevalence and with mobility limitation prevalence and incidence and long-acting anxiolytics were also associated with IADL limitation incidence. Chronic benzodiazepines users were at a marked risk of developing restrictions for the three outcomes; odds ratio: 1.71 (95% CI: 1.23-2.39) for mobility, 1.54 (95% CI: 1.14-2.10) for IADL, and 1.74 (95% CI: 1.23-2.47) for participation limitations. Benzodiazepine users are at increased risk of activity limitations regardless of the duration of action or indication. Chronic use of benzodiazepines should be avoided in order to extend disability-free survival. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Associations Between Statin Use and Physical Function in Older Adults from The Netherlands and Australia: Longitudinal Aging Study Amsterdam and Australian Longitudinal Study on Women's Health.

PubMed

van Boheemen, Laurette; Tett, Susan E; Sohl, Evelien; Hugtenburg, Jacqueline G; van Schoor, Natasja M; Peeters, G M E E

2016-06-01

Statin therapy may cause myopathy, but long-term effects on physical function are unclear. We investigated whether statin use is associated with poorer physical function in two population-based cohorts of older adults. Data were from 691 men and women (aged 69-102 years in 2005/2006) in the LASA (Longitudinal Aging Study Amsterdam) and 5912 women (aged 79-84 years in 2005) in the ALSWH (Australian Longitudinal Study on Women's Health). Statin use and dose were sourced from containers (LASA) and administrative databases (ALSWH). Physical function was assessed using performance tests, questionnaires on functional limitations and the SF-12 (LASA) and SF-36 (ALSWH) questionnaires. Cross-sectional (both studies) and 3-year prospective associations (ALSWH) were analysed for different statin dosage using linear and logistic regression. In total, 25 % of participants in LASA and 61 % in ALSWH used statins. In the cross-sectional models in LASA, statin users were less likely to have functional limitations (percentage of subjects with at least 1 limitation 63.9 vs. 64.2; odds ratio [OR] 0.6; 95 % confidence interval [CI] 0.3-0.9) and had better SF-12 physical component scores (mean [adjusted] 47.3 vs. 44.5; beta [B] = 2.8; 95 % CI 1.1-4.5); in ALSWH, statin users had better SF-36 physical component scores (mean [adjusted] 37.4 vs. 36.5; B = 0.9; 95 % CI 0.3-1.5) and physical functioning subscale scores (mean [adjusted] 55.1 vs. 52.6; B = 2.4; 95 % CI 1.1-3.8) than non-users. Similar associations were found for low- and high-dose users and in the prospective models. In contrast, no significant associations were found with performance tests. Two databases from longitudinal population studies in older adults gave comparable results, even though different outcome measures were used. In these two large cohorts, statin use was associated with better self-perceived physical function.

Interstate Variation in the Use of Fees To Fund K-12 Public Education.

ERIC Educational Resources Information Center

Wassmer, Robert W.; Fisher, Ronald C.

2002-01-01

Reviews state reliance of various user fees in public education; discusses conceptual issues regarding the use of school district user charges; analyzes statewide variations in school district user charges; suggests reasons for observed variations. (Contains 25 references.) (PKP)

Healthcare costs and utilization associated with high-risk prescription opioid use: a retrospective cohort study.

PubMed

Chang, Hsien-Yen; Kharrazi, Hadi; Bodycombe, Dave; Weiner, Jonathan P; Alexander, G Caleb

2018-05-16

Previous studies on high-risk opioid use have only focused on patients diagnosed with an opioid disorder. This study evaluates the impact of various high-risk prescription opioid use groups on healthcare costs and utilization. This is a retrospective cohort study using QuintilesIMS health plan claims with independent variables from 2012 and outcomes from 2013. We included a population-based sample of 191,405 non-elderly adults with known sex, one or more opioid prescriptions, and continuous enrollment in 2012 and 2013. Three high-risk opioid use groups were identified in 2012 as (1) persons with 100+ morphine milligram equivalents per day for 90+ consecutive days (chronic users); (2) persons with 30+ days of concomitant opioid and benzodiazepine use (concomitant users); and (3) individuals diagnosed with an opioid use disorder. The length of time that a person had been characterized as a high-risk user was measured. Three healthcare costs (total, medical, and pharmacy costs) and four binary utilization indicators (the top 5% total cost users, the top 5% pharmacy cost users, any hospitalization, and any emergency department visit) derived from 2013 were outcomes. We applied a generalized linear model (GLM) with a log-link function and gamma distribution for costs while logistic regression was employed for utilization indicators. We also adopted propensity score weighting to control for the baseline differences between high-risk and non-high-risk opioid users. Of individuals with one or more opioid prescription, 1.45% were chronic users, 4.81% were concomitant users, and 0.94% were diagnosed as having an opioid use disorder. After adjustment and propensity score weighting, chronic users had statistically significant higher prospective total (40%), medical (3%), and pharmacy (172%) costs. The increases in total, medical, and pharmacy costs associated with concomitant users were 13%, 7%, and 41%, and 28%, 21% and 63% for users with a diagnosed opioid use disorder. Both total and pharmacy costs increased with the length of time characterized as high-risk users, with the increase being statistically significant. Only concomitant users were associated with a higher odds of hospitalization or emergency department use. Individuals with high-risk prescription opioid use have significantly higher healthcare costs and utilization than their counterparts, especially those with chronic high-dose opioid use.

Chronic cocaine but not chronic amphetamine use is associated with perseverative responding in humans

PubMed Central

Roiser, Jonathan P.; Robbins, Trevor W.; Sahakian, Barbara J.

2013-01-01

Rationale Chronic drug use has been associated with increased impulsivity and maladaptive behaviour, but the underlying mechanisms of this impairment remain unclear. We investigated the ability to adapt behaviour according to changes in reward contingencies, using a probabilistic reversal-learning task, in chronic drug users and controls. Materials and methods Five groups were compared: chronic amphetamine users (n = 30); chronic cocaine users (n = 27); chronic opiate users (n = 42); former drug users of psychostimulants and opiates (n = 26); and healthy non-drug-taking control volunteers (n = 25). Participants had to make a forced choice between two alternative stimuli on each trial to acquire a stimulus–reward association on the basis of degraded feedback and subsequently to reverse their responses when the reward contingencies changed. Results Chronic cocaine users demonstrated little behavioural change in response to the change in reward contingencies, as reflected by perseverative responding to the previously rewarded stimulus. Perseverative responding was observed in cocaine users regardless of whether they completed the reversal stage successfully. Task performance in chronic users of amphetamines and opiates, as well as in former drug users, was not measurably impaired. Conclusion Our findings provide convincing evidence for response perseveration in cocaine users during probabilistic reversal-learning. Pharmacological differences between amphetamine and cocaine, in particular their respective effects on the 5-HT system, may account for the divergent task performance between the two psychostimulant user groups. The inability to reverse responses according to changes in reinforcement contingencies may underlie the maladaptive behaviour patterns observed in chronic cocaine users but not in chronic users of amphetamines or opiates. PMID:18214445

Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study.

PubMed

Fagherazzi, Guy; Gusto, Gaëlle; Affret, Aurélie; Mancini, Francesca Romana; Dow, Courtney; Balkau, Beverley; Clavel-Chapelon, Françoise; Bonnet, Fabrice; Boutron-Ruault, Marie-Christine

2017-01-01

The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary. We used data from 61,440 women in the prospective E3N-European Prospective Investigation into Cancer and Nutrition study, conducted between 1993 and 2011. We estimated hazards ratios (HRs) and 95% CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets. Compared to "never or rare" consumers of artificial sweeteners, those using them "always or almost always" had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI). Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users (HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively). Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity. A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes. © 2017 S. Karger AG, Basel.

Crack Cocaine Use and its Relationship with Violence and Hiv

PubMed Central

de Carvalho, Heraclito Barbosa; Seibel, Sergio Dario

2009-01-01

OBJECTIVES To evaluate crack cocaine use practices, risk behaviors associated with HIV infection among drug users, and their involvement with violence. INTRODUCTION HIV infections are frequent among drug users due to risky sexual behavior. It is generally accepted that crack cocaine use is related to increased levels of violence. Several reports point to an increase in violence from those involved in drug trafficking. Although HIV infections and risky sexual behavior among drug users have been quite well studied, there are few studies that evaluate violence as it relates to drugs, particularly crack. METHODS A total of 350 drug users attending drug abuse treatment clinics in São Paulo, Brazil were interviewed about their risky behaviors. Each patient had a serological HIV test done. RESULTS HIV prevalence was 6.6% (4.0 to 10.2). Violence was reported by 97% (94.7 to 99.1) of the subjects (including cases without personal involvement). Acts of violence such as verbal arguments, physical fights, threats, death threats, theft, and drug trafficking were significantly higher among crack users. A decrease in frequency of sexual intercourse was observed among users of injected drugs, though prostitution was observed as a means of obtaining drugs. A high number of crack cocaine users had a history of previous imprisonment, many for drug-related infractions. DISCUSSION The data presented are in accordance with other reports in the literature, and they show a correlation between drug use, imprisonment, violence, and drug trafficking. CONCLUSION A high HIV prevalence and associated risky sexual behaviors were observed among crack cocaine users. The society and the authorities that deal with violence related to crack users and drug trafficking should be aware of these problems. PMID:19759879

Use of Google Scholar public profiles in orthopedics.

PubMed

Tetsworth, Kevin; Fraser, Dave; Glatt, Vaida; Hohmann, Erik

2017-01-01

The purpose of this study was to survey the growth of Google Scholar public profiles in orthopedics over a 12-month period and to investigate global patterns. Data was prospectively acquired from June 2013 to June 2014. Google Scholar queries specific to orthopedic surgery were performed at 90-day intervals. Demographic aspects of each user were also compiled, including gender, current location, and primary interests. To determine differences between the growth of Google Scholar public profile registrations and citation counts, as well as differences in growth in different regions, repeated measures of analysis of variance (RMANOVA) were used. RMANOVA revealed statistically significant differences ( p = 0.0001) for regional growth. The largest growth was observed in the United Kingdom ( p = 0.009, 289%), followed by the Asia-Pacific region ( p = 0.004, 177%) and "Other" ( p = 0.006, 172%). The mean growth per 90-day interval is 19.9% ( p = 0.003) and the mean 12-month growth is 107% ( p = 0.05). Statistically significant differences between gender (male vs. female) and basic and clinical sciences ( χ 2 = 22.4, p = 0.0001) were observed. This study suggests an exponential growth in the number of authors in the field of orthopedic surgery creating a Google Scholar public profile, and at the current rate participation doubles every 10.6 months.

Knowledge retrieval as one type of knowledge-based decision support in medicine: results of an evaluation study.

PubMed

Haux, R; Grothe, W; Runkel, M; Schackert, H K; Windeler, H J; Winter, A; Wirtz, R; Herfarth, C; Kunze, S

1996-04-01

We report on a prospective, prolective observational study, supplying information on how physicians and other health care professionals retrieve medical knowledge on-line within the Heidelberg University Hospital information system. Within this hospital information system, on-line access to medical knowledge has been realised by installing a medical knowledge server in the range of about 24 GB and by providing access to it by health care professional workstations in wards, physicians' rooms, etc. During the study, we observed about 96 accesses per working day. The main group of health care professionals retrieving medical knowledge were physicians and medical students. Primary reasons for its utilisation were identified as support for the users' scientific work (50%), own clinical cases (19%), general medical problems (14%) and current clinical problems (13%). Health care professionals had accesses to medical knowledge bases such as MEDLINE (79%), drug bases ('Rote Liste', 6%), and to electronic text books and knowledge base systems as well. Sixty-five percent of accesses to medical knowledge were judged to be successful. In our opinion, medical knowledge retrieval can serve as a first step towards knowledge processing in medicine. We point out the consequences for the management of hospital information systems in order to provide the prerequisites for such a type of knowledge retrieval.

Hospital separations for cannabis- and methamphetamine-related psychotic episodes in Australia.

PubMed

Degenhardt, Louisa; Roxburgh, Amanda; McKetin, Rebecca

2007-04-02

To examine trends in hospital separations related to "drug-induced" psychosis for cannabis and methamphetamine, in the context of patterns of cannabis and methamphetamine use in the Australian population. Analysis of prospectively collected data from the National Hospital Morbidity Database on hospital separations primarily attributed to drug-induced psychosis (July 1993 - June 2004), and specifically for cannabis and amphetamines (1999-2004). Calculation of Australian population-adjusted rates of drug-induced psychosis hospital separations using estimated resident population data from the Australian Bureau of Statistics (at 30 June each year) and data on cannabis and methamphetamine use from the 2004 National Drug Strategy Household Survey. Number of hospital separations due to drug-induced psychosis, and standardised (age-specific) rates per million population and per million users. There have been notable increases in hospital separations due to drug-induced psychosis, which appear to have been driven by amphetamine-related rather than cannabis-related episodes. The rate of hospital separations was higher for amphetamine users than for cannabis users in all age groups, and the rate increased among older amphetamine users. The risk of hospitalisation for a drug-induced psychotic episode associated with amphetamine use appears to be greater than that for cannabis use in all age groups.

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis.

PubMed

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2017-07-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

PubMed Central

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2018-01-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care. PMID:27856941

Serum copper levels in users of multiload intra-uterine contraceptive devices.

PubMed

Arowojolu, A O; Otolorin, E O; Ladipo, O A

1989-12-01

The systemic absorption of copper incorporated into multiload intra-uterine contraceptive devices (IUDs), as indicated by serum copper levels in users of such devices, was assessed in a prospective longitudinal study. One hundred and ten healthy Nigerian women using either multiload copper 250 (MLCU 250) or multiload copper 375 (MLCU 375) IUDs participated in the study. Their serum copper levels were estimated serially during 12 months of continuous use of the devices. The mean (+/- s.e.m.) pre-insertion serum copper levels of our subjects using MLCU 250 (17.0 +/- 3 mumol/l) and MLCU 375 (16.7 +/- 0.5 mumol/l) were found to be lower than those reported in Americans (22.2 mumol/l) and in Germans (20.2 mumol/l), although similar to levels in Indians (17.0 mumol/l). There was no significant difference in the mean serum copper levels estimated before and after 1 month of continuous use of the device. Serial estimations of the serum copper levels in users showed that there was no alteration in these levels after a period of 12 months of continuous IUD use. We therefore conclude that the copper incorporated into multiload IUDs appears not to influence the concentration of serum copper of users.

Towards elicitation of users requirements for hospital information system: from a care process modelling technique to a web based collaborative tool.

PubMed Central

Staccini, Pascal M.; Joubert, Michel; Quaranta, Jean-Francois; Fieschi, Marius

2002-01-01

Growing attention is being given to the use of process modeling methodology for user requirements elicitation. In the analysis phase of hospital information systems, the usefulness of care-process models has been investigated to evaluate the conceptual applicability and practical understandability by clinical staff and members of users teams. Nevertheless, there still remains a gap between users and analysts in their mutual ability to share conceptual views and vocabulary, keeping the meaning of clinical context while providing elements for analysis. One of the solutions for filling this gap is to consider the process model itself in the role of a hub as a centralized means of facilitating communication between team members. Starting with a robust and descriptive technique for process modeling called IDEF0/SADT, we refined the basic data model by extracting concepts from ISO 9000 process analysis and from enterprise ontology. We defined a web-based architecture to serve as a collaborative tool and implemented it using an object-oriented database. The prospects of such a tool are discussed notably regarding to its ability to generate data dictionaries and to be used as a navigation tool through the medium of hospital-wide documentation. PMID:12463921

Motivational engagement in first-time hearing aid users: A feasibility study.

PubMed

Ferguson, Melanie; Maidment, David; Russell, Naomi; Gregory, Melanie; Nicholson, Richard

2016-07-01

To assess (1) the feasibility of incorporating the Ida Institute's Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures. A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute's Motivation Tools formed the basis for motivational engagement. First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users.

Cortical reorganization in postlingually deaf cochlear implant users: Intra-modal and cross-modal considerations.

PubMed

Stropahl, Maren; Chen, Ling-Chia; Debener, Stefan

2017-01-01

With the advances of cochlear implant (CI) technology, many deaf individuals can partially regain their hearing ability. However, there is a large variation in the level of recovery. Cortical changes induced by hearing deprivation and restoration with CIs have been thought to contribute to this variation. The current review aims to identify these cortical changes in postlingually deaf CI users and discusses their maladaptive or adaptive relationship to the CI outcome. Overall, intra-modal and cross-modal reorganization patterns have been identified in postlingually deaf CI users in visual and in auditory cortex. Even though cross-modal activation in auditory cortex is considered as maladaptive for speech recovery in CI users, a similar activation relates positively to lip reading skills. Furthermore, cross-modal activation of the visual cortex seems to be adaptive for speech recognition. Currently available evidence points to an involvement of further brain areas and suggests that a focus on the reversal of visual take-over of the auditory cortex may be too limited. Future investigations should consider expanded cortical as well as multi-sensory processing and capture different hierarchical processing steps. Furthermore, prospective longitudinal designs are needed to track the dynamics of cortical plasticity that takes place before and after implantation. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

A Survey on Renewable Energy Development in Malaysia: Current Status, Problems and Prospects

NASA Astrophysics Data System (ADS)

Alam, Syed Shah; Nor, Nor Fariza Mohd; Ahmad, Maisarah; Hashim, Nik Hazrul Nik

2016-05-01

Energy demand in Malaysia is increasing over seven per cent a year, while forty per cent of the energy is supplied from conventional fossil fuel. However, a number of social barriers have mired the social acceptance of renewable energy among the users. This study investigates the current status of renewable energy, problems and future outlook of renewable energy in Malaysia. A total of 200 respondents were surveyed from Klang Valley in Malaysia. Majority of the respondents use energy to generate electricity. Although some respondents reported using solar energy, there is lack of retail availability for solar energy. The findings show that limited information on renewable energy technologies, lack of awareness, and limited private sector engagement emerged as major barriers to sustainable renewable energy development. In addition, the respondents suggest for increasing policy support from the government to make information more accessible to mass users, provide economic incentives to investors and users, and promote small-community based renewable energy projects. The study suggests that the government begin small scale projects to build awareness on renewable energy, while academically, higher learning institutions include renewable energy syllabus in their academic curriculum. The study concluded that to have sustainable renewable energy development, government's initiative, private sector engagement and users awareness must be given priority.

Towards elicitation of users requirements for hospital information system: from a care process modelling technique to a web based collaborative tool.

PubMed

Staccini, Pascal M; Joubert, Michel; Quaranta, Jean-Francois; Fieschi, Marius

2002-01-01

Growing attention is being given to the use of process modeling methodology for user requirements elicitation. In the analysis phase of hospital information systems, the usefulness of care-process models has been investigated to evaluate the conceptual applicability and practical understandability by clinical staff and members of users teams. Nevertheless, there still remains a gap between users and analysts in their mutual ability to share conceptual views and vocabulary, keeping the meaning of clinical context while providing elements for analysis. One of the solutions for filling this gap is to consider the process model itself in the role of a hub as a centralized means of facilitating communication between team members. Starting with a robust and descriptive technique for process modeling called IDEF0/SADT, we refined the basic data model by extracting concepts from ISO 9000 process analysis and from enterprise ontology. We defined a web-based architecture to serve as a collaborative tool and implemented it using an object-oriented database. The prospects of such a tool are discussed notably regarding to its ability to generate data dictionaries and to be used as a navigation tool through the medium of hospital-wide documentation.

Hearing loss is negatively related to episodic and semantic long-term memory but not to short-term memory.

PubMed

Rönnberg, Jerker; Danielsson, Henrik; Rudner, Mary; Arlinger, Stig; Sternäng, Ola; Wahlin, Ake; Nilsson, Lars-Göran

2011-04-01

To test the relationship between degree of hearing loss and different memory systems in hearing aid users. Structural equation modeling (SEM) was used to study the relationship between auditory and visual acuity and different cognitive and memory functions in an age-hetereogenous subsample of 160 hearing aid users without dementia, drawn from the Swedish prospective cohort aging study known as Betula (L.-G. Nilsson et al., 1997). Hearing loss was selectively and negatively related to episodic and semantic long-term memory (LTM) but not short-term memory (STM) performance. This held true for both ears, even when age was accounted for. Visual acuity alone, or in combination with auditory acuity, did not contribute to any acceptable SEM solution. The overall relationships between hearing loss and memory systems were predicted by the ease of language understanding model (J. Rönnberg, 2003), but the exact mechanisms of episodic memory decline in hearing aid users (i.e., mismatch/disuse, attentional resources, or information degradation) remain open for further experiments. The hearing aid industry should strive to design signal processing algorithms that are cognition friendly.

Hand-movement-based in-vehicle driver/front-seat passenger discrimination for centre console controls

NASA Astrophysics Data System (ADS)

Herrmann, Enrico; Makrushin, Andrey; Dittmann, Jana; Vielhauer, Claus; Langnickel, Mirko; Kraetzer, Christian

2010-01-01

Successful user discrimination in a vehicle environment may yield a reduction of the number of switches, thus significantly reducing costs while increasing user convenience. The personalization of individual controls permits conditional passenger enable/driver disable and vice versa options which may yield safety improvement. The authors propose a prototypic optical sensing system based on hand movement segmentation in near-infrared image sequences implemented in an Audi A6 Avant. Analyzing the number of movements in special regions, the system recognizes the direction of the forearm and hand motion and decides whether driver or front-seat passenger touch a control. The experimental evaluation is performed independently for uniformly and non-uniformly illuminated video data as well as for the complete video data set which includes both subsets. The general test results in error rates of up to 14.41% FPR / 16.82% FNR and 17.61% FPR / 14.77% FNR for driver and passenger respectively. Finally, the authors discuss the causes of the most frequently occurring errors as well as the prospects and limitations of optical sensing for user discrimination in passenger compartments.

Land use and environmental assessment in the central Atlantic region

NASA Technical Reports Server (NTRS)

Alexander, R. H.; Fitzpatrick, K.; Lins, H. F., Jr.; Mcginty, H. K., III

1975-01-01

Data from high altitude aircraft, LANDSAT and Skylab were used in a comprehensive regional survey of land use and its associated environmental impact in the Central Atlantic Regional Ecological Test Site (CARETS). Each sensor system has advantages that were demonstrated by producing experimental land use maps and other data products, applying them to typical problems encountered in regional planning and environmental impact assessment, and presenting the results to prospective users for evaluation. An archival collection of imagery, maps, data summaries, and technical reports was assembled, constituting an environmental profile of the central Atlantic region. The investigation was organized into four closely-related modules, a land use information module, an environmental impact module, a user interaction and evaluation module, and a geographic information systems module. Results revealed a heterogeneous user community with diverse information needs, tending, however, definitely toward the higher-resolution sensor data and the larger-scale land use maps and related information products. Among project recommendations are greater efforts toward improving compatibility of federal, state, and local land use information programs, and greater efforts toward a broader exchange of imagery, computer tapes, and land use information derived therefrom.

Clinical Investigation Program.

DTIC Science & Technology

1987-09-30

Mexico , September 1987. Publications: None ! ~t 4, FAMC A.P.R. (RCS MED 300) Detail Summary Sheet (HSCR 40-23 as amended) (1) Date: 30 Sep 87 (2...Infection: A Prospective Study. Presented: 2nd Annual Symposium of the Rocky Moun-tain Flow Cytometry Users Group, Albuquerque, New Mexico , 10-11...COL, MC (9) Dept/Sv:Pe-at (10) Associate Tnvestigators (lI) Tey WoJr--s: Myron J. Levin, M.D. varicella vaccine U Co. HSC (12) Accumu tEve MEDCASE:* 1

Users Guide to Direct Digital Control of Heating, Ventilating, and Air Conditioning Equipment,

DTIC Science & Technology

1985-01-01

cycles, reset, load shedding, chiller optimization , VAV fan synchronization, and optimum start/stop. The prospective buyer of a DDC system should...in Fig- ure 4. Data on setpoints , reset schedules, and event timing, such as that presented in Figure 6, are often even more difficult to find. In con...control logic, setpoint and other data are readily available. Program logic, setpoint and schedule data, and other information stored in a DDC unit

Direct Digital Control of HVAC (Heating, Ventilating, and Air Conditioning Equipment (User’s Guide)

DTIC Science & Technology

1985-01-01

reset, load shedding, chiller optimization , VAV fan synchronization, and optimum start/stop. The prospective buyer of a DDC system should investigate...current and accurate drawings for a conventional, built-up control system such as that illustrated in Fig- ure 4. Data on setpoints , reset schedules, and...are always available in the form of the computer program code (Figure 7). In addition to the control logic, setpoint and other data are readily

Who Is Using Outdoor Fitness Equipment and How? The Case of Xihu Park.

PubMed

Chow, Hsueh-Wen; Mowen, Andrew J; Wu, Guan-Lin

2017-04-21

Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu Park. Results indicate that OFE in this park attracted considerable use, particularly in the early morning and late afternoon. During these peak-hour observations, approximately 12 users per hour used the OFE, with the majority being females and seniors. The triple arm stretch and air walker were the most popular stations. However, most OFE users interacted with less than three of the available six OFE stations. Furthermore, users spent an average of less than nine minutes on all OFE stations combined. While OFE equipment was well-used in this urban park, it appears users did not interact with OFE at rates to produce a sufficient bout or level of physical activity during their park visit. Further investigations of OFE are encouraged to determine their health impact.

GrowYourIC: an open access Python code to facilitate comparison between kinematic models of inner core evolution and seismic observations

NASA Astrophysics Data System (ADS)

Lasbleis, M.; Day, E. A.; Waszek, L.

2017-12-01

The complex nature of inner core structure has been well-established from seismic studies, with heterogeneities at various length scales, both radially and laterally. Despite this, no geodynamic model has successfully explained all of the observed seismic features. To facilitate comparisons between seismic observations and geodynamic models of inner core growth we have developed a new, open access Python tool - GrowYourIC - that allows users to compare models of inner core structure. The code allows users to simulate different evolution models of the inner core, with user-defined rates of inner core growth, translation and rotation. Once the user has "grown" an inner core with their preferred parameters they can then explore the effect of "their" inner core's evolution on the relative age and growth rate in different regions of the inner core. The code will convert these parameters into seismic properties using either built-in mineral physics models, or user-supplied ones that calculate these seismic properties with users' own preferred mineralogical models. The 3D model of isotropic inner core properties can then be used to calculate the predicted seismic travel time anomalies for a random, or user-specified, set of seismic ray paths through the inner core. A real dataset of inner core body-wave differential travel times is included for the purpose of comparing user-generated models of inner core growth to actual observed travel time anomalies in the top 100km of the inner core. Here, we explore some of the possibilities of our code. We investigate the effect of the limited illumination of the inner core by seismic waves on the robustness of kinematic model interpretation. We test the impact on seismic differential travel time observations of several kinematic models of inner core growth: fast lateral translation; slow differential growth; and inner core super-rotation. We find that a model of inner core evolution incorporating both differential growth and slow super-rotation is able to recreate some of the more intricate details of the seismic observations. Specifically we are able to "grow" an inner core that has an asymmetric shift in isotropic hemisphere boundaries with increasing depth in the inner core.

EEG frontal asymmetry related to pleasantness of music perception in healthy children and cochlear implanted users.

PubMed

Vecchiato, G; Maglione, A G; Scorpecci, A; Malerba, P; Marsella, P; Di Francesco, G; Vitiello, S; Colosimo, A; Babiloni, Fabio

2012-01-01

Interestingly, the international debate about the quality of music fruition for cochlear implanted users does not take into account the hypothesis that bilateral users could perceive music in a more pleasant way with respect to monolateral users. In this scenario, the aim of the present study was to investigate if cerebral signs of pleasantness during music perception in healthy child are similar to those observed in monolateral and in bilateral cochlear implanted users. In fact, previous observations in literature on healthy subjects have indicated that variations of the frontal EEG alpha activity are correlated with the perceived pleasantness of the sensory stimulation received (approach-withdrawal theory). In particular, here we described differences between cortical activities estimated in the alpha frequency band for a healthy child and in patients having a monolateral or a bilateral cochlear implant during the fruition of a musical cartoon. The results of the present analysis showed that the alpha EEG asymmetry patterns observed in a healthy child and that of a bilateral cochlear implanted patient are congruent with the approach-withdrawal theory. Conversely, the scalp topographic distribution of EEG power spectra in the alpha band resulting from the monolateral cochlear user presents a different EEG pattern from the normal and bilateral implanted patients. Such differences could be explained at the light of the approach-withdrawal theory. In fact, the present findings support the hypothesis that a monolateral cochlear implanted user could perceive the music in a less pleasant way when compared to a healthy subject or to a bilateral cochlear user.

Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study

PubMed Central

Carlson, Robert G.; Nahhas, Ramzi W.; Martins, Silvia S.; Daniulaityte, Raminta

2016-01-01

Background Increases in illicit pharmaceutical opioid (PO) use have been associated with risk for transition to heroin use. We identify predictors of transition to heroin use among young, illicit PO users with no history of opioid dependence or heroin use at baseline. Methods Respondent-driven sampling recruited 383 participants; 362 returned for at least one biannual structured interview over 36 months. Cox regression was used to test for associations between lagged predictors and hazard of transition to heroin use. Potential predictors were based on those suggested in the literature. We also computed population attributable risk (PAR) and the rate of heroin transition. Results Over 36 months, 27 (7.5%) participants initiated heroin use; all were white, and the rate of heroin initiation was 2.8% per year (95% CI=1.9%–4.1%). Mean length of PO at first reported heroin use was 6.2 years (SD=1.9). Lifetime PO dependence (AHR=2.39, 95% CI= 1.07–5.48; PAR=32%, 95% CI=−2%–64%), early age of PO initiation (AHR=3.08, 95%; CI= 1.26–7.47; PAR=30%, 95% CI=2%–59%), using illicit POs to get high but not to self-medicate a health problem (AHR=4.83, 95% CI= 2.11–11.0; PAR=38%, 95% CI=12%–65%), and ever using PO non-orally most often (AHR=6.57, 95% CI=2.81–17.2; PAR=63%, 95% CI=31%–86%) were significant predictors. Conclusion This is one of the first prospective studies to test observations from previous cross-sectional and retrospective research on the relationship between illicit PO use and heroin initiation among young, initially non-opioid dependent PO users. The results provide insights into targets for the design of urgently needed prevention interventions. PMID:26785634

Validating New Software for Semiautomated Liver Volumetry--Better than Manual Measurement?

PubMed

Noschinski, L E; Maiwald, B; Voigt, P; Wiltberger, G; Kahn, T; Stumpp, P

2015-09-01

This prospective study compared a manual program for liver volumetry with semiautomated software. The hypothesis was that the semiautomated software would be faster, more accurate and less dependent on the evaluator's experience. Ten patients undergoing hemihepatectomy were included in this IRB approved study after written informed consent. All patients underwent a preoperative abdominal 3-phase CT scan, which was used for whole liver volumetry and volume prediction for the liver part to be resected. Two different types of software were used: 1) manual method: borders of the liver had to be defined per slice by the user; 2) semiautomated software: automatic identification of liver volume with manual assistance for definition of Couinaud segments. Measurements were done by six observers with different experience levels. Water displacement volumetry immediately after partial liver resection served as the gold standard. The resected part was examined with a CT scan after displacement volumetry. Volumetry of the resected liver scan showed excellent correlation to water displacement volumetry (manual: ρ = 0.997; semiautomated software: ρ = 0.995). The difference between the predicted volume and the real volume was significantly smaller with the semiautomated software than with the manual method (33% vs. 57%, p = 0.002). The semiautomated software was almost four times faster for volumetry of the whole liver (manual: 6:59 ± 3:04 min; semiautomated: 1:47 ± 1:11 min). Both methods for liver volumetry give an estimated liver volume close to the real one. The tested semiautomated software is faster, more accurate in predicting the volume of the resected liver part, gives more reproducible results and is less dependent on the user's experience. Both tested types of software allow exact volumetry of resected liver parts. Preoperative prediction can be performed more accurately with the semiautomated software. The semiautomated software is nearly four times faster than the tested manual program and less dependent on the user's experience. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

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

2015-10-14

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

Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study.

PubMed

Mansi, Ishak A; English, Jenny; Zhang, Song; Mortensen, Eric M; Halm, Ethan A

2016-06-01

Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated. To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a 'healthy' cohort. A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90-365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death. We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 % confidence interval [CI] 1.55-2.41 and OR 2.15, 95 % CI 1.20-3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 % CI 0.72-1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy. Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.

Effect of concomitant use of memantine on mortality and efficacy outcomes of galantamine-treated patients with Alzheimer's disease: post-hoc analysis of a randomized placebo-controlled study.

PubMed

Hager, Klaus; Baseman, Alan S; Nye, Jeffrey S; Brashear, H Robert; Han, John; Sano, Mary; Davis, Bonnie; Richards, Henry M

2016-11-15

A large, prospective, 2-year, randomized study in patients with mild-to-moderate Alzheimer's disease or mixed dementia demonstrated reductions in mortality and cognitive/functional decline in galantamine-treated patients. A post-hoc analysis was conducted to study the effect of (the presence or absence of) concomitant memantine use on treatment outcome. Randomized patients (N = 2045) were divided into subgroups based on memantine use. Analyses included demographic and clinical characteristics (age, nursing home placement, Mini-Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD) scores) and mortality endpoints. Overall, 496 (24.3 %) patients were memantine users and were older (mean (SD), 74.0 (8.76) vs 72.8 (8.76), p = 0.008), with lower MMSE scores (18.2 (4.16) vs 19.2 (4.02), p < 0.0001) and DAD scores (58.0 (23.49) vs 62.5 (20.52), p < 0.0001) than nonusers. Mortality rates (per 100 patient-years) in memantine nonusers (n = 1549) were lower for galantamine (1.39) vs placebo-treated patients (4.15). In memantine users, mortality rates were similar for placebo-treated (4.49) and galantamine-treated patients (5.57). In memantine nonusers at 24 months, the decline in MMSE scores (effect size (95 % CI) 0.25 (0.14; 0.36)) and DAD scores (0.17 (0.06; 0.28)) from baseline was lower in galantamine patients vs placebo patients. The absence of these benefits in memantine users could not be explained by baseline age, MMSE, or DAD scores. This post-hoc analysis shows that the beneficial effects of galantamine at 2 years post treatment were not observed in patients who had been placed on background memantine. The reasons for memantine treatment and the possibility of interaction between memantine and galantamine merit further investigation. ClinicalTrials.gov NCT00679627 . Registered 15 May 2008.

Active-comparator design and new-user design in observational studies

PubMed Central

Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

2015-01-01

SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

American Meteor Society Fireball reporting system and mobile application

NASA Astrophysics Data System (ADS)

Hankey, M.

2014-07-01

The American Meteor Society (AMS) founded in 1911 pioneered the visual study of meteors and has collected data relating to meteor observations and bright fireballs for over 100 years. In December 2010, the online fireball reporting system was upgraded to an interactive application that utilizes Google Maps and other programmatic methods to pinpoint the observer's location, azimuth and elevation values with a high degree of precision. The AMS has collected 10s of 1000s of witness reports relating to 100s of events each year since the new application was released. Three dimensional triangulation methods that average the data collected from witnesses have been developed that can determine the start and end points of the meteor with an accuracy of <50 km (when compared to published solutions provided by operators of all sky cameras). RA and DEC radiant estimates can also be computed for all significant events reported to the AMS. With the release of the mobile application, the AMS is able to collect more precise elevation angles than through the web application. Users can file a new report directly on the phone or update the values submitted through a web report. After web users complete their fireball report online, they are prompted to download the app and update their observation with the more precise data provided by the sensors in the mobile device. The mobile app also provides an accurate means for the witness to report the elapsed time of the fireball. To log this value, the user drags the device across the sky where they saw the fireball. This process is designed to require no button click or user interaction to start and stop the time recording. A count down initiates the process and once the user's phone crosses the plane of azimuth for the end point of the fireball the velocity timer automatically stops. Users are asked to log the recording three times in an effort to minimize error. The three values are then averaged into a final score. Once enough witnesses have filed reports, elapsed time data collected from the mobile phone can be used to determine the velocity of the fireball. With the velocity, trajectory solution and RA/DEC the AMS can plot orbital estimates for significant fireball events reported to the society. Our hope is that overtime this catalog of events will reveal patterns relating to the origins of bright fireballs at certain times of year. The AMS also hopes to be able to associate fireball events reported to the society with known meteor showers when RA/DEC radiant estimates fall close enough to those of known showers. In addition to the enhanced fireball reporting application, the AMS Mobile App provides a meteor shower calendar with information, radiant maps and moon conditions for all upcoming showers. There is also a meteor observing function inside the app that enables meteor observers to log meteor observations directly on the phone and have that data uploaded to the AMS online database and associated with that users observing profile. To record observations the user simply points the device at the part of the sky where they saw the meteor. They then drag their finger across the screen in the direction the meteor traveled. The user is then prompted to enter the magnitude of the event and associate the meteor with a known shower that is active for that date. When the user completes their session, all of the data for each meteor along with the information relating to the session is uploaded to the AMS website. Users can then review the data online in the AMS member's area. Data across all users can be aggregated for statistical analysis and ZHR estimates. Currently the AMS has over 10,000 registered users and facebook followers. In 2013 over 680,000 people visited the AMS website and the society received over 18,000 witness reports relating to 713 confirmed unique fireball events.

Development of a Graphical User Interface to Visualize Surface Observations

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

Buckley, R.L.

1998-07-13

Thousands of worldwide observing stations provide meteorological information near the earth's surface as often as once each hour. This surface data may be plotted on geographical maps to provide the meteorologist useful information regarding weather patterns for a region of interest. This report describes the components and applications of a graphical user interface which have been developed to visualize surface observations at any global location and time of interest.

Science opportunity analyzer - a multi-mission tool for planning

NASA Technical Reports Server (NTRS)

Streiffert, B. A.; Polanskey, C. A.; O'Reilly, T.; Colwell, J.

2002-01-01

For many years the diverse scientific community that supports JPL's wide variety ofinterplanetary space missions has needed a tool in order to plan and develop their experiments. The tool needs to be easily adapted to various mission types and portable to the user community. The Science Opportunity Analyzer, SOA, now in its third year of development, is intended to meet this need. SOA is a java-based application that is designed to enable scientists to identify and analyze opportunities for science observations from spacecraft. It differs from other planning tools in that it does not require an in-depth knowledge of the spacecraft command system or operation modes to begin high level planning. Users can, however, develop increasingly detailed levels of design. SOA consists of six major functions: Opportunity Search, Visualization, Observation Design, Constraint Checking, Data Output and Communications. Opportunity Search is a GUI driven interface to existing search engines that can be used to identify times when a spacecraft is in a specific geometrical relationship with other bodies in the solar system. This function can be used for advanced mission planning as well as for making last minute adjustments to mission sequences in response to trajectory modifications. Visualization is a key aspect of SOA. The user can view observation opportunities in either a 3D representation or as a 2D map projection. The user is given extensive flexibility to customize what is displayed in the view. Observation Design allows the user to orient the spacecraft and visualize the projection of the instrument field of view for that orientation using the same views as Opportunity Search. Constraint Checking is provided to validate various geometrical and physical aspects of an observation design. The user has the ability to easily create custom rules or to use official project-generated flight rules. This capability may also allow scientists to easily impact the cost to science if flight rule changes occur. Data Output generates information based on the spacecraft's trajectory, opportunity search results or based on a created observation. The data can be viewed either in tabular format or as a graph. Finally, SOA is unique in that it is designed to be able to communicate with a variety of existing planning and sequencing tools. From the very beginning SOA was designed with the user in mind. Extensive surveys of the potential user community were conducted in order to develop the software requirements. Throughout the development period, close ties have been maintained with the science community to insure that the tool maintains its user focus. Although development is still in its early stages, SOA is already developing a user community on the Cassini project, which is depending on this tool for their science planning. There are other tools at JPL that do various pieces of what SOA can do; however, there is no other tool which combines all these functions and presents them to the user in such a convenient, cohesive, and easy to use fashion.

Are drug treatment services only for 'thieving junkie scumbags'? Drug users and the management of stigmatised identities.

PubMed

Radcliffe, Polly; Stevens, Alex

2008-10-01

This article uses qualitative interviews with 53 problematic drug users who had dropped out of treatment in England, UK to explore how they describe the stigmatisation of drug users and drug services. It discusses the construction of the category of the junkie through its association with un-controlled heroin use and criminality. It shows how some drug users carefully manage information about their discreditable identities by excluding themselves from this category, while acknowledging its validity for other drug users. The junkie identity was generally seen as shameful and therefore to be avoided, although it holds attractions for some drug users. For many of the interviewees, entry to treatment risked exposing their own activities as shaming, as they saw treatment as being a place that was populated by junkies and where it becomes more difficult to manage discreditable information. The treatment regime, e.g. the routine of supervised consumption of methadone, was itself seen by some as stigmatising and was also seen as hindering progress to the desired 'normal' life of conventional employment. Participation in the community of users of both drugs and drug services was perceived as potentially damaging to the prospects of recovery. This emphasises the importance of social capital, including links to people and opportunities outside the drug market. It also highlights the danger that using the criminal justice system to concentrate prolific offenders in treatment may have the perverse effects of excluding other people who have drug problems and of prolonging the performance of the junkie identity within treatment services. It is concluded that treatment agencies should address these issues, including through the provision of more drug services in mainstream settings, in order to ensure that drug services are not seen to be suitable only for one particularly stigmatised category of drug user.

A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India

PubMed Central

Ludwig, Cassie A; Murthy, Somasheila I; Pappuru, Rajeev R; Jais, Alexandre; Myung, David J; Chang, Robert T

2016-01-01

Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope) to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best). 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings) for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806) indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior) was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings. PMID:27146928

Prevalence of genital tract infection with Entamoeba gingivalis among copper T 380A intrauterine device users in Egypt.

PubMed

Foda, Ashraf A; El-Malky, Mohamed M

2012-01-01

This study was performed to study the prevalence and potential pathogenicity of E. gingivalis in the genital tracts of intrauterine contraceptive device (IUD) users. A prospective study conducted at the Obstetrics and Gynecology Department and Fertility Care Unit, Mansoura University Hospital, Egypt. The study was carried out on 87 IUD users and 87 nonusers. The copper T 380A IUD was removed from each woman and washed with phosphate-buffered saline (PBS) pH 7.4; the IUD wash was centrifuged. The sediment was resuspended in 2 ml PBS and divided into two portions. One portion was used for preparation of direct and iron hematoxylin-stained smears. Direct smears and stained smears were examined for detailed morphology. The second portion of the sediment was used for DNA extraction and subsequent PCR amplification targeting the small subunit ribosomal RNA of E. gingivalis. The parasite was found in 12.64% of IUD users and in 6.9% of non users (p>.3). It was found that 90.9% of those harboring E. gingivalis in their genital tract had the parasite in their oral cavity. The percentage of genital infection in IUD users increased with low level of education, rural areas, insertion in primary health-care center and among those not washing hands before checking the strings. In the infected cases, vaginal discharge was more common (81.8%) than in noninfected cases (32.9%), such difference was statistically significant (p<.05). Also, excessive vaginal discharge is more common than backache and menorrhagia in the infected cases. Higher incidence of E. gingivalis infection in IUD users is related to oral cavity infection, residence, the facility where they inserted their IUD and washing hands attitude before checking the strings. We recommend treatment of gingival infection, proper counseling and medical education on oral and genital tract hygiene for IUD users. Copyright © 2012 Elsevier Inc. All rights reserved.

Speech intelligibility and subjective benefit in single-sided deaf adults after cochlear implantation.

PubMed

Finke, Mareike; Strauß-Schier, Angelika; Kludt, Eugen; Büchner, Andreas; Illg, Angelika

2017-05-01

Treatment with cochlear implants (CIs) in single-sided deaf individuals started less than a decade ago. CIs can successfully reduce incapacitating tinnitus on the deaf ear and allow, so some extent, the restoration of binaural hearing. Until now, systematic evaluations of subjective CI benefit in post-lingually single-sided deaf individuals and analyses of speech intelligibility outcome for the CI in isolation have been lacking. For the prospective part of this study, the Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) was administered to 48 single-sided deaf CI users to evaluate the subjectively perceived CI benefit across different listening situations. In the retrospective part, speech intelligibility outcome with the CI up to 12 month post-activation was compared between 100 single-sided deaf CI users and 125 bilaterally implanted CI users (2nd implant). The positive median ratings in the BBSS differed significantly from zero for all items suggesting that most individuals with single-sided deafness rate their CI as beneficial across listening situations. The speech perception scores in quiet and noise improved significantly over time in both groups of CI users. Speech intelligibility with the CI in isolation was significantly better in bilaterally implanted CI users (2nd implant) compared to the scores obtained from single-sided deaf CI users. Our results indicate that CI users with single-sided deafness can reach open set speech understanding with their CI in isolation, encouraging the extension of the CI indication to individuals with normal hearing on the contralateral ear. Compared to the performance reached with bilateral CI users' second implant, speech reception threshold are lower, indicating an aural preference and dominance of the normal hearing ear. The results from the BBSS propose good satisfaction with the CI across several listening situations. Copyright © 2017 Elsevier B.V. All rights reserved.

Host Genetic Control of the Microbiome in Humans and Maise or Relating Host Genetic Variation to the Microbiome (2011 JGI User Meeting)

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

Ley, Ruth

2011-03-23

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Ruth Ley of Cornell University gives a presentation on "Relating Host Genetic Variation to themore » Microbiome" at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.« less

Prototype Packaged Databases and Software in Health

PubMed Central

Gardenier, Turkan K.

1980-01-01

This paper describes the recent demand for packaged databases and software for health applications in light of developments in mini-and micro-computer technology. Specific features for defining prospective user groups are discussed; criticisms generated for large-scale epidemiological data use as a means of replacing clinical trials and associated controls are posed to the reader. The available collaborative efforts for access and analysis of jointly structured health data are stressed, with recommendations for new analytical techniques specifically geared to monitoring data such as the CTSS (Cumulative Transitional State Score) generated for tacking ongoing patient status over time in clinical trials. Examples of graphic display are given from the Domestic Information Display System (DIDS) which is a collaborative multi-agency effort to computerize and make accessible user-specified U.S. and local maps relating to health, environment, socio-economic and energy data.

Genomic and Systems Biology Analyses of Social Behavior or Evolutionary Genomic Analyses of Insect Society: Eat, Drink, and Be Scary (2011 JGI User Meeting)

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

Robinson, Gene

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, CA. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Gene Robinson of the University of Illinois on Genomic and Systems Biology Analyses of Socialmore » Behavior at the 6th Annual Genomics of Energy & Environment Meeting on March 23, 2011.« less

Comparative Metagenomics of Gut and Ocean: Identification of Microbial Marker Genes for Complex Environmental Properties (2011 JGI User Meeting)

ScienceCinema

Bork, Peer

2018-02-14

The U.S. Department of Energy Joint Genome Institute (JGI) invited scientists interested in the application of genomics to bioenergy and environmental issues, as well as all current and prospective users and collaborators, to attend the annual DOE JGI Genomics of Energy & Environment Meeting held March 22-24, 2011 in Walnut Creek, Calif. The emphasis of this meeting was on the genomics of renewable energy strategies, carbon cycling, environmental gene discovery, and engineering of fuel-producing organisms. The meeting features presentations by leading scientists advancing these topics. Peer Bork of the European Molecular Biology Laboratory on Comparative Metagenomics of Gut and Ocean: Identification of Microbial Marker Genes for Complex Environmental Properties at the 6th annual Genomics of Energy & Environment Meeting on March 23, 2011.

Dehospitalisation at a general hospital in Minas Gerais: challenges and prospects.

PubMed

Silva, Kênia Lara; Sena, Roseni Rosângela de; Castro, Wesley Souza

2018-06-07

To analyse the dehospitalisation process at a general public hospital in Minas Gerais, Brazil, from the perspective of managers, health workers, users and their families. This is a qualitative, exploratory, descriptive study based on the principles of methodological and theoretical dialectics. The participants were 24 hospital health workers and 15 companions of users going through the process of dehospitalisation. Data were collected from April to June 2015 using semi-structured interviews and a field journal records and subsequently subjected to content analysis. Analysis of the empirical material led to the construction of the following categories: Dehospitalisation: viewpoint of the institution and Family organisation for the dehospitalisation process. The study reveals a deficiency in the implementation, systematisation, internal reorganisation and continuity of care after dehospitalisation. Current dehospitalisation strategies do not favour comprehensiveness and continuity of home care.

Characteristics of physical activity levels among trail users in a U.S. national sample.

PubMed

Librett, John J; Yore, Michelle M; Schmid, Thomas L

2006-11-01

The Task Force on Community Preventive Services strongly recommends environmental interventions that include enhanced access to opportunities for physical activity, such as walking and cycling trails. Although accumulating evidence indicates that trails can be effective in increasing physical activity, little is known about trail users. Cross-sectional analysis of a national sample of 3717 adults from the HealthStyles and ConsumerStyles surveys using logistic regression to determine physical activity patterns and sociodemographic correlates related to trail use, and to identify support regarding trail development policies. Almost 13% (12.7%) of the sample reported using trails at least once a month and 24.3% at least once a week. People who reported using trails at least once a week were twice as likely than people who reported rarely or never using trails to meet physical activity recommendations (odds ratio=2.3, 95% confidence interval=1.9-2.8). Nearly half (43.6%) of the non-trail users supported expanded public spaces for people to exercise, and 36.4% of the non-trail users reported that they would be willing to pay more taxes to build more parks and trails in their community. Community trails facilitate physical activity, and almost half of frequent trail users report that access to trails and other green space is important in choosing a place to live. These results support the need for prospective research on whether newly built trails promote physical activity in previously inactive people.

The chronic effects of cannabis on memory in humans: a review.

PubMed

Solowij, Nadia; Battisti, Robert

2008-01-01

Memory problems are frequently associated with cannabis use, in both the short- and long-term. To date, reviews on the long-term cognitive sequelae of cannabis use have examined a broad range of cognitive functions, with none specifically focused on memory. Consequently, this review sought to examine the literature specific to memory function in cannabis users in the nontoxicated state with the aim of identifying the existence and nature of memory impairment in cannabis users and appraising potentially related mediators or moderators. Literature searches were conducted to extract well-controlled studies that investigated memory function in cannabis users outside of the acute intoxication period, with a focus on reviewing studies published within the past 10 years. Most recent studies have examined working memory and verbal episodic memory and cumulatively, the evidence suggests impaired encoding, storage, manipulation and retrieval mechanisms in long-term or heavy cannabis users. These impairments are not dissimilar to those associated with acute intoxication and have been related to the duration, frequency, dose and age of onset of cannabis use. We consider the impact of not only specific parameters of cannabis use in the manifestation of memory dysfunction, but also such factors as age, neurodevelopmental stage, IQ, gender, various vulnerabilities and other substance-use interactions, in the context of neural efficiency and compensatory mechanisms. The precise nature of memory deficits in cannabis users, their neural substrates and manifestation requires much further exploration through a variety of behavioural, functional brain imaging, prospective and genetic studies.

Understanding Active and Passive Users: The Effects of an Active User Using Normal, Hard and Unreliable Technologies on User Assessment of Trust in Technology and Co-User

PubMed Central

Montague, Enid; JieXu

2011-01-01

The aim of this study was to understand how passive users perceive the trustworthiness of active users and technologies under varying technological conditions. An experimental study was designed to vary the functioning of technologies that active users interacted with, while passive users observed these interactions. Active and passive user ratings of technology and partner were collected. Exploratory data analysis suggests that passive users developed perceptions of technologies based on the functioning of the technology and how the active user interacted with the technologies. Findings from this research have implications for the design of technologies in environments where active and passive users interact with technologies in different ways. Future work in this area should explore interventions that lead to enhanced affective engagement and trust calibration. PMID:22192788

The importance of user centered design methods applied to the design of a new workstation: a case study.

PubMed

Duschenes, Ronaldo; Mendes, Andressa; Betiol, Adriana; Barreto, Suzana

2012-01-01

This paper presents a case study of the application of user centered design methodologies in the product development for a line of ergonomic office furniture. The study aimed to analyze the experience of using a workstation from the perspective of two groups of users, installers and end users. The observation of users in their natural context of use not only allowed the development team to identify key needs and strategies of the users, transforming them into design solutions, but mainly it warned them of the importance and impact of user involvement in the product development cycle.

Science Opportunity Analyzer (SOA) Version 8

NASA Technical Reports Server (NTRS)

Witoff, Robert J.; Polanskey, Carol A.; Aguinaldo, Anna Marie A.; Liu, Ning; Hofstadter, Mark D.

2013-01-01

SOA allows scientists to plan spacecraft observations. It facilitates the identification of geometrically interesting times in a spacecraft s orbit that a user can use to plan observations or instrument-driven spacecraft maneuvers. These observations can then be visualized multiple ways in both two- and three-dimensional views. When observations have been optimized within a spacecraft's flight rules, the resulting plans can be output for use by other JPL uplink tools. Now in its eighth major version, SOA improves on these capabilities in a modern and integrated fashion. SOA consists of five major functions: Opportunity Search, Visualization, Observation Design, Constraint Checking, and Data Output. Opportunity Search is a GUI-driven interface to existing search engines that can be used to identify times when a spacecraft is in a specific geometrical relationship with other bodies in the solar system. This function can be used for advanced mission planning as well as for making last-minute adjustments to mission sequences in response to trajectory modifications. Visualization is a key aspect of SOA. The user can view observation opportunities in either a 3D representation or as a 2D map projection. Observation Design allows the user to orient the spacecraft and visualize the projection of the instrument field of view for that orientation using the same views as Opportunity Search. Constraint Checking is provided to validate various geometrical and physical aspects of an observation design. The user has the ability to easily create custom rules or to use official project-generated flight rules. This capability may also allow scientists to easily assess the cost to science if flight rule changes occur. Data Output allows the user to compute ancillary data related to an observation or to a given position of the spacecraft along its trajectory. The data can be saved as a tab-delimited text file or viewed as a graph. SOA combines science planning functionality unique to both JPL and the sponsoring spacecraft. SOA is able to ingest JPL SPICE Kernels that are used to drive the tool and its computations. A Percy search engine is then included that identifies interesting time periods for the user to build observations. When observations are then built, flight-like orientation algorithms replicate spacecraft dynamics to closely simulate the flight spacecraft s dynamics. SOA v8 represents large steps forward from SOA v7 in terms of quality, reliability, maintainability, efficiency, and user experience. A tailored agile development environment has been built around SOA that provides automated unit testing, continuous build and integration, a consolidated Web-based code and documentation storage environment, modern Java enhancements, and a focus on usability

Coordination and management of multicenter clinical studies in trauma: Experience from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study.

PubMed

Rahbar, Mohammad H; Fox, Erin E; del Junco, Deborah J; Cotton, Bryan A; Podbielski, Jeanette M; Matijevic, Nena; Cohen, Mitchell J; Schreiber, Martin A; Zhang, Jiajie; Mirhaji, Parsa; Duran, Sarah J; Reynolds, Robert J; Benjamin-Garner, Ruby; Holcomb, John B

2012-04-01

Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the US. PROMMTT was a multisite prospective observational study of severely injured transfused trauma patients. The clinical sites collected real-time information on the timing and amounts of blood product infusions as well as colloids and crystalloids, vital signs, initial diagnostic and clinical laboratory tests, life saving interventions and other clinical care data. Between July 2009 and October 2010, PROMMTT screened 12,561 trauma admissions and enrolled 1245 patients who received one or more blood transfusions within 6h of Emergency Department (ED) admission. A total of 297 massive transfusions were observed over the course of the study at a combined rate of 5.0 massive transfusion patients/week. PROMMTT is the first multisite study to collect real-time prospective data on trauma patients requiring transfusion. Support from the Department of Defense and collaborative expertise from the ten participating centers helped to demonstrate the feasibility of prospective trauma transfusion studies. The observational data collected from this study will be an invaluable resource for research in trauma surgery and it will guide the design and conduct of future randomized trials. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Coordination and management of multicenter clinical studies in trauma: Experience from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study

PubMed Central

Rahbar, Mohammad H.; Fox, Erin E.; del Junco, Deborah J.; Cotton, Bryan A.; Podbielski, Jeanette M.; Matijevic, Nena; Cohen, Mitchell J.; Schreiber, Martin A.; Zhang, Jiajie; Mirhaji, Parsa; Duran, Sarah; Reynolds, Robert J.; Benjamin-Garner, Ruby; Holcomb, John B.

2011-01-01

Aim Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the U.S. Methods PROMMTT was a multisite prospective observational study of severely injured transfused trauma patients. The clinical sites collected real-time information on the timing and amounts of blood product infusions as well as colloids and crystalloids, vital signs, initial diagnostic and clinical laboratory tests, life saving interventions and other clinical care data. Results Between July 2009 and October 2010, PROMMTT screened 12,561 trauma admissions and enrolled 1,245 patients who received one or more blood transfusions within 6 hours of ED admission. A total of 297 massive transfusions were observed over the course of the study at a combined rate of 5.0 massive transfusion patients/week. Conclusion PROMMTT is the first multisite study to collect real-time prospective data on trauma patients requiring transfusion. Support from the Department of Defense and collaborative expertise from the ten participating centers helped to demonstrate the feasibility of prospective trauma transfusion studies. The observational data collected from this study will be an invaluable resource for research in trauma surgery and it will guide the design and conduct of future randomized trials. PMID:22001613

An Object-Oriented Graphical User Interface for a Reusable Rocket Engine Intelligent Control System

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Musgrave, Jeffrey L.; Guo, Ten-Huei; Paxson, Daniel E.; Wong, Edmond; Saus, Joseph R.; Merrill, Walter C.

1994-01-01

An intelligent control system for reusable rocket engines under development at NASA Lewis Research Center requires a graphical user interface to allow observation of the closed-loop system in operation. The simulation testbed consists of a real-time engine simulation computer, a controls computer, and several auxiliary computers for diagnostics and coordination. The system is set up so that the simulation computer could be replaced by the real engine and the change would be transparent to the control system. Because of the hard real-time requirement of the control computer, putting a graphical user interface on it was not an option. Thus, a separate computer used strictly for the graphical user interface was warranted. An object-oriented LISP-based graphical user interface has been developed on a Texas Instruments Explorer 2+ to indicate the condition of the engine to the observer through plots, animation, interactive graphics, and text.

The Growth of the User Community of the La Silla Paranal Observatory Science Archive

NASA Astrophysics Data System (ADS)

Romaniello, M.; Arnaboldi, M.; Da Rocha, C.; De Breuck, C.; Delmotte, N.; Dobrzycki, A.; Fourniol, N.; Freudling, W.; Mascetti, L.; Micol, A.; Retzlaff, J.; Sterzik, M.; Sequeiros, I. V.; De Breuck, M. V.

2016-03-01

The archive of the La Silla Paranal Observatory has grown steadily into a powerful science resource for the ESO astronomical community. Established in 1998, the Science Archive Facility (SAF) stores both the raw data generated by all ESO instruments and selected processed (science-ready) data. The growth of the SAF user community is analysed through access and publication statistics. Statistics are presented for archival users, who do not contribute to observing proposals, and contrasted with regular and archival users, who are successful in competing for observing time. Archival data from the SAF contribute to about one paper out of four that use data from ESO facilities. This study reveals that the blend of users constitutes a mixture of the traditional ESO community making novel use of the data and of a new community being built around the SAF.

Reducing High-Users' Visits to the Emergency Department by a Primary Care Intervention for the Uninsured: A Retrospective Study.

PubMed

Tsai, Meng-Han; Xirasagar, Sudha; Carroll, Scott; Bryan, Charles S; Gallagher, Pamela J; Davis, Kim; Jauch, Edward C

2018-01-01

Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use-based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users. Annual adult ED visit volumes were 16 372 preintervention (47.5% by high-users), versus 18 496 postintervention. High-users' mean annual visit rates were 5.43 (top quartile) and 0.94 (bottom quartile) preintervention, versus 3.21 and 1.11, respectively, for returning high-users, postintervention (all P < .001). Postintervention, the visit rates of new high-users were lower (lowest and top quartile rates, 0.6 and 3.23) than preintervention high-users' rates in the preintervention period. Visit rates of the top quartile of occasional users also declined. Subgroup analysis of medically uninsured high-users showed similar results. Upon classifying preintervention high-users by emergency severity, postintervention mean ESI increased 24.5% among the lowest ESI quartile, and decreased 12.2% among the top quartile. Pre- and post-intervention sample demographics and comorbidities were similar. The observed reductions in overall ED visit rates, particularly low-severity visits; highest reductions observed among high-users and the top quartile of occasional users; and the pattern of changes in emergency severity support a positive impact of the primary care intervention.

ODISEES: A New Paradigm in Data Access

NASA Astrophysics Data System (ADS)

Huffer, E.; Little, M. M.; Kusterer, J.

2013-12-01

As part of its ongoing efforts to improve access to data, the Atmospheric Science Data Center has developed a high-precision Earth Science domain ontology (the 'ES Ontology') implemented in a graph database ('the Semantic Metadata Repository') that is used to store detailed, semantically-enhanced, parameter-level metadata for ASDC data products. The ES Ontology provides the semantic infrastructure needed to drive the ASDC's Ontology-Driven Interactive Search Environment for Earth Science ('ODISEES'), a data discovery and access tool, and will support additional data services such as analytics and visualization. The ES ontology is designed on the premise that naming conventions alone are not adequate to provide the information needed by prospective data consumers to assess the suitability of a given dataset for their research requirements; nor are current metadata conventions adequate to support seamless machine-to-machine interactions between file servers and end-user applications. Data consumers need information not only about what two data elements have in common, but also about how they are different. End-user applications need consistent, detailed metadata to support real-time data interoperability. The ES ontology is a highly precise, bottom-up, queriable model of the Earth Science domain that focuses on critical details about the measurable phenomena, instrument techniques, data processing methods, and data file structures. Earth Science parameters are described in detail in the ES Ontology and mapped to the corresponding variables that occur in ASDC datasets. Variables are in turn mapped to well-annotated representations of the datasets that they occur in, the instrument(s) used to create them, the instrument platforms, the processing methods, etc., creating a linked-data structure that allows both human and machine users to access a wealth of information critical to understanding and manipulating the data. The mappings are recorded in the Semantic Metadata Repository as RDF-triples. An off-the-shelf Ontology Development Environment and a custom Metadata Conversion Tool comprise a human-machine/machine-machine hybrid tool that partially automates the creation of metadata as RDF-triples by interfacing with existing metadata repositories and providing a user interface that solicits input from a human user, when needed. RDF-triples are pushed to the Ontology Development Environment, where a reasoning engine executes a series of inference rules whose antecedent conditions can be satisfied by the initial set of RDF-triples, thereby generating the additional detailed metadata that is missing in existing repositories. A SPARQL Endpoint, a web-based query service and a Graphical User Interface allow prospective data consumers - even those with no familiarity with NASA data products - to search the metadata repository to find and order data products that meet their exact specifications. A web-based API will provide an interface for machine-to-machine transactions.

CYP2C9 Genotypes Modify Benzodiazepine-Related Fall Risk: Original Results From Three Studies With Meta-Analysis.

PubMed

Ham, Annelies C; Ziere, Gijsbertus; Broer, Linda; Swart, Karin M A; Enneman, Anke W; van Dijk, Suzanne C; van Wijngaarden, Janneke P; van der Zwaluw, Nikita L; Brouwer-Brolsma, Elske M; Dhonukshe-Rutten, Rosalie A M; van Schoor, Natasja M; Zillikens, M Carola; van Gelder, Teun; de Vries, Oscar J; Lips, Paul; Deeg, Dorly J H; de Groot, Lisette C P G M; Hofman, Albert; Witkamp, Renger F; Uitterlinden, André G; Stricker, Bruno H; van der Velde, Nathalie

2017-01-01

To investigate whether the CYP2C9*2 and *3 variants modify benzodiazepine-related fall risk. Three prospective studies; the Rotterdam Study, B-PROOF, and LASA. Community-dwelling individuals living in or near five Dutch cities. There were 11,485 participants aged ≥55 years. Fall incidents were recorded prospectively. Benzodiazepine use was determined using pharmacy dispensing records or interviews. Cox proportional hazard models adjusted for age and sex were applied to determine the association between benzodiazepine use and fall risk stratified for CYP2C9 genotype and comparing benzodiazepine users to nonusers. The results of the three studies were combined applying meta-analysis. Within benzodiazepine users, the association between genotypes and fall risk was also assessed. Three thousand seven hundred five participants (32%) encountered a fall during 91,996 follow-up years, and 4% to 15% (depending on the study population) used benzodiazepines. CYP2C9 variants had frequencies of 13% for the *2 allele and 6% for the *3 allele. Compared to nonusers, current benzodiazepine use was associated with an 18% to 36% increased fall risk across studies with a combined hazard ratio (HR) = 1.26 (95% confidence interval [CI], 1.13; 1.40). CYP2C9*2 or *3 allele variants modified benzodiazepine-related fall risk. Compared to nonusers, those carrying a CYP2C9*2 or *3 allele and using benzodiazepines had a 45% increased fall risk (HR, 1.45 95% CI, 1.21; 1.73), whereas CYP2C9*1 homozygotes using benzodiazepines had no increased fall risk (HR, 1.14; 95% CI, 0.90; 1.45). Within benzodiazepine users, having a CYP2C9*2 or *3 allele was associated with an increased fall risk (HR, 1.35; 95% CI, 1.06; 1.72). Additionally, we observed an allele dose effect; heterozygous allele carriers had a fall risk of (HR = 1.30; 95% CI, 1.05; 1.61), and homozygous allele carriers of (HR = 1.91 95% CI, 1.23; 2.96). CYP2C9*2 and *3 allele variants modify benzodiazepine-related fall risk. Those using benzodiazepines and having reduced CYP2C9 enzyme activity based on their genotype are at increased fall risk. In clinical practice, genotyping might be considered for elderly patients with an indication for benzodiazepine use. However, because the exact role of CYP2C9 in benzodiazepine metabolism is still unclear, additional research is warranted. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

ERIC Educational Resources Information Center

Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.

2011-01-01

We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

User involvement in Finland: the hybrid of control and emancipation.

PubMed

Leppo, Anna; Perälä, Riikka

2009-01-01

The new "agenda of choice" in public services emphasises service users' needs and agency. The ideals of consumerism and user involvement have set new challenges for professionals. This paper aims to explore the effects of consumerism and user involvement at the level of day-to-day service delivery, looking at the encounters between professionals and service users. The paper applies an ethnographic approach. Observation data were collected at two Finnish drug treatment institutions: a needle exchange and health counselling service, and a specialised maternity clinic for pregnant women. Data from each institution consist of seven to 12 months of participant observation notes, which were subsequently systematically coded and analysed comparing the two institutions. The promotion of new ideals does not automatically result in the empowerment of service users or the erosion of professional power. The two institutions differ greatly: institutional context and gender shape the everyday realisation of the new ideals. In both institutions, however, professionals have adopted new practices and rethought their role. The cultivation of service users' choice and agency can become valuable professional capital, a new kind of "know how" that can also be used by the professionals to justify the importance of their work. The paper provides a nuanced and contextualised insight into "how" the ideals of consumerism and user involvement are translated into everyday encounters between service providers and users.

Conversations about the Moon with Prospective Teachers in Japan

ERIC Educational Resources Information Center

Suzuki, Mariko

2003-01-01

As an instructor in courses for prospective teachers, I am interested in my students' ideas and ways in which they reconstruct their ideas in conversations about science. In the case study presented here, I reflect upon (a) ways in which I engaged prospective teachers in thinking together about their observations of a natural phenomenon, the…

Undesired Teacher Behaviours According to the Studentship Memories of Prospective Teachers in Primary School

ERIC Educational Resources Information Center

Polat, Hüseyin

2015-01-01

The purpose of this study is to explore the types of undesired behaviours observed by prospective primary school teachers during their studentship at primary school. 35 voluntary prospective teachers studying at the faculty of education in Adiyaman University participated into the study, which was conducted within qualitative research techniques.…

Hearing Health Care: perception of the users of a public service.

PubMed

Jardim, Débora Soares; Maciel, Fernanda Jorge; Piastrelli, Marina Teixeira; Lemos, Stela Maris Aguiar

2017-03-30

Evaluate hearing health service under the users' perspective according to the aspects: access, care, communication, and professional competence, and its correlation with clinical, sociodemographic and assistance characteristics. This is an observational analytic cross-sectional study with a probability sample stratified by gender and age. The Hearing Health Care Assessment questionnaire and the Brazilian Economic Classification Criterion questionnaire were used. In total, 214 users were interviewed, which were assisted from May 2009 to May 2013. It was observed that most of the evaluated users are female, elderly, literate, presenting moderate degree of hearing impairment, who had access to transportation out-of-pocket, was submitted to ENT evaluation for diagnosis and sought the service to purchase a hearing aid, besides belonging to class C. Regarding user satisfaction, most were satisfied with access, hearing evaluation, personalized service, benefit for the family, communication and information, and professional competence. In the analysis of correlation between the scores, it was found that when users are satisfied with access, as well as with communication and information, the total score increases with moderate correlation coefficient. The users showed greater satisfaction with the professional competence domain and lower satisfaction with the benefit for the family. In addition, assessment proved that access and communication are considered important quality indicators for the hearing health service according to users.

Scientific knowledge and modern prospecting

USGS Publications Warehouse

Neuerburg, G.J.

1985-01-01

Modern prospecting is the systematic search for specified and generally ill-exposed components of the Earth's crust known as ore. This prospecting depends entirely on reliable, or scientific knowledge for guidance and for recognition of the search objects. Improvement in prospecting results from additions and refinements to scientific knowledge. Scientific knowledge is an ordered distillation of observations too numerous and too complex in themselves for easy understanding and for effective management. The ordering of these observations is accomplished by an evolutionary hierarchy of abstractions. These abstractions employ simplified descriptions consisting of characterization by selected properties, sampling to represent much larger parts of a phenomenon, generalized mappings of patterns of geometrical and numerical relations among properties, and explanation (theory) of these patterns as functional relations among the selected properties. Each abstraction is predicated on the mode of abstraction anticipated for the next higher level, so that research is a deductive process in which the highest level, theory, is indispensible for the growth and refinement of scientific knowledge, and therefore of prospecting methodology. ?? 1985 Springer-Verlag.

Young adults' trajectories of Ecstasy use: a population based study.

PubMed

Smirnov, Andrew; Najman, Jake M; Hayatbakhsh, Reza; Plotnikova, Maria; Wells, Helene; Legosz, Margot; Kemp, Robert

2013-11-01

Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19-23 years. Complete data for 30 months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1-2 days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12 months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3 years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns. © 2013 Elsevier Ltd. All rights reserved.

Transcultural adaptation and validation of the patient empowerment in long-term conditions questionnaire.

PubMed

Garcimartin, Paloma; Comin-Colet, Josep; Delgado-Hito, Pilar; Badosa-Marcé, Neus; Linas-Alonso, Anna

2017-05-04

Patient empowerment is a key element to improve the results in health, increase satisfaction amongst users and obtain higher treatment compliance. The main objective of this study is to validate the Spanish version of the questionnaire "Patient empowerment in long-term conditions" which evaluates the patients' level of empowerment of chronic diseases. The secondary objective is to identify factors which predict basal empowerment and changes (improvement or deterioration) in patients with Heart Failure (HF). An observational and prospective design of psychometric type to validate a questionnaire (aim 1) and a prospective study of cohorts (aim 2). The study will include 121 patients with confirmed diagnosis of HF. Three measurements (basal, at 15 days and at 3 months) will be carried out: quality of life, self-care and empowerment. Descriptive and inferential analyses will be used. For the first aim of the study (validation), the test-retest reproducibility will be assessed through intraclass correlation coefficient; internal consistency will be assessed through Cronbach's alpha coefficient; construct validity through Pearson's correlation coefficient; and sensibility to change through effect size coefficient. Set a valid questionnaire to measure the level of empowerment of patients with chronic diseases could be an effective tool to assess the results from the provision of the health care services. It will also allow us to identify at an early stage, those groups of patients with a low level of empowerment. Hence, they could become a risk group due to poor management of the disease, with a high rate of decompensation and a higher use rate of the health system resources.

HPA axis response to psychological stress and treatment retention in residential substance abuse treatment: a prospective study.

PubMed

Daughters, Stacey B; Richards, Jessica M; Gorka, Stephanie M; Sinha, Rajita

2009-12-01

Substance abuse treatment programs are often characterized by high rates of premature treatment dropout, which increases the likelihood of relapse to drug use. Negative reinforcement models of addiction emphasize an individual's inability to tolerate stress as a key factor for understanding poor substance use treatment outcomes, and evidence indicates that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis contributes to an individual's inability to respond adaptively to stress. The aim of the current study was to examine whether HPA axis response to stress is predictive of treatment retention among a sample of drug users in residential substance abuse treatment. Prospective study assessing treatment retention among 102 individuals enrolled in residential substance abuse treatment. Participants completed two computerized stress tasks, and HPA axis response to stress was measured via salivary cortisol at five time points from baseline (pre-stress) to 30 min post-stress exposure. The main outcome measures were treatment dropout (categorical) and total number of days in treatment (continuous). A significantly higher salivary cortisol response to stress was observed in treatment dropouts compared to treatment completers. Further, Cox proportional hazards survival analyses indicated that a higher peak cortisol response to stress was associated with a shorter number of days to treatment dropout. Results indicate that a higher salivary cortisol level in response to stress is associated with an inability to remain in substance abuse treatment. These findings are the first to document a biological marker of stress as a predictor of substance abuse treatment dropout, and support the development and implementation of treatments targeting this vulnerability.

The benefits of using bluetooth accessories with hearing aids.

PubMed

Smith, Pauline; Davis, Adrian

2014-10-01

To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory - Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. The provision of bluetooth accessories can give additional reported benefit for some patients - we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.

Distributed Observer Network (DON), Version 3.0, User's Guide

NASA Technical Reports Server (NTRS)

Mazzone, Rebecca A.; Conroy, Michael P.

2015-01-01

The Distributed Observer Network (DON) is a data presentation tool developed by the National Aeronautics and Space Administration (NASA) to distribute and publish simulation results. Leveraging the display capabilities inherent in modern gaming technology, DON places users in a fully navigable 3-D environment containing graphical models and allows the users to observe how those models evolve and interact over time in a given scenario. Each scenario is driven with data that has been generated by authoritative NASA simulation tools and exported in accordance with a published data interface specification. This decoupling of the data from the source tool enables DON to faithfully display a simulator's results and ensure that every simulation stakeholder will view the exact same information every time.

Attosecond Optics and Technology: Progress to Date and Future Prospects [Invited

DTIC Science & Technology

2016-06-01

1s electron in the hydrogen atom experiences is 5.14 × 109 V∕cm. In such a strong external field, an electron can be freed from an atom via tunneling ...been replaced by laser diodes , which leads to user-friendly products that deliver either single-longitudinal mode beams for pumping laser oscillators...steps. First, an electron is released by tunneling through the potential barrier formed by the atomic Coulomb field and the driving laser field. Then

Orchestrating high-throughput genomic analysis with Bioconductor

PubMed Central

Huber, Wolfgang; Carey, Vincent J.; Gentleman, Robert; Anders, Simon; Carlson, Marc; Carvalho, Benilton S.; Bravo, Hector Corrada; Davis, Sean; Gatto, Laurent; Girke, Thomas; Gottardo, Raphael; Hahne, Florian; Hansen, Kasper D.; Irizarry, Rafael A.; Lawrence, Michael; Love, Michael I.; MacDonald, James; Obenchain, Valerie; Oleś, Andrzej K.; Pagès, Hervé; Reyes, Alejandro; Shannon, Paul; Smyth, Gordon K.; Tenenbaum, Dan; Waldron, Levi; Morgan, Martin

2015-01-01

Bioconductor is an open-source, open-development software project for the analysis and comprehension of high-throughput data in genomics and molecular biology. The project aims to enable interdisciplinary research, collaboration and rapid development of scientific software. Based on the statistical programming language R, Bioconductor comprises 934 interoperable packages contributed by a large, diverse community of scientists. Packages cover a range of bioinformatic and statistical applications. They undergo formal initial review and continuous automated testing. We present an overview for prospective users and contributors. PMID:25633503

Who's your best customer?

PubMed

MacStravic, S

1998-01-01

Conventional wisdom holds that the best customers and prospects for managed care are the healthiest consumers. This is true only because of the meager extent to which premiums can be adjusted for varying risk among individuals. If a decent health/risk adjustment system were used, the best consumers for managed care to go after would be the highest-risk, highest users of health care, provided only that risk and use can be improved. The healthiest consumers have both the least potential for improvement and the least reasons for loyalty.

Metal matrix composite fabrication processes for high performance aerospace structures

NASA Astrophysics Data System (ADS)

Ponzi, C.

A survey is conducted of extant methods of metal matrix composite (MMC) production in order to serve as a basis for prospective MMC users' selection of a matrix/reinforcement combination, cost-effective primary fabrication methods, and secondary fabrication techniques for the achievement of desired performance levels. Attention is given to the illustrative cases of structural fittings, control-surface connecting rods, hypersonic aircraft air inlet ramps, helicopter swash plates, and turbine rotor disks. Methods for technical and cost analysis modeling useful in process optimization are noted.

Promoting physician referral services. Prospective users are not necessarily the best advertising target.

PubMed

Gelb, B D; Jones, M Y

1997-01-01

Providers of physician referral services (PRSs) often focus advertising toward consumers who are least aware that such services exist. However, focusing advertising toward a more aware audience might be more useful. A recent study found that consumers most familiar with health care services are most likely to remember the concept of a PRS. Since these consumers may discuss PRSs with others, there appears to be value in promoting PRSs to more aware consumers as intermediaries to diffuse information to less aware consumers.

Applying a Data Stewardship Maturity Matrix to the NOAA Observing System Portfolio Integrated Assessment Process

NASA Astrophysics Data System (ADS)

Peng, G.; Austin, M.

2017-12-01

Identification and prioritization of targeted user community needs are not always considered until after data has been created and archived. Gaps in data curation and documentation in the data production and delivery phases limit data's broad utility specifically for decision makers. Expert understanding and knowledge of a particular dataset is often required as a part of the data and metadata curation process to establish the credibility of the data and support informed decision-making. To enhance curation practices, content from NOAA's Observing System Integrated Assessment (NOSIA) Value Tree, NOAA's Data Catalog/Digital Object Identifier (DOI) projects (collection-level metadata) have been integrated with Data/Stewardship Maturity Matrices (data and stewardship quality information) focused on assessment of user community needs. This results in user focused evidence based decision making tools created by NOAA's National Environmental Satellite, Data, and Information Service (NESDIS) through identification and assessment of data content gaps related to scientific knowledge and application to key areas of societal benefit. Through enabling user need feedback from the beginning of data creation through archive allows users to determine the quality and value of data that is fit for purpose. Data gap assessment and prioritization are presented in a user-friendly way using the data stewardship maturity matrices as measurement of data management quality. These decision maker tools encourages data producers and data providers/stewards to consider users' needs prior to data creation and dissemination resulting in user driven data requirements increasing return on investment. A use case focused on need for NOAA observations linked societal benefit will be used to demonstrate the value of these tools.

Field observations of display placement requirements and character size for presbyopic and prepresbyopic computer users.

PubMed

Bartha, Michael C; Allie, Paul; Kokot, Douglas; Roe, Cynthia Purvis

2015-01-01

Computer users continue to report eye and upper body discomfort even as workstation flexibility has improved. Research shows a relationship between character size, viewing distance, and reading performance. Few reports exist regarding text height viewed under normal office work conditions and eye discomfort. This paper reports self-selected computer display placement, text characteristics, and subjective comfort for older and younger computer workers under real-world conditions. Computer workers were provided with monitors and adjustable display support(s). In Study 1, older workers wearing progressive-addition lenses (PALs) were observed. In study 2, older workers wearing multifocal lenses and younger workers were observed. Workers wearing PALs experienced less eye and body discomfort with adjustable displays, and less eye and neck discomfort for text visual angles near or greater than ergonomic recommendations. Older workers wearing multifocal correction positioned displays much lower than younger workers. In general, computer users did not adjust character size to ensure that fovial images of text fell within the recommended range. Ergonomic display placement recommendations should be different for computer users wearing multifocal correction for presbyopia. Ergonomic training should emphasize adjusting text size for user comfort.

A Prospective Observational Study of Technical Difficulty With GlideScope-Guided Tracheal Intubation in Children.

PubMed

Zhang, Bin; Gurnaney, Harshad G; Stricker, Paul A; Galvez, Jorge A; Isserman, Rebecca S; Fiadjoe, John E

2018-05-09

The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate. We conducted this observational study at our quaternary pediatric hospital between February 2014 and August 2014. We observed 200 GlideScope-guided intubations and documented key intubation-related outcomes. Inclusion criteria for patients were <6 years of age and elective surgery requiring endotracheal intubation. We documented the number of advancement maneuvers required to intubate the trachea, the location where technical difficulty occurred, the types of maneuvers used to address difficulties, and the tracheal intubation success rate. We used a bias-corrected bootstrapping method with 300 replicates to determine the 95% confidence interval (CI) around the rate of difficulty with an intubation attempt. After excluding attempts by inexperienced clinicians, there were 225 attempts in 187 patients, 58% (131 of 225; bootstrap CI, 51.6%-64.6%]) of the attempts had technical difficulties. Technical difficulty was most likely to occur when inserting the tracheal tube between the plane of the arytenoid cartilages to just beyond the vocal cords: "zone 3." Clockwise rotation of the tube was the most common successful corrective maneuver in zone 3. The overall tracheal intubation success rate was 98% (CI, 95%-99%); however, the first attempt success rate was only 80% (CI, 74%-86%). Patients with technical difficulty had more attempts (median [interquartile range], 2 [1-3] than those without technical difficulty median (interquartile range, 1 [1-1; P value <.01]). A variety of clinicians experience technical difficulties with the GlideScope Cobalt videolaryngoscope in children. These difficulties result in more tracheal intubation attempts, an important risk factor for intubation-associated complications. Targeted education of clinicians may reduce the incidence of technical difficulties.

The effect of prothrombotic blood abnormalities on risk of deep vein thrombosis in users of hormone replacement therapy: a prospective case-control study.

PubMed

Douketis, Jim D; Julian, Jim A; Crowther, Mark A; Kearon, Clive; Bates, Shannon M; Barone, Marisa; Piovella, Franco; Middeldorp, Saskia; Prandoni, Paolo; Johnston, Marilyn; Costantini, Lorrie; Ginsberg, Jeffrey S

2011-01-01

Few studies have assessed the effect of prothrombotic blood abnormalities on the risk of deep vein thrombosis (DVT) with hormone replacement therapy (HRT). We studied postmenopausal women with suspected DVT in whom HRT use and prothrombotic blood abnormalities were sought. Cases had unprovoked DVT and controls had no DVT and without DVT risk factors. The risk of DVT was determined in women with and without prothrombotic abnormalities. A total of 510 postmenopausal women with suspected DVT were assessed; 57 cases and 283 controls were identified. Compared to HRT, nonusers without the factor V Leiden mutation, the risk of DVT was increased in estrogen-progestin HRT users (odds ratio [OR], 3.2; 95% confidence interval [CI]: 1.2-8.6) and in nonusers with the factor V Leiden mutation (OR, 5.3; 1.9-15.4) and appears multiplied in users of estrogen-progestin HRT with the factor V Leiden mutation (OR, 17.1; 3.7-78). Compared to HRT, nonusers with normal factor VIII, the risk of DVT was increased in estrogen-progestin HRT users with normal factor VIII (OR, 2.8; 1.0-7.9) and in HRT nonusers with the highest factor VIII quartile (OR, 6.0; 2.1-17), and appears to be multiplied in women who are users of estrogen-progestin HRT with the highest factor VIII quartile (OR, 17.0; 3.6-80). In postmenopausal women who are estrogen-progestin HRT users, the presence of the factor V Leiden mutation or an elevated factor VIII level appears to have a multiplicative effect on their overall risk of DVT, increasing it 17-fold compared to women without these blood abnormalities who are HRT nonusers.

Relationship between hunger, adherence to antiretroviral therapy and plasma HIV RNA suppression among HIV-positive illicit drug users in a Canadian setting.

PubMed

Anema, Aranka; Kerr, Thomas; Milloy, M-J; Feng, Cindy; Montaner, Julio S G; Wood, Evan

2014-04-01

Food insecurity may be a barrier to achieving optimal HIV treatment-related outcomes among illicit drug users. This study therefore, aimed to assess the impact of severe food insecurity, or hunger, on plasma HIV RNA suppression among illicit drug users receiving antiretroviral therapy (ART). A cross-sectional Multivariate logistic regression model was used to assess the potential relationship between hunger and plasma HIV RNA suppression. A sample of n = 406 adults was derived from a community-recruited open prospective cohort of HIV-positive illicit drug users, in Vancouver, British Columbia (BC), Canada. A total of 235 (63.7%) reported "being hungry and unable to afford enough food," and 241 (59.4%) had plasma HIV RNA < 50 copies/ml. In unadjusted analyses, self-reported hunger was associated with lower odds of plasma HIV RNA suppression (Odds Ratio = 0.59, 95% confidence interval [CI]: 0.39-0.90, p = 0.015). In multivariate analyses, this association was no longer significant after controlling for socio-demographic, behavioral, and clinical characteristics, including 95% adherence (Adjusted Odds Ratio [AOR] = 0.65, 95% CI: 0.37-1.10, p = 0.105). Multivariate models stratified by 95% adherence found that the direction and magnitude of this association was not significantly altered by the adherence level. Hunger was common among illicit drug users in this setting. Although, there was an association between hunger and lower likelihood of plasma HIV RNA suppression, this did not persist in adjusted analyses. Further research is warranted to understand the social-structural, policy, and physical factors shaping the HIV outcomes of illicit drug users.

Maternal cell phone use in early pregnancy and child's language, communication and motor skills at 3 and 5 years: the Norwegian mother and child cohort study (MoBa).

PubMed

Papadopoulou, Eleni; Haugen, Margaretha; Schjølberg, Synnve; Magnus, Per; Brunborg, Gunnar; Vrijheid, Martine; Alexander, Jan

2017-09-05

Cell phone use during pregnancy is a public health concern. We investigated the association between maternal cell phone use in pregnancy and child's language, communication and motor skills at 3 and 5 years. This prospective study includes 45,389 mother-child pairs, participants of the MoBa, recruited at mid-pregnancy from 1999 to 2008. Maternal frequency of cell phone use in early pregnancy and child language, communication and motor skills at 3 and 5 years, were assessed by questionnaires. Logistic regression was used to estimate the associations. No cell phone use in early pregnancy was reported by 9.8% of women, while 39%, 46.9% and 4.3% of the women were categorized as low, medium and high cell phone users. Children of cell phone user mothers had 17% (OR = 0.83, 95% CI: 0.77, 0.89) lower adjusted risk of having low sentence complexity at 3 years, compared to children of non-users. The risk was 13%, 22% and 29% lower by low, medium and high maternal cell phone use. Additionally, children of cell phone users had lower risk of low motor skills score at 3 years, compared to children of non-users, but this association was not found at 5 years. We found no association between maternal cell phone use and low communication skills. We reported a decreased risk of low language and motor skills at three years in relation to prenatal cell phone use, which might be explained by enhanced maternal-child interaction among cell phone users. No evidence of adverse neurodevelopmental effects of prenatal cell phone use was reported.

Screening for risk of violence using service users' self-perceptions: A prospective study from an acute mental health unit.

PubMed

Lockertsen, Øyvind; Procter, Nicolas; Vatnar, Solveig Karin Bø; Faerden, Ann; Eriksen, Bjørn Magne S; Roaldset, John Olav; Varvin, Sverre

2018-06-01

Service users' self-perception of risk has rarely been emphasized in violence risk assessments. A recent review pointed to the importance of a multidisciplinary approach, because different perspectives may provide a deeper and improved understanding of risk assessment. The aim of this study was to investigate service users' perceptions of their own risk of committing violence, using a self-report risk scale, to determine the feasibility and efficacy of this potential violence risk marker during acute mental health hospitalization. All service users admitted to a psychiatric emergency hospital in Norway during one calendar year were included (N = 512). Nearly 80% self-reported no risk or low risk; only seven (1.4%) reported moderate risk or high risk. Service users who reported moderate risk, high risk, don't know, or won't answer were more likely to be violent (OR = 4.65, 95% CI = 2.79-7.74) compared with those who reported no risk or low risk. There was a significant gender interaction with higher OR for women on both univariate and multivariate analyses. Although the OR was higher for women, women's violence rate (11.0%) was almost half that of men (21.8%). For women, sensitivity and specificity were 0.55 and 0.88, respectively; corresponding values for men were 0.40 and 0.80. Inclusion of self-perception of violence risk is the first step towards service users' collaborative involvement in violence prediction; these results indicate that self-perception can contribute to violence risk assessments in acute mental health settings. Findings also indicate that there are gender differences in these assessments. © 2017 Australian College of Mental Health Nurses Inc.

Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study

PubMed Central

Lizano-Díez, Irene; Modamio, Pilar; López-Calahorra, Pilar; Lastra, Cecilia F; Segú, Jose L; Gilabert-Perramon, Antoni; Mariño, Eduardo L

2014-01-01

Objectives To assess whether electronic prescribing is a comprehensive health management tool that may contribute to rational drug use, particularly in polymedicated patients receiving 16 or more medications in the public healthcare system in the Barcelona Health Region (BHR). Design 16 months of retrospective study followed by 12 months of prospective monitoring. Setting Primary healthcare in BHR, Catalonia, Spain. Participants All insured patients, especially those who are polymedicated in six basic health areas (BHA). Polymedicated patients were those with a consumption of ≥16 drugs/month. Interventions Monitoring demographic and consumption variables obtained from the records of prescriptions dispensed in pharmacies and charged to the public health system, as well as the resulting drug use indicators. Territorial variables related to implementation of electronic prescribing were also described and were obtained from the institutional data related to the deployment of the project. Main outcome measures Trend in drug use indicators (number of prescriptions per polymedicated user, total cost per polymedicated user and total cost per prescription) according to e-prescription implementation. Results There was a significant upward trend in the number of polymedicated users, number of prescriptions and total cost (p<0.05), which seemed independent from the implementation of electronic prescribing when comparing the preimplementation and postimplementation period. Prescriptions per user and cost per user showed a decrease between the preimplementation and postimplementation period, being significant in two BHAs (p<0.05). Conclusions Results suggest that after the implementation of electronic prescribing, the rationality of prescribing in polymedicated patients improved. In addition, this study provides a very valuable approach for future impact assessment. PMID:25377013

Statin Use and Serum Lipid Levels Are Associated With Survival Outcomes After Surgery for Renal Cell Carcinoma.

PubMed

Haddad, Ahmed Q; Jiang, Lai; Cadeddu, Jeffrey A; Lotan, Yair; Gahan, Jeffrey C; Hynan, Linda S; Gupta, Neil; Raj, Ganesh V; Sagalowsky, Arthur I; Margulis, Vitaly

2015-12-01

To evaluate the association of statin use and preoperative serum lipid parameters with oncologic outcomes following surgery for renal cell carcinoma. A total of 850 patients who underwent surgery for localized renal cell carcinoma at our institution from 2000 to 2012 were included. Use of statins, preoperative serum lipid profile, and comprehensive clinicopathologic features were retrospectively recorded. Kaplan-Meier analysis and multivariate Cox proportional hazards model were employed to compare survival outcomes. There were 342 statin users and 508 non-users. Median follow-up was 25.0 months. Statin users were older, had greater body mass index, and had worse performance status than non-users. Tumor pathologic characteristics were balanced between groups. Five-year recurrence free survival (RFS) was 77.9% for non-users compared with 87.6% for statin users (P = .004). After adjustment for clinicopathologic variables, statin use was independently associated with improved RFS (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.33-0.86, P = .011) and overall survival (HR 0.45, 95%CI 0.28-0.71, P = .001). In patients with available serum lipid parameters (n = 193), 5-year RFS was 83.8% for patients with triglycerides <250 mg/dL compared with 33.3% for those with triglycerides >250 mg/dL (P <.0001). Elevated serum triglycerides (>250 mg/dL) was independently associated with worse RFS (HR 2.69, 95%CI 1.22-5.93, P = .015) on multivariate analysis. Statin use was independently associated with improved survival, whereas elevated serum triglyceride levels correlated with worse oncologic outcomes in this cohort. These findings warrant validation in prospective studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment of the quality of cervical mucus among users of the levonorgestrel-releasing intrauterine system at different times of use.

PubMed

Moraes, Leticia G; Marchi, Nadia M; Pitoli, Ana C; Hidalgo, Maria M; Silveira, Carolina; Modesto, Waleska; Bahamondes, Luis

2016-08-01

The quality of cervical mucus (CM) among the levonorgestrel-releasing intrauterine system (LNG-IUS) users is controversial. The objectives were to assess CM compared to the levels of oestradiol (E2) and the frequency of cycles with luteal activity among users of the LNG-IUS. In total, 224 LNG-IUS users for between two months and five years were recruited at a Brazilian family planning clinic. For the cross-sectional part of the study, we enrolled 175 LNG-IUS users at 2, 6 12, 24, 36, 48, and 60 months after insertion (25 women in each group), and we performed one evaluation. For the prospective part of the study, we enrolled 49 LNG-IUS users at the same lengths of use after insertion (7 women in each group), and we evaluated these women once a week for five consecutive weeks. . Mean (± SEM) CM scores of all evaluations among women with single and weekly evaluations were between 3.3 ± 0.9 and 8.5 ± 0.3, respectively independently of the length of use of the LNG-IUS. Mean E2 values ranged from 45.5 ± 6.8 to 472.5 ± 34.7 pg/ml and the maximum ovarian follicle diameter on the days of evaluation varied from 14.0 ± 1.3 to 31.2 ± 0.4 mm. The mean CM score of all evaluations, independent of the length of use of the LNG-IUS and normal levels of serum E2, was below 10 was according to the WHO is inadequate for sperm penetration.

Individual differences in decision making and reward processing predict changes in cannabis use: a prospective functional magnetic resonance imaging study.

PubMed

Cousijn, Janna; Wiers, Reinout W; Ridderinkhof, K Richard; van den Brink, Wim; Veltman, Dick J; Porrino, Linda J; Goudriaan, Anna E

2013-11-01

Decision-making deficits are thought to play an important role in the development and persistence of substance use disorders. Individual differences in decision-making abilities and their underlying neurocircuitry may, therefore, constitute an important predictor for the course of substance use and the development of substance use disorders. Here, we investigate the predictive value of decision making and neural mechanisms underlying decision making for future cannabis use and problem severity in a sample of heavy cannabis users. Brain activity during a monetary decision-making task (Iowa gambling task) was compared between 32 heavy cannabis users and 41 matched non-using controls using functional magnetic resonance imaging. In addition, within the group of heavy cannabis users, associations were examined between task-related brain activations, cannabis use and cannabis use-related problems at baseline, and change in cannabis use and problem severity after a 6-month follow-up. Despite normal task performance, heavy cannabis users compared with controls showed higher activation during wins in core areas associated with decision making. Moreover, within the group of heavy cannabis users, win-related activity and activity anticipating loss outcomes in areas generally involved in executive functions predicted change in cannabis use after 6 months. These findings are consistent with previous studies and point to abnormal processing of motivational information in heavy cannabis users. A new finding is that individuals who are biased toward immediate rewards have a higher probability of increasing drug use, highlighting the importance of the relative balance between motivational processes and regulatory executive processes in the development of substance use disorders. © 2012 The Authors, Addiction Biology © 2012 Society for the Study of Addiction.

An internet-based survey of 96 German-speaking users of "bath salts": frequent complications, risky sexual behavior, violence, and delinquency.

PubMed

Schmoll, Sabrina; Romanek, Katrin; Stich, Raphael; Bekka, Elias; Stenzel, Jochen; Geith, Stefanie; Eyer, Florian; Rabe, Christian

2018-03-01

To define the demographics of German-speaking "bath salt" users. Prospective web-based survey of volunteer users of "bath salts". Subject recruitment/exclusion: Participation was solicited by posts in web forums frequented by users of synthetic cathinones. An invitation to participate was also disseminated via regional drug information centers. Responses were discarded if participants refused data analysis, provided incomplete surveys, were under 18 years of age (five cases), and in case of clearly improbable answers (i.e., two cases with profanity typed in free-form input fields). Overall 96 out of 180 participants provided complete questionnaires. These were further analyzed. 74% of respondents were male. 41% were under the age of 30 and a further 38% between 30 and 39 years old. Cathinones were used on more than 10 days in the preceding year by 62% of study subjects. The nasal and intravenous routes of administration were most often used. About 80% of respondents reported binge use. There were frequent co-administrations of opioids and opiates. The most common complication was prolonged confusion (47%). 16% had been involuntarily confined. One third had thoughts of violence and 16% acted on these thoughts either against themselves or others. About 44% reported high-risk sexual activity under the influence of cathinones. About 31% had driven or ridden a bike while intoxicated. About 6% had problems with law-enforcement for selling cathinones and 16% for crimes committed under the influence of cathinones. In conclusion, cathinone users are typically young males in their twenties and thirties. Most are experienced drug users, particularly of alcohol and opiates/opioids. The impact on society is tremendous as evidenced by high rates of self-reported violence, high-risk sexual activity, crimes, and traffic violations.

Maximising the benefits of satellite LST within the user community: ESA DUE GlobTemperature

NASA Astrophysics Data System (ADS)

Ghent, D.

2014-12-01

Land surface temperature (LST) is the mean radiative skin temperature of an area of land resulting from the mean balance of solar heating and land-atmosphere cooling fluxes. It is a basic determinant of the terrestrial thermal behaviour, as it controls the effective radiating temperature of the Earth's surface. The sensitivity of LST to soil moisture and vegetation cover means it is an important component in numerous applications. With the demand for LST data from Earth Observation currently experiencing considerable growth it is important that the users of this data are appropriately engaged by the LST data providers. The GlobTemperature project under the Data User Element of ESA's 4th Earth Observation Envelope Programme (2013-2017) aims to promote the wider uptake of global-scale satellite LST by the research and operational user communities; the key to success depending on the coherence and openness of the interactions between the LST and user communities. By incorporating detailed user input into the specifications, their subsequent testing of the LST data sets, and sustained access to data in a user-friendly manner through common data formats GlobTemperature is enhancing the portfolio of LST products from Earth Observation, while concurrently breaking down the barriers to successful application of such data through its programme of dialogue between the data providers and data users. Here we present the outcomes from the first phase of the project, which is achieving some innovative developments: a globally representative and consistent matchup database enabling validation and intercomparison of multi-sensor LST data sets; a prototype combined geostationary earth orbit (GEO) and low earth orbit (LEO) global data set for LST to resolve the diurnal cycle which is a key request from users of LST data; the delivery of the first LST data sets via a dedicated Data Portal in harmonised data format; and the establishment, in collaboration with international colleagues of a first working group (ILSTE-WG) dedicated to LST and Emissivity, whereby user evaluation of products by climate services aims to provide a thrust to sustained operational support of this group meeting a critical need amongst users of LST data.

Magnetic resonance imaging (MRI) of hormone-induced breast changes in young premenopausal women.

PubMed

Clendenen, Tess V; Kim, Sungheon; Moy, Linda; Wan, Livia; Rusinek, Henry; Stanczyk, Frank Z; Pike, Malcolm C; Zeleniuch-Jacquotte, Anne

2013-01-01

We conducted a pilot study to identify whether MRI parameters are sensitive to hormone-induced changes in the breast during the natural menstrual cycle and whether changes could also be observed during an oral contraceptive (OC) cycle. The New York University Langone Medical Center Institutional Review Board approved this HIPAA-compliant prospective study. All participants provided written informed consent. Participants were aged 24-31 years.We measured several non-contrast breast MRI parameters during each week of a single menstrual cycle (among 9 women) and OC cycle (among 8 women). Hormones were measured to confirm ovulation and classify menstrual cycle phase among naturally cycling women and to monitor OC compliance among OC users. We investigated how the non-contrast MRI parameters of breast fibroglandular tissue (FGT), apparent diffusion coefficient (ADC), magnetization transfer ratio (MTR), and transverse relaxation time (T2) varied over the natural and the OC cycles. We observed significant increases in MRI FGT% and ADC in FGT, and longer T2 in FGT in the luteal vs. follicular phase of the menstrual cycle. We did not observe any consistent pattern of change for any of the MRI parameters among women using OCs. MRI is sensitive to hormone-induced breast tissue changes during the menstrual cycle. Larger studies are needed to assess whether MRI is also sensitive to the effects of exogenous hormones, such as various OC formulations, on the breast tissue of young premenopausal women. Copyright © 2013 Elsevier Inc. All rights reserved.

An MRI study of white matter tract integrity in regular cannabis users: effects of cannabis use and age.

PubMed

Jakabek, David; Yücel, Murat; Lorenzetti, Valentina; Solowij, Nadia

2016-10-01

Conflicting evidence exists on the effects of cannabis use on brain white matter integrity. The extant literature has exclusively focused on younger cannabis users, with no studies sampling older cannabis users. We recruited a sample with a broad age range to examine the integrity of major white matter tracts in association with cannabis use parameters and neurodevelopmental stage. Regular cannabis users (n = 56) and non-users (n = 20) with a mean age of 32 (range 18-55 years) underwent structural and diffusion MRI scans. White matter was examined using voxel-based statistics and via probabilistic tract reconstruction. The integrity of tracts was assessed using average fractional anisotropy, axial diffusivity and radial diffusivity. Diffusion measures were compared between users and non-users and as group-by-age interactions. Correlations between diffusion measures and age of onset, duration, frequency and dose of current cannabis use were examined. Cannabis users overall had lower fractional anisotropy than healthy non-users in the forceps minor tract only (p = .015, partial eta = 0.07), with no voxel-wise differences observed. Younger users showed predominantly reduced axial diffusivity, whereas older users had higher radial diffusivity in widespread tracts. Higher axial diffusivity was associated with duration of cannabis use in the cingulum angular bundle (beta = 5.00 × 10(-5), p = .003). Isolated higher AD in older cannabis users was also observed. The findings suggest that exogenous cannabinoids alter normal brain maturation, with differing effects at various neurodevelopmental stages of life. These age-related differences are posited to account for the disparate results described in the literature.

Sensitivity Observing System Experiment (SOSE)-a new effective NWP-based tool in designing the global observing system

NASA Astrophysics Data System (ADS)

Marseille, Gert-Jan; Stoffelen, Ad; Barkmeijer, Jan

2008-03-01

Lacking an established methodology to test the potential impact of prospective extensions to the global observing system (GOS) in real atmospheric cases we developed such a method, called Sensitivity Observing System Experiment (SOSE). For example, since the GOS is non uniform it is of interest to investigate the benefit of complementary observing systems filling its gaps. In a SOSE adjoint sensitivity structures are used to define a pseudo true atmospheric state for the simulation of the prospective observing system. Next, the synthetic observations are used together with real observations from the existing GOS in a state-of-the-art Numerical Weather Prediction (NWP) model to assess the potential added value of the new observing system. Unlike full observing system simulation experiments (OSSE), SOSE can be applied to real extreme events that were badly forecast operationally and only requires the simulation of the new instrument. As such SOSE is an effective tool, for example, to define observation requirements for extensions to the GOS. These observation requirements may serve as input for the design of an operational network of prospective observing systems. In a companion paper we use SOSE to simulate potential future space borne Doppler Wind Lidar (DWL) scenarios and assess their capability to sample meteorologically sensitive areas not well captured by the current GOS, in particular over the Northern Hemisphere oceans.

Software applications for flux balance analysis.

PubMed

Lakshmanan, Meiyappan; Koh, Geoffrey; Chung, Bevan K S; Lee, Dong-Yup

2014-01-01

Flux balance analysis (FBA) is a widely used computational method for characterizing and engineering intrinsic cellular metabolism. The increasing number of its successful applications and growing popularity are possibly attributable to the availability of specific software tools for FBA. Each tool has its unique features and limitations with respect to operational environment, user-interface and supported analysis algorithms. Presented herein is an in-depth evaluation of currently available FBA applications, focusing mainly on usability, functionality, graphical representation and inter-operability. Overall, most of the applications are able to perform basic features of model creation and FBA simulation. COBRA toolbox, OptFlux and FASIMU are versatile to support advanced in silico algorithms to identify environmental and genetic targets for strain design. SurreyFBA, WEbcoli, Acorn, FAME, GEMSiRV and MetaFluxNet are the distinct tools which provide the user friendly interfaces in model handling. In terms of software architecture, FBA-SimVis and OptFlux have the flexible environments as they enable the plug-in/add-on feature to aid prospective functional extensions. Notably, an increasing trend towards the implementation of more tailored e-services such as central model repository and assistance to collaborative efforts was observed among the web-based applications with the help of advanced web-technologies. Furthermore, most recent applications such as the Model SEED, FAME, MetaFlux and MicrobesFlux have even included several routines to facilitate the reconstruction of genome-scale metabolic models. Finally, a brief discussion on the future directions of FBA applications was made for the benefit of potential tool developers.

Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study.

PubMed

Close, Helen; Mason, James M; Wilson, Douglas; Hungin, A Pali S

2012-05-29

Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT). Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD) remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. 51,182 menopausal women were identified using the UK General Practice Research Database between 1995-2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs) were calculated for GORD and proton-pump inhibitor (PPI) use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen) were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18-1.89). Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03-1.74). Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01-2.22). This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance.

An Information Architect's View of Earth Observations for Disaster Risk Management

NASA Astrophysics Data System (ADS)

Moe, K.; Evans, J. D.; Cappelaere, P. G.; Frye, S. W.; Mandl, D.; Dobbs, K. E.

2014-12-01

Satellite observations play a significant role in supporting disaster response and risk management, however data complexity is a barrier to broader use especially by the public. In December 2013 the Committee on Earth Observation Satellites Working Group on Information Systems and Services documented a high-level reference model for the use of Earth observation satellites and associated products to support disaster risk management within the Global Earth Observation System of Systems context. The enterprise architecture identified the important role of user access to all key functions supporting situational awareness and decision-making. This paper focuses on the need to develop actionable information products from these Earth observations to simplify the discovery, access and use of tailored products. To this end, our team has developed an Open GeoSocial API proof-of-concept for GEOSS. We envision public access to mobile apps available on smart phones using common browsers where users can set up a profile and specify a region of interest for monitoring events such as floods and landslides. Information about susceptibility and weather forecasts about flood risks can be accessed. Users can generate geo-located information and photos of local events, and these can be shared on social media. The information architecture can address usability challenges to transform sensor data into actionable information, based on the terminology of the emergency management community responsible for informing the public. This paper describes the approach to collecting relevant material from the disasters and risk management community to address the end user needs for information. The resulting information architecture addresses the structural design of the shared information in the disasters and risk management enterprise. Key challenges are organizing and labeling information to support both online user communities and machine-to-machine processing for automated product generation.

Activity-based prospective memory in schizophrenia.

PubMed

Kumar, Devvarta; Nizamie, S Haque; Jahan, Masroor

2008-05-01

The study reports activity-based prospective memory as well as its clinical and neuropsychological correlates in schizophrenia. A total of 42 persons diagnosed with schizophrenia and 42 healthy controls were administered prospective memory, set-shifting, and verbal working memory tasks. The schizophrenia group was additionally administered various psychopathology rating scales. Group differences, with poorer performances of the schizophrenia group, were observed on the measures of prospective memory, working memory, and set shifting. The performance on prospective memory tasks correlated with the performance levels on verbal working memory and set-shifting tasks but not with the clinical measures. This study demonstrated impaired activity-based prospective memory in schizophrenia. The impairment can be due to deficits in various neuropsychological domains.

Variations in institutional review board processes and consent requirements for trauma research: an EAST multicenter survey

PubMed Central

Nahmias, Jeffry; Brakenridge, Scott; Jawa, Randeep S; Holena, Daniel N; Agapian, John Varujan; Bruns, Brandon; Chestovich, Paul J; Chung, Bruce; Nguyen, Jonathan; Schulman, Carl I; Staudenmayer, Kristan; Dixon, Rachel; Smith, Jason W; Bernard, Andrew C; Pascual, Jose L

2018-01-01

Oversight of human subject research has evolved considerably since its inception. However, previous studies identified a lack of consistency of institutional review board (IRB) determination for the type of review required and whether informed consent is necessary, especially for prospective observational studies, which pose minimal risk of harm. We hypothesized that there is significant inter-institution variation in IRB requirements for the type of review and necessity of informed consent, especially for prospective observational trials without blood/tissue utilization. We also sought to describe investigators’ and IRB members’ attitudes toward the type of review and need for consent. Eastern Association for the Surgery of Trauma (EAST) and IRB members were sent an electronic survey on IRB review and informed consent requirement. We performed descriptive analyses as well as Fisher’s exact test to determine differences between EAST and IRB members’ responses. The response rate for EAST members from 113 institutions was 13.5%, whereas a convenience sample of IRB members from 14 institutions had a response rate of 64.4%. Requirement for full IRB review for retrospective studies using patient identifiers was reported by zero IRB member compared with 13.1% of EAST members (p=0.05). Regarding prospective observational trials without blood/tissue collection, 48.1% of EAST members reported their institutions required a full IRB review compared with 9.5% of IRB members (p=0.01). For prospective observational trials with blood/tissue collection, 80% of EAST members indicated requirement to submit a full IRB review compared with only 13.6% of IRB members (p<0.001). Most EAST members (78.6%) stated that informed consent is not ethically necessary in prospective observational trials without blood/tissue collection, whereas most IRB members thought that informed consent was ethically necessary (63.6%, p<0.001). There is significant variation in perception and practice regarding the level of review for prospective observational studies and whether informed consent is necessary. We recommend future interdisciplinary efforts between researchers and IRBs should occur to better standardize local IRB efforts. Level of evidence IV. PMID:29862323

Language development in Japanese children who receive cochlear implant and/or hearing aid.

PubMed

Iwasaki, Satoshi; Nishio, Shinya; Moteki, Hideaki; Takumi, Yutaka; Fukushima, Kunihiro; Kasai, Norio; Usami, Shin-Ichi

2012-03-01

This study aimed to investigate a wide variety of factors that influence auditory, speech, and language development following pediatric cochlear implantation (CI). Prospective collection of language tested data in profound hearing-impaired children. Pediatric CI can potentially be effective to development of practical communication skills and early implantation is more effective. We proposed a set of language tests (assessment package of the language development for Japanese hearing-impaired children; ALADJIN) consisting of communication skills testing (test for question-answer interaction development; TQAID), comprehensive (Peabody Picture Vocabulary Test-Revised; PVT-R and Standardized Comprehension Test for Abstract Words; SCTAW) and productive vocabulary (Word Fluency Test; WFT), and comprehensive and productive syntax (Syntactic processing Test for Aphasia; STA). Of 638 hearing-impaired children recruited for this study, 282 (44.2%) with >70 dB hearing impairment had undergone CI. After excluding children with low birth weight (<1800 g), those with >11 points on the Pervasive Developmental Disorder ASJ Rating Scale for the test of autistic tendency, and those <2 SD on Raven's Colored Progressive Matrices for the test of non-verbal intelligence, 190 children were subjected to this set of language tests. Sixty children (31.6%) were unilateral CI-only users, 128 (67.4%) were CI-hearing aid (HA) users, and 2 (1.1%) were bilateral CI users. Hearing loss level of CI users was significantly (p<0.01) worse than that of HA-only users. However, the threshold level, maximum speech discrimination score, and speech intelligibility rating in CI users were significantly (p<0.01) better than those in HA-only users. The scores for PVT-R (p<0.01), SCTAW, and WFT in CI users were better than those in HA-only users. STA and TQAID scores in CI-HA users were significantly (p<0.05) better than those in unilateral CI-only users. The high correlation (r=0.52) has been found between the age of CI and maximum speech discrimination score. The scores of speech and language tests in the implanted children before 24 months of age have been better than those in the implanted children after 24 months of age. We could indicate that CI was effective for language development in Japanese hearing-impaired children and early CI was more effective for productive vocabulary and syntax. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Solar research with ALMA: Czech node of European ARC as your user-support infrastructure

NASA Astrophysics Data System (ADS)

Bárta, M.; Skokić, I.; Brajša, R.; Czech ARC Node Team

2017-08-01

ALMA (Atacama Large Millimeter/sub-millimeter Array) is by far the largest project of current ground-based observational facilities in astronomy and astrophysics. It is built and operated in the world-wide cooperation (ESO, NRAO, NAOJ) at altitude of 5000m in the desert of Atacama, Chile. Because of its unprecedented capabilities, ALMA is considered as a cutting-edge research device in astrophysics with potential for many breakthrough discoveries in the next decade and beyond. In spite it is not exclusively solar-research dedicated instrument, science observations of the Sun are now possible and has recently started in the observing Cycle 4 (2016-2017). In order to facilitate user access to this top-class, but at the same moment very complicated device to researchers lacking technical expertise, a network of three ALMA Regional Centers (ARCs) has been formed in Europe, North America, and East Asia as a user-support infrastructure and interface between the observatory and users community. After short introduction to ALMA the roles of ARCs and hint how to utilize their services will be presented, with emphasis to the specific (and in Europe unique) mission of the Czech ARC node in solar research with ALMA. Finally, peculiarities of solar observations that demanded the development of the specific Solar ALMA Observing Modes will be discussed and the results of Commissioning and Science Verification observing campaigns (solar ALMA maps) will be shown.

Highest Resolution In Vivo Human Brain MRI Using Prospective Motion Correction

PubMed Central

Stucht, Daniel; Danishad, K. Appu; Schulze, Peter; Godenschweger, Frank; Zaitsev, Maxim; Speck, Oliver

2015-01-01

High field MRI systems, such as 7 Tesla (T) scanners, can deliver higher signal to noise ratio (SNR) than lower field scanners and thus allow for the acquisition of data with higher spatial resolution, which is often demanded by users in the fields of clinical and neuroscientific imaging. However, high resolution scans may require long acquisition times, which in turn increase the discomfort for the subject and the risk of subject motion. Even with a cooperative and trained subject, involuntary motion due to heartbeat, swallowing, respiration and changes in muscle tone can cause image artifacts that reduce the effective resolution. In addition, scanning with higher resolution leads to increased sensitivity to even very small movements. Prospective motion correction (PMC) at 3T and 7T has proven to increase image quality in case of subject motion. Although the application of prospective motion correction is becoming more popular, previous articles focused on proof of concept studies and technical descriptions, whereas this paper briefly describes the technical aspects of the optical tracking system, marker fixation and cross calibration and focuses on the application of PMC to very high resolution imaging without intentional motion. In this study we acquired in vivo MR images at 7T using prospective motion correction during long acquisitions. As a result, we present images among the highest, if not the highest resolution of in vivo human brain MRI ever acquired. PMID:26226146

Evolution or Entropy? Changing Reference/User Culture and the Future of Reference Librarians.

ERIC Educational Resources Information Center

Wilson, Myoung C.

2000-01-01

This article addresses issues that relate to the changing functional relationship between the reference librarian and the user, based on the observation that the advance of information technology, particularly the Internet, has altered the values, attitudes, and beliefs of library users, and, as a consequence, their micro-culture. (Author/LRW)

Exploration of Web Users' Search Interests through Automatic Subject Categorization of Query Terms.

ERIC Educational Resources Information Center

Pu, Hsiao-tieh; Yang, Chyan; Chuang, Shui-Lung

2001-01-01

Proposes a mechanism that carefully integrates human and machine efforts to explore Web users' search interests. The approach consists of a four-step process: extraction of core terms; construction of subject taxonomy; automatic subject categorization of query terms; and observation of users' search interests. Research findings are proved valuable…

Rates of Bone Loss Among Women Initiating Antidepressant Medication Use in Midlife

PubMed Central

Ruppert, Kristine; Cauley, Jane A.; Lian, YinJuan; Bromberger, Joyce T.; Finkelstein, Joel S.; Greendale, Gail A.; Solomon, Daniel H.

2013-01-01

Context: Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. Objective: The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. Design and Setting: We conducted a prospective cohort study at five clinical centers in the United States. Participants: The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). Exposure: The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. Main Outcome Measures: BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. Results: BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). Conclusions: In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck. PMID:24001746

Solar research with ALMA: Czech node of European ARC as your user-support infrastructure

NASA Astrophysics Data System (ADS)

Bárta, M.; Skokić, I.; Brajša, R.; Czech ARC Node Team

2017-08-01

ALMA (Atacama Large Millimeter/sub-millimeter Array) is by far the largest project of current ground-based observational facilities in astronomy and astrophysics. It is built and operated in the world-wide cooperation (ESO, NRAO, NAOJ) at altitude of 5000m in the desert of Atacama, Chile. Because of its unprecedented capabilities, ALMA is considered as a cutting-edge research device in astrophysics with potential for many breakthrough discoveries in the next decade and beyond. In spite it is not exclusively solar-research dedicated instrument, science observations of the Sun are now possible and has recently started in the observing Cycle 4 (2016-2017). In order to facilitate user access to this top-class, but at the same moment very complicated device to researchers lacking technical expertise, a network of three ALMA Regional Centers (ARCs) has been formed in Europe, North America, and East Asia as a user-support infrastructure and interface between the observatory and users community. After short introduction to ALMA the roles of ARCs and hint how to utilize their services will be presented, with emphasis to the specific (and in Europe unique) mission of the Czech ARC node in solar research with ALMA. Finally, peculiarities of solar observations that demanded the development of the specific Solar ALMA Observing Modes will be discuss

Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

PubMed

Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

2017-01-01

The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Who Is Using Outdoor Fitness Equipment and How? The Case of Xihu Park

PubMed Central

Chow, Hsueh-wen; Mowen, Andrew J.; Wu, Guan-lin

2017-01-01

Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu Park. Results indicate that OFE in this park attracted considerable use, particularly in the early morning and late afternoon. During these peak-hour observations, approximately 12 users per hour used the OFE, with the majority being females and seniors. The triple arm stretch and air walker were the most popular stations. However, most OFE users interacted with less than three of the available six OFE stations. Furthermore, users spent an average of less than nine minutes on all OFE stations combined. While OFE equipment was well-used in this urban park, it appears users did not interact with OFE at rates to produce a sufficient bout or level of physical activity during their park visit. Further investigations of OFE are encouraged to determine their health impact. PMID:28430141

Capturing User Reading Behaviors for Personalized Document Summarization

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

Xu, Songhua; Jiang, Hao; Lau, Francis

2011-01-01

We propose a new personalized document summarization method that observes a user's personal reading preferences. These preferences are inferred from the user's reading behaviors, including facial expressions, gaze positions, and reading durations that were captured during the user's past reading activities. We compare the performance of our algorithm with that of a few peer algorithms and software packages. The results of our comparative study show that our algorithm can produce more superior personalized document summaries than all the other methods in that the summaries generated by our algorithm can better satisfy a user's personal preferences.

Use of dispersion modelling for Environmental Impact Assessment of biological air pollution from composting: Progress, problems and prospects.

PubMed

Douglas, P; Hayes, E T; Williams, W B; Tyrrel, S F; Kinnersley, R P; Walsh, K; O'Driscoll, M; Longhurst, P J; Pollard, S J T; Drew, G H

2017-12-01

With the increase in composting asa sustainable waste management option, biological air pollution (bioaerosols) from composting facilities have become a cause of increasing concern due to their potential health impacts. Estimating community exposure to bioaerosols is problematic due to limitations in current monitoring methods. Atmospheric dispersion modelling can be used to estimate exposure concentrations, however several issues arise from the lack of appropriate bioaerosol data to use as inputs into models, and the complexity of the emission sources at composting facilities. This paper analyses current progress in using dispersion models for bioaerosols, examines the remaining problems and provides recommendations for future prospects in this area. A key finding is the urgent need for guidance for model users to ensure consistent bioaerosol modelling practices. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Design of capability measurement instruments pedagogic content knowledge (PCK) for prospective mathematics teachers

NASA Astrophysics Data System (ADS)

Aminah, N.; Wahyuni, I.

2018-05-01

The purpose of this study is to find out how the process of designing a tool of measurement Pedagogical Content Knowledge (PCK) capabilities, especially for prospective mathematics teachers are valid and practical. The design study of this measurement appliance uses modified Plomp development step, which consists of (1) initial assessment stage, (2) design stage at this stage, the researcher designs the measuring grille of PCK capability, (3) realization stage that is making measurement tool ability of PCK, (4) test phase, evaluation, and revision that is testing validation of measurement tools conducted by experts. Based on the results obtained that the design of PCK capability measurement tool is valid as indicated by the assessment of expert validator, and the design of PCK capability measurement tool, shown based on the assessment of teachers and lecturers as users of states strongly agree the design of PCK measurement tools can be used.