WorldWideScience

Sample records for accessed day month

  1. Estimation of 305 Day Milk Yield from Cumulative Monthly and Bimonthly Test Day Records in Indonesian Holstein Cattle

    Science.gov (United States)

    Rahayu, A. P.; Hartatik, T.; Purnomoadi, A.; Kurnianto, E.

    2018-02-01

    The aims of this study were to estimate 305 day first lactation milk yield of Indonesian Holstein cattle from cumulative monthly and bimonthly test day records and to analyze its accuracy.The first lactation records of 258 dairy cows from 2006 to 2014 consisted of 2571 monthly (MTDY) and 1281 bimonthly test day yield (BTDY) records were used. Milk yields were estimated by regression method. Correlation coefficients between actual and estimated milk yield by cumulative MTDY were 0.70, 0.78, 0.83, 0.86, 0.89, 0.92, 0.94 and 0.96 for 2-9 months, respectively, meanwhile by cumulative BTDY were 0.69, 0.81, 0.87 and 0.92 for 2, 4, 6 and 8 months, respectively. The accuracy of fitting regression models (R2) increased with the increasing in the number of cumulative test day used. The used of 5 cumulative MTDY was considered sufficient for estimating 305 day first lactation milk yield with 80.6% accuracy and 7% error percentage of estimation. The estimated milk yield from MTDY was more accurate than BTDY by 1.1 to 2% less error percentage in the same time.

  2. Forecast of Frost Days Based on Monthly Temperatures

    Science.gov (United States)

    Castellanos, M. T.; Tarquis, A. M.; Morató, M. C.; Saa-Requejo, A.

    2009-04-01

    Although frost can cause considerable crop damage and mitigation practices against forecasted frost exist, frost forecasting technologies have not changed for many years. The paper reports a new method to forecast the monthly number of frost days (FD) for several meteorological stations at Community of Madrid (Spain) based on successive application of two models. The first one is a stochastic model, autoregressive integrated moving average (ARIMA), that forecasts monthly minimum absolute temperature (tmin) and monthly average of minimum temperature (tminav) following Box-Jenkins methodology. The second model relates these monthly temperatures to minimum daily temperature distribution during one month. Three ARIMA models were identified for the time series analyzed with a stational period correspondent to one year. They present the same stational behavior (moving average differenced model) and different non-stational part: autoregressive model (Model 1), moving average differenced model (Model 2) and autoregressive and moving average model (Model 3). At the same time, the results point out that minimum daily temperature (tdmin), for the meteorological stations studied, followed a normal distribution each month with a very similar standard deviation through years. This standard deviation obtained for each station and each month could be used as a risk index for cold months. The application of Model 1 to predict minimum monthly temperatures showed the best FD forecast. This procedure provides a tool for crop managers and crop insurance companies to asses the risk of frost frequency and intensity, so that they can take steps to mitigate against frost damage and estimated the damage that frost would cost. This research was supported by Comunidad de Madrid Research Project 076/92. The cooperation of the Spanish National Meteorological Institute and the Spanish Ministerio de Agricultura, Pesca y Alimentation (MAPA) is gratefully acknowledged.

  3. Trends for monthly changes in days open in Holsteins

    NARCIS (Netherlands)

    Pszczola, M.J.; Aguilar, I.; Misztal, I.

    2009-01-01

    A reaction norm approach was used to estimate trends for days open (DO) with a model that indirectly accounted for heat stress. Data included 3.4 million first-parity records of DO of US Holsteins. A fixed effect model included herd-year, month of calving within region (MOC), age class, and

  4. Outcome and safety of same-day-discharge percutaneous coronary interventions with femoral access

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per

    2013-01-01

    Ongoing development in percutaneous coronary intervention (PCI) techniques and closing devices facilitates same-day-discharge in patients undergoing uncomplicated PCI procedures. We examined the safety and outcome in low-risk patients discharged the same day as PCI with femoral access was performed....

  5. 77 FR 26643 - Asian American and Pacific Islander Heritage Month, 2012

    Science.gov (United States)

    2012-05-04

    ... Proclamation 8810--Law Day, U.S.A., 2012 Proclamation 8811--Loyalty Day, 2012 Proclamation 8812--National Day... AAPI communities by improving access to Federal programs where Asian American and Pacific Islanders are... Americans and Pacific Islanders, and to observe this month with appropriate programs and activities. IN...

  6. Protection of dogs against canine heartworm infection 28 days after four monthly treatments with Advantage Multi® for Dogs.

    Science.gov (United States)

    Bowman, Dwight D; Grazette, Alyssa R; Basel, Chris; Wang, Yingying; Hostetler, Joseph A

    2016-01-08

    Monthly heartworm preventives are designed to protect dogs by killing heartworms acquired the month prior to their administration, and after treatment with most products, the drug levels rapidly dissipate to very low levels. Work with Advantage Multi® for Dogs (imidacloprid + moxidectin) topical solution showed protection against hookworm infection throughout the month after administration of several monthly doses suggesting that similar protection might occur with heartworms. This study assessed the amount of protection afforded to dogs by the administration of four monthly doses of Advantage Multi for Dogs prior to infection with third-stage heartworm larvae (Dirofilaria immitis) 28 days after the last (fourth) treatment. There were 16 purpose-bred mongrel dogs in the study that were divided into two groups, 8 control and 8 treated dogs. Dogs were housed in a manner preventing contact between animals and groups, and personal protective gear worn by staff minimised the chance spread of the topically applied product between runs. The dogs in the treated group received monthly applications of Advantage Multi for Dogs as per label instructions on Study Days 0, 28, 56, and 84. On Study Day 112, all 16 dogs received 50 third-stage larvae of D. immitis ("Missouri" isolate) via subcutaneous inoculation in the inguinal region. The study was terminated on Day 264, and the number of heartworms per dog was determined at necropsy. Moxidectin levels after 4 treatments 28 days apart were near steady state on Study Day 112 when the dogs were inoculated with D. immitis third-stage larvae. At necropsy, 152 days after infection, all the control dogs had adult worms in their pulmonary arteries (geometric mean = 33.9; range 25-41), and none of the dogs treated four times prior to infection, with the last treatment 30 days prior to infection, harbored worms at necropsy. The efficacy of prevention was 100% when the dogs were infected 28 days after the last monthly treatment

  7. Minimal access surgery in children: An initial experience of 28 months

    Directory of Open Access Journals (Sweden)

    Gupta Abhaya

    2009-01-01

    Full Text Available Background : This study reports our 28 months experience with minimal access surgery (MAS in children. Materials and Methods : This was a review of all children who underwent MAS between December 2004 and March 2007 at the Departments of Paediatric Surgery, Seth Gordhandas Sunderdas Medical College (GSMC and King Edward the VII Memorial (KEM Hospital, India. Results and observations were tabulated and analysed, comparing with observations by various other authors regarding variety of indications such as, operative time, hospital stay, conversion rate, complications, safety, and feasibilty of MAS in neonates, in the appropriate operative groups. Results : A total of 199 procedures were performed in 193 children aged between 10 days and 12 years (average age: 5.7 years. One case of each, adrenal mass, retroperitoneoscopic nephrectomy, laparoscopic congenital diaphragmatic hernia (CDH repair, and abdominoperineal pull-through for anorectal malformation, were converted to open surgeries due to technical difficulty. The overall conversion rate was 3%. Morbidity and mortality were very minimal and the procedures were well tolerated in majority of cases. Conclusion : We concluded that MAS procedures appear to be safe for a wide range of indications in neonates and children. Further development and expansion of its indications in neonatal and paediatric surgery requires further multi-institutional studies and larger cohort of patients, to compare with standards of open surgery.

  8. Information-Seeking in Family Day Care: Access, Quality and Personal Cost

    Science.gov (United States)

    Corr, L.; Davis, E.; Cook, K.; Mackinnon, A.; Sims, M.; Herrman, H.

    2014-01-01

    Family day-care (FDC) educators work autonomously to provide care and education for children of mixed ages, backgrounds and abilities. To meet the demands and opportunities of their work and regulatory requirements, educators need access to context-relevant and high quality information. No previous research has examined how and where these workers…

  9. Higher Incidence of Stroke on the Last Day of the Month in Hungary-a Role for Psychosocial Factors and Financial Insecurity?

    Science.gov (United States)

    Folyovich, András; Biczó, Dávid; Bajnok, Anna; Bessenyei, Dávid; Kis, Ibolya; Gimesi-Országh, Judit; Béres-Molnár, Anna K; Toldi, Gergely

    2016-05-01

    The seasonal cumulation of acute ischemic stroke events is a well-known phenomenon. Critical days are determined by both biological and psychosocial factors. We hypothesized that the financial stability of those with a monthly income living in an economically unpredictable environment rises upon the arrival of their salary and decreases in the preceding days, leading to anxiety and existential insecurity, which may increase the incidence of acute ischemic stroke. We assessed the daily average number of thrombolytic treatments due to acute ischemic stroke in Hungary between December 1, 2005, and November 30, 2013, calculating the ratio of thrombolytic treatments on the last day of the month (irrespectively whether it was the 28th-31st days) to thrombolytic treatments on the other days, and determined 95% confidence intervals. In this period, 7880 thrombolytic treatments were performed nationwide (2.70/day), out of which 1867 occurred on the last day of the month (19.45/day). If the 28th, 29th, or 30th was not the last day of the month, 15.8, 20.6, and 22 times less thrombolytic treatments, respectively, were performed than on the last day of that month. We propose that financial insecurity on the days prior to the receipt of a salary might play a role in the elevation of stroke incidence observed on the last day of the month in Hungary. Further analysis of this phenomenon and its psychosocial effects is needed to adequately allocate healthcare resources and to take preventive measures in the high-risk population. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Larnkjær, Anni; Ritz, Christian

    2018-01-01

    AIM: We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. METHODS: This prospective cohort study comprised 269 Danish infants aged 8-14 months and was part of a study that examined how probiotics...... affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day...... care absences on web-based questionnaires. RESULTS: Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2...

  11. Risks for upper respiratory infections in infants during their first months in day care included environmental and child-related factors.

    Science.gov (United States)

    Laursen, Rikke Pilmann; Larnkjaer, Anni; Ritz, Christian; Hojsak, Iva; Michaelsen, Kim; Mølgaard, Christian

    2018-03-14

    We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care. This prospective cohort study comprised 269 Danish infants aged eight months to 14 months and was part of a study that examined how probiotics affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day care absences on web-based questionnaires. Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI, and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2.65, but was inversely associated with having a pet (OR: 0.43), being cared for by registered child minders compared to day care centres (OR: 0.36), birthweight (OR 0.40) and age at day care enrolment (OR: 0.64). No significant risk factors for LRTIs and diarrhoea were found. Infection risks were associated with environmental factors and factors related to the child. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Estimation of Genetic Parameters for First Lactation Monthly Test-day Milk Yields using Random Regression Test Day Model in Karan Fries Cattle

    Directory of Open Access Journals (Sweden)

    Ajay Singh

    2016-06-01

    Full Text Available A single trait linear mixed random regression test-day model was applied for the first time for analyzing the first lactation monthly test-day milk yield records in Karan Fries cattle. The test-day milk yield data was modeled using a random regression model (RRM considering different order of Legendre polynomial for the additive genetic effect (4th order and the permanent environmental effect (5th order. Data pertaining to 1,583 lactation records spread over a period of 30 years were recorded and analyzed in the study. The variance component, heritability and genetic correlations among test-day milk yields were estimated using RRM. RRM heritability estimates of test-day milk yield varied from 0.11 to 0.22 in different test-day records. The estimates of genetic correlations between different test-day milk yields ranged 0.01 (test-day 1 [TD-1] and TD-11 to 0.99 (TD-4 and TD-5. The magnitudes of genetic correlations between test-day milk yields decreased as the interval between test-days increased and adjacent test-day had higher correlations. Additive genetic and permanent environment variances were higher for test-day milk yields at both ends of lactation. The residual variance was observed to be lower than the permanent environment variance for all the test-day milk yields.

  13. Cognitive Behavioral Therapy plus Amitriptyline for Children and Adolescents with Chronic Migraine Reduces Headache Days to ≤4 Per Month.

    Science.gov (United States)

    Kroner, John W; Hershey, Andrew D; Kashikar-Zuck, Susmita M; LeCates, Susan L; Allen, Janelle R; Slater, Shalonda K; Zafar, Marium; Kabbouche, Marielle A; O'Brien, Hope L; Shenk, Chad E; Rausch, Joseph R; Kroon Van Diest, Ashley M; Powers, Scott W

    2016-04-01

    The objective of this secondary analysis of results from a previously published trial (Clinical Trials Registration Number: NCT00389038) in chronic migraine in children and adolescents was to examine if participants who received cognitive behavioral therapy and amitriptyline reached a greater level of reduction in headache frequency that no longer indicated a recommendation for preventive treatment as compared to those who received headache education and amitriptyline. Chronic migraine negatively affects children's home, school, and social activities. Preventive medication therapy is suggested for 5 or more headaches per month. Reduction to one headache day per week or less may suggest that preventive treatment is no longer indicated and provide a clinically relevant outcome for treatment efficacy and patient care. Randomized study participants (N = 135) kept a daily record of their headache frequency during 20 weeks of treatment and during a 1 year follow-up period. Baseline headache frequency was determined at the end of a 28 day screening period. Post treatment frequency was determined at 20 weeks (N = 128 completed) and post treatment follow-up was measured 12 months later (N = 124 completed). A chi-square test of independence was conducted by treatment group and by time point to determine group differences in the proportion of headache days experienced. At 20 weeks (post treatment), 47% of the cognitive behavioral therapy plus amitriptyline group had ≤4 headache days per month compared to 20% of the headache education plus amitriptyline group, (P = .0011), and 32% of the cognitive behavioral therapy plus amitriptyline group had ≤3 headache days per month at 20 weeks compared to 16% of the headache education plus amitriptyline group, (P = .0304). At the month 12 follow-up, 72% of the cognitive behavioral therapy plus amitriptyline group had ≤4 headache days per month compared to 52% of the headache education plus amitriptyline group

  14. Modeling monthly meteorological and agronomic frost days, based on minimum air temperature, in Center-Southern Brazil

    Science.gov (United States)

    Alvares, Clayton Alcarde; Sentelhas, Paulo César; Stape, José Luiz

    2017-09-01

    Although Brazil is predominantly a tropical country, frosts are observed with relative high frequency in the Center-Southern states of the country, affecting mainly agriculture, forestry, and human activities. Therefore, information about the frost climatology is of high importance for planning of these activities. Based on that, the aims of the present study were to develop monthly meteorological (F MET) and agronomic (F AGR) frost day models, based on minimum shelter air temperature (T MN), in order to characterize the temporal and spatial frost days variability in Center-Southern Brazil. Daily minimum air temperature data from 244 weather stations distributed across the study area were used, being 195 for developing the models and 49 for validating them. Multivariate regression models were obtained to estimate the monthly T MN, once the frost day models were based on this variable. All T MN regression models were statistically significant (p Brazilian region are the first zoning of these variables for the country.

  15. Improving outpatient access and patient experiences in academic ambulatory care.

    Science.gov (United States)

    O'Neill, Sarah; Calderon, Sherry; Casella, Joanne; Wood, Elizabeth; Carvelli-Sheehan, Jayne; Zeidel, Mark L

    2012-02-01

    Effective scheduling of and ready access to doctor appointments affect ambulatory patient care quality, but these are often sacrificed by patients seeking care from physicians at academic medical centers. At one center, Beth Israel Deaconess Medical Center, the authors developed interventions to improve the scheduling of appointments and to reduce the access time between telephone call and first offered appointment. Improvements to scheduling included no redirection to voicemail, prompt telephone pickup, courteous service, complete registration, and effective scheduling. Reduced access time meant being offered an appointment with a physician in the appropriate specialty within three working days of the telephone call. Scheduling and access were assessed using monthly "mystery shopper" calls. Mystery shoppers collected data using standardized forms, rated the quality of service, and transcribed their interactions with schedulers. Monthly results were tabulated and discussed with clinical leaders; leaders and frontline staff then developed solutions to detected problems. Eighteen months after the beginning of the intervention (in June 2007), which is ongoing, schedulers had gone from using 60% of their registration skills to over 90%, customer service scores had risen from 2.6 to 4.9 (on a 5-point scale), and average access time had fallen from 12 days to 6 days. The program costs $50,000 per year and has been associated with a 35% increase in ambulatory volume across three years. The authors conclude that academic medical centers can markedly improve the scheduling process and access to care and that these improvements may result in increased ambulatory care volume.

  16. Conducting an acute intense interval exercise session during the Ramadan fasting month: what is the optimal time of the day?

    Science.gov (United States)

    Aziz, Abdul Rashid; Chia, Michael Yong Hwa; Low, Chee Yong; Slater, Gary John; Png, Weileen; Teh, Kong Chuan

    2012-10-01

    This study examines the effects of Ramadan fasting on performance during an intense exercise session performed at three different times of the day, i.e., 08:00, 18:00, and 21:00 h. The purpose was to determine the optimal time of the day to perform an acute high-intensity interval exercise during the Ramadan fasting month. After familiarization, nine trained athletes performed six 30-s Wingate anaerobic test (WAnT) cycle bouts followed by a time-to-exhaustion (T(exh)) cycle on six separate randomized and counterbalanced occasions. The three time-of-day nonfasting (control, CON) exercise sessions were performed before the Ramadan month, and the three corresponding time-of-day Ramadan fasting (RAM) exercise sessions were performed during the Ramadan month. Note that the 21:00 h session during Ramadan month was conducted in the nonfasted state after the breaking of the day's fast. Total work (TW) completed during the six WAnT bouts was significantly lower during RAM compared to CON for the 08:00 and 18:00 h (p effect size [d] = .55 [small] and .39 [small], respectively) sessions, but not for the 21:00 h (p = .03, d = .18 [trivial]) session. The T(exh) cycle duration was significantly shorter during RAM than CON in the 18:00 (p Ramadan fasting had a small to moderate, negative impact on quality of performance during an acute high-intensity exercise session, particularly during the period of the daytime fast. The optimal time to conduct an acute high-intensity exercise session during the Ramadan fasting month is in the evening, after the breaking of the day's fast.

  17. 4 km NODC/RSMAS AVHRR Pathfinder Cloud Screened Version 5.0 Monthly Climatologies (1985-2006) (NODC Accession 0110657)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains a global, 4km monthly sea surface temperature climatology derived from harmonic analysis of the AVHRR Pathfinder Version 5.0 sea surface...

  18. Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study.

    Science.gov (United States)

    Sivanesan, Eellan; Lubarsky, David A; Ranasinghe, Chaturani T; Sarantopoulos, Constantine D; Epstein, Richard H

    2017-09-01

    To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%. Retrospective, observational study using electronic health records. Chronic pain clinic of an academic anesthesia department. All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015. Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient's choosing ≥1 business day after calling, with no limit on the daily number of new patients. Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; Pnew patient mean cancellation rate decreased from a baseline of 35.7% by 4.2% (95% confidence interval [CI] 1.4% to 6.9%; P=0.005); however, this failed to reach the 50% reduction target of 17.8%. Appointment lag time decreased by 4.7days (95% CI 2.3 to 7.0days, Pnew patient group. More new patients were seen within 1week compared to baseline (50.6% versus 19.1%; Pnew patient visits per month increased from 158.5 to 225.0 (P=0.0004). The cancellation rate and appointment lag times did not decrease for established patient visits, as expected because open-access scheduling was not implemented for this group. Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Effects of 21-day d-amphetamine and risperidone treatment on cocaine vs food choice and extended-access cocaine intake in male rhesus monkeys.

    Science.gov (United States)

    Hutsell, Blake A; Negus, S Stevens; Banks, Matthew L

    2016-11-01

    Clinical trial data suggest amphetamine treatment is most efficacious in moderate to high frequency cocaine users. However, preclinical studies have examined amphetamine treatment effects under relatively limited cocaine access conditions with low to moderate cocaine intakes. This study determined d-amphetamine treatment effects on cocaine self-administration in rhesus monkeys under cocaine access conditions allowing for high daily cocaine intake. For comparison and as a negative control, treatment effects with the antipsychotic risperidone were also examined. Continuous 21-day treatments with ramping doses of d-amphetamine (days 1-7: 0.032mg/kg/h; days 8-21: 0.1mg/kg/h, i.v.) or risperidone (days 1-7: 0.001mg/kg/h; days 8-14: 0.0032mg/kg/h; days 15-21: 0.0056mg/kg/h, i.v.) were administered to rhesus monkeys (n=4) with daily access to two types of cocaine self-administration sessions: (1) a 2-h 'choice' session with concurrent availability of 1-g food pellets and intravenous cocaine injections (0-0.1mg/kg per injection) and (2) a 20-h 'extended-access' session with 0.1mg/kg per injection cocaine availability. Total daily cocaine intake increased >6-fold during extended cocaine access. d-Amphetamine significantly decreased total cocaine intake, but not cocaine vs food choice. In contrast, risperidone did not significantly alter either total cocaine intake or cocaine vs. food choice. These results confirm and extend previous results supporting treatment effectiveness for monoamine releasers, but not dopamine antagonists, to reduce cocaine self-administration. Moreover, these results suggest amphetamine treatment efficacy to decrease preclinical cocaine vs. food choice may depend upon cocaine access conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. 4 km NODC/RSMAS AVHRR Pathfinder Version 5.0 and 5.1 Monthly Harmonic Climatologies (1982-2008) (NODC Accession 0075098)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains a global, 4km monthly sea surface temperature climatology derived from harmonic analysis of the AVHRR Pathfinder Version 5.0 and 5.1 sea...

  1. Food Consumption and Nutrient Intake by Children Aged 10 to 48 Months Attending Day Care in The Netherlands

    NARCIS (Netherlands)

    Goldbohm, R.A.; Rubingh, C.M.; Lanting, C.L.; Joosten, K.F.M.

    2016-01-01

    The diet of young children is an important determinant of long-term health effects, such as overweight and obesity. We analyzed two-day food consumption records from 1526 young children (10–48 months old) attending 199 daycare centers across The Netherlands. Data were observed and recorded in

  2. Major femoral vascular access complications after coronary diagnostic and interventional procedures

    DEFF Research Database (Denmark)

    Dencker, Ditte; Pedersen, Frants; Engstrøm, Thomas

    2016-01-01

    surgery within 30 days were collected. Mortality data were collected for minimum 12 months. RESULTS: We identified 130 (0.54%) access complications requiring surgery; 65 pseudoaneurysms (0.28%), 46 arterial occlusions (0.19%), 15 hematomas (nine groin and six retroperitoneal hematomas) (0.06%), and 4...

  3. Recurrent 3-day cycles of water deprivation for over a month depress mating behaviour but not semen characteristics of adult rams.

    Science.gov (United States)

    Khnissi, S; Lassoued, N; Rekik, M; Ben Salem, H

    2016-02-01

    This study aimed to investigate the effect of water deprivation (WD) on reproductive traits of rams. Ten mature rams were used and allocated to two groups balanced for body weight. Control (C) rams had free access to drinking water, while water-restricted rams (WD) were deprived from water for 3 consecutive days and early on the morning of day 4, they had ad libitum access to water for 24 h, similar to C animals. The experiment lasted 32 days, that is eight 4-day cycles of water deprivation and subsequent watering. Feed and water intake were significantly affected by water deprivation; in comparison with C rams, WD rams reduced their feed intake by 18%. During the watering day of the deprivation cycle, WD rams consumed more water than C rams on the same day (11.8 (SD = 3.37) and 8.4 (SD = 1.92) l respectively; p water deprivation. However, testosterone levels were lowered as a result of water deprivation and average values were 10.9 and 6.2 (SEM 1.23) ng/ml for C and WD rams respectively (p cycles 5 and 8 of water deprivation. Several mating behaviour traits were modified as a result of water deprivation. When compared to controls, WD rams had a more prolonged time to first mount attempt (p Water deprivation may have practical implications reducing the libido and therefore the serving capacity of rams under field conditions. Journal of Animal Physiology and Animal Nutrition © 2015 Blackwell Verlag GmbH.

  4. Deeply reinverted T wave at 14 days after the onset of first anterior acute myocardial infarction predicts improved left ventricular function at 6 months.

    Science.gov (United States)

    Yokoyama, Hiroaki; Tomita, Hirofumi; Nishizaki, Fumie; Hanada, Kenji; Shibutani, Shuji; Yamada, Masahiro; Abe, Naoki; Higuma, Takumi; Osanai, Tomohiro; Okumura, Ken

    2015-03-01

    Changes in electrocardiogram (ECG), especially in the ST segment and T wave, have been recognized as a noninvasive diagnostic tool for coronary flow or myocardial injury. A deeply inverted T wave at 14 days after successful percutaneous coronary intervention (PCI) in patients with ST-segment elevation acute myocardial infarction (STEMI) predicts improved left ventricular (LV) function at 6 months. We enrolled 112 consecutive patients (88 men, 63 ± 11 years) with first anterior STEMI who underwent successful PCI. A 12-lead ECG was recorded everyday from admission through 14 days. After PCI, the first T-wave inversion was observed within 2 days, and the second occurred at 14 days. We measured the maximum depth of the reinverted T wave (Neg-T) and divided the patients into 2 groups based on the median value of Neg-T: the deep group (≥0.6 mV, n = 62) and the nondeep group (wave in precordial leads at 6 months was more frequently observed in the deep than in the nondeep group (68% vs 46%, P = 0.02). Multivariate regression analysis showed that the Neg-T and max CPK-MB were independent contributors to LVEF at 6 months. A deeply reinverted T wave at 14 days after onset of first anterior STEMI can be a useful predictive marker for improved LV function at 6 months. © 2015 Wiley Periodicals, Inc.

  5. Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

    Science.gov (United States)

    Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

    2008-01-01

    BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

  6. A three-month longitudinal study of changes in day/night serum total antioxidant capacity in paranoid schizophrenia.

    Science.gov (United States)

    Morera-Fumero, Armando L; Díaz-Mesa, Estefanía; Abreu-Gonzalez, Pedro; Fernandez-Lopez, Lourdes; Guillen-Pino, Fernando

    2017-01-01

    Free radicals and an oxidant/antioxidant imbalance have been involved in the schizophrenia pathophysiology. The total antioxidant capacity (TAC) is a measure of the antioxidant capacity of a system. Day/night changes are a biological characteristic of hormones such as melatonin or cortisol. There is little information about TAC day/night changes in schizophrenia patients. The aim of this research is to study if there are day/night changes in serum TAC levels of schizophrenia patients. Thirty-two DSM-IV schizophrenia paranoid patients were studied. Blood was sampled at 12:00 and 00:00 h at admission, discharge and three months after hospital discharge (TMAHD). TAC results are expressed as mmol of Trolox/L. Patients did not have day/night TAC differences at admission (12:00: 0.67±0.12 vs. 00:00: 0.61±0.14, p>0.14) or discharge (12:00: 0.65±0.15 vs. 00:00: 0.65±0.12, p>0.99). At TMHD, patients had significantly higher TAC levels at midday than midnight (12:00: 0.83±0.10 vs. 00:00: 0.74±0.12, pday/night serum TAC changes when clinically relapsed and the normalization of day/night serum TAC changes at TMHD can be considered as a biological marker of schizophrenia evolution.

  7. Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults.

    Science.gov (United States)

    Pedersen, E S L; Danquah, I H; Petersen, C B; Tolstrup, J S

    2016-12-03

    Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling. Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity. Clinical trials NCT01996176 .

  8. Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults

    DEFF Research Database (Denmark)

    Lunde Pedersen, Eva Sophie; Danquah, I H; Petersen, C B

    2016-01-01

    in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. METHODS: We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time....... RESULTS: Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure...... time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). CONCLUSIONS: The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great...

  9. Differential gene expression in the liver of the African lungfish, Protopterus annectens, after 6 months of aestivation in air or 1 day of arousal from 6 months of aestivation.

    Directory of Open Access Journals (Sweden)

    Kum C Hiong

    Full Text Available The African lungfish, Protopterus annectens, can undergo aestivation during drought. Aestivation has three phases: induction, maintenance and arousal. The objective of this study was to examine the differential gene expression in the liver of P. annectens after 6 months (the maintenance phase of aestivation as compared with the freshwater control, or after 1 day of arousal from 6 months aestivation as compared with 6 months of aestivation using suppression subtractive hybridization. During the maintenance phase of aestivation, the mRNA expression of argininosuccinate synthetase 1 and carbamoyl phosphate synthetase III were up-regulated, indicating an increase in the ornithine-urea cycle capacity to detoxify ammonia to urea. There was also an increase in the expression of betaine homocysteine-S-transferase 1 which could reduce and prevent the accumulation of hepatic homocysteine. On the other hand, the down-regulation of superoxide dismutase 1 expression could signify a decrease in ROS production during the maintenance phase of aestivation. In addition, the maintenance phase was marked by decreases in expressions of genes related to blood coagulation, complement fixation and iron and copper metabolism, which could be strategies used to prevent thrombosis and to conserve energy. Unlike the maintenance phase of aestivation, there were increases in expressions of genes related to nitrogen, carbohydrate and lipid metabolism and fatty acid transport after 1 day of arousal from 6 months aestivation. There were also up-regulation in expressions of genes that were involved in the electron transport system and ATP synthesis, indicating a greater demand for metabolic energy during arousal. Overall, our results signify the importance of sustaining a low rate of waste production and conservation of energy store during the maintenance phase, and the dependence on internal energy store for repair and structural modification during the arousal phase, of

  10. Cilostazol May Improve Maturation Rates and Durability of Vascular Access for Hemodialysis.

    Science.gov (United States)

    Russell, Todd E; Kasper, Gregory C; Seiwert, Andrew J; Comerota, Anthony J; Lurie, Fedor

    2017-04-01

    Cilostazol is effective in controlling pathophysiological pathways similar or identical to those involved in nonmaturation and failure of the arteriovenous access. This case-control study examined whether cilostazol would improve maturation rates and durability of vascular access for hemodialysis. The treatment group included 33 patients who received cilostazol for ≥30 days prior to creation of a dialysis access and continued with cilostazol therapy for ≥60 days after surgery. The matched (gender, age, race, diabetes, and the year of surgery) control group included 116 patients who underwent the same procedure but did not receive cilostazol prior to and at least 3 months after surgery. Primary outcomes were maturation and, for those that matured, time of functioning access, defined as the time from the first use to irreparable failure of the access. Secondary outcomes were time to maturation, complications, and time to first complication. Study group patients were 3.8 times more likely to experience fistula maturation compared to the controls (88% vs 66%, RR = 3.8, 95% confidence interval: 1.3-11.6, P = .016). Fewer patients in the study group had complications (76% vs 92%, P = .025), and the time from construction of the fistula to the first complication was longer (345.6 ± 441 days vs 198.3 ± 185.0 days, P = .025). Time to maturation was similar in both groups (119.3 ± 62.9 days vs 100.2 ± 61.7 days, P = .2). However, once matured, time to failure was significantly longer in the treatment group (903.7 ± 543.6 vs 381.6 ± 317.2 days, P = .001). Multivariate analysis confirmed that the likelihood of maturation was significantly higher in the treatment group patients. These results suggest that dialysis access patients may benefit from preoperative and postoperative cilostazol therapy. If confirmed by a randomized trial, this treatment will have a major beneficial impact on patients dependent on a well-functioning access for their hemodialysis.

  11. Electronic cigarettes, quit attempts and smoking cessation: a 6-month follow-up.

    Science.gov (United States)

    Pasquereau, Anne; Guignard, Romain; Andler, Raphaël; Nguyen-Thanh, Viêt

    2017-09-01

    There is conflicting evidence that use of e-cigarettes promotes cessation in regular smokers, but contrasting findings may be due to differing definitions of vaping. The aim was to assess whether regular use of e-cigarettes while smoking is associated with subsequent smoking cessation. Baseline internet survey with outcomes measured at 6-month follow-up. All French metropolitan territory. A total of 2057 smokers aged 15-85 years were recruited through an access panel and responded to a 6-month follow-up: 1805 exclusive tobacco smokers and 252 dual users (tobacco plus regular e-cigarette users) at baseline. The three outcomes assessed at 6 months were: a minimum 50% reduction in the number of cigarettes smoked per day, quit attempts of at least 7 days and smoking cessation of at least 7 days at the time of follow-up. Logistic regressions were performed to model the three outcomes according to regular e-cigarette use at baseline, adjusted for socio-economic variables and smoking behaviours. Baseline dual users were more likely than baseline exclusive tobacco smokers to have halved cigarette consumption [25.9 versus 11.2%, P e-cigarette regularly are more likely to try to quit smoking and reduce their cigarette consumption during the next 6 months. It remains unclear whether regular e-cigarette users are also more likely to stop smoking. © 2017 Society for the Study of Addiction.

  12. Influence of age on radioinduced cognitive disorders: Experimental studies with cerebral irradiation of 30 Gy in 10 sessions and 12 days in the Wistar rat at 1.5, 4 and 18 months

    International Nuclear Information System (INIS)

    Lamproglou, I.; Baillet, F.; Boisserie, G.; Mazeron, J.J.; Delattre, J.Y.

    2002-01-01

    The objective of this study was to determine the influence of age on the learning and memory dysfunction induced by cranial radiation in the male Wistar rat. Ninety-six 45-day-old, 70 4-month-old, and 78 18-month-old male rats were divided in two equal groups: (i) irradiated and (ii) control. A course of whole-brain radiation therapy (30 Gy in 10 fractions over 12 days) was administered to the irradiated group, while the control group received sham irradiation. Sequential behavioral studies including one and two-way avoidance tests were undertaken before and after the 7 months following radiation. The results suggest that radiation induced progressive and irreversible memory dysfunction in elderly (18-month-old) rats, but this effect was partial or almost reversible in the 4-month-old and 45-day-old rats, respectively. In return, the learning dysfunction was age non-dependent despite the fact that is occurs more rapidly in the young (45 days, 4 months) rats. (author)

  13. A three-month longitudinal study of changes in day/night serum total antioxidant capacity in paranoid schizophrenia.

    Directory of Open Access Journals (Sweden)

    Armando L Morera-Fumero

    Full Text Available Free radicals and an oxidant/antioxidant imbalance have been involved in the schizophrenia pathophysiology. The total antioxidant capacity (TAC is a measure of the antioxidant capacity of a system. Day/night changes are a biological characteristic of hormones such as melatonin or cortisol. There is little information about TAC day/night changes in schizophrenia patients. The aim of this research is to study if there are day/night changes in serum TAC levels of schizophrenia patients. Thirty-two DSM-IV schizophrenia paranoid patients were studied. Blood was sampled at 12:00 and 00:00 h at admission, discharge and three months after hospital discharge (TMAHD. TAC results are expressed as mmol of Trolox/L. Patients did not have day/night TAC differences at admission (12:00: 0.67±0.12 vs. 00:00: 0.61±0.14, p>0.14 or discharge (12:00: 0.65±0.15 vs. 00:00: 0.65±0.12, p>0.99. At TMHD, patients had significantly higher TAC levels at midday than midnight (12:00: 0.83±0.10 vs. 00:00: 0.74±0.12, p<0.006 as it has been reported in healthy subjects. There were no significant TAC differences at 12.00 and 00:00 between admission and discharge. At TMAHD, patients had significantly higher TAC levels than at admission and discharge, both at 12:00 and 00:00 h. In conclusion, the absence of day/night serum TAC changes when clinically relapsed and the normalization of day/night serum TAC changes at TMHD can be considered as a biological marker of schizophrenia evolution.

  14. One day access to a running wheel reduces self-administration of d-methamphetamine, MDMA and Methylone

    Science.gov (United States)

    Aarde, Shawn M.; Miller, Michelle L.; Creehan, Kevin M.; Vandewater, Sophia A.; Taffe, Michael A.

    2015-01-01

    Background Exercise influences drug craving and consumption in humans and drug self-administration in laboratory animals, but the effects can be variable. Improved understanding of how exercise affects drug intake or craving would enhance applications of exercise programs to human drug users attempting cessation. Methods Rats were trained in the intravenous self-administration (IVSA) of d-methamphetamine (METH; 0.05 mg/kg/inf), 3,4-methylenedioxymethamphetamine (MDMA; 0.5 mg/kg/inf) or methylone (0.5 mg/kg/inf). Once IVSA was established, the effect of ~22 hrs of wheel access in the home cage on subsequent drug taking was assessed in a two cohort crossover design. Results Provision of home cage wheel access during the day prior to IVSA sessions significantly decreased the self-administration of METH, MDMA and methylone. At the individual level, there was no correlation between the amount a rat used the wheel and the size of the individual’s decrease in drug intake. Conclusions Wheel access can reduce self-administration of a variety of psychomotor stimulants. It does so immediately, i.e., without a need for weeks of exercise prior to drug access. This study therefore indicates that future mechanistic investigations should focus on acute effects of exercise. In sum, the results predict that exercise programs can be used to decrease stimulant drug use in individuals even with no exercise history and an established drug taking pattern. PMID:25863714

  15. Endovascular Revascularization of Chronically Thrombosed Arteriovenous Fistulas and Grafts for Hemodialysis: A Retrospective Study in 15 Patients With 18 Access Sites

    International Nuclear Information System (INIS)

    Weng Meijui; Chen, Matt Chiung-Yu; Chi Wenche; Liu Yichun; Liang, Huei-Lung; Pan, Huay-Ben

    2011-01-01

    The current study retrospectively evaluated whether endovascular revascularization of chronically thrombosed and long-discarded vascular access sites for hemodialysis was feasible. Technical and clinical success rates, postintervention primary and secondary patency rates, and complications were reported. During a 1-year period, we reviewed a total of 924 interventions performed for dysfunction and/or failed hemodialysis vascular access sites and permanent catheters in 881 patients. In patients whose vascular access-site problems were considered untreatable or were considered treatable with a high risk of failure and access-site abandonment, we attempted to revascularize (resurrect) the chronically occluded and long-discarded (mummy) vascular access sites. We attempted to resurrect a total of 18 mummy access sites (mean age 46.6 ± 38.7 months; range 5–144) in 15 patients (8 women and 7 men; mean age 66.2 ± 11.5 years; age range 50–85) and had an overall technical success rate of 77.8%. Resurrection failure occurred in 3 fistulas and in 1 straight graft. The clinical success rate was 100% at 2 months after resurrection. In the 14 resurrected vascular access sites, 6 balloon-assisted maturation procedures were required in 5 fistulas; after access-site maturation, a total of 22 interventions were performed to maintain access-site patency. The mean go-through time for successful resurrection procedures was 146.6 ± 34.3 min (range 74–193). Postmaturation primary patency rates were 71.4 ± 12.1% at 30 days, 57.1 ± 13.2% at 60 days, 28.6 ± 13.4% at 90 days, and 19 ± 11.8% at 180 days. Postmaturation secondary patency rates were 100% at 30, 60, and 90 days and 81.8 ± 11.6% at 180 days. There were 2 major complications consisting of massive venous ruptures in 2 mummy access sites during balloon dilation; in both cases, prolonged balloon inflation failed to achieve hemostasis, but percutaneous N-butyl cyanoacrylate glue seal-off was performed successfully

  16. 17 CFR 31.16 - Monthly reporting requirements.

    Science.gov (United States)

    2010-04-01

    ... of business on the last business day of the month for: (i) All customer accounts, and (ii) Separately... National Futures Association, by the tenth business day of the month following the month covered by the... customers during the month for: (i) All customer accounts, and (ii) Separately for commercial leverage...

  17. 4 km NODC/RSMAS AVHRR Pathfinder Version 5.0 and 5.1 5-day Harmonic Climatologies (1982-2008) (NODC Accession 0071182)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains a global, 4km 5-day sea surface temperature climatology derived from harmonic analysis of the AVHRR Pathfinder Version 5.0 and 5.1 sea...

  18. Same-Day Versus Next-Day Repair of Fovea-Threatening Primary Rhegmatogenous Retinal Detachments.

    Science.gov (United States)

    Gorovoy, Ian R; Porco, Travis C; Bhisitkul, Robert B; de Juan, Eugene; Schwartz, Daniel M; Stewart, Jay M

    2016-01-01

    To evaluate the outcomes of same-day versus next-day repair of fovea-threatening rhegmatogenous retinal detachments (FT RRD). Retrospective, multi-surgeon observational case series. Operative reports and medical records were reviewed to evaluate a number of visual and anatomic outcomes, including presenting features, intraoperative complications, and postoperative results in the repair of primary FT RRD undergoing same-day versus next-day repair with scleral buckling, pars plana vitrectomy, or both procedures. A total of 96 consecutive patients (43 same-day, 45 next-day, and eight two days later) were compared. There was no statistically significant difference in visual outcomes between same-day and next-day repair at postoperative months 3 and 6 and at last follow-up (month 3 mean BCVA 20/30 same day; 20/32 next day; p = 0.82). Preoperative vision was strongly correlated with postoperative acuity. Effect of differences in length or type of visual symptoms, location of RRD, gender, or lens status on postoperative month 3 best-corrected visual acuity (BCVA) was not statistically significant. Overall, 85% of patients had a BCVA of 20/40 or better at postoperative month 3. Reoperation rate and intraoperative complications were not statistically different between the two groups. Re-attachment was achieved in all but one patient in both groups. Time in the operating room was longer for same-day surgery (2.98 ± 0.46 hours) compared to next-day surgery (2.54 ± 0.38 hours) (p factoring in the type of surgery performed. However, one case did progress to a macula-off detachment in a superior RRD with breaks found in lattice degeneration. Next-day surgery provided equivalent visual outcomes. Emergent, same-day surgery has logistical and resource implications as it may be more expensive, may necessitate rescheduling of previously booked cases, and may limit preoperative examination by the surgeon and perioperative team.

  19. Effective flow performances and dialysis doses delivered with permanent catheters: a 24-month comparative study of permanent catheters versus arterio-venous vascular accesses.

    Science.gov (United States)

    Canaud, Bernard; Leray-Moragues, Hélène; Kerkeni, Nadia; Bosc, Jean-Yves; Martin, Katja

    2002-07-01

    Permanent venous catheters have emerged as a long-term vascular access option for renal replacement therapy in end-stage renal disease patients. The design and venous location of catheter devices bear intrinsic flow limitations that may negatively affect the adequacy of dialysis and the patient outcome. There is limited data comparing the long-term dialysis adequacy delivered with permanent catheters vs arterio-venous vascular accesses (AVA). To explore this problem, we conducted a prospective 24-month trial comparing the flow performances and dialysis dose (Kt/Vdp) deliveries of both access options in a group of 42 haemodialysis patients during two study phases. During the first 12 months the patients completed a treatment period by means of permanent dual silicone catheters (DualKT). Then they were transferred to an AVA (40 native arterio-venous fistulas and two PTFE grafts) and monitored for an additional 12-month period. Assessments of flow adequacy and dialysis quantification were performed monthly. Dialysis adequacy was achieved in all cases. No patient had to be transferred prematurely to the AVA because of catheter failure. Three catheters had to be replaced due to bacteraemia in three patients. The mean effective blood flow rates achieved were 316+/-3.5 ml/min and 340+/-3.3 ml/min with DualKT and AVA, respectively, for a pre-set machine blood flow of 348+/-2.2 ml/min. Recirculation rates evaluated with the 'slow blood flow' method were 8.6+/-0.6 and 12.1+/-0.8% for DualKT and AVA using mean values of the solute markers urea and creatinine. Due to the possibility of a comparison veno-venous vs arterio-venous blood circulation, a corrected arterio-venous access recirculation could be derived from the difference between the two, which was around 3%. The blood flow resistance of the DualKT was slightly higher than with AVA as indicated by venous pressure differences. Kt/Vdp delivered was 1.37+/-0.02 and 1.45+/-0.02 with DualKT and AVA access respectively. The

  20. Maintenance of vascular access patency in pediatrics

    International Nuclear Information System (INIS)

    Hoffer, F.A.; Wyly, J.B.; Fellows, K.E.; Harmon, W.; Levey, R.H.

    1986-01-01

    The patency of vascular access shunts and fistulae has been prolonged by a combined surgical and radiological approach that includes percutaneous transluminal angioplasty (PTA), surgical revision, thrombectomy, and thrombolysis. Over the last 3 years, 35 vascular accesses in 27 patients were found to have angiographic abnormality. PTA was performed 32 times of 19 accesses and 7 PTAs resulted in patent accesses by the end of the study. Surgical revision was performed 9 times on 8 accesses and 2 of the surgical revisions resulted in a patent access by the end of the study. Concerning Thomas femoral shunts, PTA prolonged the patency by 2.2 months and surgical revision by 3.8 months per procedure. Concerning arteriovenous (AV) fistulae, PTA prolonged the patency by 4.3 months and surgical revision by 3.5 months per procedure. A combination of procedures effectively doubles the duration of patency of Thomas femoral shunts and almost triples the duration of patency of AV fistulae in children. Forty-one percent of these accesses remain open 1 year following the initiation of these procedures. (orig.)

  1. Availability and Price of High Quality Day Care and Female Employment

    DEFF Research Database (Denmark)

    Simonsen, Marianne

    In this paper I analyse to what degree availability and price of high quality publicly subsidised childcare affects female employment for women living in couples following maternity leave. The results show that unrestricted access to day care has a significantly positive effct on female employment.......The price effect is significantly negative: An increase in the price of child care of C=1 will decrease the female employment with 0.08% corresponding to a price elasticity of −0.17. This effect prevails during the first 12 months after childbirth....

  2. ANALYSIS OF THE STATISTICAL BEHAVIOUR OF DAILY MAXIMUM AND MONTHLY AVERAGE RAINFALL ALONG WITH RAINY DAYS VARIATION IN SYLHET, BANGLADESH

    Directory of Open Access Journals (Sweden)

    G. M. J. HASAN

    2014-10-01

    Full Text Available Climate, one of the major controlling factors for well-being of the inhabitants in the world, has been changing in accordance with the natural forcing and manmade activities. Bangladesh, the most densely populated countries in the world is under threat due to climate change caused by excessive use or abuse of ecology and natural resources. This study checks the rainfall patterns and their associated changes in the north-eastern part of Bangladesh mainly Sylhet city through statistical analysis of daily rainfall data during the period of 1957 - 2006. It has been observed that a good correlation exists between the monthly mean and daily maximum rainfall. A linear regression analysis of the data is found to be significant for all the months. Some key statistical parameters like the mean values of Coefficient of Variability (CV, Relative Variability (RV and Percentage Inter-annual Variability (PIV have been studied and found to be at variance. Monthly, yearly and seasonal variation of rainy days also analysed to check for any significant changes.

  3. The timing of GIGANTEA expression during day/night cycles varies with the geographical origin of Arabidopsis accessions.

    Science.gov (United States)

    de Montaigu, Amaury; Coupland, George

    2017-07-03

    Latitudinal clines in circadian rhythms have consistently been described in various plant species, with the most recent examples appearing in soybean cultivars and in monkey flower natural populations. These latitudinal clines provide evidence that natural variation in circadian rhythms is adaptive, but it is still unclear what adaptive benefits this variation confers, particularly because circadian rhythms are not usually measured in day/night conditions that reflect those experienced by organisms in nature. Here, we report that daily rhythms of GIGANTEA expression respond to day length in a way that depends on the latitude of origin of Arabidopsis accessions. We additionally extend previous findings by confirming that natural variation in GI expression affects growth related traits, and alters the expression of different target genes. The results support the idea that natural variation in daily rhythms of expression have broad effects on plant development and are of potential adaptive value.

  4. Open Day: General Information

    CERN Multimedia

    2004-01-01

    http://www.cern.ch/cern50/ With 50 visit points, including theatre performances, debates and visits to installations that have never before been opened to the public, CERN's 50th anniversary Open Day is set to be a day to remember. Seven hundred volunteers have signed up to help for the day. The Open Day team truly appreciates this wonderful show of support! The Open Day would not be possible without their help. Car parking and Access Cars with a CERN sticker can access all CERN sites as normal. However, to avoid congestion on Meyrin site, we ask you to park in areas that will not be open to the public (see below) and to use the shuttle services wherever possible for your transport during the day. Private cars on the French side of the border without a CERN sticker will be diverted to a car park area in the Prévessin site. There is a shuttle service connecting the Meyrin and Prévessin sites via SM18 every 20 minutes. Private cars on the Swiss side of the border without a CERN sticker will be diverte...

  5. Gridded 5-day mean sea surface height anomaly and significant wave height from Jason-1 and OSTM/Jason-2 satellites (NODC Accession 0065055)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains the gridded 5-day mean sea surface height anomaly (SSHA) and Ku Band significant wave height (SWH-KU) observed from Jason-1 and OSTM/Jason-2...

  6. Recent trends in the dispensing of 90-day-supply prescriptions at retail pharmacies: implications for improved convenience and access.

    Science.gov (United States)

    Liberman, Joshua N; Girdish, Charmaine

    2011-03-01

    Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions. To evaluate recent changes in access to and use of 90-day-supply maintenance medications dispensed via retail pharmacy. As of the first quarter of 2007, the proportion of retail-dispensed maintenance medications with a 90-day supply (compared with all maintenance prescriptions dispensed) among Medicare Part D plans, self-insured employers, and private health plans was 5.1%, 5.1%, and 5.0%, respectively. As of December 2009, this ratio had risen to 8.0% for Medicare plans and 8.1% for commercial health plans; the ratio among employers had risen more modestly to 6.1%. Of particular interest and importance, the proportion increased similarly for brand and for generic medications. There has been substantial growth in 90-day prescriptions dispensed via retail pharmacy, a trend that is likely to continue as more insurance providers adopt compatible benefit designs. It is important to continue monitoring these trends and to identify opportunities to rigorously evaluate their impact on medication adherence and healthcare costs.

  7. Developing a performance data suite to facilitate lean improvement in a chemotherapy day unit.

    Science.gov (United States)

    Lingaratnam, Senthil; Murray, Danielle; Carle, Amber; Kirsa, Sue W; Paterson, Rebecca; Rischin, Danny

    2013-07-01

    A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU. A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non-value-adding steps, reduce variation, and level workloads to improve quality and flow. Process mapping, staff and patient tracking and opinion surveys, medical record audits, and interrogation of electronic treatment records were undertaken. This project delivered a 38% reduction in median wait time on the day (from 32 to 20 minutes; P product manufactured within 10 minutes of appointment times by 29% (from 47% to 76%; P lean improvement methodology provided a robust framework for improved understanding and management of complex system constraints within a CDU, resulting in improved access to treatment and reduced waiting times on the day.

  8. Retrofit Weight-Loss Outcomes at 6, 12, and 24 Months and Characteristics of 12-Month High Performers: A Retrospective Analysis.

    Science.gov (United States)

    Painter, Stefanie; Ditsch, Gary; Ahmed, Rezwan; Hanson, Nicholas Buck; Kachin, Kevin; Berger, Jan

    2016-08-22

    Obesity is the leading cause of preventable death costing the health care system billions of dollars. Combining self-monitoring technology with personalized behavior change strategies results in clinically significant weight loss. However, there is a lack of real-world outcomes in commercial weight-loss program research. Retrofit is a personalized weight management and disease-prevention solution. This study aimed to report Retrofit's weight-loss outcomes at 6, 12, and 24 months and characterize behaviors, age, and sex of high-performing participants who achieved weight loss of 10% or greater at 12 months. A retrospective analysis was performed from 2011 to 2014 using 2720 participants enrolled in a Retrofit weight-loss program. Participants had a starting body mass index (BMI) of >25 kg/m² and were at least 18 years of age. Weight measurements were assessed at 6, 12, and 24 months in the program to evaluate change in body weight, BMI, and percentage of participants who achieved 5% or greater weight loss. A secondary analysis characterized high-performing participants who lost ≥10% of their starting weight (n=238). Characterized behaviors were evaluated, including self-monitoring through weigh-ins, number of days wearing an activity tracker, daily step count average, and engagement through coaching conversations via Web-based messages, and number of coaching sessions attended. Average weight loss at 6 months was -5.55% for male and -4.86% for female participants. Male and female participants had an average weight loss of -6.28% and -5.37% at 12 months, respectively. Average weight loss at 24 months was -5.03% and -3.15% for males and females, respectively. Behaviors of high-performing participants were assessed at 12 months. Number of weigh-ins were greater in high-performing male (197.3 times vs 165.4 times, P=.001) and female participants (222 times vs 167 times, Pactivity tracker days and average steps per day were greater in high-performing females (304.7 vs

  9. Open-access ultrasound referrals from general practice.

    LENUS (Irish Health Repository)

    Hughes, P

    2015-03-01

    Direct access referral for radiological investigations from General Practice (GP) provides an indispensable diagnostic tool and avoids the inherently long waiting time that referral through a hospital based specialty would entail. Improving access to hospital based radiology services is one of Health Information and Quality Authority\\'s key recommendations in its report on patient referrals from general practice. This study aimed to review all GP referrals for ultrasound investigations to a tertiary referral teaching hospital over a seven month period with respect to their demographics, waiting times and diagnostic outcomes. 1,090 ultrasounds originating in general practice were carried out during the study period. Positive findings were recorded in 332 (30.46%) examinations. The median waiting time from receipt of referral to the diagnostic investigation was 56 days (range 16 - 91 years). 71 (6.5%) patients had follow-up imaging investigations while recommendation for hospital based specialty referral was made in 35 cases (3.2%). Significant findings included abdominal aortic aneurysms, metastatic disease and lymphoma. Direct access to ultrasound for general practitioners allows the referring physician to make an informed decision with regard to the need for specialist referral. We believe these findings help support the case for national direct access to diagnostic ultrasound for general practitioners.

  10. Living Day by Day

    Science.gov (United States)

    Kaplan, Rachel L.; Khoury, Cynthia El; Field, Emily R. S.; Mokhbat, Jacques

    2016-01-01

    We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA) described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being “sick” and feeling “normal”: Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country. PMID:28462340

  11. Living Day by Day

    Directory of Open Access Journals (Sweden)

    Rachel L. Kaplan

    2016-05-01

    Full Text Available We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being “sick” and feeling “normal”: Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country.

  12. Behaviour of captive Ostrich chicks from 10 days to 5 months of age

    Directory of Open Access Journals (Sweden)

    Marina Freire Amado

    2011-07-01

    Full Text Available The behaviour of ostrich chicks bred in captivity was studied by using groups with 30 birds in five age groups: from 10 to 40 days of age; from 41 to 60 days of age; from 61 to 90 days of age; from 91 to 120 days of age and from 121 to 150 days of age. Six birds at each age were ringed around one of their feet and observed for four consecutive days for eight hours daily in three periods (in the morning, at noon and in the afternoon, following the "one-zero" method for sampling. The order for observation of behaviour of the six selected birds was performed randomly at every thirty minutes, totalling 16 periods or 80 minutes/bird/day. Fourteen types of behaviour were observed. There were differences among ages for behaviour like standing, walking, running, ingesting stones, ingesting feces, picking and attacking. Non-parametric-tests were used to analyse the behaviour according to age of the bird and to the periods of the day. There was a statistical difference between in the morning and at noon periods on behaviours standing, walking, eating ration and in litophagia, which were observed more frequently at the first hours of the day. When periods of the morning and afternoon were compared, the birds' age had a significant effect on behaviour sand bathing. When the periods noon/afternoon were compared, the behaviours which presented significant differences were walking, running, drinking water, eating ration, litophagia, coprophagia, dancing, sand bathing, whose occurrence was the highest during dusk. It was observed that the behaviour of young ostriches diverge according to the age and to day period.

  13. Paclitaxel-Coated Balloons for the Treatment of Dysfunctional Dialysis Access. Results from a Single-Center, Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kitrou, Panagiotis M., E-mail: panoskitrou@gmail.com; Spiliopoulos, Stavros; Papadimatos, Panagiotis; Christeas, Nicolaos; Petsas, Theodoros; Katsanos, Konstantinos; Karnabatidis, Dimitris [Patras University Hospital, Interventional Radiology Department (Greece)

    2017-01-15

    PurposeTo investigate the safety and effectiveness of lutonix paclitaxel-coated balloon (PCB) for the treatment of dysfunctional dialysis access.Materials and MethodsThis was a single-center, single-arm, retrospective analysis of 39 patients (23 male, 59 %) undergoing 61 interventions using 69 PCBs in a 20-month period. There was a balance between arteriovenous fistulae (AVF) and grafts (AVG) (20 AVFs, 19AVGs), and the majority of lesions were restenotic (25/39, 64.1 %). Mean balloon diameter used was 6.6 mm and length 73.4 mm. Primary outcome measure was target lesion primary patency (TLPP) at 6 months, while secondary outcome measures included factors affecting TLPP and major complications. As there were lesions treated more than once with PCB, authors also compared patency results after first and second PCB angioplasty.ResultsTLPP was 72.2 % at 6 months with a median patency of 260 days according to the Kaplan–Meier survival analysis. No major complications occurred. TLPP between AVFs and AVGs (311 vs. 237 days, respectively; p = 0.29) and de novo and restenotic lesions was similar (270.5 vs. 267.5 days, respectively; p = 0.50). In 14 cases, in which lesions were treated with two PCB angioplasties, a statistically significant difference in TLPP after the second treatment was noted (first intervention 179.5 days vs. second intervention 273.5 days; p = 0.032).ConclusionIn this retrospective analysis, Lutonix PCB proved to be safe and effective in treating restenosis in dysfunctional dialysis access with results comparable to the literature available. Larger studies are needed to prove abovementioned results.

  14. Day-to-day relations between stress and sleep and the mediating role of perseverative cognition.

    Science.gov (United States)

    Van Laethem, Michelle; Beckers, Debby G J; van Hooff, Madelon L M; Dijksterhuis, Ap; Geurts, Sabine A E

    2016-08-01

    The goals of this longitudinal diary-based study were to shed light on the day-level relationship between stress and subsequent sleep, and to examine whether perseverative cognition is a mediating factor in this relation. A total of 44 Dutch PhD students were followed during a two-month period, from one month before their public thesis defense (ie, a stressful life event), until one month thereafter. Participants completed short evening and morning questionnaires on eight occasions (in anticipation of and following the defense), including questions about day-level stress, sleep quality, and perseverative cognition. Objective sleep parameters were collected with the SenseWear Pro Armband. Multilevel analysis was used to analyze daily observations nested within individuals. Analyses revealed that day-level stress was not directly related to subsequent subjective sleep indicators or to subsequent objective sleep indicators. Day-level stress was significantly associated with day-level perseverative cognition, and daily variations in perseverative cognition were significantly related to several day-level objective sleep parameters (sleep efficiency, marginally to number of awakenings, and wake after sleep onset), and to several day-level subjective sleep parameters (sleep quality, number of awakenings, wake after sleep onset). Finally, mediation analyses using path analysis suggested that, on the day level, perseverative cognition functions as a mediator between stress and several sleep parameters, namely, subjective sleep quality, objective sleep efficiency, and subjective wake after sleep onset. Perseverative cognition is a promising explanatory mechanism linking day-level stress to subjective and objective measures of sleep. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

    Energy Technology Data Exchange (ETDEWEB)

    Sidhu, Arshdeep; Tan, Kong T.; Noel-Lamy, Maxime; Simons, Martin E.; Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.ca [University Health Network, University of Toronto, Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center (Canada)

    2016-10-15

    PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.

  16. Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

    International Nuclear Information System (INIS)

    Sidhu, Arshdeep; Tan, Kong T.; Noel-Lamy, Maxime; Simons, Martin E.; Rajan, Dheeraj K.

    2016-01-01

    PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.

  17. 77 FR 66525 - National Family Caregivers Month, 2012

    Science.gov (United States)

    2012-11-06

    ... National Family Caregivers Month, 2012 By the President of the United States of America A Proclamation Our... hours to providing care to their relatives or loved ones. During National Family Caregivers Month, we... veterans and their family caregivers through financial support; access to health insurance, mental health...

  18. 78 FR 66617 - National Family Caregivers Month, 2013

    Science.gov (United States)

    2013-11-05

    ... National Family Caregivers Month, 2013 By the President of the United States of America A Proclamation... is one we must recognize and support. During National Family Caregivers Month, we thank these...' family caregivers also receive access to health care. Just as our loved ones celebrate with us in our...

  19. AMSU/MSU LOWTROPO DAY/MONTH TEMP ANOMALIES AND ANNUAL CYCLE V5

    Data.gov (United States)

    National Aeronautics and Space Administration — Global lower tropospheric temperatures are derived from a series of microwave sounding instruments flown on a series of satellites. Daily Zonal and Monthly...

  20. AMSU/MSU LOWSTRAT DAY/MONTH TEMP ANOMALIES AND ANNUAL CYCLE V5

    Data.gov (United States)

    National Aeronautics and Space Administration — Global lower stratospheric temperatures are derived from a series of microwave sounding instruments flown on a series of satellites. Daily Zonal and Monthly...

  1. Prediction of the intensity and diversity of day-to-day activities among people with schizophrenia using parameters obtained during acute hospitalization.

    Science.gov (United States)

    Lipskaya-Velikovsky, Lena; Jarus, Tal; Kotler, Moshe

    2017-06-01

    Participation in day-to-day activities of people with schizophrenia is restricted, causing concern to them, their families, service providers and the communities at large. Participation is a significant component of health and recovery; however, factors predicting participation are still not well established. This study examines whether the parameters obtained during acute hospitalization can predict the intensity and diversity of participation in day-to-day activities six months after discharge. In-patients with chronic schizophrenia (N = 104) were enrolled into the study and assessed for cognitive functioning, functional capacity in instrumental activities of daily living (IADL), and symptoms. Six months after discharge, the intensity and diversity of participation in day-to-day activities were evaluated (N = 70). Multiple correlations were found between parameters obtained during hospitalization and participation diversity, but not participation intensity. The model that is better suited to the prediction of participation diversity contains cognitive ability of construction, negative symptoms and number of previous hospitalizations. The total explained variance is 37.8% (F 3,66  =   14.99, p process for the prediction of participation diversity in day-to-day activities six months after discharge. Participation diversity is best predicted through a set of factors reflecting personal and environmental indicators. Implications for rehabilitation Results of in-patient evaluations can predict the diversity of participation in day-to-day activities six months after discharge. Higher prediction of participation diversity is obtained using a holistic evaluation model that includes assessments for cognitive abilities, negative symptoms severity and number of hospitalizations.

  2. Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

    Science.gov (United States)

    Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

    2018-01-01

    Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

  3. Sun-Earth Day, 2001

    Science.gov (United States)

    Adams, Mitzi L.; Mortfield, P.; Hathaway, D. H.; Whitaker, Ann F. (Technical Monitor)

    2001-01-01

    To promote awareness of the Sun-Earth connection, NASA's Marshall Space Flight Center, in collaboration with the Stanford SOLAR Center, sponsored a one-day Sun-Earth Day event on April 27, 2001. Although "celebrated" on only one day, teachers and students from across the nation, prepared for over a month in advance. Workshops were held in March to train teachers. Students performed experiments, results of which were shared through video clips and an internet web cast. Our poster includes highlights from student experiments (grades 2 - 12), lessons learned from the teacher workshops and the event itself, and plans for Sun-Earth Day 2002.

  4. Moderate Acute Malnutrition Treatment among Children 6-23 Months and 24-59 Months Aged

    International Nuclear Information System (INIS)

    Mahamadou, Tanimoune; Traore, Modibo; Fainke, Kamayera; Magagi, Saidou

    2014-01-01

    Full text: The prevalence of acute malnutrition in Mali has slightly decreased between 2012 and 2013 in southern areas from 8.9 to 8.6 percent.The youngest children 6-23 months are seriously affected as 12.6% according the SMART nutrition survey in 2013. The aim of this study was to show how seasonality impacts relapse rates among youngest moderately malnourished children aged 6-23 month compare to 24-59 months. The World Food Programme in Mali set up Targeted Supplementary Feeding Programme (TSFP) in 1032 community health facilities to address the burden of MAM. This TSFP includes treatment of MAM with 92g of Plumpy’SupTM per days during 60 days. The entry criteria according to national protocol was Mid Upper Arm Circumference less than 125mm (MUAC = 125 mm or WHZ > = -1.5 during two consecutives visits. In addition, the programme is accompanied with community based activities such as active screening and culinary demonstration for women groups and sensitization. As a result, after 10 months of implementation, 41604 children 6-23 months aged have been admitted for MAM treatment. This represents 82% of total estimated caseload in this group (50666). During the same period, only 14% (14473) of total estimated caseload (101333) in children 24-59 months aged group have been admitted and treated. Although 74% (41604) of total admission (56077 children 6-59 months) was 6-23 months aged ,the programme performance indicators show that children 24-59 respond better to the treatment compared to 6-23 months: Average recovery rate 88% vs 87%; death rate 0.55% vs 1.07% none response 0.21% vs 0.50%. Only, the defaulter rate was higher in 24-59, 10.21% vs 7.5%. Nevertheless, compared two Sphere performance norms and threshold, the programme is fully satisfactory in all categories. The seasonal analysis shows that the highest admission in MAM programme was registered between April and September in all categories. 79% of the total caseload has been admitted during this period

  5. A review of an anaesthetic led vascular access list.

    Science.gov (United States)

    Galloway, S; Sharma, A; Ward, J; Bodenham, A R

    2005-08-01

    The demand for insertion of long-term central venous (Hickman type) catheters is thought to be increasing. Organisation is required to meet this demand in a safe and efficient manner. This report reviews the results from a dedicated, anaesthetic led vascular access list over the initial 61-month period. One thousand procedures were performed. Nine hundred and twenty catheters were inserted under local anaesthesia, with or without intravenous sedation and analgesia. Eighty catheters were removed. All procedures were performed during a dedicated once weekly, morning list. A total of 53% of all procedures were performed on a day-case basis, 43% on in-patients. Only 1.5% of patients required an unexpected overnight stay (usually medically unfit patients). There were 81 (9%) cancellations on the day of procedure due to neutropaenia, pneumonia or urinary tract infections. Ultrasound guidance was used initially selectively in 14%, latterly in 100% of procedures and fluoroscopy in all insertions to confirm or adjust catheter position. This service has been well received by patients and oncology services. In addition it provides an interesting area of practice for anaesthetists and an ideal environment for teaching more advanced aspects of central venous access. It may provide a template of service for other centres.

  6. Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access.

    Science.gov (United States)

    Costantino, Thomas G; Parikh, Aman K; Satz, Wayne A; Fojtik, John P

    2005-11-01

    We assess the success rate of emergency physicians in placing peripheral intravenous catheters in difficult-access patients who were unsuccessfully cannulated by emergency nurses. A technique using real-time ultrasonographic guidance by 2 physicians was compared with traditional approaches using palpation and landmark guidance. This was a prospective, systematically allocated study of all patients requiring intravenous access who presented to 2 university hospitals between October 2003 and March 2004. Inclusion criterion was the inability of any available nurse to obtain intravenous access after at least 3 attempts on a subgroup of patients who had a history of difficult intravenous access because of obesity, history of intravenous drug abuse, or chronic medical problems. Exclusion criterion was the need for central venous access. Patients presenting on odd days were allocated to the ultrasonographic-guided group, and those presenting on even days were allocated to the traditional-approach group. Endpoints were successful cannulation, number of sticks, time, and patient satisfaction. Sixty patients were enrolled, 39 on odd days and 21 on even days. Success rate was greater for the ultrasonographic group (97%) versus control (33%), difference in proportions of 64% (95% confidence interval [CI] 39% to 71%). The ultrasonographic group required less overall time (13 minutes versus 30 minutes, for a difference of 17 [95% CI 0.8 to 25.6]), less time to successful cannulation from first percutaneous puncture (4 minutes versus 15 minutes, for a difference of 11 [95% CI 8.2 to 19.4]), and fewer percutaneous punctures (1.7 versus 3.7, for a difference of 2.0 [95% CI 1.27 to 2.82]) and had greater patient satisfaction (8.7 versus 5.7, for a difference of 3.0 [95% CI 1.82 to 4.29]) than the traditional landmark approach. Ultrasonographic-guided peripheral intravenous access is more successful than traditional "blind" techniques, requires less time, decreases the number of

  7. Dynamical Predictability of Monthly Means.

    Science.gov (United States)

    Shukla, J.

    1981-12-01

    We have attempted to determine the theoretical upper limit of dynamical predictability of monthly means for prescribed nonfluctuating external forcings. We have extended the concept of `classical' predictability, which primarily refers to the lack of predictability due mainly to the instabilities of synoptic-scale disturbances, to the predictability of time averages, which are determined by the predictability of low-frequency planetary waves. We have carded out 60-day integrations of a global general circulation model with nine different initial conditions but identical boundary conditions of sea surface temperature, snow, sea ice and soil moisture. Three of these initial conditions are the observed atmospheric conditions on 1 January of 1975, 1976 and 1977. The other six initial conditions are obtained by superimposing over the observed initial conditions a random perturbation comparable to the errors of observation. The root-mean-square (rms) error of random perturbations at all the grid points and all the model levels is 3 m s1 in u and v components of wind. The rms vector wind error between the observed initial conditions is >15 m s1.It is hypothesized that for a given averaging period, if the rms error among the time averages predicted from largely different initial conditions becomes comparable to the rms error among the time averages predicted from randomly perturbed initial conditions, the time averages are dynamically unpredictable. We have carried out the analysis of variance to compare the variability, among the three groups, due to largely different initial conditions, and within each group due to random perturbations.It is found that the variances among the first 30-day means, predicted from largely different initial conditions, are significantly different from the variances due to random perturbations in the initial conditions, whereas the variances among 30-day means for days 31-60 are not distinguishable from the variances due to random initial

  8. Medical Surveillance Monthly Report

    Science.gov (United States)

    2016-12-01

    Illness Prevention and Sun Safety. “Sun Safety.” https:// phc.amedd.army.mil/ topics /discond/hipss/Pages/ SunSafety.aspx. Accessed on 7 December 2016. 22...febrile illness; however, after its wide- spread introduction into immunologically MSMR Vol. 23 No. 12 December 2016 Page 8 naïve populations, a...October 2016 (data as of 22 November 2016) MSMR’s Invitation to Readers Medical Surveillance Monthly Report (MSMR) invites readers to submit topics for

  9. Adolescents' alcohol use and strength of policy relating to youth access, trading hours and driving under the influence: findings from Australia.

    Science.gov (United States)

    White, Victoria; Azar, Denise; Faulkner, Agatha; Coomber, Kerri; Durkin, Sarah; Livingston, Michael; Chikritzhs, Tanya; Room, Robin; Wakefield, Melanie

    2018-06-01

    To determine (i) whether the strength of Australian alcohol control policy in three domains (youth access, trading hours and drink driving) changed during the 2000s; and (ii) estimate associations between these policies and adolescent drinking after adjusting for television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence. Repeated cross-sectional surveys conducted triennially from 2002 to 2011. Multi-level modelling examined the association between alcohol control policies and drinking prevalence after adjusting for covariates. Four Australian capital cities between 2002 and 2011. Students aged 12-17 years participating in a triennial national representative school-based survey (sample size range/survey: 9805-13 119). Outcome measures were: past month drinking and risky drinking (5+ drinks on a day) in the past 7 days. Policy strength in each of three domains (youth access, trading hours, drink-driving) were the key predictor variables. Covariates included: past 3-month television alcohol and alcohol-control advertising, alcohol outlet density, alcohol price change, negatively framed newspaper alcohol articles, adult drinking prevalence and student demographic characteristics. During the study period, the strength of youth access policies increased by 10%, trading hours policies by 14% and drink-driving policies by 58%. Past-month and risky drinking prevalence decreased (e.g. past-month: 2002: 47.4% to 2011: 26.3%). Multivariable analyses that included all policy variables and adjusted for year, student and other covariates showed past-month drinking to be associated inversely with stronger trading hours policies [odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.69, 0.94], but not youth access (OR = 0.92 95% CI = 0.81, 1.04) or drink-driving (OR = 1.00, 95% CI = 0.93, 1.09). Risky drinking was associated inversely with

  10. Internet access and usage by staff and students: a case study of ...

    African Journals Online (AJOL)

    This study focused on Internet access and usage by staff and students in the University of Jos Main Library. It investigated monthly number of users that queued to access Internet monthly and the number of users who actually had access to use the Internet between January – December 2006. Other things investigated ...

  11. Day-­to-­day speculation : designing and wearing dynamic fabric

    NARCIS (Netherlands)

    Mackey, A.M.; Wakkary, R.L.; Wensveen, S.A.G.; Tomico Plasencia, O.; Hengeveld, B.J.

    2017-01-01

    In this paper we describe Greenscreen Dress, a material speculation inquiry that investigates the wearing experience of dynamic fabric in everyday life. In this study the researcher has worn a "greenscreen garment" every day for seven months. Coupled with a chroma-key smartphone application, she has

  12. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

    Directory of Open Access Journals (Sweden)

    Natalia Alencar de Pinho

    Full Text Available Determinants of nonfunctional arteriovenous (AV access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR with 95% confidence intervals (CI of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56, diabetes (OR 1.28, 95% CI 1.15-1.44, and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase. The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

  13. 9 CFR 206.3 - Monthly report.

    Science.gov (United States)

    2010-01-01

    ... the close of business on the 15th of each month, beginning at least 45 days after the initial... the close of the next business day following the 15th. (c) What information do I need to provide in... in § 206.1. (4) Expansion clauses. Any conditions or circumstances specified by clauses in any...

  14. Breast feeding practices of mothers with children (aged 0-36 months ...

    African Journals Online (AJOL)

    increased so that the infant is eating two to four meals per day by about six months of age. Infants over six months of age need to eat meals and snacks about four to six times a day in addition to breast feeding. In this study group cereals were introduced as early as two months. The next two foods introduced were fruits and ...

  15. Developmental milestones record - 12 months

    Science.gov (United States)

    ... to 2 naps during the day SENSORY AND COGNITIVE DEVELOPMENT The typical 12-month-old: Begins pretend play ( ... Editorial team. Infant and Newborn Development Read more Toddler Development Read more NIH MedlinePlus Magazine Read more A. ...

  16. Monthly bulletin of statistics. May 1995

    International Nuclear Information System (INIS)

    1995-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  17. Monthly bulletin of statistics. January 1996

    International Nuclear Information System (INIS)

    1996-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  18. Monthly bulletin of statistics. July 1997

    International Nuclear Information System (INIS)

    1997-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  19. Monthly bulletin of statistics. June 2001

    International Nuclear Information System (INIS)

    2001-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  20. Monthly bulletin of statistics. September 1995

    International Nuclear Information System (INIS)

    1995-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  1. Monthly bulletin of statistics. December 1994

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  2. Monthly bulletin of statistics. July 1995

    International Nuclear Information System (INIS)

    1995-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  3. Monthly bulletin of statistics. September 1994

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  4. Monthly bulletin of statistics. March 1995

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  5. Monthly bulletin of statistics. October 2007

    International Nuclear Information System (INIS)

    2007-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  6. Monthly bulletin of statistics. October 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  7. Monthly Bulletin of Statistics. July 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  8. Monthly bulletin of statistics. March 1994

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  9. Monthly bulletin of statistics. February 1994

    International Nuclear Information System (INIS)

    1994-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  10. Monthly bulletin of statistics. June 1995

    International Nuclear Information System (INIS)

    1995-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  11. Monthly bulletin of statistics. November 2008

    International Nuclear Information System (INIS)

    2008-01-01

    The purpose of this publication is to present current monthly economic statistics for most of the countries and territories of the world. In addition, each month a different selection of special tables is presented showing annual and/or quarterly data on a variety of subjects illustrating important economic long-term trends and developments. Most of these special tables are also reproduced in the United Nations Statistical Yearbook. It is, however, considered to be useful to publish these data in the Bulletin as soon as they become available so that readers may have immediate access to the most current international statistical information

  12. Use and benefits of public access defibrillation in a nation-wide network

    DEFF Research Database (Denmark)

    Nielsen, Anne Møller; Folke, Fredrik; Lippert, Freddy Knudsen

    2013-01-01

    BACKGROUND: Automated External Defibrillators (AEDs) are known to increase survival after out-of-hospital cardiac arrest (OHCA). The aim of this study was to examine the use and benefit of public-access defibrillation (PAD) in a nation-wide network. We primarily sought to assess survival at 1 month...... to exercise (42% vs. 0%), and with improved 30-day survival (69% vs. 15%, p=0.001). Among those presenting with a shockable rhythm, 20 (65%) had Return of Spontaneous Circulation upon arrival of EMS and 8 (26%) were conscious, which emphasizes the diagnostic value of ECG downloads from AEDs. Survival could...

  13. Secular trends in monthly heating and cooling demands in Croatia

    Science.gov (United States)

    Cvitan, Lidija; Sokol Jurković, Renata

    2016-08-01

    This paper analyzes long-term heating and cooling trends for five locations in Croatia from 1901 to 2008 to assist in the revision of Croatia's heating and cooling energy policy. Trends in monthly heating degree-days (HDD) and cooling degree-days (CDD) were determined for three related temperature threshold values each and analyzed to provide insight into the influence of desired thermal comfort on the extent of changes in energy consumption. Monthly trends in the corresponding number of heating days (HD) and cooling days (CD) were also analyzed. A basic investigation of HDD, HD, CDD, and CD trends proved to be essential to the development of a complete description of important climate-related conditions that impact energy demands associated with heating and cooling. In a few cases, the dependence of the trends on the implemented temperature thresholds was rather pronounced and was reflected in great spatial and temporal variations in monthly trends. The statistical significance of the detected monthly trends illustrated a diverse range of possible impacts of climate changes on heating and cooling energy consumption both across and within three main climate regions in Croatia (continental, mountainous, and maritime). It is confirmed that the applied monthly scale for analyses is suitable for assessing heating and cooling practices.

  14. Feeding patterns and diet - children 6 months to 2 years

    Science.gov (United States)

    Feeding children 6 months to 2 years; Diet - age appropriate - children 6 months to 2 years; Babies - feeding solid food ... per day, but will eat more at each feeding than the first 6 months. If you feed ...

  15. Impacts of temperature and lunar day on gene expression profiles during a monthly reproductive cycle in the brooding coral Pocillopora damicornis.

    Science.gov (United States)

    Crowder, Camerron M; Meyer, Eli; Fan, Tung-Yung; Weis, Virginia M

    2017-08-01

    Reproductive timing in brooding corals has been correlated to temperature and lunar irradiance, but the mechanisms by which corals transduce these environmental variables into molecular signals are unknown. To gain insight into these processes, global gene expression profiles in the coral Pocillopora damicornis were examined (via RNA-Seq) across lunar phases and between temperature treatments, during a monthly planulation cycle. The interaction of temperature and lunar day together had the largest influence on gene expression. Mean timing of planulation, which occurred at lunar days 7.4 and 12.5 for 28- and 23°C-treated corals, respectively, was associated with an upregulation of transcripts in individual temperature treatments. Expression profiles of planulation-associated genes were compared between temperature treatments, revealing that elevated temperatures disrupted expression profiles associated with planulation. Gene functions inferred from homologous matches to online databases suggest complex neuropeptide signalling, with calcium as a central mediator, acting through tyrosine kinase and G protein-coupled receptor pathways. This work contributes to our understanding of coral reproductive physiology and the impacts of environmental variables on coral reproductive pathways. © 2017 John Wiley & Sons Ltd.

  16. A 5-day dialectical behavior therapy partial hospital program for women with borderline personality disorder: predictors of outcome from a 3-month follow-up study.

    Science.gov (United States)

    Yen, Shirley; Johnson, Jennifer; Costello, Ellen; Simpson, Elizabeth B

    2009-05-01

    This study describes naturalistic 3-month follow-up after discharge from a 5-day partial hospitalization dialectical behavior therapy (DBT) program for women diagnosed with borderline personality disorder (BPD). We also examined individual BPD criteria as predictors of treatment response. Fifty women diagnosed with BPD were consecutively recruited from a partial hospital DBT program, 47 of whom (94%) completed all assessments including baseline (prior to discharge) and 3-months post-discharge assessments. Most continued with some combination of individual psychotherapy and pharmacotherapy, and all had the option of continuing with weekly DBT skills classes. Baseline scores were compared to 3-month scores using paired two-tailed non-parametric (sign) tests. Regression analyses were conducted to identify predictors of outcome. Depression, hopelessness, anger expression, dissociation, and general psychopathology scores significantly decreased over the 3-month follow-up interval, although scores on several measures remained in the clinical range. Those who endorsed emptiness, impulsivity, and relationship disturbance demonstrated improvement on a number of outcomes, while those who endorsed identity disturbance and fear of abandonment had less improvement on some outcomes. These findings illustrate (1) that improvement occurred over a 3-month interval on a number of measures in patients receiving treatment as usual following discharge from a partial hospitalization program, and (2) that BPD is a complex, heterogeneous disorder for which there is no single pathognomonic criterion, so that each criterion should be considered individually in determining its potential effect on treatment outcomes.

  17. 76 FR 68619 - National Entrepreneurship Month, 2011

    Science.gov (United States)

    2011-11-04

    ... National Entrepreneurship Month, 2011 By the President of the United States of America A Proclamation From... Entrepreneurship Week, which begins on November 14, we can ensure our startups have access to the resources... Constitution and the laws of the United States, do hereby proclaim November 2011 as National Entrepreneurship...

  18. Impact of economic sanctions on access to noncommunicable diseases medicines in the Islamic Republic of Iran.

    Science.gov (United States)

    Kheirandish, Mehrnaz; Varahrami, Vida; Kebriaeezade, Abbas; Cheraghali, Abdol Majid

    2018-04-05

    It has been argued that economic sanctions and the economic crisis have adversely affected access to drugs. To assess the impact of economic sanctions on the Iranian banking system in 2011 and Central Bank in 2012 on access to and use of drugs for noncommunicable diseases (NCDs). An interrupted time series study assessed the effects of sanctions on drugs for diabetes (5 drug groups), asthma (5 drug groups), cancer (14 drugs) and multiple sclerosis (2 drugs). We extracted data from national reference databases on the list of drugs on the Iranian pharmaceutical market before 2011 for each selected NCD and their monthly sales. For cancer drugs, we used stratified random sampling by volume and value of sales, and source of supply (domestic or imported). Data were analysed monthly from 2008 to 2013. Market availability of 13 of 26 drugs was significantly reduced. Ten other drugs showed nonsignificant reductions in their market availability. Interferon α2b usage reduced from 0.014 defined daily doses per 1000 inhabitants per day (DID) in 2010 to 0.008 in 2013; and cytarabine from 1.40 mg per 1000 population per day in 2010 to 0.96 in 2013. Selective β2-adrenoreceptor agonists usage reduced from 8.4 to 6.8 DID in the same time period. There is strong evidence that sanctions have had a negative effect on access to drugs, particularly those that depended on the import of their raw material or finished products. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  19. 'Chasing for Water': Everyday Practices of Water Access in Peri-Urban Ashaiman, Ghana

    Directory of Open Access Journals (Sweden)

    Megan Peloso

    2014-02-01

    Full Text Available Despite recent reports suggesting that access to improved sources of drinking water is rising in Ghana, water access remains a daily concern for many of those living in the capital region. Throughout the Greater Accra Metropolitan Area (GAMA, the urban poor manage uncertainty and establish themselves in the city by leveraging a patchwork system of basic services that draws importantly from informal systems and supplies. This paper takes a case study approach, using evidence gathered from two-months of fieldwork in a peri-urban informal settlement on the fringe of Accra, to explore everyday practices involved in procuring water for daily needs that routinely lead residents outside of the official water supply system. Findings from this case study demonstrate that respondents make use of informal water services to supplement or 'patch up' gaps left by the sporadic water flow of the official service provider, currently Ghana Water Company Ltd. (GWCL. Basic water access is thus constructed through an assemblage of coping strategies and infrastructures. This analysis contributes to understandings of heterogeneity in water access by attending to the everyday practices by which informality is operationalised to meet the needs of the urban poor, in ways that may have previously been overshadowed. This research suggests, for example, that although water priced outside of the official service provider is generally higher per unit, greater security may be obtained from smaller repetitive transactions as well as having the flexibility to pursue multiple sources of water on a day-to-day basis.

  20. Review of once-monthly oral ibandronate and the use thereof

    African Journals Online (AJOL)

    The MOBILE study was a prospective, randomised, phase lll, non- inferiority study that compared the efficacy and safety of three once-monthly oral ibandronate doses (50+50 mg monthly, given on 2 consecutive days; 100 mg monthly; 150 mg monthly) with. 2.5 mg daily ibandronate, which has previously been shown.

  1. Factors affecting yearly and monthly visits to Taipei Zoo

    Science.gov (United States)

    Su, Ai-Tsen; Lin, Yann-Jou

    2018-02-01

    This study investigated factors affecting yearly and monthly numbers of visits to Taipei Zoo. Both linear and nonlinear regression models were used to estimate yearly visits. The results of both models showed that the "opening effect" and "animal star effect" had a significantly positive effect on yearly visits, while a SARS outbreak had a negative effect. The number of years had a significant influence on yearly visits. Results showed that the nonlinear model had better explanatory power and fitted the variations of visits better. Results of monthly model showed that monthly visits were significantly influenced by time fluctuations, weather conditions, and the animal star effect. Chinese New Year, summer vacation, numbers of holidays, and animal star exhibitions increased the number of monthly visits, while the number of days with temperatures at or below 15 °C, the number of days with temperatures at or above 30 °C, and the number of rainy days had significantly negative effects. Furthermore, the model of monthly visits showed that the animal star effect could last for over two quarters. The results of this study clarify the factors affecting visits to an outdoor recreation site and confirm the importance of meteorological factors to recreation use.

  2. Mortality and cardiovascular morbidity within 30 days of discharge following acute coronary syndrome in a contemporary European cohort of patients: How can early risk prediction be improved? The six-month GRACE risk score.

    Science.gov (United States)

    Raposeiras-Roubín, Sergio; Abu-Assi, Emad; Cambeiro-González, Cristina; Álvarez-Álvarez, Belén; Pereira-López, Eva; Gestal-Romaní, Santiago; Pedreira-López, Milagros; Rigueiro-Veloso, Pedro; Virgós-Lamela, Alejandro; García-Acuña, José María; González-Juanatey, José Ramón

    2015-06-01

    Given the increasing focus on early mortality and readmission rates among patients with acute coronary syndrome (ACS), this study was designed to evaluate the accuracy of the GRACE risk score for identifying patients at high risk of 30-day post-discharge mortality and cardiovascular readmission. This was a retrospective study carried out in a single center with 4229 ACS patients discharged between 2004 and 2010. The study endpoint was the combination of 30-day post-discharge mortality and readmission due to reinfarction, heart failure or stroke. One hundred and fourteen patients had 30-day events: 0.7% mortality, 1% reinfarction, 1.3% heart failure, and 0.2% stroke. After multivariate analysis, the six-month GRACE risk score was associated with an increased risk of 30-day events (HR 1.03, 95% CI 1.02-1.04; p<0.001), demonstrating good discrimination (C-statistic: 0.79 ± 0.02) and optimal fit (Hosmer-Lemeshow p=0.83). The sensitivity and specificity were adequate (78.1% and 63.3%, respectively), and negative predictive value was excellent (99.1%). In separate analyses for each event of interest (all-cause mortality, reinfarction, heart failure and stroke), assessment of the six-month GRACE risk score also demonstrated good discrimination and fit, as well as adequate predictive values. The six-month GRACE risk score is a useful tool to predict 30-day post-discharge death and early cardiovascular readmission. Clinicians may find it simple to use with the online and mobile app score calculator and applicable to clinical daily practice. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  3. Improving patient access to an interventional US clinic.

    Science.gov (United States)

    Steele, Joseph R; Clarke, Ryan K; Terrell, John A; Brightmon, Tonya R

    2014-01-01

    A continuous quality improvement project was conducted to increase patient access to a neurointerventional ultrasonography (US) clinic. The clinic was experiencing major scheduling delays because of an increasing patient volume. A multidisciplinary team was formed that included schedulers, medical assistants, nurses, technologists, and physicians. The team created an Ishikawa diagram of the possible causes of the long wait time to the next available appointment and developed a flowchart of the steps involved in scheduling and completing a diagnostic US examination and biopsy. The team then implemented a staged intervention that included adjustments to staffing and room use (stage 1); new procedures for scheduling same-day add-on appointments (stage 2); and a lead technician rotation to optimize patient flow, staffing, and workflow (stage 3). Six months after initiation of the intervention, the mean time to the next available appointment had decreased from 25 days at baseline to 1 day, and the number of available daily appointments had increased from 38 to 55. These improvements resulted from a coordinated provider effort and had a net present value of more than $275,000. This project demonstrates that structural changes in staffing, workflow, and room use can substantially reduce scheduling delays for critical imaging procedures. © RSNA, 2014.

  4. Digital technologies in Day-care institutions

    DEFF Research Database (Denmark)

    Schrøder, Vibeke; Søndergaard, Steen

    Digital technologies are gaining an ever increasing access into the activities in Danish and Nordic day-care institutions. The traditional critical viewpoint of technologies as being opposed to the well-being of children is challenged in part by substantial access to digital tools in infant life......, in part by new technologies designed with an intuitive and inviting user interface. In a one-year research project ’Digital tools in day-care-institutions’ (2015) financed by The Danish Agency for Digitisation and The Ministry of Education we have investigated the role of digital technologies in relation...... in performances of dominant cultural ways of acting and thinking. Also, most often the pedagogues’ use of technologies follow the immediate possibilities offered by the technologies. From the videos of these activities it appears that the children follow two tracks of participation. Either the children work...

  5. Protection of dogs against canine heartworm infection 28?days after four monthly treatments with Advantage Multi? for Dogs

    OpenAIRE

    Bowman, Dwight D.; Grazette, Alyssa R.; Basel, Chris; Wang, Yingying; Hostetler, Joseph A.

    2016-01-01

    Background Monthly heartworm preventives are designed to protect dogs by killing heartworms acquired the month prior to their administration, and after treatment with most products, the drug levels rapidly dissipate to very low levels. Work with Advantage Multi? for Dogs (imidacloprid?+?moxidectin) topical solution showed protection against hookworm infection throughout the month after administration of several monthly doses suggesting that similar protection might occur with heartworms. This...

  6. Clinical predictors of port infections within the first 30 days of placement.

    Science.gov (United States)

    Bamba, Ravinder; Lorenz, Jonathan M; Lale, Allison J; Funaki, Brian S; Zangan, Steven M

    2014-03-01

    To identify risk factors for port infections within 30 days of placement. A retrospective chart review of port placements from 2002-2009 was conducted. Patients who had port removals secondary to infection within the first 30 days of placement were included. This group of patients was compared with a control group of patients with ports with no evidence of infection. For every one patient with a port infection, two control subjects were chosen of the same gender and new port placement during the same month as the corresponding patient with an infected port. From 2002-2009, 4,404 ports were placed. Of the 4,404 patients, 33 (0.7%) were found to have a port infection within 30 days of placement. Compared with the control group, the early infection group had a higher prevalence of leukopenia (21.2% vs 6.1%, P = .039) and thrombocytopenia (33% vs 12%, P = .0158). There was also a higher prevalence of an inpatient hospital stay during port placement and high international normalized ratio in the early infection group. Low preoperative white blood cell and platelet counts were risk factors for early infection. Abnormal coagulation profiles and inpatient access of ports after placement could be additional risk factors. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  7. 36 CFR 903.5 - Response to request for access.

    Science.gov (United States)

    2010-07-01

    ... CORPORATION PRIVACY ACT § 903.5 Response to request for access. (a) Within 10 days of receipt of a request... available under the Privacy Act and shall notify the requesting individual in person or in writing of that... under § 903.11. Access shall be provided within 30 days of receipt of the request unless the Corporation...

  8. Public Television Channels in New York City: The First Six Months.

    Science.gov (United States)

    Calhoun, Richard

    The end results of the first six months of public access cable television (CATV) channels in New York City were in some ways disappointing. Franchise agreements for each of New York's two CATV systems called for two public-access channels to be in operation by July 1, 1971, one year after the date of the franchise awards. The channels were to be…

  9. 78 FR 66041 - 60-Day Notice of Proposed Information Collection: Multifamily Project Monthly Accounting Reports

    Science.gov (United States)

    2013-11-04

    ... calling the toll-free Federal Relay Service at (800) 877-8339. FOR FURTHER INFORMATION CONTACT: Harry... hearing or speech impairments may access this number through TTY by calling the toll-free Federal Relay....g., permitting electronic submission of responses. HUD encourages interested parties to submit...

  10. Paid sick days and stay-at-home behavior for influenza

    OpenAIRE

    Piper, Kaitlin; Youk, Ada; James, A. Everette; Kumar, Supriya

    2017-01-01

    Access to paid sick days (PSD) differs by workplace size, race/ethnicity, gender, and income in the United States. It is not known to what extent decisions to stay home from work when sick with infectious illnesses such as influenza depend on PSD access, and whether access impacts certain demographic groups more than others. We examined demographic and workplace characteristics (including access to PSD) associated with employees' decisions to stay home from work for their own or a child's ill...

  11. Reproductive Health Outcomes of Insured Women Who Access Oral Levonorgestrel Emergency Contraception

    Science.gov (United States)

    Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W.; Goler, Nancy

    2015-01-01

    Objectives To assess the level of risk for women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. Methods This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among women aged 15-44 who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Results Of 21,421 prescriptions, 14,531(67.8%) were accessed through the call center. In the subsequent 12 months, 12,127(56.6%) women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264(10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for women who accessed it through the call center -1,569(10.8%) and office visits – 695(10.1%) (adjusted OR 1.02 95% confidence interval (CI) 0.93-1.13). In the subsequent 6 months, 2,056(9.6%) women became pregnant. Women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82 95% CI 0.72-0.94); however they were more likely to become pregnant within 4-6 months (adjusted OR 1.37 95%CI 1.16-1.60). Among women who were tested for chlamydia and gonorrhea, 689(7.8%) and 928(7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Conclusions Protocols to routinely address unmet need for contraception at every call for emergency contraception and all office visits including visits with primary care providers should be investigated. PMID:25751211

  12. SNAP Participants' Eating Patterns over the Benefit Month: A Time Use Perspective.

    Science.gov (United States)

    Hamrick, Karen S; Andrews, Margaret

    2016-01-01

    Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP) often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006-08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNAP participants were increasingly more likely than nonparticipants to report a day with no eating occurrences over the benefit issuance cycle. This supports the view that there is a monthly cycle in food consumption associated with the SNAP monthly benefit issuance policy.

  13. The U.S. Geological Survey Monthly Water Balance Model Futures Portal

    Science.gov (United States)

    Bock, Andrew R.; Hay, Lauren E.; Markstrom, Steven L.; Emmerich, Christopher; Talbert, Marian

    2017-05-03

    The U.S. Geological Survey Monthly Water Balance Model Futures Portal (https://my.usgs.gov/mows/) is a user-friendly interface that summarizes monthly historical and simulated future conditions for seven hydrologic and meteorological variables (actual evapotranspiration, potential evapotranspiration, precipitation, runoff, snow water equivalent, atmospheric temperature, and streamflow) at locations across the conterminous United States (CONUS).The estimates of these hydrologic and meteorological variables were derived using a Monthly Water Balance Model (MWBM), a modular system that simulates monthly estimates of components of the hydrologic cycle using monthly precipitation and atmospheric temperature inputs. Precipitation and atmospheric temperature from 222 climate datasets spanning historical conditions (1952 through 2005) and simulated future conditions (2020 through 2099) were summarized for hydrographic features and used to drive the MWBM for the CONUS. The MWBM input and output variables were organized into an open-access database. An Open Geospatial Consortium, Inc., Web Feature Service allows the querying and identification of hydrographic features across the CONUS. To connect the Web Feature Service to the open-access database, a user interface—the Monthly Water Balance Model Futures Portal—was developed to allow the dynamic generation of summary files and plots  based on plot type, geographic location, specific climate datasets, period of record, MWBM variable, and other options. Both the plots and the data files are made available to the user for download 

  14. Radiation-induced cognitive dysfunction in 4-month old male wistar rat

    International Nuclear Information System (INIS)

    Lamproglou, I.; Bok, B.; Vranckx, R.; Delattre, J.Y.; Boisserie, G.; Mazeron, J.J.; Baillet, F.

    1997-01-01

    Behavioral dysfunction of memory process arising 4 months after whole brain irradiation (30 Gy/10 fractions/12 days) has been demonstrated in 16-27 month old rats, as compared with non irradiated rats. This study was therefore aimed at delivering the same irradiation in young rats and comparing results with those previously obtained in old rats. Thirty-three 4-month old rats were included into the study. Eighteen received whole brain irradiation (30 Gy/10 fractions/12 days), and 18 were given sham irradiation. Sequential behavior studies were done before irradiation and during the 7 months following irradiation. Significant decrease in memory function was observed in irradiated rats 1 month (p<0.001), 3 months (p<0.013), and 6 months (p=0.007) post-irradiation. This was accompanied by learning deficit 1 month (p=0.01), 4.5 months (p=0.003), and 7 months (p=0.009) post-irradiation. Response to radiation therapy observed in young rats differed from that observed in old rats. Young rats showed earlier decrease in memory function than old rats, but this deficit also arose earlier in young rats than in old rats. In two cases this deficit was permanent. (authors)

  15. Nocturnal, every-other-day, online haemodiafiltration: an effective therapeutic alternative.

    Science.gov (United States)

    Maduell, Francisco; Arias, Marta; Durán, Carlos E; Vera, Manel; Fontseré, Néstor; Azqueta, Manel; Rico, Nayra; Pérez, Nuria; Sentis, Alexis; Elena, Montserrat; Rodriguez, Néstor; Arcal, Carola; Bergadá, Eduardo; Cases, Aleix; Bedini, Jose Luis; Campistol, Josep M

    2012-04-01

    Longer and more frequent dialysis sessions have demonstrated excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. The aim of this study was to evaluate the beneficial effects of a longer (nocturnal) and more frequent (every-other-day) dialysis schedule with OL-HDF at the same or the highest convective volume. This prospective, in-centre crossover study was carried out in 26 patients, 18 males and 8 females, 49.2±14 years old, on 4-5 h thrice-weekly post-dilution OL-HDF, switched to nocturnal every-other-day OL-HDF. Patient inclusion criteria consisted of stable patients with good vascular access and with good prospects for improved occupational, psychological and social rehabilitation. Patients were randomly assigned into two groups: Group A received the same convective volume as previously for 6 months followed by a higher convective volume for a further 6 months, while Group B received the same schedule in reverse order. Nocturnal every-other-day OL-HDF was well tolerated and 56% of patients who were working during the baseline period continued to work throughout the study with practically no absenteeism. The convective volume was 26.7±2 L at baseline, 27.5±2 with the unchanged volume and 42.9±4 L with the higher volume. eKt/V increased from 1.75±0.4 to 3.37±0.9. Bicarbonate, blood urea nitrogen (BUN) and creatinine values decreased, while phosphate levels fell markedly with a 90% reduction in phosphate binders. Blood pressure and left ventricular hypertrophy (LVH) improved and the use of anti-hypertensive drugs decreased. In both groups, BUN, creatinine and β2-microglobulin reduction ratios improved. Different removal patterns were observed for myoglobin, prolactin and α1-acid glycoprotein. Nocturnal every-other-day OL-HDF could be an excellent therapeutic alternative since good tolerance and occupational rehabilitation, marked improvement in dialysis dose

  16. ARCAS (ACACIA Regional Climate-data Access System) -- a Web Access System for Climate Model Data Access, Visualization and Comparison

    Science.gov (United States)

    Hakkarinen, C.; Brown, D.; Callahan, J.; hankin, S.; de Koningh, M.; Middleton-Link, D.; Wigley, T.

    2001-05-01

    A Web-based access system to climate model output data sets for intercomparison and analysis has been produced, using the NOAA-PMEL developed Live Access Server software as host server and Ferret as the data serving and visualization engine. Called ARCAS ("ACACIA Regional Climate-data Access System"), and publicly accessible at http://dataserver.ucar.edu/arcas, the site currently serves climate model outputs from runs of the NCAR Climate System Model for the 21st century, for Business as Usual and Stabilization of Greenhouse Gas Emission scenarios. Users can select, download, and graphically display single variables or comparisons of two variables from either or both of the CSM model runs, averaged for monthly, seasonal, or annual time resolutions. The time length of the averaging period, and the geographical domain for download and display, are fully selectable by the user. A variety of arithmetic operations on the data variables can be computed "on-the-fly", as defined by the user. Expansions of the user-selectable options for defining analysis options, and for accessing other DOD-compatible ("Distributed Ocean Data System-compatible") data sets, residing at locations other than the NCAR hardware server on which ARCAS operates, are planned for this year. These expansions are designed to allow users quick and easy-to-operate web-based access to the largest possible selection of climate model output data sets available throughout the world.

  17. [One day diagnosis for breast lesions: Medical and psychological assessment--EVADIASEIN study].

    Science.gov (United States)

    Berman, A; Teig, B; Duracinsky, M; Gayet, M; Bellin, M-F; Guettier, C; Fernandez, H; Nazac, A

    2016-01-01

    Breast cancer is the most frequent feminine cancer in France and its incidence increases steadily. The time of access to medical care is an indicator of the quality of the treatments recommended by the Plan Cancer 2009-2013, as it influences the diagnosis and reduces psychological morbidity during the pre-diagnosis phase. The one-day diagnosis is a recently initiated concept, which offers to get the results of the biopsy on the day it is performed and facilitates the setting-up of therapeutic care with the surgeon met during the one-day medical consultations. The aim of this study is to evaluate the satisfaction of patients who benefited from a one-day breast lesion diagnosis, as well as confirm the decrease of time of access to medical treatment. This is an observational, non-interventional and single-centre study based on 27 patients who benefited from one-day breast lesions diagnosis over two years. The patients were only included who had a classified lesion ACR 4 or 5 and visible in the ultrasound. We analyzed the histological concordance between the biopsy and the definitive histology, the time of access to medical care, and the therapeutic treatments We analyzed the psychological impact of such an organization by sending to the patients a questionnaire including the Psychological Consequence Questionnaire (PCQ) and the Breast Cancer Anxiety Indicator (BCA) allowing to estimate the anxiety generated by the pre-diagnostic phase, the DC-Sat allowing to estimate the satisfaction of the consultation of announcement, as well as the same day diagnosis benefit. The patients were 59.8 years old in average [33-87]. The average time between the date of the mammography and the one-day diagnosis consultation (including the biopsy) was 15.0 days [0-60]. Fifty-seven percent of the patients considered this time as short. The average time between the biopsy date and the start of the treatment was 15.9 days [4-30]. The one-day diagnosis took an average of 1.6 days [1-5]. The

  18. Orlistat for Six Months in Overweight and Obese Patients

    Directory of Open Access Journals (Sweden)

    Alfredo Halpern

    2010-01-01

    Full Text Available Objective. To assess the efficacy and tolerability of the association sibutramine (10–20 mg/day and orlistat (120 mg 2-3 times a day in the treatment of obesity in a six-month open trial. Methods. 446 overweight and obese patients who sought treatment for obesity in a private clinic were assessed every 2 weeks during a period of 3 and 6 months. Results. After 3 months, the mean weight loss was 10.5 kg (−9.8% of the initial weight, =263, and after 6 months, the mean weight loss was 13.9 kg (−12.8% of the initial weight, =97. The tolerability of such association was quite acceptable and coherent with the action mechanism of each component. Conclusions. The association of orlistat and sibutramine is quite efficient and it seems to promote a higher rate of weight loss than that reported in clinical studies performed with each drug separately.

  19. Open Data Day Hackathon 2014 at Edmonton Public Library

    Directory of Open Access Journals (Sweden)

    Alex Carruthers

    2014-12-01

    Full Text Available Edmonton Public Library (EPL hosted its first hackathon for International Open Data Day 2014. International Open Data Day promotes open data policies in local, regional, and national governments worldwide, in the spirit of transparency and civic innovation. The open data movement, like public libraries, values access to information and civic engagement, and it offers opportunities for public libraries to improve their efficiency, transparency, and programming. Celebrating the event provided the Library with the additional benefit of strengthening our relationship to local government. This case study provides a practical introduction to hosting an open data hackathon as a first step to engaging the open data movement. Two follow-up surveys, one immediately after the hackathon and another five months later, were used to assess the event and determine how the Library could better support the open data community in the future. The majority of hackathon participants labelled themselves beginner programmers, were not regular library users, and appreciated the opportunity to meet city employees and other hackers who shared their interests. The Library was encouraged to increase our output of open data and to host more hackathons. Results also suggested room for improvement in the areas of developing a more formal structure to the event, connecting participants with similar interests, and providing long term support for app development. By hosting a hackathon for International Open Data Day, EPL gained both the information and the relationships necessary to release meaningful datasets and put itself in an excellent position to understand and respond to the interests and needs of the open data community.

  20. How accessible are interpreter services to dialysis patients of Non-English Speaking background?

    Directory of Open Access Journals (Sweden)

    Edward Zimbudzi

    2010-03-01

    Full Text Available Benefits of utilising professional interpreters in clinicalsettings have been well documented. However, not manystudies have focused on use of professional interpreters bydialysis patients of Non-English Speaking Background (NESBwho are in the clinical settings every second day of their lives.The underlying question for this research was to determinethe level of interpreter utilisation by dialysis patients of NESBat a major urban teaching hospital.MethodA multi-method approach was used involving (a in-depthinterviews of health care professionals working with dialysispatients to elicit their views regarding interpreter access anduse by dialysis patients of NESB, (b observations ofinteractions between staff and dialysis patients of NESB and(c review of medical records belonging to dialysis patients ofNESB who were admitted 24 months prior to the study.ResultsInterviews revealed that only 50% of Health Care Workers(HCWs had accessed an interpreter for dialysis patients ofNESB over a period of six months. Observations of staff/NESBpatient interactions showed that professional interpreterswere used in only 25% of the observed occasions. Thereview of medical records revealed that there was noevidence of interpreter use in 32% of the recordsbelonging to dialysis patients of NESB. The study alsoshowed that non-compliance with dialysis treatmentregime was more likely to occur among patients who hadlimited access to interpreters.ConclusionThe study demonstrated a suboptimal utilisation ofinterpreter services by dialysis patients of NESB. Severalbarriers to inaccessibility and underutilisation ofprofessional interpreters were identified.Recommendations to improve communication betweenHCWs and dialysis patients of NESB are suggested.

  1. Increasing access to emergency contraception through online prescription requests.

    Science.gov (United States)

    Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

    2010-01-01

    To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

  2. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    Science.gov (United States)

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  3. 75 FR 62301 - National Disability Employment Awareness Month, 2010

    Science.gov (United States)

    2010-10-08

    ... and talents of all our citizens. No individual in our Nation should face unnecessary barriers to... Disability Employment Awareness Month, we renew our focus on improving employment opportunities and career... access to technology, with advances in areas such as closed captioning, delivery of emergencyinformation...

  4. SNAP Participants' Eating Patterns over the Benefit Month: A Time Use Perspective.

    Directory of Open Access Journals (Sweden)

    Karen S Hamrick

    Full Text Available Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006-08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNAP participants were increasingly more likely than nonparticipants to report a day with no eating occurrences over the benefit issuance cycle. This supports the view that there is a monthly cycle in food consumption associated with the SNAP monthly benefit issuance policy.

  5. SNAP Participants’ Eating Patterns over the Benefit Month: A Time Use Perspective

    Science.gov (United States)

    2016-01-01

    Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP) often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006–08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNAP participants were increasingly more likely than nonparticipants to report a day with no eating occurrences over the benefit issuance cycle. This supports the view that there is a monthly cycle in food consumption associated with the SNAP monthly benefit issuance policy. PMID:27410962

  6. Worse Prognosis in Heart Failure Patients with 30-Day Readmission

    Science.gov (United States)

    Tung, Ying-Chang; Chou, Shing-Hsien; Liu, Kuan-Liang; Hsieh, I-Chang; Wu, Lung-Sheng; Lin, Chia-Pin; Wen, Ming-Shien; Chu, Pao-Hsien

    2016-01-01

    Background Heart failure (HF) readmission results in substantial expenditure on HF management. This study aimed to evaluate the readmission rate, outcome, and predictors of HF readmission. Methods Patients with reduced left ventricular ejection fraction (LVEF readmission rate, mortality and predictors of readmission. Results A total of 433 de novo HF patients with LVEF readmission rates were 10.9% and 27%, respectively. At the end of the 6-month follow-up, the readmission group had higher mortality than the non-readmission group (27.66% vs. 10.36%; p = 0.001). The survivors of the 30-day readmission had similar mortality rates at 6 months, regardless of the cause of readmission (cardiovascular vs. non-cardiovascular: 25% vs. 30.43%, p = 0.677). Among all the parameters, prescription of beta blockers independently reduced the risk of 30-day readmission (odds ratio 0.15; 95% confidence interval 0.02-0.99; p = 0.049). Conclusions Those HF patients who suffered from 30-day readmission had worse prognosis at the 6-month follow-up. Regardless of the readmission causes, the patients surviving the 30-day readmission had similar mortality rates at 6-month follow-up. These results underscored the importance of reducing readmission as a means to improve HF outcome. PMID:27899857

  7. A novel rapid access testicular cancer clinic: prospective evaluation after one year.

    Science.gov (United States)

    Carey, K; Davis, N F; Elamin, S; Ahern, P; Brady, C M; Sweeney, P

    2016-02-01

    Our institution has recently developed a rapid access outpatient clinic to investigate men with testicular lumps and/or pain suspicious for testicular cancer (TCa). To present our experience after 12 months. All referrals to the rapid access testicular clinic (RATC) clinic were prospectively analysed from 01/01/2013 to 01/01/2014. The primary outcome variable was incidence of TCa in the referred patient cohort. Secondary outcome variables were waiting times prior to clinical review and waiting times prior to radical orchidectomy in patients diagnosed with TCa. Seventy-four new patients were referred to the RATC during the 1-year period and the mean age was 34 (range 15-81 years). TCa was the most common diagnosis and was found in 18 (25 %) patients. Patients diagnosed with TCa underwent radical orchidectomy, a median of 3 (range 1-5) days after their initial GP referral. Patients requiring surgical intervention for benign scrotal pathology underwent their procedure a median of 32 (range 3-61) days after their initial referral. Of the 18 patients diagnosed with TCa, 9 (50 %) were diagnosed with a seminomatous germ cell tumour on histopathology. The RATC is a new initiative in Ireland that provides expedient and definitive treatment of patients with newly diagnosed TCa. Early treatment will ultimately improve long-term prognosis in this patient cohort.

  8. Availability and affordability of essential medicines for children in the Western part of Ethiopia: implication for access.

    Science.gov (United States)

    Sado, Edao; Sufa, Alemu

    2016-03-15

    Essential medicines (EMs) are those medicines which satisfy the priority health care needs of the population. Although it is a fundamental human right, access to essential medicines has been a big challenge in developing countries particularly for children. WHO recommends assessing the current situations on availability and affordability of EMs as the first step towards enhancing access to them. Therefore, the aim of this study was to assess access to EMs for children based on availability, affordability, and price. We adapted the WHO and Health Action International tools to measure availability, affordability, and prices of EMs. We collected data on 22 EMs for children from 15 public to 40 private sectors' drug outlets in east Wollega zone. Availability was expressed as percentage of drug outlets per sector that stocked surveyed medicines on the day of data collection, and prices were expressed as median price ratio. Affordability was measured as the number of daily wages required for the lowest-paid government unskilled worker (1.04 US $per day) to purchase one standard treatment of an acute condition or treatment for a chronic condition for a month. The average availability of essential medicines was 43 % at public and 42.8 % at private sectors. Lowest priced medicines were sold at median of 1.18 and 1.54 times their international reference prices (IRP) in the public and private sectors, respectively. Half of these medicines were priced at 0.90 to 1.3 in the public sector and 1.23 to 2.07 in the private sector times their respective IRP. Patient prices were 36 % times higher in the private sector than in the public sector. Medicines were unaffordable for treatment of common conditions prevalent in the zone at both public and private sectors as they cost a day or more days' wages for the lowest paid government unskilled worker. Access to EMs to children is hampered by low availability and high price which is unaffordable. Thus, further study on larger scale is

  9. 22 CFR 1003.3 - Access to records.

    Science.gov (United States)

    2010-04-01

    ... Foundation will complete such review not later than 30 days (excluding Saturdays, Sundays, and legal public... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Access to records. 1003.3 Section 1003.3 Foreign Relations INTER-AMERICAN FOUNDATION RULES SAFEGUARDING PERSONAL INFORMATION IN IAF RECORDS § 1003.3 Access...

  10. [Thrombosis in vascular accesses for haemodialysis: rescue treatment using invasive vascular radiological techniques].

    Science.gov (United States)

    García Medina, J; Lacasa Pérez, N; Muray Cases, S; Pérez Garrido, I; García Medina, V

    2009-01-01

    The purpose of this paper is to communicate our experience in the salvage of thrombosed haemodialysis vascular accesses using interventional radiology techniques. In the last four years, we have treated, by radiological means, 101 thrombosed haemodialysis vascular accesses. There were 44 autologous arteriovenous fistulas (43.56%) and 57 PTFE grafts (56.44%). There were 69 men (68.3%) and 32 women (31.7%). The mean age was 67.73 years (range 33-84). The mean vascular access age was 23.79 months (range 1-132). Manual catheter-directed aspiration was used. Fragmented, triturated or pushed the thrombus against the pulmonary circulation was avoided in all cases. 78 accesses were salvaged (77.2%). Autologous fistulas average and PTFE grafts success rate were 84.44% and 71.42% respectively. Angioplasty in one or more lesions after thromboaspiration was performed in all accesses, except six (5.9%). Metallic endoprostheses were implanted in 14 accesses (13.9%). Mean follow-up was 9 months (range 0-44). Primary patency was 42.3% +/- 5 at 6 months and 32% +/- 4 at one year. Autologous fistulas patency was better than PTFE grafts patency (p better than PTFE grafts. This justifies interventional radiology techniques in these situations.

  11. Day labor and occupational health: time to take a closer look.

    Science.gov (United States)

    Buchanan, Susan

    2004-01-01

    The term "day labor" refers to work performed by individuals who are hired on a temporary basis, often for one day at a time. This type of employment has increased in North America as informal work arrangements and immigration have increased. Research on the occupational health of day laborers is minimal. The objectives of this article are to review the current literature pertaining to occupational health in day laborers, and to characterize the issues that affect this population's access to occupational health services. Surveys of day laborers and other immigrant, low-wage workers show that they are at elevated risk for occupational injury and are often unable to access medical care when injured on the job. Reasons include workers' reluctance to complain about unsafe work conditions, inadequate safety training, and lack of incentive for employers to reduce workplace injuries. More research is needed to better characterize the occupational health of this population.

  12. Public sector information access policies in Europe

    NARCIS (Netherlands)

    Welle Donker, F.M.

    2010-01-01

    In the digital age geo-information has become embedded in our daily lives, such as navigation systems, community platforms, real estate information and weather forecasts. Everybody uses geo-information for their day-to-day decision making. Therefore, access to geo-information is of vital importance

  13. Automating Partial Period Bond Valuation with Excel's Day Counting Functions

    Science.gov (United States)

    Vicknair, David; Spruell, James

    2009-01-01

    An Excel model for calculating the actual price of bonds under a 30 day/month, 360 day/year day counting assumption by nesting the DAYS360 function within the PV function is developed. When programmed into an Excel spreadsheet, the model can accommodate annual and semiannual payment bonds sold on or between interest dates using six fundamental…

  14. Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement.

    Science.gov (United States)

    Kleczyński, Paweł; Bagieński, Maciej; Dziewierz, Artur; Rzeszutko, Łukasz; Sorysz, Danuta; Trębacz, Jarosław; Sobczyński, Robert; Tomala, Marek; Stąpór, Maciej; Dudek, Dariusz

    2016-10-10

    Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI. A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS). Patients who reported some problems with mobility at baseline showed better mobility after 12 months (p = 0.001). On the other hand, those who reported issues with self-care, usual activity or pain did not show significant improvement (p = 0.41; p = 0.12; p = 0.27, respectively). Patients reporting anxiety at baseline improved 12 months later (p = 0.003). VAS score showed an incremental increase during follow-up (p<0.001). Transfemoral access was associated with higher VAS score values after 1 month (median (IQR): 65.0 (50.0-75.0) vs. 54.0 (50.0-60.0); p = 0.019) but not after 12 months (70.0 (62.5-80.0) vs. 67.5 (55.0-70.0); p = 0.07) as compared to non-transfemoral access. In multivariable regression analysis, only age and the presence of coronary chronic total occlusion were independently associated with VAS score at 12 months. In-hospital, 1-, 6- and 12-month mortality rates were 6.9%, 10.9%, 15.8 and 17.8%, respectively. TAVI provides improved QoL with relatively good clinical outcomes. However, not all components of QoL may be improved. Patients treated with transfemoral access might have better QoL than those who had non-transfemoral access, especially early after TAVI.

  15. Day of Surgery Impacts Outcome: Rehabilitation Utilization on Hospital Length of Stay in Patients Undergoing Elective Meningioma Resection.

    Science.gov (United States)

    Sarkiss, Christopher A; Papin, Joseph A; Yao, Amy; Lee, James; Sefcik, Roberta K; Oermann, Eric K; Gordon, Errol L; Post, Kalmon D; Bederson, Joshua B; Shrivastava, Raj K

    2016-09-01

    Meningiomas account for approximately one third of all brain tumors in the United States. In high-volume medical centers, the average length of stay (LOS) for a patient is 6.8 days compared with 8.8 days in low-volume centers with median total admission charges equaling approximately $55,000. To our knowledge, few studies have evaluated day of surgery and its effect on hospital LOS. Our primary goal was to analyze patient outcome as a direct result of surgical date, as well as to characterize the individual variables that may impact their hospital course, early access to rehabilitation, and long-term functional status. A retrospective database was generated for cranial meningioma patients who underwent elective surgical resection at our institution over a 3-year study period (2011-2014). Inclusion criteria included any patient who underwent elective meningioma resection and was discharged either home or to a rehabilitation facility with at least 6 months of follow-up. Exclusion criteria included any patient who was not discharged after resection (i.e., expired). Each patient's medical record was evaluated for a subset of demographics and clinical variables. Given that patients who undergo surgical resection of meningiomas have a national median LOS of 6 days, we subdivided the patients into 2 cohorts: early discharge (LOS Whitney test). Day of surgery may play a significant role in LOS for meningioma patients. Clinicians should remain aware of those factors that may delay optimal patient discharge and early access to rehabilitation facilities. Further studies will need to be performed to assess the social variables that may affect LOS, as well as the financial implications for such extended hospital courses. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Roger D., E-mail: Roger.Newman@lthtr.nhs.uk [Dept. of Speech and Language Therapy, Lancashire Teaching Hospitals, Sharoe Green lane, Fulwood, Preston PR2 9HT (United Kingdom); University of Salford (United Kingdom); Nightingale, Julie [University of Salford (United Kingdom)

    2011-11-15

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  17. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    International Nuclear Information System (INIS)

    Newman, Roger D.; Nightingale, Julie

    2011-01-01

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  18. Six-month mortality among HIV-infected adults presenting for antiretroviral therapy with unexplained weight loss, chronic fever or chronic diarrhea in Malawi.

    Directory of Open Access Journals (Sweden)

    Monique van Lettow

    Full Text Available In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART. We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy.A prospective cohort study was conducted in Malawi, investigating mortality in relation to ART uptake, microbiological findings and treatment of opportunistic infection (OIs, 6 months after meeting ART eligibility criteria.Of 469 consecutive adults eligible for ART, 74(16% died within 6 months of enrolment, at a median of 41 days (IQR 20-81. 370(79% started ART at a median time of 18 days (IQR 7-40 after enrolment. Six-month case-fatality rates were higher in patients with OIs; 25/121(21% in confirmed/clinical TB and 10/50(20% with blood stream infection (BSI compared to 41/308(13% in patients with no infection identified. Median TB treatment start was 27 days (IQR 17-65 after enrolment and mortality [8 deaths (44%] was significantly higher among 18 culture-positive patients with delayed TB diagnosis compared to patients diagnosed clinically and treated promptly with subsequent culture confirmation [6/34 (18%;p = 0.04]. Adjusted multivariable analysis, excluding deaths in the first 21 days, showed weight loss >10%, low CD4 count, severe anemia, laboratory-only TB diagnosis, and not initiating ART to be independently associated with increased risk of death.Mortality remains high among chronically ill patients eligible for ART. Prompt initiation of ART is vital: more than half of deaths were among patients who never started ART. Diagnostic and treatment delay for TB was strongly associated with risk of death. More than half of deaths occurred without identification of a specific infection. ART programmes need access to rapid point-of-care-diagnostic tools for OIs. The role of early empiric OI treatment in this population

  19. Spectrophotometric assessment of the effectiveness of Opalescence PF 10%: a 14-month clinical study.

    Science.gov (United States)

    Grobler, S R; Hayward, R; Wiese, S; Moola, M H; van W Kotze, T J

    2010-02-01

    To evaluate the effectiveness of Opalescence PF 10% just after treatment, at 6-month follow-up and at a 14-month follow-up period. Opalescence PF 10% was applied nightly for 14 days. The color of teeth 11 and 21 of 17 subjects were measured with a spectrophotometer (L*; a*; b*) before treatment, just after treatment (14 days), after 6 months and after 14 months. Subjects were instructed to take note of any tooth sensitivity. For all three components (L*, a* and b*) statistical significant differences (p<0.05) in the values between base-line, after treatment (14 days later), after 6 months and after 14 months were found (Wilcoxon Signed Rank Sum Test). The decrease in L* was about 20% after 6 months and about 50% after 14 months. The a* value decreased approximately 14% after 6 months but was worse after 14 months than at the beginning. The b* value decreased the least with about 9% after 6 months and about 8% after 14 months. The decrease in DeltaE(ab)(*) was approximately 20% after 14 months. Less than 20% of the subjects experienced mild tooth sensitivity just after treatment. Significantly whiter teeth were found after treatment as well as after a 6-month follow-up period. The whiteness/brightness (L*) decreased with approximately 50% after 14 months and the a* value with approximately 50% after 7 months, while the yellowness (b* value) remained even after 14 months. The product is an effective tooth whitener resulting in only low tooth sensitivity. Re-bleaching could be done at about 14 months. Copyright 2009 Elsevier Ltd. All rights reserved.

  20. Analysis of Zero-Day Vulnerabilities in Java

    OpenAIRE

    Marius Popa

    2013-01-01

    The zero-day vulnerability is a security lack of the computer system that is unknown to software vendor. This kind of vulnerability permits building attack strategies for gaining the access to the resources and data of a computer system. The main issue of the topic is how a computer system can be protected by zero-day vulnerabilities using the actual security procedures and tools for identifying the potential attacks that exploit the vulnerabilities unknown to computer users and software prov...

  1. Temperature extremes and infant mortality in Bangladesh: Hotter months, lower mortality.

    Science.gov (United States)

    Babalola, Olufemi; Razzaque, Abdur; Bishai, David

    2018-01-01

    Our study aims to obtain estimates of the size effects of temperature extremes on infant mortality in Bangladesh using monthly time series data. Data on temperature, child and infant mortality were obtained for Matlab district of rural Bangladesh for January 1982 to December 2008 encompassing 49,426 infant deaths. To investigate the relationship between mortality and temperature, we adopted a regression with Autoregressive Integrated Moving Average (ARIMA) errors model of seasonally adjusted temperature and mortality data. The relationship between monthly mean and maximum temperature on infant mortality was tested at 0 and 1 month lags respectively. Furthermore, our analysis was stratified to determine if the results differed by gender (boys versus girls) and by age (neonates (≤ 30 days) versus post neonates (>30days and Bangladesh. Each degree Celsius increase in mean monthly temperature reduced monthly mortality by 3.672 (SE 1.544, pBangladesh. This may reflect a more heightened sensitivity of infants to hypothermia than hyperthermia in this environment.

  2. D:L-Amino Acid Modeling Reveals Fast Microbial Turnover of Days to Months in the Subsurface Hydrothermal Sediment of Guaymas Basin.

    Science.gov (United States)

    Møller, Mikkel H; Glombitza, Clemens; Lever, Mark A; Deng, Longhui; Morono, Yuki; Inagaki, Fumio; Doll, Mechthild; Su, Chin-Chia; Lomstein, Bente A

    2018-01-01

    We investigated the impact of temperature on the microbial turnover of organic matter (OM) in a hydrothermal vent system in Guaymas Basin, by calculating microbial bio- and necromass turnover times based on the culture-independent D:L-amino acid model. Sediments were recovered from two stations near hydrothermal mounds (community of microorganisms in the hydrothermal sediment demonstrated short turnover times. The modeled turnover times of microbial bio- and necromass in the hydrothermal sediments were notably faster (biomass: days to months; necromass: up to a few hundred years) than in the cold sediments (biomass: tens of years; necromass: thousands of years), suggesting that temperature has a significant influence on the microbial turnover rates. We suggest that short biomass turnover times are necessary for maintance of essential cell funtions and to overcome potential damage caused by the increased temperature.The reduced OM quality at the hyrothemal sites might thus only allow for a small population size of microorganisms.

  3. Accessible tourism: the golden key in the future for the specialized travel agencies

    Directory of Open Access Journals (Sweden)

    Gamze Özogul

    2016-03-01

    Full Text Available Purpose – The purpose of this paper is to contribute to the comprehension of the importance of “Accessible Tourism” for the specialized travel agencies by proposing suggestions and key factors to improve the supply of accessible tourism offers. Design/methodology/approach – The paper adopts specialized travel agencies on the accessible tourism perspective of disabled tourist flows. Also, this paper describes the circumstances, social, politic, economic consequences and key decisions that thereby Turkey would be recognized, preferring, establishing on the intention of purchased and suggested positive word of mouth among people. Findings – According to European Commission (EU (2013 more than half of the individuals with disabilities in the EU made approximately 170 million day trips and a similar number of overnight trips within the EU during the 12 months between mid-2012 and mid-2013. Despite the developments in tourism, lack of product/service appropriate to the travel rights of the individuals with accessibility needs is one of the obstacles should be overcome. Accessible tourism is one of the keys for the survival of the specialized travel agencies in the future. Providing appropriate product/service by targeting the individuals with accessibility needs together with a correct approach and strategy, the specialized travel agencies will be able to have a competitive advantage and continue their activities. Also this market segment will create having sustainable activity and a golden opportunity for the specialized travel agencies in the future. Originality/value – Little research has been done on accessible tourism, future development and on the impact that disabled tourists have on tourism. The paper presents suggestions on what the specialized travel agencies should do with regards to making Turkey be preferred in the future by the individuals having accessibility needs.

  4. Comparison of motor and cognitive performance of children attending public and private day care centers

    Directory of Open Access Journals (Sweden)

    Mariana M. Santos

    2013-12-01

    Full Text Available BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: Todetermine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children and another of children attending private day care centers (47 children. All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers.

  5. Electric power monthly, July 1996 with data for April 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-04-01

    EPUB is an electronic publishing system maintained by the Energy Information Administration (EIA) of the U.S. Department of Energy. EPUB allows the general public to electronically access selected energy data from many of EIA`s statistical reports. The system is a menu-driven, bulletin board type system with extensive online help capabilities that can be accessed free-of-charge 24 hours a day by using a terminal or PC with an asynchronous modem. (EPUB will be taken down briefly at midnight for backup). PC users must provide the following information to their communications software in order to successfully access the EPUB system.

  6. Same-day discharge after laparoscopic hysterectomy.

    Science.gov (United States)

    Perron-Burdick, Misa; Yamamoto, Miya; Zaritsky, Eve

    2011-05-01

    To estimate readmission rates and emergency care use by patients discharged home the same day after laparoscopic hysterectomy. This was a retrospective case series of patients discharged home the same-day after total or supracervical laparoscopic hysterectomy in a managed care setting. Chart reviews were performed for outcomes of interest which included readmission rates, emergency visits, and surgical and demographic characteristics. The two hysterectomy groups were compared using χ² tests for categorical variables and t tests or Wilcoxon rank-sum tests for continuously measured variables. One-thousand fifteen laparoscopic hysterectomies were performed during the 3-year study period. Fifty-two percent (n=527) of the patients were discharged home the same-day; of those, 46% (n=240) had total laparoscopic hysterectomies and 54% (n=287) had supracervical. Cumulative readmission rates were 0.6%, 3.6%, and 4.0% at 48 hours, 3 months, and 12 months, respectively. The most common readmission diagnoses included abdominal incision infection, cuff dehiscence, and vaginal bleeding. Less than 4% of patients presented for emergency care within 48 or 72 hours, most commonly for nausea or vomiting, pain, and urinary retention. Median uterine weight was 155 g, median blood loss was 70 mL, and median surgical time was 150 minutes. There was no difference in readmission rates or emergency visits for the total compared with the supracervical laparoscopic hysterectomy group. Same-day discharge after laparoscopic hysterectomy is associated with low readmission rates and minimal emergency visits in the immediate postoperative period. Same-day discharge may be a safe option for healthy patients undergoing uncomplicated laparoscopic hysterectomy.

  7. Retrospectively reported month-to-month variation in sleeping problems of people naturally exposed to high-amplitude annual variation in daylength and/or temperature

    Directory of Open Access Journals (Sweden)

    Arcady A. Putilov

    Full Text Available Compared to literature on seasonal variation in mood and well-being, reports on seasonality of trouble sleeping are scarce and contradictive. To extend geography of such reports on example of people naturally exposed to high-amplitude annual variation in daylength and/or temperature. Participants were the residents of Turkmenia, West Siberia, South and North Yakutia, Chukotka, and Alaska. Health and sleep-wake adaptabilities, month-to-month variation in sleeping problems, well-being and behaviors were self-assessed. More than a half of 2398 respondents acknowledged seasonality of sleeping problems. Four of the assessed sleeping problems demonstrated three different patterns of seasonal variation. Rate of the problems significantly increased in winter months with long nights and cold days (daytime sleepiness and difficulties falling and staying asleep as well as in summer months with either long days (premature awakening and difficulties falling and staying asleep or hot nights and days (all 4 sleeping problems. Individual differences between respondents in pattern and level of seasonality of sleeping problems were significantly associated with differences in several other domains of individual variation, such as gender, age, ethnicity, physical health, morning-evening preference, sleep quality, and adaptability of the sleep-wake cycle. These results have practical relevance to understanding of the roles playing by natural environmental factors in seasonality of sleeping problems as well as to research on prevalence of sleep disorders and methods of their prevention and treatment in regions with large seasonal differences in temperature and daylength.

  8. The natural history of autologous fistulas as first-time dialysis access in the KDOQI era.

    Science.gov (United States)

    Biuckians, Andre; Scott, Eric C; Meier, George H; Panneton, Jean M; Glickman, Marc H

    2008-02-01

    Patients on hemodialysis depend on durable, easily maintained vascular access. The autologous arteriovenous fistula (AVF) has been the gold standard since the introduction of the Brecia-Cimino fistula in 1966 and is echoed in the current Kidney Disease Outcomes and Quality Initiative (KDOQI) guidelines. The purpose of this study is to determine the natural history of AVF in patients requiring first-time permanent access in a large academic vascular surgery practice. We performed a retrospective review of patients undergoing new access creation from January 1, 2005 to June 30, 2005. The study group consisted of patients with no prior permanent access that underwent AVF creation. Categorical data was compared using chi2 analysis, nominal data was compared using Student t-test, and patency was determined by Kaplan-Meier curves. During the 6-month period, there were 80 first time AVF creations. The majority of patients were male (69%), African American (55%), and a history of diabetes (55%) and hypertension (96%). Seventy-five percent of patients were already undergoing hemodialysis via catheter access. Seventy-six percent of patients underwent preoperative vein mapping with a mean vein diameter of 3.1 mm. Twenty-six radiocephalic AVF (RCAVF) and 54 brachiocephalic AVF (BCAVF) were created with a mean follow-up of 278 days. At the end of follow-up, 38 (48%) AVF were being used for hemodialysis and only nine (11%) matured without the need for additional intervention. Mean time for AVF maturation was 146 days. Thirty AVF (37%) were abandoned, 16 (20%) of which were primary failures. Mean time to abandonment was 162 days. Twelve (15%) AVF remained patent but were never cannulated. The intervention rate was 1.33 interventions/patient/year and 75% of interventions were percutaneous. Kaplan-Meier analysis determined primary, primary-assisted, and secondary patency was 36% +/- 8.3, 55% +/- 6.5, and 55% +/- 6.5 at 1 year, respectively. Cumulative functional patency was 63% at

  9. Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

    Science.gov (United States)

    Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

    2017-10-01

    Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

  10. Competitive and Allelopathic Effects of Wild Rice Accessions (Oryza longistaminata) at Different Growth Stages.

    Science.gov (United States)

    Shen, Shicai; Xu, Gaofeng; Clements, David Roy; Jin, Guimei; Zhang, Fudou; Tao, Dayun; Xu, Peng

    2016-01-01

    The competitive and allelopathic effects of wild rice (Oryza longistaminata) accessions on barnyard grass at different growth stages determined by days after sowing (0, 30, 60 and 90 days) were studied in greenhouse pot experiments. Wild rice accession RL159 exhibited the greatest height and tillering. The weed suppression rates of wild rice accessions OL and F1 on barnyard grass were significantly higher than for other rice accessions, with the lowest being O. sativa cultivar RD23. The highest suppression rates of OL and F1 were 80.23 and 73.96% at barnyard grass growth stages of 90 days and 60 days. At a 90 growth stage, wild rice accessions RL159 and RL169 caused 61.33 and 54.51% inhibition in barnyard grass growth, respectively. Under the same conditions, the competitive inhibition rates of OL, F1, RL159, RL169 and RL219 against barnyard grass were markedly lower than their weed suppressive effects, but were relatively similar for RD23. The allelopathic inhibition of OL and F1 on barnyard grass was significantly higher than other rice accessions. The highest allelopathic rates of OL and F1 were 60.61 and 56.87% at the 0 day growth stage. It is concluded that wild rice accessions OL and F1 exhibited the highest allelopathic activity along with moderate competitive ability against barnyard grass; wild rice accession RL159 had the highest competitive ability and moderate allelopathic activity on barnyard grass. Thus, the three wild rice accessions OL, F1 and RL159 could be used as ideal breeding materials for cultivated rice improvement.

  11. Visits to Registered Nurses: An Opportunity to Increase Contraceptive Access in California.

    Science.gov (United States)

    Parker, Emese C; Kong, Kevin; Watts, Leslie A; Schwarz, Eleanor B; Darney, Philip D; Thiel de Bocanegra, Heike

    In 2013, California passed Assembly Bill (A.B.) 2348, approving registered nurses (RNs) to dispense patient self-administered hormonal contraceptives and administer injections of hormonal contraceptives. The Family Planning, Access, Care and Treatment (Family PACT) program, which came into effect in 1997 to expand low-income, uninsured California resident access to contraceptives at no cost, is one program in which qualified RNs can dispense and administer contraceptives. The aims of this study were to (a) describe utilization of RN visits within California's Family PACT program and (b) evaluate the impact of RN visits on client birth control acquisition during the first 18 months after implementation of A.B. 2348 (January 1, 2013 to June 30, 2014). A descriptive observational design using administrative databases was used. Family PACT claims were retrieved for RN visits and contraception. Paid claims for contraceptive dispensing and/or administration visits by physicians, nurse practitioners, certified nurse midwives, and physician assistants were compared before and after the implementation of A.B. 2348 at practice sites where RN visits were and were not utilized. Contraceptive methods and administration procedures were identified using Healthcare Common Procedure Coding System codes, National Drug Codes, and Common Procedural Terminology codes. Claims data for healthcare facilities were abstracted by site location based on a unique combination of National Provider Identifier (NPI), NPI Owner, and NPI location number. RN visits were found mainly in Northern California and the Central Valley (73%). Sixty-eight percent of RN visits resulted in same-day dispensing and/or administration of hormonal (and/or barrier) methods. Since benefit implementation, RN visits resulted in a 10% increase in access to birth control dispensing and/or administration visits. RN visits were also associated with future birth control acquisition and other healthcare utilization within the

  12. Surveillance of Hemodialysis Vascular Access with Ultrasound Vector Flow Imaging

    DEFF Research Database (Denmark)

    Brandt, Andreas Hjelm; Olesen, Jacob Bjerring; Lindskov Hansen, Kristoffer

    2015-01-01

    -functioning vascular access with as few complications as possible and preferred vascular access is an AVF. Dysfunction due to stenosis is a common complication, and regular monitoring of volume flow is recommended to preserve AVF patency. UDT is considered the gold standard for volume flow surveillance, but VFI has...... proven to be more precise, when performing single repeated instantaneous measurements. Three patients with AVF were monitored with UDT and VFI monthly for five months. A commercial ultrasound scanner with a 9 MHz linear array transducer with integrated VFI was used to obtain data. UDT values were...... be used for surveillance of volume flow....

  13. Access to antiretroviral therapy among HIV/AIDS patients in Chiang Mai province, Thailand.

    Science.gov (United States)

    Himakalasa, Woraluck; Grisurapong, Siriwan; Phuangsaichai, Sasipen

    2013-01-01

    The objective of this study is to investigate the access to antiretroviral treatment among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in Chiang Mai province, Thailand. Access to antiretroviral treatment is defined in terms of availability, affordability, and acceptability. The data for the study were collected during the period of April 1, 2012-May 31, 2012 from a sample of 380 HIV/AIDS patients in eight hospitals who had received antiretroviral treatment for more than 6 months at the time of data collection. The results of the study show that for most patients, the average traveling time to access health care was acceptable, but the nearly half day waiting time caused them to be absent from their work. In particular, it took longer for patients in the rural and lower income groups to access the treatment than the other groups. Their travel times and food costs relating to the treatment were found to be relatively high and therefore these patients had a higher tendency to borrow or seek financial assistance from their relatives. However, due to improvements in the access to treatment, most patients were satisfied with the services they received. The results imply that policy should be implemented to raise the potential of subdistrict hospitals where access to antiretroviral treatment is available, with participating HIV/AIDS patients acting as volunteers in providing services and other forms of health promotion to new patients. Privacy issues could be reduced if the antiretroviral treatment was isolated from other health services. Additionally, efforts to educate HIV/AIDS patients and society at large should be made.

  14. Reproductive health outcomes of insured adolescent and adult women who access oral levonorgestrel emergency contraception.

    Science.gov (United States)

    Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W; Goler, Nancy

    2015-04-01

    To assess the level of risk for adolescents and women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among adolescents and women aged 15-44 years who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Of 21,421 prescriptions, 14,531 (67.8%) were accessed through the call center. In the subsequent 12 months, 12,127 (56.6%) adolescents and women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264 (10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for adolescents and women who accessed it through the call center-1,569 (10.8%) and office visits-695 (10.1%) (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.13). In the subsequent 6 months, 2,056 (9.6%) adolescents and women became pregnant. Adolescents and women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82, 95% CI 0.72-0.94); however, they were more likely to become pregnant within 4-6 months (adjusted OR 1.37, 95% CI 1.16-1.60). Among adolescents and women who were tested for chlamydia and gonorrhea, 689 (7.8%) and 928 (7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Protocols to routinely address unmet needs for contraception at every call for emergency contraception and all office visits, including visits with primary care providers, should be investigated.

  15. Unsafe sexual behaviors among HIV-positive men and women in Honduras: the role of discrimination, condom access, and gender.

    Science.gov (United States)

    Paz-Bailey, Gabriela; Isern Fernandez, Virginia; Morales Miranda, Sonia; Jacobson, Jerry O; Mendoza, Suyapa; Paredes, Mayte A; Danaval, Damien C; Mabey, David; Monterroso, Edgar

    2012-01-01

    We conducted a study among HIV-positive men and women in Honduras to describe demographics, HIV risk behaviors and sexually transmitted infection prevalence, and identify correlates of unsafe sex. Participants were recruited from HIV clinics and nongovernmental organizations in Tegucigalpa and San Pedro Sula, Honduras in a cross-sectional study in 2006. We used audio-assisted computer interviews on demographics; behaviors in the past 12 months, 6 months, and 30 days; and access to care. Assays performed included herpes (HSV-2 Herpes Select), syphilis (rapid plasma reagin [RPR] and Treponema pallidum particle agglutination assay [TPPA]) serology, and other sexually transmitted infections by polymerase chain reaction (PCR). Bivariate and multivariate analyses were conducted to assess variables associated with unprotected sex across all partner types in the past 12 months. Of 810 participants, 400 were from Tegucigalpa and 410 from San Pedro Sula; 367 (45%) were men. Mean age was 37 years (interquartile range: 31-43). Consistent condom use for men and women was below 60% for all partner types. In multivariate analysis, unprotected sex was more likely among women (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.2-3.1, P = 0.007), those with HIV diagnoses within the past year (OR: 2.0, 95% CI: 1.1-3.7, P = 0.016), those reporting difficulty accessing condoms (OR: 2.6, 95% CI: 1.4-4.7, P = 0.003), and those reporting discrimination (OR: 1.8, 95% CI: 1.1-3.0, P = 0.016). Programs targeting HIV-positive patients need to address gender-based disparities, improve condom access and use, and help establish a protective legal and policy environment free of stigma and discrimination.

  16. GO RIO: Achieving Universal Access to Mass Transit

    Science.gov (United States)

    Martinez, Ted, Jr.; Castaneda-Calleros, Russell

    2009-01-01

    GO RIO is a universal access, mass-transit program that has been offered to all students who are registered full-time at Rio Hondo College. Through an agreement with five local transit agencies, full-time students can obtain a pass that provides full access seven days a week throughout the entire semester.

  17. 10 CFR 26.65 - Pre-access drug and alcohol testing.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Pre-access drug and alcohol testing. 26.65 Section 26.65... § 26.65 Pre-access drug and alcohol testing. (a) Purpose. This section contains pre-access testing... days. If an individual has negative results from drug and alcohol tests that were conducted under the...

  18. Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report October 2014

    Energy Technology Data Exchange (ETDEWEB)

    Ogden, Dan [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    Advanced Test Reactor National Scientific User Facility (ATR NSUF) Monthly Report October 2014 Highlights • Rory Kennedy, Dan Ogden and Brenden Heidrich traveled to Germantown October 6-7, for a review of the Infrastructure Management mission with Shane Johnson, Mike Worley, Bradley Williams and Alison Hahn from NE-4 and Mary McCune from NE-3. Heidrich briefed the group on the project progress from July to October 2014 as well as the planned path forward for FY15. • Jim Cole gave two invited university seminars at Ohio State University and University of Florida, providing an overview of NSUF including available capabilities and the process for accessing facilities through the peer reviewed proposal process. • Jim Cole and Rory Kennedy co-chaired the NuMat meeting with Todd Allen. The meeting, sponsored by Elsevier publishing, was held in Clearwater, Florida, and is considered one of the premier nuclear fuels and materials conferences. Over 340 delegates attended with 160 oral and over 200 posters presented over 4 days. • Thirty-one pre-applications were submitted for NSUF access through the NE-4 Combined Innovative Nuclear Research Funding Opportunity Announcement. • Fourteen proposals were received for the NSUF Rapid Turnaround Experiment Summer 2014 call. Proposal evaluations are underway. • John Jackson and Rory Kennedy attended the Nuclear Fuels Industry Research meeting. Jackson presented an overview of ongoing NSUF industry research.

  19. Harvard Law School Proxy Access Roundtable

    OpenAIRE

    Bebchuk, Lucian Arye; Hirst, Scott

    2010-01-01

    This paper contains the proceedings of the Proxy Access Roundtable that was held by the Harvard Law School Program on Corporate Governance on October 7, 2009. The Roundtable brought together prominent participants in the debate - representing a range of perspectives and experiences - for a day of discussion on the subject. The day’s first two sessions focused on the question of whether the Securities and Exchange Commission should provide an access regime, or whether it should leave the adopt...

  20. Evaluation and comparison of a flumethrin-imidacloprid collar and repeated monthly treatments of fipronil/(s)-methoprene to control flea, Ctenocephalides f. felis, infestations on cats for eight months.

    Science.gov (United States)

    Dryden, Michael W; Smith, Vicki; Davis, Wendell L; Settje, Terry; Hostetler, Joe

    2016-05-17

    This controlled laboratory study was designed to evaluate the efficacy of the 10 % imidacloprid/4.5 % flumethrin collar (Seresto®, Bayer Animal Health) against fleas (Ctenocephalides f. felis) on cats, when compared to fipronil (9.8 %w/w)/(s)-methoprene (11.8 % w/w) topical spot-on formulation (Frontline® Plus for Cats and Kittens, Merial). Thirty cats were randomized into three groups of ten animals based on pre-treatment flea counts: Group 1: imidacloprid/flumethrin collar; Group 2: fipronil/(s)-methoprene topical spot-on and Group 3: non-treated controls. The imidacloprid/flumethrin collars were applied one time on Day 0, while the fipronil/(s)-methoprene spot-on was administered every 30 days from Day 0 through Day 210. Cats were infested with 100 fleas on study days 0, 7, 14, 29, 59, 89, 119, 149, 179, 209 and 239. All flea counts were conducted by combing to remove fleas on post-treatment days 2, 8, 15, 30, 60, 90, 120, 150, 180, 210 and 240. The efficacy of the imidacloprid/flumethrin collar ranged from 98.2 to 100 % for eight months. The efficacy of fipronil/(s)-methoprene spot-on ranged from 68.2 to 99.9 %. Efficacy was imidacloprid/flumethrin collar group when compared to the fipronil/(s)-methoprene group on Days 90, 150 and 210 (P imidacloprid/flumethrin collar (Seresto®, Bayer Animal Health) maintained excellent ( > 98.2 %) efficacy against fleas on cats for the entire 8 month study. Monthly applications of fipronil/(s)-methoprene (Frontline® Plus for Cats and Kittens, Merial) generally had high, but variable (68.2 to 99.9 %) efficacy over the course of the eight month study. Based on the very high residual efficacy achieved by the imidacloprid/flumethrin collar in this study, veterinarians should expect that this collar will control and eliminate existing flea infestations on cats and in their in-home premises as long as every flea infested host is treated.

  1. STATISTICAL ANALYSIS AND TRENDS OF DRY DAYS IN SYLHET REGION OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Syed Mustakim Ali Shah

    2014-01-01

    Full Text Available The rainfall distribution in Bangladesh is not uniform and refl ecting topography. Hilly Sylhet region receives substantial rainfall every year compare to other regions of Bangladesh. Though Sylhet region is less vulnerable to drought but weather pattern is not constant and changing day by day. Hence as a part of drought an alysis, behavior of dry days is important. This study focuses on dry days pattern and associ ated changes from daily records of last 54 years for Sylhet region. Monthly, yearly and seasonal variations of dry days were analyzed to check for major changes. In order to inve stigate extreme dry events, time history of monthly dry days data were transformed into fre quency domain using the Fast Fourier Transform (FFT. Variability of dry days in tim e scale was also checked from filtered signals which is very useful for drought a nalysis, agricultural development and disaster management for the north-east region of Bangladesh.

  2. Powernext Day-AheadTM statistics April 30, 2005

    International Nuclear Information System (INIS)

    2005-04-01

    The introduction of a power exchange in France is a direct response to the opening up of the European electricity markets. Powernext SA is a Multilateral Trading Facility in charge of managing an optional and anonymous organised exchange offering: - Day-ahead contracts for the management of volume risk on Powernext Day-Ahead TM since 21 November 2001, - Medium term contracts for the management of price risk on Powernext Futures TM since 18 June 2004. This document presents in a series of tables and graphics the April 30, 2005 update of Powernext Day-Ahead TM statistics: traded volumes and average prices from November 2001 to April 2005, monthly overview from April 2004 to April 2005 (volumes, prices and price spreads), weekly overview from January to April 2005, daily and hourly overview and market resilience for April 2005, power consumption in March and April 2005 (average consumption, average forecasted consumption and average price on Powernext Day-Ahead TM ), power consumption on the French hub from January to April 2005 and Powernext Day-Ahead TM prices, transfer capacities in April 2005 (daily capacity allocations for France-Germany, France-Switzerland and France-Spain, daily and monthly capacity allocations for France-Belgium, auction on the France-UK Interconnector, daily and yearly capacity allocation for France-Italy), temperature variations in France from November 2004 to April 2005 and average prices on Powernext Day-Ahead TM , and balancing mechanism for March-April 2005 (half-hourly imbalance settlement prices). (J.S.)

  3. CERN Confirms commitment to Open Access

    CERN Multimedia

    2005-01-01

    The CERN Library Information desk.At a meeting on the Wednesday before Easter, the Executive Committee endorsed a policy of open access to all the laboratory's results, as expressed in the document ‘Continuing CERN action on Open Access' (http://cds.cern.ch/record/828991/files/open-2005-006.pdf), released by its Scientific Information Policy Board (SIPB) earlier in the month. "This underlines CERN's commitment to sharing the excitement of fundamental research with as wide an audience as possible", said Guido Altarelli, current SIPB chairman. Open Access to scientific knowledge is today the goal of an increasing component of the worldwide scientific community. It is a concept, made possible by new electronic tools, which would bring enormous benefits to all readers by giving them free access to research results. CERN has implicitly supported such moves from its very beginning. Its Convention (http://cds.cern.ch/record/330625/files/cm-p00046871.pdf), adopted in 1953, requires openness, stipulating that "......

  4. Association of mandated language access programming and quality of care provided by mental health agencies.

    Science.gov (United States)

    McClellan, Sean R; Snowden, Lonnie

    2015-01-01

    This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

  5. Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats

    Directory of Open Access Journals (Sweden)

    Akamatsu Akinori

    2012-02-01

    Full Text Available Abstract Background Chlorine dioxide (CD gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio is judged as safe on the basis of a battery of toxicological examinations. Methods CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human.

  6. 78 FR 66613 - National Diabetes Month, 2013

    Science.gov (United States)

    2013-11-05

    ... those we have lost to diabetes and support those living with the illness, let us look to a day with... National Diabetes Month, 2013 By the President of the United States of America A Proclamation With more than 25 million Americans living with a diabetes diagnosis, and many more going undiagnosed, diabetes...

  7. 75 FR 1263 - National Mentoring Month, 2010

    Science.gov (United States)

    2010-01-08

    ... Slavery and Human Trafficking Prevention Month, 2010 #0; #0; #0; Presidential Documents #0; #0; #0;#0... the President of the United States of America A Proclamation Every day, mentors in communities across... States of America, by virtue of the authority vested in me by the Constitution and the laws of the United...

  8. Forecasting Strategies for Predicting Peak Electric Load Days

    Science.gov (United States)

    Saxena, Harshit

    Academic institutions spend thousands of dollars every month on their electric power consumption. Some of these institutions follow a demand charges pricing structure; here the amount a customer pays to the utility is decided based on the total energy consumed during the month, with an additional charge based on the highest average power load required by the customer over a moving window of time as decided by the utility. Therefore, it is crucial for these institutions to minimize the time periods where a high amount of electric load is demanded over a short duration of time. In order to reduce the peak loads and have more uniform energy consumption, it is imperative to predict when these peaks occur, so that appropriate mitigation strategies can be developed. The research work presented in this thesis has been conducted for Rochester Institute of Technology (RIT), where the demand charges are decided based on a 15 minute sliding window panned over the entire month. This case study makes use of different statistical and machine learning algorithms to develop a forecasting strategy for predicting the peak electric load days of the month. The proposed strategy was tested for a whole year starting May 2015 to April 2016 during which a total of 57 peak days were observed. The model predicted a total of 74 peak days during this period, 40 of these cases were true positives, hence achieving an accuracy level of 70 percent. The results obtained with the proposed forecasting strategy are promising and demonstrate an annual savings potential worth about $80,000 for a single submeter of RIT.

  9. Day-to-day correlation of equatorial electrojet at two stations separated by 2000 km

    Directory of Open Access Journals (Sweden)

    R. G. Rastogi

    2007-05-01

    Full Text Available Day-to-day fluctuations of the daily range of the geomagnetic field H at the equatorial electrojet stations Ancon (ANC, 77.0° W and Sao Luis (SLZ, 44.2° W are described for the period January–June 1993. The H field started increasing between midnight and sunrise, reaching a peak shortly before noon. The daily range of H was maximum during March and April and minimum during June. Regardless of the month, the range in H was significantly larger at ANC than at SLZ. The 27-day running mean of the range of H varied from 80 nT to 125 nT at SLZ and from 105 nT to 180 nT at ANC. The day-to-day values of the range of H showed very faithful variations at the two stations. The deviations of the daily range of H from its 27-day running mean values showed good correlation between the two stations. Some large storm-time effects were seen at both stations. The correlation was still significant, when data were corrected for Dst index values. It is suggested that the range in H at the two electrojet stations, separated by more than 2000 km, are affected by some common sources other than the ring current, which need to be identified. Spectral analysis of the range of H shows remarkable similarity at the two stations, with a dominant period of 15 days at both stations.

  10. A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes.

    Science.gov (United States)

    Silverman, K; Svikis, D; Robles, E; Stitzer, M L; Bigelow, G E

    2001-02-01

    This study evaluated a novel drug abuse treatment, the Therapeutic Workplace. In this treatment, patients are paid to perform jobs or to participate in job training. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Pregnant and postpartum drug abuse patients (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants were invited to work 3 hr every weekday for 6 months and could earn up to $4,030 in vouchers for abstinence, workplace attendance, and performance. On average, 45% of participants attended the workplace per day. Relative to controls, the Therapeutic Workplace nearly doubled patients' abstinence from opiates and cocaine (33% vs. 59% of thrice-weekly urine samples drug negative, respectively, p Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women.

  11. Colour Day: an innovative project

    CERN Multimedia

    Staff Association

    2016-01-01

    This year, the Children’s Day-Care Centre (EVE) and School works on the theme of colours. Every class has their own project revolving around this common theme. The class of Claire, Sandrine and Nadia, introduced a monthly “Colour Day”. The objective of this day is to offer children different activities (arts and crafts, baking, etc.) designed around a specific colour. The children get a chance to decorate their classroom and learn in many different ways inspired by the colours blue, red, and many others. The parents are also called to contribute and invited to dress their children in the colour of the day. In September, we discovered the colour blue, in October it was time for red, and in mid-November yellow will brighten up our structure. Everyone plays along, making this a very festive day for us all. On Tuesday, 20 September, we saw the whole School turn blue! We were all dressed in blue and we made blue paintings, too! We made beautiful artwork inspired by artists like Ma...

  12. Equity in access to health care in a rural population in Malaysia: A cross-sectional study.

    Science.gov (United States)

    Lim, Ka Keat; Sivasampu, Sheamini; Mahmud, Fatihah

    2017-04-01

    To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia. Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program. A rural plantation estate in the West Coast of Peninsular Malaysia. One hundred and thirty out of 142 adults above 18 years old who attended the program. Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable. A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P  RM 2000 per month) (OR 51.27, P population, the latter associated with education level, subjective health status and income. Despite not being generalisable, the findings highlight the need for a national level study on equity in access before the country reforms its health system. © 2016 National Rural Health Alliance Inc.

  13. Patient access in plastic surgery: an operational and financial analysis of service-based interventions to improve ambulatory throughput in an academic surgery practice.

    Science.gov (United States)

    Hultman, Charles Scott; Gilland, Wendell G; Weir, Samuel

    2015-06-01

    available new patient appointment dropped from 52 to 38 days, whereas the same metric for a preoperative appointment plunged from 46 to 16 days. The size of the new patient backlog fell from 169 to 110 patients, and total monthly clinic volume climbed from 574 to 766 patients. Our "chaos" rate dropped from 12.3% to 1.8%. Mean patient cycle time in the clinic decreased dramatically from 127 to 44 minutes. Mean monthly productivity for the practice increased from 2479 to 2702 RVUs. Although our collection rate did not change, days in A/R dropped from 66 to 57 days. Mean monthly charges increased from U.S. $535,213 to U.S. $583,193, and mean monthly collections improved from U.S. $181,967 to U.S. $210,987. Payer mix remained unchanged. Implementation of a PAcE initiative, focusing on outpatient clinic throughput, yields significant improvements in access to care, patient satisfaction as measured by complaints, physician productivity, and financial performance. An academic, university-based, plastic surgery practice can use throughput interventions to deliver timely care and to enhance financial viability.

  14. Adverse events following 12 and 18 month vaccinations: a population-based, self-controlled case series analysis.

    Directory of Open Access Journals (Sweden)

    Kumanan Wilson

    Full Text Available BACKGROUND: Live vaccines have distinct safety profiles, potentially causing systemic reactions one to 2 weeks after administration. In the province of Ontario, Canada, live MMR vaccine is currently recommended at age 12 months and 18 months. METHODS: Using the self-controlled case series design we examined 271,495 12 month vaccinations and 184,312 18 month vaccinations to examine the relative incidence of the composite endpoint of emergency room visits or hospital admissions in consecutive one day intervals following vaccination. These were compared to a control period 20 to 28 days later. In a post-hoc analysis we examined the reasons for emergency room visits and the average acuity score at presentation for children during the at-risk period following the 12 month vaccine. RESULTS: Four to 12 days post 12 month vaccination, children had a 1.33 (1.29-1.38 increased relative incidence of the combined endpoint compared to the control period, or at least one event during the risk interval for every 168 children vaccinated. Ten to 12 days post 18 month vaccination, the relative incidence was 1.25 (95%, 1.17-1.33 which represented at least one excess event for every 730 children vaccinated. The primary reason for increased events was statistically significant elevations in emergency room visits following all vaccinations. There were non-significant increases in hospital admissions. There were an additional 20 febrile seizures for every 100,000 vaccinated at 12 months. CONCLUSIONS: There are significantly elevated risks of primarily emergency room visits approximately one to two weeks following 12 and 18 month vaccination. Future studies should examine whether these events could be predicted or prevented.

  15. LB02.03: EVALUATION OF DAY-BY-DAY BLOOD PRESSURE VARIABILITY IN CLINIC (DO WE STILL NEED STANDARD DEVIATION?).

    Science.gov (United States)

    Ryuzaki, M; Nakamoto, H; Hosoya, K; Komatsu, M; Hibino, Y

    2015-06-01

    Blood pressure (BP) variability correlates with cardio-vascular disease as BP level itself. There is not known easy way to evaluate the BP variability in clinic.To evaluate the usefulness of maximum-minimum difference (MMD) of BP in a month compared to standard deviation (SD), as an index of BP variability. Study-1: Twelve patients (age 65.9 ± 12.1 y/o) were enrolled. Measurements of home systolic (S) BP were required in the morning. The 12 months consecutive data and at least 3 times measurements a month were required for including. (Mean 29.0 ± 4.5 times/month in the morning). We checked the correlation between MMD and SD. Study-2: Six hemodialized patients monitored with i-TECHO system (J of Hypertens 2007: 25: 2353-2358) for longer than one year were analyzed. As in study-1, we analyzed the correlation between SD and MMD of SBP. 17.4 ± 11.9 times per month. Study-3: The data from our previous study (FUJIYAM study Clin. Exp Hypertens 2014: 36:508-16) were extracted. 1524 patient-month morning BP data were calculated as in study-1. Picking up data measuring more than 24 times a month, 517 patient-month BP data were analyzed. We compared the ratio to 25 times measured data of SD and MMD, in the setting 5, 10, 15, 20 times measured data. Study-1: SBP, MMD was correlated very well to SD (p  2 times. If data were extracted (measurements>24 times), correlation was 0.927 (P < 0.0001). The equation of SBPSD = 1.520+ 0.201xMMD. The ratios of SD to 25 times were as follows; 0.956 in 5 times, 0.956 in 10, 0.979 in 15, 0.991 in 20 times. The ratios of MMD to 25 times were as follows; 0.558 in 5, 0.761 in 10, 0.874 in 15, 0.944 in 20. We can assume SD easily by measuring MMD as an index of day-by-day BP variability of a month. The equation formulas were very similar though the patients' groups were different. But we have to be careful how many times patients measure in a month.

  16. Access to IEEE Electronic Library

    CERN Multimedia

    2007-01-01

    From 2007, the CERN Library now offers readers online access to the complete IEEE Electronic Library (Institute of Electrical and Electronics Engineers). This new licence gives unlimited online access to all IEEE and IET (previously IEE) journals and proceedings as well as all current IEEE standards and selected archived ones. Some of the titles offer volumes back to 1913. This service currently represents more than 1,400,000 full-text articles! This leading engineering information resource replaces the previous service, a sub-product of the IEEE database called 'IEEE Enterprise', which offered online access to the complete collection of IEEE journals and proceedings, but with limited features. The service had become so popular that the CERN Working Group for Acquisitions recommended that the Library subscribe to the complete IEEE Electronic Library for 2007. Usage statistics for recent months showed there was a demand for the service from a large community of CERN users and we were aware that many users h...

  17. Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

    Science.gov (United States)

    Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

    2017-01-01

    To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

  18. Restructuring Big Data to Improve Data Access and Performance in Analytic Services Making Research More Efficient for the Study of Extreme Weather Events and Application User Communities

    Science.gov (United States)

    Ostrenga, D.; Shen, S.; Vollmer, B.; Meyer, D. L.

    2017-12-01

    NASA climate reanalysis dataset from MERRA-2 contains numerous data for atmosphere, land, and ocean, that are grouped into 95 products of archived volume over 300 TB. The data files are saved as hourly-file, day-file (hourly time interval) and month-file containing up to 125 parameters. Due to the large number of data files and the sheer data volumes, it is a challenging for users, especially those in the application research community, to handle dealing with the original data files. Most of these researchers prefer to focus on a small region or single location using the hourly data for long time periods to analyze extreme weather events or say winds for renewable energy applications. At the GES DISC, we have been working closely with the science teams and the application user community to create several new value added data products and high quality services to facilitate the use of the model data for various types of research. We have tested converting hourly data from one-day per file into different data cubes, such as one-month, one-year, or whole-mission and then continued to analyze the efficiency of the accessibility of this newly structured data through various services. Initial results have shown that compared to the original file structure, the new data has significantly improved the performance for accessing long time series. It is noticed that the performance is associated to the cube size and structure, the compression method, and how the data are accessed. The optimized data cube structure will not only improve the data access, but also enable better online analytic services for doing statistical analysis and extreme events mining. Two case studies will be presented using the newly structured data and value added services, the California drought and the extreme drought of the Northeastern states of Brazil. Furthermore, data access and analysis through cloud storage capabilities will be investigated.

  19. World Food Day 2015 | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-25

    May 25, 2016 ... World Food Day 2015 ... Canadian Lorne Babiuk, a global leader in vaccine research, Killam Prize and Gairdner Wightman Award laureate, ... Sign up now for IDRC news and views sent directly to your inbox each month.

  20. A Poisson regression approach to model monthly hail occurrence in Northern Switzerland using large-scale environmental variables

    Science.gov (United States)

    Madonna, Erica; Ginsbourger, David; Martius, Olivia

    2018-05-01

    In Switzerland, hail regularly causes substantial damage to agriculture, cars and infrastructure, however, little is known about its long-term variability. To study the variability, the monthly number of days with hail in northern Switzerland is modeled in a regression framework using large-scale predictors derived from ERA-Interim reanalysis. The model is developed and verified using radar-based hail observations for the extended summer season (April-September) in the period 2002-2014. The seasonality of hail is explicitly modeled with a categorical predictor (month) and monthly anomalies of several large-scale predictors are used to capture the year-to-year variability. Several regression models are applied and their performance tested with respect to standard scores and cross-validation. The chosen model includes four predictors: the monthly anomaly of the two meter temperature, the monthly anomaly of the logarithm of the convective available potential energy (CAPE), the monthly anomaly of the wind shear and the month. This model well captures the intra-annual variability and slightly underestimates its inter-annual variability. The regression model is applied to the reanalysis data back in time to 1980. The resulting hail day time series shows an increase of the number of hail days per month, which is (in the model) related to an increase in temperature and CAPE. The trend corresponds to approximately 0.5 days per month per decade. The results of the regression model have been compared to two independent data sets. All data sets agree on the sign of the trend, but the trend is weaker in the other data sets.

  1. Audit of day case surgery in LAUTECH teaching hospital, Osogbo ...

    African Journals Online (AJOL)

    Background/ method: A retrospective study of all patients operated as day-case at the Ladoke Akintola University Teaching Hospital Osogbo over a period of 14 months (October 2000 to November 2001) was carried out. Results: Seventy-six patients were operated as day-cases within the study period, but 74 case notes ...

  2. Prospective evaluation of an internet-linked handheld computer critical care knowledge access system.

    Science.gov (United States)

    Lapinsky, Stephen E; Wax, Randy; Showalter, Randy; Martinez-Motta, J Carlos; Hallett, David; Mehta, Sangeeta; Burry, Lisa; Stewart, Thomas E

    2004-12-01

    Critical care physicians may benefit from immediate access to medical reference material. We evaluated the feasibility and potential benefits of a handheld computer based knowledge access system linking a central academic intensive care unit (ICU) to multiple community-based ICUs. Four community hospital ICUs with 17 physicians participated in this prospective interventional study. Following training in the use of an internet-linked, updateable handheld computer knowledge access system, the physicians used the handheld devices in their clinical environment for a 12-month intervention period. Feasibility of the system was evaluated by tracking use of the handheld computer and by conducting surveys and focus group discussions. Before and after the intervention period, participants underwent simulated patient care scenarios designed to evaluate the information sources they accessed, as well as the speed and quality of their decision making. Participants generated admission orders during each scenario, which were scored by blinded evaluators. Ten physicians (59%) used the system regularly, predominantly for nonmedical applications (median 32.8/month, interquartile range [IQR] 28.3-126.8), with medical software accessed less often (median 9/month, IQR 3.7-13.7). Eight out of 13 physicians (62%) who completed the final scenarios chose to use the handheld computer for information access. The median time to access information on the handheld handheld computer was 19 s (IQR 15-40 s). This group exhibited a significant improvement in admission order score as compared with those who used other resources (P = 0.018). Benefits and barriers to use of this technology were identified. An updateable handheld computer system is feasible as a means of point-of-care access to medical reference material and may improve clinical decision making. However, during the study, acceptance of the system was variable. Improved training and new technology may overcome some of the barriers we

  3. Measuring accessibility and congestion in Accra

    DEFF Research Database (Denmark)

    Møller-Jensen, Lasse; Kofie, Richard Y.; Allotey, Albert N.M.

    2012-01-01

    Based on extensive gps-measurements, the paper addresses the level of intra-urban accessibility and provides indications of the level of congestion in Accra, Ghana. Traffic flows within the urban area are analyzed with respect to speed, time-of-day, direction, road type and land cover type. The s...... and less during off-peak hours. Delays are frequently found within the inner fringe areas. The paper discusses the methodological potentials and barriers for applying gps tracklog points for analysing traffic flows within an urban road network........ The speed information is extrapolated to cover the total mapped urban road net¬work with time- and direction-specific data. A series of time-distance maps are created using network analysis to illustrate the level of accessibility at different times of the day and at different directions relative...... to the city centre. Peak hour traffic speeds are compared with off-peak levels and theoretical free-flow estimations to provide an indica-tion of the level of congestion. It is found that the core areas are somewhat congested during the day period, while the fringe areas are more congested during peak hours...

  4. A Frequency-Based Assignment Model under Day-to-Day Information Evolution of Oversaturated Conditions on a Feeder Bus Service

    Directory of Open Access Journals (Sweden)

    Silin Zhang

    2017-02-01

    Full Text Available Day-to-day information is increasingly being implemented in transit networks worldwide. Feeder bus service (FBS plays a vital role in a public transit network by providing feeder access to hubs and rails. As a feeder service, a space-time path for frequent passengers is decided by its dynamic strategy procedure, in which a day-to-day information self-learning mechanism is identified and analyzed from our survey data. We formulate a frequency-based assignment model considering day-to-day evolution under oversaturated conditions, which takes into account the residual capacity of bus and the comfort feelings of sitting or standing. The core of our proposed model is to allocate the passengers on each segment belonging to their own paths according to multi-utilities transformed from the time values and parametric demands, such as frequency, bus capacity, seat comfort, and stop layout. The assignment method, albeit general, allows us to formulate an equivalent optimization problem in terms of interaction between the FBS’ operation and frequent passengers’ rational behaviors. Finally, a real application case is generated to test the ability of the modeling framework capturing the theoretical consequents, serving the passengers’ dynamic externalities.

  5. Implementation and usefulness of single access laparoscopic segmental and total colectomy.

    LENUS (Irish Health Repository)

    Baig, Muhammad N

    2012-02-06

    Aim:  Single access laparoscopic surgery is a recent vogue in the field of minimally invasive colorectal surgery. While selected series have indicated feasibility, we prospectively examined its usefulness for resectional surgery in routine practice. Method:  All patients undergoing laparoscopic colorectal resection over a twelve month period were considered for a single access approach by a single surgical team in a university hospital. This utilised a \\'Glove\\' port via a 3-5 cm periumbilical or stomal site incision with standard rigid laparoscopic instruments then being used. Results:  Of 74 planned laparoscopic colorectal resections, 35 (47%) were performed by this single incision laparoscopic modality without disruption of theatre list efficiency or surgical training obligations. The mean (range) age and BMI of these 25 consecutive right sided resections, 8 total colectomies (7 urgent operations) and 2 anterior resections was 58 (22-82) years and 23.9 (18.6-36.2) kg\\/m(2) respectively. The modal postoperative day of discharge was 4. For right sided resections, the mean (range) post-op stay in those undergoing surgery for benign disease was 4, while for those undergoing operation for neoplasia (n=18, mean age 71 years) it was 5.8 days and the average lymph node harvest was 13. Use of the glove port reduced trocar cost by 58% (€60\\/£53) by allowing use of trocar sleeves alone without obturators. Conclusion:  Single incision laparoscopic surgery is an effective option for abdominal surgery and seems especially suited for laparoscopic-assisted right sided colonic resections. The Glove port technique facilitates procedural frequency and familiarity and proves economically favourable.

  6. Open Access Policy for CERN Physics Publications

    CERN Multimedia

    2014-01-01

    CERN is committed to Open Access. It represents one of the values written in our Convention sixty years ago and is increasingly important for our Member States.   In the last edition of the Bulletin, this article described how CERN is doing with regards to open access publishing today. On Thursday this week, the Open Access Policy for CERN Physics Publications* was endorsed by the Scientific Information Policy Board (SIPB) and approved by the Director-General the same day . For any clarifications regarding the policy, please contact the Scientific Information Service library.desk@cern.ch. * A French version of the policy will be made available shortly.

  7. Monthly morphometric data on captive Kemps ridley sea turtles from 1998-2014 (NCEI Accession 0156880)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data contains monthly morphometric measurements on captive reared sea turtles at the Galveston, TX NOAA lab. Morphometric measurements are taken to track growth...

  8. Improving Health Care Accessibility: Strategies and Recommendations.

    Science.gov (United States)

    Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Access time refers to the interval between requesting and actual outpatient appointment. It reflects healthcare accessibility and has a great influence on patient treatment and satisfaction. King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia studied the accessibility to outpatient services in order to develop useful strategies and recommendations for improvement. Utilized, unutilized and no-show appointments were analyzed. It is crucial to manage no-shows and short notice appointment cancellations by preparing a waiting list for those patients who can be called in to an appointment on the same day using an open access policy. An overlapping appointment scheduling model can be useful to minimize patient waiting time and doctor idle time in addition to the sensible use of appointment overbooking that can significantly improve productivity.

  9. Preschool Children’s Memory for Word Forms Remains Stable Over Several Days, but Gradually Decreases after Six Months

    Directory of Open Access Journals (Sweden)

    Katherine Ruth Gordon

    2016-09-01

    Full Text Available Research on word learning has focused on children’s ability to identify a target object when given the word form after a minimal number of exposures to novel word-object pairings. However, relatively little research has focused on children’s ability to retrieve the word form when given the target object. The exceptions involve asking children to recall and produce forms, and children typically perform near floor on these measures. In the current study, 3- to 5-year-old children were administered a novel test of word form that allowed for recognition memory and manual responses. Specifically, when asked to label a previously trained object, children were given three forms to choose from: the target, a minimally different form, and a maximally different form. Children demonstrated memory for word forms at three post-training delays: 10 minutes (short-term, 2 to 3 days (long-term, and 6 months to 1 year (very long-term. However, children performed worse at the very long-term delay than the other time points, and the length of the very long-term delay was negatively related to performance. When in error, children were no more likely to select the minimally different form than the maximally different form at all time points. Overall, these results suggest that children remember word forms that are linked to objects over extended post-training intervals, but that their memory for the forms gradually decreases over time without further exposures. Furthermore, memory traces for word forms do not become less phonologically specific over time; rather children either identify the correct form, or they perform at chance.

  10. Cryosat: Mission Status, Achievements and Data Access

    Science.gov (United States)

    Parrinello, T.; Mardle, N.; Hoyos Ortega, B.; Bouzinac, C.; Badessi, S.; Frommknecht, B.; Wingham, D.; CryoSat Mission Team

    2011-12-01

    CryoSat-2 was launched on the 8th April 2010 and it is the first European ice mission dedicated to monitoring precise changes in the thickness of polar ice sheets and floating sea ice over a 3-year period. Cryosat-2 carries an innovative radar altimeter called the Synthetic Aperture Interferometric Altimeter (SIRAL) with two antennas and with extended capabilities to meet the measurement requirements for ice-sheets elevation and sea-ice freeboard. Initial results have shown that data is of high quality thanks to an altimeter that is behaving exceptional well within its design specifications. After an intensive but rewarding six months of commissioning, the CryoSat mission entered the science phase in November last year. Data was released to the scientific community in February 2011 and since then, products have been systematically distributed to more than 150 Principal Investigators and used by more than 400 scientists worldwide. This community is increasing every day. Scope of this paper is to describe the current mission status and the main scientific achievements since the start of the science phase. Topics will also include programmatic highlights and information on accessing Cryosat products following the new ESA Earth Observation Data Policy.

  11. Marginalized Student Access to Technology Education

    Science.gov (United States)

    Kurtcu, Wanda M.

    The purpose of this paper is to investigate how a teacher can disrupt an established curriculum that continues the cycle of inequity of access to science, technology, engineering, and math (STEM) curriculum by students in alternative education. For this paper, I will focus on the technology components of the STEM curriculum. Technology in the United States, if not the world economy, is developing at a rapid pace. Many areas of day to day living, from applying for a job to checking one's bank account online, involve a component of science and technology. The 'gap' in technology education is emphasized between the 'haves and have-nots', which is delineated along socio-economic lines. Marginalized students in alternative education programs use this equipment for little else than remedial programs and credit recovery. This level of inequity further widens in alternative education programs and affects the achievement of marginalized students in credit recovery or alternative education classes instead of participation technology classes. For the purposes of this paper I focus on how can I decrease the inequity of student access to 21st century technology education in an alternative education program by addressing the established curriculum of the program and modifying structural barriers of marginalized student access to a technology focused curriculum.

  12. Straight configuration saphenous vein transposition to popliteal artery for vascular access.

    Science.gov (United States)

    Caco, Gentian; Golemi, Dhurata; Likaj, Eriola

    2017-03-21

    The saphenous vein is commonly used as a vascular graft in peripheral artery surgery but rarely used for vascular access. The literature on straight configuration saphenous vein transposition to the popliteal artery is scarce. Here we present two cases of straight configuration saphenous vein transposition to the popliteal artery for vascular access, the surgical technique and respective follow-up. Two young men, aged 29 and 36 years, were chosen for lower-limb vascular access for hemodialysis. The first patient was paraplegic since birth. He used his arms to move so upper extremity vascular access was avoided. The second patient presented with an infected upper extremity arteriovenous graft (AVG) and after multiple closed AVFs he had no more available arm veins. Both patients received autologous lower extremity straight configuration saphenous vein transpositions to the popliteal artery under spinal anesthesia in May and October 2012, respectively. Cannulation of the fistula was allowed after one month. There were no early complications. Slight swelling on the leg appeared in one of the patients. Both fistulas were still functional after 36 and 32 months, respectively. The straight configuration saphenous vein transposition to popliteal artery is simple to perform, offers a long and straight segment for cannulation and may be a suitable autologous vascular access in selected patients.

  13. The concept of and factors affecting transport accessibility of seaports

    Directory of Open Access Journals (Sweden)

    Janusz Dąbrowski

    2012-03-01

    Full Text Available Transport accessibility of seaports is a frequently studied area in economic research. In practice, port operators and authorities use it to promote their services and compete in the market. Up to this day, theoretical basis of seaports transport accessibility has not been properly described. The article attempts to systematize and expend the knowledge in this field. New definitions of transport availability from wider and narrower perspectives were suggested; different types of accessibility and their mutual relations were explained. These ideas were complemented by introducing classification of factors affecting transport accessibility of seaports.

  14. Can people with Alzheimer's disease improve their day-to-day functioning with a tablet computer?

    Science.gov (United States)

    Imbeault, Hélène; Langlois, Francis; Bocti, Christian; Gagnon, Lise; Bier, Nathalie

    2018-07-01

    New technologies, such as tablet computers, present great potential to support the day-to-day living of persons with Alzheimer's disease (AD). However, whether people with AD can learn how to use a tablet properly in daily life remains to be demonstrated. A single case study was conducted with a 65-year-old woman with AD. A specific and structured intervention tailored to her needs was conceptualised for the use of a calendar application on a tablet computer according to the following learning stages: Acquisition, Application and Adaptation. In spite of her severe episodic memory deficit, she showed progressive learning of the tablet application during the intervention phase. Furthermore, data compiled over 12 months post-use show that she used the tablet successfully in her day-to-day life. She was even able to transfer her newly acquired ability to other available applications designed to monitor regular purchases, consult various recipes and play games. Tablet computers thereby offer a promising avenue for cognitive rehabilitation for persons with AD. This success was mainly achieved through a one-on-one individual programme tailored to this person. The limits and constraints of utilising tablet computers for persons with AD are discussed.

  15. Estimating daily flow duration curves from monthly streamflow data

    CSIR Research Space (South Africa)

    Smakhtin, VU

    2000-01-01

    Full Text Available The paper describes two techniques by which to establish 1-day (1d) flow duration curves at an ungauged site where only a simulated or calculated monthly flow time series is available. Both methods employ the straightforward relationships between...

  16. The progression of heartworm associated respiratory disease (HARD) in SPF cats 18 months after Dirofilaria immitis infection.

    Science.gov (United States)

    Dillon, A Ray; Blagburn, Bryon L; Tillson, Michael; Brawner, William; Welles, Betsy; Johnson, Calvin; Cattley, Russell; Rynders, Pat; Barney, Sharron

    2017-11-09

    Heartworm-associated respiratory disease (HARD) in cats is induced by the arrival and death of immature adult Dirofilaria immitis in the pulmonary system and is indistinguishable from mature adult heartworm infection. A controlled, blind research study investigated the long-term (18 months post infection, PI) consequences of the inflammatory response associated with the death of immature adult heartworms in cats. Three groups of cats, 10 per group, were infected with 100 third-stage (L3) larvae by subcutaneous injection. Group A cats were treated with selamectin (Revolution®; Zoetis) per label directions at 28 days PI and once monthly for 17 months. Group B cats were treated orally with ivermectin (Ivomec®; Merial) at 150 μg/kg) at 70 days PI, then every 2 weeks for 15 months. Group C cats were untreated PI. At baseline (Day 0) and on Days 70, 110, 168, 240, 309, 380, and 505 PI, peripheral blood, serum, bronchial lavage, and thoracic radiographic images were collected. The selamectin-treated cats (Group A) and ivermectin-treated cats (Group B) were free of heartworms or heartworm fragments at necropsy. All cats became heartworm antibody positive at some time point in the study except for one cat in Group A. Only cats in Group C (all with adult heartworms) were heartworm antigen positive. The heartworm antibody titer for Group B was highest on Days 110 to 168 and then decreased over time and 50% were serologically antibody negative on Day 240. Eosinophilic bronchoalveolar lavage (BAL) cytology and peripheral eosinophilia were most pronounced on Day 110 in all cats. Randomly distributed myofibrocytes in the lungs of some Group A cats suggest that precardiac larval stages were affecting the lungs. Radiographs in Group B cats demonstrated partial resolution of the initial HARD reaction but chronic myofibrocyte proliferation was histologically evident 18 months after infection. HARD was induced by immature adult worm infection with progressive improvement

  17. Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

    Energy Technology Data Exchange (ETDEWEB)

    Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

    2016-12-15

    PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

  18. Improving Accessibility to Medical Services for Persons with Disabilities in Thailand

    Directory of Open Access Journals (Sweden)

    Anpatcha Sakhornkhan

    2012-06-01

    Full Text Available Purpose: This action research aimed at developing an action plan to improve the accessibility to home health care and assistive devices for persons with disabilities in a rural community, and to evaluate changes in the numbers of such persons who received appropriate home health care and assistive devices after a three-month implementation of the action plan.Method: The study was conducted at a sub-district of Maha Sarakham Province, Thailand. The main beneficiaries were 99 persons with disabilities (mean age55.4±18.7 years. Group meetings were organised for persons with disabilities, caregivers, and various community members. An action plan for improving the accessibility of persons with disabilities to home health care and assistive devices was collaboratively formulated and implemented for three months.Results: The main strategy for improving accessibility was to increase the competency of village health volunteers in providing home health care and assistive devices to persons with disabilities. After the three-month action plan implementation, the number of persons with disabilities who received appropriate home health care, i.e. at least once a month, significantly increased from 33.3% to 72.2% (Chi-square test, PConclusions: Under the supervision of physical therapists and/or other allied health professionals, the village health volunteer is likely to be a key person for improving the accessibility to home health care and assistive devices for persons with disabilities in a rural community.Limitations: The study was limited to only one sub-district. No comparable areas were studied. Further, since the study recruited persons with disabilities from a rural community, applicability of the findings to persons with disabilities in an urban community should be considered judiciously.

  19. [Does open access publishing increase the impact of scientific articles? An empirical study in the field of intensive care medicine].

    Science.gov (United States)

    Riera, M; Aibar, E

    2013-05-01

    Some studies suggest that open access articles are more often cited than non-open access articles. However, the relationship between open access and citations count in a discipline such as intensive care medicine has not been studied to date. The present article analyzes the effect of open access publishing of scientific articles in intensive care medicine journals in terms of citations count. We evaluated a total of 161 articles (76% being non-open access articles) published in Intensive Care Medicine in the year 2008. Citation data were compared between the two groups up until April 30, 2011. Potentially confounding variables for citation counts were adjusted for in a linear multiple regression model. The median number (interquartile range) of citations of non-open access articles was 8 (4-12) versus 9 (6-18) in the case of open access articles (p=0.084). In the highest citation range (>8), the citation count was 13 (10-16) and 18 (13-21) (p=0.008), respectively. The mean follow-up was 37.5 ± 3 months in both groups. In the 30-35 months after publication, the average number (mean ± standard deviation) of citations per article per month of non-open access articles was 0.28 ± 0.6 versus 0.38 ± 0.7 in the case of open access articles (p=0.043). Independent factors for citation advantage were the Hirsch index of the first signing author (β=0.207; p=0.015) and open access status (β=3.618; p=0.006). Open access publishing and the Hirsch index of the first signing author increase the impact of scientific articles. The open access advantage is greater for the more highly cited articles, and appears in the 30-35 months after publication. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  20. Living Day by Day: The Meaning of Living With HIV/AIDS Among Women in Lebanon.

    Science.gov (United States)

    Kaplan, Rachel L; Khoury, Cynthia El; Field, Emily R S; Mokhbat, Jacques

    2016-01-01

    We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA) described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being "sick" and feeling "normal": Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country.

  1. Using Social Media to Increase Accessibility to Online Teaching Resources.

    Science.gov (United States)

    O'Kelly, B; McHugh, S; McHugh, T; Fady, N; Boyle, E; Hill, A D K

    2015-09-01

    The key learning points of Surgical Grand Rounds (SGR) are often not accessible at times of exam revision for students. We sought to use Twitter as an online teaching repository. A SGR Twitter profile was created. 23 SGR presentations were made accessible on Twitter over a 3 month period. 93 students were invited to complete a questionnaire assessing usage of the repository. 84 (90%) in total responded, of these, 25 (80.6%) felt that the online provision of SGR through twitter was "useful". The majority (71%) felt that the online content was easily accessible. The novel use of social media is a useful adjunctive educational tool in accessing an online repository of SGR presentations.

  2. SNAP Participants? Eating Patterns over the Benefit Month: A Time Use Perspective

    OpenAIRE

    Hamrick, Karen S.; Andrews, Margaret

    2016-01-01

    Individuals receiving monthly benefits through the U.S. Supplemental Nutrition Assistance Program (SNAP) often fall short of food at the end of the month and some report feelings of hunger. To investigate this situation, we used time diaries from the 2006-08 American Time Use Survey and Eating & Health Module to identify the timing of days where respondents reported no eating occurrences. Analysis includes descriptive statistics, a logit model, and a simulated benefit month. We found that SNA...

  3. Open access, open education resources and open data in Uganda ...

    African Journals Online (AJOL)

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in ...

  4. A 10-days heatwave around flowering superimposed on climate change conditions significantly affects production of 22 barley accessions

    DEFF Research Database (Denmark)

    Ingvordsen, Cathrine Heinz; Lyngkjær, Michael F.; Peltonen-Sainio, Pirjo

    2015-01-01

    Extreme climate events as heatwaves, floods and storms cause acute changes in season variability influencing primary production and are very likely to increase in magnitude and/or frequency (IPCC, AR5, WGI). In the present study 22 primarily Nordic barley accessions were grown in four basic clima...... climate change conditions on numerous accessions in order to select appropriate genotypes for breeding future cultivars that can secure the primary production....

  5. Combating information overload: a six-month pilot evaluation of a knowledge management system in general practice.

    Science.gov (United States)

    O'Brien, C; Cambouropoulos, P

    2000-01-01

    A six-month prospective study was conducted on the usefulness and usability of a representative electronic knowledge management tool, the WAX Active Library, for 19 general practitioners (GPs) evaluated using questionnaires and audit trail data. The number of pages accessed was highest in the final two months, when over half of the access trails were completed within 40 seconds. Most GPs rated the system as easy to learn, fast to use, and preferable to paper for providing information during consultations. Such tools could provide a medium for the activities of knowledge officers, help demand management, and promote sharing of information within primary care groups and across NHSnet or the Internet. PMID:10962792

  6. Primaquine double dose for 7 days is inferior to single-dose treatment for 14 days in preventing Plasmodium vivax recurrent episodes in Suriname

    Science.gov (United States)

    Mac Donald-Ottevanger, M Sigrid; Adhin, Malti R; Jitan, Jeetendra Kumar; Bretas, Gustavo; Vreden, Stephen GS

    2018-01-01

    Background Recurrent episodes of Plasmodium vivax are caused by dormant liver stages of the parasite, which are not eradicated by choloroquine. Therefore, effective treatment also includes the use of primaquine (PQ). However, this secondary preventive therapy is often not effective, mostly due to poor adherence to the relatively long treatment course, justifying a comparative study of the efficacy of different durations of PQ treatment. Materials and methods We included patients presenting with an acute and documented P. vivax infection from January 2006 to February 2008. All patients received chloroquine 25 mg/kg over a 3-day period. Subsequently, patients in group 7D received PQ 30 mg/day for 7 days, and patients in group 14D received standard PQ 15 mg/day for 14 days. All doses were given under supervision and patients were followed up for at least 6 months. The Kaplan–Meier method was used to estimate cumulative probability of recurrence up to 12 months after treatment initiation stratified by treatment group. Cox regression was used to assess possible determinants for recurrent parasitemia. Results Forty-seven of the 79 included patients (59.5%) were allocated to group 7D and 32 patients (40.5%) were allocated to group 14D. Recurrent parasitemia was detected in 31.9% of the cases in group 7D compared to 12.5% of the cases in group 14D (hazard ratio [HR] =3.36, 95% CI 1.11–10.16). Cumulative probability for recurrent parasitemia at 3, 6, and 12 months was 0.201 (95% CI 0.106–0.362), 0.312 (95% CI 0.190–0.485), and 0.424 (95% CI 0.274–0.615) for group 7D and 0.100 (95% CI 0.033–0.279), 0.100 (95% CI 0.033–0.279), and 0.138 (95% CI 0.054–0.327) for group 14D, respectively. When adjusted for possible confounders, differences in recurrent parasitemia remained significant between the two regimens in Cox regression analysis. Conclusion More than 30% of the patients receiving shorter treatment course had recurrent parasitemia, suggesting that the

  7. Auditory-Visual Context and Memory Retrieval in 3-Month-Old Infants

    Science.gov (United States)

    Daman-Wasserman, Michelle; Brennan, Barbara; Radcliffe, Fiona; Prigot, Joyce; Fagen, Jeffrey

    2006-01-01

    In 3 experiments, 3-month-old infants were trained to move an overhead mobile by kicking 1 of their feet in the presence of a distinctive visual (crib bumpers) and auditory (music) context. In Experiment 1A, 5-day but not 1-day retention was disrupted if either or both elements of the context present during the retention test were novel. In…

  8. 76 FR 47133 - Endangered and Threatened Wildlife and Plants; 90-Day Finding and 12-Month Determination on a...

    Science.gov (United States)

    2011-08-04

    ..., and specific soil types. Our implementing regulations at 50 CFR 424.02 define ``special management...; Panam[aacute]; Colombia; Trinidad and Tobago; Guyana; Suriname; French Guiana; and southern Brazil (M... `reproduction [site]' which includes the sandy beaches and open access to the ocean that constitute the `soil...

  9. An evaluation of 1-day disposable contact lens wear in a population of allergy sufferers.

    Science.gov (United States)

    Hayes, Valérie Y; Schnider, Cristina M; Veys, Jane

    2003-06-01

    This was a multi-site, 128-subject, bilateral crossover study to evaluate subjective comfort and slit-lamp findings with 1-day disposable contact lenses in a population of allergy sufferers during periods when allergen levels were elevated. The study involved 1-month of single-use daily wear with a 1-day disposable test lens (1. DAY ACUVUE Brand Contact Lenses, Johnson & Johnson Vision Care) and 1-month of daily wear with subjects' habitual lenses replaced to their usual replacement schedule. Pollen and mould counts were obtained for each site 1 week prior to the study and twice weekly throughout the study period. Subjective comfort and slit-lamp findings were recorded at baseline and after 1-month's wear of each modality. Sixty-seven percent of subjects agreed that the 1-day disposable lenses provided improved comfort when compared to the lenses they wore prior to the study, compared with 18% agreeing that the new pair of habitual lenses provided improved comfort. The 1-day disposable lenses showed greater improvement in slit-lamp findings from baseline than new habitual lenses. The use of 1-day disposable lenses is an effective strategy for managing allergy-suffering contact lens wearers.

  10. Short-term variations in core surface flow resolved from an improved method of calculating observatory monthly means

    DEFF Research Database (Denmark)

    Olsen, Nils; Whaler, K. A.; Finlay, Chris

    2014-01-01

    Monthly means of the magnetic field measurements taken by ground observatories are a useful data source for studying temporal changes of the core magnetic field and the underlying core flow. However, the usual way of calculating monthly means as the arithmetic mean of all days (geomagnetic quiet...... as well as disturbed) and all local times (day and night) may result in contributions from external (magnetospheric and ionospheric) origin in the (ordinary, omm) monthly means. Such contamination makes monthly means less favourable for core studies. We calculated revised monthly means (rmm......), and their uncertainties, from observatory hourly means using robust means and after removal of external field predictions, using an improved method for characterising the magnetospheric ring current. The utility of the new method for calculating observatory monthly means is demonstrated by inverting their first...

  11. Streaming movies, media, and instant access

    CERN Document Server

    Dixon, Wheeler Winston

    2013-01-01

    Film stocks are vanishing, but the iconic images of the silver screen remain -- albeit in new, sleeker formats. Today, viewers can instantly stream movies on televisions, computers, and smartphones. Gone are the days when films could only be seen in theaters or rented at video stores: movies are now accessible at the click of a button, and there are no reels, tapes, or discs to store. Any film or show worth keeping may be collected in the virtual cloud and accessed at will through services like Netflix, Hulu, and Amazon Instant.The movies have changed, and we are changing with them.

  12. Risk factors for 30-day reoperation and 3-month readmission: analysis from the Quality and Outcomes Database lumbar spine registry.

    Science.gov (United States)

    Wadhwa, Rishi K; Ohya, Junichi; Vogel, Todd D; Carreon, Leah Y; Asher, Anthony L; Knightly, John J; Shaffrey, Christopher I; Glassman, Steven D; Mummaneni, Praveen V

    2017-08-01

    OBJECTIVE The aim of this paper was to use a prospective, longitudinal, multicenter outcome registry of patients undergoing surgery for lumbar degenerative disease in order to assess the incidence and factors associated with 30-day reoperation and 90-day readmission. METHODS Prospectively collected data from 9853 patients from the Quality and Outcomes Database (QOD; formerly known as the N 2 QOD [National Neurosurgery Quality and Outcomes Database]) lumbar spine registry were retrospectively analyzed. Multivariate binomial regression analysis was performed to identify factors associated with 30-day reoperation and 90-day readmission after surgery for lumbar degenerative disease. A subgroup analysis of Medicare patients stratified by age (readmission rate was 6.3%. Multivariate analysis demonstrated that higher ASA class (OR 1.46 per class, 95% CI 1.25-1.70) and history of depression (OR 1.27, 95% CI 1.04-1.54) were factors associated with 90-day readmission. Medicare beneficiaries had a higher rate of 90-day readmissions compared with those who had private insurance (OR 1.43, 95% CI 1.17-1.76). Medicare patients readmission included higher ASA class and a history of depression. The 90-day readmission rates were higher for Medicare beneficiaries than for those who had private insurance. Medicare patients < 65 years of age were more likely to undergo reoperation within 30 days and to be readmitted within 90 days after their index surgery.

  13. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have 45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  14. Access to Workplace Accommodations to Support Breastfeeding after Passage of the Affordable Care Act.

    Science.gov (United States)

    Kozhimannil, Katy B; Jou, Judy; Gjerdingen, Dwenda K; McGovern, Patricia M

    2016-01-01

    This study examines access to workplace accommodations for breastfeeding, as mandated by the Affordable Care Act, and its associations with breastfeeding initiation and duration. We hypothesize that women with access to reasonable break time and private space to express breast milk would be more likely to breastfeed exclusively at 6 months and to continue breastfeeding for a longer duration. Data are from Listening to Mothers III, a national survey of women ages 18 to 45 who gave birth in 2011 and 2012. The study population included women who were employed full or part time at the time of survey. Using two-way tabulation, logistic regression, and survival analysis, we characterized women with access to breastfeeding accommodations and assessed the associations between these accommodations and breastfeeding outcomes. Only 40% of women had access to both break time and private space. Women with both adequate break time and private space were 2.3 times (95% CI, 1.03-4.95) as likely to be breastfeeding exclusively at 6 months and 1.5 times (95% CI, 1.08-2.06) as likely to continue breastfeeding exclusively with each passing month compared with women without access to these accommodations. Employed women face unique barriers to breastfeeding and have lower rates of breastfeeding initiation and shorter durations, despite compelling evidence of associated health benefits. Expanded access to workplace accommodations for breastfeeding will likely entail collaborative efforts between public health agencies, employers, insurers, and clinicians to ensure effective workplace policies and improved breastfeeding outcomes. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  15. 76 FR 76023 - National Impaired Driving Prevention Month, 2011

    Science.gov (United States)

    2011-12-06

    ... an unacceptable loss of life from traffic accidents that involve drugs, alcohol, and distracted... Prevention Month, we recommit to preventing tragedy before it strikes by ensuring our family members and... parents, educators, and community leaders who work with young people every day are our Nation's best...

  16. Genetic Analysis of Milk Yield Using Random Regression Test Day Model in Tehran Province Holstein Dairy Cow

    Directory of Open Access Journals (Sweden)

    A. Seyeddokht

    2012-09-01

    Full Text Available In this research a random regression test day model was used to estimate heritability values and calculation genetic correlations between test day milk records. a total of 140357 monthly test day milk records belonging to 28292 first lactation Holstein cattle(trice time a day milking distributed in 165 herd and calved from 2001 to 2010 belonging to the herds of Tehran province were used. The fixed effects of herd-year-month of calving as contemporary group and age at calving and Holstein gene percentage as covariate were fitted. Orthogonal legendre polynomial with a 4th-order was implemented to take account of genetic and environmental aspects of milk production over the course of lactation. RRM using Legendre polynomials as base functions appears to be the most adequate to describe the covariance structure of the data. The results showed that the average of heritability for the second half of lactation period was higher than that of the first half. The heritability value for the first month was lowest (0.117 and for the eighth month of the lactation was highest (0.230 compared to the other months of lactation. Because of genetic variation was increased gradually, and residual variance was high in the first months of lactation, heritabilities were different over the course of lactation. The RRMs with a higher number of parameters were more useful to describe the genetic variation of test-day milk yield throughout the lactation. In this research estimation of genetic parameters, and calculation genetic correlations were implemented by random regression test day model, therefore using this method is the exact way to take account of parameters rather than the other ways.

  17. Students Across Texas Celebrate Astronomy Day

    Science.gov (United States)

    Preston, S.; Wetzel, M.; Hemenway, M. K.

    2010-08-01

    Over the past three years, McDonald Observatory has offered special Astronomy Day videoconference programs to students across Texas—the second largest state in the U.S. (Only Alaska is larger). Videoconferencing allows many students and teachers access to our Observatory, which is remotely located 180 miles (290 kilometers) from any major city. McDonald Observatory partners with Connect2Texas to advertise the Astronomy Day event. Connect2Texas provides the electronic bridge between schools and the Observatory. They also provide an online evaluation for teachers to complete. In 2009 the Astronomy Day videoconference celebrated the International Year of Astronomy and the historic observations made by Galileo Galilei. During the videoconference, the classes explore the Moon or Venus by making real-time telescopic observations. Students also receive an introduction to the Observatory, an opportunity to perform an activity relating to Galileo's observations, and an interview with an astronomer. A website provides teachers pre-and post-video conference materials, instructions, and a certificate of completion that can be customized for each student. The website also lists content alignment with state science education standards.

  18. Does better access to FPs decrease the likelihood of emergency department use? Results from the Primary Care Access Survey.

    Science.gov (United States)

    Mian, Oxana; Pong, Raymond

    2012-11-01

    To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Population-based telephone survey. Ontario. A total of 8502 Ontario residents aged 16 years and older. Emergency department use in the 12 months before the survey. Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use.

  19. INTERDEPENDENCE BETWEEN DRY DAYS AND TEMPERATURE OF SYLHET REGION: CORRELATION ANALYSIS

    Directory of Open Access Journals (Sweden)

    Syed Mustakim Ali Shah

    2016-01-01

    Full Text Available Climate change can have profound impact on weather conditions around the world such as heavy rainfall, drought, global warming and so on. Understanding and predicting these natural variations is now a key research challenge for disaster-prone country like Bangladesh. This study focuses on the north eastern part of Bangladesh which is a hilly region, plays an important role in the ecological balance of the country along with socio-economic development. Present study analyses the behavior of maximum temperature and dry days using different statistical tools. Pearson’s correlation matrix and Man-Kendall’s tau are used to correlate monthly dry days with monthly maximum temperature, and also their annual trend. A moderate correlation was found mostly in dry summer months. In addition, a positive trend was observed in Man Kendall’s trend test of yearly temperature which might be an indication of global warming in this region.

  20. Race and time from diagnosis to radical prostatectomy: does equal access mean equal timely access to the operating room?--Results from the SEARCH database.

    Science.gov (United States)

    Bañez, Lionel L; Terris, Martha K; Aronson, William J; Presti, Joseph C; Kane, Christopher J; Amling, Christopher L; Freedland, Stephen J

    2009-04-01

    African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007 at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasian men, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.

  1. In vitro propagation and acclimatization of genipapo accessions

    Directory of Open Access Journals (Sweden)

    Francielen Paola de Sa

    2016-04-01

    Full Text Available ABSTRACT Genipapo is a species with an intermediate seed storage behavior, and its germination is slow and asynchronous; therefore the tissue culture is an alternative strategy for the propagation in large-scale. This study aimed to evaluate three genipapo accessions at different micropropagation stages (adventitious shoot induction, in vitro rooting and acclimatization. Genipapo nodal segments from the Sabinópolis (AS, Cruz das Almas (CZA and Núcleo Bandeirante (NB accessions were used and inoculated in culture media with 0 and 1.0 mg L-1 6-benzylaminopurine (BAP. Different indole-3-butyric acid (IBA concentrations were tested for in vitro rooting. Subsequently, the effect of two substrates on the seedling development of three genipapo accessions was assessed. The molecular characterization of accessions was performed using 15 inter-simple sequence repeat (ISSR primers, and genotype clustering was performed based on genetic dissimilarity using the Unweighted Pair-Group Method with Arithmetic Mean (UPGMA. Culture media supplementation with 1.0 mg L-1 BAP favors the development of adventitious shoots and promotes a higher callogenesis percentage, leaf number and feasibility at 90 days of in vitro culture. The immersion of the basal portion of shoots for 20 seconds in all IBA solutions induces the rhizogenesis in the genipapo accessions at 90 days of in vitro culture. The substrates consisting of washed sand + dried coconut shell powder, at a 1:1 ratio by volume, and Topstrato HT(r may be recommended for genipapo acclimatization. The NB accession is genetically different from the CZA and AS populations and shows superiority for most of the variables analyzed.

  2. Heating- and growing-degree days at Chalk River Nuclear Laboratories, 1976-1980

    International Nuclear Information System (INIS)

    Jay, P.C.; Wildsmith, D.P.

    1981-05-01

    An update of the report, Heating- and Growing-Degree-Days at Chalk River Nuclear Laboratories (AECL-5547) is presented along with various other meteorological variables which were not included in the previous publication. Also included, and shown in graph form, are the monthly degree-day frequencies. (author)

  3. Do expanded seven-day NHS services improve clinical outcomes? Analysis of comparative institutional performance from the ?NHS Services, Seven Days a Week? project 2013?2016

    OpenAIRE

    Gan, Hoong-Wei; Wong, Danny Jon Nian; Dean, Benjamin John Floyd; Hall, Alistair Scott

    2017-01-01

    Background The cause of adverse weekend clinical outcomes remains unknown. In 2013, the ?NHS Services, Seven Days a Week? project was initiated to improve access to services across the seven-day week. Three years on, we sought to analyse the impact of such changes across the English NHS. Methods Aggregated trust-level data on crude mortality rates, Summary Hospital-Level Mortality Indicator (SHMI), mean length of stay (LOS), A&E admission and four-hour breach rates were obtained from national...

  4. Do expanded seven-day NHS services improve clinical outcomes? Analysis of comparative institutional performance from the "NHS Services, Seven Days a Week" project 2013-2016

    OpenAIRE

    Gan, H-W; Wong, D. J. N.; Dean, B. J. F.; Hall, A. S.

    2017-01-01

    Background: The cause of adverse weekend clinical outcomes remains unknown. In 2013, the “NHS Services, Seven Days a Week” project was initiated to improve access to services across the seven-day week. Three years on, we sought to analyse the impact of such changes across the English NHS. Methods: Aggregated trust-level data on crude mortality rates, Summary Hospital-Level Mortality Indicator (SHMI), mean length of stay (LOS), A&E admission and four-hour breach rates were obtained f...

  5. 75 FR 17845 - National Sexual Assault Awareness Month, 2010

    Science.gov (United States)

    2010-04-07

    ... Sexual Assault Awareness Month, 2010 By the President of the United States of America A Proclamation Every day, women, men, and children across America suffer the pain and trauma of sexual assault. From verbal harassment and intimidation to molestation and rape, this crime occurs far too frequently, goes...

  6. Perceived Accessibility of Public Transport as a Potential Indicator of Social Inclusion

    Directory of Open Access Journals (Sweden)

    Katrin Lättman

    2016-06-01

    Full Text Available Perceived accessibility has been acknowledged as an important aspect of transport policy since the 70s. Nevertheless, very few empirical studies have been conducted in this field. When aiming to improve social inclusion, by making sustainable transport modes accessible to all, it is important to understand the factors driving perceived accessibility. Unlike conventional accessibility measures, perceived accessibility focuses on the perceived possibilities and ease of engaging in preferred activities using different transport modes. We define perceived accessibility in terms of how easy it is to live a satisfactory life with the help of the transport system, which is not necessarily the same thing as the objective standard of the system. According to previous research, perceived accessibility varies with the subjectively-rated quality of the mode of transport. Thus, improvements in quality (e.g. trip planning, comfort, or safety increase the perceived accessibility and make life easier to live using the chosen mode of transport. This study (n=750 focuses on the perceived accessibility of public transport, captured using the Perceived Accessibility Scale PAC (Lättman, Olsson, & Friman, 2015. More specifically, this study aims to determine how level of quality affects the perceived accessibility in public transport. A Conditional Process Model shows that, in addition to quality, feeling safe and frequency of travel are important predictors of perceived accessibility. Furthermore, elderly and those in their thirties report a lower level of perceived accessibility to their day-to-day activities using public transport. The basic premise of this study is that subjective experiences may be as important as objective indicators when planning and designing for socially inclusive transport systems.

  7. Investigating Access Performance of Long Time Series with Restructured Big Model Data

    Science.gov (United States)

    Shen, S.; Ostrenga, D.; Vollmer, B.; Meyer, D. J.

    2017-12-01

    Data sets generated by models are substantially increasing in volume, due to increases in spatial and temporal resolution, and the number of output variables. Many users wish to download subsetted data in preferred data formats and structures, as it is getting increasingly difficult to handle the original full-size data files. For example, application research users, such as those involved with wind or solar energy, or extreme weather events, are likely only interested in daily or hourly model data at a single point or for a small area for a long time period, and prefer to have the data downloaded in a single file. With native model file structures, such as hourly data from NASA Modern-Era Retrospective analysis for Research and Applications Version-2 (MERRA-2), it may take over 10 hours for the extraction of interested parameters at a single point for 30 years. The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) is exploring methods to address this particular user need. One approach is to create value-added data by reconstructing the data files. Taking MERRA-2 data as an example, we have tested converting hourly data from one-day-per-file into different data cubes, such as one-month, one-year, or whole-mission. Performance are compared for reading local data files and accessing data through interoperable service, such as OPeNDAP. Results show that, compared to the original file structure, the new data cubes offer much better performance for accessing long time series. We have noticed that performance is associated with the cube size and structure, the compression method, and how the data are accessed. An optimized data cube structure will not only improve data access, but also may enable better online analytic services.

  8. Is socially integrated community day care for people with dementia associated with higher user satisfaction and a higher job satisfaction of staff compared to nursing home-based day care?

    Science.gov (United States)

    Marijke van Haeften-van Dijk, A; Hattink, Bart J J; Meiland, Franka J M; Bakker, Ton J E M; Dröes, Rose-Marie

    2017-06-01

    To investigate whether community-based (CO) day care with carer support according to the proven effective Meeting Centres Support Programme model is associated with higher satisfaction of people with dementia (PwD) and their informal caregivers (CG) and with a higher job satisfaction among care staff compared to traditional nursing home-based (NH) day care. Data were collected in 11 NH day care centres and 11 CO day care centres. User satisfaction of PwD and CG was evaluated in the 11 NH day care centres (n PwD = 41, n CG = 39) and 11 CO day care centres (n PwD = 28, n CG = 36) with a survey after six months of participation. Job satisfaction was measured only in the six NH day care centres that recently transformed to CO day care, with two standard questionnaires before (n STAFF = 35), and six months after the transition (n STAFF = 35). PwD were more positive about the communication and listening skills of staff and the atmosphere and activities at the CO day care centre. Also, CG valued the communication with, and expertise of, staff in CO day care higher, and were more satisfied with the received emotional, social and practical support. After the transition, satisfaction of staff with the work pace increased, but satisfaction with learning opportunities decreased. PwD and CG were more satisfied about the communication with the staff and the received support in CO day care than in NH day care. Overall job satisfaction was not higher, except satisfaction about work pace.

  9. Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

    Science.gov (United States)

    Agha, Sohail; Gage, Anastasia; Balal, Asma

    2007-05-01

    With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to

  10. Effect of Improving Dietary Quality on Arterial Stiffness in Subjects with Type 1 and Type 2 Diabetes: A 12 Months Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Kristina S. Petersen

    2016-06-01

    Full Text Available People with diabetes have accelerated arterial stiffening. The aim of this study was to determine the effect of increasing fruit, vegetable and dairy intake for 12 months on carotid femoral pulse wave velocity (cfPWV, augmentation index (AIx, and central blood pressure (cBP, compared to a usual diet control, in people with type 1 and type 2 diabetes. In a 12 months randomised controlled trial, cfPWV, AIx and cBP were measured every 3 months. The intervention group received dietary counselling to increase consumption of fruit (+1 serving/day; 150 g/day, vegetables (+2 servings/day; 150 g/day and dairy (+1 serving/day; 200–250 g/day at baseline, 1, 3, 6 and 9 months. The control group continued on their usual diet. One hundred and nine participants were randomised and 92 (intervention n = 45; control n = 47 completed. At 3 months, fruit (184 g/day; p = 0.001 and dairy (83 g/day; p = 0.037 intake increased in the intervention group compared with the control group but this increase was not maintained at 12 months. After adjustment for baseline measurements there was no time by treatment effect for central systolic or diastolic BP, AIx or cfPWV. A time effect existed for AIx which modestly increased over time. Peripheral diastolic BP and central pulse pressure were improved in the intervention group compared with the control group at 12 months. In the cohort with type 1 and type 2 diabetes, improving dietary quality by increasing consumption of fruit, vegetables and dairy did not improve cBP, AIx or cfPWV, compared with a control group continuing on their usual diet, after 12 months.

  11. A diary after dinner: How the time of event recording influences later accessibility of diary events.

    Science.gov (United States)

    Szőllősi, Ágnes; Keresztes, Attila; Conway, Martin A; Racsmány, Mihály

    2015-01-01

    Recording the events of a day in a diary may help improve their later accessibility. An interesting question is whether improvements in long-term accessibility will be greater if the diary is completed at the end of the day, or after a period of sleep, the following morning. We investigated this question using an internet-based diary method. On each of five days, participants (n = 109) recorded autobiographical memories for that day or for the previous day. Recording took place either in the morning or in the evening. Following a 30-day retention interval, the diary events were free recalled. We found that participants who recorded their memories in the evening before sleep had best memory performance. These results suggest that the time of reactivation and recording of recent autobiographical events has a significant effect on the later accessibility of those diary events. We discuss our results in the light of related findings that show a beneficial effect of reduced interference during sleep on memory consolidation and reconsolidation.

  12. Temporary authorization for use: does the French patient access programme for unlicensed medicines impact market access after formal licensing?

    Science.gov (United States)

    Degrassat-Théas, Albane; Paubel, Pascal; Parent de Curzon, Olivier; Le Pen, Claude; Sinègre, Martine

    2013-04-01

    To reach the French market, a new drug requires a marketing authorization (MA) and price and reimbursement agreements. These hurdles could delay access to new and promising drugs. Since 1992, French law authorizes the use of unlicensed drugs on an exceptional and temporary basis through a compassionate-use programme, known as Temporary Authorization for Use (ATU). This programme was implemented to improve early access to drugs under development or authorized abroad. However, it is suspected to be inflationary, bypassing public bodies in charge of health technology assessment (HTA) and of pricing. The aim of this study is to observe the market access after the formal licensing of drugs that went through this compassionate-use programme. We included all ATUs that received an MA between 1 January 2005 and 30 June 2010. We first examined market access delays from these drugs using the standard administrative path. We positioned this result in relation to launch delays observed in France (for all outpatient drugs) and in other major European markets. Second, we assessed the bargaining power of a hospital purchaser after those drugs had obtained an MA by calculating the price growth rate after the approval. During the study period, 77 ATUs were formally licensed. The study concluded that, from the patient's perspective, licensing and public bodies' review time was shortened by a combined total of 36 months. The projected 11-month review time of public bodies may be longer than delays usually observed for outpatient drugs. Nonetheless, the study revealed significant benefits for French patient access based on comparable processing to launch time with those of other European countries with tight price control policies. In return, a 12 % premium, on average, is paid to pharmaceutical companies while drugs are under this status (sub-analysis on 56 drugs). In many instances, the ATU programme responds to a public health need by accelerating the availability of new drugs

  13. [Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?].

    Science.gov (United States)

    García Cortés, Ma J; Viedma, G; Sánchez Perales, M C; Borrego, F J; Borrego, J; Pérez del Barrio, P; Gil Cunquero, J M; Liébana, A; Pérez Bañasco, V

    2005-01-01

    Autologous access is the best vascular access for dialysis also in older patients and it should be mature when patient needs hemodialysis. It is not always possible. Surgeon availability and demographic characteristics of patients (age, diabetes, vascular disease...) are factors that determine primary vascular access. To analyse outcome and vascular access complications in elderly who start hemodialysis without vascular access. All patients older than 75 years who initiated hemodialysis without vascular access between January 2000 and June 2002 were included, They were divided en two groups depending on primary vascular access. GI: arterio-venous fistulae. GIIl: Tunnelled cuffed catheter. Epidemiological and analytical data, vascular access complications related, as well as patient and first permanent vascular access survival from their inclusion in dialysis up to December 2002 were analysed and compared in both groups. 32 patients were studied. GI: n = 17 (4 men) and GIIl: n =1 5 (8 men), age: 79.9 +/- 3.8 and 81.7 +/- 4 years respectively (ns). There were no differences in sex and comorbidity (diabetes, ischemic heart disease, peripheral vascular disease and hypertension). It took GI 3 months to get a permanent vascular access suitable for using, while it took GIIl 1.3 months (p catheters was higher in GI (3.35 vs 1.87 p central venous thrombosis happen in GI (I: 25 CVT/100 patients-year) vs 30% in GIIl (I = 14.4/100 patients-year) (ns). No significant differences neither in bleeding (66.7% vs 33.3%) nor ischemia (75% vs 25%) were found. Dialysis dose (Kt/V) as well as anaemia degree were similar in both groups. Permanent vascular access survival after 2 years was 45.8% in GI and 24% in GII (ns). Patient survival was similar in GI and GII (72% vs 51% ns). Elderly who start hemodialysis without vascular access took longer to get a suitable permanent vascular access when arterio-venous fistulae is placed than with a tunnelled cuffed hemodialysis catheter. As a

  14. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

    Science.gov (United States)

    Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

    2012-12-01

    Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  15. Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

    Directory of Open Access Journals (Sweden)

    Pil Young Jung

    Full Text Available Background: Totally implantable access port (TIAP provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92 and subclavian approach (Group 2, n = 79 between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868. Twenty four complications were occurred (14.0%, including pneumothorax (n = 1, 0.6%, migration/malposition (n = 4, 2.3%, pinch-off syndrome (n = 4, 2.3%, malfunction (n = 2, 1.1%, infection (n = 8, 4.7%, and venous thrombosis (n = 5, 2.9%. The overall incidence was 8.7% and 20.3% in each group (p = 0.030. Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033. The mechanical complication free probability is significantly higher in group 1 (p = 0.040. Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

  16. Secret Sauce and Snake Oil: Writing Monthly Reports in a Highly Contingent Environment

    Science.gov (United States)

    Spinuzzi, Clay

    2010-01-01

    At a search marketing company, each search engine optimization (SEO) specialist writes up to 10 to 12 complex 20-page monthly reports in the first ten business days of each month. These SEO specialists do not consider themselves to be writers, yet they generate these structurally and rhetorically complex reports as a matter of course, while…

  17. Socioeconomic inequalities in the access to and quality of health care services

    Directory of Open Access Journals (Sweden)

    Bruno Pereira Nunes

    2014-12-01

    Full Text Available OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days for assistance, and waiting time (in hours in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

  18. Day-to-day variations in health behaviors and daily functioning: two intensive longitudinal studies.

    Science.gov (United States)

    Flueckiger, Lavinia; Lieb, Roselind; Meyer, Andrea H; Witthauer, Cornelia; Mata, Jutta

    2017-04-01

    In two intensive longitudinal studies we examined the daily dynamics in health behaviors and their associations with two important indicators of young adults' daily functioning, namely, affect and academic performance. Over a period of 8 months, university students (Study 1: N = 292; Study 2: N = 304) reported sleep, physical activity, snacking, positive and negative affect, and learning goal achievement. A subsample wore an actigraph to provide an additional measurement of sleep and physical activity and participated in a controlled laboratory snacking situation. Multilevel structural equation models showed that better day-to-day sleep quality or more physical activity than usual, but not snacking, were associated with improved daily functioning, namely, affect and learning goal achievement. Importantly, self-report measurements of health behaviors correlated with behavioral measurements. These findings have the potential to inform health promotion programs aimed at supporting young adults in their daily functioning in good physical and mental health.

  19. Discharge on the day of birth, parental response and health and schooling outcomes

    DEFF Research Database (Denmark)

    Sievertsen, Hans Henrik; Wüst, Miriam

    Exploiting the Danish roll-out of same-day discharge policies, we find that treated newborns have a higher probability of first-month hospital readmission. This result may suggest that parents substitute postpartum hospital stays with readmissions. However, a same-day discharge also increases the...

  20. ACOG Committee Opinion Number 542: Access to emergency contraception.

    Science.gov (United States)

    2012-11-01

    Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

  1. RESEARCH ON THE MEAT PRODUCTION DIFFERENCES DETERMINED BY THE BIRTH MONTH OF THE FATTENED STEERS

    Directory of Open Access Journals (Sweden)

    Agatha POPESCU

    2014-04-01

    Full Text Available The purpose of the paper was to assess the effect of the birth month on some meat production characters such as live weight at the age of 180 days, live weight at the age of 365 days and daily gain during the fattening period in progeny testing for bulls' breeding value estimation in order to correct the biases determined by this environmental factor. In this purpose, the following linear mathematical model was used: xij=m . ai . eij, where xij - the live record of the "j" steer in the month "i" (i=1,2,....12, m- geometrical average of the meat production characters taken into account, ai- the multiplicative effect of the birth month "i" and eij – the residual multiplicative effect. A number of 1,705 half-brothers belonging to 105 Friesian bulls from Romania was included in this progeny testing. In order to eliminate the biases âi, adequate multiplicative adjusting factors were calculated as 1/âi.. The conclusion was that the effects of birth month on the meat production in terms of live weight at the age of 180 days, live weight at the age of 365 days and daily gain during the fattening period should not be ignored, on the contrary, they should be eliminated by correcting the real data using corresponding adjusting factors. Therefore, adjusting factors are justifed to be used in order to improve the accuracy of the bulls' breeding value estimation for meat production.

  2. Powernext Day-AheadTM products and market organization

    International Nuclear Information System (INIS)

    2004-06-01

    The introduction of a power exchange in France is a direct response to the opening up of the European electricity markets. Powernext SA is a Multilateral Trading Facility in charge of managing the French power exchange through an optional and anonymous organised exchange offering: - Day-ahead contracts for the management of volume risk on Powernext Day-Ahead TM since 21 November 2001, - Medium term contracts for the management of price risk on Powernext Futures TM since 18 June 2004. This document presents the principle of the trading of hourly contracts on Powernext Day-Ahead TM , the accessibility of the market, the SAPRI trading platform operated by Nord Pool, the Scandinavian power exchange, the validation of the auction results, the collaboration with LCH.Clearnet SA to secure and facilitate the transactions, and the delivery guarantee implemented by RTE (the French energy transport network). (J.S.)

  3. Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

    Science.gov (United States)

    Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

    2017-12-01

    Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  4. 76 FR 62289 - National Disability Employment Awareness Month, 2011

    Science.gov (United States)

    2011-10-07

    ..., and out- build the rest of the world. During National Disability Employment Awareness Month, we... opportunity to apply for jobs, and it will allow Federal employees to better use technology at work. To win... for all people. IN WITNESS WHEREOF, I have hereunto set my hand this third day of October, in the year...

  5. A Model for Quantifying Sources of Variation in Test-day Milk Yield ...

    African Journals Online (AJOL)

    A cow's test-day milk yield is influenced by several systematic environmental effects, which have to be removed when estimating the genetic potential of an animal. The present study quantified the variation due to test date and month of test in test-day lactation yield records using full and reduced models. The data consisted ...

  6. HIV status, breastfeeding modality at 5 months and postpartum maternal weight changes over 24 months in rural South Africa.

    Science.gov (United States)

    Chetty, Terusha; Carter, Rosalind J; Bland, Ruth M; Newell, Marie-Louise

    2014-07-01

    To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa. In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days). Using generalised estimating equation mixed models, allowing for repeated measures, we compared postpartum weight change (kg) from the first maternal postpartum weight within the first 6 weeks (baseline weight) to each subsequent visit through 24 months among 2340 HIV-infected and -uninfected women with live births and at least two postpartum weight measurements. HIV-infected (-0.2 kg CI: -1.7 to 1.3 kg; P = 0.81) and -uninfected women (-0.5 kg; 95% CI: -2.1 to 1.2 kg; P = 0.58) had marginal non-significant weight loss from baseline to 24 months postpartum. Adjusting for HIV status, socio-demographic, pregnancy-related and infant factors, 5-month feeding modality was not significantly associated with postpartum weight change: weight change by 24 months postpartum, compared to the change in the reference EBF group, was 0.03 kg in NBF (95% CI: -2.5 to +2.5 kg; P = 0.90) and 0.1 kg in MF (95% CI: -3.0 to +3.2 kg; P = 0.78). HIV-infected and -uninfected women experienced similar weight loss over 24 months. Weight change postpartum was not associated with 5-month breastfeeding modality among HIV-infected and -uninfected women. © 2014 John Wiley & Sons Ltd.

  7. Persistence with weekly and monthly bisphosphonates among postmenopausal women: analysis of a US pharmacy claims administrative database

    Directory of Open Access Journals (Sweden)

    Fan T

    2013-11-01

    Full Text Available Tao Fan, Qiaoyi Zhang, Shuvayu S Sen Global Health Outcomes, Merck, Whitehouse Station, NJ, USA Background: Bisphosphonates are available in daily, weekly, and monthly dosing formulations to treat postmenopausal osteoporosis. Some researchers suggested that adherence to monthly bisphosphonate might be different from that with weekly or daily bisphosphonate because of different dosing regimens. However, the actual persistency rates in regular practice settings are unknown. Objectives: To compare persistence rates with alendronate 70 mg once weekly (AOW, risedronate 35 mg once weekly (ROW, and ibandronate 150 mg once monthly (IOM in a US pharmacy claims database. Methods: In this retrospective cohort study, pharmacy claims data of patients with new bisphosphonate prescriptions were extracted for women aged ≥ 50 years who had an AOW, ROW, or IOM prescription (index prescription between December 30, 2004 and May 31, 2005 (the index period and did not have the index Rx during the previous 12 months. Patients’ records were reviewed for at least 5 months from their index date to November 2, 2005 (the follow-up period. Patients were considered persistent if they neither discontinued (failed to refill the index Rx within a 45-day period following the last supply day of the previous dispensing nor switched (changed to another bisphosphonate during the follow-up period. Medication-possession ratio was defined as days with index prescription supplies/total days of follow-up. Results: Among 44,635 patients, 25,207 (56.5% received prescriptions of AOW, 18,689 (41.9% ROW, and 739 (1.7% IOM as the index prescription. In all, 35.1% of AOW patients, 32.5% of ROW patients, and 30.4% of IOM patients (P < 0.0001 AOW vs ROW or IOM had persisted with their initial therapy, whereas 64.0% of AOW, 66.4% of ROW, and 68.2% of IOM patients discontinued (P < 0.0001 during follow-up. The medication-possession ratio (days with index prescription supplies/total days of

  8. Positioning hospitals for improved access to capital.

    Science.gov (United States)

    Ponton, Kevin T; Sandrick, Karen M

    2002-11-01

    Hospitals need to actively position themselves in the next 18 to 24 months to ensure continued access to financing. Hospitals need to shift their focus from investment income to operations. Hospitals should recognize the importance of balance-sheet liquidity to institutional investors. Not-for-profit hospitals should focus on both sides of the balance sheet. Healthcare executives need to develop effective leadership and investor-relations skills.

  9. Three-day clotrimazole treatment in candidal vulvovaginitis.

    Science.gov (United States)

    Masterton, G; Napier, I R; Henderson, J N; Roberts, J E

    1977-01-01

    The accepted modern practice is to treat each sexually transmitted disease with the shortest possible course of treatment consistent with success. In candidal vulvovaginitis, six days is the minimum period that has so far been found to be successful, but we report here a further reduction to three days. Patients were given two clotrimazole pessaries nightly for three consecutive nights; the overall success rate was 89-4% one month after treatment. This compares favourably with the 93% cure rate reported with the six-day course of clotrimazole. With both the long and short courses, patients having their first attack of genital candidosis responded better than those with a history of previous infection. Short courses of clotrimazole treatment are particularly valuable in dealing with uncooperative women who stop treatment at the earliest possible moment. Clinical and laboratory diagnostic pitfalls and their possible influence upon the therapeutic outcome are also discussed. PMID:870143

  10. Uniform access to clinical data in a distributed environment. Radiology

    International Nuclear Information System (INIS)

    Adelhard, K.; Swoboda, N.; Nissen-Meyer, S.; Reiser, M.

    1999-01-01

    Purpose: Providing medical reports on wards and ambulatory settings in electronic form can improve the quality of health care delivery. Radiology was chosen as an example to demonstrate how to implement uniform access to clinical data in a hospital. Method: Medical professionals at the university hospital in Munich, Grosshadern, have access to all radiological reports of their patients. Web browsers are used as a front end. A centralized administration of users and patients is in place. Results: Centralized access control and patient selection guarantee uniform access to all applicable data via intranet and controls access rights. The high acceptance of this service is reflected by the high number of 150 requests per day. Discussion: Access to radiological reports within the Grosshadern University Clinics was enabled via web browsers in a short time. The high acceptance of the system also proves its easy use. Integration of the system in a centralized user and patient identification system supports the unified access to clinical data. (orig.) [de

  11. Monthly ENSO Forecast Skill and Lagged Ensemble Size

    Science.gov (United States)

    Trenary, L.; DelSole, T.; Tippett, M. K.; Pegion, K.

    2018-04-01

    The mean square error (MSE) of a lagged ensemble of monthly forecasts of the Niño 3.4 index from the Climate Forecast System (CFSv2) is examined with respect to ensemble size and configuration. Although the real-time forecast is initialized 4 times per day, it is possible to infer the MSE for arbitrary initialization frequency and for burst ensembles by fitting error covariances to a parametric model and then extrapolating to arbitrary ensemble size and initialization frequency. Applying this method to real-time forecasts, we find that the MSE consistently reaches a minimum for a lagged ensemble size between one and eight days, when four initializations per day are included. This ensemble size is consistent with the 8-10 day lagged ensemble configuration used operationally. Interestingly, the skill of both ensemble configurations is close to the estimated skill of the infinite ensemble. The skill of the weighted, lagged, and burst ensembles are found to be comparable. Certain unphysical features of the estimated error growth were tracked down to problems with the climatology and data discontinuities.

  12. The optimal time of day for training during Ramadan: A review study

    Directory of Open Access Journals (Sweden)

    Hamdi Chtourou

    2014-04-01

    Full Text Available Literature concerning the effects of Ramadan fasting on sports performance presents conflicting results. In this context, some studies reported a significant impairment of sports performance during the month of Ramadan. However, other studies suggested that Ramadan fasting has no significant effect on physical performance.  The discrepancies between the studies could be explained by time-of-day variations in testing. In this regard, recent studies reported that Ramadan negatively affects the afternoon sports performance; however, the morning and the evening (after breaking the fast performances were not affected by fasting. This suggests that the optimal time of day for training during Ramadan is the morning or the evening. Therefore, coaches should schedule the training sessions in the morning or evening during the month of Ramadan. However, further studies should investigate the effect of training at a specific time of day on sports performance during Ramadan.

  13. The Optimal Time of Day for Training during Ramadan: A Review Study

    Directory of Open Access Journals (Sweden)

    Hamdi Chtourou

    2014-03-01

    Full Text Available Literature concerning the effects of Ramadan fasting on sports performance presents conflicting results. In this context, some studies reported a significant impairment of sports performance during the month of Ramadan. However, other studies suggested that Ramadan fasting has no significant effect on physical performance. The discrepancies between the studies could be explained by time-of-day variations in testing. In this regard, recent studies reported that Ramadan negatively affects the afternoon sports performance; however, the morning and the evening (after breaking the fast performances were not affected by fasting. This suggests that the optimal time of day for training during Ramadan is the morning or the evening. Therefore, coaches should schedule the training sessions in the morning or evening during the month of Ramadan. However, further studies should investigate the effect of training at a specific time of day on sports performance during Ramadan.

  14. Home iv Antibiotic Therapy through a Medical Day Care Unit

    Directory of Open Access Journals (Sweden)

    Marie Gourdeau

    1993-01-01

    Full Text Available An out-patient parenteral antibiotic therapy program provided through a medical day care unit was evaluated in a tertiary care hospital. From July 11, 1988 to December 31, 1990, 122 patients were treated either on site at the unit or at home with self-administered intravenous antibiotics. In all, 142 courses of parenteral antibiotics (mostly cephalosporins and clindamycin were given for a total of 124 infections, mostly bone and soft tissue infections (67 of 124, 54%. The duration of out-patient therapy ranged from two to 62 days with a mean duration of 9.4 days if treated at the unit, or 13.2 days in the home care model (1476 patient-days. Vein access was peripheral and catheters remained functional for an average of 4.9 days (range 0.5 to 22 days. Only two patients experienced adverse drug reactions that necessitated modification of treatment. One other case was readmitted to the hospital for surgical debridement. The average cost per patient-day was $66 compared with $375 for in-hospital therapy. This program proved to be safe, efficient, and cost-effective.

  15. Fresh produce consumption and the association between frequency of food shopping, car access, and distance to supermarkets

    Science.gov (United States)

    Gustat, Jeanette; O'Malley, Keelia; Luckett, Brian G.; Johnson, Carolyn C.

    2015-01-01

    Background Fresh fruit and vegetables are important components of a healthy diet. Distance to a supermarket has been associated with the ability to access fresh produce. Methods A randomly sampled telephone survey was conducted with the main shopper for 3000 households in New Orleans, Louisiana in 2011. Individuals were asked where and how often they shopped for groceries, frequency of consumption of a variety of foods, and whether they had access to a car. Bivariate models assessed the relationship between four outcomes: car access, distance to the store patronized by the respondent, number of monthly shopping trips, and daily servings of produce. Structural equation modeling (SEM) was used to distinguish direct and indirect effects. Results In bivariate models, car access was positively associated with number of shopping trips and produce consumption while distance was inversely associated with shopping trips. In SEM models, produce consumption was not associated with car access or distance, but to the number of monthly shopping trips. Conclusion The frequency of shopping is associated with car access but a further distance deters it. Access to stores closer to the shopper may promote more frequent shopping and consumption of produce. PMID:26844049

  16. Right of access to energy

    International Nuclear Information System (INIS)

    Delgado Triana, Yanelys; Fariñas Wong, Ernesto Yoel

    2015-01-01

    Energy is essential for the development of our life and for the development of production capacity. However, a number of people worldwide without this living, specifically power. To the extent that increase energy needs for domestic, industrial and agricultural use, each day more indispensable need access to this recognition as a human right or fundamental respect is made, so some questions in this paper are required both denominations, being essential to consider the emergence and evolution of these. An analysis of the international protection they receive the right of access to energy services, although currently there are no international treaties that specifically recognize it also performs a number of initiatives that promote its preservation manifested and recognized in several abstractly legal instruments, such as declarations, covenants and conventions. (full text)

  17. Primaquine double dose for 7 days is inferior to single-dose treatment for 14 days in preventing Plasmodium vivax recurrent episodes in Suriname

    Directory of Open Access Journals (Sweden)

    Mac Donald-Ottevanger MS

    2017-12-01

    Full Text Available M Sigrid Mac Donald-Ottevanger,1 Malti R Adhin,2 Jeetendra Kumar Jitan,3 Gustavo Bretas,4 Stephen GS Vreden1 1Foundation for Scientific Research Suriname (SWOS, 2Department of Biochemistry, Anton de Kom University of Suriname, 3Department of Public Health, Ministry of Health, Paramaribo, Suriname; 4Independent consultant, Rio de Janeiro, Brazil Background: Recurrent episodes of Plasmodium vivax are caused by dormant liver stages of the parasite, which are not eradicated by choloroquine. Therefore, effective treatment also includes the use of primaquine (PQ. However, this secondary preventive therapy is often not effective, mostly due to poor adherence to the relatively long treatment course, justifying a comparative study of the efficacy of different durations of PQ treatment. Materials and methods: We included patients presenting with an acute and documented P. vivax infection from January 2006 to February 2008. All patients received chloroquine 25 mg/kg over a 3-day period. Subsequently, patients in group 7D received PQ 30 mg/day for 7 days, and patients in group 14D received standard PQ 15 mg/day for 14 days. All doses were given under supervision and patients were followed up for at least 6 months. The Kaplan–Meier method was used to estimate cumulative probability of recurrence up to 12 months after treatment initiation stratified by treatment group. Cox regression was used to assess possible determinants for recurrent parasitemia. Results: Forty-seven of the 79 included patients (59.5% were allocated to group 7D and 32 patients (40.5% were allocated to group 14D. Recurrent parasitemia was detected in 31.9% of the cases in group 7D compared to 12.5% of the cases in group 14D (hazard ratio [HR] =3.36, 95% CI 1.11–10.16. Cumulative probability for recurrent parasitemia at 3, 6, and 12 months was 0.201 (95% CI 0.106–0.362, 0.312 (95% CI 0.190–0.485, and 0.424 (95% CI 0.274– 0.615 for group 7D and 0.100 (95% CI 0.033–0.279, 0

  18. Accessibility of services for early infant diagnosis of Human ...

    African Journals Online (AJOL)

    Accessibility of services for early infant diagnosis of Human Immunodeficiency Virus in sub-Saharan Africa: a systematic review. ... infants who received a virological test within the first 2 months of life in sub-Saharan Africa varied from 3 to 58%, far below the 80% recommended level by the World Health Organization.

  19. Access to diagnostic tests and essential medicines for cardiovascular diseases and diabetes care: cost, availability and affordability in the West Region of Cameroon.

    Directory of Open Access Journals (Sweden)

    Ahmadou M Jingi

    Full Text Available To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD and diabetes in the West region of Cameroon, a low-income setting.A survey was conducted on the availability and cost of twelve routine tests and twenty medicines for CVD and diabetes in eight health districts (four urban and four rural covering over 60% of the population of the region (1.8 million. We analyzed the percentage of tests and medicines available, the median price against the international reference price (median price ratio for the medicines, and affordability in terms of the number of days' wages it would cost the lowest-paid unskilled government worker for initial investigation tests and procurement for one month of treatment.The availability of tests varied between 10% for the ECG to 100% for the fasting blood sugar. The average cost for the initial investigation using the minimum tests cost 29.76 days' wages. The availability of medicines varied from 36.4% to 59.1% in urban and from 9.1% to 50% in rural settings. Only metformin and benzathine-benzylpenicilline had a median price ratio of ≤ 1.5, with statins being largely unaffordable (at least 30.51 days' wages. One month of combination treatment for coronary heart disease costs at least 40.87 days' wages.The investigation and management of patients with medium-to-high cardiovascular risk remains largely unavailable and unaffordable in this setting. An effective non-communicable disease program should lay emphasis on primary prevention, and improve affordable access to essential medicines in public outlets.

  20. An analysis of prediction skill of monthly mean climate variability

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Arun; Chen, Mingyue; Wang, Wanqiu [Climate Prediction Center, National Centers for Environmental Prediction (CPC/NCEP), Camp Springs, MD (United States)

    2011-09-15

    In this paper, lead-time and spatial dependence in skill for prediction of monthly mean climate variability is analyzed. The analysis is based on a set of extensive hindcasts from the Climate Forecast System at the National Centers for Environmental Prediction. The skill characteristics of initialized predictions is also compared with the AMIP simulations forced with the observed sea surface temperature (SST) to quantify the role of initial versus boundary conditions in the prediction of monthly means. The analysis is for prediction of monthly mean SST, precipitation, and 200-hPa height. The results show a rapid decay in skill with lead time for the atmospheric variables in the extratropical latitudes. Further, after a lead-time of approximately 30-40 days, the skill of monthly mean prediction is essentially a boundary forced problem, with SST anomalies in the tropical central/eastern Pacific playing a dominant role. Because of the larger contribution from the atmospheric internal variability to monthly time-averages (compared to seasonal averages), skill for monthly mean prediction associated with boundary forcing is also lower. The analysis indicates that the prospects of skillful prediction of monthly means may remain a challenging problem, and may be limited by inherent limits in predictability. (orig.)

  1. Day-to-day and within-day variation in urinary iodine excretion

    DEFF Research Database (Denmark)

    Rasmussen, Lone Banke; Ovesen, L.; Christiansen, E.

    1999-01-01

    Objective: To examine the day-to-day and within-day variation in urinary iodine excretion and the day-to-day variation in iodine intake. Design: Collection of consecutive 24-h urine samples and casual urine samples over 24 h. Setting: The study population consisted of highly motivated subjects fr...

  2. Influence of age on radioinduced cognitive disorders: Experimental studies with cerebral irradiation of 30 Gy in 10 sessions and 12 days in the Wistar rat at 1.5, 4 and 18 months; Influence de l'age sur les troubles cognitifs radioinduits : etudes experimentales avec irradiation cerebrale de 30 Gy en 10 seances et 12 jours chez le rat Wistar de 1 1/2, 4 et 18 mois

    Energy Technology Data Exchange (ETDEWEB)

    Lamproglou, I. [Lab. de Chimie et Biophysique des Traceurs, Faculte de Medecine Xavier Bichat, Paris (France); Baillet, F.; Boisserie, G.; Mazeron, J.J. [Service de Radiotherapie, Hopital de la Pitie-Salpetriere, Paris (France); Delattre, J.Y. [Dept. of Neurology and Inst. National de la Sante et de la Recherche Medicale, INSERM, Hopital de la Pitie-Salpetriere, Paris (France)

    2002-07-01

    The objective of this study was to determine the influence of age on the learning and memory dysfunction induced by cranial radiation in the male Wistar rat. Ninety-six 45-day-old, 70 4-month-old, and 78 18-month-old male rats were divided in two equal groups: (i) irradiated and (ii) control. A course of whole-brain radiation therapy (30 Gy in 10 fractions over 12 days) was administered to the irradiated group, while the control group received sham irradiation. Sequential behavioral studies including one and two-way avoidance tests were undertaken before and after the 7 months following radiation. The results suggest that radiation induced progressive and irreversible memory dysfunction in elderly (18-month-old) rats, but this effect was partial or almost reversible in the 4-month-old and 45-day-old rats, respectively. In return, the learning dysfunction was age non-dependent despite the fact that is occurs more rapidly in the young (45 days, 4 months) rats. (author)

  3. Intramuscular ketamine to facilitate pediatric central vascular access.

    Science.gov (United States)

    Denmark, T Kent; Hargrove, Jenny R; Brown, Lance

    2004-07-01

    Obtaining prompt vascular access in young children presenting to the emergency department (ED) is frequently both necessary and technically challenging. The objective of our study was to describe our experience using intramuscular (IM) ketamine to facilitate the placement of central venous catheters in children presenting to our ED needing vascular access in a timely fashion. We performed a retrospective medical record review of all pediatric patients central venous catheter facilitated by the use of IM ketamine. Eleven children met our inclusion criteria. Most of the children were young and medically complicated. The children ranged in age from 6 months to 8 years. The only complication identified was vomiting experienced by an 8-year-old boy. Emergency physicians successfully obtained central venous access in all subjects in the case series. The use of IM ketamine to facilitate the placement of central venous catheters in children who do not have peripheral venous access appears to be helpful. Emergency physicians may find it useful to be familiar with this use of IM ketamine.

  4. Field screening of guar (cyamopsis tetragonoloba (l.) taub.) accessions for enhanced forage production on hot drylands

    International Nuclear Information System (INIS)

    Ali, Z.; Ashraf, M.

    2015-01-01

    To explore the high biomass producing accessions of guar (Cyamopsis tetragonoloba (L.) Taub.), under hot and dry conditions, an experiment was conducted under natural field conditions located at Research Station, University College of Agriculture, Sargodha, Pakistan using 36 different accessions. Twenty-day old plants grown under normal irrigation were subjected to control and drought (withholding of irrigation for 20 and 40 days) conditions. It was observed that plant fresh and dry biomass, plant height, net CO/sub 2/ assimilation rate (Pn), transpiration rate (E) and inter CO/sub 2/ conc. (Ci) of all guar accessions under study decreased considerably on withholding of irrigation for both 20 and 40 days. Of all guar accessions, Acc. BR99, 5597, BWP 5595, BWP 5596, BWP 5609, BWP 5611, 24323, Chiniot Black, Khushab Black were relatively higher in plant height and plant biomass (fresh and dry) under water stress conditions. However, a significant increase particularly in BR99, BWP 5595, BWP 5599, BWP 5609, 41671 followed by Sialkot White was observed in the relative membrane permeability of all guar accessions under water limited conditions. All accessions varied significantly in terms of Pn, E and Ci. Accessions BR90, BR99, BWP 5596, 24323, 24332, Chiniot Black, Khushab Black, 41671, 24323, BWP 5611, Khushab White, Mardan, Khanewal Local 2 and Sialkot White were better in Pn, Ci and E. No significant change was observed in the water-use efficiency of guar accessions under water-limited conditions. Overall, BR99, 5597, BWP 5595, BWP 5596, BWP 5609, BWP 5611, 24323, Chiniot Black and Khushab Black were higher, whereas accessions BWP 5595, 24321, Khushab White, Silanwali White, Sialkot Black and Khanewal Local lower in plant biomass and different gas exchange characteristics under water limited conditions, so the earlier mentioned accessions can be recommended as high biomass producing guar accessions for their cultivation on hot drought-prone areas. (author)

  5. Health Care Access and Utilization after the 2010 Pakistan Floods.

    Science.gov (United States)

    Jacquet, Gabrielle A; Kirsch, Thomas; Durrani, Aqsa; Sauer, Lauren; Doocy, Shannon

    2016-10-01

    Introduction The 2010 floods submerged more than one-fifth of Pakistan's land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks. Hypothesis Damage and loss of critical infrastructure will affect the population's ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods. A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance. A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (Pfloods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses. Jacquet GA , Kirsch T , Durrani A , Sauer L , Doocy S . Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485-491.

  6. Exploring the evidence in pediatric hematology and oncology nursing through the "article of the month".

    Science.gov (United States)

    Linder, Lauri

    2010-01-01

    As the scope of pediatric hematology and oncology nursing expands, nurses are challenged with staying current in the evidence guiding their practice. Nurse-reported barriers to accessing and utilizing research include lack of time as well as difficulty in accessing, understanding, and synthesizing findings. Journal clubs provide a process to guide nurses in the review of current literature related to their practice and promote utilization of research and evidence-based practice among nurses. This article describes the transition of an in-person journal club to an electronically delivered "Article of the Month." The "Article of the Month" is offered six times each year and is posted on the service line's password-protected intranet website. Oversight of the "Article of the Month" is provided by the service line clinical nurse specialist who selects articles based on an annual learning needs assessment and develops a quiz to assess learning and promote critical thinking among nursing staff. Outcomes include anecdotal reports of increased staff confidence in managing emergent patient care needs and greater appreciation of nursing care issues for children with cancer. Areas for future development include exploring options for increasing in-person discussion of issues addressed in the "Article of the Month" among staff members, extending the "Article of the Month" to nurses in other service areas who care for children with cancer, and increasing staff participation in article selection and quiz item development. An ultimate goal is to develop formal evaluation strategies to link this educational strategy to clinical outcomes.

  7. Turn-off-the-Month Effect on Stocks in LQ45 Index and Various Sectors in the Indonesia Stock Exchange using GARCH (p,q

    Directory of Open Access Journals (Sweden)

    Galih Pandekar

    2012-01-01

    Full Text Available There are few types of anomalies that occur in the Indonesia Stock Exchange, for example monthly effect, day-of-the-week effect, January effect, holiday effect, and turn-of-the-month effect. The existence of these anomalies is in contrast to the efficient market hypothesis theory, due to a signifi-cant difference in returns during certain periods. By using time-series analysis and the GARCH(p,q method, the existence of the turn-of-the-month effect has been found in the Jakarta Composite Index, sectoral indexes, and stocks in LQ45. The turn-of-the-month effect seems to be seen in the last two days and the four previous days of each month. The January effect does not incite the turn-of-the-month effect. The turn-of-the-month effect appears due to an increasing volume of stocks acquired by investment managers who want to see their portfolio performance better. ";} // -->activate javascript

  8. Efficiency of the kidney disease outcomes quality initiative guidelines for preemptive vascular access in an academic setting.

    Science.gov (United States)

    Kimball, Traci A; Barz, Ken; Dimond, Kelly R; Edwards, James M; Nehler, Mark R

    2011-09-01

    cannulated was 285 days (range, 30-1265 days). Complications encountered were maturation failure for cannulation (15%), focal stenosis requiring intervention (13%), inadequate flows on HD (9%), steal syndrome (9%), and thrombosis (8%). Cumulative functional patency for all AVFs was 19% and 27% at 6 and 12 months, respectively, with a mean number of two interventions per AVF (range, 1-10). Mortality during the study was 23%. Despite successful creation and maturation of a preemptive AVF in nearly two-thirds of patients who started HD during the follow-up and given the following observations: the high overall mortality of the population, the morbidity and costs in secondary procedures of AVF creation, and the high incidence of abandonment, it is unclear if this strategy would demonstrate a benefit in a randomized trial when compared to other access strategies. Copyright © 2011 Society for Vascular Surgery. All rights reserved.

  9. Preliminary Antiplaque Efficacy of Aloe Vera Mouthwash on 4 Day ...

    African Journals Online (AJOL)

    Background: Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it ...

  10. The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Mala Sachdeva

    2012-01-01

    Full Text Available Background. The contribution of the hemodialysis (HD vascular access type to inflammation is unclear. Methods. We conducted a prospective observational study in an incident HD population. C-reactive protein (CRP, interleukin-6 (IL-6, and interferon-γ-induced protein (IP-10 were measured before and at 6-time points after access placement for 1 year. Results. Sixty-four incident HD patients were included (tunneled catheter (TC, =40, arteriovenous fistula (AVF, =14, and arteriovenous graft (AVG, =10. A mixed effects model was performed to adjust for age, sex, race, coronary artery disease, diabetes mellitus, infections, access thrombosis, initiation of HD, and days after access surgery. In comparison to AVFs, the presence of a TC was associated with significantly higher levels of CRP (=0.03, IL-6 (=0.07, and IP-10 (=0.03. The presence of an AVG was associated with increases in CRP (=0.01 and IP-10 (=0.07. Conclusions. Patients who initiate HD with a TC or an AVG have a heightened state of inflammation, which may contribute to the excess 90-day mortality after HD initiation.

  11. Access to scientific publications: the scientist's perspective.

    Directory of Open Access Journals (Sweden)

    Yegor Voronin

    Full Text Available BACKGROUND: Scientific publishing is undergoing significant changes due to the growth of online publications, increases in the number of open access journals, and policies of funders and universities requiring authors to ensure that their publications become publicly accessible. Most studies of the impact of these changes have focused on the growth of articles available through open access or the number of open-access journals. Here, we investigated access to publications at a number of institutes and universities around the world, focusing on publications in HIV vaccine research--an area of biomedical research with special importance to the developing world. METHODS AND FINDINGS: We selected research papers in HIV vaccine research field, creating: 1 a first set of 50 most recently published papers with keywords "HIV vaccine" and 2 a second set of 200 articles randomly selected from those cited in the first set. Access to the majority (80% of the recently published articles required subscription, while cited literature was much more accessible (67% freely available online. Subscriptions at a number of institutions around the world were assessed for providing access to subscription-only articles from the two sets. The access levels varied widely, ranging among institutions from 20% to 90%. Through the WHO-supported HINARI program, institutes in low-income countries had access comparable to that of institutes in the North. Finally, we examined the response rates for reprint requests sent to corresponding authors, a method commonly used before internet access became widespread. Contacting corresponding authors with requests for electronic copies of articles by email resulted in a 55-60% success rate, although in some cases it took up to 1.5 months to get a response. CONCLUSIONS: While research articles are increasingly available on the internet in open access format, institutional subscriptions continue to play an important role. However

  12. Knowledge unbound selected writings on Open Access, 2002-2011

    CERN Document Server

    Suber, Peter

    2016-01-01

    Peter Suber has been a leading advocate for open access since 2001 and has worked full time on issues of open access since 2003. As a professor of philosophy during the early days of the internet, he realized its power and potential as a medium for scholarship. As he writes now, "it was like an asteroid crash, fundamentally changing the environment, challenging dinosaurs to adapt, and challenging all of us to figure out whether we were dinosaurs." When Suber began putting his writings and course materials online for anyone to use for any purpose, he soon experienced the benefits of that wider exposure. In 2001, he started a newsletter -- the Free Online Scholarship Newsletter, which later became the SPARC Open Access Newsletter -- in which he explored the implications of open access for research and scholarship. This book offers a selection of some of Suber's most significant and influential writings on open access from 2002 to 2010. In these texts, Suber makes the case for open access to research; answers c...

  13. 2015 Relaunch as Open Access Pediatric Neurology Briefs

    OpenAIRE

    Millichap, John J.; Millichap, J. Gordon

    2015-01-01

    Pediatric Neurology Briefs (PNB) has been published monthly since 1987 as a continuing education service designed to expedite and facilitate review of current medical literature concerning pediatric neurology. In 2015, PNB is relaunched as an open access, peer-reviewed, journal with an expanded editorial board.  PNB has a new website and content management system capable of organizing peer-review and providing improved...

  14. Access to diagnostics in primary care and the impact on a primary care led health service.

    LENUS (Irish Health Repository)

    O'Riordan, M

    2015-02-01

    We undertook a postal survey of GPs to establish their current access to radiological and endoscopic tests. More than one fifth of GPs do not have direct access to abdominal (n = 42, 21.4%) or pelvic (n = 49, 24.6%) ultrasound in the public system. Where access is available public patients have an average 14 week waiting period. In stark contrast in the private system virtually all GPs have direct access (n = 159, 99.2% and n = 156, 98.8% respectively for abdominal and pelvic ultrasound) with an average wait of just over four days. Direct access to CT scan in the public system is available to the minority of GPs, e.g. n = 31, 18.4% for chest scan, in the public system; even where available, there is an average 12 week wait for this. In comparison 151 (88.6%) GPs have access to CT chest scanning in the private sector with an average waiting time of 5.4 working days. Such limited access to diagnostics impacts on the delivery of a quality service.

  15. Access to a running wheel inhibits the acquisition of cocaine self-administration.

    Science.gov (United States)

    Smith, Mark A; Pitts, Elizabeth G

    2011-12-01

    Physical activity decreases cocaine self-administration in laboratory animals and is associated with positive outcomes in substance abuse treatment programs; however, less is known about its efficacy in preventing the establishment of regular patterns of substance use in drug-naive individuals. The purpose of the present study was to examine the effects of access to a running wheel on the acquisition of cocaine self-administration in experimentally naive rats. Male, Long-Evans rats were obtained at weaning and assigned to sedentary (no wheel) or exercising (access to wheel) conditions immediately upon arrival. After six weeks, rats were surgically implanted with intravenous catheters and placed in operant conditioning chambers for 2 h/day for 15 consecutive days. Each session began with a noncontingent priming infusion of cocaine, followed by a free-operant period in which each response on the active lever produced an infusion of cocaine on a fixed ratio (FR1) schedule of reinforcement. For days 1-5, responding was reinforced with 0.25 mg/kg/infusion cocaine; for days 6-15, responding was reinforced with 0.75 mg/kg/infusion cocaine. In addition, all rats were calorically restricted during days 11-15 to 85% to 95% of their free-feeding body weight. Compared to sedentary rats, exercising rats acquired cocaine self-administration at a significantly slower rate and emitted significantly fewer active lever presses during the 15 days of behavioral testing. These data indicate that access to a running wheel inhibits the acquisition of cocaine self-administration, and that physical activity may be an effective intervention in substance abuse prevention programs. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Science.gov (United States)

    Whittaker, William; Anselmi, Laura; Kristensen, Søren Rud; Lau, Yiu-Shing; Bailey, Simon; Bower, Peter; Checkland, Katherine; Elvey, Rebecca; Rothwell, Katy; Stokes, Jonathan; Hodgson, Damian

    2016-09-01

    Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators. Throughout 2014, 56 primary care practices (346,024 patients) in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients) providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access) in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866), and a 26.6% (95% CI -39.2% to -14.1%) relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184). There was an insignificant relative reduction of 3.1% in total emergency

  17. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Directory of Open Access Journals (Sweden)

    William Whittaker

    2016-09-01

    Full Text Available Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators.Throughout 2014, 56 primary care practices (346,024 patients in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866, and a 26.6% (95% CI -39.2% to -14.1% relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184. There was an insignificant relative reduction of 3.1% in

  18. AIR PRESSURE and Other Data from 19930701 to 19931231 (NCEI Accession 9400072)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The accession contains copy of bathythermograph data in the (TESAC) format. This contains six months data that was sent as radio messages from ships to Ocean...

  19. Automated Computer Access Request System

    Science.gov (United States)

    Snook, Bryan E.

    2010-01-01

    The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

  20. The outcome and complications of the DiaTAP bioCarbon button-graft vascular access device in haemodialysis patients: a two-year experience.

    Science.gov (United States)

    Paul, M D; Parfrey, P; Marshall, D; Aldrete, V; Purchase, L; Gault, H

    1986-01-01

    The outcome and complications which developed in 8 hemodialysis patients who received 12 DiaTAP bioCarbon button vascular-access devices were reviewed. All patients had a poor vascular access history. Three of twelve devices have been replaced because of thrombosis and two because of infection. Four patients have had 10 episodes of reduced blood flow. Streptokinase infusion into the DiaTAP button led to improved blood flow in 8 of 10 episodes. The 6-month survival rate of the DiaTAP access device was 67% and the average functioning life was 9.4 months. It was a valuable form of access when others had failed.

  1. 2015 Relaunch as Open Access Pediatric Neurology Briefs.

    Science.gov (United States)

    Millichap, John J; Millichap, J Gordon

    2015-01-01

    Pediatric Neurology Briefs (PNB) has been published monthly since 1987 as a continuing education service designed to expedite and facilitate review of current medical literature concerning pediatric neurology. In 2015, PNB is relaunched as an open access, peer-reviewed, journal with an expanded editorial board. PNB has a new website and content management system capable of organizing peer-review and providing improved indexing, DOI assignment, and online full-text article view. Digitization of back issues, archiving, and inclusion in PubMed are future goals. The new online open access PNB aims to reach more physicians, researchers, and other healthcare providers with highlights of the latest advances in pediatric neurology and commentaries by specialists in the field.

  2. Crenosoma vulpis infection in a four-month old puppy

    Directory of Open Access Journals (Sweden)

    Matos B.

    2016-09-01

    Full Text Available Here we report the case of a diagnostic and treatment challenge in a four-month old dog from England, presented with one-month history of unproductive cough. Antigen blood test for Angiostrongylus vasorum infection was negative. Thoracic radiographs revealed a generalised bronchointerstitial pattern and bronchoscopy showed moving nematodes in the mucus of the bronchial wall. Additionally, Baermann technique revealed a high burden of larvae per gram of faeces. Morphological and molecular analyses confirmed that they were first stage larvae of Crenosoma vulpis. The infection was firstly treated with a spot-on solution containing 10% imidacloprid + 2.5% moxidectin, but the dog was still positive after 13 days. Therefore, a seven-day course of fenbendazole was prescribed. This represents one of the youngest dogs ever reported naturally infected by C. vulpis. The scant number of reported cases of crenosomosis has led practitioners to consider it as a rare parasitic disease in dogs, delaying a correct and targeted on-time diagnosis. Further studies are needed to perceive the real prevalence of this lungworm and to understand if it is a rare parasite or just rarely diagnosed.

  3. Comparison of access to medicines between Klang Valley and East ...

    African Journals Online (AJOL)

    income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia. Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, ...

  4. Yersinia enterocolitica septicaemia from transfusion of red cell concentrate stored for 16 days.

    OpenAIRE

    Jones, B L; Saw, M H; Hanson, M F; Mackie, M J; Scott, J; Murphy, W G

    1993-01-01

    Two cases of transfusion transmitted Yersinia enterocolitica biotype 3, serotype 09 infection occurred in south east Scotland within four months of each other. In one case, a 79 year old man died the day after receiving a unit of red cell concentrate that had been stored for 29 days after donation. In the second case a 78 year old man died three days after transfusion of a unit of red cell concentrate that had been collected 16 days before transfusion. The donors of both units had no symptoms...

  5. Italian Percutaneous EVAR (IPER) Registry: outcomes of 2381 percutaneous femoral access sites' closure for aortic stent-graft.

    Science.gov (United States)

    Pratesi, G; Barbante, M; Pulli, R; Fargion, A; Dorigo, W; Bisceglie, R; Ippoliti, A; Pratesi, C

    2015-12-01

    The aim of this paper was to report outcomes of endovascular aneurysm repair with percutaneous femoral access (pEVAR) using Prostar XL and Proglide closure systems (Abbot Vascular, Santa Clara, CA, USA), from the multicenter Italian Percutaneous EVAR (IPER) registry. Consecutive patients affected by aortic pathology treated by EVAR with percutaneous access (pEVAR) between January 2010 and December 2014 at seven Italian centers were enrolled in this multicenter registry. All the operators had an experience of at least 50 percutaneous femoral access procedures. Data were prospectively collected into a dedicated online database including patient's demographics, anatomical features, intra- and postoperative outcomes. A retrospective analysis was carried out to report intraoperative and 30-day technical success and access-related complication rate. Uni- and multivariate analyses were performed to identify factors potentially associated with an increased risk of percutaneous pEVAR failure. A total of 2381 accesses were collected in 1322 patients, 1249 (94.4%) male with a mean age of 73.5±8.3 years (range 45-97). The overall technical success rate was 96.8% (2305/2381). Major intraoperative access-related complications requiring conversion to surgical cut-down were observed in 3.2% of the cases (76/2381). One-month pEVAR failure-rate was 0.25% (6/2381). Presence of femoral artery calcifications resulted to be a significant predictor of technical failure (OR: 1.69; 95% CI: 1.03-2.77; P=0.036) at multivariate analysis. No significant association was observed with sex (P=0.28), obesity (P=0.64), CFA diameter (P=0.32), level of CFA bifurcation (P=0.94) and sheath size >18 F (P=0.24). The use of Proglide was associated with a lower failure rate compared to Prostar XL (2.5% vs. 3.3%) despite not statistically significant (P=0.33). The results of the IPER registry confirm the high technical success rate of percutaneous EVAR when performed by experienced operators, even in

  6. Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients.

    Science.gov (United States)

    Spiliopoulos, Stavros; Kitrou, Panagiotis; Christeas, Nikolaos; Karnabatidis, Dimitris

    2016-01-01

    Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head. This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month. Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two <5 cm hematomas (6.6%) not necessitating treatment. In this prospective study, Starclose SE® VCD was safe and effective for hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.

  7. Assessment of unhealthy days among Iranian reproductive age women in 2012.

    Science.gov (United States)

    Jarahi, Lida; Ziaee, Maliheh

    2015-01-01

    Unhealthy days are defined as the number of days during the past 30 days that a woman has not had a feeling of wellbeing. Wellbeing includes the woman's judgments about the level of satisfaction and quality in her life. Assessment of a woman's perception of unhealthy days can be used to help her determine the extent of the burdens associated with mental and physical feelings that things are not going well in her life, job and relationship. This study was conducted to measure unhealthy days and the general health status in Iranian women of reproductive age based on their own perceptions. The participants of this study were women of reproductive age who were referred to health centers in Mashhad, Iran, in 2012. With the stratified random sampling method, 220 women were included in the study. The health-related quality of life-4 (HRQOL-4) questionnaire was used to assess the women's self-perceived unhealthy days. The data that were collected were analyzed by Kruskal-Wallis, chi-squared, Pearson correlation, and logistic linear regression tests with SPSS 11.5. The mean age of the participants was 32.6 years, and the median number of the self-perceived unhealthy days was 7.1 days (per month). In the domains of physical, mental, and disability unhealthy days, the data indicated 2 days, 2.1 days, and 0.1 day in a month, respectively. Also, nearly half of the participants reported that their general health status was poor to fair. The Kruskal-Wallis test showed that there was a significant difference between unhealthy days in the different age groups (p=0.01) as well as for the physical (p=0.02) and mental domains (p=0.4). The results of the regression analysis showed that the number of physical unhealthy days increased with age, number of children, and education. The number of mental unhealthy days increased with age, and the number of disability days increased as the age at which they were married decreased (pWomen with less education who were older than 40, who married

  8. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.

    Science.gov (United States)

    Trepanowski, John F; Kroeger, Cynthia M; Barnosky, Adrienne; Klempel, Monica C; Bhutani, Surabhi; Hoddy, Kristin K; Gabel, Kelsey; Freels, Sally; Rigdon, Joseph; Rood, Jennifer; Ravussin, Eric; Varady, Krista A

    2017-07-01

    Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C

  9. Editorial Challenging barriers to surgical access in lower and middle ...

    African Journals Online (AJOL)

    unmet surgical needs globally.2 Barriers to surgical access lead to delayed presentation of ... educational constraints (First Delay). Once the decision to ... Day of surgery cancellations have implications in both high- and low- income countries.

  10. Reirradiation of head and neck neoplasms using twice-a-day scheduling

    International Nuclear Information System (INIS)

    Tercilla, O.F.; Schmidt-Ullrich, R.; Wazer, D.E.

    1993-01-01

    Between 1985 and 1988, we have explored the value of twice-a-day (BID) irradiation for the retreatment of head and neck neoplasms. In this pilot study of ten patients we used a schedule of BID irradiation at fraction sizes between 1.4 and 1.6 Gy separated by at least 6 h. Of the four patients were treated with curative intent, three patients received 30 Gy in 20 fractions over twelve days followed within ten days by an interstitial/intracavitary Ir-192 implant boost to doses of 30 to 40 Gy and one patient was treated with a 32 Gy BID boost. Four patients were reirradiated with aggressive palliation and received 45 Gy in 30 fractions over 26 days including a break in the third week. The remaining two patients were treated with palliative intent to 30 Gy in 20 fractions over twelve days. Eight patients were treated for recurrent/persistent or second carcinomas, one for a recurrent glomus jugulare tumor. At a median follow-up of 36 months, ranging from six to 61 months, nine of ten patients experienced excellent symptomatic relief. Five patients are alive and free of tumor, one patient is alive with distant metastases, and two each are dead from local or systemic tumor progression. All four patients retreated for cure are alive with no evidence of local disease. The tolerance and tumor control rate of the BID reirradition schedule were good with severe late sequelae in only one patient. (orig.) [de

  11. A Fatal Case of Lithium Battery Ingestion in a 2-Month-Old Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Faiza Safi

    2017-12-01

    Full Text Available Ingestion of batteries by children became more frequent in recent years, due to the increasing accessibility of electronic toys and devices to children. We report a fatal evolution of battery ingestion in a 2-month-old boy.Lithium battery ingestion is a serious condition with high risk of life-threatening complications in childhood and it can be fatal especially in extreme age, under 6 months. Urgent endoscopic removal is the best treatment to reduce the risk of morbidity and mortality.

  12. Dairy cow preference for different types of outdoor access.

    Science.gov (United States)

    Smid, Anne-Marieke C; Weary, Daniel M; Costa, Joao H C; von Keyserlingk, Marina A G

    2018-02-01

    Dairy cows display a partial preference for being outside, but little is known about what aspects of the outdoor environment are important to cows. The primary aim of this study was to test the preference of lactating dairy cattle for pasture versus an outdoor sand pack during the night. A secondary aim was to determine whether feeding and perching behavior changed when cows were provided outdoor access. A third objective was to investigate how the lying behavior of cows changed when given access to different outdoor areas. Ninety-six lactating pregnant cows were assigned to 8 groups of 12 animals each. After a baseline phase of 2 d in which cows were kept inside the freestall barn, cows were habituated to the outdoor areas by providing them access to each of the 2 options for 24 h. Cows were then given access, in random order by group, to either the pasture (pasture phase) or the sand pack (sand phase). As we tested the 2 outdoor options using space allowances consistent with what would be practical on commercial dairy farms, the space provided on pasture was larger (21,000 m 2 ) than that provided on the sand pack (144 m 2 ). Cows were tested at night (for 2 nights in each condition), from 2000 h until morning milking at approximately 0800 h, as preference to be outdoors is strongest at this time. During the next 3 nights cows were given access to both outside options simultaneously (choice phase). Feeding and perching behaviors were recorded when cows were indoors during the day and night periods. Lying behavior was automatically recorded by HOBO data loggers (Onset, Bourne, MA). Cows spent more time outside in the pasture phase (90.0 ± 5.9%) compared with the sand phase (44.4 ± 6.3%). When provided simultaneous access to both options, cows spent more time on pasture than on the sand pack (90.5 ± 2.6% vs. 0.8 ± 0.5%, respectively). Time spent feeding indoors during the day did not change regardless of what type of outdoor access was provided, but there was a

  13. Direct access: how is it working?

    Science.gov (United States)

    Turner, S; Ross, M

    2017-02-10

    Aim The aim of this study was to identify and survey dental hygienists and therapists working in direct access practices in the UK, obtain their views on its benefits and disadvantages, establish which treatments they provided, and what barriers they had encountered.Method The study used a purposive sample of GDC-registered hygienists and therapists working in practices offering direct access, identified through a 'Google' search. An online survey was set up through the University of Edinburgh, and non-responses followed up by post.Results The initial search identified 243 individuals working in direct access practices. Where a practice listed more than one hygienist/therapist, one was randomly selected. This gave a total of 179 potential respondents. Eighty-six responses were received, representing a response rate of 48%. A large majority of respondents (58, 73%) were favourable in their view of the GDC decision to allow direct access, and most thought advantages outnumbered disadvantages for patients, hygienists, therapists and dentists. There were no statistically significant differences in views between hygienists and therapists. Although direct access patients formed a small minority of their caseload for most respondents, it is estimated that on average respondents saw approximately 13 per month. Treatment was mainly restricted to periodontal work, irrespective of whether the respondent was singly or dually qualified. One third of respondents reported encountering barriers to successful practice, including issues relating to teamwork and dentists' unfavourable attitudes. However, almost two thirds (64%) felt that direct access had enhanced their job satisfaction, and 45% felt their clinical skills had increased.Discussion Comments were mainly positive, but sometimes raised worrying issues, for example in respect to training, lack of dental nurse support and the limited availability of periodontal treatment under NHS regulations.

  14. Investigating the relationship between persistent reflux flow on the first postoperative day and recurrent varicocele in varicocelectomy patients.

    Science.gov (United States)

    Cil, Ahmet Said; Bozkurt, Murat; Kara Bozkurt, Duygu; Gok, Mustafa

    2015-01-01

    The aim of this study was to investigate the presence of persistent reflux flow on the first postoperative day using color Doppler sonography (CDS) in patients who had undergone sub-inguinal varicocelectomy, and to research the relationship between persistent reflux flow and recurrent varicocele. A total of 54 patients were included in the study. Ages of the patients were between 21 and 38 years (mean 27.3 ± 7.6). All patients were evaluated four times with CDS: preoperatively, first postoperative day, 3 months postoperative, and finally 6 months after the operation. Preoperative venous diameters were measured between 3 and 5.5 mm; mean vein diameters were 3.8 ± 0.7 mm for the left side and 3.4 ± 0.4 mm for the right side. Mean duration of reflux was 3.5 ± 0.3 seconds on the left side and 2.9 ± 0.7 seconds on the right side. First postoperative day persistent Valsalva-induced reflux flow was seen in 10 patients (18%). Mean venous diameter was measured 1.8 ± 0.9 mm. Three months after the operation, Valsalva-induced reflux flow was seen in two patients (3%) in whom reflux was not seen on the first postoperative day. After 6 months, venous diameters larger than 2 mm at rest and the occurrence of reflux during the Valsalva maneuver were considered to be a recurrence. Six months after the operation, 12 patients had recurrent varicocele. Detecting persistent reflux with CDS on the first postoperative day was found to be 85% sensitive and 100% specific for showing recurrence. Valsalva-induced persistent reflux flow investigated with CDS on the first postoperative day can be used to show success of the surgery and is also an indicator of recurrence in varicocelectomy patients.

  15. Auditing Medical Records Accesses via Healthcare Interaction Networks

    Science.gov (United States)

    Chen, You; Nyemba, Steve; Malin, Bradley

    2012-01-01

    Healthcare organizations are deploying increasingly complex clinical information systems to support patient care. Traditional information security practices (e.g., role-based access control) are embedded in enterprise-level systems, but are insufficient to ensure patient privacy. This is due, in part, to the dynamic nature of healthcare, which makes it difficult to predict which care providers need access to what and when. In this paper, we show that modeling operations at a higher level of granularity (e.g., the departmental level) are stable in the context of a relational network, which may enable more effective auditing strategies. We study three months of access logs from a large academic medical center to illustrate that departmental interaction networks exhibit certain invariants, such as the number, strength, and reciprocity of relationships. We further show that the relations extracted from the network can be leveraged to assess the extent to which a patient’s care satisfies expected organizational behavior. PMID:23304277

  16. Changes of complement values in calves during the first month of life.

    Science.gov (United States)

    Mueller, R; Boothby, J T; Carroll, E J; Panico, L

    1983-05-01

    Hemolytic complement activity and the 3rd component of complement (C3) concentrations were measured in the blood sera of 8 dams before, at, and after parturition, and in the sera of their calves before and after feeding colostrum and at fixed intervals up to 1 month of life. The mean hemolytic titer in the dams, as measured by incubating guinea pig RBC sensitized with bovine natural antibodies in serially diluted serum, was slightly less than 200 and was not influenced by parturition and onset of lactation. The titers in the sera of the calves immediately after birth ranged from 63 to 149 with a mean of 99. One day later, values in all calves had dropped markedly to a mean of 39. During the following month, the titers increased and reached the precolostral levels after about 4 weeks; however, these titers were still far below the titers measured in adult cows. A similar pattern was seen in the C3 concentration. The mean value at birth was 28% of the values measured in adult cows. Values decreased to 18% one day later and increased during the following month to 43% of the adult C3 concentration.

  17. Ultra-processed food product brands on Facebook pages: highly accessed by Brazilians through their marketing techniques.

    Science.gov (United States)

    Horta, Paula M; Rodrigues, Fernanda T; Dos Santos, Luana C

    2018-06-01

    To analyse the content and extent of marketing of ultra-processed food products (UPP) and their brand pages on Facebook, which are highly accessed by Brazilians. Descriptive. Sixteen UPP brand pages on Facebook were selected from 250 pages that were the most liked by Brazilians in October 2015. We analysed the frequency of 'likes' and members 'talking about' each one of the pages, in addition to fifteen marketing techniques used in the previous year (September 2014 to October 2015). The number of posts, likes, 'shares' and 'commentaries', and the mean number of likes, shares and commentaries per post, were collected for one month, from 23 September to 23 October 2015. The two most liked pages were: Coke® (93 673 979 likes) and McDonald's® (59 749 819 likes). Regarding the number of people talking about the pages, McDonald's led with 555 891 commentaries, followed by Coke (287 274), Burger King® (246 148) and Kibon® (244 523). All pages used marketing techniques, which included photos, user conversations, presence of brand elements and links. Videos were observed on 93·8 % of the pages; promotions on 68·8 %; and celebrities on 62·5 %. In one month, Garoto®, Outback® and Coke were brands that published more than one post per day. Kibon achieved the highest ratio of likes per post (285 845·50) and Burger King had the highest mean shares per post (10 083·93), including commentaries per post (7958·13). UPP marketing is extensively used on Facebook pages and is highly accessed by Brazilians, with UPP companies employing a diversity of marketing strategies.

  18. All in a day's work -- women of village Kamad.

    Science.gov (United States)

    Devi, L; Devi, Y; Mendhapurkar, S

    1993-02-01

    The conditions of rural women in villages of Kamad, Dhandi, Kumarkot, and Brahmpuri in Uttar Pradesh in India are revealed in the responses of 3 women to questions about their life. Improvement in women's conditions can be accomplished by empowerment; the women agreed that having women's groups and open discussion would help women stand up to their husbands who beat them or take their money. Conversations with the women were initially blocked by the village men, but after 5 months, dialogues were conducted. The conversations reflect very labor-intensive activity every day regardless of the season. Jungle surrounds the villages and the climate is harsh with both monsoons and snow. Men do not care for their women very well, and health and reproductive functions are neglected. The women are hopeful that things will change. Minu Devi explained that she was bought for Rs.5000 by her husband when she was 6-7 years old, but most now marry at 12-14 years and the girl's father is paid Rs.20,000-30,000. The work day is 18-20 hours. If the husband is disobeyed or the wife refuses to work, the husband tells his wife that he has the right to beat her. Minu's first child was born when she was 13-14, but died within hours. There was no understanding of prenatal or postnatal care. The practice of childbirth was described: living in the cattle house on a bed of paddy husks, and giving birth with the help of a Dai. The mother cuts the umbilical cord with a sickle and heats water to bathe herself and baby. Cooking, squatting, and washing clothes are all performed in the cattle house. A ration of rice and ghee is provided. After 24 hours, the mother must walk to a crossroads and throw away the birth remains and bathe within 3 days. On day 5 she is allowed to go to the river to wash clothes. Others may not touch her clothes and her path is sprinkled with cow urine. Day 11 brings with it some salt for the rice portion. Thereafter she may move to another room although still without

  19. One-day stability test for distillate fuel oils

    Energy Technology Data Exchange (ETDEWEB)

    Gyrath, F W; Dunn, Jr, F R; Smith, Jr, A C

    1958-08-01

    A one-day stability test is described. One liter of oil was placed in a glass bottle along with several steel strips, the bottle was purged with oxygen, sealed, and placed in an oven at 100/sup 0/C (212/sup 0/F) for 24 hours. At the end of the test, the oil was cooled and filtered, and the sediment on the filter was dried and weighed. The results of the one-day test were correlated with the results of storage tests in which oil samples were stored for six months at 29.4/sup 0/C (85/sup 0/F) in 30-gallon steel drums or in glass bottles containing steel strips. At the end of storage, sediment was measured by filtering and weighing. The one-day stability test was also compared with storage in 100-barrel tanks at ambient temperature. The one-day stability test was in good agreement with the storage tests, and could be used to predict the amount of sediment that would be formed in storage.

  20. 76 FR 45574 - Agency Information Collection Request: 30-Day Public Comment Request

    Science.gov (United States)

    2011-07-29

    ... actuaries at health insurers. Data collection activities will be completed within 60 days (two months) of...-administered web survey Chief Actuary at health insurance 408 1 45/60 306 companies. Mary Forbes, Paperwork...

  1. Solving large test-day models by iteration on data and preconditioned conjugate gradient.

    Science.gov (United States)

    Lidauer, M; Strandén, I; Mäntysaari, E A; Pösö, J; Kettunen, A

    1999-12-01

    A preconditioned conjugate gradient method was implemented into an iteration on a program for data estimation of breeding values, and its convergence characteristics were studied. An algorithm was used as a reference in which one fixed effect was solved by Gauss-Seidel method, and other effects were solved by a second-order Jacobi method. Implementation of the preconditioned conjugate gradient required storing four vectors (size equal to number of unknowns in the mixed model equations) in random access memory and reading the data at each round of iteration. The preconditioner comprised diagonal blocks of the coefficient matrix. Comparison of algorithms was based on solutions of mixed model equations obtained by a single-trait animal model and a single-trait, random regression test-day model. Data sets for both models used milk yield records of primiparous Finnish dairy cows. Animal model data comprised 665,629 lactation milk yields and random regression test-day model data of 6,732,765 test-day milk yields. Both models included pedigree information of 1,099,622 animals. The animal model ¿random regression test-day model¿ required 122 ¿305¿ rounds of iteration to converge with the reference algorithm, but only 88 ¿149¿ were required with the preconditioned conjugate gradient. To solve the random regression test-day model with the preconditioned conjugate gradient required 237 megabytes of random access memory and took 14% of the computation time needed by the reference algorithm.

  2. A Clinical Study of the Effectiveness of Two Different 10% Carbamide Peroxide Bleaching Products: A 6-Month Followup

    Directory of Open Access Journals (Sweden)

    S. R. Grobler

    2011-01-01

    Full Text Available The purpose of this study was to evaluate the efficacy of two different 10% carbamide peroxide bleaching products just after treatment and after a 6-month follow-up period. Methods. Two 10% carbamide peroxide products (Opalescence PF and Nite White ACP were applied nightly for 14 days, according to the manufacturers' instructions. The color of teeth 11 and 21 of thirty-four subjects having A2 or darker teeth were measured with a spectrophotometer (L∗;a∗;b∗ before treatment, just after treatment (14 days and after 6 months. Results and Conclusions. Both products produced significant whitening of teeth with total color change (ΔEab∗ of approximately 5.20 units. There was a significant improvement in all 3 color coordinates (L*,a*, and b∗ for up to 6 months postbleaching (P<.05. Nite White showed a higher degree of relapse (27% than Opalescence (18% over the 6-month period. It is suggested that rebleaching after 6 months is not necessary.

  3. Radiological study of the thoracic limb in the growing Iberian pig (from birth to 16 months) [ossification

    International Nuclear Information System (INIS)

    Mayoral, A.J.; Vivo, J.M.; Guillen, M.T.; Regodon, S.

    1995-01-01

    The chronology of the ossification of the thoracic limb of the growing Iberian pig is analyzed by the radiological method, from birth to 482 days (16 months). 48 individuals have been used (24 males, 24 females), from different origins and distributed within 6 age groups : birth(1 day), weaning (58 days), preparation (234 days), beginning (352 days), half (424 days) and end (482 days) of fattening. The appearance and the evolution of the ossification centres were observed, as well as some phenomena occurring during the fusion of the ossification centres

  4. Temporal course of cerebrospinal fluid dynamics and amyloid accumulation in the aging rat brain from three to thirty months

    Directory of Open Access Journals (Sweden)

    Chiu Catherine

    2012-01-01

    Full Text Available Abstract Background Amyloid accumulation in the brain parenchyma is a hallmark of Alzheimer's disease (AD and is seen in normal aging. Alterations in cerebrospinal fluid (CSF dynamics are also associated with normal aging and AD. This study analyzed CSF volume, production and turnover rate in relation to amyloid-beta peptide (Aβ accumulation in the aging rat brain. Methods Aging Fischer 344/Brown-Norway hybrid rats at 3, 12, 20, and 30 months were studied. CSF production was measured by ventriculo-cisternal perfusion with blue dextran in artificial CSF; CSF volume by MRI; and CSF turnover rate by dividing the CSF production rate by the volume of the CSF space. Aβ40 and Aβ42 concentrations in the cortex and hippocampus were measured by ELISA. Results There was a significant linear increase in total cranial CSF volume with age: 3-20 months (p p p p -1 to 12 months (11.30 day-1 and then a decrease to 20 months (10.23 day-1 and 30 months (6.62 day-1. Aβ40 and Aβ42 concentrations in brain increased from 3-30 months (p Conclusions In young rats there is no correlation between CSF turnover and Aβ brain concentrations. After 12 months, CSF turnover decreases as brain Aβ continues to accumulate. This decrease in CSF turnover rate may be one of several clearance pathway alterations that influence age-related accumulation of brain amyloid.

  5. The Fish Assemblage of a Newfoundland Estuary: Diel, Monthly and Annual Variation

    Science.gov (United States)

    Methven, D. A.; Haedrich, R. L.; Rose, G. A.

    2001-06-01

    Twice monthly sampling over two 16 month periods at a shallow site on Newfoundland's east coast showed the fish assemblage to be dominated by four taxa ( Gasterosteus aculeatus, G. wheatlandi, Osmerus mordax, Gadus spp.) that accounted for 96% of the individuals collected. Of the 16 479 fish measured, 65% were adults based on the estimated size of first spawning. The fish assemblage was dominated (86%) by species with demersal eggs, several of which spawn at the same shallow sites used by juveniles as nursery sites. Coastal spawning and demersal eggs maintain offspring in coastal nursery areas where survival is thought to be increased. Number of species and number of fish were both correlated with water temperature being highest from mid-summer to early autumn and lowest in winter. Temperature, time of spawning, and movements of juveniles and adults facilitated grouping species into five assemblages based on seasonal abundance: seasonal periodic species (summer and winter), regular species, regular species collected in all seasons except winter, and occasional (rare) species. At the diel scale, two consistent species groupings were observed: species that showed no significant difference between day and night and species caught primarily at night. Number of night species exceeded day species by a factor of two. No seine-caught species in shallow water exhibited significantly higher catches during the day. Observations by SCUBA divers indicated some species were more abundant during day time at slightly deeper depths. This observation in conjunction with day and night seining in shallower water, suggests these species aggregate in deeper water during day and move to shallow waters at night.

  6. Characterisation of immune responses in healthy foals when a multivalent vaccine protocol was initiated at age 90 or 180 days.

    Science.gov (United States)

    Davis, E G; Bello, N M; Bryan, A J; Hankins, K; Wilkerson, M

    2015-11-01

    Protection from infectious disease requires antigen-specific immunity. In foals, most vaccine protocols are delayed until 6 months to avoid maternal antibody interference. Susceptibility to disease may exist prior to administration of vaccination at age 4-6 months. The aim of this investigation was to characterise immune activation among healthy foals in response to a multivalent vaccine protocol and compare immune responses when foals were vaccinated at age either 90 or 180 days. Randomised block design. Twelve healthy foals with colostral transfer were blocked for age and randomly assigned to vaccination at age 90 days (treatment) or at age 180 days (control). Vaccination protocols included a 3-dose series and booster vaccine administered at age 11 months. Immune response following vaccination at age 90 or 180 days was comparable for several measures of cellular immunity. Antigen specific CD4+ and CD8+ expression of interleukin-4, interferon-γ and granzyme B to eastern equine encephalomyelitis, western equine encephalomyelitis, West Nile virus, tetanus toxoid, equine influenza and equine herpesvirus-1/4 antigens were evident for both groups 30 days after initial vaccine and at age 344 days. Both groups showed a significant increase in antigen-specific immunoglobulin G expression following booster vaccine at age 11 months, thereby indicating memory immune responses. The data presented in this report demonstrate that young foals are capable of immune activation following a 3-dose series with a multivalent vaccine, despite presence of maternal antibodies. Although immune activation does not automatically confer protection, several of the immune indicators measured showed comparable expression in foals vaccinated at 3 months relative to control foals vaccinated at age 6 months. In high-risk situations where immunity may be required earlier than following a conventional vaccine series, our data provide evidence that foals respond to immunisation initiated at 3 months

  7. Spatial distributions of heating, cooling, and industrial degree-days in Turkey

    Science.gov (United States)

    Yildiz, I.; Sosaoglu, B.

    2007-11-01

    The degree-day method is commonly used to estimate energy consumption for heating and cooling in residential, commercial and industrial buildings, as well as in greenhouses, livestock facilities, storage facilities and warehouses. This article presents monthly and yearly averages and spatial distributions of heating, cooling, and industrial degree-days at the base temperatures of 18 °C and 20 °C, 18 °C and 24 °C, and 7 °C and 13 °C, respectively; as well as the corresponding number of days in Turkey. The findings presented here will facilitate the estimation of heating and cooling energy consumption for any residential, commercial and industrial buildings in Turkey, for any period of time (monthly, seasonal, etc.). From this analysis it will also be possible to compare and design alternative building systems in terms of energy efficiencies. If one prefers to use set point temperatures to indicate the resumption of the heating season would also be possible using the provided information in this article. In addition, utility companies and manufacturing/marketing companies of HVAC systems would be able to easily determine the demand, marketing strategies and policies based on the findings in this study.

  8. Assessment of Genetic Diversity of Some Finger Millet (Eleusine coracana (L. Gaertn. Accessions Using Morphological Markers

    Directory of Open Access Journals (Sweden)

    D.V.S. Kaluthanthri

    2017-03-01

    Full Text Available AbstractGermplasm characterization is an important link between conservation and utilizationof plant genetic resources. The study was conducted to characterize randomly selected 20finger millet germplasm accessions obtained from Plant Genetic Resource Center,Gannoruwa, Sri Lanka using morphological markers. Morphological study was carried outusing Randomized Complete Block Design (RCBD and 15 morphological markers wererecorded. Analysis of variance (ANOVA results for quantitative morphological charactersrevealed that all quantitative morphological characters measured differed significantly(p˂0.05 among the accessions used for the study, indicating higher levels of morphologicaldiversity. According to the ANOVA results, days to flowering and days to maturity showhigh level of predictive capability while flag leaf length and number of productive tillersshow comparatively low level of predictive capability. Principal component analysisindicated that morphological characters such as days to flowering, finger number and yieldper plant were the important traits contributing for the overall variability implying thatbreeding effort on those traits can meet the targeted objective. The clustering pattern ofstudied finger millet accessions based on morphological markers comprised of two majorclusters. Both clusters comprised of Indian accessions those conserved at PGRC, Gannoruwaand as well as Sri Lankan accessions.Results of the study suggest a considerable morphological variability, which couldexist among the studied traits. Furthermore, this study revealed that the genetic diversityexisted irrespective to the geographical origin. This finding justifies the importance ofgermplasm characterization.Keywords: Finger Millet, Morphological Markers, Germplasm Accessions, GeneticDiversity, Crop Improvement

  9. Pyrimidine dimers in Drosophila chromatin become increasingly accessible after irradiation

    International Nuclear Information System (INIS)

    Harris, P.V.; Boyd, J.B.

    1987-01-01

    A prokaryotic DNA-repair enzyme has been utilized as a probe for changes in the accessibility of pyrimidine dimers in Drosophila chromatin following UV irradiation. The results demonstrate a rapid cellular response to physiologically relevant doses of radiation which results in at least a 40% increase in accessible dimers. This increase occurs in two incision-deficient mutants which indicates that the excision-repair process, at or beyond the incision step, is not required or responsible for the increase. In the absence of excision the increase in accessibility persists for a least 2 days following irradiation. The observed increase in accessibility is inhibited by both novobiocin and coumermycin. These inhibitors do not inhibit the initial rate of incision, but do reduce dimer excision measured over more extended periods. A pre-incision process is proposed which actively exposes DNA lesions to excision repair. A fraction of the genome is postulated to be accessible without the intervention of that process. (Auth.)

  10. Accessibility evaluation of the IFMIF liquid lithium loop considering activated erosion/corrosion materials deposition

    International Nuclear Information System (INIS)

    Nakamura, H.; Takemura, M.; Yamauchi, M.; Fischer, U.; Ida, M.; Mori, S.; Nishitani, T.; Simakov, S.; Sugimoto, M.

    2005-01-01

    This paper presents an evaluation of accessibility of the Li loop piping considering activated corrosion product. International Fusion Materials Irradiation Facility (IFMIF) is a deuteron-lithium (Li) stripping reaction neutron source for fusion materials testing. Target assembly and back wall are designed as fully remote maintenance component. Accessibility around the Li loop piping will depend on activation level of the deposition materials due to the back wall erosion/corrosion process under liquid Li flow. Activation level of the corrosion products coming from the AISI 316LN back wall is calculated by the ACT-4 of the THIDA-2 code system. The total activities after 1 day, 1 week, 1 month and 1 year cooling are 3.1 x 10 14 , 2.8 x 10 14 , 2.3 x 10 14 and 7.5 x 10 13 Bq/kg, respectively. Radiation dose rate around the Li loop pipe is calculated by QAD-CGGP2R code. Activated area of the back wall is 100 cm 2 . Corrosion rate is assumed 1 μm/year. When 10% of the corrosion material is supposed to be deposited on the inner surface of the pipe, the dose rate is calculated to be less than a permissible level of 10 μSv/h for hands-on maintenance, therefore, the maintenance work is assessed to be possible

  11. Traumatic Maculopathy 6 Months after Injury: A Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Sílvia Mendes

    2014-03-01

    Full Text Available Purpose: This study aims to report a case of traumatic maculopathy in a 12-year-old male following blunt trauma in his left eye (LE who presented 6 months after injury. Methods: Retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results: A previously healthy, 12-year-old male presented for a routine visit with complaints of a 2-month history of decreased visual acuity in his LE. Six months before the initial visit, he suffered blunt trauma to the LE during a struggle and had no medical observation. At the visit, best-corrected visual acuity (BCVA in the LE was counting fingers and in the right eye, it was 20/20. Fundus examination of the LE showed a central macular lesion of 1 disc diameter with fibrosis, increased retinal thickness and intraretinal hemorrhage. Optical coherence tomography showed disruption of the inner/outer segment (IS/OS photoreceptor junction, increased reflectivity, cell infiltration of the retinal wall and retinal pigment epithelium detachment. Retinal thickness was 289 μm at the site of the lesion. A fluorescein angiogram revealed early impregnation and late diffusion. High-dose steroid pulse therapy (intravenous methylprednisolone 500 mg for 3 days and oral prednisolone 30 mg, tapering for 10 days was done. LE BCVA increased to 20/200, and retinal thickness decreased by 71 μm 1 week after treatment. Off-label intravitreal triamcinolone (IVTA; 0.05 ml/2 mg was administered 2 weeks after oral treatment in an attempt to achieve additional improvement. Three weeks after IVTA, LE BCVA improved to 20/150 and retinal thickness decreased by 10 μm. Three months after the initial visit, LE BCVA was 20/125 and retinal thickness 208 μm. Conclusion: We present a case of commotio retinae caused by an ocular blunt trauma 6 months before, with loss of BCVA. BCVA improved after oral steroids and IVTA. Nevertheless, fibrosis and disruption of the IS

  12. Antarctica Day: An International Celebration

    Science.gov (United States)

    Pope, A.; Hambrook Berkman, J.; Berkman, P. A.

    2013-12-01

    involving the International Association of Antarctic Tour Operators; and public lectures and online videos (including a notable submission from Polar Educators International). Antarctica Day was initiated as a legacy of the 2009 Antarctic Treaty Summit (www.atsumit50.aq), which was convened at the Smithsonian Institution with 40 sponsoring institutions from around the world as part of the International Polar Year. Antarctic Day involved participants from 14 nations in 2010. 28 nations in 2011, and 26 nations in 2012 with representatives from all 7 continents. Antarctica Day 2013 will have recently taken place before the AGU Fall Meeting 2013, and we will present updates at that time. Our aim is to continue expanding Antarctica Day as a globally-accessible platform to share, interpret and cherish the values associated with Antarctica for the benefit of present and future generations. We look forward to the discussion and sharing that this session will provide.

  13. International Women's Day observed in Malaysia.

    Science.gov (United States)

    1999-12-01

    On the eve of International Women's Day, 80 women representing five women's groups in Malaysia, including Persatuan Sahabat Wanita, CAW's network member, marched from Petaling Jaya to Penang to attend the Women's Day celebration. The group had organized the visitation in order to strengthen its networking. During their meeting with some reporters before their departure to Penang, they demanded that the women's groups be consulted before any guideline on the prevention and handling of sexual harassment at the workplace is drawn up. They said that they have been handling several complaints and their input would help the Human Resource Ministry formulate a comprehensive set of guidelines. This demand by the women's group was in response to the announcement by the Human Resource Minister Datuk Lim Ah Lek that in a month time a code would be ready on guidelines about the establishment and implementation of in-house preventive and redress mechanisms for dealing with sexual harassment. full text

  14. Two-day thionamide withdrawal prior to radioiodine uptake sufficiently increases uptake and does not exacerbate hyperthyroidism compared to 7-day withdrawal in Graves' disease

    International Nuclear Information System (INIS)

    Kubota, Sumihisa; Ohye, Hidemi; Yano, Genichiro; Nishihara, Eijun; Kudo, Takumi; Ito, Mitsuru; Fukata, Shuji; Amino, Nobuyuki; Kuma, Kanji; Miyauchi, Akira

    2006-01-01

    The appropriate period of antithyroid drug (ATD) discontinuation before radioiodine therapy is the most critical problem in Graves' disease patients under going treatment with ATD. To determine the optimal period that does not alter the outcome of radioiodine therapy or exacerbate hyperthyroidism, we compared serum FT4 levels at radioiodine uptake (RAIU) and therapy outcomes between a 2-day withdrawal group and 7-day withdrawal group. We prospectively recruited 43 patients for the 2-day withdrawal protocol and retrospectively reviewed 49 patients treated with radioiodine following the protocol of 7-day withdrawal. There was no significant difference in RAIU between the 2 groups. The mean serum FT4 level measured on the first day of 24-h RAIU of the 7-day group was significantly higher than that in the 2-day group. There were no significant differences in the outcomes at each point (6 months, 1 year, and 2 years after therapy) between the 2 groups. Our results indicated that withdrawal of ATD for 2 days is superior to 7 days in that 2 days discontinuation did not exacerbate hyperthyroidism. In order to prevent serum thyroid hormone increase after ATD withdrawal and radioiodine therapy, a 2-day ATD withdrawal period before radioiodine therapy may be useful for high-risk patients such as the elderly and patients with cardiac complications. We believe that the 2-day ATD withdrawal method may be useful for patients undergoing treatment with ATD who are to undergo radioiodine therapy. (author)

  15. Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

    Science.gov (United States)

    Narayan, Anand; Lobner, Katie; Fritz, Jan

    2018-02-01

    The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. SEA SURFACE TEMPERATURE and Other Data from MULTIPLE SHIPS From Sea of Japan from 19930101 to 19930630 (NODC Accession 9300173)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The sea surface temperature data in this accession was collected in Sea of Japan. Data in this accession was collected over a six month period from thermistor. The...

  17. Day-case tonsillectomy: practical solution or practical impossibility.

    LENUS (Irish Health Repository)

    Kharytaniuk, N

    2015-01-01

    The use of day case surgery is on the rise. In order to improve efficiency and reduce cost, it has been proposed that tonsillectomy could be undertaken as a day-case procedure in Ireland. A retrospective, chart-based study was carried out. The medical and social criteria of all patients who underwent tonsillectomy during a twelve-month period were evaluated. Individual, local and national factors were identified and international comparisons were made. Of 161 patients included, 43 (27%) were considered suitable for day case tonsillectomy (DCT). The distance\\/time criteria from hospital excluded 64% of patients. The diagnosis of obstructive sleep apnoea was the single most common medical reason for exclusion. Support structures were deficient. Local factors must be considered before any policy or targets are developed for DCT. Patient safety is the fundamental tenet. Currently, the infrastructure and the support required for a patient-focused, safe efficient DCT are deficient, and need investment.

  18. Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

    Science.gov (United States)

    Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

    2014-11-01

    Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian

  19. Growth rate correlates negatively with protein turnover in Arabidopsis accessions.

    Science.gov (United States)

    Ishihara, Hirofumi; Moraes, Thiago Alexandre; Pyl, Eva-Theresa; Schulze, Waltraud X; Obata, Toshihiro; Scheffel, André; Fernie, Alisdair R; Sulpice, Ronan; Stitt, Mark

    2017-08-01

    Previous studies with Arabidopsis accessions revealed that biomass correlates negatively to dusk starch content and total protein, and positively to the maximum activities of enzymes in photosynthesis. We hypothesized that large accessions have lower ribosome abundance and lower rates of protein synthesis, and that this is compensated by lower rates of protein degradation. This would increase growth efficiency and allow more investment in photosynthetic machinery. We analysed ribosome abundance and polysome loading in 19 accessions, modelled the rates of protein synthesis and compared them with the observed rate of growth. Large accessions contained less ribosomes than small accessions, due mainly to cytosolic ribosome abundance falling at night in large accessions. The modelled rates of protein synthesis resembled those required for growth in large accessions, but were up to 30% in excess in small accessions. We then employed 13 CO 2 pulse-chase labelling to measure the rates of protein synthesis and degradation in 13 accessions. Small accessions had a slightly higher rate of protein synthesis and much higher rates of protein degradation than large accessions. Protein turnover was negligible in large accessions but equivalent to up to 30% of synthesised protein day -1 in small accessions. We discuss to what extent the decrease in growth in small accessions can be quantitatively explained by known costs of protein turnover and what factors may lead to the altered diurnal dynamics and increase of ribosome abundance in small accessions, and propose that there is a trade-off between protein turnover and maximisation of growth rate. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

  20. Consumo alimentar de crianças de 6 a 18 meses em creches Six to eighteen-month-old children's food intake in day-care centers

    Directory of Open Access Journals (Sweden)

    Mônica Glória Neumann Spinelli

    2003-12-01

    Full Text Available OBJETIVO: Verificar o consumo alimentar de crianças entre 6 e 18 meses e avaliar a adequação de nutrientes. MÉTODOS: O estudo foi realizado com 106 crianças em creches do Município de São Paulo. Para verificar o consumo alimentar utilizou-se o método de pesagem direta, durante cinco dias. Para análise dos macro e micronutrientes utilizaram-se as referências Organización Mundial de la Salud 1985 e Dietary Reference Intakes 1997, e para fibras adotou-se a recomendação da American Academy of Pediatrics 1993. RESULTADOS: O estudo revelou oferta insuficiente de energia, ferro, cálcio, vitamina A e fibras. A proteína e a vitamina C excederam as recomendações. CONCLUSÃO: Nos moldes do programa atual, é necessário que a criança receba, no domicílio, uma refeição láctea e outra salgada para complementar principalmente cálcio, energia, ferro e fibras.OBJECTIVE: To verify the food intake of children from 6 to 18 months old and to evaluate nutrient adequacy. METHODS: This study was carried out with 106 children, in day-care centers from the city of São Paulo. Food intake was evaluated through food weighing during five days. The Organización Mundial de la Salud, 1985, Dietary Reference Intakes, 1997 and American Academy of Pediatrics, 1993 were used as references for the analysis of macronutrients, micronutrientes and fibers, respectively. RESULTS: The study revealed insufficient offering of energy, iron, calcium, vitamin A and fiber. Protein and vitamin C were over the recommended amounts. CONCLUSION: The children must receive one milky and one salty meal at home in order to complement food given at centers, mainly regarding, calcium, iron, energy and fiber.

  1. [Etiology and clinical course of urinary tract infections in infants less than 3 months-old].

    Science.gov (United States)

    Hernández-Bou, Susanna; Trenchs Sainz de la Maza, Victoria; Alarcón Gamarra, Marcela; Camacho Díaz, Juan A; Gené Giralt, Amadeu; Luaces Cubells, Carles

    2015-10-01

    Infants less than 3 months of age with urinary tract infection are usually hospitalized. Recent studies show that a less aggressive management for those patients aged ≥ 29 days may be feasible. To determine the complication rate in infantsurinary tract infection, and to identify the causative agents and their antibiotic susceptibility. A retrospective study was conducted on infants<3 months of age with positive urinalysis results, together with a positive urine culture from a catheterized specimen and seen in the Emergency Department from 2007 to 2012. Demographics, clinical and microbiology (microorganism isolated and antibiotic susceptibility) data were collected. The complications rate (bacteremia, bacterial meningitis, renal abscess, surgical intervention, Intensive Care Unit admission, or death) were calculated for the overall sample and for different age groups (<29, 29-60, and 61-90 days). A total of 460 patients are included; 137 (29.8%)<29, 166 (36.1%) 29-60, and 157 (34.1%) 61-90 days of age. Twenty four (5.4%; 95% CI: 3.6-7.8) had bacteremia; 15 (10.9%; 95% CI: 6.7-17.3) were<29 days; 8 (4.9%; 95% CI: 2.5-9.4) were 29-60 days, and one (0.7%; 95% CI: 0.1-3.7) was 61-90 days of age (P<.001). One neonate (0.8%; 95% CI: 0.1-4.1) had bacterial meningitis, and 2, renal abscess. Escherichia coli was the common pathogen identified (87.2%) in the urine culture, with a susceptibility to amoxicillin-clavulanate, gentamicin, and cefixime of 89.2, 97.0, and 96.0%, respectively. Complications are low in infants<3 months of age with UTI, especially in those ≥ 29 days of age. The identification of patients at very low risk for complications would allow a less aggressive management. Escherichia coli antibiotic susceptibility remains stable, but continuing careful surveillance is essential to optimize empirical antibiotic treatment. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights

  2. Young Children in Day and Night Care: Negotiating and Constructing Belonging during Daily Arrivals

    Science.gov (United States)

    Salonen, Eija; Laakso, Marja-Leena; Sevón, Eija

    2016-01-01

    The paper aims at understanding the processes related to young children's belonging during daily arrivals at day and night care. Two aspects of a child's belonging are considered: membership and sense of belonging. Data were gathered by ethnographic observation of 8 children aged from 20 to 36 months in two Finnish day care centres offering day…

  3. Minimal access surgery for mitral valve endocarditis.

    Science.gov (United States)

    Barbero, Cristina; Marchetto, Giovanni; Ricci, Davide; Mancuso, Samuel; Boffini, Massimo; Cecchi, Enrico; De Rosa, Francesco Giuseppe; Rinaldi, Mauro

    2017-08-01

    Minimal access mitral valve surgery (MVS) has already proved to be feasible and effective with low perioperative mortality and excellent long-term outcomes. However, experience in more complex valve diseases such as infective endocarditis (IE) still remains limited. The aim of this retrospective study was to evaluate early and long-term results of minimal access MVS for IE. Data were entered into a dedicated database. Analysis was performed retrospectively for the 8-year period between January 2007 and April 2015. During the study period, 35 consecutive patients underwent minimal access MVS for IE at our department. Twenty-four had diagnosis of native MV endocarditis (68.6%) and 11 of mitral prosthesis endocarditis (31.4%).Thirty patients underwent early MVS (85.7%), and 5 patients were operated after the completion of antibiotic treatment (14.3%). Seven patients underwent MV repair (20%), 17 patients underwent MV replacement (48.6%), and 11 patients underwent mitral prosthesis replacement (31.4%). Thirty-day mortality was 11.4% (4 patients). No neurological or vascular complications were reported. One patient underwent reoperation for prosthesis IE relapse after 37 days. Overall actuarial survival rate at 1 and 5 years was 83%; freedom from MV reoperation and/or recurrence of IE at 1 and 5 years was 97%. Minimally invasive MVS for IE is feasible and associated with good early and long-term results. Preoperative accurate patient selection and transoesophageal echocardiography evaluation is mandatory for surgical planning. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  4. Paid sick days and stay-at-home behavior for influenza.

    Directory of Open Access Journals (Sweden)

    Kaitlin Piper

    Full Text Available Access to paid sick days (PSD differs by workplace size, race/ethnicity, gender, and income in the United States. It is not known to what extent decisions to stay home from work when sick with infectious illnesses such as influenza depend on PSD access, and whether access impacts certain demographic groups more than others. We examined demographic and workplace characteristics (including access to PSD associated with employees' decisions to stay home from work for their own or a child's illness. Linking the 2009 Medical Expenditure Panel Survey (MEPS consolidated data file to the medical conditions file, we used multivariate Poisson regression models with robust variance estimates to identify factors associated with missed work for an employee's own or a child's illness/injury, influenza-like-illness (ILI, and influenza. Controlling for gender, race/ethnicity, education, and income, access to PSD was associated with a higher probability of staying home for an employee's own illness/injury, ILI, or influenza, and for a child's illness/injury. Hispanic ethnicity was associated with a lower prevalence of staying home for the employee's own or a child's illness compared to non-Hispanic Whites. Access to PSD was associated with a significantly greater increase in the probability of staying home among Hispanics than among non-Hispanic Whites. Women had a significantly higher probability of staying home for their child's illness compared to men, suggesting that women remain the primary caregivers for ill children. Our results indicate that PSD access is important to encourage employees to stay home from work when sick with ILI or influenza. Also, PSD access may be important to enable stay-at-home behavior among Hispanics. We conclude that access to PSD is likely to reduce the spread of disease in workplaces by increasing the rate at which sick employees stay home from work, and reduce the economic burden of staying home on minorities, women, and

  5. Single-Access Laparoscopic Surgery for Ileal Disease

    Directory of Open Access Journals (Sweden)

    Mohamed Moftah

    2012-01-01

    Full Text Available Aim. Single-access laparoscopic surgery (SALS can be effective for benign and malignant diseases of the ileum in both the elective and urgent setting. Methods. Ten consecutive, nonselected patients with ileal disease requiring surgery over a twelve month period were included. All had a preoperative abdominopelvic computerized tomogram. Peritoneal access was achieved via a single transumbilical incision and a “surgical glove port” utilized as our preferred access device. With the pneumoperitoneum established, the relevant ileal loop was located using standard rigid instruments. For ileal resection, anastomosis, or enterotomy, the site of pathology was delivered and addressed extracorporeally. Result. The median (range age of the patients was 42.5 (22–78 years, and the median body mass index was 22 (20.2–28 kg/m2. Procedures included tru-cut biopsy of an ileal mesenteric mass, loop ileostomy and ileotomy for impacted gallstone extraction as well as ileal (=3 and ileocaecal resection (=4. Mean (range incision length was 2.5 (2–5 cm. All convalescences were uncomplicated. Conclusions. These preliminary results show that SALS is an efficient and safe modality for the surgical management of ileal disease with all the advantages of minimal access surgery and without requiring a significant increase in theatre resource or cost or incurring extra patient morbidity.

  6. Building the capacity of family day care educators to promote children's social and emotional wellbeing: an exploratory cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sims Margaret

    2011-11-01

    Full Text Available Abstract Background Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children's social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children's mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of "Thrive," an intervention program to build the capacity of family day care educators to promote children's social and emotional wellbeing. Thrive aims to increase educators' knowledge, confidence and skills in promoting children's social and emotional wellbeing. Methods/Design This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5 who each supervise 10-15 educators. The intervention group (field workers and educators will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children's social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70 assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post

  7. Remote Sensing Open Access Journal: Leading a New Paradigm in Publishing

    Directory of Open Access Journals (Sweden)

    Prasad S. Thenkabail

    2011-12-01

    Full Text Available Remote Sensing is a pathfinding open access journal providing great opportunities for the growing community of remote sensing and geoscience scientists and practitioners to publish high quality research and practical papers expeditiously. It is a journal keeping up with the changing times we live in: open access, instant access, free access, and global access from whichever precise latitude and longitude you live in on the planet Earth or for that matter anywhere in space as long as we have internet access! So, open access journals are breaking many paradigms and setting forth new ones that will soon become the norm as we advance into the twenty-first century. The days of inordinate delays in publishing good science research articles are fast disappearing with open access journals. In remote sensing and geoscience, Remote Sensing (http://www.mdpi.com/journal/remotesensing/ is one of the pioneers, thanks to the vision of Dr. Shu-Kun Lin, the publisher. It started in the year 2009 with headquarters in Basel, Switzerland and a branch office in Beijing, China. It will soon complete Volume 3 by the end of 2011.

  8. Nutrient intake of children (36 months) fed fermented foods in urban ...

    African Journals Online (AJOL)

    A 3-day weighed food intake study was conducted with 200 children aged 36 months in two urban and rural communities in Anambra and Enugu states. Means, standard error of the mean and Duncan's multiple range test were the statistical tools used to analyze the data. The daily mean energy intake, protein, thiamin, ...

  9. Comparison of Axillary Loop and Straight Grafts Patency and Their Complications for Hemodialylis Access

    Directory of Open Access Journals (Sweden)

    J KHoshnevis

    2011-08-01

    Full Text Available Introduction & Objective: Dialysis vascular access complications are important causes of morbidity in chronic hemodialysis patients. The aim of the present study was a comparison of auxillary loop and atraight grafts patency and its complications for hemodialysis access. Materials & Methods: In this cohort study conducted at Shahid Beheshti Medical University, 58 patients who underwent placement of loop or straight access grafts were included in the study. Demographics, primary and secondary patency rates and complications like thrombosis, infection, bleeding, steal syndrome and other complications were compared in these two groups. The collected data was analyzed by the SPSS statistical software using the chi-square test, t-test, and logistic regression. Results: Thrombosis rates were 51.1% and 53.8% in straight and loop groups respectively (P=0.862, steal syndrome rates were 2.2% and 7.7% in straight and loop groups respectively (P=0.341, psudoanevrism were 11.1% and 23.1% in straight and loop groups respectively (P=0.270, bleeding rates were 4.4% and 0% in straight and loop groups respectively (P=0.439, infection rate were 8.9% and 7.7% in straight and loop groups respectively (P=0.892, and primary patency rate after 1 month were 88.9% and 92.3% respectively (P=0.721, and primary patency rate after 24 month were 31% and 55.5% respectively (P=0.058. Secondary patency rate after 3 month were 75.6% and 92.3% respectively (P=0.189, and secondary patency rate after 24 month were 37.9% and 66.7% respectively (P=0.044. Conclusion: PTFE vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, there was no significant different between two groups for complications and early patency, but late patency was better in loop group. More study is necessary for final judgment.

  10. Evaluation of the challenges faced in increasing contraceptive access within a community college population.

    Science.gov (United States)

    Lamme, Jacqueline; Edelman, Alison; Padua, Emily; Jensen, Jeffrey T

    2017-01-01

    Research demonstrates removing barriers to access, decreasing costs and offering same-day placement of long-acting reversible contraception (LARC) increases contraceptive uptake in young women. For those in community college (CC), LARC utilization might reduce the risk of dropout and improve degree completion. We identified a local school who had documented an unmet need for on-campus services through a recent student assessment. We then established an on-campus, same day contraceptive clinic at the CC as part of a clinical trial. We found that students did not use the service even after multiple attempts to increase awareness and we ended the study. Here, we report lessons learned from attempting research in this environment in addition to results from a follow-up survey to determine why students did not access the clinical resource. Students reported that they already had good access to contraception and preferred to get their healthcare off-campus. This study demonstrates the complexities of studying highly focused interventions to influence access to care in the current health care environment with ever changing regulations. NCT02735551 . Registered April 6, 2016.

  11. Long-Term Retention in 3.5-Month-Olds: Familiarization Time and Individual Differences in Attentional Style.

    Science.gov (United States)

    Courage, Mary L.; Howe, Mark L.

    2001-01-01

    Examined effect of familiarization on 3.5-month-olds' retention of visual stimuli with varying delay times. Found support for retention models in which direction of attentional preferences (novel, familiar, or null) depends on memory accessibility. Short lookers showed better retention over time than long lookers, indicating that much of the…

  12. 47 CFR 76.975 - Commercial leased access dispute resolution.

    Science.gov (United States)

    2010-10-01

    ... declaration and the party submitting the protected material. The Commission has full authority to fashion... leased access complaint within 90 days of the close of the pleading cycle. (2) The Media Bureau, after... the proposals or choose to fashion its own remedy. (i) During the pendency of a dispute, a party...

  13. Results of a customer-based, post-market surveillance survey of the HeRO access device.

    Science.gov (United States)

    Fusselman, Maureen

    2010-08-01

    In order to supplement post-market surveillance data on the HeRO vascular access device, a non-scientific customer survey was conducted to obtain quantitative data from dialysis providers caring for patients implanted with the device. Dialysis nurses involved in the care of HeRO patients were contacted in order to obtain post-implant device performance information for 10% of patients implanted with the device at the time of the survey. Thirty-eight dialysis units with a total of 65 HeRO patients participated in the survey. The total duration of HeRO device use was 348.4 months with an average use of 5.4 months. Thirty-eight of the 65 HeRO patients (58.5%) were reported to not have experienced any performance issues. There were 28 device performance incidents reported for the remaining 27 patients included in the survey. Occlusion was the single most commonly reported device-related performance issue with 18 patients (27.7%) experiencing 25 occlusive episodes. The majority of the patients who had an occlusion (66.7%) only experienced one occlusive event. Infections occurred in 4 patients (6.2%) with an overall infection rate of 0.38 per 1,000 patient days. Post-market clinical experience during the first 18 months of commercialization of the HeRO device were in line with expectations based on the results from initial clinical studies with the device. Device occlusion remains the most commonly reported performance issue with the reported rate in this survey less than that which was reported in earlier published studies with the device.

  14. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China.

    Science.gov (United States)

    Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

    2015-06-26

    This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

  15. The relation between residential property and its surroundings and day- and night-time residential burglary

    NARCIS (Netherlands)

    Montoya, Lorena; Junger, Marianne; Ongena, Yfke

    This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

  16. The Relation Between Residential Property and its Surroundings and Day- and Night-Time Residential Burglary

    NARCIS (Netherlands)

    Montoya, L.; Junger, Marianne; Ongena, Yfke

    This article examines how residential property and its surroundings influence day- and night-time residential burglary. Crime Prevention Through Environmental Design (CPTED) principles of territoriality, surveillance, access control, target hardening, image maintenance, and activity support underpin

  17. Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department.

    Science.gov (United States)

    Southard, Erik P; Neufeld, Jonathan D; Laws, Stephanie

    2014-07-01

    Mentally ill patients in crisis presenting to critical access hospital emergency rooms often face exorbitant wait times to be evaluated by a trained mental health provider. Patients may be discharged from the hospital before receiving an evaluation or boarded in a hospital bed for observation, reducing quality and increasing costs. This study examined the effectiveness of an emergency telemental health evaluation service implemented in a rural hospital emergency room. Retrospective data collection was implemented to consider patients presenting to the emergency room for 212 days prior to telemedicine interventions and for 184 days after. The study compared measures of time to treatment, length of stay (regardless of inpatient or outpatient status), and door-to-consult time. There were 24 patients seen before telemedicine was implemented and 38 seen using telemedicine. All patients had a mental health evaluation ordered by a physician and completed by a mental health specialist. Significant reductions in all three time measures were observed. Mean and median times to consult were reduced from 16.2 h (standard deviation=13.2 h) and 14.2 h, respectively, to 5.4 h (standard deviation =6.4 h) and 2.6 h. Similar reductions in length of stay and door-to-consult times were observed. By t tests, use of telemedicine was associated with a statistically significant reduction in all three outcome measures. Telemedicine appears to be an effective intervention for mentally ill patients by providing more timely access to mental health evaluations in rural hospital emergency departments.

  18. Between Anzac Day and Waitangi Day

    Directory of Open Access Journals (Sweden)

    Czerwińska Anna

    2017-12-01

    Full Text Available This paper discusses the historical background and significance of the two most important national holidays in New Zealand: Waitangi Day and Anzac Day. Waitangi Day is celebrated on the 6th February and it commemorates the signing of the Treaty of Waitangi between British representatives and a number of Māori chiefs in 1840. Following the signing of the treaty New Zealand became effectively a British colony. Anzac Day is celebrated on 25th April, i.e., on the anniversary of the landing of soldiers of the Australian and New Zealand Army Corps (ANZAC on the Gallipoli peninsula in Turkey in 1915, during World War One. There are three major differences between these two holidays: the process of those days becoming national holidays, the level of contestation, and the changing messages they have carried. The present study analyzes the national discourse around Anzac Day and Waitangi Day in New Zealand, and attempts to reveal how the official New Zealand government rhetoric about national unity becomes deconstructed. The following analysis is based on a selection of online articles from the New Zealand Herald and Stuff published in Auckland and Wellington, respectively. Both cities are populated by multi-ethnic groups, with Auckland featuring the largest Māori population.

  19. Impact of immediate access to the electronic medical record on anatomic pathology performance.

    Science.gov (United States)

    Renshaw, Andrew A; Gould, Edwin W

    2013-07-01

    To assess the overall impact of access to the electronic medical record (EMR) on anatomic pathology performance. We reviewed the results of all use of the EMR by 1 pathologist over an 18-month period. Of the 10,107 cases (913 cytology and 9,194 surgical pathology) reviewed, the EMR (excluding anatomic pathology records) was accessed in 222 (2.2% of all cases, 6.5% of all cytology cases, and 1.8% of all surgical pathology cases). The EMR was used to evaluate a critical value in 20 (9.0%) cases and make a more specific diagnosis in 77 (34.7%) cases, a less specific diagnosis in 4 (1.8%) cases, and a systemic rather than localized diagnosis in 4 (1.8%) cases. The percentage of cases in which the physician was contacted decreased from 7.3% for the prior 18 months to 6.7%, but this change was not significant (P = .13). Twelve cases were subsequently sent for interinstitutional consultation, and no disagreements were identified. The EMR was accessed in 2.2% of all surgical pathology and cytology cases and affected the diagnosis in 48% of these cases.

  20. Validity of administrative database code algorithms to identify vascular access placement, surgical revisions, and secondary patency.

    Science.gov (United States)

    Al-Jaishi, Ahmed A; Moist, Louise M; Oliver, Matthew J; Nash, Danielle M; Fleet, Jamie L; Garg, Amit X; Lok, Charmaine E

    2018-03-01

    We assessed the validity of physician billing codes and hospital admission using International Classification of Diseases 10th revision codes to identify vascular access placement, secondary patency, and surgical revisions in administrative data. We included adults (≥18 years) with a vascular access placed between 1 April 2004 and 31 March 2013 at the University Health Network, Toronto. Our reference standard was a prospective vascular access database (VASPRO) that contains information on vascular access type and dates of placement, dates for failure, and any revisions. We used VASPRO to assess the validity of different administrative coding algorithms by calculating the sensitivity, specificity, and positive predictive values of vascular access events. The sensitivity (95% confidence interval) of the best performing algorithm to identify arteriovenous access placement was 86% (83%, 89%) and specificity was 92% (89%, 93%). The corresponding numbers to identify catheter insertion were 84% (82%, 86%) and 84% (80%, 87%), respectively. The sensitivity of the best performing coding algorithm to identify arteriovenous access surgical revisions was 81% (67%, 90%) and specificity was 89% (87%, 90%). The algorithm capturing arteriovenous access placement and catheter insertion had a positive predictive value greater than 90% and arteriovenous access surgical revisions had a positive predictive value of 20%. The duration of arteriovenous access secondary patency was on average 578 (553, 603) days in VASPRO and 555 (530, 580) days in administrative databases. Administrative data algorithms have fair to good operating characteristics to identify vascular access placement and arteriovenous access secondary patency. Low positive predictive values for surgical revisions algorithm suggest that administrative data should only be used to rule out the occurrence of an event.

  1. Effect of collagen hydrolysate in articular pain: a 6-month randomized, double-blind, placebo controlled study.

    Science.gov (United States)

    Bruyère, O; Zegels, B; Leonori, L; Rabenda, V; Janssen, A; Bourges, C; Reginster, J-Y

    2012-06-01

    Evaluation of the efficacy and safety of a food supplement made of collagen hydrolysate 1200 mg/day versus placebo during 6 months, in subjects with joint pain at the lower or upper limbs or at the lumbar spine. Comparative double-blind randomized multicenter study in parallel groups. 200 patients of both genders of at least 50 years old with joint pain assessed as ≥30 mm on a visual analogical scale (VAS). Collagen hydrolysate 1200 mg/day or placebo during 6 months. Comparison of the percentage of clinical responder between the active collagen hydrolysate group and the placebo group after 6 months of study. A responder subject was defined as a subject experiencing a clinically significant improvement (i.e. by 20% or more) in the most painful joint using the VAS score. All analyses were performed using an intent-to-treat procedure. At 6 months, the proportion of clinical responders to the treatment, according to VAS scores, was significantly higher in the collagen hydrolysate (CH) group 51.6%, compared to the placebo group 36.5% (pvs. 39.6%, p=0.53). No significant difference in terms of security and tolerability was observed between the two groups. This study suggests that collagen hydrolysate 1200 mg/day could increase the number of clinical responders (i.e. improvement of at least 20% on the VAS) compared to placebo. More studies are needed to confirm the clinical interest of this food supplement. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Comparison of evening and morning dosing of travoprost 0.004%/timolol 0.5% fixed combination in 6 month period.

    Science.gov (United States)

    Suić, Smiljka Popović; Laus, Katia Novak; Dosen, Vukosava Maricic; Ekert, Miroslav; Mandić, Zdravko; Bojić, Lovro

    2010-09-01

    An open label, multi-center, 6 months observational study of new fixed combination (travoprost 0.004%/timolol 0.5%), in order to evaluate both efficacy (intraocular pressure lowering) and tolerability (patient and investigator satisfaction) of two dosing regimens--evening (PM) and morning (AM). After screening for enrollment, to 40 patients (79 eyes with primary open angle glaucoma or ocular hypertension), new fixed combination travoprost 0.004%/timolol 0.5% was prescribed once a day in the evening (PM). Patients were enrolled according to each investigator decision on indication for travoprost 0.004%/timolol 0.5% fixed combination once a day, without washout period after previous medication. Intraocular pressure was measured at 9 AM at all time control points: at baseline, after 1 month, after 3 months and after 6 month. After 1 month, screening for nonresponders (criteria: 20% intraocular pressure lowering) and subjects with major side effects was performed. At second control visit, after 3 months PM dosing, intraocular pressure was measured and patients were instructed to continue once a day the same medication, but in the morning (AM) for consequent 3 months. After 1 month, reduction in mean intraocular pressure value was 21.66%. At the visit after 3 month, the mean intraocular pressure was 15.67 +/- 2.17 mm Hg (reduction 21.14%). 3 month after dosing regimen changed to AM (6 month after beginning of travoprost 0.004%/timolol 0.5% combination therapy), reduction in intraocular pressure value was 19.86%. The differences (mean +/- standard deviation) in intraocular pressure values after 1, 3 and 6 month were all highly statistically significant compared to baseline values. The tolerability was evaluated in five steps (Likert scale) ranging from unsatisfactory to excellent by both patient and investigator--taken at 3 and 6 month control visit. 95% of patients and 100% of investigators were satisfied with the possibility of choosing dosing regimen for travoprost 0

  3. Spatial structure of monthly rainfall measurements average over 25 years and trends of the hourly variability of a current rainy day in Rwanda.

    Science.gov (United States)

    Nduwayezu, Emmanuel; Kanevski, Mikhail; Jaboyedoff, Michel

    2013-04-01

    Climate plays a vital role in a wide range of socio-economic activities of most nations particularly of developing countries. Climate (rainfall) plays a central role in agriculture which is the main stay of the Rwandan economy and community livelihood and activities. The majority of the Rwandan population (81,1% in 2010) relies on rain fed agriculture for their livelihoods, and the impacts of variability in climate patterns are already being felt. Climate-related events like heavy rainfall or too little rainfall are becoming more frequent and are impacting on human wellbeing.The torrential rainfall that occurs every year in Rwanda could disturb the circulation for many days, damages houses, infrastructures and causes heavy economic losses and deaths. Four rainfall seasons have been identified, corresponding to the four thermal Earth ones in the south hemisphere: the normal season (summer), the rainy season (autumn), the dry season (winter) and the normo-rainy season (spring). Globally, the spatial rainfall decreasing from West to East, especially in October (spring) and February (summer) suggests an «Atlantic monsoon influence» while the homogeneous spatial rainfall distribution suggests an «Inter-tropical front» mechanism. What is the hourly variability in this mountainous area? Is there any correlation with the identified zones of the monthly average series (from 1965 to 1990 established by the Rwandan meteorological services)? Where could we have hazards with several consecutive rainy days (using forecasted datas from the Norwegian Meteorological Institute)? Spatio-temporal analysis allows for identifying and explaining large-scale anomalies which are useful for understanding hydrological characteristics and subsequently predicting these hydrological events. The objective of our current research (Rainfall variability) is to proceed to an evaluation of the potential rainfall risk by applying advanced geospatial modelling tools in Rwanda: geostatistical

  4. Hemodialysis Access Usage Patterns in the Incident Dialysis Year and Associated Catheter-Related Complications

    Science.gov (United States)

    Xue, Hui; Ix, Joachim H.; Wang, Weiling; Brunelli, Steven M.; Lazarus, Michael; Hakim, Raymond; Lacson, Eduardo

    2012-01-01

    Background Hemodialysis(HD) access is considered a critical and actionable determinant of morbidity, with a growing literature suggesting that initial HD access type is an important marker of long term outcomes. Accordingly, we examined HD access during the incident dialysis period, focusing on infection risk and successful fistula creation over the first dialysis year. Study Design Longitudinal cohort Setting & Participants All United States adults admitted to Fresenius Medical Care North America facilities within 15 days of first maintenance dialysis session between January 1 and December 31, 2007. Predictor Vascular access type at HD initiation Outcomes Vascular access type at 90 days and at the end of the first year on HD, bloodstream infection within the first year by access type, and catheter complication rate. Results Amongst the 25,003 incident dialysis patients studied, 19,622(78.5%) initiated dialysis with a catheter, 4,151(16.6%) with a fistula, and 1,230(4.9%) with a graft. At 90 days, 14,105(69.7%) had a catheter, 4432(21.9%) patients had a fistula, and 1705(8.4%) had a graft. Functioning fistulas and grafts at dialysis initiation had first year failure rates of 10% and 15%, respectively. Grafts were seldom replaced by fistulas (3%), while 7,064 (47.6%) of all patients who initiated with a catheter alone still had only a catheter at 1 year. Overall, 3,327 (13.3%) patients had at least one positive blood culture during follow-up, with the risk being similar between fistula and graft groups, but approximately 3-fold higher in patients with a catheter (p<0.001 for either comparison). Nearly one in three catheters (32.5%) will require TPA use by median time of 41 days, with 59% requiring more than one TPA administration. Limitations Potential underestimation of bacteremia because follow-up blood culture results did not include samples sent to local laboratories. Conclusions Among a large and representative population of incident US dialysis patients

  5. Treatment of hemodialysis vascular access rupture irresponsive to prolonged balloon tamponade: Retrospective evaluation of the effectiveness of N-butyl cyanoacrylate seal-off technique

    Energy Technology Data Exchange (ETDEWEB)

    Weng, Mei Jul; Liang, Huei Lung; Pan, Huay Ben [Dept. of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung (China); Chen, Matt Chiung Yu [Dept. of Radiology, Yuan' s General Hospital, Kaohsiung (China)

    2013-01-15

    -seal-off primary patency vs. secondary patency at 90, 180 and 360 days were 66.7 ± 11.1% vs. 94.4 ± 5.4%; 33.3 ± 11.1% vs. 83.3 ± 8.8%; and 13.3 ± 8.5% vs. 63.3 ± 12.1%, respectively. Our results suggest that the NBCA seal-off technique is effective for immediate control of a venous rupture irresponsive to prolonged balloon tamponade, during interventions for hemodialysis accesses. Both high technical and clinical success rates can be achieved. However, the treatment is not durable, and about 40% of the completely sealed off accesses are associated with developed delayed pseudoaneurysms in a 2-month of follow-up. Further repair of the vascular tear site, with surgery or stent-graft insertion, is often necessary.

  6. Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

    International Nuclear Information System (INIS)

    Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.; Siegel, Randall L.; Biswal, Rajiv; Gribbin, Christopher E.; Tokarz, Robert

    2000-01-01

    Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically significant

  7. Powernext Day-AheadTM statistics - June 30, 2006

    International Nuclear Information System (INIS)

    2006-01-01

    The introduction of a power exchange in France is a direct response to the opening up of the European electricity markets. Powernext SA is a Multilateral Trading Facility in charge of managing an optional and anonymous organised exchange offering: - Day-ahead contracts for the management of volume risk on Powernext Day-Ahead TM since 21 November 2001, - Medium term contracts for the management of price risk on Powernext Futures TM since 18 June 2004. This document presents in a series of tables and graphics the June 30, 2006 update of Powernext Day-Ahead TM statistics: daily traded volumes and base-load prices from November 2001 to June 2006, monthly overview from June 2005 to June 2006 (volumes and prices), weekly overview from March to June 2006 (volumes and prices), daily and hourly overview and market resilience for June 2006, power consumption in May and June 2006 (average consumption, average forecasted consumption and average price on Powernext Day-Ahead TM ), power consumption on the French hub from July 2005 to May 2006 and Powernext Day-Ahead TM prices, transfer capacities in June 2006 (auction results for France-Germany, France-Belgium, France-UK, France-Spain and France-Italy, and daily capacity allocation for France-Switzerland), temperature variations in France from January 2005 to June 2006 and base-load Powernext Day-Ahead TM prices, and balancing mechanism for April, May and June 2006 (half-hourly imbalance settlement prices). (J.S.)

  8. Disparities in access to emergency general surgery care in the United States.

    Science.gov (United States)

    Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

    2018-02-01

    As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Socioeconomic inequalities in the access to and quality of health care services

    OpenAIRE

    Nunes, Bruno Pereira; Thumé, Elaine; Tomasi, Elaine; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2014-01-01

    OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in...

  10. Tibiopedal Access for Crossing of Infrainguinal Artery Occlusions

    Science.gov (United States)

    Walker, Craig M.; Mustapha, Jihad; Zeller, Thomas; Schmidt, Andrej; Montero-Baker, Miguel; Nanjundappa, Aravinda; Manzi, Marco; Palena, Luis Mariano; Bernardo, Nelson; Khatib, Yazan; Beasley, Robert; Leon, Luis; Saab, Fadi A.; Shields, Adam R.; Adams, George L.

    2016-01-01

    Purpose: To report a prospective, multicenter, observational study (ClinicalTrials.gov identifier NCT01609621) of the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). Methods: Twelve sites around the world prospectively enrolled 197 patients (mean age 71±11 years, range 41-93; 129 men) from May 2012 to July 2013 who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary. The population consisted of 64 (32.5%) claudicants (Rutherford categories 2/3) and 133 (67.5%) patients with critical limb ischemia (Rutherford category ≥4). A primary antegrade attempt to cross had been made prior to the tibiopedal attempt in 132 (67.0%) cases. Techniques used for access, retrograde lesion crossing, and treatment were at the operator’s discretion. Follow-up data were obtained 30 days after the procedure. Results: Technical tibiopedal access success was achieved in 184 (93.4%) of 197 patients and technical occlusion crossing success in 157 (85.3%) of the 184 successful tibial accesses. Failed access attempts were more common in women (9 of 13 failures). The rate of successful crossing was roughly equivalent between sexes [84.7% (50/59) women compared to 85.6% (107/125) men]. Technical success did not differ significantly based on a prior failed antegrade attempt: the access success rate was 92.4% (122/132) after a failed antegrade access vs 95.4% (62/65) in those with a primary tibiopedal attempt (p=0.55). Similarly, crossing success was achieved in 82.8% (101/122) after a failed antegrade access vs 90.3% (56/62) for patients with no prior antegrade attempt (p=0.19). Minor complications related to the access site occurred in 11 (5.6%) cases; no patient had access vessel thrombosis, compartment syndrome, or surgical revascularization. Conclusion: Tibiopedal access appears to be safe and can be used effectively for the

  11. The psychological process of reintegration following a nine month/260 day solo sailboat circumnavigation of the globe.

    Science.gov (United States)

    Kjaergaard, Anders; Leon, Gloria R; Venables, Noah C

    2015-04-01

    The focus of this case report is on the psychological reintegration process following the achievement of a highly challenging long-duration and solitary endeavor. The participant was a 29 year old male who successfully circumnavigated the globe during a 260 day solo sailing expedition. We assessed the psychological aftermath in terms of stability and change in personality characteristics and personal beliefs prior to, and at 180 and 360 days after the completion of the journey. Overall, the personality configuration reflected adaptive personality functioning. A belief in an internal locus of control was consistent throughout, as were perceptions of personal growth as a result of the circumnavigation experience. NEO PI-R Neuroticism, Extraversion, Openness, and Triarchic Psychopathy Measure (Tri-PM) Boldness scores remained stable. Positive personality change was reflected by an elevation in Conscientiousness; negative change by a decline in Agreeableness and an increase in Tri-PM Disinhibition. While overall the participant exhibited positive change as a result of his journey, there were also some negative aspects of the reintegration phase in regard to interactions with other persons. This latter change may be related to the effects of isolation from usual social contacts over an extended period. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  12. The influence of nurse home visits, including provision of 3 months of contraceptives and contraceptive counseling, on perceived barriers to contraceptive use and contraceptive use self-efficacy.

    Science.gov (United States)

    Melnick, Alan L; Rdesinski, Rebecca E; Creach, E Dawn; Choi, Dongseok; Harvey, S Marie

    2008-01-01

    To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy. We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy. The mean age of participants was 24.7 years. Three-fourths had household incomes under $25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline. Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.

  13. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  14. Need and feasibility of telemedicine in non-urban day care centres.

    Science.gov (United States)

    Setia, Monika; DelliFraine, Jami L

    2010-01-01

    There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas.

  15. An investigation of an open-access model for scaling up methadone maintenance treatment.

    Science.gov (United States)

    Madden, Lynn M; Farnum, Scott O; Eggert, Kathryn F; Quanbeck, Andrew R; Freeman, Robert M; Ball, Samuel A; Schottenfeld, Richard S; Shi, Julia M; Savage, Mary Ellen; Barry, Declan T

    2018-02-17

    To examine retrospectively patient and programmatic outcomes following the development and implementation of an 'open-access' model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. Medical and administrative records were abstracted to compare data for 1 year before and 9 years after initiating the implementation of an open-access treatment model in May 2007. Methadone maintenance treatment center in Connecticut, USA. Individuals with opioid use disorder entering treatment between July 2006 and June 2015. In June 2015, 64% (n = 2594) of the sample were men and 80% (n = 3133) reported that they were white. The Network for the Improvement of Addiction Treatment-informed open-access treatment model uses process improvement strategies to improve treatment access and capacity. Census, waiting time, retention, non-medical opioid use, patient mortality and financial sustainability (net income and state-block grants as proportions of revenue). In the 9 years following the initial implementation of the open-access model, patient census increased by 183% from 1431 to 4051, and average waiting-time days decreased from 21 to 0.3 (same day) without apparent deleterious effects on rates of retention, non-medical opioid use or mortality. Between fiscal years (FY) 06 and FY 15, net operating margin rose from 2 to 10%, while state-block grant revenues declined 14% and the proportion of total revenue from state-block grant revenue decreased from 49 to 24%. An open-access model for rapid enrolment of people with opioid use disorder in methadone treatment appears to improve treatment access, capacity, and financial sustainability without evidence of deleterious effects on treatment outcomes. © 2018 Society for the Study of Addiction.

  16. China's first family planning publicity month.

    Science.gov (United States)

    Shen, G

    1983-05-01

    China conducted its 1st nationwide Family Planning Publicity Month in 1983, from New Year's Day to Spring Festival (February 13). The campaign emphasized the rural areas and focused on explaining why family planning is a state policy. The most noticeable achievements of this campaign were that every household became familiar with the fact that family planning is a basic state policy. The majority of the population take this policy seriously, realizing that strict control of population growth is both a good and imperative policy. More than 1,830,000 propaganda columns and photo exhibitions were displayed, 5,900,000 radio and television programs broadcast, 2,010,000 theatrical performances, movie and slide showings presented, and 97,000,000 copies of materials published for public dissemination. The activities were varied and interesting, vivid and lively, and purposeful and persuasive. 1 of the most effective methods of publicizing population control has been the presentation of comparative statistics. This aspect of the campaign was a specific and lively form of education in population theory and practice. The presentation of statistics that show the relationship among population, land use, grain produce, and income enabled the population to reason out why population growth needs to match economic and social development. Another important accomplishment of the publicity month was that a large number of couples of reproductive age became convinced of the need to use contraception. According to the incomplete statistics, 8,860,000 people had surgical operations for birth control. The universal promotion of ligations by either partner of a reproductive couple who already had given birth to a 2nd child was an important development of family planning technique promoted simultaneously with the promotion of IUDs. The increase in the number of people doing family planning work was another achievement of the publicity month. More than 15,240,000 publicity personnel and 760

  17. Which journals do primary care physicians and specialists access from an online service?

    Science.gov (United States)

    McKibbon, K Ann; Haynes, R Brian; McKinlay, R James; Lokker, Cynthia

    2007-07-01

    The study sought to determine which online journals primary care physicians and specialists not affiliated with an academic medical center access and how the accesses correlate with measures of journal quality and importance. Observational study of full-text accesses made during an eighteen-month digital library trial was performed. Access counts were correlated with six methods composed of nine measures for assessing journal importance: ISI impact factors; number of high-quality articles identified during hand-searches of key clinical journals; production data for ACP Journal Club, InfoPOEMs, and Evidence-Based Medicine; and mean clinician-provided clinical relevance and newsworthiness scores for individual journal titles. Full-text journals were accessed 2,322 times by 87 of 105 physicians. Participants accessed 136 of 348 available journal titles. Physicians often selected journals with relatively higher numbers of articles abstracted in ACP Journal Club. Accesses also showed significant correlations with 6 other measures of quality. Specialists' access patterns correlated with 3 measures, with weaker correlations than for primary care physicians. Primary care physicians, more so than specialists, chose full-text articles from clinical journals deemed important by several measures of value. Most journals accessed by both groups were of high quality as measured by this study's methods for assessing journal importance.

  18. Patterns of Practice in Palliative Radiotherapy for Painful Bone Metastases: Impact of a Regional Rapid Access Clinic on Access to Care

    International Nuclear Information System (INIS)

    Wu, Jackson S.Y.; Kerba, Marc; Wong, Rebecca K.S.; Mckimmon, Erin; Eigl, Bernhard; Hagen, Neil A.

    2010-01-01

    Purpose: External beam radiotherapy (RT) is commonly indicated for the palliation of symptomatic bone metastases, but there is evidence of underutilization of this treatment modality in palliative care for cancer populations. This study was conducted to investigate factors that influenced the use of palliative RT services at a regional comprehensive cancer center. Methods and Materials: A cohort of patients with radiographically confirmed bone metastases and first-time users of palliative RT between 2003 and 2005 was retrospectively reviewed from the time of initial diagnosis of bone metastases to death or last follow-up. Type of radiation treatment service provider used (rapid access or routine access) and patient-, tumor-, and treatment-related factors were analyzed for their influences on the number of treatment courses given over the duration of disease. Results: A total of 887 patients received 1,354 courses of palliative RT for bone metastases at a median interval of 4.0 months between courses. Thirty-three percent of patients required more than one RT course. Increased age and travel distance reduced the likelihood and number of treatment courses, while service through a rapid access clinic was independently associated with an increase in subsequent use of palliative RT. Conclusions: A rapid access service model for palliative RT facilitated access to RT. Travel distance and other factors remained substantial barriers to use of palliative RT services. The pattern of practice suggests an unmet need for symptom control in patients with bone metastases.

  19. The influence of supplemental docosahexaenoic and arachidonic acids during pregnancy and lactation on neurodevelopment at eighteen months

    NARCIS (Netherlands)

    van Goor, Saskia A.; Dijck-Brouwer, D. A. Janneke; Erwich, Jan Jaap H. M.; Schaafsma, Anne; Hadders-Algra, Mijna

    2011-01-01

    Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for neurodevelopment. The effects of DHA (220 mg/day, n=41), DHA+AA (220 mg/day, n=39) or placebo (n=34) during pregnancy and lactation on neurodevelopment at 18 months, and the relations between umbilical cord DHA, AA and Mead acid

  20. Synoptic Monthly Gridded WOD Absolute Geostrophic Velocity (SMG-WOD-V) (January 1945 - December 2014) with the P-Vector Method (NCEI Accession 0146195)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The SMG-WOD-V dataset comprises synoptic monthly global gridded fields of absolute geostrophic velocity inverted from the synoptic monthly gridded WOD temperature...

  1. Effect of a comprehensive programme to provide universal access to care for sputum-smear-positive multidrug-resistant tuberculosis in China: a before-and-after study.

    Science.gov (United States)

    Li, Renzhong; Ruan, Yunzhou; Sun, Qiang; Wang, Xiexiu; Chen, Mingting; Zhang, Hui; Zhao, Yanlin; Zhao, Jin; Chen, Cheng; Xu, Caihong; Su, Wei; Pang, Yu; Cheng, Jun; Chi, Junying; Wang, Qian; Fu, Yunting; Huan, Shitong; Wang, Lixia; Wang, Yu; Chin, Daniel P

    2015-04-01

    China has a quarter of all patients with multidrug-resistant tuberculosis (MDRTB) worldwide, but less than 5% are in quality treatment programmes. In a before-and-after study we aimed to assess the effect of a comprehensive programme to provide universal access to diagnosis, treatment, and follow-up for MDRTB in four Chinese cities (population 18 million). We designated city-level hospitals in each city to diagnose and treat MDRTB. All patients with smear-positive pulmonary tuberculosis diagnosed in Center for Disease Control (CDC) clinics and hospitals were tested for MDRTB with molecular and conventional drug susceptibility tests. Patients were treated with a 24 month treatment package for MDRTB based on WHO guidelines. Outpatients were referred to the CDC for directly observed therapy. We capped total treatment package cost at US$4644. Insurance reimbursement and project subsidies limited patients' expenses to 10% of charges for services within the package. We compared data from a 12 month programme period (2011) to those from a retrospective survey of all patients with MDRTB diagnosed in the same cities during a baseline period (2006-09). 243 patients were diagnosed with MDRTB or rifampicin-resistant tuberculosis during the 12 month programme period compared with 92 patients (equivalent to 24 per year) during the baseline period. 172 (71%) of 243 individuals were enrolled in the programme. Time from specimen collection for resistance testing to treatment initiation decreased by 90% (from median 139 days [IQR 69-207] to 14 days [10-21]), the proportion of patients who started on appropriate drug regimen increased 2·7 times (from nine [35%] of 26 patients treated to 166 [97%] of 172), and follow-up by the CDC after initial hospitalisation increased 24 times (from one [4%] of 23 patients to 163 [99%] of 164 patients). 6 months after starting treatment, the proportion of patients remaining on treatment increased ten times (from two [8%] of 26 patients to 137 [80

  2. Predicting Early Center Care Utilization in a Context of Universal Access

    Science.gov (United States)

    Zachrisson, Henrik Daae; Janson, Harald; Naerde, Ane

    2013-01-01

    This paper reports predictors for center care utilization prior to 18 months of age in Norway, a country with a welfare system providing up to one-year paid parental leave and universal access to subsidized and publicly regulated center care. A community sample of 1103 families was interviewed about demographics, family, and child characteristics…

  3. Violence against civilians and access to health care in North Kivu, Democratic Republic of Congo: three cross-sectional surveys

    Directory of Open Access Journals (Sweden)

    Encinas Luis

    2010-11-01

    Full Text Available Abstract Background The province of North Kivu in the Democratic Republic of Congo has been afflicted by conflict for over a decade. After months of relative calm, offences restarted in September 2008. We did an epidemiological study to document the impact of violence on the civilian population and orient pre-existing humanitarian aid. Methods In May 2009, we conducted three cross-sectional surveys among 200 000 resident and displaced people in North Kivu (Kabizo, Masisi, Kitchanga. The recall period covered an eight month period from the beginning of the most recent offensives to the survey date. Heads of households provided information on displacement, death, violence, theft, and access to fields and health care. Results Crude mortality rates (per 10 000 per day were below emergency thresholds: Kabizo 0.2 (95% CI: 0.1-0.4, Masisi 0.5 (0.4-0.6, Kitchanga 0.7 (0.6-0.9. Violence was the reported cause in 39.7% (27/68 and 35.8% (33/92 of deaths in Masisi and Kitchanga, respectively. In Masisi 99.1% (897/905 and Kitchanga 50.4% (509/1020 of households reported at least one member subjected to violence. Displacement was reported by 39.0% of households (419/1075 in Kitchanga and 99.8% (903/905 in Masisi. Theft affected 87.7% (451/514 of households in Masisi and 57.4% (585/1019 in Kitchanga. Access to health care was good: 93.5% (359/384 of the sick in Kabizo, 81.7% (515/630 in Masisi, and 89.8% (651/725 in Kitchanga received care, of whom 83.0% (298/359, 87.5% (451/515, and 88.9% (579/651, respectively, did not pay. Conclusions Our results show the impact of the ongoing war on these civilian populations: one third of deaths were violent in two sites, individuals are frequently subjected to violence, and displacements and theft are common. While humanitarian aid may have had a positive impact on disease mortality and access to care, the population remains exposed to extremely high levels of violence.

  4. The impact of Internet access for people with spinal cord injuries: a descriptive analysis of a pilot study.

    Science.gov (United States)

    Houlihan, Bethlyn Vergo; Drainoni, Mari-Lynn; Warner, Grace; Nesathurai, Shanker; Wierbicky, Jane; Williams, Steven

    2003-04-22

    A pilot study was undertaken regarding the effect of Internet access on health-related quality of life (HRQoL) and self-reported impact for people with spinal cord injuries (SCI). This study is unique in providing free Internet access and looking at benefits for people with disabilities. HRQoL was measured using indicators of global health and social isolation at baseline and after 6 to 19 months of use via telephone interviews on a convenience sample of 23 adults with SCI. Additionally, monthly telephone surveys measured usage patterns, recreation, and self-reported impact. Both quantitative and qualitative analyses were conducted. Bivariate tests for differences in proportions and paired T-tests were conducted. Qualitatively, conceptual categories of impact were created using the Constant Comparative Method. Qualitatively, the predominant benefit was quality of life, mentioned by 61% of participants 46% of months surveyed, with quantitative trends towards improved emotional health. Ease of access to information, social connection, and quality of information were also frequently reported, with modest support from quantitative data. The study's persuasive qualitative results suggest the Internet has particular benefit to people with disabilities and that rehabilitation goals should include leisure. Further scientific research is strongly warranted.

  5. Using Operational Analysis to Improve Access to Pulmonary Function Testing

    Directory of Open Access Journals (Sweden)

    Ada Ip

    2016-01-01

    Full Text Available Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15, with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.

  6. Longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence

    NARCIS (Netherlands)

    Hendriksen, Ingrid J.M.; Bernaards, Claire M.; Steijn, Wouter M. P.; Hildebrandt, Vincent H.

    OBJECTIVE: The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence. METHODS: At the start and end of a five-month intervention program at the workplace, as well as 10 months after the

  7. Access For All

    DEFF Research Database (Denmark)

    Andersen, Ove Kjeld; Hjulmand, Christian

    2005-01-01

    Approximately 30% of the Danish population has severe problems in reading everyday text. In the light of the increasing amount of text available on the Internet this poses a democratic challenge to ensure “equal access” to information. The Talking Internet service - Access For All (AFA) - offers...... a free Internet-based tool for reading aloud any marked text with a synthetic voice. The only requirements are a standard equipped PC running a recent Windows OS and an Internet connection. Experiences gathered from running the service for more than 28 months underline the viability of the concept....... There is a clear need for a free internet based Danish text-to-speech synthesizer. Furthermore, the current state of technology i.e. internet bandwidth, response time and server technology is sufficient for setting up an online automatic reading service that is used by steadily growing number of individuals...

  8. Conflict and Trade-Offs between Efficiency and Access: A Case of Day and Boarding Secondary Schools in Kenya

    Science.gov (United States)

    Zachariah, Kosgei K.; Joshua, Keter K.

    2016-01-01

    While education is considered to be a human right and need, the delivery of secondary education in Kenya has been slow due to a number of bottlenecks that includes: (one), differential trends in access and participation in secondary school education with low participation of the poor and (two), low efficiency and quality of education as indicated…

  9. Objectively recorded physical activity in pregnancy and postpartum in a multi-ethnic cohort: association with access to recreational areas in the neighbourhood.

    Science.gov (United States)

    Richardsen, Kåre Rønn; Mdala, Ibrahimu; Berntsen, Sveinung; Ommundsen, Yngvar; Martinsen, Egil Wilhelm; Sletner, Line; Jenum, Anne Karen

    2016-07-07

    Physical activity may reduce the risk of adverse pregnancy outcomes; however, compared to non-pregnant women, a lower proportion of pregnant women meet the physical activity guidelines. Our objectives were to explore overall changes and ethnic differences in objectively recorded moderate-to-vigorous intensity physical activity (MVPA) during pregnancy and postpartum and to investigate the associations with objective and perceived access to recreational areas. We analysed 1,467 person-observations from 709 women in a multi-ethnic population-based cohort, with MVPA data recorded with the SenseWear™ Pro(3) Armband in early pregnancy (mean gestational week (GW) 15), mid-pregnancy (mean GW 28) and postpartum (mean postpartum week 14). MVPA was limited to bouts ≥10 min. Women were nested within 56 neighbourhoods defined by postal code area. We derived neighbourhood-level objective access to recreational areas (good vs limited) by geographic information systems. We collected information about perceived access (high vs low perception) to recreational areas in early pregnancy. We treated ethnicity, objective and perceived access as explanatory variables in separate models based on linear mixed effects regression analyses. Overall, MVPA dropped between early and mid-pregnancy, followed by an increase postpartum. Western women performed more MVPA than women in other ethnic groups across time points, but the differences increased postpartum. Women residing in neighbourhoods with good objective access to recreational areas accumulated on average nine additional MVPA minutes/day (p perceived and objective access to recreational areas remained significantly associated with MVPA. The association between MVPA and access to recreational areas did not differ by time point, ethnic group or socio-economic position. In all ethnic groups, we observed a decline in MVPA between early and mid-pregnancy. However, at both time points during pregnancy, and especially three months

  10. Physical activity intensities in youth: the effect of month of assessment.

    Science.gov (United States)

    Silva, Pedro; Seabra, André; Saint-Maurice, Pedro; Soares-Miranda, Luisa; Mota, Jorge

    2013-01-01

    There is clear evidence that environmental factors play an important role regarding physical activity (PA) and sedentary behaviour (SB) in youth. This short report highlights seasonal differences in the amount and intensities of PA and SB, in Portuguese youth. Three hundred and eighty-seven participants (aged 14.7 ± 1.9 years), 220 girls, used the Actigraph GT1M accelerometer for 7 days (15-second epochs), between January and June in 2008. PA and SB differences were assessed using an ANCOVA. Boys had significantly higher values of PA, with the exception of Light intensity. Girls were significantly more sedentary. PA intensities and SB changed significantly according to gender and month of assessment. SB (Gender F = 16.32, p Gender F = 9.30, p = 0.002; Month F = 8.37, p Gender*Month F = 2.24, p = 0.050), Moderate PA (Gender F = 40.04, p Gender F = 32.89, p genders increased PA from winter to summer months and SB decreased. Seasonality in PA intensities and SB suggest that interventions to promote PA and decrease SB must be tailored to take into consideration the month of the year they are going to be implemented and also gender characteristics.

  11. Associations between e-cigarette access and smoking and drinking behaviours in teenagers.

    Science.gov (United States)

    Hughes, Karen; Bellis, Mark A; Hardcastle, Katherine A; McHale, Philip; Bennett, Andrew; Ireland, Robin; Pike, Kate

    2015-03-31

    Public health concerns regarding e-cigarettes and debate on appropriate regulatory responses are focusing on the need to prevent child access to these devices. However, little is currently known about the characteristics of those young people that are accessing e-cigarettes. Using a cross-sectional survey of 14-17 year old school students in North West England (n = 16,193) we examined associations between e-cigarette access and demographics, conventional smoking behaviours, alcohol consumption, and methods of accessing cigarettes and alcohol. Access to e-cigarettes was identified through a question asking students if they had ever tried or purchased e-cigarettes. One in five participants reported having accessed e-cigarettes (19.2%). Prevalence was highest among smokers (rising to 75.8% in those smoking >5 per day), although 15.8% of teenagers that had accessed e-cigarettes had never smoked conventional cigarettes (v.13.6% being ex-smokers). E-cigarette access was independently associated with male gender, having parents/guardians that smoke and students' alcohol use. Compared with non-drinkers, teenagers that drank alcohol at least weekly and binge drank were more likely to have accessed e-cigarettes (adjusted odds ratio [AOR] 1.89, P smoking cessation. Those most likely to access e-cigarettes may already be familiar with illicit methods of accessing age-restricted substances.

  12. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China

    Directory of Open Access Journals (Sweden)

    Shijun Lu

    2015-06-01

    Full Text Available This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR and 95% confidence intervals (CI of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57 and 1.47 (1.06, 2.02, respectively (p < 0.001 for trend test. This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

  13. Complete and Voluntary Starvation of 50 Days

    Directory of Open Access Journals (Sweden)

    Bradley Elliott

    2016-09-01

    Full Text Available A 34-year-old obese male (96.8 kg; BMI, 30.2 kg m −1 volitionally undertook a 50-day fast with the stated goal of losing body mass. During this time, only tea, coffee, water, and a daily multivitamin were consumed. Severe and linear loss of body mass is recorded during these 50 days (final 75.4 kg; BMI, 23.5 kg mT 1 . A surprising resilience to effects of fasting on activity levels and physical function is noted. Plasma samples are suggestive of early impairment of liver function, and perturbations to cardiovascular dynamics are also noted. One month following resumption of feeding behavior, body weight was maintained (75.0 kg; BMI, 23.4 kg m −1 . Evidence-based decision-making with the fasting or hunger striking patient is limited by a lack of evidence. This case report suggests that total body mass, not mass lost, may be a key observation in clinical decision-making during fasting and starvation.

  14. Are essential medicines in Malaysia accessible, affordable and available?

    Science.gov (United States)

    Saleh, Kamaruzaman; Ibrahim, Mohamed I M

    2005-12-01

    To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain

  15. Long-term memory, forgetting, and deferred imitation in 12-month-old infants

    OpenAIRE

    Klein, Pamela J.; Meltzoff, Andrew N.

    1999-01-01

    Long-term recall memory, as indexed by deferred imitation, was assessed in 12-month-old infants. Independent groups of infants were tested after retention intervals of 3 min, 1 week and 4 weeks. Deferred imitation was assessed using the ‘observation-only’ procedure in which infants were not allowed motor practice on the tasks before the delay was imposed. Thus, the memory could not have been based on re-accessing a motor habit, because none was formed in the first place. After the delay, memo...

  16. Income-Related Inequalities in Access to Dental Care Services in Japan.

    Science.gov (United States)

    Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2017-05-12

    Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

  17. Stability of pyrimethamine in a liquid dosage formulation stored for three months.

    Science.gov (United States)

    Nahata, M C; Morosco, R S; Hipple, T F

    1997-12-01

    The stability of pyrimethamine in a liquid dosage formulation stored for up to three months was studies. Commercially available 25-mg pyrimethamine tablets were crushed with a mortar and pestle and mixed with a 1:1 mixture of Simple Syrup, NF, and 1% methylcellulose to yield a suspension with a pyrimethamine concentration of 2 mg/mL. The suspension was poured into 10 amber plastic and 10 amber glass prescription bottles; 5 plastic and 5 glass bottles were stored at 4 degrees C, and the remaining bottles were kept at 25 degrees C. Samples were collected at intervals up to 91 days and tested for pyrimethamine concentration by stability-indicating high-performance liquid chromatography. Pyrimethamine remained stable throughout the three-month study period under all conditions. At 4 degrees C, pyrimethamine concentrations remained above 96% of the initial concentration; at 25 degrees C, pyrimethamine concentrations remained above 91%. No substantial changes in pH were observed. Pyrimethamine was stable for at least 91 days in an oral suspension stored in plastic or glass prescription bottles at 4 or 25 degrees C.

  18. The Effect of Haemodialysis Access Types on Cardiac Performance and Morbidities in Patients with Symptomatic Heart Disease.

    Science.gov (United States)

    Chuang, Min-Kai; Chang, Chin-Hao; Chan, Chih-Yang

    2016-01-01

    Little is known about whether the arteriovenous type haemodialysis access affects cardiac function and whether it is still advantageous to the uremic patient with symptomatic heart disease. We conducted a retrospective comparative study. Patients with heart disease and end-stage renal disease that had a new chronic access created between January 2007 and December 2008 and met the inclusion criteria were assessed. The endpoint was major adverse event (MAE)-free survivals of arteriovenous access (AVA) and tunneled cuffed double-lumen central venous catheter (CVC) groups. Whether accesses worsened heart failure was also evaluated. There were 43 CVC patients and 60 AVA patients. The median follow-up time from access creation was 27.6 months (IQR 34.7, 10.9~45.6). Although CVC patients were older than AVA patients (median age 78.0, IQR 14.0 vs. 67.5, IQR 16.0, respectively, p = .009), they manifested non-inferior MAE-free survival (mean 17.1, 95% CI 10.3~24.0 vs. 12.9, 95% CI 8.5~17.4 months in CVC and AVA patients, respectively, p = .290). During follow-up, more patients in the AVA group than in the CVC group deteriorated in heart failure status (35 of 57 vs. 10 of 42, respectively, odds ratio 5.1, p heart disease and end stage renal disease (ESRD), CVC patients showed non-inferior MAE-free survival in comparison to those in the AVA group. AV type access could deteriorate heart failure. Accordingly, uremic patients with symptomatic heart disease are not ideal candidates for AV type access creation.

  19. Immediate access to antiretroviral therapy is important in children living with HIV

    Directory of Open Access Journals (Sweden)

    Sangeeta Das Bhattacharya

    2016-01-01

    Full Text Available This article reviews a case of a child with perinatal HIV followed for 30 months during a prospective cohort study on pneumonia prevention in HIV-infected children. The point of this case report is to illustrate how delayed access to antiretroviral therapy (ART in HIV-infected children impacts immunization response and growth. Given the WHO's early release guideline changes on ART recommendations and the expected full revised guidelines coming out this year, this article is a timely discussion on the need for access to ART for HIV infected Indian children regardless of CD4 count.

  20. April 2017 critical care case of the month

    Directory of Open Access Journals (Sweden)

    Raschke RA

    2017-04-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness: A 20-year-old woman was transferred from another medical center for care. She was pregnant and initially presented with a one day history of crampy abdominal pain with nausea and vomiting after eating old, bad tasting chicken two days previously. She had pain of her right arm and a non-displaced humeral fracture was seen on x-ray. The etiology of the fracture was unclear. Her illness rapidly progressed to respiratory distress requiring intubation. The fetus had deceleration of heart tones leading to a cesarean section and delivery of a non-viable infant. Subsequently, she had rapid progression of shock and anuria. Past Medical History: She had a previous history of a seizure disorder which was managed with levetiracetam, clonazepam, and folic acid. There was a previous intentional opiate overdose 2 years earlier. One month prior to admission she had visited her husband in Iraq. After returning to the US …

  1. Safety and efficacy of using the Viabahn endoprosthesis for percutaneous treatment of vascular access complications after transfemoral aortic valve implantation

    DEFF Research Database (Denmark)

    De Backer, Ole; Arnous, Samer; Sandholt, Benjamin

    2015-01-01

    Vascular access complications (VACs) remain one of the biggest challenges when performing transcatheter aortic valve implantation (TAVI). This study aimed to investigate the short- and medium-term safety and efficacy of the Viabahn endoprosthesis (Gore, Flagstaff, AZ) when used to treat TAVI......-induced vascular injury. Over a 40-month period, 354 patients underwent true percutaneous transfemoral (TF)-TAVI using a CoreValve and Prostar-XL closure system; this was our study population. A VAC leading to acute intervention occurred in 72 patients (20.3%) - of these, 18 were managed by balloon angioplasty, 48...... were treated by Viabahn stenting (technical success rate 98%), and 6 needed surgical intervention. Overall, this approach resulted in a major VAC rate of 3.1% (n = 11) in our study cohort. Length of hospitalization and 30-day mortality rates were comparable in patients with a VAC treated by Viabahn...

  2. Preliminary results in advanced head and neck cancer with radiotherapy by multiple fractions a day

    International Nuclear Information System (INIS)

    Gonzalez, D.G.; Breur, K.; Schueren, E. v.d.

    1980-01-01

    Nine patients with advanced head and neck cancer were treated by irradiation consisting of three fractions a day of 180 rad administered with intervals of 4 h. The total dose was 4860-5400 rad in an overall time of 11-12 days. The acute mucosal reactions produced by this multifractionated schedule were similar to those observed with conventional fractionation. The acute skin reactions were minimal. The period of acute reactions were shorter than is generally observed with conventional fractionation. In six patients with a follow-up time of six months or longer no late reactions were detected with the exception of one patient requiring permanent tracheostomy because of laryngeal oedema. In the whole group of patients loco-regional control of the disease was achieved. Six patients had maintained the full response for six months or longer. The results so far obtained with this multiple fractions a day schedule are encouraging. More patients have to be entered in this study in order to draw definitive conclusions. (author)

  3. [Evaluation of the National Vaccination Day in Bogota, D.C., 2001].

    Science.gov (United States)

    Prieto Alvarado, Franklyn E; de la Hoz Restrepo, Fernando P

    2003-01-01

    A national immunization day-NID, aimed at improving vaccination coverage, was carried out in Colombia in November 2001. The main objective of the study was to measure the proportion of children under 2 years either completing their immunization schedule or advancing through it by receiving doses during the NID. Besides, we also evaluated the proportion of lost opportunities for vaccination during the NID and the impact of the media (TV, ratio, newspapers, etc.) in advertising the NID. In order to evaluate the impact of immunization a cross sectional survey was carried out in Bogotá in the waiting rows of the 30 randomly selected vaccination posts; 623 participants were systematically chosen. The outcomes were analyzed by age, socioeconomic level and type of health insurance-SSS. Only children holding a vaccination card were considered eligible for the study. Most people become aware about NID through TV, 81%, followed by radio advertisements, 22%. After attending NID the proportion of fully vaccinated children, according to PAHO scheme, raised from 46% to 66%, a 43% increase. This increase was even higher among children aged less than 6 months (140% increment). There were no differences in the increment by social stratum or affiliation to the SSS. Among the children studied we identified a 24% of loss opportunities for vaccination that did not differ by socioeconomic level or SSS groups. Our results suggest that, despite its high costs, NID might be useful to transiently overcome barriers for adequate access to health services.

  4. Evidence for varying social strategies across the day in chacma baboons.

    Science.gov (United States)

    Sick, Claudia; Carter, Alecia J; Marshall, Harry H; Knapp, Leslie A; Dabelsteen, Torben; Cowlishaw, Guy

    2014-07-01

    Strong social bonds can make an important contribution to individual fitness, but we still have only a limited understanding of the temporal period relevant to the adjustment of social relationships. While there is growing recognition of the importance of strong bonds that persist for years, social relationships can also vary over weeks and months, suggesting that social strategies may be optimized over shorter timescales. Using biological market theory as a framework, we explore whether temporal variation in the benefits of social relationships might be sufficient to generate daily adjustments of social strategies in wild baboons. Data on grooming, one measure of social relationships, were collected from 60 chacma baboons (Papio ursinus) across two troops over a six month period. Our analyses suggest that social strategies can show diurnal variation, with subordinates preferentially grooming more dominant individuals earlier in the day compared with later in the day. These findings indicate that group-living animals may optimize certain elements of their social strategies over relatively short time periods. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  5. Day-to-day changes in ionospheric electron content

    International Nuclear Information System (INIS)

    Tyagi, T.R.

    1978-01-01

    Large day-to-day variations have been observed in the ionospheric electron content or the so-called Faraday content derived from ATS-6 measurements at Gauhati (26.15 deg N, 91.75 deg E) for the period November 1975 to July 1976. The changes occur in the form of single-day abnormality, alternate day-to-day fluctuations and long-term periodic fluctuations with a periodicity of about 45 days. In all the cases the fluctuations are as large as plus or minus 40% from the average level. These changes are not correlated with solar or magnetic activity

  6. Methodology of Day-To-Day Ship Costs Assessment

    Directory of Open Access Journals (Sweden)

    Milojka Počuča

    2006-09-01

    Full Text Available The paper presents a methodology of assessing the day-to-day fixed costs of maritime cargo ships. The authoress refersthe reader to factors that affect the amount affixed daily costsand the day-to-day voyage costs of ships. In the last chapter thepaper presents an estimation of the average daily fixed costsand day-to-day voyage costs of ships per type and size for theyear 2003. Besides particular explanations, the reader is refe"ed to data bases that authentically impart data on the structureof maritime fleets and their technical characteristics, aswell as databases on prices and costs in maritime transport.

  7. Xerostomia: A day and night difference

    International Nuclear Information System (INIS)

    Dijkema, Tim; Raaijmakers, Cornelis P.J.; Braam, Pètra M.; Roesink, Judith M.; Monninkhof, Evelyn M.; Terhaard, Chris H.J.

    2012-01-01

    Purpose: To compare patient-reported xerostomia during daytime and during nighttime with objectively measured parotid and submandibular gland function in a cohort of head-and-neck cancer (HNC) patients treated with RT. Materials and methods: A cohort of 138 HNC patients underwent objective measurements of parotid (PF) and submandibular (SMF) gland function and completed a xerostomia questionnaire (XQ) before RT, at 6 weeks, 6 months and 1 year after RT. No attempt was made to spare the submandibular gland(s). The XQ contained specific questions concerning the sensation of dry mouth during day- (XD) and nighttime (XN), scored on a 5-point Likert scale. Patients with no or mild (grade 1–3) xerostomia and patients with more severe (grade 4–5) complaints were grouped together. Results: Before RT, no association existed between dry mouth complaints and PF or SMF. At 6 weeks, 6 months and 1 year after RT; 37%, 51% and 36% had grade 4–5 XD and 65%, 64% and 56% had grade 4–5 XN, respectively. Patients with grade 4–5 XD and XN had significantly worse SMF at all time points after RT compared to patients with grade 1–3 XD and XN, while PF was significantly worse only at 6 weeks after RT. In multivariate analyses, SMF was consistently the most important factor related to XN after treatment. PF significantly influenced XD at 6 weeks and 1 year after RT. Conclusions: Differentiating between complaints during day- and nighttime in xerostomia research is necessary. Dry mouth at night is a frequent problem after (parotid-sparing) RT for HNC and is explained by submandibular gland dysfunction. Sparing of the contralateral submandibular gland, in addition to parotid gland sparing, may result in improved patient-reported xerostomia.

  8. Access Request Trustworthiness in Weighted Access Control Framework

    Institute of Scientific and Technical Information of China (English)

    WANG Lun-wei; LIAO Xiang-ke; WANG Huai-min

    2005-01-01

    Weighted factor is given to access control policies to express the importance of policy and its effect on access control decision. According to this weighted access control framework, a trustworthiness model for access request is also given. In this model, we give the measure of trustworthiness factor to access request, by using some idea of uncertainty reasoning of expert system, present and prove the parallel propagation formula of request trustworthiness factor among multiple policies, and get the final trustworthiness factor to decide whether authorizing. In this model, authorization decision is given according to the calculation of request trustworthiness factor, which is more understandable, more suitable for real requirement and more powerful for security enhancement than traditional methods. Meanwhile the finer access control granularity is another advantage.

  9. For the Public Good: Research Impact and the Promise of Open Access

    OpenAIRE

    DePauw, Karen P.; Seyam, Mohammed; Roy, Siddhartha; Abbas, Montasir; Hole, Brian; Potter, Peter

    2016-01-01

    As a land-grant institution, Virginia Tech is committed to research that meaningfully engages with the vital concerns of our day such as feeding, building, and empowering a healthy world. How does Virginia Tech’s commitment to engagement fit with the Open Access vision for unrestricted online access to scholarly research? Have OA journals, public repositories, and federal mandates simply made a researcher’s life more complicated or could OA be the key to unlocking research impact on a global ...

  10. Household food access and child malnutrition: results from the eight-country MAL-ED study

    Directory of Open Access Journals (Sweden)

    Psaki Stephanie

    2012-12-01

    Full Text Available Abstract Background Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. Methods We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Results Average age of study children was 41 months. Mean food access insecurity score (range: 0–27 was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42% was much higher than the prevalence of wasting (6%. In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008. A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17. Conclusions Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and

  11. Household food access and child malnutrition: results from the eight-country MAL-ED study.

    Science.gov (United States)

    Psaki, Stephanie; Bhutta, Zulfiqar A; Ahmed, Tahmeed; Ahmed, Shamsir; Bessong, Pascal; Islam, Munirul; John, Sushil; Kosek, Margaret; Lima, Aldo; Nesamvuni, Cebisa; Shrestha, Prakash; Svensen, Erling; McGrath, Monica; Richard, Stephanie; Seidman, Jessica; Caulfield, Laura; Miller, Mark; Checkley, William

    2012-12-13

    Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Average age of study children was 41 months. Mean food access insecurity score (range: 0-27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17). Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

  12. Fish oil affects immune function in 9 to 12 month old infants

    DEFF Research Database (Denmark)

    Damsgaard, Camilla Trab; Lauritzen, Lotte; Kjær, Tanja

    2006-01-01

    /day) or no fish oil and cow’s milk or infant formula from 9 to 12 month of age in 64 healthy Danish infants. Before and after the intervention we measured the fatty acid composition of erythrocyte (RBC) membranes, plasma IgE levels, C-reactive protein and soluble IL-2 receptors (sIL-2R) as well as cytokine...

  13. A Case of Probable Amisulpride Induced Mania after Eight Months of Therapy

    Directory of Open Access Journals (Sweden)

    Prakash Thapa

    2017-01-01

    Full Text Available Development of manic symptoms during treatment with atypical antipsychotics can be a troublesome side effect that has been described with most atypical antipsychotics. However, reports of amisulpride induced mania have been rare. Here, we report the case of an 18-year-old male patient diagnosed with schizophrenia, who developed manic symptoms while on treatment with amisulpride. While previous reports have described occurrence of mania within days to three months of treatment with amisulpride, we report a case where manic symptoms occurred after around eight months of therapy. We have also attempted to describe the possible risk factors based on the available case studies.

  14. Early Experience with the Amplatzer Vascular Plug II for Occlusive Purposes in Arteriovenous Hemodialysis Access

    International Nuclear Information System (INIS)

    Powell, Steven; Narlawar, Ranjeet; Odetoyinbo, Tolulola; Littler, Peter; Oweis, Deyana; Sharma, Ajay; Bakran, Ali

    2010-01-01

    The Amplatzer Vascular Plug Type II (AVP II) has proven effective in the therapeutic embolization of various vascular lesions. It benefits from very rapid occlusion of the target lesion and can be deployed, retrieved, and redeployed if required. There is no literature available on use of the AVP II in the maintenance, closure, and management of complicated arteriovenous access in hemodialysis patients. In this series, we present our clinical experience with the use of the AVP II for embolization of problematic hemodialysis access. The AVP II is a self-expandable Nitinol wire-mesh device. Mounted on a delivery wire it has the capability to be deployed, recaptured, and redeployed. In total seven patients (four males: one diabetic, all nonsmokers), with ages ranging from 44 to 81 years (mean, 63 years), were treated between July 2008 and January 2009. One patient had not started dialysis. The remaining six patients had varied histories, with the time on hemodialysis ranging from 1 to 21 years. Retrospective review of clinical notes revealed patient demographics, type of access, device size, deployment site, and outcomes. Indications for embolization included steal syndrome (one patient), high-flow tributaries (two patients), and limb swelling (four patients). All patients had clinical and sonographical follow-up to 3 months. Surgical ligation had either failed, was considered a contraindication due to concerns regarding wound healing, or was considered difficult due to complex venous anatomy. Only one device was used in each patient, ranging from 6 to 16 mm in diameter. Immediate technical success was seen in 100%. All these patients were followed up clinically in the vascular access radiology clinic at 4 weeks and 3 months. Occlusion of the treated vessel and resolution of symptoms were reconfirmed in 100% of cases at 3 months. It was also noted whether patients were having successful dialysis, if required. There were no complications. Average procedural time was 19

  15. Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

    OpenAIRE

    Talarico, Valentina; Barreca, Massimo; Galiano, Rossella; Galati, Maria Concetta; Raiola, Giuseppe

    2016-01-01

    An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intox...

  16. In an Age of Open Access to Research Policies: Physician and Public Health NGO Staff Research Use and Policy Awareness.

    Science.gov (United States)

    Moorhead, Laura L; Holzmeyer, Cheryl; Maggio, Lauren A; Steinberg, Ryan M; Willinsky, John

    2015-01-01

    Through funding agency and publisher policies, an increasing proportion of the health sciences literature is being made open access. Such an increase in access raises questions about the awareness and potential utilization of this literature by those working in health fields. A sample of physicians (N=336) and public health non-governmental organization (NGO) staff (N=92) were provided with relatively complete access to the research literature indexed in PubMed, as well as access to the point-of-care service UpToDate, for up to one year, with their usage monitored through the tracking of web-log data. The physicians also participated in a one-month trial of relatively complete or limited access. The study found that participants' research interests were not satisfied by article abstracts alone nor, in the case of the physicians, by a clinical summary service such as UpToDate. On average, a third of the physicians viewed research a little more frequently than once a week, while two-thirds of the public health NGO staff viewed more than three articles a week. Those articles were published since the 2008 adoption of the NIH Public Access Policy, as well as prior to 2008 and during the maximum 12-month embargo period. A portion of the articles in each period was already open access, but complete access encouraged a viewing of more research articles. Those working in health fields will utilize more research in the course of their work as a result of (a) increasing open access to research, (b) improving awareness of and preparation for this access, and (c) adjusting public and open access policies to maximize the extent of potential access, through reduction in embargo periods and access to pre-policy literature.

  17. Open access publishing in the biomedical sciences: could funding agencies accelerate the inevitable changes?

    Science.gov (United States)

    Glover, Steven William; Webb, Anne; Gleghorn, Colette

    2006-09-01

    Open access is making a noticeable impact on access to information. In 2005, many major research funders, including the Wellcome Trust, National Institutes for Health (NIH), and the Research Councils UK (RCUK), set out their position in a number of statements. Of particular note was the stipulation that authors receiving grants must deposit their final manuscript in an open access forum within 6-12 months of publication. The paper will look at the open access position statements issued by some of the major funding bodies in the biomedical sciences. The paper will also look at the models used by publishers to provide open or delayed access, such as Oxford Open from Oxford University Press, HighWire Press' delayed access policy, BioMed Central, and Public Library of Science (PLoS). There are now over 1.2 million articles in PubMed that are freely accessible via publishers' websites.(1) Could funding agencies accelerate the move to open access? The list of funding agencies supporting open access is growing. The National Institutes for Health and the Wellcome Trust have been joined by many of the world's major funders in biomedical research whose goal it is to make their research findings available with no barriers.

  18. Safety and tolerability of pasireotide long-acting release in acromegaly-results from the acromegaly, open-label, multicenter, safety monitoring program for treating patients who have a need to receive medical therapy (ACCESS) study.

    Science.gov (United States)

    Fleseriu, Maria; Rusch, Elisha; Geer, Eliza B

    2017-01-01

    Pasireotide long-acting release is a somatostatin analog that is indicated for treatment of patients with acromegaly. This analysis documents the safety of pasireotide long-acting release in patients with acromegaly enrolled in the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). ACCESS is an open-label, multicenter, single-arm, expanded-treatment protocol designed to provide patients access to pasireotide long-acting release pending regulatory approval. Patients received pasireotide long-acting release 40 mg administered intramuscularly every 28 days. The primary outcome was the proportion of patients having a treatment-emergent grade ≥3 or serious adverse event. Efficacy data were not collected. Forty-four adult patients with active acromegaly were enrolled in the study for an average of 37.6 weeks (range, 4-70 weeks). Twenty-five grade ≥3 treatment-emergent adverse events were reported in 11 patients (25.0 %), 3 of whom (27.3 %) experienced grade ≥3 hyperglycemia. In patients treated with pasireotide long-acting release for ≥3 months (n = 42), mean glycated hemoglobin and fasting plasma glucose levels increased significantly from 5.9 % and 100.4 mg/dL at baseline to 6.8 % and 135.9 mg/dL at 3 months, respectively. Ten patients (22.7 %) were treated with pasireotide long-acting release for ≥15 months, after which mean glycated hemoglobin and fasting plasma glucose levels were 6.3 % and 123 mg/dL, respectively. Twenty-one patients (48 %) initiated antidiabetic medication. Grade ≥3 adverse events (primary outcome) were reported in 25.0 % of acromegaly patients treated with pasireotide long-acting release in a clinical setting. Hyperglycemia-related adverse events were reported in 45.5 % of patients, but were typically manageable, supporting the role of pasireotide long-acting release as a safe treatment option for acromegaly patients.

  19. submitter Studies of CMS data access patterns with machine learning techniques

    CERN Document Server

    De Luca, Silvia

    This thesis presents a study of the Grid data access patterns in distributed analysis in the CMS experiment at the LHC accelerator. This study ranges from the deep analysis of the historical patterns of access to the most relevant data types in CMS, to the exploitation of a supervised Machine Learning classification system to set-up a machinery able to eventually predict future data access patterns - i.e. the so-called dataset “popularity” of the CMS datasets on the Grid - with focus on specific data types. All the CMS workflows run on the Worldwide LHC Computing Grid (WCG) computing centers (Tiers), and in particular the distributed analysis systems sustains hundreds of users and applications submitted every day. These applications (or “jobs”) access different data types hosted on disk storage systems at a large set of WLCG Tiers. The detailed study of how this data is accessed, in terms of data types, hosting Tiers, and different time periods, allows to gain precious insight on storage occupancy ove...

  20. Technical Training: New Course on Microsoft Access 2003 - ECDL Module 5

    CERN Multimedia

    Monique Duval

    2005-01-01

    CERN Technical Training 2005: Learning for the LHC! The CERN Technical Training programme is now proposing a new course on Microsoft Access 2003, designed for people using Access to work with databases. The course programme will include the description of the objects of an Access database, and how to work with Access, creating and using queries, tables, forms and reports. After this course, participants will be at the level of the ECDL Certificate, Database Module 5. Optionally, it will be possible to stand the ECDL examination at the CERN Training Centre. The first scheduled session of this two-day course on Microsoft Access 2003 will take place on March 15-16, 2005. The number of participants to each session is limited to 12. The course will be in English, with an English-French bilingual instructor. The course fee is 400.- CHF per person, scaling down in case of a class of more than 4 participants. The cost of the optional ECDL certification, that will take place at a subsequent date, is 112.- CHF for t...

  1. Technical Training: New Course on Microsoft Access 2003 - ECDL Module 5

    CERN Multimedia

    Monique Duval

    2005-01-01

    CERN Technical Training 2005: Learning for the LHC! The CERN Technical Training programme is now proposing a new course on Microsoft Access 2003, designed for people using Access to work with databases. The course programme will include the description of the objects of an Access database, and how to work with Access, creating and using queries, tables, forms and reports. After this course, participants will be at the level of the ECDL Certificate, Database Module 5. Optionally, it will be possible to stand the ECDL examination at the CERN Training Centre. The first scheduled session of this two-day course on Microsoft Access 2003 will take place on March 15-16, 2005. The number of participants to each session is limited to 12. The course will be in English, with an English-French bilingual instructor. The course fee is 400.- CHF per person, scaling down in case of a class of more than 4 participants. The cost of the optional ECDL certification, that will take place at a subsequent date, is 112.- CHF for ...

  2. The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission.

    Science.gov (United States)

    Baillie, Charles A; VanZandbergen, Christine; Tait, Gordon; Hanish, Asaf; Leas, Brian; French, Benjamin; Hanson, C William; Behta, Maryam; Umscheid, Craig A

    2013-12-01

    Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. Retrospective and prospective cohort. Healthcare system consisting of 3 hospitals. All adult patients admitted from August 2009 to September 2012. An automated readmission risk flag integrated into the EHR. Thirty-day all-cause and 7-day unplanned healthcare system readmissions. Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge. © 2013 Society of Hospital Medicine.

  3. The relationship between diet and perceived and objective access to supermarkets among low-income housing residents

    Science.gov (United States)

    Caspi, Caitlin E.; Kawachi, Ichiro; Subramanian, S.V.; Adamkiewicz, Gary; Sorensen, Glorian

    2013-01-01

    In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in “food deserts,” or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in “food deserts,” as the average distance to a supermarket was 0.76 km (range 0.13–1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures. PMID:22727742

  4. Efficacy of SMART Stent Placement for Salvage Angioplasty in Hemodialysis Patients with Recurrent Vascular Access Stenosis

    Directory of Open Access Journals (Sweden)

    Shingo Hatakeyama

    2011-01-01

    Full Text Available Vascular access stenosis is a major complication in hemodialysis patients. We prospectively observed 50 patients in whom 50 nitinol shape-memory alloy-recoverable technology (SMART stents were used as salvage therapy for recurrent peripheral venous stenosis. Twenty-five stents each were deployed in native arteriovenous fistula (AVF and synthetic arteriovenous polyurethane graft (AVG cases. Vascular access patency rates were calculated by Kaplan-Meier analysis. The primary patency rates in AVF versus AVG at 3, 6, and 12 months were 80.3% versus 75.6%, 64.9% versus 28.3%, and 32.3% versus 18.9%, respectively. The secondary patency rates in AVF versus AVG at 3, 6, and 12 months were 88.5% versus 75.5%, 82.6% versus 61.8%, and 74.4% versus 61.8%, respectively. Although there were no statistically significant difference in patency between AVF and AVG, AVG showed poor tendency in primary and secondary patency. The usefulness of SMART stents was limited in a short period of time in hemodialysis patients with recurrent vascular access stenosis.

  5. Synoptic Bi-monthly and Storm Response Water Quality Sampling in Southern Kaneohe Bay, HI 2005-2007 (NODC Accession 0060061)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Synoptic sampling including water column profiles and collected surface water samples was conducted on a bi-monthly basis throughout the rainy season(October-May)...

  6. Mental Health Service Utilization among Students and Staff in 18 Months Following Dawson College Shooting

    Directory of Open Access Journals (Sweden)

    Paule Miquelon

    2014-07-01

    Full Text Available Objectives The aim of this study was to investigate service utilization by students and staff in the 18 months following the September 13, 2006, shooting at Dawson College, Montreal, as well as the determinants of this utilization within the context of Canada’s publicly managed healthcare system. Methods A sample of 948 from among the college’s 10,091 students and staff agreed to complete an adapted computer or web-based standardized questionnaire drawn from the Statistics Canada 2002 Canadian Community Health Survey cycle 1.2 on mental health and well-being. Results In the 18 months following the shooting, there was a greater incidence and prevalence not only of PTSD, but also of other anxiety disorders, depression, and substance abuse. Staff and students were as likely to consult a health professional when presenting a mental or substance use disorder, with females more likely to do so than males. Results also indicated that there was relatively high internet use for mental health reasons by students and staff (14% overall. Conclusions Following a major crisis event causing potential mass trauma, even in a society characterized by easy access to public, school and health services and when the population involved is generally well educated, the acceptability of consulting health professionals for mental health or substance use problems represents a barrier. However, safe internet access is one way male and female students and staff can access information and support and it may be useful to further exploit the possibilities afforded by web-based interviews in anonymous environments.

  7. Mental Health Service Utilization among Students and Staff in 18 Months Following Dawson College Shooting.

    Science.gov (United States)

    Miquelon, Paule; Lesage, Alain; Boyer, Richard; Guay, Stéphane; Bleau, Pierre; Séguin, Monique

    2014-01-01

    The aim of this study was to investigate service utilization by students and staff in the 18 months following the September 13, 2006, shooting at Dawson College, Montreal, as well as the determinants of this utilization within the context of Canada's publicly managed healthcare system. A sample of 948 from among the college's 10,091 students and staff agreed to complete an adapted computer or web-based standardized questionnaire drawn from the Statistics Canada 2002 Canadian Community Health Survey cycle 1.2 on mental health and well-being. In the 18 months following the shooting, there was a greater incidence and prevalence not only of PTSD, but also of other anxiety disorders, depression, and substance abuse. Staff and students were as likely to consult a health professional when presenting a mental or substance use disorder, with females more likely to do so than males. Results also indicated that there was relatively high internet use for mental health reasons by students and staff (14% overall). Following a major crisis event causing potential mass trauma, even in a society characterized by easy access to public, school and health services and when the population involved is generally well educated, the acceptability of consulting health professionals for mental health or substance use problems represents a barrier. However, safe internet access is one way male and female students and staff can access information and support and it may be useful to further exploit the possibilities afforded by web-based interviews in anonymous environments.

  8. Pediatric central venous access devices: nursing interventions

    Directory of Open Access Journals (Sweden)

    Duffy EA

    2017-05-01

    Full Text Available Elizabeth A Duffy, Kathryn N Nelson Department of Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, MI, USA Abstract: A central venous catheter (CVC is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study 

  9. Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance.

    Directory of Open Access Journals (Sweden)

    Victoria Pattison de Menil

    Full Text Available The gap in Kenya between need and treatment for mental disorders is wide, and private providers are increasingly offering services, funded in part by private health insurance (PHI. Chiromo, a 30-bed psychiatric hospital in Nairobi, forms part of one of the largest private psychiatric providers in East Africa. The study evaluated the effects of insurance on service use and charge, questioning implications on access to care. Data derive from invoices for 455 sequential patients, including 12-month follow-up. Multi-linear and binary logistic regressions explored the effect of PHI on readmission, cumulative length of stay, and treatment charge. Patients were 66.4% male with a mean age of 36.8 years. Half were employed in the formal sector. 70% were admitted involuntarily. Diagnoses were: substance use disorder 31.6%; serious mental disorder 49.5%; common mental disorder 7%; comorbid 7%; other 4.9%. In addition to daily psychiatric consultations, two-thirds received individual counselling or group therapy; half received lab tests or scans; and 16.2% received ECT. Most took a psychiatric medicine. Half of those on antipsychotics were given only brands. Insurance paid in full for 28.8% of patients. Mean length of stay was 11.8 days and, in 12 months, 16.7 days (median 10.6. 22.2% were readmitted within 12 months. Patients with PHI stayed 36% longer than those paying out-of-pocket and had 2.5 times higher odds of readmission. Mean annual charge per patient was Int$ 4,262 (median Int$ 2,821. Insurers were charged 71% more than those paying out-of-pocket--driven by higher fees and longer stays. Chiromo delivers acute psychiatric care each year to approximately 450 people, to quality and human rights standards higher than its public counterpart, but at considerably higher cost. With more efficient delivery and wider insurance coverage, Chiromo might expand from its occupancy of 56.6% to reach a larger population in need.

  10. When Every Day Is Professional Development Day

    Science.gov (United States)

    Tienken, Christopher H.; Stonaker, Lew

    2007-01-01

    In the Monroe Township (New Jersey) Public Schools, teachers' learning occurs daily, not just on one day in October and February. Central office and school-level administrators foster job-embedded teacher growth. Every day is a professional development day in the district, but that has not always been so. How did the district become a system with…

  11. Impact of Arterial Access Site on Outcomes After Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Hamon, Martial; Coste, Pierre; Van't Hof, Arnoud

    2015-01-01

    BACKGROUND: In European Ambulance Acute Coronary Syndrome Angiography (EUROMAX), bivalirudin improved 30-day clinical outcomes with reduced major bleeding compared with heparins plus optional glycoprotein IIb/IIIa inhibitors. We assessed whether choice of access site (radial or femoral) had an im...

  12. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    International Nuclear Information System (INIS)

    Andrade, Pedro Beraldo de; Andrade, Mônica Vieira Athanazio de; Barbosa, Robson Alves; Labrunie, André; Hernandes, Mauro Esteves; Marino, Roberto Luiz; Precoma, Dalton Bertolim; Sá, Francisco Carleial Feijó de; Berwanger, Otávio; Mattos, Luiz Alberto Piva e

    2014-01-01

    The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques

  13. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Pedro Beraldo de, E-mail: pedroberaldo@cardiol.br; Andrade, Mônica Vieira Athanazio de; Barbosa, Robson Alves; Labrunie, André [Santa Casa de Misericórdia de Marília, São Paulo -SP (Brazil); Hernandes, Mauro Esteves [Santa Casa de Votuporanga, São Paulo -SP (Brazil); Marino, Roberto Luiz [Hospital Madre Teresa, Belo Horizonte -MG (Brazil); Precoma, Dalton Bertolim [Sociedade Hospital Angelina Caron, Campina Grande do Sul -PR (Brazil); Sá, Francisco Carleial Feijó de [Hospital do Coração do Cariri, Barbalha -CE (Brazil); Berwanger, Otávio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo -SP (Brazil); Mattos, Luiz Alberto Piva e [Sociedade Brasileira de Cardiologia, São Paulo -SP (Brazil); Instituto Dante Pazzanese de Cardiologia, São Paulo -SP (Brazil); Unidades de Hemodinâmica e Intervenção Cardiovascular Rede D' Or / São Luiz, São Paulo, SP (Brazil)

    2014-06-15

    The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.

  14. Food Access Patterns and Barriers among Midlife and Older Adults with Mobility Disabilities

    Directory of Open Access Journals (Sweden)

    Deborah L. Huang

    2012-01-01

    Full Text Available We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants’ ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home.

  15. Artificial neural network optimisation for monthly average daily global solar radiation prediction

    International Nuclear Information System (INIS)

    Alsina, Emanuel Federico; Bortolini, Marco; Gamberi, Mauro; Regattieri, Alberto

    2016-01-01

    Highlights: • Prediction of the monthly average daily global solar radiation over Italy. • Multi-location Artificial Neural Network (ANN) model: 45 locations considered. • Optimal ANN configuration with 7 input climatologic/geographical parameters. • Statistical indicators: MAPE, NRMSE, MPBE. - Abstract: The availability of reliable climatologic data is essential for multiple purposes in a wide set of anthropic activities and operative sectors. Frequently direct measures present spatial and temporal lacks so that predictive approaches become of interest. This paper focuses on the prediction of the Monthly Average Daily Global Solar Radiation (MADGSR) over Italy using Artificial Neural Networks (ANNs). Data from 45 locations compose the multi-location ANN training and testing sets. For each location, 13 input parameters are considered, including the geographical coordinates and the monthly values for the most frequently adopted climatologic parameters. A subset of 17 locations is used for ANN training, while the testing step is against data from the remaining 28 locations. Furthermore, the Automatic Relevance Determination method (ARD) is used to point out the most relevant input for the accurate MADGSR prediction. The ANN best configuration includes 7 parameters, only, i.e. Top of Atmosphere (TOA) radiation, day length, number of rainy days and average rainfall, latitude and altitude. The correlation performances, expressed through statistical indicators as the Mean Absolute Percentage Error (MAPE), range between 1.67% and 4.25%, depending on the number and type of the chosen input, representing a good solution compared to the current standards.

  16. Impact of religious feast days on youth suicide attempts in Istanbul, Turkey.

    Science.gov (United States)

    Akkaya-Kalayci, Türkan; Popow, Christian; Waldhör, Thomas; Özlü-Erkilic, Zeliha

    2015-01-01

    Suicidal behaviour is related to psychosocial and biological factors. Although suicide is strictly forbidden by the Islamic faith, there are non-confirmed observations of increased suicidality on religious feast days. The objective of the present study was to find out if suicide attempts of youths living in Istanbul increase on religious feast days compared to ordinary and non-religious holidays. We retrospectively analyzed all suicide attempts (N = 2,232) of young people up to 25 years of age seeking support at various hospitals in Istanbul in 2010. The main hypothesis was that the number of suicide attempts would increase during religious feast days. The number of suicide attempts was higher on religious feast days and non-religious holidays except for New Year's Day and International Labour Day than the daily average number of the actual months. Like on ordinary days, more female than male youth (84.9% vs. 15.1%) attempted suicide on feast days. We speculate that changes of the daily rhythm and increased family interaction on feast days and non-religious holidays could lead to unexpected confrontations and disputes instead of the expected positive family climate. This "Broken-Promise Effect" and changes of the daily rhythm could contribute to the observed increased suicidal behaviour.

  17. AIR PRESSURE and Other Data From World-Wide Distribution from 19930101 to 19930630 (NODC Accession 9300191)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The accession contains Temperature and Depth bathythermograph data in the (TESAC) format. This contains six month data that was sent as radio messages from ships to...

  18. Evaluating Expected Costs and Benefits of Granting Access to New Treatments on the Basis of Progression-Free Survival in Non-Small-Cell Lung Cancer.

    Science.gov (United States)

    Lakdawalla, Darius N; Chou, Jacquelyn W; Linthicum, Mark T; MacEwan, Joanna P; Zhang, Jie; Goldman, Dana P

    2015-05-01

    Surrogate end points may be used as proxy for more robust clinical end points. One prominent example is the use of progression-free survival (PFS) as a surrogate for overall survival (OS) in trials for oncologic treatments. Decisions based on surrogate end points may expedite regulatory approval but may not accurately reflect drug efficacy. Payers and clinicians must balance the potential benefits of earlier treatment access based on surrogate end points against the risks of clinical uncertainty. To present a framework for evaluating the expected net benefit or cost of providing early access to new treatments on the basis of evidence of PFS benefits before OS results are available, using non-small-cell lung cancer (NSCLC) as an example. A probabilistic decision model was used to estimate expected incremental social value of the decision to grant access to a new treatment on the basis of PFS evidence. The model analyzed a hypothetical population of patients with NSCLC who could be treated during the period between PFS and OS evidence publication. Estimates for delay in publication of OS evidence following publication of PFS evidence, expected OS benefit given PFS benefit, incremental cost of new treatment, and other parameters were drawn from the literature on treatment of NSCLC. Incremental social value of early access for each additional patient per month (in 2014 US dollars). For "medium-value" model parameters, early reimbursement of drugs with any PFS benefit yields an incremental social cost of more than $170,000 per newly treated patient per month. In contrast, granting early access on the basis of PFS benefit between 1 and 3.5 months produces more than $73,000 in incremental social value. Across the full range of model parameter values, granting access for drugs with PFS benefit between 3 and 3.5 months is robustly beneficial, generating incremental social value ranging from $38,000 to more than $1 million per newly treated patient per month, whereas access

  19. Preliminary Analyses Showed Short-Term Mental Health Improvements after a Single-Day Manager Training.

    Science.gov (United States)

    Boysen, Elena; Schiller, Birgitta; Mörtl, Kathrin; Gündel, Harald; Hölzer, Michael

    2018-01-10

    Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees' psychological risk factors, we conducted a specific manager training. Within this investigation, we wanted to learn about the training's effects and acceptance. A single-day manager training was provided in a large industrial company in Germany. The participants were asked to fill out questionnaires regarding their own physical and mental health condition as well as their working situation. Questionnaires were distributed at baseline, 3-month, and 12-month follow-up. At this point of time the investigation is still ongoing. The current article focuses on short-term preliminary effects. Analyses only included participants that already completed baseline and three months follow-up. Preliminary results from three-month follow-up survey ( n = 33, nmale = 30, Mage = 47.5) indicated positive changes in the manager's mental health condition measured by the Patient Health Questionnaire for depression (PHQ-9: Mt1 = 3.82, Mt2 = 3.15). Training managers about common mental disorders and risk factors at the workplace within a single-day workshop seems to promote positive effects on their own mental health. Especially working with the managers on their own early stress symptoms might have been an important element.

  20. Web accessibility standards and disability: developing critical perspectives on accessibility.

    Science.gov (United States)

    Lewthwaite, Sarah

    2014-01-01

    Currently, dominant web accessibility standards do not respect disability as a complex and culturally contingent interaction; recognizing that disability is a variable, contrary and political power relation, rather than a biological limit. Against this background there is clear scope to broaden the ways in which accessibility standards are understood, developed and applied. Commentary. The values that shape and are shaped by legislation promote universal, statistical and automated approaches to web accessibility. This results in web accessibility standards conveying powerful norms fixing the relationship between technology and disability, irrespective of geographical, social, technological or cultural diversity. Web accessibility standards are designed to enact universal principles; however, they express partial and biopolitical understandings of the relation between disability and technology. These values can be limiting, and potentially counter-productive, for example, for the majority of disabled people in the "Global South" where different contexts constitute different disabilities and different experiences of web access. To create more robust, accessible outcomes for disabled people, research and standards practice should diversify to embrace more interactional accounts of disability in different settings. Implications for Rehabilitation Creating accessible experiences is an essential aspect of rehabilitation. Web standards promote universal accessibility as a property of an online resource or service. This undervalues the importance of the user's intentions, expertize, their context, and the complex social and cultural nature of disability. Standardized, universal approaches to web accessibility may lead to counterproductive outcomes for disabled people whose impairments and circumstances do not meet Western disability and accessibility norms. Accessible experiences for rehabilitation can be enhanced through an additional focus on holistic approaches to

  1. Nutrition accesses among patients receiving enteral treatment in the home environment.

    Science.gov (United States)

    Sznajder, Janusz; Ślefarska-Wasilewska, Marta; Wójcik, Piotr

    2017-10-31

    Enteral feeding in the home environment is connected with creating access to digestive tract, and thanks to that, this kind of treatment is possible. The gold standard in enteral nutrition is PEG, other types of access are: nasogastric tube, gastronomy and jejunostomy. In the article 851 patients who were treated nutritionally in the home environment, in the nutrition clinic, Nutrimed Górny Śląsk, were analyzed. It was described how, in practice, the schedule of nutrition access looks like in the nutrition clinic at a time of qualifying patients to the treatment (PEG 47,35%, gastronomy 18,91%, nasogastric tube 17,39%,jejunostomy 16,33%) and how it changes among patients treated in the nutrition clinic during specific period of time - to the treatment there were qualified patients with at least three-month period of therapy ( second evaluation: PEG 37,01%, gastrostomy 31,13%, nasogastric tube 16,98%, jejunostomy 15,86%). The structure of changes was described, also the routine and the place in what exchanging or changing nutrition access was analyzed. The biggest changes in quantity, among all groups of ill people concerned patients with PEG and gastronomy. In most cases the intervention connected with exchanging access to the digestive tract could be implemented at patient's home.

  2. Evolution of impedance field telemetry after one day of activation in cochlear implant recipients.

    Directory of Open Access Journals (Sweden)

    Hao-Chun Hu

    Full Text Available Changes in impedance between 24 hours and one month after cochlear implantation have never been explored due to the inability to switch on within one day. This study examined the effect of early activation (within 24 hours on the evolution of electrode impedance with the aim of providing information on the tissue-to-electrode interface when electrical stimulation was commenced one day post implantation.We performed a retrospective review at a single institution. Patients who received a Nucleus 24RECA implant system (Cochlear, Sydney, Australia and underwent initial switch-on within 24 hours postoperatively were included. Impedance measurements were obtained intraoperatively and postoperatively at 1 day, 1 week, 4 weeks, and 8 weeks.A significant drop in impedance was noted 1 day after an initial activation within 24 hours followed by a significant rise in impedance in all channels until 1 week, after which the impedance behaved differently in different segments. Basal and mid-portion electrodes revealed a slight increase while apical electrodes showed a slight decrease in impedance from 1 week to 8 weeks postoperatively. Impedance was relatively stable 4 weeks after surgery.This is the first study to report the evolution of impedance in all channels between initial mapping 1 day and 1 month after cochlear implantation. The underlying mechanism for the differences in behavior between different segments of the electrode may be associated with the combined effect of dynamics among the interplay of cell cover formation, electrical stimulation, and fibrotic reaction.

  3. Grain protein concentration and harvestable protein under future climate conditions. A study of 108 spring barley accessions

    DEFF Research Database (Denmark)

    Ingvordsen, Cathrine Heinz; Gislum, René; Jørgensen, Johannes Ravn

    2016-01-01

    In the present study a set of 108 spring barley (H. vulgare L.) accessions were cultivated under predicted future levels of temperature and [CO2] as single factors and in combination (IPCC, AR5, RCP8.5). Across all genotypes, elevated [CO2] (700 ppm day/night) slightly decreased protein concentra......In the present study a set of 108 spring barley (H. vulgare L.) accessions were cultivated under predicted future levels of temperature and [CO2] as single factors and in combination (IPCC, AR5, RCP8.5). Across all genotypes, elevated [CO2] (700 ppm day/night) slightly decreased protein...

  4. Natural gas monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    The Natural Gas Monthly highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the Natural Gas Monthly features articles designed to assist readers in using and interpreting natural gas information.

  5. Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

    Science.gov (United States)

    Koshy, Linda M; Aberle, Laura H; Krucoff, Mitchell W; Hess, Connie N; Mazzaferri, Ernest; Jolly, Sanjit S; Jacobs, Alice; Gibson, C Michael; Mehran, Roxana; Gilchrist, Ian C; Rao, Sunil V

    2018-01-01

    This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI). Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown. We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference. Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound. This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

  6. D:L-Amino Acid Modeling Reveals Fast Microbial Turnover of Days to Months in the Subsurface Hydrothermal Sediment of Guaymas Basin

    Directory of Open Access Journals (Sweden)

    Mikkel H. Møller

    2018-05-01

    Full Text Available We investigated the impact of temperature on the microbial turnover of organic matter (OM in a hydrothermal vent system in Guaymas Basin, by calculating microbial bio- and necromass turnover times based on the culture-independent D:L-amino acid model. Sediments were recovered from two stations near hydrothermal mounds (<74°C and from one cold station (<9°C. Cell abundance at the two hydrothermal stations dropped from 108 to 106 cells cm-3 within ∼5 m of sediment depth resulting in a 100-fold lower cell number at this depth than at the cold site where numbers remained constant at 108 cells cm-3 throughout the recovered sediment. There were strong indications that the drop in cell abundance was controlled by decreasing OM quality. The quality of the sedimentary OM was determined by the diagenetic indicators %TAAC (percentage of total organic carbon present as amino acid carbon, %TAAN (percentage of total nitrogen present as amino acid nitrogen, aspartic acid:β-alanine ratios, and glutamic acid:γ-amino butyric acid ratios. All parameters indicated that the OM became progressively degraded with increasing sediment depth, and the OM in the hydrothermal sediment was more degraded than in the uniformly cold sediment. Nonetheless, the small community of microorganisms in the hydrothermal sediment demonstrated short turnover times. The modeled turnover times of microbial bio- and necromass in the hydrothermal sediments were notably faster (biomass: days to months; necromass: up to a few hundred years than in the cold sediments (biomass: tens of years; necromass: thousands of years, suggesting that temperature has a significant influence on the microbial turnover rates. We suggest that short biomass turnover times are necessary for maintance of essential cell funtions and to overcome potential damage caused by the increased temperature.The reduced OM quality at the hyrothemal sites might thus only allow for a small population size of microorganisms.

  7. Monthly Weather Review

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Supplements to the Monthly Weather Review publication. The Weather Bureau published the Monthly weather review Supplement irregularly from 1914 to 1949. The...

  8. Evolution of accesses to information on breast cancer and screening on the Brazilian National Cancer Institute website: an exploratory study.

    Science.gov (United States)

    Vasconcellos-Silva, Paulo Roberto; Sormunen, Taina; Craftman, Åsa Gransjön

    2018-04-01

    Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS) we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009) of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA). We found significant increasing accesses to BC and transient "attention peaks". Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a "prevention culture"; lack of confidence in health system and screening programs; "celebrity effect" in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

  9. Dairy consumption and cardiometabolic health: outcomes of a 12-month crossover trial

    Directory of Open Access Journals (Sweden)

    Crichton Georgina E

    2012-03-01

    Full Text Available Abstract Background A growing body of research suggests that regular consumption of dairy foods may counteract obesity and other components of the metabolic syndrome. However, human intervention trials are lacking. We aimed to determine the cardiometabolic health effects of increasing the consumption of reduced fat dairy foods in adults with habitually low dairy intakes in the absence of energy restriction. Methods An intervention trial was undertaken in 61 overweight or obese adults who were randomly assigned to a high dairy diet (HD, 4 serves of reduced fat dairy/day or a low dairy control diet (LD, ≤1 serve/day for 6 months then crossed over to the alternate diet for a further 6 months. A range of anthropometric and cardiometabolic parameters including body composition, metabolic rate, blood lipids, blood pressure and arterial compliance were assessed at the end of each diet phase. Results Total energy intake was 1120 kJ/day higher during the HD phase, resulting in slight weight gain during this period. However, there were no significant differences between HD and LD in absolute measures of waist circumference, body weight, fat mass or any other cardiometabolic parameter. Conclusion Recommended intakes of reduced fat dairy products may be incorporated into the diet of overweight adults without adversely affecting markers of cardiometabolic health. Trial Registration The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12608000538347 on 24th October, 2008.

  10. Oceanographic data collected from Marsh Island (USCG day mark green 21) by Center for Coastal Margin Observation and Prediction (CMOP) and assembled by Northwest Association of Networked Ocean Observation Systems (NANOOS) in the Columbia River Estuary and North East Pacific Ocean from 2001-09-17 to 2006-10-12 (NCEI Accession 0162177)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0162177 contains navigational and physical data collected at Marsh Island (USCG day mark green 21), a fixed station in the Columbia River estuary -...

  11. Early primary repair of tetralogy of fallot in neonates and infants less than four months of age.

    Science.gov (United States)

    Tamesberger, Melanie I; Lechner, Evelyn; Mair, Rudolf; Hofer, Anna; Sames-Dolzer, Eva; Tulzer, Gerald

    2008-12-01

    The ideal age for correction of tetralogy of Fallot is still under discussion. The aim of this study was to analyze morbidity and mortality in patients who underwent early primary repair of tetralogy of Fallot at the age of less than 4 months and to assess whether neonates, who needed early repair within the first 4 weeks of life, faced an increased risk. From 1995 to 2006, 90 consecutive patients with tetralogy of Fallot and pulmonary stenosis underwent early primary repair. Patient charts were analyzed retrospectively for two groups: group A, 25 neonates younger than 28 days who needed early operation owing to duct-dependent pulmonary circulation or severe hypoxemia; and group B, 65 infants younger than 4 months of age who underwent elective early repair. There was no 30-day mortality; late mortality was 2% after a median follow-up time of 4.7 years. Seven of 88 patients (8%) needed reoperation and twelve of 88 patients (14%) needed reintervention. Groups A and B did not differ significantly in terms of intensive care unit stay, days of mechanical ventilation, overall hospital stay, major or minor complications, or reoperation. Significant differences were found in a more frequent use of a transannular patch (p = 0.045) and more reinterventions (p = 0.046) in group A. Early primary repair of tetralogy of Fallot can be performed safely and effectively in infants younger than 4 months of age and even in neonates younger than 28 days with duct-dependent pulmonary circulation or severe hypoxemia.

  12. Direct data access protocols benchmarking on DPM

    Science.gov (United States)

    Furano, Fabrizio; Devresse, Adrien; Keeble, Oliver; Mancinelli, Valentina

    2015-12-01

    The Disk Pool Manager is an example of a multi-protocol, multi-VO system for data access on the Grid that went though a considerable technical evolution in the last years. Among other features, its architecture offers the opportunity of testing its different data access frontends under exactly the same conditions, including hardware and backend software. This characteristic inspired the idea of collecting monitoring information from various testbeds in order to benchmark the behaviour of the HTTP and Xrootd protocols for the use case of data analysis, batch or interactive. A source of information is the set of continuous tests that are run towards the worldwide endpoints belonging to the DPM Collaboration, which accumulated relevant statistics in its first year of activity. On top of that, the DPM releases are based on multiple levels of automated testing that include performance benchmarks of various kinds, executed regularly every day. At the same time, the recent releases of DPM can report monitoring information about any data access protocol to the same monitoring infrastructure that is used to monitor the Xrootd deployments. Our goal is to evaluate under which circumstances the HTTP-based protocols can be good enough for batch or interactive data access. In this contribution we show and discuss the results that our test systems have collected under the circumstances that include ROOT analyses using TTreeCache and stress tests on the metadata performance.

  13. Month of the Year Effect Pada Beberapa Pasar Modal di Asia Tenggara dan Pasar Komoditas

    Directory of Open Access Journals (Sweden)

    Robiyanto Robiyanto

    2016-06-01

    Full Text Available One of prominent phenomenon in capital market is month of the year effect which is the occurence of certain monthly pattern in capital market return during trading years. There were enormous researches, which had been done to explain this phenomenon in capital market but the results always varied. Unfortunately there was a few research to explain this phenomenon in commodities market. Based on these facts, research about this seasonality still need to be done both in capital market and commodities market. Data used in this study were several South East Asia monthly closing stock market indexes and several commodity product monthly closing prices such as gold, silver, platinum, paladium and West Texas Intermediate Crude Oil during January 1999 – March 2014 period. GARCH (1,1 was employed to analyze the data. The finding shows that month of the year effect still exist in capital market in South East Asia and commodity market during research period with various occurences. Each capital market and commodity market behaves variously during trading year. This may lead to an opportunity, which can be grabbed by active market switching strategy for sophisticated investors, and investors who have multiple access to regional capital markets and commodity markets.

  14. Broadband Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Broadband Access. Worldwide market for broadband access $30 Billion! Over 200 million broadband subscribers worldwide! Various Competing Broadband access. Digital Subscriber line; Wireless; Optical Fiber.

  15. One-day behavioral intervention in depressed migraine patients: effects on headache.

    Science.gov (United States)

    Dindo, Lilian; Recober, Ana; Marchman, James; O'Hara, Michael W; Turvey, Carolyn

    2014-03-01

    To determine whether a 1-day behavioral intervention, aimed at enhancing psychological flexibility, improves headache outcomes of migraine patients with comorbid depression. Migraine is often comorbid with depression, with each disorder increasing the risk for onset and exacerbation of the other. Managing psychological triggers, such as stress and depression, may result in greater success of headache management. Sixty patients with comorbid migraine and depression were assigned to a 1-day Acceptance and Commitment Training plus Migraine Education workshop (ACT-ED; N = 38) or to treatment as usual (TAU; N = 22). Patients completed a daily headache diary prior to, and for 3 months following, the intervention. Clinical variables examined included headache frequency/severity, medication use, disability, and visit to a health care professional. Comparisons were made between baseline findings and findings at the 3-month follow up. Participants assigned to the ACT-ED condition exhibited significant improvements in headache frequency, headache severity, medication use, and headache-related disability. In contrast, the TAU group did not exhibit improvements. The difference in headache outcomes between ACT-ED and TAU was not statistically significant over time (ie, the treatment by time interaction was nonsignificant). These results complement those of a previous report showing effects of ACT-ED vs TAU on depression and disability. A 1-day ACT-ED workshop targeting psychological flexibility may convey benefit for patients with comorbid migraine and depression.These pilot study findings merit further investigation using a more rigorously designed large-scale trial.

  16. CERN Open Days 2013, Point 5 - CMS: CMS Experiment

    CERN Multimedia

    CERN Photolab

    2013-01-01

    Stand description: Come to LHC's Point 5 and visit the Compact Muon Solenoid (CMS) experiment that discovered the Higgs boson ! Descend 100 metres underground and take a walk in the cathedral-sized cavern housing the 14,000-tonne CMS detector. Ask Higgs hunters and other scientists just about anything, be it questions about their work, particle physics or the engineering challenges of building CMS.  On surface no restricted access  Point 5 will be abuzz all day long with activities for all ages, including literally "cool" cryogenics shows featuring the world's fastest ice-cream maker, dance performances, and much more.

  17. Accessibility to primary health care services in the state of Goiás

    Directory of Open Access Journals (Sweden)

    Juliana Pires Ribeiro

    2015-09-01

    Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

  18. Error-related brain activity predicts cocaine use after treatment at 3-month follow-up.

    Science.gov (United States)

    Marhe, Reshmi; van de Wetering, Ben J M; Franken, Ingmar H A

    2013-04-15

    Relapse after treatment is one of the most important problems in drug dependency. Several studies suggest that lack of cognitive control is one of the causes of relapse. In this study, a relative new electrophysiologic index of cognitive control, the error-related negativity, is investigated to examine its suitability as a predictor of relapse. The error-related negativity was measured in 57 cocaine-dependent patients during their first week in detoxification treatment. Data from 49 participants were used to predict cocaine use at 3-month follow-up. Cocaine use at follow-up was measured by means of self-reported days of cocaine use in the last month verified by urine screening. A multiple hierarchical regression model was used to examine the predictive value of the error-related negativity while controlling for addiction severity and self-reported craving in the week before treatment. The error-related negativity was the only significant predictor in the model and added 7.4% of explained variance to the control variables, resulting in a total of 33.4% explained variance in the prediction of days of cocaine use at follow-up. A reduced error-related negativity measured during the first week of treatment was associated with more days of cocaine use at 3-month follow-up. Moreover, the error-related negativity was a stronger predictor of recent cocaine use than addiction severity and craving. These results suggest that underactive error-related brain activity might help to identify patients who are at risk of relapse as early as in the first week of detoxification treatment. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China.

    Science.gov (United States)

    Li, Man; Zhong, Renyao; Zhu, Shanwen; Ramsay, Lauren C; Li, Fen; Coyte, Peter C

    2018-06-06

    Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  20. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

    Directory of Open Access Journals (Sweden)

    Man Li

    2018-06-01

    Full Text Available Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1 explore regional differences in community living infrastructure; and (2 to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  1. Emergency contraception: Sources of information and perceptions of access among young adults.

    Science.gov (United States)

    Garrett, Kyla P; Widman, Laura; Francis, Diane B; Noar, Seth M

    2016-01-01

    Emergency contraception (EC) can prevent pregnancy for up to 5 days after unprotected sex. Although EC has become increasingly available, little is known about perceptions of young adults regarding access to EC or whether information sources about EC relate to perceived access among young adults. Over a 1-week period in November 2013, a self-report survey was administered to 352 college students (67% women) at the student union of a large, public university in the southeastern United States. The survey assessed three aspects of EC: perceived access, information sources, and prior use. Twenty-one percent of participants had used EC. Participants reported relatively high perceptions of access to EC, with females reporting higher perceptions of access than males. Prior to the study, 7.4% of students had never heard of EC; the remaining students had heard of EC from an average of four sources. Among women, hearing of EC from media, interpersonal, or health education sources was significantly associated with greater perceived access (ps sources were associated with perceived access (ps > .10). Future EC awareness efforts for women should leverage all three of these sources, while future research should examine specific sources to focus on the content, quality, and frequency of messages.

  2. Comparison of two indwelling central venous access catheters in dogs undergoing fractionated radiotherapy

    International Nuclear Information System (INIS)

    Evans, K.L.; Smeak, D.D.; Couto, C.G.; Hammer, A.S.; Gaynor, J.S.

    1994-01-01

    Twenty dogs with neoplasms requiring multiple radiation treatments received either percutaneous vascular access catheters (PVACs; Cook, Bloomington, IN) or subcutaneous vascular access ports (SVAPs; Vascular-Access-Ports, Norfolk Medical Products, Inc., Skokie, IL); 10 dogs were entered in each group. All catheters were implanted and removed aseptically and the catheter tips were cultured during implant removal. Complications with PVACs included mild incisional swelling and redness and accidental severance or rupture of the catheter. Complications with SVAPs included incisional or port swelling, bruising or redness, hematoma formation, and pain. Ports in 4 of these dogs could not be used for 1 to 3 days after surgery because of swelling and pain. Surgical wound complications, when pooled for comparison, occurred significantly more frequently with the SVAPs (P = .023). Wound complications associated with both catheters were self-limiting and resolved within 7 days. Bacterial cultures were positive in two PVACs and four SVAP tips, however, none of these dogs had clinical signs of infection or sepsis. Although both types of indwelling catheters were functional in a clinical setting, PVACs were preferred to SVAPs for dogs undergoing radiation therapy because of decreased time for implantation and fewer overall complications

  3. Chemists, Access, Statistics

    Science.gov (United States)

    Holmes, Jon L.

    2000-06-01

    IP-number access. Current subscriptions can be upgraded to IP-number access at little additional cost. We are pleased to be able to offer to institutions and libraries this convenient mode of access to subscriber only resources at JCE Online. JCE Online Usage Statistics We are continually amazed by the activity at JCE Online. So far, the year 2000 has shown a marked increase. Given the phenomenal overall growth of the Internet, perhaps our surprise is not warranted. However, during the months of January and February 2000, over 38,000 visitors requested over 275,000 pages. This is a monthly increase of over 33% from the October-December 1999 levels. It is good to know that people are visiting, but we would very much like to know what you would most like to see at JCE Online. Please send your suggestions to JCEOnline@chem.wisc.edu. For those who are interested, JCE Online year-to-date statistics are available. Biographical Snapshots of Famous Chemists: Mission Statement Feature Editor: Barbara Burke Chemistry Department, California State Polytechnic University-Pomona, Pomona, CA 91768 phone: 909/869-3664 fax: 909/869-4616 email: baburke@csupomona.edu The primary goal of this JCE Internet column is to provide information about chemists who have made important contributions to chemistry. For each chemist, there is a short biographical "snapshot" that provides basic information about the person's chemical work, gender, ethnicity, and cultural background. Each snapshot includes links to related websites and to a biobibliographic database. The database provides references for the individual and can be searched through key words listed at the end of each snapshot. All students, not just science majors, need to understand science as it really is: an exciting, challenging, human, and creative way of learning about our natural world. Investigating the life experiences of chemists can provide a means for students to gain a more realistic view of chemistry. In addition students

  4. News UK public libraries offer walk-in access to research Atoms for Peace? The Atomic Weapons Establishment and UK universities Students present their research to academics: CERN@school Science in a suitcase: Marvin and Milo visit Ethiopia Inspiring telescopes A day for everyone teaching physics 2014 Forthcoming Events

    Science.gov (United States)

    2014-05-01

    UK public libraries offer walk-in access to research Atoms for Peace? The Atomic Weapons Establishment and UK universities Students present their research to academics: CERN@school Science in a suitcase: Marvin and Milo visit Ethiopia Inspiring telescopes A day for everyone teaching physics 2014 Forthcoming Events

  5. Tubal endometriosis diagnosed within one month after menarche: a case report.

    Science.gov (United States)

    Yamamoto, K; Mitsuhashi, Y; Takaike, T; Takase, K; Hoshiai, H; Noda, K

    1997-03-01

    A 13-year-old nulligravida girl, 158.5 cm in height and 76.0 kg in body weight, came to our department complaining of continuous right lower abdominal pain. One month earlier, an ovarian cyst in the right ovary, about 3 cm in diameter, was found when she underwent appendectomy at another hospital, but was left untreated. Menarche occurred at the age of 13 years and 1 month, which was after the appendectomy and 24 days before the present operation. Right hematosalpinx with peripheral obstruction and a para-ovarian serous cyst on the same side were diagnosed, and therefore right salpingectomy with para-ovarian cyst resection was performed. The bilateral ovaries and uterus were completely normal by inspection. The post operative histological examination confirmed hematosalpinx and revealed tubal endometriosis.

  6. Rainfall and Coconut Accession Explain the Composition and Abundance of the Community of Potential Auchenorrhyncha Phytoplasma Vectors in Brazil.

    Science.gov (United States)

    Silva, Flaviana G; Passos, Eliana M; Diniz, Leandro E C; Farias, Adriano P; Teodoro, Adenir V; Fernandes, Marcelo F; Dollet, Michel

    2018-04-05

    Coconut plantations are attacked by the lethal yellowing (LY), which is spreading rapidly with extremely destructive effects in several countries. The disease is caused by phytoplasmas that occur in the plant phloem and are transmitted by Haplaxius crudus (Van Duzee) (Auchenorrhyncha: Cixiidae). Owing to their phloem-sap feeding habit, other planthopper species possibly act as vectors. Here, we aimed at assessing the seasonal variation in the Auchenorrhyncha community in six dwarf coconut accessions. Also, we assessed the relative contribution of biotic (coconut accession) and abiotic (rainfall, temperature) in explaining Auchenorrhyncha composition and abundance. The Auchenorrhyncha community was monthly evaluated for 1 yr using yellow sticky traps. Among the most abundant species, Oecleus sp., Balclutha sp., Deltocephalinae sp.2, Deltocephalinae sp.3, Cenchreini sp., Omolicna nigripennis Caldwell (Derbidae), and Cedusa sp. are potential phytoplasma vectors. The composition of the Auchenorrhyncha community differed between dwarf coconut accessions and periods, namely, in March and April (transition from dry to rainy season) and August (transition from rainy to dry season). In these months, Oecleus sp. was predominantly found in the accessions Cameroon Red Dwarf, Malayan Red Dwarf, and Brazilian Red Dwarf Gramame, while Cenchreini sp. and Bolbonota sp. were dominant in the accessions Brazilian Yellow Dwarf Gramame, Malayan Yellow Dwarf, and Brazilian Green Dwarf Jequi. We conclude that dwarf coconut host several Auchenorrhyncha species potential phytoplasma vectors. Furthermore, coconut accessions could be exploited in breeding programs aiming at prevention of LY. However, rainfall followed by accessions mostly explained the composition and abundance of the Auchenorrhyncha community.

  7. Poverty, Transportation Access, and Medication Nonadherence.

    Science.gov (United States)

    Hensley, Caroline; Heaton, Pamela C; Kahn, Robert S; Luder, Heidi R; Frede, Stacey M; Beck, Andrew F

    2018-04-01

    Variability in primary medication nonadherence (PMN), or failure to fill a new prescription, influences disparities and widens equity gaps. This study sought to evaluate PMN across 1 metropolitan area and assess relationships with underlying zip code-level measures. This was a retrospective observational study using data extracted from 1 regional community pharmacy market-share leader (October 2016-April 2017). Data included patient age, sex, payer, medication type, and home zip code. This zip code was connected to US census measures enumerating poverty and vehicle access, which were treated as continuous variables and within quintiles. The prescription-level outcome was whether prescriptions were not filled within 30 days of reaching the pharmacy. The ecological-level outcome was PMN calculated for each zip code (numerator, unfilled prescriptions; denominator, received prescriptions). There were 213 719 prescriptions received by 54 included pharmacies; 12.2% were unfilled. Older children, boys, and those with public insurance were more likely to have prescriptions not filled. Prescriptions originating from the highest poverty quintile were significantly more likely to not be filled than those from the lowest poverty quintile (adjusted odds ratio 1.60; 95% confidence interval 1.52-1.69); a similar pattern was noted for vehicle access (adjusted odds ratio 1.77; 95% confidence interval 1.68-1.87). At the ecological level, there were significant, graded relationships between PMN rates and poverty and vehicle access (both P < .0001); these gradients extended across all medication classes. Poverty and vehicle access are related to significant differences in prescription- and ecological-level PMN across 1 metropolitan area. Pharmacists and pharmacies can be key partners in population health efforts. Copyright © 2018 by the American Academy of Pediatrics.

  8. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    Directory of Open Access Journals (Sweden)

    Pedro Beraldo de Andrade

    2014-07-01

    Full Text Available Background: The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Objective: To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. Methods: From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. Results: The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. Conclusions: The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.

  9. Diminished growth and lower adiposity in hyperglycemic very low birth weight neonates at 4 months corrected age.

    Science.gov (United States)

    Scheurer, J M; Gray, H L; Demerath, E W; Rao, R; Ramel, S E

    2016-02-01

    Characterize the relationship between neonatal hyperglycemia and growth and body composition at 4 months corrected age (CA) in very low birth weight (VLBW) preterm infants. A prospective study of VLBW appropriate-for-gestation infants (N=53). All blood glucose measurements in the first 14 days and nutritional intake and illness markers until discharge were recorded. Standard anthropometrics and body composition via air displacement plethysmography were measured near term CA and 4 months CA. Relationships between hyperglycemia and anthropometrics and body composition were examined using multivariate linear regression. Infants with >5 days of hyperglycemia were lighter (5345 vs 6455 g, P⩽0.001), shorter (57.9 vs 60.9 cm, P⩽0.01), had smaller occipital-frontal head circumference (39.4 vs 42.0 cm, P⩽0.05) and were leaner (percent body fat 15.0 vs 23.8, P⩽0.01) at 4 months CA than those who did not have hyperglycemia, including after correcting for nutritional and illness factors. Neonatal hyperglycemia in VLBW infants is associated with decreased body size and lower adiposity at 4 months CA independent of nutritional deficit, insulin use and illness. Downregulation of the growth hormone axis may be responsible. These changes may influence long-term growth and cognitive development.

  10. Multivariate analysis applied to monthly rainfall over Rio de Janeiro state, Brazil

    Science.gov (United States)

    Brito, Thábata T.; Oliveira-Júnior, José F.; Lyra, Gustavo B.; Gois, Givanildo; Zeri, Marcelo

    2017-10-01

    Spatial and temporal patterns of rainfall were identified over the state of Rio de Janeiro, southeast Brazil. The proximity to the coast and the complex topography create great diversity of rainfall over space and time. The dataset consisted of time series (1967-2013) of monthly rainfall over 100 meteorological stations. Clustering analysis made it possible to divide the stations into six groups (G1, G2, G3, G4, G5 and G6) with similar rainfall spatio-temporal patterns. A linear regression model was applied to a time series and a reference. The reference series was calculated from the average rainfall within a group, using nearby stations with higher correlation (Pearson). Based on t-test ( p River (G5) and the metropolitan area of the city of Rio de Janeiro (G6). The driest months in all regions were June, July and August, while November, December and January were the rainiest months. Sharp transitions occurred when considering monthly accumulated rainfall: from January to February, and from February to March, likely associated with episodes of "veranicos", i.e., periods of 4-15 days of duration with no rainfall.

  11. Climate factors affecting fertility after cervical insemination during the first months of the breeding season in Rasa Aragonesa ewes

    Science.gov (United States)

    Santolaria, P.; Yániz, J.; Fantova, E.; Vicente-Fiel, S.; Palacín, I.

    2014-09-01

    This study was carried out to examine the impact of several climate variables on the pregnancy rate after cervical artificial insemination (AI) of Rasa Aragonesa ewes. Data were derived from 8,977 inseminations in 76 well-managed flocks performed during the first month of the breeding season (July to October). The following data were recorded for each animal: farm, year, month of AI, parity, lambing-treatment interval, inseminating ram, AI technician, and climatic variables such as mean, maximum and minimum temperature, mean and maximum relative humidity, rainfall, and mean and maximum temperature-humidity index (THI) for each day from day 12 before AI to day 14 post-AI. Means were furthermore calculated for the following periods around AI (day 0): -12 to 0, -2 to 0, AI day, 0 to 2, and 0 to 14. Logistic regression analysis indicated that the likelihood of pregnancy decreased when maximum temperature in the 2 days prior to AI was higher than 30 °C (by a factor of 0.81). Fertility was also lower for primiparous ewes and in multiparous ewes with more than five previous parturitions. Other factors with significant impact on fertility were flock, technician, inseminating ram, and a lambing-AI interval longer than 240 days. It was concluded that the 2 days prior to AI seems to be the period when heat stress had the greatest impact on pregnancy rate in Rasa Aragonesa ewes.

  12. Does better access to FPs decrease the likelihood of emergency department use?

    Science.gov (United States)

    Mian, Oxana; Pong, Raymond

    2012-01-01

    Abstract Objective To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Design Population-based telephone survey. Setting Ontario. Participants A total of 8502 Ontario residents aged 16 years and older. Main outcome measures Emergency department use in the 12 months before the survey. Results Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use. PMID:23152473

  13. Guillain-Barre syndrome in a 7-month-old boy successfully applied plasma exchange.

    Science.gov (United States)

    Akarcan, Sanem Eren; İşgüder, Rana; Yılmaz, Ünsal; Ayhan, Yüce; Ceylan, Gökhan; Ağın, Hasan

    2016-02-01

    Despite being the most common cause of acute flaccid paralysis in children Guillain-Barré syndrome has a low incidence under 18 years old, and is even rarer under the age of 2. Established treatment regimens include intravenous immunoglobulin and plasma exchange in older children and adults. However very limited data are available for the efficacy and safety of plasma exchange in infants younger than 12 month-old. This article presents the experience of plasma exchange in the case of 7-month-old boy diagnosed with Guillain-Barré syndrome. A 7-month-old boy was referred to the pediatric intensive care unit with a 10-day history of progressive weakness, feeding difficulty and constipation. He was diagnosed with axonal Guillain-Barré syndrome on the basis of clinical and electromyographical findings. The patient recovered fully with intravenous immunoglobulin and plasma exchange. Plasma exchange may be a safe option in the treatment in infants with Guillain-Barré syndrome as young as 7-month-age. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice.

    Science.gov (United States)

    Koester, Ralf; Kaehler, Jan; Ebelt, Henning; Soeffker, Gerold; Werdan, Karl; Meinertz, Thomas

    2010-10-01

    The anti-anginal efficacy of the selective I(f) inhibitor ivabradine has been demonstrated in controlled clinical trials. However, there is limited information about the safety and efficacy of a combined treatment of ivabradine with beta-blockers, particularly outside of clinical trials in every day practice. This analysis from the REDUCTION study evaluated the safety and efficacy of a combined therapy of beta-blockers and ivabradine in every day practice. In this multi-center study 4,954 patients with stable angina pectoris were treated with ivabradine in every day routine practice and underwent a clinical follow-up for 4 months. 344 of these patients received a co-medication with beta-blockers. Heart rate (HR), angina pectoris episodes, nitrate consumption, overall efficacy and tolerance were analyzed. After 4 months of treatment with ivabradine HR was reduced by 12.4 ± 11.6 bpm from 84.3 ± 14.6 to 72.0 ± 9.9 bpm, p every day practice.

  15. Single port access for laparoscopic lateral segmentectomy.

    Science.gov (United States)

    Inoue, Yoshihiro; Asakuma, Mitsuhiro; Hirokawa, Fumitoshi; Hayashi, Michihiro; Shimizu, Tetsunosuke; Uchiyama, Kazuhisa

    2017-12-01

    Single-port access laparoscopic lateral segmentectomy (LLS) has been developed as a novel minimally invasive surgery. We have experience with this LLS technique. To report our technique and patients' postoperative course in a series of single-port access LLS performed in our department. We also examine the cosmetic outcome, safety, and utility of the procedure. Between February 2010 and October 2016, 54 patients who underwent single- or multiple-port laparoscopic or open lateral segmentectomy (LS) were retrospectively analyzed with respect to cosmetic outcome, safety, and utility. In the single LLS group, the laparoscopic procedure was successfully completed for all 14 patients. The median operative time was significantly shorter in the single LLS group (123 min; range: 50-270 min) than in the other groups. Estimated blood loss was also significantly lower in the single LLS group (10 ml; range: 0-330 ml). During the first 7 postoperative days, the visual analog scale pain score and the use of additional analgesia were not significantly different between groups. The single LLS group had a 7.1% complication rate (Clavien-Dindo classification > IIIA); this was not significantly different between groups. Single-port access LLS is a procedure with excellent cosmetic results, although, with regard to invasiveness, there are no major differences from conventional LLS.

  16. Towards combined global monthly gravity field solutions

    Science.gov (United States)

    Jaeggi, Adrian; Meyer, Ulrich; Beutler, Gerhard; Weigelt, Matthias; van Dam, Tonie; Mayer-Gürr, Torsten; Flury, Jakob; Flechtner, Frank; Dahle, Christoph; Lemoine, Jean-Michel; Bruinsma, Sean

    2014-05-01

    Currently, official GRACE Science Data System (SDS) monthly gravity field solutions are generated independently by the Centre for Space Research (CSR) and the German Research Centre for Geosciences (GFZ). Additional GRACE SDS monthly fields are provided by the Jet Propulsion Laboratory (JPL) for validation and outside the SDS by a number of other institutions worldwide. Although the adopted background models and processing standards have been harmonized more and more by the various processing centers during the past years, notable differences still exist and the users are more or less left alone with a decision which model to choose for their individual applications. This procedure seriously limits the accessibility of these valuable data. Combinations are well established in the area of other space geodetic techniques, such as the Global Navigation Satellite Systems (GNSS), Satellite Laser Ranging (SLR), and Very Long Baseline Interferometry (VLBI). Regularly comparing and combining space-geodetic products has tremendously increased the usefulness of the products in a wide range of disciplines and scientific applications. Therefore, we propose in a first step to mutually compare the large variety of available monthly GRACE gravity field solutions, e.g., by assessing the signal content over selected regions, by estimating the noise over the oceans, and by performing significance tests. We make the attempt to assign different solution characteristics to different processing strategies in order to identify subsets of solutions, which are based on similar processing strategies. Using these subsets we will in a second step explore ways to generate combined solutions, e.g., based on a weighted average of the individual solutions using empirical weights derived from pair-wise comparisons. We will also assess the quality of such a combined solution and discuss the potential benefits for the GRACE and GRACE-FO user community, but also address minimum processing

  17. Two-port access versus four-port access laparoscopic ovarian cystectomy.

    Science.gov (United States)

    Choi, Won-Kyu; Kim, Jang-Kew; Yang, Jung-Bo; Ko, Young-Bok; Nam, Sang-Lyun; Lee, Ki-Hwan

    2014-09-01

    This study was conducted to compare the surgical outcomes between two-port access and four-port access laparoscopic ovarian cystectomy. Four hundred and eighty nine patients who had received two-port access laparoscopic ovarian cystectomy (n=175) and four-port access laparoscopic ovarian cystectomy (n=314) in Chungnam National University Hospital from January 2009 to August 2012 were analyzed retrospectively. The data were compared between the bilaterality of the cysts and cyst diameter of less than 6 cm and 6 cm or more. There were no significant differences in patient's age, parity, body weight, body mass index and history of previous surgery between the two-port and four-port access laparoscopy group. Bilaterality of ovarian cysts was more in fourport access laparoscopy group (13.7% vs. 32.5%, P=0.000). There were no significant differences in operation time, hemoglobin change, hospital stay, adhesiolysis, transfusion, and insertion of hemo-vac between the two-port and four-port access laparoscopy group for size matched compare. However additional analgesics were more in four-port access laparoscopy group for unilateral ovarian cystectomy. Two-port access laparoscopic surgery was feasible and safe for unilateral and bilateral ovarian cystectomy compare with four-port access laparoscopic surgery.

  18. The importance of daily physical activity for improved exercise tolerance in heart failure patients with limited access to centre-based cardiac rehabilitation.

    Science.gov (United States)

    Sato, Noriaki; Origuchi, Hideki; Yamamoto, Umpei; Takanaga, Yasuhiro; Mohri, Masahiro

    2012-09-01

    Supervised cardiac rehabilitation provided at dedicated centres ameliorates exercise intolerance in patients with chronic heart failure. To correlate the amount of physical activity outside the hospital with improved exercise tolerance in patients with limited access to centre-based programs. Forty patients (median age 69 years) with stable heart failure due to systolic left ventricular dysfunction participated in cardiac rehabilitation once per week for five months. Using a validated single-axial accelerometer, the number of steps and physical activity-related energy expenditures on nonrehabilitation days were determined. Median (interquartile range) peak oxygen consumption was increased from 14.4 mL/kg/min (range 12.9 mL/kg/min to 17.8 mL/kg/min) to 16.4 mL/kg/min (range 13.9 mL/kg/min to 19.1 mL/kg/min); Pdaily number of steps (Pexercise time per day and time spent for light (≤3 metabolic equivalents) exercise, but not with time spent for moderate/vigorous (>3 metabolic equivalents) exercise. The number of steps and energy expenditures outside the hospital were correlated with improved exercise capacity. An accelerometer may be useful for guiding home-based cardiac rehabilitation.

  19. Direct data access protocols benchmarking on DPM

    CERN Document Server

    Furano, Fabrizio; Keeble, Oliver; Mancinelli, Valentina

    2015-01-01

    The Disk Pool Manager is an example of a multi-protocol, multi-VO system for data access on the Grid that went though a considerable technical evolution in the last years. Among other features, its architecture offers the opportunity of testing its different data access frontends under exactly the same conditions, including hardware and backend software. This characteristic inspired the idea of collecting monitoring information from various testbeds in order to benchmark the behaviour of the HTTP and Xrootd protocols for the use case of data analysis, batch or interactive. A source of information is the set of continuous tests that are run towards the worldwide endpoints belonging to the DPM Collaboration, which accumulated relevant statistics in its first year of activity. On top of that, the DPM releases are based on multiple levels of automated testing that include performance benchmarks of various kinds, executed regularly every day. At the same time, the recent releases of DPM can report monitoring infor...

  20. Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Huang, Jian-Kang; Ma, Ling; Song, Wen-Hua; Lu, Bang-Yu; Huang, Yu-Bin; Dong, Hui-Ming

    2016-01-01

    Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC). Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively. The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery. The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC.

  1. Breastfeeding in Tigray and Gonder, Ethiopia, with special reference to exclusive/almost exclusive breastfeeding beyond six months.

    Science.gov (United States)

    Getahun, Zewditu; Scherbaum, Veronika; Taffese, Yonas; Teshome, Beka; Biesalski, Hans Konrad

    2004-11-01

    This study assesses the initiation and duration of exclusive/almost exclusive breastfeeding (Ex/AEx-BF) versus partial breastfeeding (P-BF) and its relationship to infant growth and maternal body mass index (BMI) in Ethiopian infants up to 12 months of age (Tigray n = 471; Gonder n =596). Initiation of breastfeeding within 1 hr after birth was 1.7 times more common in Tigray. In Gonder 19% of the mothers started breastfeeding on the third day of delivery and consequently, a significant higher proportion of newborns were offered prelacteal feeds (Phigher in both regions compared to the Ex/AEx-BF group (in Gonder 25% vs 5.9%; in Tigray 42.9% vs 33.3%). Nutrition education to raise awareness of mothers regarding initiation of exclusive breastfeeding directly after birth, the value of colostrum and avoidance of pre-postlacteal feeds, needs to be implemented. A new health package to be implemented could be a proper vehicle to reach the rural population, which doesn't have access to health services. The relationship between infant growth, mode of feeding and mothers nutritional status should be further investigated, particularly in populations with a high prevalence of maternal and infant nutrition and where long term breastfeeding is practiced.

  2. Effect of the number of Ramadan fasting days on maternal and neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2014-09-01

    Full Text Available Introduction: Gynecologists and perinatologists are left with many unanswered questions and concerns regarding fasting during pregnancy and its effects on maternal and neonatal health. The current study was conducted to investigate the correlation between the number of Ramadan fasting days and pregnancy outcomes. Materials & Methods: In this descriptive, analytical study, 641 newborns, whose mothers had fasting experience during pregnancy, were enrolled and allocated to three groups, based on the number of maternal fasting days during pregnancy (group A: ≤10 days, group B: 11-20 days, and group C: 21-30 days. Demographic and anthropometric data of neonates and mothers were recorded. Descriptive statistics, Chi-square, and non-parametric tests were performed for data analysis. Results: No statistically significant difference was found in maternal weight (during the last month of pregnancy, neonatal height, incidence of pre-term labor, or neonatal congenital abnormality in the three groups. Increased number of fasting days was not correlated with decreased neonatal head circumference or weight, while 1- and 5-minute Apgar scores significantly improved (P

  3. Statistical properties of the deviations of f 0 F 2 from monthly medians

    Directory of Open Access Journals (Sweden)

    Y. Tulunay

    2002-06-01

    Full Text Available The deviations of hourly f 0 F 2 from monthly medians for 20 stations in Europe during the period 1958-1998 are studied. Spectral analysis is used to show that, both for original data (for each hour and for the deviations from monthly medians, the deterministic components are the harmonics of 11 years (solar cycle, 1 year and its harmonics, 27 days and 12 h 50.49 m (2nd harmonic of lunar rotation period L 2 periodicities. Using histograms for one year samples, it is shown that the deviations from monthly medians are nearly zero mean (mean < 0.5 and approximately Gaussian (relative difference range between %10 to %20 and their standard deviations are larger for daylight hours (in the range 5-7. It is shown that the amplitude distribution of the positive and negative deviations is nearly symmetrical at night hours, but asymmetrical for day hours. The positive and negative deviations are then studied separately and it is observed that the positive deviations are nearly independent of R12 except for high latitudes, but negative deviations are modulated by R12 . The 90% confidence interval for negative deviations for each station and each hour is computed as a linear model in terms of R12. After correction for local time, it is shown that for all hours the confidence intervals increase with latitude but decrease above 60N. Long-term trend analysis showed that there is an increase in the amplitude of positive deviations from monthly means irrespective of the solar conditions. Using spectral analysis it is also shown that the seasonal dependency of negative deviations is more accentuated than the seasonal dependency of positive deviations especially at low latitudes. In certain stations, it is also observed that the 4th harmonic of 1 year corresponding to a periodicity of 3 months, which is missing in f 0 F 2 data, appears in the spectra of negative variations.

  4. Implementation of strategies to increase adolescents' access to fruit and vegetables at school

    DEFF Research Database (Denmark)

    Aarestrup, Anne Kristine; Jørgensen, Thea Suldrup; Jørgensen, Sanne Ellegaard

    2015-01-01

    schools. METHODS: We used data from 20 intervention schools involved in the school-based multicomponent Boost trial targeting 13-year-olds' FV consumption. The environmental components at school included daily provision of free FV and promotion of a pleasant eating environment. Questionnaire data......BACKGROUND: Access to fruit and vegetables (FV) is associated with adolescents' FV consumption. However, little is known about implementation of strategies to increase access to FV at schools. We examined the implementation of two environmental components designed to increase access to FV at Danish...... was collected by the end of the nine-month intervention period among 1,121 pupils (95%), from all school principals (n = 20) and half way through the intervention period and by the end of the intervention among 114 teachers (44%). The implementation of the components was examined descriptively using...

  5. Time of day influences the voluntary intake and behavioral response to methamphetamine and food reward.

    Science.gov (United States)

    Keith, Diana R; Hart, Carl L; Robotham, Margaret; Tariq, Maliha; Le Sauter, Joseph; Silver, Rae

    2013-09-01

    The circadian timing system influences a vast array of behavioral responses. Substantial evidence indicates a role for the circadian system in regulating reward processing. Here we explore time of day effects on drug anticipation, locomotor activity, and voluntary methamphetamine (MA) and food intake in animals with ad libitum food access. We compared responses to drug versus a palatable treat during their normal sleep times in early day (zeitgeber time (ZT) 0400) or late day (ZT 1000). In the first study, using a between-subjects design, mice were given daily 1-h access to either peanut butter (PB-Alone) or to a low or high concentration of MA mixed in PB (MA+PB). In study 2, we repeated the experiment using a within-subjects design in which mice could choose between PB-Alone and MA+PB at either ZT 0400 or 1000. In study 3, the effects of MA-alone were investigated by evaluating anticipatory activity preceding exposure to nebulized MA at ZT 0400 vs. ZT 1000. Time of day effects were observed for both drug and palatable treat, such that in the between groups design, animals showed greater intake, anticipatory activity, and post-ingestional activity in the early day. Furthermore, there were differences among mice in the amount of MA ingested but individuals were self-consistent in their daily intake. The results for the within-subjects experiment also revealed robust individual differences in preference for MA+PB or PB-Alone. Interestingly, time of day effects on intake were observed only for the preferred substance. Anticipatory activity preceding administration of MA by nebulization was also greater at ZT 0400 than ZT 1000. Finally, pharmacokinetic response to MA administered intraperitoneally did not vary as a function of time of administration. The results indicate that time of day is an important variable mediating the voluntary intake and behavioral effects of reinforcers. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Accessible Support for Family Caregivers of Seniors with Chronic Conditions: From Isolation to Inclusion

    Science.gov (United States)

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family…

  7. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

    Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.

  8. Open access, open education resources and open data in Uganda.

    Science.gov (United States)

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country.

  9. Accessibility and preferred use of online Web applications among WIC participants with Internet access.

    Science.gov (United States)

    Bensley, Robert J; Hovis, Amanda; Horton, Karissa D; Loyo, Jennifer J; Bensley, Kara M; Phillips, Diane; Desmangles, Claudia

    2014-01-01

    This study examined the current technology use of clients in the western Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) region and the preferences these current clients have for using new technologies to interact with WIC. Cross-sectional convenience sample for online survey of WIC clients over 2 months in 2011. A weighted sample of 8,144 participants showed that the majority of WIC clients have access to the Internet using a computer or mobile phone. E-mail, texting, and Facebook were technologies most often used for communication. Significant differences (P video chat. Technologies should be considered for addressing WIC clients' needs, including use of text messaging and smartphone apps for appointments, education, and other WIC services; online scheduling and nutrition education; and a stronger Facebook presence for connecting with WIC clients and breastfeeding support. Published by Elsevier Inc.

  10. Getting Scientists Ready for Open Access: The Approaches of Forschungszentrum Jülich

    Directory of Open Access Journals (Sweden)

    Thomas Arndt

    2018-05-01

    Full Text Available Many scientific institutions are faced with the question of how they should inform their scientists and scientific coordinators about the option of publishing open access. This task is one that libraries have taken upon themselves: libraries are familiar with the market participants and have years of experience in teaching information and publication literacy. This case report looks at two approaches taken by the Central Library of Forschungszentrum Jülich in 2017. It highlights the motivation, strategy, resources and implementation, as well as the first evaluation of both approaches. The first approach was a redesign of the training courses offered by the Central Library with a focus on the target groups and new contents. The second approach was implemented as part of International Open Access Week and involved offering an information event tailored to each scientific institute. The event was customized to meet the needs of the target group defined by each institute, the institute itself, and was organized individually. As a result of these efforts, the open access rate increased over the last few months and at 48% open access in 2017, Forschungszentrum Jülich is well on its way to achieving the open access goals set by the Helmholtz Association.

  11. Adolescent Substance Abuse and Mental Health: Problem Co-Occurrence and Access to Services

    Science.gov (United States)

    Winstanley, Erin L.; Steinwachs, Donald M.; Stitzer, Maxine L.; Fishman, Marc J.

    2012-01-01

    The purpose of this study is to identify factors associated with adolescent alcohol or drug (AOD) abuse/dependence, mental health and co-occurring problems, as well as factors associated with access to treatment. This is a secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2000. The 12-month prevalence rate of…

  12. Patent foramen ovale closure using a bioabsorbable closure device: safety and efficacy at 6-month follow-up.

    Science.gov (United States)

    Van den Branden, Ben J; Post, Martijn C; Plokker, Herbert W; ten Berg, Jurriën M; Suttorp, Maarten J

    2010-09-01

    The aim of this study was to assess the mid-term safety and efficacy of percutaneous patent foramen ovale (PFO) closure using a bioabsorbable device (BioSTAR, NMT Medical, Boston, Massachusetts). Closure of PFO in patients with cryptogenic stroke has proven to be safe and effective using different types of permanent devices. All consecutive patients who underwent percutaneous PFO closure with the bioabsorbable closure device between November 2007 and January 2009 were included. Residual shunt was assessed using contrast transthoracic echocardiography. Sixty-two patients (55% women, mean age 47.7 ± 11.8 years) underwent PFO closure. The in-hospital complications were a surgical device retrieval in 2 patients (3.2%), device reposition in 1 (1.6%), and a minimal groin hematoma in 6 patients (9.7%). The short-term complications at 1-month follow-up (n = 60) were a transient ischemic attack in the presence of a residual shunt in 1 patient and new supraventricular tachycardia in 7 patients (11.3%). At 6-month follow-up (n = 60), 1 patient without residual shunt developed a transient ischemic attack and 1 developed atrial fibrillation. A mild or moderate residual shunt was noted in 51.7%, 33.9%, and 23.7% after 1-day, 1-month, and 6-month follow-up, respectively. A large shunt was present in 8.3%, 3.4%, and 0% after 1-day, 1-month, and 6-month follow-up. Closure of PFO using the bioabsorbable device is associated with a low complication rate and a low recurrence rate of embolic events. However, a relatively high percentage of mild or moderate residual shunting is still present at 6-month follow-up. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Access technique and its problems in parenteral nutrition - Guidelines on Parenteral Nutrition, Chapter 9.

    Science.gov (United States)

    Jauch, K W; Schregel, W; Stanga, Z; Bischoff, S C; Brass, P; Hartl, W; Muehlebach, S; Pscheidl, E; Thul, P; Volk, O

    2009-11-18

    Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7-10 days) parenteral nutrition (PN) requires central venous access whereas for PN 3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7-10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site.

  14. Changes in root morphology and dry matter production in Pfaffia glomerata (Spreng. Pedersen accessions in response to excessive zinc

    Directory of Open Access Journals (Sweden)

    K. BERNARDY

    Full Text Available ABSTRACT Zinc (Zn participates of numerous metabolic processes in plants. However, it can become toxic to plants in excessive concentrations in the soil. Pfaffia glomerata is a Brazilian medicinal species that has stood out because of its numerous chemical and functional properties, mainly by the triterpene saponins and ecdysteroids accumulated in its roots. This study aimed to evaluate the effects of zinc excess on many root morphological parameters of Pfaffia glomerata. A 4 x 3 factorial design was employed in a completely randomized scheme with 3 replicates. The treatments consisted of four concentrations of Zn (2, 100, 200, and 300 µM and three accessions of P. glomerata (BRA, GD, and JB grown in a hydroponic system for 7 and 14 days. Differences in root morphology and dry mass production were observed among the three accessions in response to excessive Zn. Some growth parameters of GD accession increased with the addition of Zn, ranging from 36 to 79 µM. However, the GD and JB accessions presented reduction in dry mass production, root area, length, and volume with increasing Zn levels. The BRA accession, which had the lowest growth among accessions, presented chlorotic leaves. The shoot/root dry mass ratio and root diameter increased linearly for BRA and GD accessions at 7 days. Based on the evaluated parameters, we observed the following order of Zn excess tolerance in P. glomerata accessions: GD> JB> BRA.

  15. Oceanographic data collected from Cathlamet Bay North Channel (USCG day mark green 3) by Center for Coastal Margin Observation and Prediction (CMOP) and assembled by Northwest Association of Networked Ocean Observation Systems (NANOOS) in the Columbia River Estuary and North East Pacific Ocean from 2000-07-02 to 2016-11-09 (NCEI Accession 0161822)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0161822 contains navigational and physical data collected at Cathlamet Bay North Channel (USCG day mark green 3), a fixed station in the Columbia...

  16. Repository on maternal child health: health portal to improve access to information on maternal child health in India.

    Science.gov (United States)

    Khanna, Rajesh; Karikalan, N; Mishra, Anil Kumar; Agarwal, Anchal; Bhattacharya, Madhulekha; Das, Jayanta K

    2013-01-02

    Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. The portal 'Repository on Maternal Child Health' was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Efficient management of health information

  17. Repository on maternal child health: Health portal to improve access to information on maternal child health in India

    Directory of Open Access Journals (Sweden)

    Khanna Rajesh

    2013-01-01

    Full Text Available Abstract Background Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. Methods The portal ‘Repository on Maternal Child Health’ was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. Results The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01, increase in the web traffic through search engines (p-value 0.00, and decrease in the bounce rate (p-value 0.03. There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa

  18. Does open access improve the process and outcome of podiatric care?

    Science.gov (United States)

    Wrobel, James S; Davies, Michael L; Robbins, Jeffrey M

    2011-05-19

    Open access to clinics is a management strategy to improve healthcare delivery. Providers are sometimes hesitant to adopt open access because of fear of increased visits for potentially trivial complaints. We hypothesized open access clinics would result in decreased wait times, increased number of podiatry visits, fewer no shows, higher rates of acute care visits, and lower minor amputation rates over control clinics without open access. This study was a national retrospective case-control study of VHA (Veterans Hospital Administration) podiatry clinics in 2008. Eight case facilities reported to have open podiatry clinic access for at least one year were identified from an email survey. Sixteen control facilities with similar structural features (e.g., full time podiatrists, health tech, residency program, reconstructive foot surgery, vascular, and orthopedic surgery) were identified in the same geographic region as the case facilities. Twenty-two percent of facilities responded to the survey. Fifty-four percent reported open access and 46% did not. There were no differences in facility or podiatry panel size, podiatry visits, or visit frequency between the cases and controls. Podiatry visits trended higher for control facilities but didn't reach statistical significance. Case facilities had more new consults seen within 30 days (96%, 89%; P = 0.050) and lower minor amputation rates (0.62/1,000, 1.0/1,000; P = 0.041). The VHA is the worlds largest managed care organization and it relies on clinical efficiencies as one mechanism to improve the quality of care. Open access clinics had more timely access for new patients and lower rates of minor amputations.

  19. Use of vascular access ports in femoral veins of dogs and cats with cancer.

    Science.gov (United States)

    Cahalane, Alane Kosanovich; Rassnick, Kenneth M; Flanders, James A

    2007-11-01

    To evaluate long-term function of vascular access ports (VAPs) implanted in the femoral vein of dogs and cats undergoing cancer treatment. Prospective clinical study. 3 dogs and 6 cats treated via chemotherapy or radiation. VAPs were surgically implanted in the left femoral vein of 3 dogs and 6 cats over a 1-year period. Injection port location was alternated to either a caudal thoracic or ilial location in each patient. Duration of VAP function, ease of infusion, and ease of aspiration through the VAPs were recorded, and associated complications were assessed at each VAP use. Client satisfaction with VAP placement was evaluated by use of a questionnaire. Primary uses of the VAPs included blood sampling and delivering sedative or chemotherapeutic drugs. Median duration of successful infusion was 147 days (range, 60 to 370 days), and median duration of successful aspiration was 117 days (range, 10 to 271 days). The frequency of signs of VAP-related discomfort was low (7% of patient observations). Clients were satisfied with their decision to use VAPs. Complications included partial (n = 7) or complete (2) VAP occlusion, port migration (1), and presumptive infection (1). Results suggested that VAP implantation into the femoral vein provides an acceptable means of chronic venous access in dogs and cats undergoing cancer treatment.

  20. Access to abortion: what women want from abortion services.

    Science.gov (United States)

    Wiebe, Ellen R; Sandhu, Supna

    2008-04-01

    Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments

  1. Effects of a long-day light programme on the motility and membrane integrity of cooled-stored and cyropreserved semen in Shetland pony stallions.

    Science.gov (United States)

    Deichsel, Katharina; Schrammel, Nadine; Aurich, Jörg; Aurich, Christine

    2016-04-01

    Increasing day length in spring stimulates reproductive functions in horses. In this study, we have analysed the effect of artificial long days on the quality of cooled-stored and cryopreserved semen in Shetland stallions. Stallions of the treatment group (AL, n = 8) were exposed to 16 h light and 8h darkness from 15th December to 20th March while control stallions (CON, n = 7) were kept under natural photoperiod. Semen was collected once weekly and processed for cooled-storage and cryopreservation once per month. Total and progressive motility and percentage of membrane intact spermatozoa were analysed at 24, 48 and 72 h of cooled-storage and after freezing-thawing, respectively. Total and progressive motility and membrane integrity decreased during cooled-storage for 72 h in each month and both groups (p semen differed between groups and months. In conclusion, motility of cooled-stored semen was reduced in January and increased in stallions kept under a long day light programme for at least 30 days. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Open access

    NARCIS (Netherlands)

    Valkenburg, P.M.

    2015-01-01

    Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in

  3. Does a one-day workshop improve clinical faculty's comfort and behaviour in practising and teaching evidence-based medicine? A Canadian mixed methods study.

    Science.gov (United States)

    Allen, David; Abourbih, Jacques; Maar, Marion; Boesch, Lisa; Goertzen, James; Cervin, Catherine

    2017-07-13

    The purpose of this study was to determine the impact of a 1-day evidence-based medicine (EBM) workshop on physician attitudes and behaviours around teaching and practicing EBM. A mixed methods study using a before/after cohort. A medical school delivering continuing professional development to 1250 clinical faculty over a large geographic area in Canada. 105 physician clinical faculty members. A 1-day workshop presented at 11 different sites over an 18-month period focusing on EBM skills for teaching and clinical practice. (1) A quantitative survey administered immediately before and after the workshop, and 3-6 months later, to assess the hypothesis that comfort with teaching and practising EBM can be improved.(2) A qualitative survey of the expectations for, and impact of the workshop on, participant behaviours and attitudes using a combination of pre, post and 3 to 6-month follow-up questionnaires, and telephone interviews completed 10-14 months after the workshop. Physician comfort with their EBM clinical skills improved on average by 0.93 points on a 5-point Likert scale, and comfort with EBM teaching skills by 0.97 points (p values 0.001). Most of this improvement was sustained 3-6 months later. Three to fourteen months after the workshop, half of responding participants reported that they were using the Population Intervention Comparator Outcome (PICO) methodology of question framing for teaching, clinical practice or both. Comfort in teaching and practicing EBM can be improved by a 1-day workshop, with most of this improvement sustained 3-6 months later. PICO question framing can be learnt at a 1-day workshop, and is associated with a self-reported change in clinical and teaching practice 3-14 months later. This represents both level 2 (attitudes) and level 3 (behaviours) change using the Kirkpatrick model of evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

  4. [Hospital admisions and consultations in a dialysis population].

    Science.gov (United States)

    Reichert, J

    2007-01-01

    The hemodialysis (HD) population continues growing and aging, reason why they are required to adapt the human, economic and materials resources to be taken care of. To analyze the distribution of the consultations and the times of admissions in the different Hospital services of which an peripheral arranged HD Center depends. We analyzed all the consultations to the Hospital Urgencies Departments and Hospitable admissions of all the patients who received HD in the arranged Center Ponfedial, (sanitary area Ponferrada of 150,000 inhabitants) in period 01/12/02 to the 31/05/05. We prospectively examined a population of 87 HD patients (71.0+/-12.5 years, 77.9 % male, 31.4% diabetics) time in HD 21.0+/-22.7 months. They were a total of 286 (9.5/month) consultations in the Service of Urgencies (2.31 consult/patient/year), 37.4% of them did not motivate admissions. The most frequent consultation (28,9%) was the complications of vascular access (70,9% of them required positioning a transitory catheter; 1.1 complication of catheter/months, 1 permanent catheter is placed/1.2 months and 1 fistulography/1.2 months), cardiac causes 10.3%, acute pulmonar edema: 9.3%, infectious: 8.4% and traumatologic: 8.4%. There were 179 admissions (5.9/month; 1.44 hospitalizations/patient/year; 4.0+/-14.2 days of admissions): cardiovascular cause: 37.4%, by vascular access: 18.4%, infectious disease: 17.0%, digestive: 6.7%, traumatologic: 3.9% and by other causes: 11.0%. The cardiovascular group takes 46.5% (60.8% of them by vascular peripheral disease) of the total of days of hospitalizations, infectious 16.7%, neoplasic 8.4% and vascular access 7.6%. The neoplasic causes were the greater average with 36.0+/-21.6 days of hospitalization, by amputations 23.0+/-38.1 days, by stroke 14.5+/-10.6 days, infected ulcers of lower extremities members 10.0+/-19.0, other vascular treatments 10.0+/-4.7, ischemic heart disease 8.5+/-20.3 and heart failure 7.5+/-5.2 days. Our prevalent population of 49

  5. Three-month outcome of ziv-aflibercept for exudative age-related macular degeneration.

    Science.gov (United States)

    Mansour, Ahmad M; Chhablani, Jay; Antonios, Rafic S; Yogi, Rohit; Younis, Muhammad H; Dakroub, Rola; Chahine, Hasan

    2016-12-01

    In vitro and in vivo studies did not detect toxicity to the retinal pigment epithelium cells using intravitreal ziv-aflibercept. Our purpose is to ascertain the 3-month safety and efficacy in wet age-related macular degeneration (AMD) treated with intravitreal ziv-aflibercept. Prospectively, consecutive patients with wet AMD underwent ziv-aflibercept intravitreal injection (1.25 mg/0.05 mL) from March 2015 to November 2015. Monitoring of best-corrected visual acuity, intraocular inflammation, cataract progression and by spectral domain optical coherence tomography were carried out at baseline day 1, 1 week, 1 month, 2 months and 3 months after injections. 30 eyes were treated (22 Caucasians, 8 Indians; 16 men, 14 women; 14 right eyes and 16 left eyes) with mean age of 74.3 years with 11 treatment-naïve cases and 19 having had treatment-non-naïve. Best-corrected visual acuity improved from baseline logMAR 1.08-0.74 at 1 week, 0.72 at 1 month, 0.67 at 2 months and 0.71 at 3 months (p<0.001 for all time periods). Central macular thickness in microns decreased from 332.8 to 302.0 at 1 week, 244.8 at 1 month, 229.0 at 2 months and 208.2 at 3 months (p<0.001 for all time periods). There were no signs of intraocular inflammation, or change in lens status or increase in intraocular pressure throughout the study. Off label use of ziv-aflibercept improves visual acuity, without detectable ocular toxicity and offers a cheaper alternative to the same molecule aflibercept, especially in low/middle-income countries and in countries where aflibercept (Eylea) is not available. NCT02486484. 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/.

  6. Associations with legal representation in a compensation setting 12 months after injury.

    Science.gov (United States)

    Casey, Petrina P; Feyer, Anne Marie; Cameron, Ian D

    2015-05-01

    Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes. To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability. Inception cohort study. 246 people with WAD compensation claim. Legal involvement and Functional Rating Index at 12 months post injury. Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months. At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (pdisadvantage, have had a prior claim and a worse baseline health profile compared to those without a lawyer. Understanding this profile could allow for improved claims processes and targeted interventions to assist this group through any perceived complexities in the

  7. Oceanographic data collected from Lower Sand Island light (USCG day mark green 5) by Center for Coastal Margin Observation and Prediction (CMOP) and assembled by Northwest Association of Networked Ocean Observation Systems (NANOOS) in the Columbia River Estuary and North East Pacific Ocean from 1997-07-12 to 2014-01-15 (NCEI Accession 0162181)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0162181 contains navigational and physical data collected at Lower Sand Island light (USCG day mark green 5), a fixed station in the Columbia River...

  8. Open Access @ DTU

    DEFF Research Database (Denmark)

    Ekstrøm, Jeannette

    Open Access is high on the agenda in Denmark and internationally. Denmark has announced a national strategy for Open Access that aims to achieve Open Access to 80% in 2017 and 100% in 2022 to peer review research articles. All public Danish funders as well as H2020 requires that all peer review...... articles that is an outcome of their funding will be Open Access. Uploading your full texts (your final author manuscript after review ) to DTU Orbit is a fundamental part of providing Open Access to your research. We are here to answer all your questions with regards to Open Access and related topics...... such as copyright, DTU Orbit, Open Access journals, APCs, Vouchers etc....

  9. Healthcare Access for Iraqi Refugee Children in Texas: Persistent Barriers, Potential Solutions, and Policy Implications.

    Science.gov (United States)

    Vermette, David; Shetgiri, Rashmi; Al Zuheiri, Haidar; Flores, Glenn

    2015-10-01

    To identify access barriers to healthcare and potential interventions to improve access for Iraqi refugee children. Four focus groups were conducted using consecutive sampling of Iraqi refugee parents residing in the US for 8 months to 5 years. Eight key-informant interviews also were conducted with employees of organizations serving Iraqi refugee families, recruited using snowball sampling. Focus groups and interviews were audiotaped, transcribed, and analyzed using margin coding and grounded theory. Iraqi refugees identified provider availability, Medicaid maintenance and renewal, language issues, and inadequate recognition of post-traumatic stress disorder as barriers to care for their children. Interviewees cited loss of case-management services and difficulties in understanding the Medicaid renewal process as barriers. Potential interventions to improve access include community-oriented efforts to educate parents on Medicaid renewal, obtaining services, and accessing specialists. Given the enduring nature of language and Medicaid renewal barriers, policies addressing eligibility alone are insufficient.

  10. Evolution of accesses to information on breast cancer and screening on the Brazilian National Cancer Institute website: an exploratory study

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Vasconcellos-Silva

    Full Text Available Abstract Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009 of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA. We found significant increasing accesses to BC and transient “attention peaks”. Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a “prevention culture”; lack of confidence in health system and screening programs; “celebrity effect” in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

  11. Five-day bismuth-free triple therapy for the eradication of Helicobacter pylori and reduction of duodenal ulcer relapse

    International Nuclear Information System (INIS)

    Coelho, L.G.; Passos, M.C.; Chausson, Y.; Castro L de, P.

    1991-01-01

    Previous studies have demonstrated that the eradication of Helicobacter pylori (H. pylori) is associated with a significant reduction of the rate of duodenal ulcer (DU) relapse. The aim of this study was to assess the long-term effect of a bismuth-free triple therapy on the eradication of H. pylori and reduction of DU relapse. After informed consent, 61 patients with endoscopically proven DU and H. pylori infection detected on 14C-urea breath test (BT) were included in the study. All patients received a combination of furazolidone, amoxicillin, and metronidazole, three times a day, for 5 days, in addition to eventual classical antiulcer agents prescribed by their attending physicians. BT was repeated after an interval of at least 60 days to evaluate H. pylori eradication. Endoscopy and another BT were performed again at 6.5 months after therapy to detect possible recurrences. Forty-eight patients completed the trial: 26 (54%) patients were negative for H. pylori at 6.5 months after the end of treatment, and 22 (46%) persisted H. pylori positive. Ninety-two percent of the patients in whom the bacteria were eradicated showed endoscopically healed ulcers and were asymptomatic, and two that were symptomatic presented only occasional pain not requiring therapy. Among the 22 patients who persisted H. pylori positive, six (27%) showed endoscopically active ulcers (p = 0.012) and eight (36%) patients continued to be symptomatic (p less than 0.01), and were still using antiulcer drugs (p = 0.002) 6.5 months after treatment. It is concluded that combined treatment with furazolidone, amoxicillin, and metronidazole for 5 days represents a well-tolerated, inexpensive, and effective therapeutic regime for the eradication of H. pylori and abolition of DU relapse in more than 50% of the patients during a follow-up period of 6.5 months

  12. A Pulmonary Rehabilitation Decisional Score to Define Priority Access for COPD Patients

    Directory of Open Access Journals (Sweden)

    Michele Vitacca

    2017-01-01

    Full Text Available This retrospective study aimed to evaluate, through an ad hoc 17-item tool, the Pulmonary Rehabilitation Decisional Score (PRDS, the priority access to PR prescription by respiratory specialists. The PRDS, scoring functional, clinical, disability, frailty, and participation parameters from 0 = low priority to 34 = very high priority for PR access, was retrospectively calculated on 124 specialist reports sent to the GP of subjects (aged 71±11 years, FEV1%  51±17 consecutively admitted to our respiratory outpatient clinic. From the specialist’s report the final subject’s allocation could be low priority (LP (>60 days, high priority (HP (30–60 days, or very high priority (VHP (<30 days to rehabilitation. The PRDS calculation showed scores significantly higher in VHP versus LP (p<0.001 and significantly different between HP and VHP (p<0.001. Comparing the specialist’s allocation decision and priority choice based on PRDS cut-offs, PR prescription was significantly more appropriate in VHP than in HP (p=0.016. Specialists underprescribed PR in 49% of LP cases and overprescribed it in 46% and 30% of the HP and VHP prescriptions, respectively. A multicomprehensive score is feasible being useful for staging the clinical priorities for PR prescription and facilitating sustainability of the health system.

  13. Committee Opinion No 707: Access to Emergency Contraception.

    Science.gov (United States)

    2017-07-01

    Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

  14. MANAJEMEN SARANA PRASARANA DI DAY CARE BABY’S HOME SALATIGA

    Directory of Open Access Journals (Sweden)

    Desi Kusumawati

    2017-01-01

    Full Text Available Day Care is one form of early childhood education in non formal education program that organize nurturing and social welfare of children from birth up to the age of 6 years. This study aimed to identify the suitability of existing infrastructure in Baby's Home day care with the ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3; and to provide an overview why the planning, maintenance and inventory in Baby's Home day care were not optimal. This study was qualitative research. The subject was Baby's Home day care Salatiga. Technique of collecting data using interviews, observation and documents. Data were analyzed using Miles and Huberman Model. Data validation using triangulation technique of data. Facilities and infrastructure in Baby's Home day care which conform with ACT of Minister of Education and Culture No. 137 of 2014 Article 32 Paragraph 3 of were the area of land, space of activities inside and outside, hand washing facilities, showers and latrines, and access to health facilities. While things were not conform included the bedroom, dining room, and covered trash. The cause of the planning, maintenance and inventory of facilities and infrastructure have not optimally done because the plan was not carried out continuously, the lack of personnel to assist in the maintenance, and did not have the administrative staff specifically for inventory. Advice can be given to Baby's Home day care is to conduct procurement planning infrastructure on sleeping room, dining room and trash. In addition, the maintenance to existing infrastructure must be made as well as the inventory of infrastructure in order to facilitate the planning purchasing.

  15. Individual Public Transportation Accessibility is Positively Associated with Self-Reported Active Commuting.

    Science.gov (United States)

    Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette; Glümer, Charlotte

    2014-01-01

    Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used to analyze the association between accessibility, expressed as access area, and being an active commuter. Public transport accessibility area based on all stops within walking and cycling distance was positively associated with being an active commuter. Distance to work, age, and gender modified the associations. Residing within 10 km commute distance and in areas of high accessibility was associated with being an active commuter and meeting the recommendations of physical activity. For the respondents above 29 years, individual public transportation accessibility was positively associated with being an active commuter. Women having high accessibility had significantly higher odds of being an active commuter compared to having a low accessibility. For men, the associations were insignificant. This study extends the knowledge about the driving forces of using public transportation for commuting by examining the individual public transportation accessibility. Findings suggest that transportation accessibility supports active commuting and planning of improved public transit accessibility

  16. Hematological and immunological parameters of 4-1/2-month-old pigs infected with PRRS virus

    DEFF Research Database (Denmark)

    Nielsen, Jens; Bøtner, Anette

    1997-01-01

    4-1/2-month old SPF pigs were experimentally infected with PRRS virus. Blood samples were collected with regular intervals up to day 35 post inoculation (PI). Serum was used for PRRS virus isolation and antibody detection and stabilized blood for total leucocyte counts, differential counts and ch...

  17. Exploiting the Modified Colombo-Nyquist Rule for Co-estimating Sub-monthly Gravity Field Solutions from a GRACE-like Mission

    Science.gov (United States)

    Devaraju, B.; Weigelt, M.; Mueller, J.

    2017-12-01

    In order to suppress the impact of aliasing errors on the standard monthly GRACE gravity-field solutions, co-estimating sub-monthly (daily/two-day) low-degree solutions has been suggested as a solution. The maximum degree of the low-degree solutions is chosen via the Colombo-Nyquist rule of thumb. However, it is now established that the sampling of satellites puts a restriction on the maximum estimable order and not the degree - modified Colombo-Nyquist rule. Therefore, in this contribution, we co-estimate low-order sub-monthly solutions, and compare and contrast them with the low-degree sub-monthly solutions. We also investigate their efficacies in dealing with aliasing errors.

  18. Editorial - Open Access and accessing openness

    Directory of Open Access Journals (Sweden)

    Yngve Nordkvelle

    2008-12-01

    Full Text Available Seminar.net enters it’s fourth year, and has reached a state of maturity in a number of meanings: it receives manuscripts from all continents, the articles are read from 134 countries, of which India represents the highest number of readers, a number of articles have been read by more than 10 000 interested persons, and the frequency of issues is now three per year, and will reach four by next year. Interested parties now approach us in order to learn about our policies and practices.It takes time to become established and influential in the sense that articles are cited and referred to in prestigious publications. Still, the most prestigious publications are on paper. Many countries now embark on a policy that rewards researchers that publish in international journals, preferably in English. National languages are rendered less significant. In the UK, the research assessment exercise (RAE, and several other countries with a publication or citation based reward system in research, tend to favour quantitative dimensions at the expense of the quality of the publication. International publishing houses are huge profit-making companies that over years have increased their profit rates, charging increasingly economically pressured higher education institution with high subscription rates. With the advent of electronic publishing their position is severely challenged. It has been noted that the most significant publication of the last couple of decades was an electronic publication: Tim Berners Lee published the protocol for the World Wide Web in 1990. It was never refereed, nor was controlled by appointed gatekeepers of the “establishment”. The number of Open Access publications is rising every day, and the number of e-journals for academic publishing is reaching higher and higher numbers. In a recent case The Faculty of Arts and Sciences at Harvard University decided, that Harvard employees must publish all their material simultaneously on the

  19. The Effects of Data Gaps on the Calculated Monthly Mean Maximum and Minimum Temperatures in the Continental United States: A Spatial and Temporal Study.

    Science.gov (United States)

    Stooksbury, David E.; Idso, Craig D.; Hubbard, Kenneth G.

    1999-05-01

    Gaps in otherwise regularly scheduled observations are often referred to as missing data. This paper explores the spatial and temporal impacts that data gaps in the recorded daily maximum and minimum temperatures have on the calculated monthly mean maximum and minimum temperatures. For this analysis 138 climate stations from the United States Historical Climatology Network Daily Temperature and Precipitation Data set were selected. The selected stations had no missing maximum or minimum temperature values during the period 1951-80. The monthly mean maximum and minimum temperatures were calculated for each station for each month. For each month 1-10 consecutive days of data from each station were randomly removed. This was performed 30 times for each simulated gap period. The spatial and temporal impact of the 1-10-day data gaps were compared. The influence of data gaps is most pronounced in the continental regions during the winter and least pronounced in the southeast during the summer. In the north central plains, 10-day data gaps during January produce a standard deviation value greater than 2°C about the `true' mean. In the southeast, 10-day data gaps in July produce a standard deviation value less than 0.5°C about the mean. The results of this study will be of value in climate variability and climate trend research as well as climate assessment and impact studies.

  20. Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

    Science.gov (United States)

    Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

    2009-01-01

    Background While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. Methods The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Results Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors