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Sample records for burden comparing intensive

  1. Comparative Analysis of Informal Caregiver Burden in Advanced Cancer, Dementia and Acquired Brain Injury

    OpenAIRE

    Harding, Richard; Gao, Wei; Jackson, Diana; Pearson, Clare; Murray, Joanna; Higginson, Irene J

    2015-01-01

    CONTEXT: Measurement and improvement of informal caregiver burden are central aims of policy and intervention. Burden itself is a complex construct and total burden can differ by patient diagnosis, although how diagnosis affects different aspects of caregiver subjective burden is unclear.OBJECTIVES: To compare the subjective burden of caregivers across three diagnostic groups using the 22-item Zarit Burden Inventory (ZBI).METHODS: We performed a secondary analysis of pooled cross-sectional da...

  2. Burden of highly resistant microorganisms in a Dutch intensive care unit

    NARCIS (Netherlands)

    Aardema, H.; Arends, J. P.; de Smet, A. M. G. A.; Zijlstra, J. G.

    2015-01-01

    Background: The occurrence of highly resistant microorganisms (HRMOs) is a major threat to critical care patients, leading to worse outcomes, need for isolation measures, and demand for second-line or rescue antibiotics. The aim of this study was to quantify the burden of HRMOs in an intensive care

  3. Tax burden in EU countries – a comparative study

    Directory of Open Access Journals (Sweden)

    Kaštan, M.

    2010-12-01

    Full Text Available The paper is focused on the overall tax burden and tax policy of European countries. The theoretical part of the paper explains the term of tax burden and summarizes its measuring possibilities. It especially deals with the tax quota as the most generally applied indicator but some alternative indicators, such as the tax freedom day or tax misery index, are also mentioned. The empirical part of the paper is aimed on the comparison of tax burden of “old” and “new” EU member states following mentioned indicators. Certain tax policy recommendations are formulated on the basis of performed comparison.

  4. A COMPARATIVE STUDY OF CAREGIVER BURDEN IN CANCER CERVIX AND CANCER BREAST ILLNESSES

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    Srinivasagopalan, Nappinnai, Solayappan

    2015-07-01

    Full Text Available Background: Caregivers of individuals suffering from cancer illnesses are at risk of having subjected to mental health consequences. There is a paucity of data comparing the caregiver burden of cancer breast and cancer cervix patients. Aim: The aim of the present study is to compare the caregiver burden of cancer breast and cancer cervix patients. To study the association of caregiver burden with demographic factors like age, gender, duration of caregiving etc. Materials & Methods: This Cross sectional study is performed on the key relatives of patients of 31 cancer cervix and 31 cancer breast patients. Burden assessment schedule was used. Results: Our findings suggest burden is more in male caregivers of breast cancer patients. It is not so in caregivers of cancer cervix patients. Whenever the caregiver is closely related to the patients the burden is high in both groups. Whenever the burden scores were high the depression scores were also high. Treatment modalities as a whole correlates with burden scores in caregivers of breast cancer patients but not in cancer cervix patients. Conclusion: Caregivers with breast and cervical cancer patients are vulnerable if the caregiver is male, from low socioeconomical background, more closely related and when the patients received poor treatment modalities.

  5. Family burden in patient with schizophrenia and depressive disorder: A comparative study

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    Sateesh R Koujalgi

    2013-01-01

    Full Text Available Background: Family care burden among schizophrenia and depressive disorders has not been addressed in the research. Family burden was significantly high in patient with schizophrenia except the effect on physical health of other family member. Comparing burden in these two groups may help in the psychosocial management. Aim: The aim of the study was to examine family care burden in families of schizophrenia patient and compare them with patients having depressive disorders. Materials and Methods: One hundred family caregivers of patient with schizophrenia and 100 family caregivers of patient with depressive disorders were recruited for the study. It was cross sectional study. The patients were diagnosed as having schizophrenia (all types and depressive disorders using International Classification of Disease-10, Classification of Mental and Behavioral Disorders, Diagnostic Criteria for Research ICD-10 DCR criteria. Pollack and Perlick scale was used to identify the key family caregivers. Patient with 2 or more than 2 years duration of illness were included in the study groups. Family burden was assessed in the both groups by using the Family Burden Interview Schedule (FBIS of Pai and Kapur. Data was analyzed using the descriptive statistics, Chi-square test. Results: Caregivers of patients with schizophrenia in comparison to depressive disorder has significantly increased mean FBIS score (P<0.001. The family burden was significantly high in family caregivers of patients with the schizophrenia except the effect on physical health of other family members. Conclusion: To conclude caregivers of patient with schizophrenia experience high-level of burden than the caregivers of patients with the depressive disorders.

  6. Comparing burden of dermatologic disease to search interest on google trends.

    Science.gov (United States)

    Whitsitt, Jacob; Karimkhani, Chante; Boyers, Lindsay N; Lott, Jason P; Dellavalle, Robert P

    2015-01-15

    Google Trends is a publicly available resource for comparing Internet search query frequency and trends interest in queries over time. The tool provides country, region, and city-specific data for term search volume on Google Search. Our study sought to compare the relative search interest to the burden of disease for the fifteen skin conditions studied by the Global Burden of Disease (GBD) 2010 project. Searches on Google Trends were conducted by using the most inclusive terms and true ICD code definitions as possible for the skin conditions studied. We report that relative interest on Google Trends did largely correlate to burden of disease reported by the GBD 2010 study, though some conditions were either underrepresented or overrepresented. Acne and herpes were the most Googled skin disease terms. This study provides further insight into what may be the most burdensome skin diseases because those with more burdensome diseases likely sought out information on their condition.

  7. The comparative burden of salmonellosis in the European Union member states, associated and candidate countries

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    de Jong Birgitta

    2006-01-01

    Full Text Available Abstract Background Salmonella is an infectious agents causing numerous cases of illness each year, and thereby having significant economic impact. Using returning Swedish travellers we estimated the burden of salmonellosis in different European countries. Methods From the Swedish database on notifiable communicable diseases 15,864 cases with travel-associated salmonellosis acquired in Europe from 1997–2003 were retrieved. These cases were compared to a dataset from the same years on 14,171 randomly selected Swedish residents, with a history of recent overnight travel in Europe. Distribution of salmonellosis in returning travellers and the distribution of Salmonella Enteritidis was analysed for different member states in the European Union, associated and candidate countries. The risk of being notified with a salmonella infection after return from each European country/region was calculated, and compared with official reporting data rom these countries. Using Norway as reference country, we could 1 construct comparable incidence estimates and 2 calculate the "under-reporting" in each country compared to Norway. Results The highest burden of salmonellosis was estimated for Bulgaria (2741/100,000, followed by Turkey with 2344/100 000 and Malta with 2141/100 000. S. Enteritidis is the dominating serotype, 66.9 % of all cases and phage type 4 accounts for 37.5 % of the S. Enteritidis cases Conclusion Using returning tourists as a sentinel population can provide a useful base for comparison of disease burdens in different countries/regions. Focusing prevention of salmonellosis to prevention of egg and poultry associated S. Enteritidis infection will have a major impact from a public health perspective and will significantly lower the burden of disease in most European countries.

  8. Does early intensive multifactorial treatment reduce total cardiovascular burden in individuals with screen-detected diabetes?

    DEFF Research Database (Denmark)

    Simmons, R K; Sharp, S J; Sandbaek, A

    2012-01-01

    Aims  To describe the total cardiovascular burden (cardiovascular morbidity or mortality, revascularization or non-traumatic amputation) in individuals with screen-detected diabetes in the ADDITION-Europe trial and to quantify the impact of the intervention on multiple cardiovascular events over ...

  9. A comparative study of care burden and social support among caregivers of persons with schizophrenia and epilepsy

    OpenAIRE

    Nilufer Karim; Arif Ali; SP Deuri

    2015-01-01

    Background: The caregivers of persons with epilepsy and schizophrenia undergo severe emotional, physical, financial burden due to the nature, chronicity, disability, and stigma attached to the illness. Aim: To assess the burden and social support among caregivers of persons with schizophrenia and epilepsy. Method: The study was conducted at the Out Patient Department of LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur. It was a comparative study. Purposive samplin...

  10. A burden of knowledge: A qualitative study of experiences of neonatal intensive care nurses' concerns when keeping information from parents.

    Science.gov (United States)

    Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

    2015-12-01

    Improved life-sustaining technology in the neonatal intensive care has resulted in an increased probability of survival for extremely premature babies. In the neonatal intensive care, the condition of a baby can deteriorate rapidly. Nurses and parents are together for long periods at the bedside and so form close and trusting relationships. Neonatal nurses as the constant caregivers may be presented with contradictory demands in attempting to meet the baby's needs and being a patient and family advocate. This article aims to explore the issues arising for neonatal nurses when holding information about changes to a condition of a baby that they are unable to share with parents. Data were collected via interviews with 24 neonatal nurses in New South Wales, Australia. A qualitative approach was used to analyse the data. The theme 'keeping secrets' was identified and comprised of three sub-themes 'coping with potentially catastrophic news', 'fear of inadvertent disclosure' and 'a burden that could damage trust'. Keeping secrets and withholding information creates internal conflict in the nurses as they balance the principle of confidentiality with the parent's right to know information. The neonatal nurses experienced guilt and shame when they were felt forced by circumstances to keep secrets or withhold information from the parents of extremely premature babies.

  11. Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units

    Science.gov (United States)

    Larsson, Mattias; Nadjm, Behzad; Dinh, Quynh-Dao; Nilsson, Lennart E.; Rydell, Ulf; Le, Tuyet Thi Diem; Trinh, Son Hong; Pham, Hung Minh; Tran, Cang Thanh; Doan, Hanh Thi Hong; Tran, Nguyen Thua; Le, Nhan Duc; Huynh, Nhuan Van; Tran, Thao Phuong; Tran, Bao Duc; Nguyen, Son Truong; Pham, Thao Thi Ngoc; Dang, Tam Quang; Nguyen, Chau Van Vinh; Lam, Yen Minh; Thwaites, Guy; Van Nguyen, Kinh; Hanberger, Hakan

    2016-01-01

    Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts. PMID:26824228

  12. Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units.

    Directory of Open Access Journals (Sweden)

    Vu Dinh Phu

    Full Text Available Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs. We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs across Vietnam.Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08:00 a.m. on the survey day were included.Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing. Pneumonia accounted for 79.4% (804/1012 of HAIs Most HAIs (84.5% [855/1012] were acquired in the survey hospital with 42.5% (363/855 acquired prior to ICU admission and 57.5% (492/855 developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76, urinary catheter (OR 2.12, no involvement of a family member in patient care (OR 1.94, and surgery after admission (OR 1.66. 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%], Pseudomonas aeruginosa (100/726 [13.8%], and Klebsiella pneumoniae (84/726 [11.6%], with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/3287 patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively.A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts.

  13. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

    NARCIS (Netherlands)

    Lim, S.S.; Vos, T.; Flaxman, A.D.; Danaei, G.; Shibuya, K.; Adair-Rohani, H.; Amann, M.; Anderson, H.R.; Andrews, K.G.; Aryee, M.; Atkinson, C.; Bacchus, L.J.; Bahalim, A.N.; Balakrishnan, K.; Balmes, J.; Barker-Collo, S.; Baxter, A.; Bell, M.L.; Blore, J.D.; Blyth, F.; Bonner, C.; Borges, G.; Bourne, R.; Boussinesq, M.; Brauer, M.; Brooks, P.; Bruce, N.G.; Brunekreef, B.; Bryan-Hancock, C.; Bucello, C.; Buchbinder, R.; Bull, F.; Burnett, R.T.; Byers, T.E.; Calabria, B.; Carapetis, J.; Carnahan, E.; Chafe, Z.; Charlson, F.; Chen, H.; Chen, J.S.; Cheng, A.T.; Child, J.C.; Cohen, A.; Colson, K.E.; Cowie, B.C.; Darby, S.; Darling, S.; Davis, A.; Degenhardt, L.; Dentener, F.; Des Jarlais, D.C.; Devries, K.; Dherani, M.; Ding, E.L.; Dorsey, E.R.; Driscoll, T.; Edmond, K.; Ali, S.E.; Engell, R.E.; Erwin, P.J.; Fahimi, S.; Falder, G.; Farzadfar, F.; Ferrari, A.; Finucane, M.M.; Flaxman, S.; Fowkes, F.G.R.; Freedman, G.; Freeman, M.K.; Gakidou, E.; Ghosh, S.; Giovannucci, E.; Gmel, G.; Graham, K.; Grainger, R.; Grant, B.; Gunnell, D.; Gutierrez, H.R.; Hall, W.; Hoek, H.W.; Hogan, A.; Hosgood, H.D.; Hoy, D.; Hu, H.; Hubbell, B.J.; Hutchings, S.J.; Ibeanusi, S.E.; Jacklyn, G.L.; Jasrasaria, R.; Jonas, J.B.; Kan, H.; Kanis, J.A.; Kassebaum, N.; Kawakami, N.; Khang, Y-H.; Khatibzadeh, S.; Khoo, J-P.; de Kok, C.; Laden, F.; Lalloo, R.; Lan, Q.; Lathlean, T.; Leasher, J.L.; Leigh, J.; Li, Y.; Lin, J.K.; Lipshultz, S.E.; London, S.; Lozano, R.; Lu, Y.; Mak, J.; Malekzadeh, R.; Mallinger, L.; Marcenes, W.; March, L.; Marks, R.; Martin, R.; McGale, P.; McGrath, J.; Mehta, S.; Mensah, G.A.; Merriman, T.R.; Micha, R.; Michaud, C.; Mishra, V.; Hanafiah, K.M.; Mokdad, A.A.; Morawska, L.; Mozaffarian, D.; Murphy, T.; Naghavi, M.; Neal, B.; Nelson, P.K.; Nolla, J.M.; Norman, R.; Olives, C.; Omer, S. B; Orchard, J.; Osborne, R.; Ostro, B.; Page, A.; Pandey, K.D.; Parry, C.D.H.; Passmore, E.; Patra, J.; Pearce, N.; Pelizzari, P.M.; Petzold, M.; Phillips, M.R.; Pope, D.; Pope, C.A.; Powles, J.; Rao, M.; Razavi, H.; Rehfuess, E.A.; Rehm, J.T.; Ritz, B.; Rivara, F.P.; Roberts, T.; Robinson, C.; Rodriguez-Portales, J.A.; Romieu, I.; Room, R.; Rosenfeld, L.C.; Roy, A.; Rushton, L.; Salomon, J.A.; Sampson, U.; Sanchez-Riera, L.; Sanman, E.; Sapkota, A.; Seedat, S.; Shi, P.; Shield, K.; Shivakoti, R.; Singh, G.M.; Sleet, D.A.; Smith, E.; Smith, K.R.; Stapelberg, N.J.C.; Steenland, K.; Stöckl, H.; Stovner, L.J.; Straif, K.; Straney, L.; Thurston, G.D.; Tran, J.H.; van Dingenen, R.; van Donkelaar, A.; Veerman, J.L.; Vijayakumar, L.; Weintraub, R.; Weissman, M.M.; White, R.A.; Whiteford, H.; Wiersma, S.T.; Wilkinson, J.D.; Williams, H.C.; Williams, W.; Wilson, N.; Woolf, A.D.; Yip, P.; Zielinski, J.M.; Lopez, A.D.; Murray, C.J.L.; Ezzati, M.

    2012-01-01

    BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk

  14. General Medical Burden in Bipolar Disorder: Findings from the LiTMUS Comparative Effectiveness Trial

    Science.gov (United States)

    Kemp, David E.; Sylvia, Louisa G.; Calabrese, Joseph R.; Nierenberg, Andrew A.; Thase, Michael E.; Reilly-Harrington, Noreen A.; Ostacher, Michael J.; Leon, Andrew C.; Ketter, Terence A.; Friedman, Edward S.; Bowden, Charles L.; Pencina, Michael; Iosifescu, Dan V.

    2013-01-01

    Objective This study examined general medical illnesses and their association with clinical features of bipolar disorder. Methods Data were cross-sectional and derived from the Lithium Treatment – Moderate Dose Use Study (LiTMUS), which randomized symptomatic adults (n=264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment (OPT) or to OPT alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale (CIRS) score ≥ 4 and < 4, respectively. Results The baseline prevalence of significant medical comorbidity was 53% (n=139). Patients with high medical burden were more likely to present in a major depressive episode (P=.04), meet criteria for obsessive-compulsive disorder (P=.02), and experience a greater number of lifetime mood episodes (P=0.02). They were also more likely to be prescribed a greater number of psychotropic medications (P=.002). Sixty-nine percent of the sample was overweight or obese as defined by body mass index (BMI), with African-Americans representing the racial group with the highest proportion of stage II obesity (BMI ≥ 35; 31%, n=14). Conclusions The burden of comorbid medical illnesses was high in this generalizable sample of treatment-seeking patients and appears associated with worsened course of illness and psychotropic medication patterns. (Funded by NIMH Contract N01MH80001; ClinicalTrials.gov number NCT00667745). PMID:23465084

  15. High-intensity interval training evokes larger serum BDNF levels compared with intense continuous exercise.

    Science.gov (United States)

    Saucedo Marquez, Cinthia Maria; Vanaudenaerde, Bart; Troosters, Thierry; Wenderoth, Nicole

    2015-12-15

    Exercise can have a positive effect on the brain by activating brain-derived neurotrophic factor (BDNF)-related processes. In healthy humans there appears to be a linear relationship between exercise intensity and the positive short-term effect of acute exercise on BDNF levels (i.e., the highest BDNF levels are reported after high-intensity exercise protocols). Here we performed two experiments to test the effectiveness of two high-intensity exercise protocols, both known to improve cardiovascular health, to determine whether they have a similar efficacy in affecting BDNF levels. Participants performed a continuous exercise (CON) protocol at 70% of maximal work rate and a high-intensity interval-training (HIT) protocol at 90% of maximal work rate for periods of 1 min alternating with 1 min of rest (both protocols lasted 20 min). We observed similar BDNF kinetics in both protocols, with maximal BDNF concentrations being reached toward the end of training (experiment 1). We then showed that both exercise protocols significantly increase BDNF levels compared with a rest condition (CON P = 0.04; HIT P exercise are slightly more effective than continuous high-intensity exercise for elevating serum BDNF. Additionally, 73% of the participants preferred the HIT protocol (P = 0.02). Therefore, we suggest that the HIT protocol might represent an effective and preferred intervention for elevating BDNF levels and potentially promoting brain health.

  16. A comparative study of care burden and social support among caregivers of persons with schizophrenia and epilepsy

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    Nilufer Karim

    2015-07-01

    Full Text Available Background: The caregivers of persons with epilepsy and schizophrenia undergo severe emotional, physical, financial burden due to the nature, chronicity, disability, and stigma attached to the illness. Aim: To assess the burden and social support among caregivers of persons with schizophrenia and epilepsy. Method: The study was conducted at the Out Patient Department of LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur. It was a comparative study. Purposive sampling technique was used for selection of the sample. The sample for the current study comprised of caregivers of 30 persons with schizophrenia and 30 persons suffering from epilepsy. A semi-structured socio-demographic data sheet, the Burden Assessment Schedule (BAS, the Social Support Questionnaire, and the General Health Questionnaire were administered to the caregivers. Results: There was no significant difference reported by the caregivers in the two groups with the entire domains of BAS and perceived social support. Physical and mental health, and caregivers’ strategy domains of BAS had significant negative correlation at 0.05 levels with perceived social support. External support, support of patient, taking responsibility, and other relation domains of BAS had significant negative correlation at the 0.01 level with perceived social support. Conclusion: While the two groups had no significant difference with the entire domains of BAS and perceived social support; physical and mental health, and caregivers’ strategy had significant negative correlation with perceived social support.

  17. Comparative hatchability of lake trout eggs differing in contaminant burden and incubation conditions

    Science.gov (United States)

    Mac, M.J.; Berlin, W.H.; Rottiers, D.V.

    1981-01-01

    In 1972, fertilized eggs of lake trout (Salvelinus namaycush) from the Marquette (Michigan) State Fish Hatchery (where levels of contaminants are relatively low) and eggs from lake trout collected in Michigan waters of Lake Michigan near Saugatuck and Charlevoix (where levels of PCB's and DDE are elevated) were incubated at hatchery temperatures (6° C) and at temperatures simulating the natural temperature cycle of Lake Michigan (1-8° C). Survival to yolk absorption of larvae from these three sources ranged from 40.3 to 65.5%, and no correlation was observed between survival and the level of PCB's and DDE in the eggs. Additional studies in 1975 with lake trout eggs from the same three sources confirmed previous observations that the elevated levels of PCB's and DDE in eggs from Lake Michigan did not appear to affect the percent hatch of lake trout eggs or survival of the fry to the swim-up stage. When fry hatched from eggs with an elevated contaminant burden were starved for several weeks, we observed no abnormal increase in posthatching mortality during the period when the yolk stores were being consumed.

  18. Comparative meta-analysis of tuberculosis contact investigation interventions in eleven high burden countries.

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    Lucie Blok

    Full Text Available Screening of household contacts of tuberculosis (TB patients is a recommended strategy to improve early case detection. While it has been widely implemented in low prevalence countries, the most optimal protocols for contact investigation in high prevalence, low resource settings is yet to be determined. This study evaluated contact investigation interventions in eleven lower and middle income countries and reviewed the association between context or program-related factors and the yield of cases among contacts.We reviewed data from nineteen first wave TB REACH funded projects piloting innovations to improve case detection. These nineteen had fulfilled the eligibility criteria: contact investigation implementation and complete data reporting. We performed a cross-sectional analysis of the percentage yield and case notifications for each project. Implementation strategies were delineated and the association between independent variables and yield was analyzed by fitting a random effects logistic regression.Overall, the nineteen interventions screened 139,052 household contacts, showing great heterogeneity in the percentage yield of microscopy confirmed cases (SS+, ranging from 0.1% to 6.2%. Compared to the most restrictive testing criteria (at least two weeks of cough the aOR's for lesser (any TB related symptom and least (all contacts restrictive testing criteria were 1.71 (95%CI 0.94-3.13 and 6.90 (95% CI 3.42-13.93 respectively. The aOR for inclusion of SS- and extra-pulmonary TB was 0.31 (95% CI 0.15-0.62 compared to restricting index cases to SS+ TB. Contact investigation contributed between <1% and 14% to all SS+ cases diagnosed in the intervention areas.This study confirms that high numbers of active TB cases can be identified through contact investigation in a variety of contexts. However, design and program implementation factors appear to influence the yield of contact investigation and its concomitant contribution to TB case detection.

  19. Improving comparability between microarray probe signals by thermodynamic intensity correction

    DEFF Research Database (Denmark)

    Bruun, G. M.; Wernersson, Rasmus; Juncker, Agnieszka

    2007-01-01

    different probes. It is therefore of great interest to correct for the variation between probes. Much of this variation is sequence dependent. We demonstrate that a thermodynamic model for hybridization of either DNA or RNA to a DNA microarray, which takes the sequence-dependent probe affinities......Signals from different oligonucleotide probes against the same target show great variation in intensities. However, detection of differences along a sequence e.g. to reveal intron/exon architecture, transcription boundary as well as simple absent/present calls depends on comparisons between...... into account significantly reduces the signal fluctuation between probes targeting the same gene transcript. For a test set of tightly tiled yeast genes, the model reduces the variance by up to a factor approximately 1/3. As a consequence of this reduction, the model is shown to yield a more accurate...

  20. Caregiving burden and psychological distress among spouses of bipolar patients – comparative analysis of subtype I and II

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    Aleksandra Izabela Arciszewska

    2015-12-01

    The specific types of bipolar disorder (I and II have the different impact on partners, which affects their subjective and objective burden and relationship with patients, indicating a real need to offer them an adequate help, depending on subtype of patient’s bipolar disorder, as well as the spouse sex.

  1. Dynamic bioluminescence imaging for quantitative tumour burden assessment using IV or IP administration of d-luciferin: effect on intensity, time kinetics and repeatability of photon emission

    Energy Technology Data Exchange (ETDEWEB)

    Keyaerts, Marleen; Vanhove, Chris; Caveliers, Vicky; Bossuyt, Axel; Lahoutte, Tony [Vrije Universiteit Brussel (VUB), In Vivo Cellular and Molecular Imaging (ICMI) Laboratory, Brussels (Belgium); University Hospital Brussels (UZ-Brussel), Department of Nuclear Medicine, Brussels (Belgium); Verschueren, Jacob [University of Antwerp, Bio-Imaging lab, Department of Biomedical Sciences, Antwerp (Belgium); Bos, Tomas J. [Vrije Universiteit Brussel (VUB), Department of Haematology and Immunology, Brussels (Belgium); Tchouate-Gainkam, Lea O.; Peleman, Cindy [Vrije Universiteit Brussel (VUB), In Vivo Cellular and Molecular Imaging (ICMI) Laboratory, Brussels (Belgium); Breckpot, Karine [Vrije Universiteit Brussel (VUB), Laboratory of Molecular and Cellular Therapy, Department of Physiology and Immunology, Brussels (Belgium)

    2008-05-15

    In vivo bioluminescence imaging (BLI) is a promising technique for non-invasive tumour imaging. d-luciferin can be administrated intraperitonealy or intravenously. This will influence its availability and, therefore, the bioluminescent signal. The aim of this study is to compare the repeatability of BLI measurement after IV versus IP administration of d-luciferin and assess the correlation between photon emission and histological cell count both in vitro and in vivo. Fluc-positive R1M cells were subcutaneously inoculated in nu/nu mice. Dynamic BLI was performed after IV or IP administration of d-luciferin. Maximal photon emission (PE{sub max}) was calculated. For repeatability assessment, every acquisition was repeated after 4 h and analysed using Bland-Altman method. A second group of animals was serially imaged, alternating IV and IP administration up to 21 days. When mice were killed, PE{sub max} after IV administration was correlated with histological cell number. The coefficients of repeatability were 80.2% (IV) versus 95.0% (IP). Time-to-peak is shorter, and its variance lower for IV (p < 0.0001). PE{sub max} was 5.6 times higher for IV. A trend was observed towards lower photon emission per cell in larger tumours. IV administration offers better repeatability and better sensitivity when compared to IP. In larger tumours, multiple factors may contribute to underestimation of tumour burden. It might, therefore, be beneficial to test novel therapeutics on small tumours to enable an accurate evaluation of tumour burden. (orig.)

  2. The burden of cancer risk in Canada's indigenous population: a comparative study of known risks in a Canadian region

    Directory of Open Access Journals (Sweden)

    Elias B

    2011-10-01

    Full Text Available Brenda Elias1, Erich V Kliewer1–3, Madelyn Hall1, Alain A Demers1,2, Donna Turner1,2, Patricia Martens1, Say P Hong1, Lyna Hart4, Caroline Chartrand5, Garry Munro41Faculty of Medicine, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada; 2CancerCare Manitoba, Winnipeg, MB, Canada; 3British Columbia Cancer Agency, Vancouver, BC, Canada; 4Assembly of Manitoba Chiefs Health Information Research Governance Committee, Winnipeg, MB, Canada; 5Manitoba First Nations Diabetes Integration Project, Winnipeg, MB, CanadaBackground: Canadian First Nations, the largest of the Aboriginal groups in Canada, have had lower cancer incidence and mortality rates than non-Aboriginal populations in the past. This pattern is changing with increased life expectancy, a growing population, and a poor social environment that influences risk behaviors, metabolic conditions, and disparities in screening uptake. These factors alone do not fully explain differences in cancer risk between populations, as genetic susceptibility and environmental factors also have significant influence. However, genetics and environment are difficult to modify. This study compared modifiable behavioral risk factors and metabolic-associated conditions for men and women, and cancer screening practices of women, between First Nations living on-reserve and a non-First Nations Manitoba rural population (Canada.Methods: The study used data from the Canadian Community Health Survey and the Manitoba First Nations Regional Longitudinal Health Survey to examine smoking, binge drinking, metabolic conditions, physical activity, fruit/vegetable consumption, and cancer-screening practices.Results: First Nations on-reserve had significantly higher rates of smoking (P < 0.001, binge drinking (P < 0.001, obesity (P < 0.001 and diabetes (P < 0.001, and less leisure-time physical activity (P = 0.029, and consumption of fruits and vegetables (P < 0.001. Sex differences were also

  3. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

    Science.gov (United States)

    Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Hanafiah, Khayriyyah Mohd; Mokdad, Ali A; Morawska, Lidia; Mozaff arian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope III, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid

    2014-01-01

    Summary Background Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. Methods We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. Findings In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2–7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5–7·0]), and alcohol use (5·5% [5·0–5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8–9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6–8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4–6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2–10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect

  4. A fenbendazole oral drench in addition to an ivermectin pour-on reduces parasite burden and improves feedlot and carcass performance of finishing heifers compared with endectocides alone.

    Science.gov (United States)

    Reinhardt, C D; Hutcheson, J P; Nichols, W T

    2006-08-01

    Two studies utilizing 1,862 yearling heifers were conducted to determine the effects of a fenbendazole oral drench in addition to an ivermectin pour-on (SG+IVPO), compared with an ivermectin pour-on (IVPO) or a doramectin injectable (DMX) alone, on parasite burden, feedlot performance, and carcass merit of feedlot cattle. In the first study, heifers receiving the SG+IVPO had fewer (P = 0.02) cattle retreated for disease and 73% fewer (P = 0.06) worm eggs per fecal sample 98 d after treatment than heifers treated with IVPO. Heifers treated with SG+IVPO consumed more DM, had greater ADG, were heavier at slaughter, and had heavier carcasses than IVPO-treated heifers (P fenbendazole oral drench and an ivermectin pour-on reduced parasite burden and increased feed intake, ADG, and carcass weight in feedlot heifers compared with treatment with an endectocide alone.

  5. Influenza surveillance in Europe. Comparing intensity levels calculated using the Moving Epidemic Method.

    LENUS (Irish Health Repository)

    Vega, Tomás

    2015-05-30

    Although influenza-like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge.

  6. Industrial Capital Intensity and Comparative Advantages Dynamism of Indonesian Export Products

    Directory of Open Access Journals (Sweden)

    Ni Putu Wiwin Setyari

    2015-12-01

    Full Text Available The development of new trade theory which incorporates the interaction between trade and international capital flows indicates if the possibility of changes in a country's comparative advantage due to the opening of international capital flows. International capi tal flows allow for changes in the industrial structure of a country depends on the composition of the products produced in that coun try. More capital-intensive types of products produced by a country, the greater the need for capital and the higher marginal rate of capital that can be given to attract greater international capital flows. Therefore, a comparative advantage should be seen as dynamic rather than static. As a country with large population, Indonesia tends to specialize in labor -intensive products. The other hand, efforts to attract foreign direct investment are very intensively conducted. The estimation results indicate if there was a shift in the pattern of industrial specialization Indonesia, from labor –intensive tends toward capital intensive.

  7. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

    OpenAIRE

    Forouzanfar, Mohammad H; Afshin, Ashkan; Alexander, Lily T; Anderson, H. Ross; Bhutta, Zulficiar A.; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Cercy, Kelly; Charlson, Fiona J.; Cohen, Aaron J; Dandona, Lalit; Estep, Kara; Ferrari, Alize J.; Frostad, Joseph J.

    2016-01-01

    Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate att...

  8. Comparing cutaneous research funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with 2010 Global Burden of Disease results.

    Directory of Open Access Journals (Sweden)

    Chante Karimkhani

    Full Text Available Disease burden data helps guide research prioritization.To determine the extent to which grants issued by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS reflect disease burden, measured by disability-adjusted life years (DALYs from Global Burden of Disease (GBD 2010 project.Two investigators independently assessed 15 skin conditions studied by GBD 2010 in the NIAMS database for grants issued in 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010.The United States NIAMS database and GBD 2010 skin condition disability data.Relationship of NIAMS grant database topic funding with percent total GBD 2010 DALY and DALY rank for 15 skin conditions.During fiscal year 2013, 1,443 NIAMS grants were issued at a total value of $424 million. Of these grants, 17.7% covered skin topics. Of the total skin disease funding, 82% (91 grants were categorized as "general cutaneous research." Psoriasis, leprosy, and "other skin and subcutaneous diseases" (ie; immunobullous disorders, vitiligo, and hidradenitis suppurativa were over-represented when funding was compared with disability. Conversely, cellulitis, decubitus ulcer, urticaria, acne vulgaris, viral skin diseases, fungal skin diseases, scabies, and melanoma were under-represented. Conditions for which disability and funding appeared well-matched were dermatitis, squamous and basal cell carcinoma, pruritus, bacterial skin diseases, and alopecia areata.Degree of representation in NIAMS is partly correlated with DALY metrics. Grant funding was well-matched with disability metrics for five of the 15 studied skin diseases, while two skin diseases were over-represented and seven were under-represented. Global burden estimates provide increasingly transparent and important information for investigating and prioritizing national research funding allocations.

  9. The intensity contrast of solar granulation: comparing Hinode SP results with MHD simulations

    NARCIS (Netherlands)

    Danilovic, S.; Gandorfer, A.; Lagg, A.; SchÜssler, M.; Solanki, S.K.; Vögler, A.; Katsukawa, Y.; Tsuneta, S.

    2008-01-01

    Context. The contrast of granulation is an important quantity characterizing solar surface convection. Aims. We compare the intensity contrast at 630 nm, observed using the Spectro-Polarimeter (SP) aboard the Hinode satellite, with the 3D radiative MHD simulations of Vögler & Schüssler (2007, A&A, 4

  10. Comparative Overview of UWB and VLC for Data- Intensive and Security-Sensitive Applications

    DEFF Research Database (Denmark)

    Prasad, Ramjee; Mihovska, Albena D.; Cianca, Ernestina;

    2012-01-01

    This paper provides a comparative overview of two short-range wireless technologies with high potential for use in various data-intensive and security-sensitive applications, namely, ultra wideband (UWB) and visible light communications (VLC). Both are emerging technologies with some unique...

  11. Emergy-based comparative analysis of energy intensity in different industrial systems.

    Science.gov (United States)

    Liu, Zhe; Geng, Yong; Wang, Hui; Sun, Lu; Ma, Zhixiao; Tian, Xu; Yu, Xiaoman

    2015-12-01

    With the rapid economic development, energy consumption of China has been the second place in the world next to the USA. Usually, measuring energy consumption intensity or efficiency applies heat unit which is joule per gross domestic production (GDP) or coal equivalent per GDP. However, this measuring approach is only oriented by the conversion coefficient of heat combustion which does not match the real value of the materials during their formation in the ecological system. This study applied emergy analysis to evaluate the energy consumption intensity to fill this gap. Emergy analysis is considered as a bridge between ecological system and economic system, which can evaluate the contribution of ecological products and services as well as the load placed on environmental systems. In this study, emergy indicator for performing energy consumption intensity of primary energy was proposed. Industrial production is assumed as the main contributor of energy consumption compared to primary and tertiary industries. Therefore, this study validated this method by investigating the two industrial case studies which were Dalian Economic Development Area (DEDA) and Fuzhou economic and technological area (FETA), to comparatively study on their energy consumption intensity between the different kinds of industrial systems and investigate the reasons behind the differences. The results show that primary energy consumption (PEC) of DEDA was much higher than that of FETA during 2006 to 2010 and its primary energy consumption ratio (PECR) to total emergy involvement had a dramatically decline from year 2006 to 2010. In the same time, nonrenewable energy of PEC in DEDA was also much higher than that in FETA. The reason was that industrial structure of DEDA was mainly formed by heavy industries like petro-chemistry industry, manufacturing industries, and high energy-intensive industries. However, FETA was formed by electronic business, food industry, and light industries. Although

  12. Empowerment in intensive care: patient experiences compared to next of kin and staff beliefs.

    Science.gov (United States)

    Wåhlin, Ingrid; Ek, Anna-Christina; Idvall, Ewa

    2009-12-01

    Experiences of critically ill patients are an important aspect of the quality of care in intensive care units. If next of kin and staff try to empower the patient, this is probably performed in accordance with their beliefs about what patients experience as empowering. As intensive care patients often have difficulties communicating, staff and next of kin need to interpret their wishes, but there is limited knowledge about how correct picture next of kin and staff have of the intensive care patient's experiences. The aim of this study was to compare intensive care patients' experiences of empowerment with next of kin and staff beliefs. Interviews with 11 intensive care patients, 12 next of kin and 12 staff were conducted and analysed using a content analysis method. The findings showed that the main content is quite similar between patient experiences, next of kin beliefs and staff beliefs, but a number of important differences were identified. Some of these differences were regarding how joy of life and the will to fight were generated, the character of relationships, teamwork, humour, hope and spiritual experiences. Staff and next of kin seemed to regard the patient as more unconscious than the patient him/herself did.

  13. Predictors and outcome of obstetric admissions to intensive care unit: A comparative study.

    Science.gov (United States)

    Jain, Shruti; Guleria, Kiran; Vaid, Neelam B; Suneja, Amita; Ahuja, Sharmila

    2016-01-01

    This descriptive observational study was carried out in Guru Teg Bahadur Hospital to identify predictors and outcome of obstetric admission to Intensive Care Unit (ICU). Ninety consecutive pregnant patients or those up to 42 days of termination of pregnancy admitted to ICU from October 2010 to December 2011 were enrolled as study subjects with selection of a suitable comparison group. Qualitative statistics of both groups were compared using Pearson's Chi-square test and Fisher's exact test. Odds ratio was calculated for significant factors. Low socioeconomic status, duration of complaints more than 12 h, delay at intermediary facility, and peripartum hysterectomy increased probability of admission to ICU. High incidence of obstetric admissions to ICU as compared to other countries stresses on need for separate obstetric ICU. Availability of high dependency unit can decrease preload to ICU by 5%. Patients with hemorrhagic disorders and those undergoing peripartum hysterectomy need more intensive care.

  14. Ultratrace element contents in rat tissues: Comparative analysis of serum and hair as indicative matrices of the total body burden

    Directory of Open Access Journals (Sweden)

    Skalny Anatoly V.

    2016-01-01

    Full Text Available The aim of this study was to investigate the distribution of ultratrace elements in rat tissues and to perform a comparative analysis of hair and serum as potential bioindicators of the total ultratrace element content. Thirty-six male Wistar rats were fed a standard chow containing 0.006±0.000, 0.001±0.000, 0.017±0.002, 0.382±0.031, 0.168±0.014, 3.211±0.134, 0.095±0.006, 0.000±0.000, 6.675±0.336, 15.327±0.564, 0.002±0.000, and 1.185±0.202 μg/g of silver (Ag, gold (Au, cesium (Cs, gallium (Ga, germanium (Ge, lanthanum (La, niobium (Nb, platinum (Pt, rubidium (Rb, titanium (Ti, thallium (Tland zirconium (Zr, respectively, from weaning to 3 months old. The ultratrace element content in the liver, kidney, muscle, heart, serum and hair was assessed using inductively coupled plasma mass spectrometry. The obtained data indicate that the highest concentrations of most of the studied elements (Ti, Zr, Ge, Nb, tungsten (W, La, uranium (U, Ag, Au, Pt are in hair, whereas the lowest were observed in the serum. Statistical analysis revealed a significant association between concentrations in the hair and other tissues for Cs, Ti, Nb, Tl, La, U and Au. At the same time, serum Cs, Rb, Ti, Ge, Nb, W, Ga, Tl and La concentrations significantly correlated with the tissue content of the respective ultratrace elements. It can be concluded that hair may be used as a potential bioindicator for certain ultratrace element content in the mammalian organism.

  15. Assessment of subjective intensity of pain during ultrasonic supragingival calculus removal: A comparative study

    Directory of Open Access Journals (Sweden)

    Sachin Malagi

    2014-01-01

    Full Text Available Background: The background of the following study is to measure the subjective intensity of pain using the verbal rating scale (VRS during supragingival scaling in relation to mandibular anteriors, with an ultrasonic scaler, with 2 different inserts (Slimline and Focus spray- split mouth study. Materials and Methods: A total of 30 subjects with a combination of 17 males and 13 females with the chronic generalized gingivitis with a minimum calculus score of 1 (CSSI - Ennever J 1961 who reported to Department of Periodontics, Yenepoya Dental College, Mangalore were chosen for the study. Ultrasonic magnetostrictive scaler unit CAVITRON BOBCAT PRO ® - (DENTSPLY with maximum power setting at 130A and 25kHZ frequency with 2 different inserts i.e., Slim line insert and Focus spray (DENTSPLY were used for supragingival scaling in the study. A VRS was used to assess the subjective intensity of pain. Results: There was no statistically significant difference in pain perception when the scores were compared using Wilcoxon signed rank test. VRS rating scores with slimline inserts showed a pain intensity of 2 in 43.3%, 1 in 53.3% and 0 in 3.3%, whereas the focus spray insert showed a pain intensity of 1 in 23.3% and 0 in 76.7%. Statistical analysis showed a P = 0.251 and a z - 1.147 a . Conclusions: The use of both Slim line insert and Focus spray inserts when used at same settings of the scaling unit, showed no statistical significant difference in the intensity of pain perceived and it showed no correlation between patient acceptance and their pain perception.

  16. Comparing Particle-in-Cell QED Models for High-Intensity Laser-Plasma Interactions

    Science.gov (United States)

    Luedtke, Scott V.; Labun, Lance A.; Hegelich, Björn Manuel

    2016-10-01

    High-intensity lasers, such as the Texas Petawatt, are pushing into new regimes of laser-matter interaction, requiring continuing improvement and inclusion of new physics effects in computer simulations. Experiments at the Texas Petawatt are reaching intensity regimes where new physics-quantum electrodynamics (QED) corrections to otherwise classical plasma dynamics-becomes important. We have two particle-in-cell (PIC) codes with different QED implementations. We review the theory of photon emission in QED-strong fields, and cover the differing PIC implementations. We show predictions from the two codes and compare with ongoing experiments. This work was supported by NNSA cooperative agreement DE-NA0002008, the Defense Advanced Research Projects Agency's PULSE program (12-63-PULSE-FP014) and the Air Force Office of Scientific Research (FA9550-14-1-0045). HPC resources provided by TACC.

  17. A comparative study of intensive Litopenaeus vannamei culture on four bottom substrates without water change

    Science.gov (United States)

    Shan, Hongwei; Zhang, Li; Gao, Lei; Su, Yuepeng; Bao, Weiyang; Ma, Shen

    2014-08-01

    The effect of four bottom substrates, oyster shell powder (OP), sugarcane bagasse (SB), a mixture of OP and SB (OS) and fresh soil (FS), on the water quality and bacterial and zooplankton density of intensive shrimp ( Litopenaeus vannamei) culture tanks without water change and the growth performance of cultured shrimp were compared in this study. At the end of a 110 days culturing trial, the total ammonium-N (TAN) of the water on SB and the nitrite nitrogen (NO2-N) on OS was significantly lower than that on the other substrates ( Pvannamei without water change than OP and FS. To our knowledge, this study presents the first evidence regarding the effect of different bottom substrates on intensive shrimp culture.

  18. Is liquid heparin comparable to dry balanced heparin for blood gas sampling in intensive care unit?

    Directory of Open Access Journals (Sweden)

    Viswas Chhapola

    2014-01-01

    Full Text Available Introduction: Blood gas (BG analysis is required for management of critically ill patients in emergency and intensive care units. BG parameters can be affected by the type of heparin formulations used-liquid heparin (LH or dry balanced heparin (DBH. This study was conducted to determine whether blood gas, electrolyte, and metabolite estimations performed by using DBH and LH are comparable. Materials and Methods: A prospective study was conducted at pediatric intensive care unit (PICU of a tertiary care hospital. Paired venous samples were collected from 35 consecutive children in commercially prepared DBH syringes and custom-prepared LH syringes. Samples were immediately analyzed by blood gas analyzer and compared for pH, pCO 2 , pO 2 , HCO 3 - , Na + , K + , Cl - , and lactate. Paired comparisons were done and agreement was assessed by Bland-Altman difference plots. The 95% limits of absolute agreement (LOA were compared with the specifications for total allowable error (TEa. Results: The P values were significant for all measured parameters, with the exception of pCO 2 and K +. Bland-Altman difference plots showed wide LOA for pCO 2 , pO 2 , HCO3 - , Na + , K + , and Cl - when compared against TEa. For pCO 2 , HCO3 - , Na + , K + , and Cl - , 40%, 23%, 77%, 34%, and 54% of samples were outside the TEa limits, respectively, with LH. Conclusion: Our study showed that there is poor agreement between LH and DBH for the BG parameters pCO2, pO2, HCO3 - , K + , Na + , and Cl - and, thus, are not comparable. But for pH and lactate, LH and DBH can be used interchangeably.

  19. Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial

    DEFF Research Database (Denmark)

    Skielboe, Ane Katrine; Bandholm, Thomas Quaade; Hakmann, Stine

    2017-01-01

    BACKGROUND: Physical activity at moderate-high intensity is recommended to prevent lifestyle diseases. Patients with atrial fibrillation are at risk of a sedentary lifestyle due to fear of exercise-induced episodes of atrial fibrillation. The burden of arrhythmia can be reduced by physical exercise....... The effect of exercise intensity on burden of atrial fibrillation needs to be studied further. METHODS AND RESULTS: In a 12-week randomized controlled trial, 76 patients with paroxysmal/persistent atrial fibrillation were allocated to perform exercise at either low intensity or high intensity (50% and 80......% of maximal perceived exertion, respectively). Primary outcome was burden of AF measured by daily electrocardiography-reporting during 12 weeks. Secondarily, change in maximal oxygen uptake (peak VO2) and 1-year hospitalization was compared between low and high intensity exercise. Sixty-three patients...

  20. Which T category of nasopharyngeal carcinoma may benefit most from volumetric modulated arc therapy compared with step and shoot intensity modulated radiation therapy.

    Directory of Open Access Journals (Sweden)

    Ying Sun

    Full Text Available BACKGROUND: To compare volumetric modulated arc therapy (VMAT with conventional step and shoot intensity modulated radiation therapy (s-IMRT in nasopharyngeal carcinoma (NPC patients, and identify which T category patient gains the maximum benefit from VMAT. METHODS: Fifty-two patients that randomly selected from 205 patients received VMAT at a single center were retrospectively replanned with s-IMRT. For a fair comparison, the planning target volume (PTV coverage of the 2 plans was normalized to the same level. A standard planning constraint set was used; the constraints for the organs at risk (OARs were individually adapted. The calculated doses to the PTV and OARs were compared for s-IMRT and VMAT plans generated using the Monaco treatment planning system. RESULTS: VMAT and s-IMRT plans had similar PTV coverage and OAR sparing within all T categories. However, in stratified analysis, VMAT plans lead to better or similar sparing of the OARs in early T category patients; and lead to poorer sparing of the OARs in advanced T category patients (P<0.05. VMAT shows significant advantages for low dose burden (P<0.05 compared with s-IMRT. The delivery time per fraction for VMAT (424±64 s was shorter than s-IMRT (778 ± 126 s, p<0.01. CONCLUSIONS: VMAT provides similar dose coverage of the PTVs and similar/better normal tissue sparing in early T category NPC, and poorer OARs sparing in advanced T category NPC. And VMAT shows significant advantages for low dose burden and delivery time.

  1. Intensity modulated radiotherapy versus volumetric modulated arc therapy in breast cancer: A comparative dosimetric analysis

    Directory of Open Access Journals (Sweden)

    KR Muralidhar

    2015-01-01

    Full Text Available Purpose: Intensity modulated radiotherapy (IMRT and volumetric modulated arc therapy (VMAT has the capacity to optimize the dose distribution. We analyzed the dosimetric differences of plans in treatment planning system (TPS between VMAT and IMRT in treating breast cancer. Methods: Fourteen patients were simulated, planned, and treated with VMAT using single, double or partial arcs. IMRT treatments were generated using 4 to 5 tangential IMRT fields for the same patients. All treatment plans were planned for 50 Gy in 25 fractions. The VMAT and IMRT plans were compared using the planning target volume (PTV dose and doses to the other organs at risk (OARs. Results: For the PTV, comparable minimum, mean, maximum, median, and modal dose as well equivalent sphere diameter of the structure (Equis were observed between VMAT and IMRT plans and found that these values were significantly equal in both techniques. The right lung mean and modal doses were considerably higher in VMAT plans while maximum value was considerably lower when compared with IMRT plans. The left lung mean and modal doses were higher with VMAT while maximum doses were higher in IMRT plans. The mean dose to the heart and maximum dose to the spinal cord was lower with IMRT. The mean dose to the body was higher in VMAT plans while the maximum dose was higher in IMRT plans. Conclusion: Four field tangential IMRT delivered comparable PTV dose with generally less dose to normal tissues in our breast cancer treatment study. The IMRT plans typically had more favourable dose characteristics to the lung, heart, and spinal cord and body dose when compared with VMAT. The only minor advantage of VMAT for breast cases was slightly better PTV coverage.

  2. Quantitative analysis of tumor burden in mouse lung via MRI.

    Science.gov (United States)

    Tidwell, Vanessa K; Garbow, Joel R; Krupnick, Alexander S; Engelbach, John A; Nehorai, Arye

    2012-02-01

    Lung cancer is the leading cause of cancer death in the United States. Despite recent advances in screening protocols, the majority of patients still present with advanced or disseminated disease. Preclinical rodent models provide a unique opportunity to test novel therapeutic drugs for targeting lung cancer. Respiratory-gated MRI is a key tool for quantitatively measuring lung-tumor burden and monitoring the time-course progression of individual tumors in mouse models of primary and metastatic lung cancer. However, quantitative analysis of lung-tumor burden in mice by MRI presents significant challenges. Herein, a method for measuring tumor burden based upon average lung-image intensity is described and validated. The method requires accurate lung segmentation; its efficiency and throughput would be greatly aided by the ability to automatically segment the lungs. A technique for automated lung segmentation in the presence of varying tumor burden levels is presented. The method includes development of a new, two-dimensional parametric model of the mouse lungs and a multi-faceted cost function to optimally fit the model parameters to each image. Results demonstrate a strong correlation (0.93), comparable with that of fully manual expert segmentation, between the automated method's tumor-burden metric and the tumor burden measured by lung weight.

  3. Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes

    DEFF Research Database (Denmark)

    Tao, L; Wilson, E C F; Wareham, N J

    2015-01-01

    Aims To examine the short- and long-term cost-effectiveness of intensive multifactorial treatment compared with routine care among people with screen-detected Type 2 diabetes. Methods Cost–utility analysis in ADDITION-UK, a cluster-randomized controlled trial of early intensive treatment in peopl...

  4. Comparing USGS national seismic hazard maps with internet-based macroseismic intensity observations

    Science.gov (United States)

    Mak, Sum; Schorlemmer, Danijel

    2016-04-01

    Verifying a nationwide seismic hazard assessment using data collected after the assessment has been made (i.e., prospective data) is a direct consistency check of the assessment. We directly compared the predicted rate of ground motion exceedance by the four available versions of the USGS national seismic hazard map (NSHMP, 1996, 2002, 2008, 2014) with the actual observed rate during 2000-2013. The data were prospective to the two earlier versions of NSHMP. We used two sets of somewhat independent data, namely 1) the USGS "Did You Feel It?" (DYFI) intensity reports, 2) instrumental ground motion records extracted from ShakeMap stations. Although both are observed data, they come in different degrees of accuracy. Our results indicated that for California, the predicted and observed hazards were very comparable. The two sets of data gave consistent results, implying robustness. The consistency also encourages the use of DYFI data for hazard verification in the Central and Eastern US (CEUS), where instrumental records are lacking. The result showed that the observed ground-motion exceedance was also consistent with the predicted in CEUS. The primary value of this study is to demonstrate the usefulness of DYFI data, originally designed for community communication instead of scientific analysis, for the purpose of hazard verification.

  5. Comparative study on the economic burden of patients with tuberculosis%结核病患者疾病经济负担比较研究

    Institute of Scientific and Technical Information of China (English)

    仇桑桑; 陆慧; 张思慜; 姜伟; 黄莉芳; 王建明

    2014-01-01

    Objective:To analyze the economic burden of tuberculosis patients in areas with different economic levels, and to explore factors related to their economic burden. Methods: Two counties from Jiangsu Province, Zhangjiagang and Taixing, were selected as the study sites. Tuberculosis patients who had already completed the standard anti-tuberculosis treatment from 2010 to 2013 were recruited as the study subjects. Direct and indirect costs due to the disease were collected and compared between these two areas. Results: A total of 590 patients who had completed the survey were involved in the analysis, including 274 cases from Zhangjiagang and 316 cases from Taixing. The average total costs were 18 793.3 (median: 9 965.0) CNY for patients in Zhangjiagang and 6 598.3 (median: 2 263.0) CNY for patients in Taixing, respectively. The difference of costs between these two areas was significant (Z = 10.42, P < 0.001). Ⅰn Zhangjiagang, the per capita out-of-pocket direct cost was 7 448.0 CNY and the per capita indirect cost was 6 856.4 CNY. Ⅰn Taixing, the per capita out-of-pocket direct cost was 3 024.0 CNY and the per capita indirect cost was 2 615.2 CNY. Factors related to the out-of-pocket direct costs were migrant population, diagnosis delay, hospitalization, taking liver protective drugs and using the second-line drugs in Zhangjiagang, etc, and adverse drug reactions, abnormal liver function, diagnosis delay, hospitalization, taking liver protective drugs and using the second-line drugs, etc, in Taixing. Conclusion: Although the government provides free-service policy for tuberculosis, patients still need to bear a high economic burden, especially in economically developed areas.%了解经济发展水平不同地区结核病患者疾病经济负担及其影响因素。以江苏省张家港市和泰兴市为研究现场,以2010~2013年完成规定抗结核疗程的肺结核病患者为研究对象,收集并比较患者因病支付的直

  6. The influence of neuroticism and extraversion on the perceived burden of dementia caregivers: an exploratory study.

    Science.gov (United States)

    González-Abraldes, Isabel; Millán-Calenti, José Carlos; Lorenzo-López, Laura; Maseda, Ana

    2013-01-01

    Most studies reflect dementia caregivers usually sustain higher levels of burden compared to other caregivers. However, they do not consider variability within the caregiver, such as personality traits. The purpose of this study was to examine the influence of extraversion and neuroticism on dementia caregiver burden. A cross-sectional descriptive study was conducted with 33 caregivers looking after demented-patients. All caregivers had intense burden levels, and their personality, depression, anxiety and self-rated health were evaluated. Personality variables had important effects on the caregiver burden and consequences on their mental health. Neuroticism was significantly correlated with burden (r=0.6, ptrait (r=0.67, pneuroticism (r=-0.42, ptrait anxiety (r=0.66, ppersonality in the theoretical and empirical models of the caring process. It is necessary to adequately assess the caregiver personality, as those presenting high levels of neuroticism and low levels of extraversion are more vulnerable to experience negative caring effects.

  7. Comparative outcomes for three-dimensional conformal versus intensity-modulated radiation therapy for esophageal cancer.

    Science.gov (United States)

    Freilich, J; Hoffe, S E; Almhanna, K; Dinwoodie, W; Yue, B; Fulp, W; Meredith, K L; Shridhar, R

    2015-01-01

    Emerging data suggests a benefit for using intensity modulated radiation therapy (IMRT) for the management of esophageal cancer. We retrospectively reviewed patients treated at our institution who received definitive or preoperative chemoradiation with either IMRT or 3D conformal radiation therapy (3DCRT) between October 2000 and January 2012. Kaplan Meier analysis and the Cox proportional hazard model were used to evaluate survival outcomes. We evaluated a total of 232 patients (138 IMRT, 94 3DCRT) who received a median dose of 50.4 Gy (range, 44-64.8) to gross disease. Median follow up for all patients, IMRT patients alone, and 3DCRT patients alone was 18.5 (range, 2.5-124.2), 16.5 (range, 3-59), and 25.9 months (range, 2.5-124.2), respectively. We observed no significant difference based on radiation technique (3DCRT vs. IMRT) with respect to median overall survival (OS) (median 29 vs. 32 months; P = 0.74) or median relapse free survival (median 20 vs. 25 months; P = 0.66). On multivariable analysis (MVA), surgical resection resulted in improved OS (HR 0.444; P 20% weight loss (OR 0.51; P = 0.050). Our data suggest that while IMRT-based chemoradiation for esophageal cancer does not impact survival there was significantly less toxicity. In the IMRT group there was significant decrease in weight loss and grade ≥3 toxicity compared to 3DCRT.

  8. Cryogenic Current Comparator as Low Intensity Beam Current Monitor in the CERN Antiproton Decelerators

    CERN Document Server

    Fernandes, M; Soby, L; Welsch, CP

    2013-01-01

    In the low-energy Antiproton Decelerator (AD) and the future Extra Low ENergy Antiproton (ELENA) rings at CERN, an absolute measurement of the beam intensity is essential to monitor any losses during the deceleration and cooling phases. However, existing DC current transformers can hardly reach the μA level, while at the AD and ELENA currents can be as low as 100 nA. A Cryogenic Current Comparator (CCC) based on a superconducting quantum interference device (SQUID) is currently being designed and shall be installed in the AD and ELENA machines. It should meet the following specifications: A current resolution smaller than 10 nA, a dynamic range covering currents between 100 nA and 1 mA, as well as a bandwidth from DC to 1 kHz. Different design options are being considered, including the use of low or high temperature superconductor materials, different CCC shapes and dimensions, different SQUID characteristics, as well as electromagnetic shielding requirements. In this contribution we present first results f...

  9. Worldwide burden of diabetes

    Directory of Open Access Journals (Sweden)

    Jaikrit Bhutani

    2014-01-01

    Full Text Available Diabetes is a pandemic of major public health importance cannot be disputed. While the IDF data does emphasis the importance of diabetes as a global public health problem, it does not place in perspective the ranking of diabetes as compared to other diseases and illnesses. The GBD data highlight this fact in multiple ways. The disease and its complications or comorbid conditions rank high in the list of risk factors, and causes of death. This communication describes the global burden of diabetes especially south-east Asia and the statistical sequelae of the disease.

  10. A Comparative Study of Intensity Markers in Engineering and Applied Linguistics

    Science.gov (United States)

    Behnam, Biook; Mirzapour, Fatemeh

    2012-01-01

    Writers use intensity markers as one of strategies in order to negotiate their claims and to make their writings persuasive and credible. This study is an attempt to examine the type, frequency, and functions of intensity markers in research articles of two disciplines of Applied Linguistics and Electrical Engineering by analyzing surface…

  11. Burden of HIV and Syphilis: A Comparative Evaluation between Male Sex Workers and Non-Sex-Worker Men Who Have Sex with Men in Urban China.

    Directory of Open Access Journals (Sweden)

    Weiming Tang

    Full Text Available The increasing burden of sexually transmitted infections (STIs including HIV and syphilis among male sex workers (MSWs is a major global concern. The aim of our study was to evaluate the difference between MSWs and non-commercial MSMs in China.During 2008-09, in a cross-sectional study, 2618 adult MSM were recruited through respondent-driven and snowball sampling from seven cities of China. Information regarding socio-demographics, risk behaviors, HIV-related knowledge and STI-related symptoms were collected and participants were tested for HIV and syphilis.Among 2618 participating MSM, 9.97% sold sex to males. HIV prevalence was 7.45% (6.13% among MSWs and 7.59% among non-MSW MSM and syphilis prevalence was 14.32% (10.73% for MSWs and 14.72% for non-MSW MSM. Compared to non-MSW MSM, MSWs were more likely to be younger (adjusted odds ratio: aOR = 0.91, 95% confidence interval: 95%CI=0.88-0.93, never married (aOR = 4.38, 95% CI = 2.38-6.80, less educated, heterosexual (aOR = 13.04, 95% CI = 6.08-27.95, less knowledgeable regarding HIV (aOR = 0.70, 95% CI=0.51-0.96, experiencing symptoms of STI (aOR = 2.16, 95% CI = 1.47-3.19, engaging in condomless vaginal intercourse (aOR = 2.16, 95% CI = 1.47-3.19 and less likely to engage in condomless anal intercourse (aOR = 0.62, 95% CI = 0.46-0.85.High HIV and syphilis prevalence warranted urgent intervention targeting MSWs as a separate sentinel group for efficient surveillance owing to their different distribution from non-MSW MSM. Although male sex workers and non-commercial homosexuals have similar rates of HIV and syphilis, MSWs have different characteristics which should be considered in designing intervention programs targeting them.

  12. Cardiovascular exercise and burden of arrhythmia in patients with atrial fibrillation - A randomized controlled trial

    Science.gov (United States)

    Bandholm, Thomas Quaade; Hakmann, Stine; Mourier, Malene; Kallemose, Thomas; Dixen, Ulrik

    2017-01-01

    Background Physical activity at moderate-high intensity is recommended to prevent lifestyle diseases. Patients with atrial fibrillation are at risk of a sedentary lifestyle due to fear of exercise-induced episodes of atrial fibrillation. The burden of arrhythmia can be reduced by physical exercise. The effect of exercise intensity on burden of atrial fibrillation needs to be studied further. Methods and results In a 12-week randomized controlled trial, 76 patients with paroxysmal/persistent atrial fibrillation were allocated to perform exercise at either low intensity or high intensity (50% and 80% of maximal perceived exertion, respectively). Primary outcome was burden of AF measured by daily electrocardiography-reporting during 12 weeks. Secondarily, change in maximal oxygen uptake (peak VO2) and 1-year hospitalization was compared between low and high intensity exercise. Sixty-three patients completed the follow-up. In the intention-to-treat analysis, we found no statistical difference in burden of atrial fibrillation between low and high intensity exercise (incidence rate ratio 0.742, 95% CI 0.29–1.91, P = 0.538). No serious adverse events were reported and there was no difference in hospitalization between the two exercise groups. Both exercise groups improved significantly in peak VO2 (low intensity: 3.62 mL O2/kg/min, SD 3.77; high intensity: 2.87 mL O2/kg/min, SD 4.98), with no statistical difference between-groups (mean difference: 0.76 mL O2/kg/min, 95% CI -3.22–1.7). Conclusions High intensity physical exercise was not superior to low intensity physical exercise in reducing burden of atrial fibrillation. HI exercise was well tolerated; no evidence of an increased risk was found for HI compared to LI exercise. Larger studies are required to further prove our findings. Trial registration ClinicalTrials.gov NCT01817998 PMID:28231325

  13. Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

    Directory of Open Access Journals (Sweden)

    Reams R Renee

    2009-02-01

    Full Text Available Abstract Background African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade. Results Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks. Conclusion The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.

  14. Global burden of COPD.

    Science.gov (United States)

    López-Campos, José Luis; Tan, Wan; Soriano, Joan B

    2016-01-01

    It is estimated that the world population will reach a record 7.3 billion in 2015, and the high burden of chronic conditions associated with ageing and smoking will increase further. Respiratory diseases in general receive little attention and funding in comparison with other major causes of global morbidity and mortality. In particular, chronic obstructive pulmonary disease (COPD) has been a major public health problem and will remain a challenge for clinicians within the 21st century. Worldwide, COPD is in the spotlight, since its high prevalence, morbidity and mortality create formidable challenges for health-care systems. This review emphasizes the magnitude of the COPD problem from a clinician's standpoint by drawing extensively from the new findings of the Global Burden of Disease study. Updated, distilled information on the population distribution of COPD is useful for the clinician to help provide an appreciation of the relative impact of COPD in daily practice compared with other chronic conditions, and to allocate minimum resources in anticipation of future needs in care. Despite recent trends in reduction of COPD standardized mortality rates and some recent successes in anti-smoking efforts in a number of Western countries, the overarching demographic impact of ageing in an ever-expanding world population, joined with other factors such as high rates of smoking and air pollution in Asia, will ensure that COPD will continue to pose an ever-increasing problem well into the 21st century.

  15. Plutonium and the risk of cancer. A comparative analysis of Pu-body burdens due to releases from nuclear plants (Chelyabinsk-65, Gomel area) and global fallout.

    Science.gov (United States)

    Hohryakov, V F; Syslova, C G; Skryabin, A M

    1994-03-01

    Results of the analysis of dynamic body burdens of Pu in adult inhabitants of Chelyabinsk-65 (not occupationally exposed) and different areas of the Gomel region are presented for 1990-1991. The data are based on radiochemical analyses of Pu in human organs and tissues. Comparison with the published data on global Pu and our data for human autopsies (Ufa, Russia) revealed that estimates of Pubody burdens in Chelyabinsk-65 residents were up to 30 times higher than global levels and depended on the period of residence in town. The Pu body contents of Gomel citizens 4-5 years after the Chernobyl accident are on average 3-4 times higher than the global levels. Activity of Pu-238 in various organs constitutes 4.7-26.0% (on the average 13.5 +/- 5.0%) of the total alpha-activity of Pu-238 and Pu-239, 240. The expected number of cancers induced by incorporated plutonium is approximately the same for the two population groups despite their different sizes and does not differ from the global level by more than one order of magnitude.

  16. Compared to Palliative Care, Working in Intensive Care More than Doubles the Chances of Burnout: Results from a Nationwide Comparative Study

    Science.gov (United States)

    Teixeira, Carla Margarida; Carvalho, Ana Sofia; Hernández-Marrero, Pablo

    2016-01-01

    Introduction Professionals working in intensive and palliative care units, hence caring for patients at the end-of-life, are at risk of developing burnout. Workplace conditions are determinant factors to develop this syndrome among professionals providing end-of-life care. Objectives To identify and compare burnout levels between professionals working in intensive and palliative care units; and to assess which workplace experiences are associated with burnout. Methods A nationwide, multicentre quantitative comparative survey study was conducted in Portugal using the following instruments: Maslach Burnout Inventory–Human Services Survey, Questionnaire of workplace experiences and ethical decisions, and Questionnaire of socio-demographic and professional characteristics. A total of 355 professionals from 10 intensive care and 9 palliative care units participated in the survey. A series of univariate and multivariate logistic regression analyses were performed; odds ratio sidelong with 95% confidence intervals were calculated. Results 27% of the professionals exhibited burnout. This was more frequent in intensive care units (OR = 2.525, 95% CI: 1.025–6.221, p = .006). Univariate regression analyses showed that higher burnout levels were significantly associated with conflicts, decisions to withhold/withdraw treatment, and implementing palliative sedation. When controlling for socio-demographic and educational characteristics, and setting (intensive care units versus palliative care units), higher burnout levels were significantly and positively associated with experiencing conflicts in the workplace. Having post-graduate education in intensive/palliative care was significantly but inversely associated to higher burnout levels. Conclusions Compared to palliative care, working in intensive care units more than doubled the likelihood of exhibiting burnout. Experiencing conflicts (e.g., with patients and/or families, intra and/or inter-teams) was the most significant

  17. A comparative study of hair removal at an NHS hospital: Luminette intense pulsed light versus electrolysis.

    Science.gov (United States)

    Harris, Karen; Ferguson, Janice; Hills, Samantha

    2014-04-01

    Twenty-five women, referred for hair removal by electrolysis, were enrolled in a split face study to treat facial hirsutism. Each patient was treated on six occasions: one-half of the face with electrolysis and the other side with an intense pulsed light source. Patients were evaluated with respect to reduction in hair counts, side effects and discomfort during treatment. Re-growth was assessed at 3, 6 and 9 months following treatment. All patients, except one with very sparse, fair hair growth, preferred treatment with the Intense Pulsed Light and rated their average hair reduction with this method as 77% after five treatments. The overall patient satisfaction rates as determined by visual analogue scales were 8.3 out of 10 for IPL and 5.4 out of 10 for electrolysis.

  18. Can Protocolised Weaning Applied in Denmark Transfer to Egyptian Intensive Care Units? A Comparative Study

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Zaiton, Hala; Pedersen, Birthe D.;

    2011-01-01

    The aim of this study was to investigate whether protocol-directed weaning applied by nurses in the Intensive Care Unit at Odense University Hospital in Denmark (ICUD) can be transferred to the Intensive Care Unit at Zagazig University Hospital in Egypt (ICUE), where weaning is physician......-directed. Patients were randomly assigned to receive either protocol-directed or physician-directed weaning from mechan-ical ventilation the results of the study referred that using protocol guidance, weaned patients from mechanical ventilation more safely and more quickly than in the physician-directed weaning...... employed at ICUE. This was due both to initiating the weaning process earlier and shortening its duration. ICU length of stay, risk of VAP and hospital mortality rate were lower in the group receiving protocol-directed weaning....

  19. The potential benefit of swallowing sparing intensity modulated radiotherapy to reduce swallowing dysfunction : An in silico planning comparative study

    NARCIS (Netherlands)

    van der Laan, Hans Paul; Christianen, Miranda E M C; Bijl, Hendrik P; Schilstra, C; Langendijk, Johannes A

    2012-01-01

    PURPOSE: To apply recently developed predictive models for swallowing dysfunction to compare the predicted probabilities of swallowing dysfunction for standard intensity modulated radiotherapy (ST-IMRT) and swallowing sparing IMRT (SW-IMRT). MATERIALS AND METHODS: Thirty head and neck cancer patient

  20. Elite female soccer players perform more high-intensity running when playing in international games compared with domestic league games

    DEFF Research Database (Denmark)

    Andersson, Helena Å.; Randers, Morten Bredsgaard; Heiner-Møller, Anja;

    2010-01-01

    The purpose of this study was to compare movement pattern, fatigue development, and heart rate (HR) for top-class elite female players when playing international (INT) vs. domestic league games (DOM). Video-based time-motion analyses and HR recordings were performed on 17 players during INT and DOM....... The distances covered in high-intensity running (HIR) and sprinting were longer (p game types......, the amount of HIR was reduced by 24-27% (p game. The midfielders covered longer (p game and in the most intense 5-minute period of the games, whereas...

  1. The Global Cancer Burden

    Centers for Disease Control (CDC) Podcasts

    2012-02-02

    This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

  2. Sensory dynamics of intense microwave irradiation: A comparative study of aversive behaviors by mice and rats

    Energy Technology Data Exchange (ETDEWEB)

    Justesen, D.R.

    1981-10-01

    The results of two experiments are reported, the first on 24 mice and 14 rats, all experimentally naive, that were observed for evidence of adventitious escape from faradic shock or from a potentially lethal, 2450-MHz microwave field in a multi-mode cavity. All of ten rats irradiated at a whole-body-averaged dose rate of 60 mW/g convulsed and expired, presumably from radiation-induced hyperpyrexia. Eight of ten mice irradiated at 60 mW/g survived the four sessions of irradiation, but reliable evidence of escape learning was not observed. The data of the second experiment, which was a pilot study of four rats with an extensive history of exposure to intense but intermittently applied microwave fields, revealed that the animals learned to thermoregulate behaviorally by locomoting in and out of the safe-area circle. A strong relation between dose rate (30, 60, and 120 mW/g) and proportion of time spent in the safe area was observed (r = .97). Post-exposure means of colonic temperature during three sets of sessions under the different rates of energy dosing were highly stable and averaged 39.6 deg C.

  3. Greater impact of acute high-intensity interval exercise on post-exercise executive function compared to moderate-intensity continuous exercise.

    Science.gov (United States)

    Tsukamoto, Hayato; Suga, Tadashi; Takenaka, Saki; Tanaka, Daichi; Takeuchi, Tatsuya; Hamaoka, Takafumi; Isaka, Tadao; Hashimoto, Takeshi

    2016-03-01

    Aerobic moderate-intensity continuous exercise (MCE) can improve executive function (EF) acutely, potentially through the activation of both physiological and psychological factors. Recently, high-intensity interval exercise (HIIE) has been reported to be more beneficial for physical adaptation than MCE. Factors for EF improvement can potentially be more enhanced by HIIE than by MCE; but the effects of HIIE on EF remain unknown. Therefore, we aimed to examine to what extent HIIE impacts post-exercise EF immediately after exercise and during post-exercise recovery, compared with traditional MCE. Twelve healthy male subjects performed cycle ergometer exercise based on either HIIE or MCE protocols in a randomized and counterbalanced order. The HIIE protocol consisted of four 4-min bouts at 90% of peak VO2 with 3-min active recovery at 60% of peak VO2. A volume-matched MCE protocol was applied at 60% of peak VO2. To evaluate EF, a color-words Stroop task was performed pre- and post-exercise. Improvement in EF immediately after exercise was the same for the HIIE and MCE protocols. However, the improvement of EF by HIIE was sustained during 30 min of post-exercise recovery, during which MCE returned to the pre-exercise level. The EF response in the post-exercise recovery was associated with changes in physiological and psychological responses. The present findings showed that HIIE and MCE were capable of improving EF. Moreover, HIIE could prolong improvement in EF during post-exercise recovery. For the first time, we suggest that HIIE may be more effective strategy than MCE for improving EF.

  4. Elite female soccer players perform more high-intensity running when playing in international games compared with domestic league games.

    Science.gov (United States)

    Andersson, Helena A; Randers, Morten B; Heiner-Møller, Anja; Krustrup, Peter; Mohr, Magni

    2010-04-01

    The purpose of this study was to compare movement pattern, fatigue development, and heart rate (HR) for top-class elite female players when playing international (INT) vs. domestic league games (DOM). Video-based time-motion analyses and HR recordings were performed on 17 players during INT and DOM. The distances covered in high-intensity running (HIR) and sprinting were longer (p game types, the amount of HIR was reduced by 24-27% (p game. The midfielders covered longer (p game and in the most intense 5-minute period of the games, whereas no differences were observed between the game types for defenders. No difference in the HR response was found between INT and DOM. In conclusion, more HIR and sprinting occur in international compared with domestic games, which may affect the fatigue development for players in physically demanding roles. Thus, our results are important to coaches to prepare players to meet the challenges of international soccer games and show that the ability to perform intense intermittent exercise should be trained regularly in elite female players.

  5. The Public Stigma of Problem Gambling: Its Nature and Relative Intensity Compared to Other Health Conditions.

    Science.gov (United States)

    Hing, Nerilee; Russell, Alex M T; Gainsbury, Sally M; Nuske, Elaine

    2016-09-01

    Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling.

  6. Geometry-based vs. intensity-based medical image registration: A comparative study on 3D CT data.

    Science.gov (United States)

    Savva, Antonis D; Economopoulos, Theodore L; Matsopoulos, George K

    2016-02-01

    Spatial alignment of Computed Tomography (CT) data sets is often required in numerous medical applications and it is usually achieved by applying conventional exhaustive registration techniques, which are mainly based on the intensity of the subject data sets. Those techniques consider the full range of data points composing the data, thus negatively affecting the required processing time. Alternatively, alignment can be performed using the correspondence of extracted data points from both sets. Moreover, various geometrical characteristics of those data points can be used, instead of their chromatic properties, for uniquely characterizing each point, by forming a specific geometrical descriptor. This paper presents a comparative study reviewing variations of geometry-based, descriptor-oriented registration techniques, as well as conventional, exhaustive, intensity-based methods for aligning three-dimensional (3D) CT data pairs. In this context, three general image registration frameworks were examined: a geometry-based methodology featuring three distinct geometrical descriptors, an intensity-based methodology using three different similarity metrics, as well as the commonly used Iterative Closest Point algorithm. All techniques were applied on a total of thirty 3D CT data pairs with both known and unknown initial spatial differences. After an extensive qualitative and quantitative assessment, it was concluded that the proposed geometry-based registration framework performed similarly to the examined exhaustive registration techniques. In addition, geometry-based methods dramatically improved processing time over conventional exhaustive registration.

  7. Caregiver Burden: Looking Beyond the Unidimensional Total Score.

    Science.gov (United States)

    Lau, Sabrina; Chong, Mei Sian; Ali, Noorhazlina; Chan, Mark; Chua, Kia Chong; Lim, Wee Shiong

    2015-01-01

    The Zarit Burden Interview allows caregiver burden to be interpreted from a total score. However, recent studies propose a multidimensional Zarit Burden Interview model. This study aims to determine the agreement between unidimensional (UD) and multidimensional (MD) classification of burden, and differences in predictors among identified groups. We studied 165 dyads of dementia patients and primary caregivers. Caregivers were dichotomized into low-burden and high-burden groups based upon: (1) UD score using quartile cutoffs; and (2) MD model via exploratory cluster analysis. We compared UD versus MD 2×2 classification of burden using κ statistics. Caregivers not showing agreement by either definition were classified as "intermediate" burden. We performed binary logistic regression to ascertain differences in predictive factors. The 2 models showed moderate agreement (κ=0.72, P<0.01), yielding 104 low, 20 intermediate (UD "low burden"/MD "high burden"), and 41 high-burden caregivers. Neuropsychiatric symptoms [odds ratio (OR)=1.27, P=0.003], coresidence (OR=6.32, P=0.040), and decreased caregiving hours (OR=0.99, P=0.018) were associated with intermediate burden, whereas neuropsychiatric symptoms (OR=1.21, P=0.001) and adult children caregivers (OR=2.80, P=0.055) were associated with high burden. Our results highlight the differences between UD and MD classification of caregiver burden. Future studies should explore the significance of the noncongruent intermediate group and its predictors.

  8. COMPARATIVE ANALYSIS OF THE INTENSITY AND DISTRIBUTION OF HEAVY RAINS IN ZHEJIANG PROVINCE CAUSED BY TYPHOONS HAITANG AND MATSA

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-hai; ZHU Xiao-ming; WANG Li-hua

    2007-01-01

    Study was carried out on two landfall typhoons Haitang and Matsa, which affected Zhejiang province seriously in 2005. Firstly, the similarity and difference between the two typhoon-induced heavy rains were compared and it was pointed out that both of them brought strong large-scale precipitation and the maximum centers of rainfall were located on the north side of the landfall site. Making landfall on Fujian, Haitang was weaker than Matsa in intensity but surpassed it in rainfall. Then with focus on intensity,moving speed, structure of typhoon, circulation and terrain, the two typhoon-related heavy rains were compared and analyzed. Results show that the asymmetrical distribution of rainfall was closely related to the structure of typhoons themselves, moisture transportation and mesoscale terrain. In contrast to the south side, the north side was hotter and wetter and water vapor was also more abundant. The phenomenon of more rainfall induced by Haitang was in connection with the following reasons. Invading cold air led to rainfall increases, weakened dynamic field and slower movement both benefited precipitation. For the last part, the cold characteristic of air mass over Zhejiang was also a favorable factor for the rain.

  9. Posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment compared to children who survived a major fire disaster

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2008-05-01

    Full Text Available Abstract Background The goals were to determine the presence of posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands. Methods Children completed the Dutch Children's Responses to Trauma Inventory at three and nine months after discharge from the paediatric intensive care unit (PICU. Comparison data were available from 355 children survivors who completed the same questionnaire 10 months after a major fire disaster. Results Thirty-six children aged eight to 17 years completed questionnaires at three month follow-up, nine month follow-up, or both. More than one third (34.5% of the children had subclinical PTSD, while 13.8% were likely to meet criteria for PTSD. Maternal PTSD was the strongest predictor for child PTSD. There were no significant differences in (subclinical PTSD symptoms either over time or compared to symptoms of survivors from the fire disaster. Conclusion This study shows that a considerable number of children have persistent PTSD after PICU treatment. Prevention of PTSD is important to minimize the profound adverse effects that PTSD can have on children's well-being and future development.

  10. Dosimetric study comparing intensity modulated and conformal pelvic radiotherapy boost plans in locally advanced cancer cervix in NCI-Cairo

    Institute of Scientific and Technical Information of China (English)

    Mohamed Mahmoud; Hesham A. EL-Hossiny; Nashaat A. Diab; Mahmoud Shosha

    2013-01-01

    Objective: This study was to compare 5 field conformal technique to the intensity modulated radiotherapy (IMRT) 8 fields technique in boosting locally advanced cancer cervix cases after external beam radiotherapy with respect to target volume coverage and dose to normal tissues. Methods: We conducted a single institutional comparative dosimetric analysis of 10 patients with cancer cervix who was presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2012 to September 2012 and received a CRT boost in the place of planned brachytherapy after large field pelvic radiotherapy (PRT) with concurrent chemotherapy were retrospectively identified. All tumors were situated in the low central pelvis. Two plans were done for every patient; one using the 8 fields IMRT and the second one using 5 fields' 3DCRT the two techniques were then compared using dose volume histogram (DVH) analysis for the PTV, bladder, rectum and both femoral heads. Results: Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both plans while it was demonstrates that the 8 fields IMRT technique carried less doses reaching OARs (rectum, bladder, both femoral heads). Conclusion: From the present study, it is concluded that IMRT technique spared more efficiently OARs than CRT technique but both techniques covered the PTV adequately so whenever possible IMRT technique should be used.

  11. Burden of Osteoporosis in Iran

    Directory of Open Access Journals (Sweden)

    F Abolhassani

    2004-11-01

    Full Text Available Osteoporosis is the most common metabolic bone disease. In addition to morbidity, osteoporotic fractures also increase mortality risk in affected patients. Enough evidence is not available to indicate that, like western countries, osteoporosis is a public health problem in Iran. Therefore EMRC planned to estimate the burden of osteoporotic fractures in year 2001 based on existing sources of data. The EMRC study on bone density, the MOH study on unintentional injuries, and international literature on mortality risk following osteoporotic fractures were the main sources of information used for this study. To estimate burden of osteoporotic fractures, the prevalence of osteoporosis, the incidence of osteoporotic fractures, and the relative risk of mortality following these fractures were approximated. The mean duration of disability following major osteoporotic fractures was estimated through epidemiologic modeling. Assumptions on the disability weights of morbid conditions resulting from osteoporotic fractures were made through comparing these conditions with similar ones in Global Burden of Disease Study. Based on mortality and incidence rates, mean durations of disability, and disability weights; the DALYs indicator was calculated for Spine, Hip, and Forearm fractures. In women hip, spine, and forearm fractures were responsible for 15880, 1269, and 121 mortality- and morbidity-related lost years of life respectively. Similar figures in men were 16495, 2225, and 37 years. Collectively osteoporosis deprived Iranian population from 36026 healthy years of life (18757 in men and 17270 in women in 2001. Higher burden of osteoporosis in men, mainly results from higher risk of mortality following fractures in male sex. The national study on unintentional injuries indicates that the incidence of osteoporotic hip fractures in Iranian population is much less than other populations. Higher bone mineral density and other probable differences between Iranians

  12. The intensity of immunogold labeling of deplasticized acrylic sections compared to deplasticized epoxy sections-Theoretical deductions and experimental data.

    Science.gov (United States)

    Brorson, Sverre-Henning; Reinholt, Finn P

    2008-01-01

    The purpose of this study was to compare the level of immunogold labeling of deplasticized acrylic sections and deplasticized epoxy sections. Pure protein gels of IgG, albumin and thyroglobulin were produced by glutaraldehyde fixation and embedded in non-crosslinked acrylic resin (Technovit 9100) and epoxy resin (Epon 812), respectively. Ultrathin sections of acrylic and epoxy resin were separately deplasticized in 2-methoxyethyl acetate (MEA) and sodium ethoxide. Quantitative immunogold labeling was performed with anti-IgG, anti-albumin and anti-thyroglobulin antibodies on sections of the corresponding protein gels. For all antibodies tested, the intensity of labeling for deplasticized acrylic sections was significantly higher (two to four times) than for the corresponding deplasticized epoxy sections. The results fit with a theoretically deduced relation: the quotient of the labeling of two deplasticized sections of different resins is equivalent to the square root of the quotient of the labeling of the similar sections not exposed to any kind of pre-treatment. The practical significance of the results is that immunolabeling of deplasticized non-crosslinked acrylic resin results in more intense immunogold labeling than deplasticized epoxy sections. Deplasticizing is most useful when the requirements for ultrastructural preservation according to conventional criteria are moderate. Our theoretically deduced results also indicate that deplasticized Technovit (or other non-crosslinked acrylic resins) sections will be significantly better suited for immunolabeling at the light microscopic level than deplasticized epoxy sections.

  13. Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

    Directory of Open Access Journals (Sweden)

    L Nithya

    2014-01-01

    Full Text Available The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC intensity modulated radiation therapy (IMRT plans with volumetric modulated arc therapy (VMAT plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI and the conformity index (CI of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases.

  14. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Forouzanfar, Mohammad H.; Afshin, Ashkan; Alexander, Lily T.; Anderson, H. Ross; Bhutta, Zulficiar A.; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Cercy, Kelly; Charlson, Fiona J.; Cohen, Aaron J.; Dandona, Lalit; Estep, Kara; Ferrari, Alize J.; Frostad, Joseph J.; Fullman, Nancy; Gething, Peter W.; Godwin, William W.; Griswold, Max; Kinfu, Yohannes; Kyu, Hmwe H.; Larson, Heidi J.; Liang, Xiaofeng; Lim, Stephen S.; Liu, Patrick Y.; Lopez, Alan D.; Lozano, Rafael; Marczak, Laurie; Mensah, George A.; Mokdad, Ali H.; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Neal, Bruce; Reitsma, Marissa B.; Roth, Gregory A.; Salomon, Joshua A.; Sur, Patrick J.; Vos, Theo; Wagner, Joseph A.; Wang, Haidong; Zhao, Yi; Zhou, Maigeng; Aasvang, Gunn Marit; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Abraham, Biju; Abu-Raddad, Laith J.; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C.; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M.; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A.; Alvarez Martin, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H.; Anderson, Benjamin O.; Antonio, Carl Abelardo T.; Anwar, Palwasha; Arnlov, Johan; Al Artaman, Ali; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel G. Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C.; Balakrishnan, Kalpana; Barac, Aleksandra; Barber, Ryan M.; Barker-Collo, Suzanne L.; Baernighausen, Till; Barquera, Simon; Barregard, Lars; Barrero, Lope H.; Basu, Sanjay; Bans, Carolina; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bell, Michelle L.; Bello, Aminu K.; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D.; Borschmann, Rohan; Boufous, Soufiane; Bourne, Rupert R. A.; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J. K.; Brenner, Hermann; Broday, David M.; Brugha, Traolach S.; Brunekreef, Bert; Butt, Zahid A.; Cahill, Leah E.; Calabria, Bianca; Ricardo Campos-Nonato, Ismael; Cardenas, Rosario; Carpenter, David; Casey, Daniel C.; Castaneda-Oquela, Carlos A.; Castillo Rivas, Jacqueline; Estanislao Castro, Ruben; Catala-Lopez, Ferran; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A.; Choi, Jee-Young Jasmine; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Coates, Matthew M.; Colquhoun, Samantha M.; Cooper, Leslie Trumbull; Cooperrider, Kimberly; Cornaby, Leslie; Cortinovis, Monica; Crump, John A.; Cuevas-Nasu, Lucia; Damasceno, Albertino; Dandona, Rakhi; Darby, Sarah C.; Dargan, Paul I.; das Neves, Jose; Davis, Adrian C.; Davletov, Kairat; Filipa de Castro, E.; De la Cruz-Gongora, Vanessa; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C.; del Pozo-Cruz, Borja; Dellavalle, Robert P.; Deribew, Amare; Des Jarlais, Don C.; Dharmaratne, Samath D.; Dhillon, Preet K.; Diaz-Tome, Cesar; Dicker, Daniel; Ding, Eric L.; Dorsey, E. Ray; Doyle, Kerrie E.; Driscoll, Tim R.; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Erskine, Holly E.; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Aquino Faraon, Emerito Jose; Farid, Talha A.; Sofia E Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Feigin, Valery L.; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G.; Fischer, Florian; Fitchett, Joseph R. A.; Fleming, Tom; Foigt, Nataliya; Foreman, Kyle; Fowkes, F. Gerry R.; Franklin, Richard C.; Fuerst, Thomas; Futran, Neal D.; Gakidou, Emmanuela; Garcia-Basteiro, Alberto L.; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M.; Gessner, Bradford D.; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Goenka, Shifalika; Carmen Gomez-Cabrera, Mari; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C.; Goto, Atsushi; Gouda, Hebe N.; Gugnani, Harish Chander; Guillemin, Francis; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A.; Haagsma, Juanita A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Gessessew Bugssa; Halasa, Yara A.; Hamadeh, Randah Ribhi; Hamidi, Samer; Handal, Alexis J.; Hankey, Graeme J.; Hao, Yuantao; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Maria Haro, Josep; Hassanvand, Mohammad Sadegh; Hassen, Tahir Ahmed; Havmoeller, Rasmus; Beatriz Heredia-Pi, Ileana; Francisco Hernandez-Llanes, Norberto; Heydarpour, Pouria; Hoek, Hans W.; Hoffman, Howard J.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hoy, Damian G.; Hsairi, Mohamed; Htet, Aung Soe; Hu, Guoqing; Huang, John J.; Husseini, Abdullatif; Hutchings, Sally J.; Huybrechts, Inge; Iburg, Kim Moesgaard; Idrisov, Bulat T.; Ileanu, Bogdan Vasile; Inoue, Manami; Jacobs, Troy A.; Jacobsen, Kathryn H.; Jahanmehr, Nader; Jakovljevic, Mihajlo B.; Jansen, Henrica A. F. M.; Jassal, Simerjot K.; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Ying; Jibat, Tariku; Jin, Ye; Johnson, Catherine O.; Jonas, Jost B.; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S.; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khang, Young-Ho; Khatibzadeh, Shahab; Khera, Sahil; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Cho-il; Kim, Daniel; Kimokoti, Ruth W.; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D.; Kokubo, Yoshihiro; Kopec, Jacek A.; Koul, Parvaiz A.; Koyanagi, Ai; Kravchenko, Michael; Kromhout, Hans; Krueger, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Kuchenbecker, Ricardo S.; Bicer, Burcu Kucuk; Kuipers, Ernst J.; Kumar, G. Anil; Kwan, Gene F.; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lan, Qing; Larsson, Anders; Latif, Asma Abdul; Beatriz Lawrynowicz, Alicia Elena; Leasher, Janet L.; Leigh, James; Leung, Janni; Levi, Miriam; Li, Xiaohong; Li, Yichong; Liang, Juan; Liu, Shiwei; Lloyd, Belinda K.; Logroscino, Giancarlo; Lotufo, Paulo A.; Lunevicius, Raimundas; Maclntyre, Michael; Mahdavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Manamo, Wondimu Ayele Ayele; Mapoma, Chabila C.; Marcenes, Wagner; Martin, Randall V.; Martinez-Raga, Jose; Masiye, Felix; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M.; McGrath, John J.; McKee, Martin; Meaney, Peter A.; Medina, Catalina; Mehari, Alem; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Mensink, Gert B. M.; Meretoja, Atte; Meretoja, Tuomo J.; Mesfin, Yonatan Moges; Mhimbira, Francis Apolinary; Miller, Ted R.; Mills, Edward J.; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N.; Mohammadi, Alireza; Mohammed, Shafiu; Mola, Glen Liddell D.; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Morawska, Lidia; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich O.; Mullany, Erin; Mumford, John Everett; Murthy, Gudlavalleti Venkata Satyanarayana; Nachega, Jean B.; Naheed, Aliya; Nangia, Vinay; Nassiri, Nariman; Newton, John N.; Ng, Marie; Quyen Le Nguyen, [Unknown; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Norheim, Ole F.; Norman, Rosana E.; Norrving, Bo; Nyakarahuka, Luke; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R.; Olsen, Helen; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Orozco, Ricardo; Ortiz, Alberto; Ota, Erika; Mahesh, P. A.; Pana, Adrian; Park, Eun-Kee; Parry, Charles D.; Parsaeian, Mahboubeh; Patel, Tejas; Caicedo, Angel J. Paternina; Patil, Snehal T.; Patten, Scott B.; Patton, George C.; Pearce, Neil; Pereira, David M.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B.; Pillay, Julian David; Plass, Dietrich; Polinder, Suzanne; Pond, Constance D.; Pope, C. Arden; Pope, Daniel; Popova, Svetlana; Poulton, Richie G.; Pourmalek, Farshad; Prasad, Noela M.; Qorbani, Mostafa; Rabiee, Rynaz H. S.; Radfar, Amir; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Rana, Saleem M.; Ranganathan, Kavitha; Rao, Puja; Razo Garcia, Christian Aspacia; Refaat, Amany H.; Rehm, Colin D.; Rehm, Jurgen; Reinig, Nikolas; Remuzzi, Giuseppe; Resnikoff, Serge; Ribeiro, Antonio L.; Rivera, Juan A.; Rolm, Hirbo Shore; Rodriguez, Anna; Rodriguez-Ramirez, Sonia; Rojas-Rueda, David; Roman, Yesenia; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Dolores Sanchez-Nino, Maria; Sanchez-Pimienta, Tania G.; Sandar, Logan; Santomauro, Damian F.; Santos, Itamar S.; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schmidhuber, Josef; Schmidt, Maria Ines; Schneider, Ione J. C.; Schoettker, Ben; Schutte, Aletta E.; Schwebel, David C.; Scott, James G.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Levy, Teresa Shamah; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N.; Shi, Peilin; Shibuya, Kenji; Shigematsu, Mika; Shin, Min-Jeong; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Shrime, Mark G.; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Alves Silveira, Dayane Gabriele; Silverberg, Jonathan I.; Simard, Edgar P.; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A.; Singh, Prashant Kumar; Slepak, Erica Leigh; Soljak, Michael; Soneji, Samir; Sorensen, Reed J. D.; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Steckling, Nadine; Steel, Nicholas; Stein, Dan J.; Stein, Murray B.; Stockl, Heidi; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F.; Swaminathan, Soumya; Sykes, Bryan L.; Szoeke, Cassandra E. I.; Tabares-Seisdedos, Rafael; Takahashi, Ken; Talongwa, Roberto Tchio; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Belaynew Wasie; Taylor, Hugh R.; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Tegegne, Teketo Kassaw; Tekle, Dejen Yemane; Terkawi, Abdullah Sulieman; Thakur, J. S.; Thomas, Bernadette A.; Thomas, Matthew Lloyd; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tillmann, Taavi; Tobe-Gai, Ruoyan; Tobollik, Myriam; Topor-Madry, Roman; Topouzis, Fotis; Towbin, Jeffrey Allen; Bach Xuan Tran,; Dimbuene, Zacharie Tsala; Tsilimparis, Nikolaos; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N.; Undurraga, Eduardo A.; Uneke, Chigozie Jesse; Uthman, Olalekan A.; van Donkelaar, Aaron; van Os, Jim; Varakin, Yuri Y.; Vasankari, Tommi; Veerman, J. Lennert; Venketasubramanian, Narayanaswamy; Violante, Francesco S.; Vollset, Stein Emil; Wagner, Gregory R.; Waller, Stephen G.; Wang, JianLi; Wang, Linhong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A.; Wijeratne, Tissa; Wiysonge, Charles Shey; Wolfe, Charles D. A.; Won, Sungho; Woolf, Anthony D.; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z.; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zhu, Jun; Zipkin, Ben; Zodpey, Sanjay; Zuhlke, Liesl Joanna; Murray, Christopher J. L.

    2016-01-01

    Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debate

  15. A comparative study of reduced dose alemtuzumab in matched unrelated donor and related donor reduced intensity transplants.

    Science.gov (United States)

    Jardine, Laura; Publicover, Amy; Bigley, Venetia; Hale, Geoff; Pearce, Kim; Dickinson, Anne; Jackson, Graham; Collin, Matthew

    2015-03-01

    In vivo T cell depletion with 100 mg alemtuzumab prevents graft-versus-host disease (GVHD) in reduced intensity conditioned transplants but is associated with delayed immune reconstitution, a higher risk of infection and relapse. De-escalation studies have shown that a reduced dose of 30 mg is as effective as 100 mg in preventing GVHD in matched related donor (MRD) transplants. Dose reduction in matched unrelated donor (MUD) transplants is feasible but the comparative efficacy of alemtuzumab in this setting is not known and opinions vary widely concerning the optimal level of GVHD prophylaxis that should be achieved. Through retrospective analysis we made an objective comparison of MUD transplants receiving an empirically reduced dose of 60 mg, with MRD transplants receiving a 30 mg dose. We observed proportionate levels of alemtuzumab according to dose but an inverse relationship with body surface area particularly in MRD transplants. MUD transplants experienced more acute and chronic GVHD, higher T cell chimerism, more sustained use of ciclosporin and less need for donor lymphocyte infusion than MRD transplants. Thus, doubling the dose of alemtuzumab to 60 mg did not provide equivalent prevention of GVHD after MUD transplant although there was no difference in non-relapse mortality or survival compared with MRD transplants.

  16. Neonatal Intensive Care Nurses' Perceptions of Parental Participation in Infant Pain Management: A Comparative Focus Group Study.

    Science.gov (United States)

    Axelin, Anna; Anderzén-Carlsson, Agneta; Eriksson, Mats; Pölkki, Tarja; Korhonen, Anne; Franck, Linda S

    2015-01-01

    This comparative focus group study explored nurses' experiences and perceptions regarding parental participation in infant pain management in the neonatal intensive care unit (NICU). A total of 87 nurses from 7 NICUs in Finland, Sweden, and the United States participated in focus-group interviews (n = 25). Data were analyzed using deductive and inductive thematic analysis. Nurses' experiences and perceptions varied considerably, from nurses being in control, to nurses sharing some control with parents, to nurse-parent collaboration in infant pain management. When nurses controlled pain management, parents were absent or passive. In these cases, the nurses believed this led to better pain control for infants and protected parents from emotional distress caused by infant pain. When nurses shared control with parents, they provided information and opportunities for participation. They believed parent participation was beneficial, even if it caused nurses or parents anxiety. When nurses collaborated with parents, they negotiated the optimal pain management approach for an individual infant. The collaborative approach was most evident for the nurses in the Swedish NICUs and somewhat evident in the NICUs in Finland and the United States. Further research is needed to address some nurses' perceptions and concerns and to facilitate greater consistency in the application of evidence-based best practices.

  17. Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

    Science.gov (United States)

    Rashid, Mahbub; Khan, Nayma; Jones, Belinda

    2016-01-01

    This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed.

  18. The effects of an intensive behavior and nutrition intervention compared to standard of care on weight outcomes in CF.

    Science.gov (United States)

    Stark, Lori J; Opipari-Arrigan, Lisa; Quittner, Alexandra L; Bean, Judy; Powers, Scott W

    2011-01-01

    Inadequate intake and suboptimal growth are common problems for patients with CF and a critical target for intervention. The purpose of this study was to compare the growth outcomes of children with CF who participated in a randomized clinical trial to improve energy intake and weight to children with CF receiving standard of care during the same time period. Our primary outcome was change in body mass index z-score (BMI z-score) over 2 years. An exploratory outcome was forced expiratory volume at 1-sec (FEV(1) ) over 2 years. Participants were children ages 4-12 with CF, who participated in a randomized clinical trial of behavior plus nutrition intervention versus nutrition education alone, and a matched Comparison Sample receiving standard of care drawn from the Cystic Fibrosis Foundation (CFF) Registry. Children in the Clinical Trial Group (N=67) participated in a 9-week, nutrition intervention and were followed at regular intervals (3, 6, 12, 18, and 24 months) for 2 years post-treatment to obtain anthropometric and pulmonary function data. For each child in the Comparison Sample (N=346), these measures were obtained from the CFF Registry at matching intervals for the 27-month period corresponding to the clinical trial. Over 27 months, children in the Clinical Trial Group (the combined sample of the behavior plus nutrition and the nutrition alone) demonstrated significantly less decline in BMI z-score, -0.05 (SD=0.68, CI= -0.23 to 0.13), as compared to children in the Comparison Sample, -0.21 (SD=0.67, CI= -0.31 to -0.11). No statistically significant differences were found for decline in FEV(1) between children in the Clinical Trial Group and the Comparison Sample. The key implication of these findings is that intensive behavioral and nutritional intervention is effective and needs to be adapted so that it can be broadly disseminated into clinical practice.

  19. Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients

    Institute of Scientific and Technical Information of China (English)

    Tao Wang; Yun-Liang Cui; Zhao-Fen Lin; De-Chang Chen

    2016-01-01

    Background: Both procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis ofbacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia.The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis ofbacteremia in Intensive Care Unit (ICU).Methods: The medical records of 420 patients in ICU were retrospectively reviewed.Patients (n =241) who met the inclusion criteria were subjected to blood culture (BC) for the analysis of the endotoxin or PCT levels.The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors.Patients' BC episodes were divided into BC negative, Gram-negative (GN) bacteria, Gram-positive bacteria, and fungi groups.The PCT and plasma endotoxin levels were compared in the different groups.Results: A total of 241 patients with 505 episodes of BC were analyzed.The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups.GN bacteremia was more prevalent than Gram-positive bacteremia.The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.The plasma endotoxin significantly differed among different groups and was bacterial species dependent.Conclusions: Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia.Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China.And PCT is a more valuable biomarker than endotoxin

  20. Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gunther, Jillian R. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sato, Mariko; Chintagumpala, Murali [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Ketonen, Leena [Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jones, Jeremy Y. [Department of Pediatric Radiology, Texas Children' s Hospital, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Paulino, Arnold C. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Okcu, M. Fatih; Su, Jack M. [Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children' s Cancer Center, Houston, Texas (United States); Weinberg, Jeffrey [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Boehling, Nicholas S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Khatua, Soumen [Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Adesina, Adekunle [Department of Pathology, Baylor College of Medicine, Texas Children' s Hospital, Houston, Texas (United States); Dauser, Robert; Whitehead, William E. [Department of Neurosurgery, Texas Children' s Hospital, Houston, Texas (United States); Mahajan, Anita, E-mail: amahajan@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem.

  1. Longer Intestinal Persistence of Enterococcus faecalis Compared to Enterococcus faecium Clones in Intensive-Care-Unit Patients

    NARCIS (Netherlands)

    Ruiz-Garbajosa, Patricia; del Campo, Rosa; Coque, Teresa M.; Asensio, Angel; Bonten, Marc; Willems, Rob; Baquero, Fernando; Canton, Rafael

    2009-01-01

    The dynamics of intestinal colonization with enterococcal clones in intensive-care-unit (ICU) patients was evaluated. Eight patients admitted directly to the neurosurgical ICU at the Ramon y Cajal University Hospital (Madrid, Spain) from the community and with no overlapping stay during a 10-month p

  2. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Forouzanfar, Mohammad H; Alexander, Lily; Anderson, H Ross; Bachman, Victoria F; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J; Kc, Astha; Kyu, Hmwe H; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Ozgoren, Ayse Abbasoglu; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M E; Aburto, Tania C; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsène K; Adsuar, José C; Afshin, Ashkan; Agardh, Emilie E; Al Khabouri, Mazin J; Al Lami, Faris H; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Aleman, Alicia V; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K; Alla, François; Allebeck, Peter; Allen, Peter J; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Ameh, Emmanuel A; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Arnlöv, Johan; Arsenijevic, Valentina S Arsic; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Atkinson, Charles; Avila, Marco A; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Ruvalcaba, Carolina Batis; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Benzian, Habib; Bernabé, Eduardo; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bikbov, Boris; Abdulhak, Aref A Bin; Blore, Jed D; Blyth, Fiona M; Bohensky, Megan A; Başara, Berrak Bora; Borges, Guilherme; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J; Brenner, Hermann; Briggs, Adam D M; Broday, David M; Brooks, Peter M; Bruce, Nigel G; Brugha, Traolach S; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N; Bukhman, Gene; Bulloch, Andrew G; Burch, Michael; Burney, Peter G J; Campos-Nonato, Ismael R; Campuzano, Julio C; Cantoral, Alejandra J; Caravanos, Jack; Cárdenas, Rosario; Cardis, Elisabeth; Carpenter, David O; Caso, Valeria; Castañeda-Orjuela, Carlos A; Castro, Ruben E; Catalá-López, Ferrán; Cavalleri, Fiorella; Çavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Chugh, Sumeet S; Cirillo, Massimo; Claßen, Thomas Kd; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T; Coresh, Josef; Courville, Karen J; Criqui, Michael H; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; de Castro, E Filipa; De la Cruz-Góngora, Vanessa; De Leo, Diego; de Lima, Graça; Degenhardt, Louisa; Del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Jarlais, Don C Des; Dessalegn, Muluken; deVeber, Gabrielle A; Devries, Karen M; Dharmaratne, Samath D; Dherani, Mukesh K; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Durrani, Adnan M; Ebel, Beth E; Ellenbogen, Richard G; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J; Ferri, Cleusa P; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Paleo, Urbano Fra; Franklin, Richard C; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpé, Fortuné G; Gansevoort, Ron T; García-Guerra, Francisco A; Gasana, Evariste; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Pete; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A M; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Dantes, Hector Gomez; Gona, Philimon; de Cosio, Teresita Gonzalez; González-Castell, Dinorah; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutiérrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A; Hamadeh, Randah R; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hedayati, Mohammad T; Heredia-Pi, Ileana B; Hernandez, Lucia; Heuton, Kyle R; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hornberger, John C; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J; Hubbell, Bryan J; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L; Iburg, Kim M; Idrisov, Bulat T; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H; Jansen, Henrica A; Jarvis, Deborah L; Jassal, Simerjot K; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Roseline, Sidibe S Kany; Karam, Nadim E; Karch, André; Karema, Corine K; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W; Kinfu, Yohannes; Kinge, Jonas M; Kissela, Brett M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kwan, Gene F; Lai, Taavi; Balaji, Arjun Lakshmana; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis O; Lavados, Pablo M; Lawrynowicz, Alicia E; Leasher, Janet L; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lindsay, M Patrice; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; London, Stephanie J; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M P; MacIntyre, Michael F; Magis-Rodriguez, Carlos; Mahdi, Abbas A; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C; Marape, Marape; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marks, Guy B; Martin, Randall V; Marzan, Melvin B; Mashal, Mohammad T; Masiye, Felix; Mason-Jones, Amanda J; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; McKay, Abigail C; McKee, Martin; McLain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mills, Edward J; Misganaw, Awoke; Mishra, Santosh; Ibrahim, Norlinah Mohamed; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L; Monasta, Lorenzo; Hernandez, Julio C Montañez; Montico, Marcella; Moore, Ami R; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Mozaffarian, Dariush; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murthy, Kinnari S; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, Km Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ngalesoni, Frida N; de Dieu Ngirabega, Jean; Nguyen, Grant; Nguyen, Nhung T; Nieuwenhuijsen, Mark J; Nisar, Muhammad I; Nogueira, José R; Nolla, Joan M; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Caicedo, Angel J Paternina; Patten, Scott B; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pedraza, Lilia S; Pedroza, Andrea; Stokic, Ljiljana Pejin; Pekericli, Ayfer; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A L; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pond, Constance D; Pope, C Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M; Qato, Dima M; Quezada, Amado D; Quistberg, D Alex A; Racapé, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Rao, Mayuree; Razavi, Homie; Reddy, K Srinath; Refaat, Amany H; Rehm, Jürgen; Remuzzi, Giuseppe; Ribeiro, Antonio L; Riccio, Patricia M; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A; Salvo, Deborah; Sampson, Uchechukwu K; Sanabria, Juan R; Sanchez, Luz Maria; Sánchez-Pimienta, Tania G; Sanchez-Riera, Lidia; Sandar, Logan; Santos, Itamar S; Sapkota, Amir; Satpathy, Maheswar; Saunders, James E; Sawhney, Monika; Saylan, Mete I; Scarborough, Peter; Schmidt, Jürgen C; Schneider, Ione J C; Schöttker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Serdar, Berrin; Servan-Mori, Edson E; Shaddick, Gavin; Shahraz, Saeid; Levy, Teresa Shamah; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin H; Shinohara, Yukito; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga D; Silberberg, Donald H; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soljak, Michael; Soneji, Samir; Søreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stapelberg, Nicolas J C; Stathopoulou, Vasiliki; Steckling, Nadine; Stein, Dan J; Stein, Murray B; Stephens, Natalie; Stöckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L; Tabb, Karen M; Takahashi, Ken; Talongwa, Roberto T; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Te Ao, Braden J; Teixeira, Carolina M; Téllez Rojo, Martha M; Terkawi, Abdullah S; Texcalac-Sangrador, José Luis; Thackway, Sarah V; Thomson, Blake; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobollik, Myriam; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeffrey A; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X; Trasande, Leonardo; Trillini, Matias; Trujillo, Ulises; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Uzun, Selen B; van de Vijver, Steven; Van Dingenen, Rita; van Gool, Coen H; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi J; Vasconcelos, Ana Maria N; Vavilala, Monica S; Veerman, Lennert J; Velasquez-Melendez, Gustavo; Venketasubramanian, N; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wallin, Mitchell T; Wan, Xia; Wang, Haidong; Wang, JianLi; Wang, Linhong; Wang, Wenzhi; Wang, Yanping; Warouw, Tati S; Watts, Charlotte H; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wessells, K Ryan; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Williams, Hywel C; Williams, Thomas N; Woldeyohannes, Solomon M; Wolfe, Charles D A; Wong, John Q; Woolf, Anthony D; Wright, Jonathan L; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L; Yang, Gonghuan; Yano, Yuichiro; Ye, Pengpeng; Yenesew, Muluken; Yentür, Gökalp K; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Younoussi, Zourkaleini; Yu, Chuanhua; Zaki, Maysaa E; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zhu, Shankuan; Zou, Xiaonong; Zunt, Joseph R; Lopez, Alan D; Vos, Theo; Murray, Christopher J

    2015-01-01

    BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for preve

  3. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Forouzanfar, Mohammad H.; Alexander, Lily; Anderson, H. Ross; Bachman, Victoria F.; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M.; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J.; Astha, K. C.; Kyu, Hmwe H.; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A.; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Ozgoren, Ayse Abbasoglu; Abd-Allah, Foad; Abera, Semaw F.; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M. E.; Aburto, Tania C.; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsene K.; Adsuar, Jose C.; Afshin, Ashkan; Agardh, Emilie E.; Al Khabouri, Mazin J.; Al Lami, Faris H.; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I.; Alegretti, Miguel A.; Aleman, Alicia V.; Alemu, Zewdie A.; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K.; Alla, Francois; Allebeck, Peter; Allen, Peter J.; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A.; Amare, Azmeraw T.; Ameh, Emmanuel A.; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O.; Antonio, Carl Abelardo T.; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Arnlov, Johan; Arsenijevic, Valentina S. Arsic; Artaman, Al; Asghar, Rana J.; Assadi, Reza; Atkins, Lydia S.; Atkinson, Charles; Avila, Marco A.; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C.; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M.; Barker-Collo, Suzanne L.; Barquera, Simon; Barregard, Lars; Barrero, Lope H.; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C.; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O.; Ruvalcaba, Carolina Batis; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L.; Benjet, Corina; Bennett, Derrick A.; Benzian, Habib; Bernabe, Eduardo; Beyene, Tariku J.; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfi Qar A.; Bikbov, Boris; Bin Abdulhak, Aref A.; Blore, Jed D.; Blyth, Fiona M.; Bohensky, Megan A.; Basara, Berrak Bora; Borges, Guilherme; Bornstein, Natan M.; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R.; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J.; Brenner, Hermann; Briggs, Adam D. M.; Broday, David M.; Brooks, Peter M.; Bruce, Nigel G.; Brugha, Traolach S.; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N.; Bukhman, Gene; Bulloch, Andrew G.; Burch, Michael; Burney, Peter G. J.; Campos-Nonato, Ismael R.; Campuzano, Julio C.; Cantoral, Alejandra J.; Caravanos, Jack; Cardenas, Rosario; Cardis, Elisabeth; Carpenter, David O.; Caso, Valeria; Castaneda-Orjuela, Carlos A.; Castro, Ruben E.; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cavlin, Alanur; Chadha, Vineet K.; Chang, Jung-chen; Charlson, Fiona J.; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P.; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A.; Chuang, Ting-Wu; Chugh, Sumeet S.; Cirillo, Massimo; Classen, Thomas K. D.; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M.; Contreras, Alejandra G.; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T.; Coresh, Josef; Courville, Karen J.; Criqui, Michael H.; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I.; Davis, Adrian; Davitoiu, Dragos V.; Dayama, Anand; de Castro, E. Filipa; De la Cruz-Gongora, Vanessa; De Leo, Diego; de Lima, Graca; Degenhardt, Louisa; del Pozo-Cruz, Borja; Dellavalle, Robert P.; Deribe, Kebede; Derrett, Sarah; Jarlais, Don C. Des; Dessalegn, Muluken; deVeber, Gabrielle A.; Devries, Karen M.; Dharmaratne, Samath D.; Dherani, Mukesh K.; Dicker, Daniel; Ding, Eric L.; Dokova, Klara; Dorsey, E. Ray; Driscoll, Tim R.; Duan, Leilei; Durrani, Adnan M.; Ebel, Beth E.; Ellenbogen, Richard G.; Elshrek, Yousef M.; Endres, Matthias; Ermakov, Sergey P.; Erskine, Holly E.; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A.; Farzadfar, Farshad; Fay, Derek F. J.; Feigin, Valery L.; Feigl, Andrea B.; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J.; Ferri, Cleusa P.; Flaxman, Abraham D.; Fleming, Thomas D.; Foigt, Nataliya; Foreman, Kyle J.; Paleo, Urbano Fra; Franklin, Richard C.; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpe, Fortune G.; Gansevoort, Ron T.; Garcia-Guerra, Francisco A.; Gasana, Evariste; Geleijnse, Johanna M.; Gessner, Bradford D.; Gething, Pete; Gibney, Katherine B.; Gillum, Richard F.; Ginawi, Ibrahim A. M.; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Dantes, Hector Gomez; Gona, Philimon; de Cosio, Teresita Gonzalez; Gonzalez-Castell, Dinorah; Gotay, Carolyn C.; Goto, Atsushi; Gouda, Hebe N.; Guerrant, Richard L.; Gugnani, Harish C.; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A.; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A.; Hamadeh, Randah R.; Hammami, Mouhanad; Hankey, Graeme J.; Hao, Yuantao; Harb, Hilda L.; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I.; Hedayati, Mohammad T.; Heredia-Pi, Ileana B.; Hernandez, Lucia; Heuton, Kyle R.; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W.; Man, Howard J. Hoff; Hornberger, John C.; Hosgood, H. Dean; Hoy, Damian G.; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J.; Hubbell, Bryan J.; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L.; Iburg, Kim M.; Idrisov, Bulat T.; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H.; Jansen, Henrica A.; Jarvis, Deborah L.; Jassal, Simerjot K.; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N.; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B.; Juel, Knud; Kan, Haidong; Roseline, Sidibe S. Kany; Karam, Nadim E.; Karch, Andre; Karema, Corine K.; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S.; Kemp, Andrew H.; Kengne, Andre P.; Keren, Andre; Khader, Yousef S.; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A.; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W.; Kinfu, Yohannes; Kinge, Jonas M.; Kissela, Brett M.; Kivipelto, Miia; Knibbs, Luke D.; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M. Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kuipers, Ernst J.; Kulkarni, Chanda; Kulkarni, Veena S.; Kumar, G. Anil; Kwan, Gene F.; Lai, Taavi; Balaji, Arjun Lakshmana; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C.; Larson, Heidi J.; Larsson, Anders; Laryea, Dennis O.; Lavados, Pablo M.; Lawrynowicz, Alicia E.; Leasher, Janet L.; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S.; Lindsay, M. Patrice; Lipshultz, Steven E.; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K.; Logroscino, Giancarlo; London, Stephanie J.; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A.; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M. P.; MacIntyre, Michael F.; Magis-Rodriguez, Carlos; Mahdi, Abbas A.; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C.; Marape, Marape; Marcenes, Wagner; Margolis, David J.; Margono, Christopher; Marks, Guy B.; Martin, Randall V.; Marzan, Melvin B.; Mashal, Mohammad T.; Masiye, Felix; Mason-Jones, Amanda J.; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M.; Mazorodze, Tasara T.; Mckay, Abigail C.; Mckee, Martin; McLain, Abigail; Meaney, Peter A.; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A.; Meltzer, Michele; Memish, Ziad A.; Mendoza, Walter; Mensah, George A.; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R.; Mills, Edward J.; Misganaw, Awoke; Mishra, Santosh; Ibrahim, Norlinah Mohamed; Mohammad, Karzan A.; Mokdad, Ali H.; Mola, Glen L.; Monasta, Lorenzo; Hernandez, Julio C. Montaez; Montico, Marcella; Moore, Ami R.; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N.; Arian, Dariush Mozaff; Mueller, Ulrich O.; Mukaigawara, Mitsuru; Mullany, Erin C.; Murthy, Kinnari S.; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S.; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K. M. Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P.; Newton, Charles R.; Ngalesoni, Frida N.; Ngirabega, Jean de Dieu; Nguyen, Grant; Nguyen, Nhung T.; Nieuwenhuijsen, Mark J.; Nisar, Muhammad I.; Nogueira, Jose R.; Nolla, Joan M.; Nolte, Sandra; Norheim, Ole F.; Norman, Rosana E.; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O.; Omer, Saad B.; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S.; Pain, Amanda W.; Pandian, Jeyaraj D.; Panelo, Carlo Irwin A.; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D.; Caicedo, Angel J. Paternina; Patten, Scott B.; Paul, Vinod K.; Pavlin, Boris I.; Pearce, Neil; Pedraza, Lilia S.; Pedroza, Andrea; Stokic, Ljiljana Pejin; Pekericli, Ayfer; Pereira, David M.; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A. L.; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B.; Petzold, Max; Phillips, Michael R.; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V.; Polinder, Suzanne; Pond, Constance D.; Pope, C. Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M.; Qato, Dima M.; Quezada, Amado D.; Quistberg, D. Alex A.; Racape, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M.; Rao, Mayuree; Razavi, Homie; Reddy, K. Srinath; Refaat, Amany H.; Rehm, Juergen; Remuzzi, Giuseppe; Ribeiro, Antonio L.; Riccio, Patricia M.; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M.; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L.; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A.; Salvo, Deborah; Sampson, Uchechukwu K.; Sanabria, Juan R.; Sanchez, Luz Maria; Sanchez-Pimienta, Tania G.; Sanchez-Riera, Lidia; Sandar, Logan; Santos, Itamar S.; Sapkota, Amir; Satpathy, Maheswar; Saunders, James E.; Sawhney, Monika; Saylan, Mete I.; Scarborough, Peter; Schmidt, Juergen C.; Schneider, Ione J. C.; Schoettker, Ben; Schwebel, David C.; Scott, James G.; Seedat, Soraya; Sepanlou, Sadaf G.; Serdar, Berrin; Servan-Mori, Edson E.; Shaddick, Gavin; Shahraz, Saeid; Levy, Teresa Shamah; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin H.; Shinohara, Yukito; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga D.; Silberberg, Donald H.; Simard, Edgar P.; Sindi, Shireen; Singh, Abhishek; Singh, Gitanjali M.; Singh, Jasvinder A.; Skirbekk, Vegard; Sliwa, Karen; Soljak, Michael; Soneji, Samir; Soreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stapelberg, Nicolas J. C.; Stathopoulou, Vasiliki; Steckling, Nadine; Stein, Dan J.; Stein, Murray B.; Stephens, Natalie; Stoeckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F.; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L.; Tabb, Karen M.; Takahashi, Ken; Talongwa, Roberto T.; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Ao, Braden J. Te; Teixeira, Carolina M.; Rojo, Martha M. Tellez; Terkawi, Abdullah S.; Texcalac-Sangrador, Jose Luis; Thackway, Sarah V.; Thomson, Blake; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tillmann, Taavi; Tobollik, Myriam; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeff Rey A.; Toyoshima, Hideaki; Traebert, Jeff Erson; Tran, Bach X.; Trasande, Leonardo; Trillini, Matias; Trujillo, Ulises; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, Emin Murat; Uchendu, Uche S.; Ukwaja, Kingsley N.; Uzun, Selen B.; van de Vijver, Steven; Van Dingenen, Rita; Van Gool, Coen H.; Van Os, Jim; Varakin, Yuri Y.; Vasankari, Tommi J.; Vasconcelos, Ana Maria N.; Vavilala, Monica S.; Veerman, Lennert J.; Velasquez-Melendez, Gustavo; Venketasubramanian, N.; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S.; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R.; Waller, Stephen G.; Wallin, Mitchell T.; Wan, Xia; Wang, Haidong; Wang, JianLi; Wang, Linhong; Wang, Wenzhi; Wang, Yanping; Warouw, Tati S.; Watts, Charlotte H.; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Wessells, K. Ryan; Westerman, Ronny; Whiteford, Harvey A.; Wilkinson, James D.; Williams, Hywel C.; Williams, Thomas N.; Woldeyohannes, Solomon M.; Wolfe, Charles D. A.; Wong, John Q.; Woolf, Anthony D.; Wright, Jonathan L.; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L.; Yang, Gonghuan; Yano, Yuichiro; Ye, Pengpeng; Yenesew, Muluken; Yentuer, Goekalp K.; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z.; Younoussi, Zourkaleini; Yu, Chuanhua; Zaki, Maysaa E.; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zhu, Shankuan; Zou, Xiaonong; Zunt, Joseph R.; Lopez, Alan D.; Vos, Theo; Murray, Christopher J.

    2015-01-01

    Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for preven

  4. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Forouzanfar, Mohammad H; Alexander, Lily; Anderson, H Ross; Bachman, Victoria F; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J; Kc, Astha; Kyu, Hmwe H; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Ozgoren, Ayse Abbasoglu; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M E; Aburto, Tania C; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsène K; Adsuar, José C; Afshin, Ashkan; Agardh, Emilie E; Al Khabouri, Mazin J; Al Lami, Faris H; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Aleman, Alicia V; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K; Alla, François; Allebeck, Peter; Allen, Peter J; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Ameh, Emmanuel A; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Cunningham, Solveig Argeseanu; Arnlöv, Johan; Arsenijevic, Valentina S Arsic; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Atkinson, Charles; Avila, Marco A; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Ruvalcaba, Carolina Batis; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Benzian, Habib; Bernabé, Eduardo; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bikbov, Boris; Abdulhak, Aref A Bin; Blore, Jed D; Blyth, Fiona M; Bohensky, Megan A; Başara, Berrak Bora; Borges, Guilherme; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J; Brenner, Hermann; Briggs, Adam D M; Broday, David M; Brooks, Peter M; Bruce, Nigel G; Brugha, Traolach S; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N; Bukhman, Gene; Bulloch, Andrew G; Burch, Michael; Burney, Peter G J; Campos-Nonato, Ismael R; Campuzano, Julio C; Cantoral, Alejandra J; Caravanos, Jack; Cárdenas, Rosario; Cardis, Elisabeth; Carpenter, David O; Caso, Valeria; Castañeda-Orjuela, Carlos A; Castro, Ruben E; Catalá-López, Ferrán; Cavalleri, Fiorella; Çavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Chugh, Sumeet S; Cirillo, Massimo; Claßen, Thomas Kd; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T; Coresh, Josef; Courville, Karen J; Criqui, Michael H; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; de Castro, E Filipa; De la Cruz-Góngora, Vanessa; De Leo, Diego; de Lima, Graça; Degenhardt, Louisa; Del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Jarlais, Don C Des; Dessalegn, Muluken; deVeber, Gabrielle A; Devries, Karen M; Dharmaratne, Samath D; Dherani, Mukesh K; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Durrani, Adnan M; Ebel, Beth E; Ellenbogen, Richard G; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J; Ferri, Cleusa P; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Paleo, Urbano Fra; Franklin, Richard C; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpé, Fortuné G; Gansevoort, Ron T; García-Guerra, Francisco A; Gasana, Evariste; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Pete; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A M; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Dantes, Hector Gomez; Gona, Philimon; de Cosio, Teresita Gonzalez; González-Castell, Dinorah; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutiérrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A; Hamadeh, Randah R; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hedayati, Mohammad T; Heredia-Pi, Ileana B; Hernandez, Lucia; Heuton, Kyle R; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hornberger, John C; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J; Hubbell, Bryan J; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L; Iburg, Kim M; Idrisov, Bulat T; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H; Jansen, Henrica A; Jarvis, Deborah L; Jassal, Simerjot K; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Roseline, Sidibe S Kany; Karam, Nadim E; Karch, André; Karema, Corine K; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W; Kinfu, Yohannes; Kinge, Jonas M; Kissela, Brett M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kwan, Gene F; Lai, Taavi; Balaji, Arjun Lakshmana; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis O; Lavados, Pablo M; Lawrynowicz, Alicia E; Leasher, Janet L; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lindsay, M Patrice; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; London, Stephanie J; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M P; MacIntyre, Michael F; Magis-Rodriguez, Carlos; Mahdi, Abbas A; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C; Marape, Marape; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marks, Guy B; Martin, Randall V; Marzan, Melvin B; Mashal, Mohammad T; Masiye, Felix; Mason-Jones, Amanda J; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; McKay, Abigail C; McKee, Martin; McLain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mills, Edward J; Misganaw, Awoke; Mishra, Santosh; Ibrahim, Norlinah Mohamed; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L; Monasta, Lorenzo; Hernandez, Julio C Montañez; Montico, Marcella; Moore, Ami R; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Mozaffarian, Dariush; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murthy, Kinnari S; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, Km Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ngalesoni, Frida N; de Dieu Ngirabega, Jean; Nguyen, Grant; Nguyen, Nhung T; Nieuwenhuijsen, Mark J; Nisar, Muhammad I; Nogueira, José R; Nolla, Joan M; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Caicedo, Angel J Paternina; Patten, Scott B; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pedraza, Lilia S; Pedroza, Andrea; Stokic, Ljiljana Pejin; Pekericli, Ayfer; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A L; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pond, Constance D; Pope, C Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M; Qato, Dima M; Quezada, Amado D; Quistberg, D Alex A; Racapé, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Rao, Mayuree; Razavi, Homie; Reddy, K Srinath; Refaat, Amany H; Rehm, Jürgen; Remuzzi, Giuseppe; Ribeiro, Antonio L; Riccio, Patricia M; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A; Salvo, Deborah; Sampson, Uchechukwu K; Sanabria, Juan R; Sanchez, Luz Maria; Sánchez-Pimienta, Tania G; Sanchez-Riera, Lidia; Sandar, Logan; Santos, Itamar S; Sapkota, Amir; Satpathy, Maheswar; Saunders, James E; Sawhney, Monika; Saylan, Mete I; Scarborough, Peter; Schmidt, Jürgen C; Schneider, Ione J C; Schöttker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Serdar, Berrin; Servan-Mori, Edson E; Shaddick, Gavin; Shahraz, Saeid; Levy, Teresa Shamah; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin H; Shinohara, Yukito; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga D; Silberberg, Donald H; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soljak, Michael; Soneji, Samir; Søreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stapelberg, Nicolas J C; Stathopoulou, Vasiliki; Steckling, Nadine; Stein, Dan J; Stein, Murray B; Stephens, Natalie; Stöckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L; Tabb, Karen M; Takahashi, Ken; Talongwa, Roberto T; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Te Ao, Braden J; Teixeira, Carolina M; Téllez Rojo, Martha M; Terkawi, Abdullah S; Texcalac-Sangrador, José Luis; Thackway, Sarah V; Thomson, Blake; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobollik, Myriam; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeffrey A; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X; Trasande, Leonardo; Trillini, Matias; Trujillo, Ulises; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Uzun, Selen B; van de Vijver, Steven; Van Dingenen, Rita; van Gool, Coen H; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi J; Vasconcelos, Ana Maria N; Vavilala, Monica S; Veerman, Lennert J; Velasquez-Melendez, Gustavo; Venketasubramanian, N; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wallin, Mitchell T; Wan, Xia; Wang, Haidong; Wang, JianLi; Wang, Linhong; Wang, Wenzhi; Wang, Yanping; Warouw, Tati S; Watts, Charlotte H; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wessells, K Ryan; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Williams, Hywel C; Williams, Thomas N; Woldeyohannes, Solomon M; Wolfe, Charles D A; Wong, John Q; Woolf, Anthony D; Wright, Jonathan L; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L; Yang, Gonghuan; Yano, Yuichiro; Ye, Pengpeng; Yenesew, Muluken; Yentür, Gökalp K; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Younoussi, Zourkaleini; Yu, Chuanhua; Zaki, Maysaa E; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zhu, Shankuan; Zou, Xiaonong; Zunt, Joseph R; Lopez, Alan D; Vos, Theo; Murray, Christopher J

    2015-01-01

    BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for preve

  5. Rationale and design of the Exercise Intensity Trial (EXCITE: A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer

    Directory of Open Access Journals (Sweden)

    Herndon James E

    2010-10-01

    Full Text Available Abstract Background The Exercise Intensity Trial (EXcITe is a randomized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training, relative to attention control, on aerobic capacity, physiologic mechanisms, patient-reported outcomes, and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy. Methods/Design Using a single-center, randomized design, 174 postmenopausal women (58 patients/study arm with histologically confirmed, operable breast cancer presenting to Duke University Medical Center (DUMC will be enrolled in this trial following completion of primary therapy (including surgery, radiation therapy, and chemotherapy. After baseline assessments, eligible participants will be randomized to one of two supervised aerobic training interventions (moderate-intensity or moderate/high-intensity aerobic training or an attention-control group (progressive stretching. The aerobic training interventions will include 150 mins.wk-1 of supervised treadmill walking per week at an intensity of 60%-70% (moderate-intensity or 60% to 100% (moderate to high-intensity of the individually determined peak oxygen consumption (VO2peak between 20-45 minutes/session for 16 weeks. The progressive stretching program will be consistent with the exercise interventions in terms of program length (16 weeks, social interaction (participants will receive one-on-one instruction, and duration (20-45 mins/session. The primary study endpoint is VO2peak, as measured by an incremental cardiopulmonary exercise test. Secondary endpoints include physiologic determinants that govern VO2peak, patient-reported outcomes, and biomarkers associated with breast cancer recurrence/mortality. All endpoints will be assessed at baseline and after the intervention (16 weeks. Discussion EXCITE is designed to investigate the intensity of aerobic training required to induce optimal

  6. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  7. Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Hout, W.B. van den; Jong, Z. de; Munneke, M.; Hazes, J.M.W.; Breedveld, F.C.; Vliet Vlieland, T.P.M.

    2005-01-01

    OBJECTIVE: To estimate the cost utility and cost effectiveness of long-term, high-intensity exercise classes compared with usual care in rheumatoid arthritis (RA) patients. METHODS: RA patients (n = 300) were randomly assigned to either exercise classes or UC; followup lasted for 2 years. Outcome me

  8. Comparing Intensity Elicited Maximum Reflex Amplitude Between Noise Induced Hearing Loss & Acoustic Trauma at 1 kHz, Contra laterally, and Investigate Relationship Between Amplitude and Hearing Impairment

    Directory of Open Access Journals (Sweden)

    Dr. Yones Lotfi

    2001-05-01

    Full Text Available Method and Materials; this cross sectional descriptive and analytic survey was done at Golestan navy hospital in Tehran, between June 1998 and March 1999 on total of 69 male subject (104 ears, 50 acoustic trauma & 54 noise induced H.L between 20 to 40 ears old. Results: The mean acoustic reflex threshold at 1 kHz showed there is no significant difference between two groups. 2- The intensity elicited maximum reflex amplitude at 1 kHz didn;t produce at a significant linear correlation with subjects age and ear canal volume in both groups. 3- The intensity elicited maximum reflex amplitude in NIHL group wasn't shown a significant correlation with ear compliance and gradient. 4- The mean Intensity (SPL elicited maximum reflex amplitude in NIHL group was more than mean intensity (SPL in acoustic trauma group. 5- The mean intensity (SL elicited maximum reflex amplitude in NIHL group was More than mean intensity (SL in acoustic trauma group. Conclusion: Acoustic reflex amplitude is reduced for subjects with NIHL compared with acoustic trauma subjects.

  9. Burden attributable to child maltreatment in Australia.

    Science.gov (United States)

    Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E

    2015-10-01

    Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies.

  10. Burden in the main caregiver

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    Fabiola Yonte Huete

    2010-09-01

    Full Text Available Objectives: The main objective is to determine the degree of burden in the main caregivers of dependent patients, to analyse the profile of informal caregivers and dependent patients. Their claims and help received with caring, the influence of mental deteriorate and duration of care giving regarding the burden of caregivers.Methods: Descriptive cross-sectional observational study amongst 50 caregivers and dependents. We used descriptive statistics and correlational studies. Results: 86 % of caregivers were women, middle aged, son/daughter of the dependent, married, with basic studies, no work outside the home, the average time in the role of caregiver was 16,96 hours a day and 2,1 free hours a day. 64 % of them received family support and 68 % wish to receive economic aid. It was found that for 38 % of the caregivers there was no burden at all, 34 % of them had a minimum burden and 28 % a greater burden.Conclusion: There are some caregivers with moderate or great burden. Our caregiver wishes to receive economic help. Our research shows that the decrease of mental health and the years of evolution do not have a significant statistically influence on caregivers. It is necessary prioritize the interventions and its recipients, provide solutions for caregivers with a greater burden, trying to keep away “caregiver syndrome”.

  11. Caregiver burden in dependent elderly.

    Directory of Open Access Journals (Sweden)

    José Mauricio Ocampo

    2009-11-01

    Full Text Available Objectives: To determine the frequency and the associated factors with the presence of care burden imposed by dependent elderly of Buenaventura, Valle; Colombia. Design: A pilot cross-sectional study. Patients and methods: Between March and May of 2006, data were collected on 35 over 60 years old patients who live in the community of Buenaventura, with a score in the Barthel index Results: The mean age and the standard deviation of the patient group was 78.9±10 years. There was a larger proportion of women (68.5%. In the care givers, the regular age and the standard deviation was 49.4±18.8 years, where 91% were women. It was found that for 54.2% of the caregivers there was no burden at all, 40% of them had a minimum burden and the others a greater burden. Bivariate analysis between the care giver’s burden and the number of chronic disease, the score on the minimental test, elderly depression and the family APGAR, resulted in statistic association (p Conclusions: There is an association between aged people, dependent in basic common day activities related with physical aspects, and care giver’s burden. Being the caregivers mostly family members, further studies must be focused on identifying and realizing interventions to prevent or limit the decrease of declining mental health and loss of life quality and the consequent increase of the care giver’s burden.

  12. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

  13. Socioeconomic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

    2014-01-01

    who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement. CONCLUSION: HAE poses a considerable burden on patients...... and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks....

  14. Starch and lipid accumulation in eight strains of six Chlorella species under comparatively high light intensity and aeration culture conditions.

    Science.gov (United States)

    Takeshita, Tsuyoshi; Ota, Shuhei; Yamazaki, Tomokazu; Hirata, Aiko; Zachleder, Vilém; Kawano, Shigeyuki

    2014-04-01

    The microalgae family Chlorella species are known to accumulate starch and lipids. Although nitrogen or phosphorous deficiencies promote starch and lipids formation in many microalgae, these deficiencies also limit their growth and productivity. Therefore, the Chlorellaceae strains were attempted to increase starch and lipids productivity under high-light-intensity conditions (600-μmol photons m(-2)s(-1)). The 12:12-h light-dark (LD) cycle conditions elicited more stable growth than the continuous light (LL) conditions, whereas the starch and lipids yields increased in LL conditions. The amount of starch and lipids per cell increased in Chlorella viscosa and Chlorella vulgaris in sulfur-deficient medium, and long-chain fatty acids with 20 or more carbon atoms accumulated in cells grown in sulfur-deficient medium. Accumulation of starch and lipids was investigated in eight strains. The accumulation was strain-dependent, and varied according to the medium and light conditions. Five of the eight Chlorella strains exhibited similar accumulation patterns.

  15. Comparative study of shape, intensity and texture features and support vector machine for white blood cell classification

    Directory of Open Access Journals (Sweden)

    Mehdi Habibzadeh

    2013-04-01

    Full Text Available The complete blood count (CBC is widely used test for counting and categorizing various peripheral particles in the blood. The main goal of the paper is to count and classify white blood cells (leukocytes in microscopic images into five major categories using features such as shape, intensity and texture features. The first critical step of counting and classification procedure involves segmentation of individual cells in cytological images of thin blood smears. The quality of segmentation has significant impact on the cell type identification, but poor quality, noise, and/or low resolution images make segmentation less reliable. We analyze the performance of our system for three different sets of features and we determine that the best performance is achieved by wavelet features using the Dual-Tree Complex Wavelet Transform (DT-CWT which is based on multi-resolution characteristics of the image. These features are combined with the Support Vector Machine (SVM which classifies white blood cells into their five primary types. This approach was validated with experiments conducted on digital normal blood smear images with low resolution.

  16. Fludarabine-based reduced intensity conditioning transplants have a higher incidence of cytomegalovirus reactivation compared with myeloablative transplants.

    Science.gov (United States)

    George, B; Kerridge, I; Gilroy, N; Huang, G; Hertzberg, M; Gottlieb, D; Bradstock, K

    2010-05-01

    Two hundred and ten adult CMV seropositive patients undergoing myeloablative conditioning (MAC) [n=127] or reduced intensity conditioning (RIC) [n=83] transplants (HCT) were serially monitored for CMV reactivation and disease, using a qualitative polymerase chain reaction (PCR) followed by quantitation with pp65 antigen or quantitative PCR. CMV reactivation occurred in 53 RIC (63.9%) and 61 MAC (48%; P=0.03) transplants at a median of 47 days (range: 24-1977). Risk factors identified included acute GVHD (P=0.001), RIC regimen (P=0.03), unrelated donor (P=0.02), use of anti-thymocyte globulin/alemtuzumb (P=0.02) and use of bone marrow in MAC transplants (P=0.011). On multivariate analysis, RIC transplants and acute GVHD remained independent predictors. Treatment with antiviral drugs resulted in CMV negativity rates of 86.8% in MAC and 88.6% in RIC transplants. CMV disease occurred in 10.8% of RIC and 4.7% of MAC transplants (P=0.15). At a median follow-up of 26 months (range: 3-88), 48.1% of RIC and 50.3% of MAC transplants are alive. The higher incidence of CMV reactivation among RIC transplants suggests the need for novel prophylactic or pre-emptive strategies in this high-risk group of patients.

  17. A comparative assessment of intensive and extensive wastewater treatment technologies for removing emerging contaminants in small communities.

    Science.gov (United States)

    Matamoros, Víctor; Rodríguez, Yolanda; Albaigés, Joan

    2016-01-01

    Ecosystem pollution due to the lack of or inefficient wastewater treatment coverage in small communities is still a matter of great concern, even in developed countries. This study assesses the seasonal performance of 4 different full-scale wastewater technologies that have been used in small communities (<2000 population equivalent) for more than 10 years in terms of emerging contaminant (EC), chemical oxygen demand (COD), total suspended solids (TSS) and NH4-N removal efficiency. The studied technologies, which were selected due to their widespread use, included two intensive treatment systems (an extended aeration system (AS) and a rotating biological contactor (RBC)) and two extensive treatment systems (a constructed wetland (CW) and a waste stabilization pond (WSP)), all located in north-eastern Spain. The studied compounds belonged to the groups of pharmaceuticals, sunscreen compounds, fragrances, antiseptics, flame retardants, surfactants, pesticides and plasticizers. The 25 ECs occurred in wastewater at concentrations ranging from undetectable to 80 μg L(-1). The average removal efficiency was 42% for the CW, 62% for the AS, 63% for the RBC and 82% for the WSP. All the technologies except the WSP system showed seasonal variability in the removal of ECs. The ecotoxicological assessment study revealed that, whilst all the technologies were capable of decreasing the aquatic risk, only the WSP yielded no risk in both seasons.

  18. [Comparative evaluation of influence of low-intensity laser radiation of different spectrum components and regimen of laser work upon microcirculation in comprehensive treatment of chronic parodontitis].

    Science.gov (United States)

    Krechina, E K; Shidova, A V; Maslova, V V

    2008-01-01

    Comparative study of the influence details of low-intensity pulse and continuous oscillation of laser radiation of red and infrared parts of spectrum upon microcirculation indices in comprehensive treatment of chronic parodontitis of light and middle severity was performed. For the first time the predominantly activating influence upon microcirculation in gingival tissues of the pulsed laser radiation in the red part of spectrum was established.

  19. The burden of Alzheimer's disease.

    Science.gov (United States)

    Burns, Alistair

    2000-07-01

    Alzheimer's disease (AD) imposes a severe burden upon patients and their carers. In particular, family carers of AD patients face extreme hardship and distress that represents a major but often hidden burden on healthcare systems. Carers often experience clinically significant alterations in physical and mental health, particularly depression. A number of individual features of the dementia syndrome that are known to be particularly burdensome to carers include the degree of cognitive impairment, amount of help required with activities of daily living, personality changes and the presence of psychiatric symptoms and behavioural disturbances. The neuropsychiatric features of AD patients can adversely impact the relationship between the patient and caregiver generating feelings of strain, burden and social isolation. Individual characteristics of the caregiver including personality, gender, degree of formal and informal support and physical and mental health, as well as attributional style ('coping style') and expressed emotion (critical or hostile attitudes), also dictate carer burden. As informal caregivers play such a crucial role in the care of AD patients, appropriate management strategies that incorporate interventions which address the specific burdens of the individual caregiver are essential. Reducing the burden of care can be achieved by the combination of a number of individual and general measures, including education, respite and emotion-focused interventions. These measures, accompanied by non-pharmacological strategies, are extremely important in the total care of the AD patient, with the emphasis on maintaining people in the community as long as possible.

  20. The transition to hospital consultant: Denmark and the Netherlands compared on preparedness for practice, perceived intensity and contextual factors

    NARCIS (Netherlands)

    Westerman, M.; Teunissen, P.W.; Jorgensen, R.L.; Fokkema, J.P.; Siegert, C.E.; Vleuten, C.P.M. van der; Scherpbier, A.J.J.A.; Ringsted, C.; Scheele, F.

    2013-01-01

    Introduction: Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and g

  1. Longer Intestinal Persistence of Enterococcus faecalis Compared to Enterococcus faecium Clones in Intensive-Care-Unit Patients▿

    Science.gov (United States)

    Ruiz-Garbajosa, Patricia; del Campo, Rosa; Coque, Teresa M.; Asensio, Angel; Bonten, Marc; Willems, Rob; Baquero, Fernando; Cantón, Rafael

    2009-01-01

    The dynamics of intestinal colonization with enterococcal clones in intensive-care-unit (ICU) patients was evaluated. Eight patients admitted directly to the neurosurgical ICU at the Ramón y Cajal University Hospital (Madrid, Spain) from the community and with no overlapping stay during a 10-month period in 2006 were studied. Rectal swab specimens were collected on admission and daily until the patients were discharged. Clonality was determined by pulsed-field gel electrophoresis and multilocus sequence typing. Clonal colonization dynamics were estimated by using two new parameters: the clonal diversity per patient per day (CDPD) and the clonal persistence ratio (CPR). Enterococcus faecalis isolates (n = 123) and Enterococcus faecium isolates (n = 66) were resolved into 13 and 15 clones, respectively. The CDPD of E. faecalis steadily increased during admission, and E. faecalis showed a higher (P = 0.001) CPR value than E. faecium (0.86 and 0.42, respectively). E. faecium, with the exception of an ampicillin-resistant clone belonging to clonal complex 17, frequently appeared as a short-term colonizer, even though the E. faecalis clones had significantly (P = 0.03) more days under antibiotic exposure than E. faecium (77.5 and 65 days/100 colonization days, respectively). E. faecalis had a longer persistence than E. faecium, except for the CC17 ampicillin-resistant clone, and E. faecalis showed a cumulative increase in CDPD, whereas E. faecium did not. CDPD and CPR were useful for measuring the dynamics of intestinal colonization with enterococcal clones. PMID:19052172

  2. Family burden in injecting versus noninjecting opioid users

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: A substance-dependent person in the family affects almost all aspects of family life that also impact the lives of the significant others and causes enormous burden. Objectives: This study was aimed to assess the pattern of burden borne by the family caregivers of patients with opioid-dependence-injecting drug users (IDU and noninjecting drug users (NIDU. Materials and Methods: A cross-sectional study was conducted with ICD-10 diagnosed-opioid-dependent subjects (IDU and NIDU, N = 40 in each group and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in North India. Family Burden interview schedule was used to assess the pattern of burden borne by the family caregivers. Results: The IDU group was characterized by older age, longer duration of substance dependence, greater subjective and objective family burden in all the areas compared to NIDU group, and single status and unemployment were associated with severe objective burden. The family burden was associated neither with age, education, or duration of dependence of the patients, nor with family size, type of caregiver or caregiver′s education in either group. Conclusion: All caregivers reported a moderate or severe burden, which indicates the significance and need for further work in this area.

  3. Comparative study of energy of particles ejected from coulomb explosion of rare gas and metallic clusters irradiated by intense femtosecond laser field

    Science.gov (United States)

    Boucerredj, N.; Beggas, K.

    2016-10-01

    We present our study of high intensity femtosecond laser field interaction with large cluster of Kr and Na (contained 2.103 to 2.107 atoms). When laser intensity is above a critical value, it blows off all of electrons from the cluster and forms a non neutral ion cloud. The irradiation of these clusters by the intense laser field leads to highly excitation energy which can be the source of energetic electrons, electronic emission, highly charge, energetic ions and fragmentation process. During the Coulomb explosion of the resulting highly ionized, high temperature nanoplasma, ions acquire again their energy. It is shown that ultra fast ions are produced. The goal of our study is to investigate in detail a comparative study of the expansion and explosion then the ion energy of metallic and rare gas clusters irradiated by an intense femtosecond laser field. We have found that ions have a kinetic energy up to 105 eV and the Coulomb pressure is little than the hydrodynamic pressure. The Coulomb explosion of a cluster may provide a new high energy ion source.

  4. Optimized fluorescence diagnosis of tumors by comparing five-ALA-induced xenofluorescence and autofluorescence intensities of a murine tumor/nontumor tissue system cultivated on the CAM

    Science.gov (United States)

    Stroebele, Simone; Dressler, Cathrin; Ismail, M. Samy; Daskalaki, Anita; Philipp, Carsten M.; Berlien, Hans-Peter; Weitzel, H.; Liebsch, M.; Spielmann, H.

    1995-12-01

    The in vivo model of the chorioallantoic membrane of fertilized chicken embryos (CAM) was employed for studying the fluorescence characteristics of tumor tissue in comparison with non tumorous tissue. Tumors were grown from the murine fibrosarcoma cell line SSK II and murine 3T3 fibroblasts (clone A31) were used for cultivating non tumorous tissue. Autofluorescence and xenofluorescence intensities induced by 5-aminolaevulinic acid (5-ALA) were compared. Exogenous administration of 5-ALA, an early precursor in haem synthesis, induces accumulation of endogenous photoactive porphyrins, in particular protoporphyrin IX (PpIX). Fluorescence investigations were performed after 3-4d of incubation, when the tissues had reached macroscopically three dimensional stages of growth. Fluorescences were excited with a HBO-X 100 W lamp (Carl Zeiss) at a wavelength (lambda) equals 405 plus or minus 5 nm. Emissions were detected in the spectral range above 630 nm and visualized by real time digital image processing (Argus 10, HAMAMATSU) using an ICCD camera (HAMAMATSU). After administration of 0.4 mmolar 5-ALA solution to the CAM inoculated tissues the SSK II tumors exhibited higher fluorescence intensities than the 3T3 non tumorous tissues. Autofluorescence intensities of both types of tissues were not distinguishable. Furthermore, the effects of several biochemicals on the xenofluorescence intensities of the fibrosarcoma and fibroblast tissues were investigated.

  5. A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery – Part I: model planning

    Directory of Open Access Journals (Sweden)

    Biagioli Bonizella

    2007-11-01

    Full Text Available Abstract Background Different methods have recently been proposed for predicting morbidity in intensive care units (ICU. The aim of the present study was to critically review a number of approaches for developing models capable of estimating the probability of morbidity in ICU after heart surgery. The study is divided into two parts. In this first part, popular models used to estimate the probability of class membership are grouped into distinct categories according to their underlying mathematical principles. Modelling techniques and intrinsic strengths and weaknesses of each model are analysed and discussed from a theoretical point of view, in consideration of clinical applications. Methods Models based on Bayes rule, k-nearest neighbour algorithm, logistic regression, scoring systems and artificial neural networks are investigated. Key issues for model design are described. The mathematical treatment of some aspects of model structure is also included for readers interested in developing models, though a full understanding of mathematical relationships is not necessary if the reader is only interested in perceiving the practical meaning of model assumptions, weaknesses and strengths from a user point of view. Results Scoring systems are very attractive due to their simplicity of use, although this may undermine their predictive capacity. Logistic regression models are trustworthy tools, although they suffer from the principal limitations of most regression procedures. Bayesian models seem to be a good compromise between complexity and predictive performance, but model recalibration is generally necessary. k-nearest neighbour may be a valid non parametric technique, though computational cost and the need for large data storage are major weaknesses of this approach. Artificial neural networks have intrinsic advantages with respect to common statistical models, though the training process may be problematical. Conclusion Knowledge of model

  6. Comparing the effects of aerobic and stretching exercises on the intensity of primary dysmenorrhea in the students of universities of bushehr.

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    Farideh Vaziri

    2015-03-01

    Full Text Available To compare the effects of aerobic and stretching exercises on severity of primary dysmenorrhea.This randomized clinical trial was conducted on 105 female students who were suffering from primary dysmenorrhea. The participants were divided into aerobic exercise, stretching exercise, and control groups. The two intervention groups did the exercises three times a week for eight weeks (two menstrual cycles. The intensity of dysmenorrhea was determined using a modified questionnaire that assessed several symptoms of dysmenorrhea. After all, the data were compared between and within groups through analysis of variance.Before the intervention, the mean intensity of dysmenorrhea was 40.38 ± 5.5, 37.40 ± 3.8, and 38.45±3.3 in aerobic, stretching, and control groups, respectively, but the difference was not statistically significant. After the intervention, however, a significant difference was found among the three groups regarding the mean intensity of dysmenorrhea in the first and second menstrual cycles. Also, a significant difference was observed between the aerobic group and the control group as well as between the stretching group and the control group. Within group comparisons showed a significant difference in the aerobic and the stretching group before and after the interventions. However, no such difference was observed in control group.Both aerobic and stretching exercises were effective in reducing the severity of dysmenorrhea. Therefore, women could choose one of these two methods with regard to their interest and lifestyle.

  7. Rising Burden of Obesity in Asia

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    Ambady Ramachandran

    2010-01-01

    Full Text Available Overweight and obesity have reached epidemic proportions in many Asian countries. These countries also face a grave burden of obesity-related disorders such as diabetes, hypertension, and cardiovascular diseases, which develop at a younger age than in Western populations. These disorders are also manifested in childhood. The major causative factors are related to the lifestyle changes occurring due to rapid socioeconomic transition. Asian populations show several differences in genetic factors when compared with the white population, and they also have lower cut points for environmental risk factors. National programmes targeting public awareness, education and improved structural facilities to facilitate healthy lifestyle are the keys to alleviate the economic and health care burden of the obesity-related disorders.

  8. Ultrasound Versus the Landmark Technique: A Prospective Randomized Comparative Study of Internal Jugular Vein Cannulation in an Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    B R Shrestha

    2011-06-01

    Full Text Available OBJECTIVE: The aim of this study is to find out if an ultrasound technique has advantages over the conventional landmark technique. METHODS: This is a prospective randomized comparative study on 120 patients requiring central venous cannulation of the right internal jugular vein. The study comprised of two groups: ultrasound and landmark groups, each consisting of 60 patients. The outcome measures were compared between the groups. RESULTS: Cannulation of the internal jugular vein was successful in 58 patients in the ultrasound group and in 53 in the landmark group. The number of attempts was 1.5 (1 - 3 and 2 (1 - 3 in the ultrasound and landmark group respectively (p = 0.001. The time taken for the successful cannulation was 4.9 +/- 1.7 minutes in the ultrasound approach and 8.0 +/- 2.8 minutes in the landmark approach (p = 0.00. The internal jugular vein diameter in the supine position was 11.2 +/- 1.5 mm which increased to 15.04 +/- 1.5 mm with a 15 degrees head-down position in the USG group (p = 0.001. The first attempt success rate was 39/60 (63% in the ultrasound group and 19/60 (32% with the landmark technique. The seven (12% failure cases in the landmark group were rescued by the ultrasound technique. Inadvertent carotid artery puncture occurred in 2/60 (3% and 6/60 (10% of patients in the ultrasound and land mark group respectively. CONCLUSIONS: Ultrasound improves success rate, minimizes cannulation time and complications during internal jugular vein cannulation. It can be employed as a rescue technique in cases of a failed landmark technique. Keywords:cannulation, central, landmark, technique, ultrasound.

  9. Comparative study to estimate the productive performance of different sheep breeds of Balochistan in semi intensive conditions

    Directory of Open Access Journals (Sweden)

    Masroor A. Bajwa

    2010-07-01

    Full Text Available The objective of the study was to explore the productive performance of the different breedsof sheep prevailing in different parts of the Balochistan province. Two hundred and forty (240 ramlambs of five different breeds were divided into 5 groups of 48 animals of same breed in each groupused in the experiment. The animals were fed wheat straw ad libitum, green Barseem @ 3 kg/day/headand a commercial concentrate ration @ 0.20, 0.30, 0.35, 0.40 and 0.50 kg/day/head for five monthsperiod respectively. There was significant differences in total weight gain and average daily gain ofbreeds (P0.05 between each otheras well as Rakhshani and Harnai. Lowest weight gain was observed in Beverigh sheep. Biometricparameters of height, length and girth was observed significantly different among breeds (P<0.05.Consistent growth performance was found in Mengali and Balochi as compare to others breeds.Variations in productive and biometric performance were due to genetic potential of breeds andenvironmental factors.

  10. The Burden of Burnout.

    Science.gov (United States)

    Elmariah, Hany; Thomas, Samantha; Boggan, Joel C; Zaas, Aimee; Bae, Jonathan

    This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P Burnout remains a significant problem even with recent duty hour modifications.

  11. Burden of Proof in Bioethics.

    Science.gov (United States)

    Koplin, Julian J; Selgelid, Michael J

    2015-11-01

    A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons.

  12. ASSESSMENT OF MAXIMUM ALLOWABLE FISCAL BURDEN ON UKRAINE NATIONAL ECONOMY

    Directory of Open Access Journals (Sweden)

    M. Aleksandrova

    2014-03-01

    Full Text Available The article was reviewed reproductive aspect of the relationship between fiscal burden and a penchant for economic development under certain assumptions about the relationship of these variables. The analysis was based on a fairly simple dynamic model in which the share of income that goes to the development of production, relying constant. Computed optimal fiscal burden for the economic development of the country is 19.29% of GDP. The estimation and comparison of the calculations of the tax burden followed its dynamics, by comparative assessment with those of developed countries. The prospects of the proposed approach for predicting the development of national economy were analyzed.

  13. Indigenous identity: burden or liberation?

    DEFF Research Database (Denmark)

    Steur, Luisa Johanna

    2010-01-01

    With the rise of ‘adivasi’ (‘indigenous’ or ‘tribal’) movements in different parts of South Asia in the past two decades, the question of how to understand ‘adivasi identity’ has become hotly debated: is it a burden, inviting distorted stereotypical depictions of subaltern people, or is it a prom......With the rise of ‘adivasi’ (‘indigenous’ or ‘tribal’) movements in different parts of South Asia in the past two decades, the question of how to understand ‘adivasi identity’ has become hotly debated: is it a burden, inviting distorted stereotypical depictions of subaltern people...

  14. Burden of allergic respiratory disease

    DEFF Research Database (Denmark)

    Linneberg, A; Petersen, Karin Dam; Hahn-Pedersen, J

    2016-01-01

    ; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patients' HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective...... the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease...

  15. Comparing the costs and benefits of floating rice-based and intensive rice-based farming systems in the Mekong delta

    Directory of Open Access Journals (Sweden)

    Van Kien Nguyen

    2015-09-01

    Full Text Available This paper compares financial costs and benefits of floating rice-based and intensive rice farming systems using data from focus group discussions and household survey in four locations in the Mekong Delta. We argue that the net financial benefit per 1000m2 of integrated floating rice-based farming systems is greater than the net financial benefit of intensive rice farming system. The total net benefit of floating rice-leeks shows the highest net benefit (VND 24.8 mil./1000 m2, followed by floating rice-sweet corn- two baby corn crops and cattle systems (VND 18.5 mil./1000m2, and floating rice-chili (VND 16.7-17.7 mil./1000m2. If farmers cultivate monoculture of rice either two or three crops, the net benefits are ranging from VND 2.2-4.8 mil./1000m2 respectively. Alternatively, farmers integrate vegetables; the net benefit was ranging from VND 5.6 to 11.7 mil./1000m2. The net benefit of the two rice crops is lowest (VND 1.3-2.3 mil./1000m2. Surprisingly, if farmers convert from two intensive rice crops to two maize crops, the net benefit can reach to VND 21 million/1000m2. The results support the argument that the floating rice based systems allows farmers diversified into profitable upland crops, which can help farmers to improve their total income.

  16. Caregiver Burden in Epilepsy: Determinants and Impact

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    Ioannis Karakis

    2014-01-01

    Full Text Available Aim. Caregiver burden (CB in epilepsy constitutes an understudied area. Here we attempt to identify the magnitude of this burden, the factors associated with it, and its impact to caregiver quality of life (QOL. Methods. 48 persons with epilepsy (PWE underwent video-EEG monitoring and their caregivers completed questionnaires providing demographic, disease-related, psychiatric, cognitive, sleep, QOL, and burden information. Results. On regression analysis, higher number of antiepileptic drugs, poorer patient neuropsychological performance, lower patient QOL score, and lower caregiver education level were associated with higher CB. Time allocated to patient care approximated but did not attain statistical significance. A moderate inverse correlation between CB and caregiver QOL physical component summary score and a stronger inverse correlation between CB and caregiver QOL mental component summary score were seen. Conclusion. In a selected cohort of PWE undergoing video-EEG monitoring, we identified modest degree of CB, comparable to that reported in the literature for other chronic neurological conditions. It is associated with specific patient and caregiver characteristics and has a negative effect on caregiver QOL.

  17. Immunity and the burden of herpes zoster.

    Science.gov (United States)

    Choi, Won Suk; Kwon, Soon Sun; Lee, Jacob; Choi, Su-Mi; Lee, Jin Soo; Eom, Joong Sik; Sohn, Jang Wook; Choeng, Hee Jin

    2014-03-01

    The burden of herpes zoster may be related to patients' immunity, although this has not been studied extensively. This hypothesis was tested in a matched case-control study of patients with herpes zoster who sought treatment at one of seven university hospitals in Korea from January 1, 2007, to December 31, 2010. Patients diagnosed with herpes zoster were placed into three groups based on their immune status: severely immunocompromised, mild-to-moderately immunocompromised, and normal immunity. Each patient in the severely immunocompromised group was matched with one patient in the mild-to-moderately immunocompromised group and one patient in the normal immunity group in the same hospital based on age, sex, and date of herpes zoster onset. A total of 582 patients with herpes zoster were included in the analysis: 194 in each of the three groups. Patients in the severely immunocompromised group had the highest herpes zoster-related hospitalization rate as compared to patients in the mild-to-moderately immunocompromised and normal immune groups (P herpes zoster-related medical cost increased significantly with the deterioration of patients' immunity (P herpes zoster burden was observed as the patients' immunity decreased. Therefore, effective measures are necessary to prevent herpes zoster and reduce its burden in severely immunocompromised patients.

  18. The economic burden of hemodialysis in Jordan

    Directory of Open Access Journals (Sweden)

    Emad Adel Al-Shdaifat

    2013-01-01

    Full Text Available Background: Hemodialysis treatment is a costly procedure that requires specific resources. It has a considerable burden on patients, caregivers, and healthcare system. The aim of this study was to estimate the economic burden borne by the Ministry of Health (MOH in Jordan, with a focus on direct medical, direct non-medical, and indirect cost. Materials and Methods:The study was conducted at MOH hospitals in Jordan, from August to November 2010. A total of 138 patients and 49 caregivers were involved in the study. An economic evaluation study was used to analyze the burden of hemodialysis treatment at MOH, Jordan. Direct medical costs were estimated through micro and macro costing from the provider′s perspective. Patients′ and caregivers′ costs were included to calculate direct non-medical costs. Human capital approach was employed to evaluate the productivity loss for indirect cost and premature death and potential year life loss was used to estimate the premature death cost. Results: The total burden of hemodialysis at MOH, Jordan was USD17.70 million per year. Cost per session was $72 and the annual cost per patient was $9976. Direct medical cost was $7.20 million (41% and direct non-medical cost was $2.02 million (11%. On the other hand, indirect cost (productivity loss was $8.48 million (48%. All 722 patients on hemodialysis at MOH hospitals consumed 2.7% of MOH budget. Conclusions: Costs of treating and managing patients on hemodialysis at MOH hospitals in Jordan are substantial. Therefore, efforts should be taken to slow down the progress of renal failure to save resources and a comparative study with other modalities, such as continuous ambulatory peritoneal dialysis and kidney transplantation, should be considered.

  19. Comparable effects of low-intensity electromagnetic irradiation at the frequency of 51.8 and 53 GHz and antibiotic ceftazidime on Lactobacillus acidophilus growth and survival.

    Science.gov (United States)

    Soghomonyan, Diana; Trchounian, Armen

    2013-01-01

    The effects of low-intensity electromagnetic irradiation (EMI) with the frequencies of 51.8 and 53 GHz on Lactobacillus acidophilus growth and survival were revealed. These effects were compared with antibacterial effects of antibiotic ceftazidime. Decrease in bacterial growth rate by EMI was comparable with the inhibitory effect of ceftazidime (minimal inhibitory concentration-16 μM) and no enhanced action was observed with combined effects of EMI and the antibiotic. However, EMI-enhanced antibiotic inhibitory effect on bacterial survival. The kinetics of the bacterial suspension oxidation-reduction potential up to 24 h of the growth was changed by EMI and ceftazidime. The changes were more strongly expressed by combined effects of EMI and antibiotic especially up to 12 h. Moreover, EMI did not change overall energy (glucose)-dependent H(+) efflux across the membrane but it increased N,N'-dicyclohexylcarbodiimide (DCCD)-inhibited H(+) efflux. In contrast, this EMI in combination with ceftazidime decreased DCCD-sensitive H(+) efflux. Low-intensity EMI had inhibitory effect on L. acidophilus bacterial growth and survival. The effect on bacterial survival was more significant in the combination with ceftazidime. The H(+)-translocating F 0 F 1-ATPase, for which DCCD is specific inhibitor, might be a target for EMI and ceftazidime. The revealed bactericide effects on L. acidophilus can be applied in biotechnology, food producing and safety technology.

  20. Measuring the burden of neglected tropical diseases: the global burden of disease framework.

    Directory of Open Access Journals (Sweden)

    Colin D Mathers

    Full Text Available Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY.This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.

  1. Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women

    Directory of Open Access Journals (Sweden)

    Haifeng Zhang

    2017-01-01

    Full Text Available This study compared the effect of prolonged moderate-intensity continuous training (MICT on reducing abdominal visceral fat in obese young women with that of work-equivalent (300 kJ/training session high-intensity interval training (HIIT. Forty-three participants received either HIIT (n=15, MICT (n=15, or no training (CON, n=13 for 12 weeks. The abdominal visceral fat area (AVFA and abdominal subcutaneous fat area (ASFA of the participants were measured through computed tomography scans preintervention and postintervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Following HIIT and MICT, comparable reductions in AVFA (−9.1, −9.2 cm2, ASFA (−35, −28.3 cm2, and combined AVFA and ASFA (−44.7, −37.5 cm2, p>0.05 were observed. Similarly, reductions in fat percentage (−2.5%, −2.4%, total fat mass (−2.8, −2.8 kg, and fat mass of the android (−0.3, −0.3 kg, gynoid (−0.5, −0.7 kg, and trunk (−1.6, −1.2 kg, p>0.05 regions did not differ between HIIT and MICT. No variable changed in CON. In conclusion, MICT consisting of prolonged sessions has no quantitative advantage, compared with that resulting from HIIT, in abdominal visceral fat reduction. HIIT appears to be the predominant strategy for controlling obesity because of its time efficiency.

  2. Comparable Effects of High-Intensity Interval Training and Prolonged Continuous Exercise Training on Abdominal Visceral Fat Reduction in Obese Young Women

    Science.gov (United States)

    Zhang, Haifeng; Tong, Tom K.; Qiu, Weifeng; Zhang, Xu; Zhou, Shi

    2017-01-01

    This study compared the effect of prolonged moderate-intensity continuous training (MICT) on reducing abdominal visceral fat in obese young women with that of work-equivalent (300 kJ/training session) high-intensity interval training (HIIT). Forty-three participants received either HIIT (n = 15), MICT (n = 15), or no training (CON, n = 13) for 12 weeks. The abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) of the participants were measured through computed tomography scans preintervention and postintervention. Total fat mass and the fat mass of the android, gynoid, and trunk regions were assessed through dual-energy X-ray absorptiometry. Following HIIT and MICT, comparable reductions in AVFA (−9.1, −9.2 cm2), ASFA (−35, −28.3 cm2), and combined AVFA and ASFA (−44.7, −37.5 cm2, p > 0.05) were observed. Similarly, reductions in fat percentage (−2.5%, −2.4%), total fat mass (−2.8, −2.8 kg), and fat mass of the android (−0.3, −0.3 kg), gynoid (−0.5, −0.7 kg), and trunk (−1.6, −1.2 kg, p > 0.05) regions did not differ between HIIT and MICT. No variable changed in CON. In conclusion, MICT consisting of prolonged sessions has no quantitative advantage, compared with that resulting from HIIT, in abdominal visceral fat reduction. HIIT appears to be the predominant strategy for controlling obesity because of its time efficiency. PMID:28116314

  3. Parental burden associated with borderline personality disorder in female offspring.

    Science.gov (United States)

    Goodman, Marianne; Patil, Uday; Triebwasser, Joseph; Hoffman, Perry; Weinstein, Zachary A; New, Antonia

    2011-02-01

    To identify aspects of parental burden associated with borderline personality disorder (BPD), an anonymous internet survey linked to BPD support websites was developed for parents to complete on their BPD offspring and unaffected siblings. The questions cover aspects of the child's life from pregnancy through young adulthood, and query about the impact of the child's BPD on six domains of the parent's life, including physical and emotional health, marriage, job, standard of living, social life, and career trajectory. Additionally, financial burden was assessed with questions pertaining to insurance and out-of pocket costs associated with the BPD disorder. BPD offspring were identified by meeting diagnostic criteria embedded within the survey and having been given a diagnosis of BPD by a professional at some point in their life. We report on 233 female offspring meeting strict criteria for BPD. Parents of daughters with BPD endorsed varying levels of impact on the six domains comprising burden with the largest impact on emotional health which was impacted in over 88% of the respondents. Over 50% of parents endorsed four or greater of the six burden items. Particular aspects of the offspring's BPD symptom profile correlated with intensity of parental burden included including problems in adolescence with acting out behavior (p disorder led to about $50,000 in additional costs. Parents of female offspring with BPD experience burden in multiple domains of their life and many have incurred substantial financial expense. Increasing awareness of co-morbid conditions in the BPD proband that significantly increase parental burden may be indicators for the provision of increased family support.

  4. Simultaneous Integrated Boost Using Intensity-Modulated Radiotherapy Compared With Conventional Radiotherapy in Patients Treated With Concurrent Carboplatin and 5-Fluorouracil for Locally Advanced Oropharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Clavel, Sebastien, E-mail: sebastien.clavel@umontreal.ca [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen, David H.A.; Fortin, Bernard [Department of Radiation Oncology, Hopital Maisonneuve-Rosemont, Montreal, QC (Canada); Despres, Philippe [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Khaouam, Nader [Department of Radiation Oncology, Hopital Maisonneuve-Rosemont, Montreal, QC (Canada); Donath, David [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis [Department of Head and Neck Surgery, Centre Hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Hopital Maisonneuve-Rosemont, Montreal, QC (Canada)

    2012-02-01

    Purpose: To compare, in a retrospective study, the toxicity and efficacy of simultaneous integrated boost using intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) in patients treated with concomitant carboplatin and 5-fluorouracil for locally advanced oropharyngeal cancer. Methods and Materials: Between January 2000 and December 2007, 249 patients were treated with definitive chemoradiation. One hundred patients had 70 Gy in 33 fractions using IMRT, and 149 received CRT at 70 Gy in 35 fractions. Overall survival, disease-free survival, and locoregional control were estimated using the Kaplan-Meier method. Results: Median follow-up was 42 months. Three-year actuarial rates for locoregional control, disease-free survival, and overall survival were 95.1% vs. 84.4% (p = 0.005), 85.3% vs. 69.3% (p = 0.001), and 92.1% vs. 75.2% (p < 0.001) for IMRT and CRT, respectively. The benefit of the radiotherapy regimen on outcomes was also observed with a Cox multivariate analysis. Intensity-modulated radiotherapy was associated with less acute dermatitis and less xerostomia at 6, 12, 24, and 36 months. Conclusions: This study suggests that simultaneous integrated boost using IMRT is associated with favorable locoregional control and survival rates with less xerostomia and acute dermatitis than CRT when both are given concurrently with chemotherapy.

  5. The Amsterdam Studies of Acute Psychiatry - II (ASAP-II: a comparative study of psychiatric intensive care units in the Netherlands

    Directory of Open Access Journals (Sweden)

    van Venrooij Janine

    2009-09-01

    Full Text Available Abstract Background The number of patients in whom mental illness progresses to stages in which acute, and often forced treatment is warranted, is on the increase across Europe. As a consequence, more patients are involuntarily admitted to Psychiatric Intensive Care Units (PICU. From several studies and reports it has become evident that important dissimilarities exist between PICU's. The current study seeks to describe organisational as well as clinical and patient related factors across ten PICU's in and outside the Amsterdam region, adjusted for or stratified by level of urbanization. Method/Design This paper describes the design of the Amsterdam Studies of Acute Psychiatry II (ASAP-II. This study is a prospective observational cohort study comparing PICU's in and outside the Amsterdam region on various patient characteristics, treatment aspects and recovery related variables. Dissimilarities were measured by means of collecting standardized forms which were filled out in the framework of care as usual, by means of questionnaires filled out by mental health care professionals and by means of extracting data from patient files for every consecutive patient admitted at participating PICU's during a specific time period. Urbanization levels for every PICU were calculated conform procedures as proposed by the Dutch Central Bureau for Statistics (CBS. Discussion The current study may provide a deeper understanding of the differences between psychiatric intensive care units that can be used to promote best practice and benchmarking procedures, and thus improve the standard of care.

  6. The Burden of Musculoskeletal Conditions

    OpenAIRE

    Clémence Palazzo; Jean-François Ravaud; Agathe Papelard; Philippe Ravaud; Serge Poiraudeau

    2014-01-01

    OBJECTIVE: Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability. METHODS: Data on disabilities associated with RMDs were extracted from the national 2008-2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the ...

  7. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Directory of Open Access Journals (Sweden)

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  8. A Comparative Study of Sector Tax Burden Differences between Value-added Tax and Business Tax%增值税和营业税行业税负差异研究

    Institute of Scientific and Technical Information of China (English)

    聂海峰; 刘怡

    2011-01-01

    货物劳务税在行业间的转嫁,使得税务部门从该行业征收的税收(实征税收)与最终转嫁到该行业的税收(归宿税收)之间出现差异。本文使用投入产出模型,假设货物劳务税向后转嫁,计算了国内增值税与营业税的归宿情况。研究发现,征收增值税的行业普遍产生了税收转嫁,降低了税收负担率,而免征增值税的第一产业和第三产业的归宿税收普遍高于实征税收。为此,在增值税扩围改革时应充分考虑税收转嫁对行业归宿税收的影响因素。%The shifting of goods and service tax from one sector to another leads to the difference between the tax levied by the tax authority from one sector and the tax shifted to that sector. This paper uses an input-output model to calculate the tax incidences of the value-added tax and business tax in China by assuming the goods and service tax to be shifted forward. The paper finds that tax shifting occurs all over the sectors paying value-added taxes and that results in a reduction of tax burden. However, in general, the shifted taxes of the primary industry and the tertiary industry are larger than their respective taxes to be levied although they are exempted from the VAT. The paper points out that it is necessary to consider the impact of tax shifting on the tax incidence of one sector in the process of the expansion of the VAT scope.

  9. Comparative cost-effectiveness of stereotactic body radiation therapy versus intensity-modulated and proton radiation therapy for localized prostate cancer.

    Directory of Open Access Journals (Sweden)

    Anju eParthan

    2012-08-01

    Full Text Available Objective. To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer.Methods. A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publically available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY gained between treatments. Analyses were conducted from both a payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed.Results. Compared to intensity modulated radiation therapy (IMRT and proton beam therapy (PT, stereotactic body radiation therapy (SBRT was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost effective in 75%, and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75%, and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusions. Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

  10. Global Economic Burden of Norovirus Gastroenteritis.

    Directory of Open Access Journals (Sweden)

    Sarah M Bartsch

    Full Text Available Despite accounting for approximately one fifth of all acute gastroenteritis illnesses, norovirus has received comparatively less attention than other infectious pathogens. With several candidate vaccines under development, characterizing the global economic burden of norovirus could help funders, policy makers, public health officials, and product developers determine how much attention and resources to allocate to advancing these technologies to prevent and control norovirus.We developed a computational simulation model to estimate the economic burden of norovirus in every country/area (233 total stratified by WHO region and globally, from the health system and societal perspectives. We considered direct costs of illness (e.g., clinic visits and hospitalization and productivity losses.Globally, norovirus resulted in a total of $4.2 billion (95% UI: $3.2-5.7 billion in direct health system costs and $60.3 billion (95% UI: $44.4-83.4 billion in societal costs per year. Disease amongst children <5 years cost society $39.8 billion, compared to $20.4 billion for all other age groups combined. Costs per norovirus illness varied by both region and age and was highest among adults ≥55 years. Productivity losses represented 84-99% of total costs varying by region. While low and middle income countries and high income countries had similar disease incidence (10,148 vs. 9,935 illness per 100,000 persons, high income countries generated 62% of global health system costs. In sensitivity analysis, the probability of hospitalization had the largest impact on health system cost estimates ($2.8 billion globally, assuming no hospitalization costs, while the probability of missing productive days had the largest impact on societal cost estimates ($35.9 billion globally, with a 25% probability of missing productive days.The total economic burden is greatest in young children but the highest cost per illness is among older age groups in some regions. These large

  11. Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

    Directory of Open Access Journals (Sweden)

    Randall Kuhn

    Full Text Available The Global Burden of Disease (GBD studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.We estimate the avoidable burden associated with HAP using International Futures (IFs, an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI and four noncommunicable diseases (NCDs. We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs

  12. Power generation from chemically cleaned coals: do environmental benefits of firing cleaner coal outweigh environmental burden of cleaning?

    DEFF Research Database (Denmark)

    Ryberg, Morten W.; Owsianiak, Mikolaj; Laurent, Alexis;

    2015-01-01

    Power generation from high-ash coals is a niche technology for power generation, but coal cleaning is deemed necessary to avoid problems associated with low combustion efficiencies and to minimize environmental burdens associated with emissions of pollutants originating from ash. Here, chemical...... beneficiation of coals using acid and alkali–acid leaching procedures is evaluated as a potential coal cleaning technology employing life cycle assessment (LCA). Taking into account the environmental benefits from firing cleaner coal in pulverized coal power plants and the environmental burden of the cleaning....... Chemical cleaning can be optimized with regard to electricity, heat and methanol use for the hydrothermal washing step, and could have environmental impact comparable to that of physical cleaning if the overall resource intensiveness of chemical cleaning is reduced by a factor 5 to 10, depending...

  13. Investigating the burden of parasitic zoonotic diseases

    OpenAIRE

    2010-01-01

    Although the global burden for most parasitic zoonoses is not yet known, it is clear that collectively parasitic zoonoses have a similar human disease burden to any one of the big three human infectious diseases: malaria, tuberculosis or HIV. In addition many also have a substantial animal health and economic burden.

  14. Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes : analysis of the ADDITION-UK cluster-randomized controlled trial

    NARCIS (Netherlands)

    Tao, L.; Wilson, E. C. F.; Wareham, N. J.; Sandbaek, A.; Rutten, G. E. H. M.; Lauritzen, T.; Khunti, K.; Davies, M. J.; Borch-Johnsen, K.; Griffin, S. J.; Simmons, R. K.

    2015-01-01

    Aims To examine the short- and long-term cost-effectiveness of intensive multifactorial treatment compared with routine care among people with screen-detected Type 2 diabetes. Methods Cost-utility analysis in ADDITION-UK, a cluster-randomized controlled trial of early intensive treatment in people w

  15. Imaging of low back pain: comparative role of high intensity zone in diagnosing the discogenic low back pain with evidence-based radiology

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhi-ye; MA Lin; LI Tao

    2009-01-01

    Background Discography is a gold standard for the diagnosis of the low back pain (LBP), but it has potential dangers for the development of discitis, cerebral spinal fluid leakage, retroperitoneal bleeding, acute new back pain and the tremendous radiation exposure to the patient. Using "evidence-based radiology" methods, the comparative roles of high intensity zone (HIZ) in diagnosing discogenic LBP were evaluated. Methods A focused clinical question was designed and a Pubmed and manual search were performed to identify the role of HIZ on MRI T2WI compared with discography. The studies retrieved were assessed for validity and strength.Sensitivity, specificity, likelihood ratios (LRs) and graphs of conditional probability were evaluated from the best current study by evidence-based radiology.Results Best evidence was retrieved in ten articles from 1992 to 2007. The best evidence level was 1 b and the strength of the evidence included: sensitivity 0.63 (0.51,0.76), specificity 0.97 (0.92,1.00), positive predictive value 0.95, negative predictive value 0.72, positive LRs 18.37 and negative LRs 0.38. The gold standard of discogenic LBP is the provocative discography.Conclusions For suspected discogenic LBP, HIZ is limited for the diagnosis if HIZ is positive, which suggests further discography. In contrast HIZ is a good test for diagnosis if HIZ is negative, which indicates the disease can be excluded.

  16. Intense pulsed light versus photodynamic therapy using liposomal methylene blue gel for the treatment of truncal acne vulgaris: a comparative randomized split body study.

    Science.gov (United States)

    Moftah, Nayera Hassan; Ibrahim, Shady Mahmoud; Wahba, Nadine Hassan

    2016-05-01

    Acne vulgaris is an extremely common skin condition. It often leads to negative psychological consequences. Photodynamic therapy (PDT) using intense pulsed light has been introduced for effective treatment of acne. The objective was to study the effect of PDT in truncal acne vulgaris using liposomal methylene blue (LMB) versus IPL alone. Thirty-five patients with varying degrees of acne were treated with topical 0.1 % LMB hydrogel applied on the randomly selected one side of the back, and after 60 min the entire back was exposed to IPL. The procedure was done once weekly for three sessions and patients were re-evaluated 1 month after the third session by two independent dermatologists. Acne severity was graded using the Burton scale. Patient satisfaction using Cardiff Acne Disability Index (CADI) was recorded before and after treatment. On LMB-pretreated side, inflammatory acne lesion counts were significantly decreased by 56.40 % compared with 34.06 % on IPL alone. Marked improvement was seen on LMB-pretreated side in 11.5 % of patients compared with 2.8 % on IPL alone. There was a correlation between CADI score and overall improvement. Our study concluded that LMB-IPL is more effective than IPL alone, safe with tolerable pain in the treatment of acne vulgaris on the back. LMB-IPL is more effective than IPL alone, safe with tolerable pain in the treatment of acne vulgaris on the back.

  17. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  18. The increasing burden of depression

    Directory of Open Access Journals (Sweden)

    Lépine J-P

    2011-05-01

    Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

  19. 45 CFR 672.17 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion....

  20. 40 CFR 305.33 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following...

  1. 40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Burden of presentation; burden of... ENVIRONMENTAL PROTECTION AGENCY GENERAL CONSOLIDATED RULES OF PRACTICE GOVERNING THE ADMINISTRATIVE ASSESSMENT... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The...

  2. Comparative dosimetry of volumetric modulated arc therapy and limited-angle static intensity-modulated radiation therapy for early-stage larynx cancer

    Energy Technology Data Exchange (ETDEWEB)

    Riegel, Adam C.; Antone, Jeffrey [Department of Radiation Medicine, North Shore–LIJ Health System, New Hyde, Park, NY (United States); Schwartz, David L., E-mail: dschwartz3@nshs.edu [Department of Radiation Medicine, North Shore–LIJ Health System, New Hyde, Park, NY (United States); Hofstra–NSLIJ School of Medicine, Hempstead, NY (United States)

    2013-04-01

    To compare relative carotid and normal tissue sparing using volumetric-modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) for early-stage larynx cancer. Seven treatment plans were retrospectively created on 2 commercial treatment planning systems for 11 consecutive patients with T1-2N0 larynx cancer. Conventional plans consisted of opposed-wedged fields. IMRT planning used an anterior 3-field beam arrangement. Two VMAT plans were created, a full 360° arc and an anterior 180° arc. Given planning target volume (PTV) coverage of 95% total volume at 95% of 6300 cGy and maximum spinal cord dose below 2500 cGy, mean carotid artery dose was pushed as low as possible for each plan. Deliverability was assessed by comparing measured and planned planar dose with the gamma (γ) index. Full-arc planning provided the most effective carotid sparing but yielded the highest mean normal tissue dose (where normal tissue was defined as all soft tissue minus PTV). Static IMRT produced next-best carotid sparing with lower normal tissue dose. The anterior half-arc produced the highest carotid artery dose, in some cases comparable with conventional opposed fields. On the whole, carotid sparing was inversely related to normal tissue dose sparing. Mean γ indexes were much less than 1, consistent with accurate delivery of planned treatment. Full-arc VMAT yields greater carotid sparing than half-arc VMAT. Limited-angle IMRT remains a reasonable alternative to full-arc VMAT, given its ability to mediate the competing demands of carotid and normal tissue dose constraints. The respective clinical significance of carotid and normal tissue sparing will require prospective evaluation.

  3. Alcohol-attributed disease burden in four Nordic countries

    DEFF Research Database (Denmark)

    Agardh, Emilie E; Danielsson, Anna-Karin; Ramstedt, Mats;

    2016-01-01

    AIMS: To compare alcohol-attributed disease burden in four Nordic countries 1990-2013, by overall disability adjusted life years (DALYs), and separated by premature mortality (YLL), and health loss to non-fatal conditions (YLD), 2) to examine whether changes in alcohol consumption informs alcohol......, changes in consumption generally corresponded to changes in disease burden, but not to the same extent in Sweden and Norway. All countries had a similar disease pattern and the majority of DALYs were due to YLLs (62-76%), mainly from alcohol use disorder, cirrhosis, transport injuries, self......-harm and violence. YLDs from alcohol use disorder accounted for 41% and 49% of DALYs in Denmark and Finland compared to 63% and 64% in Norway and Sweden 2013. CONCLUSIONS: Finland and Denmark has a higher alcohol-attributed disease burden than Sweden and Norway in the period 1990 to 2013. Changes in consumption...

  4. A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

    Directory of Open Access Journals (Sweden)

    Carter Ashley JR

    2012-07-01

    Full Text Available Abstract Background Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; “Years of Life Lost” (YLL measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers. Conclusions These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden.

  5. Factors Underpinning Caregiver Burden in Frontotemporal Dementia Differ in Spouses and their Children

    Science.gov (United States)

    Kaizik, Cassandra; Caga, Jashelle; Camino, Julieta; O’Connor, Claire M.; McKinnon, Colleen; Oyebode, Jan R.; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

    2017-01-01

    The objectives of this observational study were to (1) compare spousal and child caregiver burden; (2) compare co-resident and live-out child caregiver burden; and (3) investigate factors influencing spousal and child caregiver burden. Data was collected from 90 caregivers of people with frontotemporal degeneration (FTD) recruited from the Frontotemporal Dementia Research Group (Frontier) at Neuroscience Research, Australia. Of this caregiver group, 43 were spousal caregivers and 47 were child caregivers. Caregiver burden and emotional state were evaluated using the short Zarit Burden Interview and the short version of the Depression, Anxiety and Stress Scale-21. The Social Network Index was applied to ascertain the social network of the caregiver, while the Intimate Bond Measure was used to evaluate the current quality of the relationship between the caregiver and the person with dementia. The Frontotemporal Dementia Rating Scale was used to assess severity of dementia. Spousal and child caregivers experienced similar levels of burden, depression, anxiety, and stress, regardless of disease severity. Co-resident child caregivers had smaller social networks and greater burden than live-out caregivers. Dementia severity was key in spousal caregiver burden, whereas caregiver depression was most important in child caregiver burden. Child and spousal caregivers of individuals with FTD share similar levels of burden, influenced by different factors. Future interventions need to account for these differences. PMID:28106550

  6. Pilot study comparing multi-family therapy to single family therapy for adults with anorexia nervosa in an intensive eating disorder program.

    Science.gov (United States)

    Dimitropoulos, Gina; Farquhar, Jamie C; Freeman, Victoria Emily; Colton, Patricia Anne; Olmsted, Marion Patricia

    2015-07-01

    Multi-family therapy (MFT) has yet to be evaluated in families of adults with anorexia nervosa (AN). The study aims were: (i) assess the feasibility of MFT for AN; and, (ii) assess whether MFT is associated with improved outcomes for families compared with single-family therapy (SFT). Adult patients with AN consecutively referred to an eating disorder treatment program were assigned (non-randomly) to receive eight sessions of SFT or MFT. Assessment occurred pre-therapy, immediately post-therapy, and at 3-month follow-up. A total of 37 female patients (13 SFT, 24 MFT) and 45 family members (16 SFT, 29 MFT) completed treatment. There were significant time effects for patients' BMI, eating disorder-related psychopathology and multiple family outcome measures. There were no differences between MFT and SFT on family outcome measures at end of treatment and 3 months post treatment. MFT is a feasible intervention that can be used in adult intensive treatment for those with AN.

  7. Comparative evaluation of long pulse alexandrite laser and intense pulsed light systems for pseudofolliculitis barbae treatment with one year of follow up

    Directory of Open Access Journals (Sweden)

    Leheta Tahra

    2009-01-01

    Full Text Available Background: Existing remedies for controlling pseudofolliculitis barbae (PFB are sometimes helpful; however the positive effects are often short lived. The only definitive cure for PFB is permanent removal of the hair follicle. Aims: Our aim was to compare the efficacy of the Alexandrite laser with the intense pulsed light system in the treatment of PFB and to follow up the recurrence. Methods: Twenty male patients seeking laser hair removal for the treatment of PFB were enrolled in this study. One half of the face was treated with the long-pulse Alexandrite laser and the other half was treated with the IPL system randomly. The treatment outcome and any complications were observed and followed up for one year. Results: All patients exhibited a statistically significant decrease in the numbers of papules. Our results showed that the Alexandrite-treated side needed seven sessions to reach about 80% improvement, while the IPL-treated side needed 10-12 sessions to reach about 50% improvement. During the one year follow up period, the Alexandrite-treated side showed recurrence in very minimal areas, while the IPL-treated side showed recurrence in bigger areas. Conclusions: Our results showed that both systems might improve PFB but Alexandrite laser was more effective at reducing PFB than IPL.

  8. Comparative study of temperature measurements in ex vivo swine muscle and a tissue-mimicking material during high intensity focused ultrasound exposures

    Science.gov (United States)

    Maruvada, S.; Liu, Y.; Pritchard, W. F.; Herman, B. A.; Harris, G. R.

    2012-01-01

    Tissue-mimicking materials (TMMs) can provide a convenient, stable, and reproducible means for testing high intensity focused ultrasound (HIFU) devices. When TMMs containing thermal sensors are used to measure ultrasound-induced temperature rise, it is important that measurement results reasonably represent those that occur in biological tissue. Therefore the aim of this paper is to compare the thermal behavior of the TMM under HIFU exposure to that of ex vivo tissue. This was accomplished using both a previously developed TMM and fresh ex vivo swine muscle that were instrumented with bare 50 µm thin wire thermocouples. HIFU at 825 kHz was focused at the thermocouple junction. 30 s exposures of increasing peak negative pressure (1 to 5 MPa) were applied and the temperature profile during and after sonication was recorded. B-mode imaging was used to monitor bubble activity during sonication. If bubble formation was noted during the sonication, the sonication was repeated at the same pressure levels two more times at 20 min intervals. Temperature traces obtained at various pressure levels demonstrated similar types of heating profiles in both the tissue and TMM, the exact nature of which depended on whether bubbles formed during the HIFU exposure. The onset of bubble activity occurred at lower ultrasonic pressures in the TMM, but the basic temperature rise features due to HIFU exposure were essentially the same for both materials.

  9. A comparative study of ternary Al-Sn-Cu immiscible alloys prepared by conventional casting and casting under high-intensity ultrasonic irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kotadia, H.R., E-mail: hiren.kotadia@kcl.ac.uk [Department of Physics, King' s College London, Strand, London WC2R 2LS (United Kingdom); Das, A. [Materials Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, SA2 8PP (United Kingdom); Doernberg, E.; Schmid-Fetzer, R. [Clausthal University of Technology, Institute of Metallurgy, Robert-Koch-Str. 42, D-38678 Clausthal-Zellerfeld (Germany)

    2011-12-15

    Highlights: Black-Right-Pointing-Pointer Systematic investigation on the solidification microstructure of ternary Al-Sn-Cu immiscible system aided by computational thermodynamics calculations. Black-Right-Pointing-Pointer Comparative study of conventional casting and casting under high-intensity ultrasonic irradiation. Black-Right-Pointing-Pointer Demonstrated the high effectiveness of ultrasound exposure during solidification. Black-Right-Pointing-Pointer Effect of cavitation on nucleation and the relative effects of cavitation and acoustic streaming on the dispersion of Sn-rich liquid phases have been explained from the experimental observation. Cavitation was found to promote fragmentation and dispersion of Sn-rich liquid leading to homogeneous dispersion of refined Sn phase. Microstructural modification was found to be contributed by cavitation and associated shockwave generation while bulk fluid flow under acoustic streaming was found to be less effective on the microstructure evolution. Black-Right-Pointing-Pointer Globular and highly refined {alpha}-Al formed near the radiator through enhanced heterogeneous nucleation in contrast to dendritic {alpha}-Al observed in conventional solidification. - Abstract: A comparative study on the microstructure of four ternary Al-Sn-Cu immiscible alloys, guided by the recent thermodynamic assessment of the system, was carried out with specific focus on the soft Sn particulate distribution in hard Al-rich matrix in the presence and absence of ultrasonic irradiation during solidification. The results clearly demonstrate high effectiveness of ultrasonication in promoting significantly refined and homogeneously dispersed microstructure, probably aided by enhanced nucleation and droplet fragmentation under cavitation. While conventional solidification produced highly segregated Sn phase at the centre and bottom of Sn-rich alloy ingots, ultrasonic treatment produced effective dispersion irrespective of the alloy constitution in

  10. Comparative Toxicity and Dosimetric Profile of Whole-Pelvis Versus Prostate Bed-Only Intensity-Modulated Radiation Therapy After Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Deville, Curtiland, E-mail: deville@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vapiwala, Neha [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Lin Haibo; Bar Ad, Voichita; Tochner, Zelig; Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2012-03-15

    Purpose: To assess whether whole-pelvis (WP) intensity modulated radiation therapy (IMRT) for prostate cancer (PCa) after prostatectomy is associated with increased toxicity compared to prostate-bed only (PB) IMRT. Methods and Materials: All patients (n = 67) undergoing postprostatectomy IMRT to 70.2 Gy at our institution from January 2006 to January 2009 with minimum 12-month follow-up were divided into WP (n = 36) and PB (n = 31) comparison groups. WP patients received initial pelvic nodal IMRT to 45 Gy. Pretreatment demographics, bladder and rectal dose-volume histograms, and maximum genitourinary (GU) and gastrointestinal (GI) toxicities were compared. Logistic regression models evaluated uni- and multivariate associations between pretreatment demographics and toxicities. Results: Pretreatment demographics including age and comorbidities were similar between groups. WP patients had higher Gleason scores, T stages, and preoperative prostate-specific antigen (PSA) levels, and more WP patients underwent androgen deprivation therapy (ADT). WP minimum (Dmin) and mean bladder doses, bladder volumes receiving more than 5 Gy (V5) and V20, rectal Dmin, and PB bladder and rectal V65 were significantly increased. Maximum acute GI toxicity was Grade 2 and was increased for WP (61%) vs. PB (29%) patients (p = 0.001); there was no significant difference in acute Grade {>=}2 GU toxicity (22% WP vs. 10% PB; p = 0.193), late Grade {>=}2 GI toxicity (3% WP vs. 0% PB; p = 0.678), or late Grade {>=}2 GU toxicity (28% WP vs. 19% PB; p = 0.274) with 25-month median follow-up (range, 12-44 months). On multivariate analysis, long-term ADT use was associated with Grade {>=}2 late GU toxicity (p = 0.02). Conclusion: Despite dosimetric differences in irradiated bowel, bladder, and rectum, WP IMRT resulted only in clinically significant increased acute GI toxicity in comparison to that with PB IMRT, with no differences in GU or late GI toxicity.

  11. Obesity associated noncommunicable disease burden

    Directory of Open Access Journals (Sweden)

    Jyoti Bala Banjare

    2016-01-01

    Full Text Available World is facing rapid transition in health sector for under nutrition and over nutrition. Obesity is a challenging epidemic and increased Body Mass Index (BMI influences on almost all body systems leading to development of non-communicable diseases. Chronic but slow growing non-infectious pathology of body organization give upsurge onset of non-communicable disorders. Obesity related Non-communicable diseases (NCDs leads to millions of deaths all around the world, rapidly becoming economic burden worldwide. Pathophysiology and extend of obesity is responsible for ill effects of health. In obesity Low grade Inflammation and antioxidant disproportion plays vital role in development of NCDs. Effective health education, professional counselling from public health authorities, free health care, and social insurance can be effective in controlling growing non communicable disease globally. The present analysis attempts to study association of obesity with different NCDs in terms of prevalence and underlying mechanisms.

  12. Evaluation of Burden Descent Model for Burden Distribution in Blast Furnace

    Institute of Scientific and Technical Information of China (English)

    Ping ZHOU; Peng-yu SHI; Yan-po SONG; Kai-le TANG; Dong FU; Chenn QZHOU

    2016-01-01

    Mathematical models for burden descending process have been applied to obtain whole burden structures in blast furnace,whereas the accuracy of those burden descent models has not been sufficiently investigated.Special evaluation method based on timeline burden profiles was established to quantitatively evaluate the error between ex-perimental and modeled burden structures.Four existing burden descent models were utilized to describe the burden structure of a 1/20 scaled warm blast furnace.Input modeling conditions including initial burden profile,descending volumes in each time interval,and normalized descending velocity distribution were determined via special image pro-cessing technology.Modeled burden structures were evaluated combined with the published experimental data.It is found that all the models caught the main profile of the burden structure.Furthermore,the improved nonuniform de-scent model (Model IV)shows the highest level of precision especially when burden descends with unstable velocity distribution tendency.Meanwhile,the traditional nonuniform descent model (Model III)may also be desirable to model the burden descending process when the burden descending velocity presents a linear tendency.Finally,the uni-form descent model (Model I)might be the first option for roughly predicting burden structure.

  13. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  14. Comparative study of diode laser versus neodymium-yttrium aluminum: garnet laser versus intense pulsed light for the treatment of hirsutism

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    Neerja Puri

    2015-01-01

    Full Text Available Introduction: Lasers are widely used for the treatment of hirsutism. But the choice of the right laser for the right skin type is very important. Before starting with laser therapy, it is important to assess the skin type, the fluence, the pulse duration and the type of laser to be used. Aims: To compare the efficacy and side effects of Diode laser, Neodymium-yttrium aluminum - garnet (Nd: YAG laser and intense pulsed light (IPL on 30 female patients of hirsutism. Materials and Methods: Thirty female patients with hirsutism were selected for a randomised controlled study. The patients were divided into three groups of 10 patients each. In group I patients diode laser was used, in group II patients long pulsed Nd: YAG laser was used and in group III, IPL was used. The patients were evaluated and result graded according to a 4-point scale as excellent, >75% reduction; good, 50-75% reduction; fair; 25-50% reduction; and poor, <25% reduction in hair density. Results: It was seen that the percentage of hair reduction after two sessions of treatment was maximum (40% in the diode laser group, followed by 35% hair reduction in the Nd: Yag laser group and 10% hair reduction in the IPL group. The percentage of hair reduction after four sessions of treatment was maximum (64% in the diode laser group, followed by 62% hair reduction in the Nd: Yag laser group and 48% hair reduction in the IPL group. The percentage of hair reduction after eight sessions of treatment was maximum (92% in the diode laser group, followed by 90% hair reduction in the Nd: YAG group and 70% hair reduction in the IPL group. Conclusions: To conclude for the Indian skin with dark hairs, the diode laser still stands the test of time. But, since the diode laser has a narrow margin of safety, proper pre and post-procedure cooling is recommended. Although, the side effects of Nd: YAG laser are less as compared to the diode laser, it is less efficacious as compared to the diode laser.

  15. Putting Evidence into Practice: nursing assessment and interventions to reduce family caregiver strain and burden.

    Science.gov (United States)

    Honea, Norissa J; Brintnall, Ruthann; Given, Barbara; Sherwood, Paula; Colao, Deirdre B; Somers, Susan C; Northouse, Laurel L

    2008-06-01

    Family caregiving often is associated with multiple rewards, yet the diversity and intensity of caregiving roles also can result in caregiver strain and burden. Using interventions to reduce the strain and burden on caregivers of patients with cancer is an important role nurses play. This article is a critical review and synthesis of the evidence regarding assessment tools and interventions aimed at reducing caregiver strain and burden in the oncology population. Although the striking finding is the limited number of interventions targeted toward oncology caregivers, suggestions from the literature are offered to support and promote healthy outcomes for family caregivers.

  16. A comparative analysis of 3D conformal deep inspiratory–breath hold and free-breathing intensity-modulated radiation therapy for left-sided breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reardon, Kelli A.; Read, Paul W.; Morris, Monica M. [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Reardon, Michael A. [Department of Radiology, University of Virginia, Charlottesville, VA (United States); Geesey, Constance [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Wijesooriya, Krishni, E-mail: kw5wx@hscmail.mcc.virginia.edu [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States)

    2013-07-01

    Patients undergoing radiation for left-sided breast cancer have increased rates of coronary artery disease. Free-breathing intensity-modulated radiation therapy (FB-IMRT) and 3-dimensional conformal deep inspiratory–breath hold (3D-DIBH) reduce cardiac irradiation. The purpose of this study is to compare the dose to organs at risk in FB-IMRT vs 3D-DIBH for patients with left-sided breast cancer. Ten patients with left-sided breast cancer had 2 computed tomography scans: free breathing and voluntary DIBH. Optimization of the IMRT plan was performed on the free-breathing scan using 6 noncoplanar tangential beams. The 3D-DIBH plan was optimized on the DIBH scan and used standard tangents. Mean volumes of the heart, the left anterior descending coronary artery (LAD), the total lung, and the right breast receiving 5% to 95% (5% increments) of the prescription dose were calculated. Mean volumes of the heart and the LAD were lower (p<0.05) in 3D-DIBH for volumes receiving 5% to 80% of the prescription dose for the heart and 5% for the LAD. Mean dose to the LAD and heart were lower in 3D-DIBH (p≤0.01). Mean volumes of the total lung were lower in FB-IMRT for dose levels 20% to 75% (p<0.05), but mean dose was not different. Mean volumes of the right breast were not different for any dose; however, mean dose was lower for 3D-DIBH (p = 0.04). 3D-DIBH is an alternative approach to FB-IMRT that provides a clinically equivalent treatment for patients with left-sided breast cancer while sparing organs at risk with increased ease of implementation.

  17. Economic and Disease Burden of Dengue in Mexico

    Science.gov (United States)

    Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J.; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S.

    2015-01-01

    Background Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. Methods and Findings We estimated the annual economic and disease burden of dengue in Mexico for the years 2010–2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000–253,000) symptomatic and 119 (95%CL: 75–171) fatal dengue episodes annually on average (2010–2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151–292) million, or $1.56 (95%CL: 1.38–2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87–209) million or $0.80 per capita (95%CL: 0.62–1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36–99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. Conclusion With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak

  18. Economic and disease burden of dengue in Mexico.

    Directory of Open Access Journals (Sweden)

    Eduardo A Undurraga

    2015-03-01

    Full Text Available Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies.We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000 symptomatic and 119 (95%CL: 75-171 fatal dengue episodes annually on average (2010-2011, compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292 million, or $1.56 (95%CL: 1.38-2.68 per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209 million or $0.80 per capita (95%CL: 0.62-1.12 corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99 disability-adjusted life years (DALYs per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden.With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of

  19. Greater effects of high- compared with moderate-intensity interval training on cardio-metabolic variables, blood leptin concentration and ratings of perceived exertion in obese adolescent females.

    Science.gov (United States)

    Racil, G; Coquart, J B; Elmontassar, W; Haddad, M; Goebel, R; Chaouachi, A; Amri, M; Chamari, K

    2016-06-01

    This study examined the effects of high- vs. moderate-intensity interval training on cardiovascular fitness, leptin levels and ratings of perceived exertion (RPE) in obese female adolescents. Forty-seven participants were randomly assigned to one of three groups receiving either a 1:1 ratio of 15 s of effort comprising moderate-intensity interval training (MIIT at 80% maximal aerobic speed: MAS) or high-intensity interval training (HIIT at 100% MAS), with matched 15 s recovery at 50% MAS, thrice weekly, or a no-training control group. The HIIT and MIIT groups showed improved (p HIIT group showed decreased waist circumference (WC) (p = 0.017). The effect of exercise on maximal oxygen uptake (VO2max) was significant (p = 0.019, ES = 0.48 and p = 0.010, ES = 0.57, HIIT and MIIT, respectively). The decrease of rate-pressure product (RPP) (p HIIT and MIIT, respectively) followed the positive changes in resting heart rate and blood pressures. Blood glucose, insulin level and the homeostasis model assessment index for insulin decreased (p HIIT and MIIT, respectively. In the post-intervention period, blood leptin was strongly associated with %BF (p HIIT and MIIT groups, respectively, while RPE was strongly associated with BM (p HIIT group. The results suggest that high-intensity interval training may produce more positive effects on health determinants in comparison with the same training mode at a moderate intensity.

  20. The complex liaison between cachexia and tumor burden (Review).

    Science.gov (United States)

    De Lerma Barbaro, Andrea

    2015-10-01

    Cachexia is a wasting syndrome that afflicts end-stage cancer patients. Whereas a consensus statement for a definition of cachexia recently has been accomplished, a useful measurement for this condition at present is lacking. The aim of the present review is to discuss the advantage of introducing the measurement of tumor burden for a better overall evaluation of cachexia. Our suggestion ensues from a somewhat novel perspective in the field of infectious disease research where a careful measurement of the pathogen load, between i.e. different host genotypes, leads to the definition of the concept of tolerance to the infectious insult. Indeed tolerance concurs, together the more classical resistance, in maintaining the host reproductive fitness or health state. Noticeably a similar reasoning may apply to tumor biology as well. Whereas the extent of cachexia increases with tumor burden, the relationship between these two correlates of tumor progression fluctuates in a broad range. We have selected from the literature studies in the rodent model where significant variation in the course of the wasting illness during cancer was observed and quantitatively assessed comparing experimental groups marked by different genotype, drug treatment, diet or gender. These studies may be further classified in two categories: the former where the experimental condition associated to milder cachexia is accompanied to a lesser tumor burden, the latter where the inhibition of cachexia results disentangled from the tumor burden, that is the whole number of cancer cells results unchanged or even, paradoxically, is increased. In addition we survey, even in the context of human malignancy, the significance and feasibility of plotting quantitative estimates of cachexia against the whole tumor burden. Ultimately, the principal endeavor of introducing the measurement of tumor burden, in both experimental and clinical oncology, may be to achieve a better assessment of the inter

  1. Formalising arguments about the burden of persuasion.

    NARCIS (Netherlands)

    Prakken, H.; Sartor, G.

    2007-01-01

    This paper presents an argument-based logic for reasoning about allocations of the burden of persuasion. The logic extends the system of Prakken (2001), which in turn modified the system of Prakken & Sartor (1996) with the possibility to distribute the burden of proof over both sides in an argument

  2. 40 CFR 179.91 - Burden of going forward; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns...

  3. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; Heide, Uulke A. van der; Herk, Marcel van [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-03-15

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade ≥1, ≥2, and ≥3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P<.001) with IG-IMRT for anorectum, anal canal, and bladder. The mean dose to the anorectum was 34.4 Gy versus 47.3 Gy (P<.001), 23.6 Gy versus 44.6 Gy for the anal canal (P<.001), and 33.1 Gy versus 43.2 Gy for the bladder (P<.001). Significantly lower grade ≥2 toxicity was observed for proctitis, stool frequency ≥6/day, and urinary frequency ≥12/day. IG-IMRT resulted in significantly lower overall RTOG grade ≥2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade ≥2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions.

  4. COMPARATIVE EVALUATION OF CENTRAL VENOUS VERSUS ARTERIAL BLOOD SAMPLE FOR REPETITIVE MEASUREMENTS IN CRITICALLY ILL PATIENTS ADMITTED IN INTENSIVE CARE UNIT

    Directory of Open Access Journals (Sweden)

    Rukhsana

    2015-08-01

    Full Text Available OBJECTIVES: The purpose of present study was to evaluate the reliability of central venous blood gas monitoring as an alternative to arterial blood gas monitoring and to assess that the central venous catheter is convenient and reliable source of blood for repetitive measurement of pH bicarbonate and PCO2 in critically ill patients admitted in surgical intensive care unit (SICU. METHODS: We took one hundred patients who required ABG analysis between 20 - 60 years of age. The cases were divided in four groups which constituted major admissions in SICU in one year. Out of one hundred patients for the study there were 19 Poisoning patients, 15 Trauma patients, 40 Major abdominal surgery patients, 26 Hypovolemic shock patients and others. Central Venous blood drawn within 5 min of an ABG measurement and the samples analyzed immediately on automated ABG analyzer were compared. RESULTS: Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements of arterial and venous blood with coefficient of correlation 0.979 for pH. The coefficient of correlation was highly positive i.e. 0.926 for PCO 2 and 0.955 for HCO 3 - which is statistically significant. There was also positive correlation for saturation between arterial and venous blood i.e. 0.57 with clinically acceptable difference and is statistically significant. The difference in pO 2 measurements was however higher with correlation coefficient of 0.259 although the arterial saturation and finger oximetry reveals a good degree of agreement with clinically acceptable bias. CONCLUSION: Venous blood gas (VBG analysis clearly does not replace ABG analysis in determining exact pO 2 status and arterial puncture may still be required for invasive arterial BP monitoring. With positive correlation and regression plots obtained, venous samples can be used as an alternative to arterial samples depending on the significant positive correlation values obtained for

  5. The burden of musculoskeletal conditions.

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    Clémence Palazzo

    Full Text Available OBJECTIVE: Despite the burden of rheumatic and musculoskeletal diseases (RMDs, these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability. METHODS: Data on disabilities associated with RMDs were extracted from the national 2008-2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the World Health Organization's International Classification of Functioning, Disability and Health for analysis. Diagnosis and disabilities were self-reported. We assessed the risk of disability associated with RMDs using odds ratios (ORs and the societal impact of RMDs using the average attributable fraction (AAF. RESULTS: Overall 27.7% (about 17.3 million people (95% CI 26.9-28.4% of the population reported having RMDs. The most prevalent RMDs were low back pain (12.5%, 12.1-13.1 and osteoarthritis (12.3%, 11.8-12.7. People reporting osteoarthritis were more disabled in walking (adjusted OR 1.9, 1.7-2.2 than those without. People reporting inflammatory arthritis were more limited in activities of daily living (from 1.4, 1.2-1.8 for walking to 2.1, 1.5-2.9 for moving around. From a societal perspective, osteoarthritis was the main contributor to activity limitations (AAF 22% for walking difficulties. Changing jobs was mainly attributed to neck pain (AAF 13% and low back pain (11.5%. CONCLUSION: RMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field.

  6. National Economic Burden Associated with Management of Periodontitis in Malaysia

    Directory of Open Access Journals (Sweden)

    Tuti Ningseh Mohd Dom

    2016-01-01

    Full Text Available Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010 data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  7. National Economic Burden Associated with Management of Periodontitis in Malaysia.

    Science.gov (United States)

    Mohd Dom, Tuti Ningseh; Ayob, Rasidah; Abd Muttalib, Khairiyah; Aljunid, Syed Mohamed

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  8. Economic Study of Global Tobacco Burden

    Science.gov (United States)

    In an interview on Cancer Currents, Dr. Mark Parascandola discusses findings from an economics study showing that, globally, tobacco use burdens economies with more than US $1 trillion annually in health care costs and lost productivity.

  9. The injury mortality burden in Guinea

    OpenAIRE

    Mamady Keita; Yao Hongyan; Zhang Xujun; Xiang Huiyun; Tan Hongzhuan; Hu Guoqing

    2012-01-01

    Abstract Background The injury mortality burden of Guinea has been rarely addressed. The paper aimed to report patterns of injury mortality burden in Guinea. Methods We retrieved the mortality data from the Guinean Annual Health Statistics Report 2007. The information about underlying cause of deaths was collected based on Guinean hospital discharge data, Hospital Mortuary and City Council Mortuary data. The causes of death are coded in the 9th International Classification of Diseases (ICD-9)...

  10. The Psychological Burden of Skin Diseases

    DEFF Research Database (Denmark)

    Dalgard, Florence J; Gieler, Uwe; Tomas-Aragones, Lucia

    2015-01-01

    The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational...... with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications....

  11. Application of Optimal Sinter Burden Design

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The application of the optimal sinter burden design in the sinter shop of No.1 Iron-making Plant in Tangshan Iron & Steel Corp was reported. By using burden calculation and simulating production under different situations, it is demonstrated that the technology can provide the relevant information in product quality and cost etc. for decision-makers. The technology has been used to guide production of the Sinter Shop since 2000, and a remarkable achievement has been obtained.

  12. Dementia caregiver burden: reliability of the Brazilian version of the Zarit caregiver burden interview

    Directory of Open Access Journals (Sweden)

    Anita Taub

    2004-04-01

    Full Text Available The object of this article is to examine the reliability of the Brazilian version of the Zarit Caregiver Burden Interview (ZBI. The instrument is a 22-item scale assessing the extent to which caregivers view their responsibilities as having an adverse impact on their social life, health, emotional well-being, and finances. We assessed 50 primary informal caregivers of demented patients coming from 3 different health care centers, using the test-retest method. Analysis of the results showed an intraclass reliability coefficient of 0.88, while Cronbach's coefficient alpha was 0.77 for the test and 0.80 for the retest items. The Brazilian version of ZBI shows sufficient reliability, comparable to the original version.

  13. Sacroiliac joint pain: burden of disease

    Directory of Open Access Journals (Sweden)

    Cher D

    2014-04-01

    Full Text Available Daniel Cher,1 David Polly,2 Sigurd Berven31SI-BONE, Inc., San Jose, CA, USA; 2Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA; 3Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USAObjectives: The sacroiliac joint (SIJ is an important and significant cause of low back pain. We sought to quantify the burden of disease attributable to the SIJ.Methods: The authors compared EuroQol 5D (EQ-5D and Short Form (SF-36-based health state utility values derived from the preoperative evaluation of patients with chronic SIJ pain participating in two prospective clinical trials of minimally invasive SIJ fusion versus patients participating in a nationally representative USA cross-sectional survey (National Health Measurement Study [NHMS]. Comparative analyses controlled for age, sex, and oversampling in NHMS. A utility percentile for each SIJ subject was calculated using NHMS as a reference cohort. Finally, SIJ health state utilities were compared with utilities for common medical conditions that were published in a national utility registry.Results: SIJ patients (number [n]=198 had mean SF-6D and EQ-5D utility scores of 0.51 and 0.44, respectively. Values were significantly depressed (0.28 points for the SF-6D utility score and 0.43 points for EQ-5D; both P<0.0001 compared to NHMS controls. SIJ patients were in the lowest deciles for utility compared to the NHMS controls. The SIJ utility values were worse than those of many common, major medical conditions, and similar to those of other common preoperative orthopedic conditions.Conclusion: Patients with SIJ pain presenting for minimally invasive surgical care have marked impairment in quality of life that is worse than in many chronic health conditions, and this is similar to other orthopedic conditions that are commonly treated surgically. SIJ utility values are in the lowest two deciles when compared to control populations

  14. Percepção dos alunos de ciências contábeis em relação à carga tributária no Brasil: um estudo comparativo entre alunos ingressantes e concluintes = Accounting students’ perception of the tax burden in Brazil: a comparative study between freshmen and senior students

    Directory of Open Access Journals (Sweden)

    Geordana Mendonça Curcino

    2013-03-01

    Full Text Available O objetivo geral deste artigo foi analisar comparativamente a percepção dos alunos ingressantes e concluintes de Graduação em Ciências Contábeis em relação à carga tributária no Brasil. Para atingir o citado objetivo, realizou-se um estudo descritivo, com abordagem quantitativa, e utilização de um questionário, que foi aplicado aos três primeiros e três últimos períodos do curso de Ciências Contábeis de uma universidade federal mineira. Tal questionário foi elaborado com três blocos, o primeiro destinado a coletar dados sobre o perfil da amostra e os dois últimos compostos por questões sobre a carga tributária. Para análise dos dados foi utilizado o teste t de Student, para a verificação da ocorrência ou não de significância estatística entre as diferenças de respostas obtidas dos grupos. Os resultados sugerem que houve poucas diferenças significativas entre as percepções dos graduandos iniciantes e concluintes em relação à carga tributária no Brasil e que, portanto, a condição de concluinte não conferiu aos discentes maiores conhecimentos do que aos iniciantes. Além disso, verificou-se que os concluintes possuem uma visão mais pessimista em relação ao sistema tributário nacional do que os iniciantes. The general purpose of this article was to make a comparative analysis of the perceptions of entering and graduating Accounting students in relation to the tax burden in Brazil. To achieve the purpose, a descriptive study was performed with a quantitative approach and a questionnaire was used, applied to the first three and last three periods of the Accounting course at a Federal University in Minas Gerais. This questionnaire was designed with three blocks, the first designed to collect data on the sample profile, and the last two consisting of questions about the tax burden. In data analysis, we used the Student's t test to verify the presence or absence of statistics significance between the

  15. The financial burden of medical spending: estimates and implications for evaluating the impact of ACA reforms.

    Science.gov (United States)

    Abramowitz, Joelle; O'Hara, Brett

    2015-04-01

    This article uses the 2013 Current Population Survey Annual Social and Economic Supplement to estimate the financial burden of medical out-of-pocket costs by comparing medical out-of-pocket expenditures to income. This measure is important for evaluating the magnitude of burden, better understanding who bears it, and establishing a baseline to assess the impact of the Patient Protection and Affordable Care Act. We examine the distribution of burden and the incidence of high burden across all families and by individuals' health insurance status and demographic and socioeconomic characteristics. We look more closely at one group vulnerable to having high burden: those younger than age 65 with incomes between 138% and 200% of the federal poverty line. We find that 18.5% of these individuals have incomes below the threshold of expansion Medicaid eligibility after accounting for non-over-the-counter medical expenses and examine the characteristics associated with being classified below this threshold.

  16. Comparing morbidity and cancer control after 3D-conformal (70/74 Gy) and intensity modulated radiotherapy (78/82 Gy) for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dolezel, Martin [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Charles University in Prague, First Faculty of Medicine, Prague (Czech Republic); Faculty of Medicine and Dentistry, Department of Oncology, Olomouc (Czech Republic); Odrazka, Karel [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Charles University in Prague, First Faculty of Medicine, Prague (Czech Republic); Charles University in Prague, Third Faculty of Medicine, Prague (Czech Republic); Zouhar, Milan; Jansa, Jan; Paluska, Petr [University Hospital Hradec Kralove, Department of Oncology and Radiotherapy, Hradec Kralove (Czech Republic); Vaculikova, Miloslava [Hospital Trutnov, Department of Oncology, Trutnov (Czech Republic); Sefrova, Jana [Hospital Prachatice, Department of Oncology, Prachatice (Czech Republic); Kohlova, Tereza [Proton Therapy Center, Prague (Czech Republic); Vanasek, Jaroslav [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Kovarik, Josef [The Freeman Hospital, Northern Centre for Cancer Care, Newcastle upon Tyne (United Kingdom)

    2015-04-01

    The purpose of this work was to compare toxicity and cancer control between patients with prostate cancer treated using three-dimensional conformal radiotherapy (3D-CRT) and those treated using intensity-modulated radiation therapy (IMRT). A total of 553 patients with prostate cancer were treated with 3D-CRT 70-74 Gy (3D-CRT 70, 3D-CRT 74) or IMRT 78-82 Gy (IMRT 78, IMRT/SIB 82). Late toxicity was scored according to FC-RTOG/LENT criteria. Biochemical failure was defined using the Phoenix and ASTRO definitions. The 5-year risk of grade 2-4 genitourinary toxicity was 26.3 % (3D-CRT 70), 27.2 % (3D-CRT 74), 17.3 % (IMRT 78), and 25.1 % (IMRT/SIB 82) without statistical differences. The 5-year risk of grade 2-4 gastrointestinal toxicity was 19.4 % (3D-CRT 70), 42.1 % (3D-CRT 74), 20.5 % (IMRT 78), and 26.6 % (IMRT/SIB 82). The differences between 3D-CRT 74 and 3D-CRT 70 and between 3D-CRT 74 and IMRT 78 were statistically significant (log rank p = 0.03). The 5-year Phoenix PSA relapse-free survival (PSA-RFS) in low-risk, intermediate-risk, and high-risk patients treated using 3D-CRT were 89.4, 65.5, and 57.8 %, respectively. Patients treated with IMRT achieved the following results: 90.9, 89.4, and 83.9 %. Clinical relapse-free survival (C-RFS) in patients treated using 3D-CRT vs. IMRT for the aforementioned groups were 94.7 vs. 100 %, 86.8 vs. 98.6 %, and 84.4 vs. 94.5 %. Disease-free survival (DFS) for patients treated using 3D-CRT were 83.1, 70.9, and 71.5 %. The IMRT group reached 95.8, 89.1, and 87.6 %. The PSA-RFS for intermediate- and high-risk patients were statistically significant, while C-RFS and DFS were marginally better. Dose escalation with IMRT was associated with improved cancer control in intermediate- and high-risk patients in comparison with 3D-CRT, without compromising toxicity. (orig.) [German] Es erfolgte ein Vergleich von Toxizitaet und Tumorkontrolle bei Patienten mit Prostatakarzinom nach der Behandlung mit dreidimensionaler konformaler

  17. Validation of the Burden Index of Caregivers (BIC, a multidimensional short care burden scale from Japan

    Directory of Open Access Journals (Sweden)

    Hagiwara Akiko

    2006-08-01

    Full Text Available Abstract Background We constructed a concise multidimensional care burden scale that reflects circumstances unique to Japan, with a focus on intractable neurological diseases. We surveyed 646 family caregivers of patients with intractable neurological diseases or stroke using 28 preliminary care burden scale items obtained from qualitative research. The results were used to finalize the feeling of care burden scale (BIC: burden index of caregivers, and verify its reliability and validity. Methods The survey was conducted among caregivers providing home health care to patients with intractable neurological diseases (PD [Parkinson's disease], SCD [spinocerebellar degeneration], MSA [multiple system atrophy], and ALS [amyotrophic lateral sclerosis] or CVA (cerebrovascular accident using a mailed, self-administered questionnaire between November, 2003 and May, 2004. Results Response rates for neurological and CVA caregivers were 50% and 67%, respectively, or 646 in total (PD, 279; SCD, 78; MSA, 39; ALS, 30; and CVA, 220. Item and exploratory factor analyses led to a reduction to 11 items, comprising 10 items from the 5 domains of time-dependent burden, emotional burden, existential burden, physical burden, and service-related burden; and 1 item on total burden. Examination of validity showed a moderate correlation between each domain of the BIC and the SF-8 (Health related quality of life scale, Short Form-8, while the correlation coefficient of the overall BIC and CES-D was 0.62. Correlation between the BIC and ZBI, a preexisting care burden scale, was high (r = 0.84, while that with the time spent on providing care was 0.47. The ICC (Intraclass correlation coefficient by test-retest reliability was 0.83, and 0.68 to 0.80 by individual domain. Conclusion These results show that the BIC, a new care burden scale comprising 11 items, is highly reliable and valid.

  18. Burden and mental health among caregivers of veterans with traumatic brain injury/polytrauma.

    Science.gov (United States)

    Griffin, Joan M; Lee, Minji K; Bangerter, Lauren R; Van Houtven, Courtney Harold; Friedemann-Sánchez, Greta; Phelan, Sean M; Carlson, Kathleen F; Meis, Laura A

    2017-01-01

    Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center. Structural equation modeling was used to examine the relationship between caregiver stress (i.e., veterans' neurobehavioral problems and intensity of care required), and caregiver well-being (i.e., caregiver burden and mental health). Analyses also examined how intrapersonal, family or social, and financial resources mediate and moderate the relationship between caregiver stress and well-being. Results indicate that veterans' neurobehavioral problems and intensity of required care were associated with more caregiver burden, and more burden was associated with poor mental health. Intrapersonal and family or social resources mediated the relationship between veteran functioning and mental health. Family or social resources also moderated the relationship between care intensity and burden. The model explained a moderate amount of variability in burden (59%) and a substantial amount in mental health (75%). We conclude that caregivers of veterans with neurobehavioral problems who require intense care are at risk for burden and poor mental health. Increasing resources to bolster family or social resources may reduce risks. (PsycINFO Database Record

  19. An International Comparative Analysis on China's Economic Growth and the Convergence in Energy Intensity Gap and Its Economic Mechanism%An International Comparative Analysis on China's Economic Growth and the Convergence in Energy Intensity Gap and Its Economic Mechanism

    Institute of Scientific and Technical Information of China (English)

    Qi Shaozhou; Yun Bo; Li Kai

    2011-01-01

    In this paper, the authors have empirically analyzed the convergence in per capita GDP gap and the convergence in the variation of energy intensity with respect to the change of per capita GDP between China and eight developed countries. Then, the authors run a regression on the impact of decisive factors of economic growth on energy intensity and its change, so as to find out the economic mechanism of energy intensity gap changing with respect to the variation of economic growth. This study concludes that: First, there is a convergence in per capita GDP gap between China and the eight developed countries. With the convergence in per capita GDP gap, the energy intensity gap between China and eight different countries also converge, and the convergence rate of the latter is faster than that of the former, i.e. if the per capita GDP gap between China and the eight developed countries decreases by 1%, the energy intensity gap between them will correspondingly decrease by 1.552%. Second, the energy intensity decreases with the improvement of industrial structure, the rising of energy prices, the advances of technology, and the expansion of investment in fixed assets, and it slightly increases with the increase of FDI. Third, the energy intensity gap between China and eight developed countries narrows with the lessening of the difference in fixed assets investment, energy prices, and technological progress between China and eight developed countries, yet increases with the narrowing of the difference in FDI, and has no significant correlation with the difference in industrial structure. Fourth, the narrowing of difference in per capita GDP between China and the eight developed countries can result in the lessening of energy intensity gap, whose economic mechanism is that the decisive factors, such as difference in investment, technology, and the competition mechanism of prices, which can determine the difference in economic growth, can significantly affect the energy

  20. Mobilized peripheral blood stem cells compared with bone marrow from HLA-identical siblings for reduced-intensity conditioning transplantation in acute myeloid leukemia in complete remission

    DEFF Research Database (Denmark)

    Nagler, Arnon; Labopin, Myriam; Shimoni, Avichai;

    2012-01-01

    to compare the outcome of mobilized peripheral blood stem cells (PBSC) (n = 1430) vs. bone marrow (BM) (n = 107) for acute myelogenous leukemia (AML) patients with complete remission that underwent RIC-alloSCT from compatible sibling donors. The leukemia features, the disease status, and the time from......, relapse, and NRM when comparing PBSC to BM grafts from sibling donors following RIC conditioning. This is the first study comparing PBSC to BM grafts in the RIC setting, analyzing a homogeneous population of patients with AML in remission. Whether PBSC should be preferred for advanced phases...

  1. Sound Intensity

    DEFF Research Database (Denmark)

    Crocker, M.J.; Jacobsen, Finn

    1997-01-01

    This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique....

  2. Hepatitis C virus infection in Argentina: Burden of chronic disease

    Institute of Scientific and Technical Information of China (English)

    Ezequiel; Ridruejo; Fernando; Bessone; Jorge; R; Daruich; Chris; Estes; Adrián; C; Gadano; Homie; Razavi; Federico; G; Villamil; Marcelo; O; Silva

    2016-01-01

    AIM: To estimate the progression of the hepatitis C virus(HCV) epidemic and measure the burden of HCVrelated morbidity and mortality. METHODS: Age- and gender-defined cohorts were used to follow the viremic population in Argentina and estimate HCV incidence, prevalence, hepatic complications, and mortality. The relative impact of two scenarios on HCV-related outcomes was assessed:(1) increased sustained virologic response(SVR); and(2) increased SVR and treatment.RESULTS: Under scenario 1, SVR raised to 85%-95% in 2016. Compared to the base case scenario, there was a 0.3% reduction in prevalent cases and liverrelated deaths by 2030. Given low treatment rates, cases of hepatocellular carcinoma and decompensated cirrhosis decreased < 1%, in contrast to the base case in 2030. Under scenario 2, the same increases in SVR were modeled, with gradual increases in the annual diagnosed and treated populations. This scenario decreased prevalent infections 45%, liver-related deaths 55%, liver cancer cases 60%, and decompensated cirrhosis 55%, as compared to the base case by 2030. CONCLUSION: In Argentina, cases of end stage liver disease and liver-related deaths due to HCV are still growing, while its prevalence is decreasing. Increasing in SVR rates is not enough, and increasing in the number of patients diagnosed and candidates for treatment is needed to reduce the HCV disease burden. Based on this scenario, strategies to increase diagnosis and treatment uptake must be developed to reduce HCV burden in Argentina.

  3. Somatostatin Negatively Regulates Parasite Burden and Granulomatous Responses in Cysticercosis

    Directory of Open Access Journals (Sweden)

    Mitra Khumbatta

    2014-01-01

    Full Text Available Cysticercosis is an infection of tissues with the larval cysts of the cestode, Taenia  solium. While live parasites elicit little or no inflammation, dying parasites initiate a granulomatous reaction presenting as painful muscle nodules or seizures when cysts are located in the brain. We previously showed in the T. crassiceps murine model of cysticercosis that substance P (SP, a neuropeptide, was detected in early granulomas and was responsible for promoting granuloma formation, while somatostatin (SOM, another neuropeptide and immunomodulatory hormone, was detected in late granulomas; SOM’s contribution to granuloma formation was not examined. In the current studies, we used somatostatin knockout (SOM−/− mice to examine the hypothesis that SOM downmodulates granulomatous inflammation in cysticercosis, thereby promoting parasite growth. Our results demonstrated that parasite burden was reduced 5.9-fold in SOM−/− mice compared to WT mice (P<0.05. This reduction in parasite burden in SOM−/− mice was accompanied by a 95% increase in size of their granulomas (P<0.05, which contained a 1.5-fold increase in levels of IFN-γ and a 26-fold decrease in levels of IL-1β (P<0.05 for both compared to granulomas from WT mice. Thus, SOM regulates both parasite burden and granulomatous inflammation perhaps through modulating granuloma production of IFN-γ and IL-1β.

  4. Dietary burden calculations relating to fish metabolism studies.

    Science.gov (United States)

    Schlechtriem, Christian; Pucher, Johannes; Michalski, Britta

    2016-03-30

    Fish farming is increasingly dependent on plant commodities as a source of feed leading to an increased risk for pesticide residues in aquaculture diets and consequently their transfer into aquaculture food products. The European pesticide regulation requires fish metabolism and fish feeding studies where residues in fish feed exceed 0.1 mg kg(-1) of the total diet (dry weight basis) to enable the setting of appropriate maximum residue levels in fish commodities. Fish dietary burden calculation is therefore an important prerequisite to decide on further experimental testing as part of the consumer risk assessment. In this review, the different aquaculture production systems are compared with regard to their specific feeding practices and the principles of dietary burden calculation are described.

  5. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  6. A comparative analysis of computational approaches to relative protein quantification using peptide peak intensities in label-free LC-MS proteomics experiments.

    Science.gov (United States)

    Matzke, Melissa M; Brown, Joseph N; Gritsenko, Marina A; Metz, Thomas O; Pounds, Joel G; Rodland, Karin D; Shukla, Anil K; Smith, Richard D; Waters, Katrina M; McDermott, Jason E; Webb-Robertson, Bobbie-Jo

    2013-02-01

    Liquid chromatography coupled with mass spectrometry (LC-MS) is widely used to identify and quantify peptides in complex biological samples. In particular, label-free shotgun proteomics is highly effective for the identification of peptides and subsequently obtaining a global protein profile of a sample. As a result, this approach is widely used for discovery studies. Typically, the objective of these discovery studies is to identify proteins that are affected by some condition of interest (e.g. disease, exposure). However, for complex biological samples, label-free LC-MS proteomics experiments measure peptides and do not directly yield protein quantities. Thus, protein quantification must be inferred from one or more measured peptides. In recent years, many computational approaches to relative protein quantification of label-free LC-MS data have been published. In this review, we examine the most commonly employed quantification approaches to relative protein abundance from peak intensity values, evaluate their individual merits, and discuss challenges in the use of the various computational approaches.

  7. A Comparative Analysis of Computational Approaches to Relative Protein Quantification Using Peptide Peak Intensities in Label-free LC-MS Proteomics Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Matzke, Melissa M.; Brown, Joseph N.; Gritsenko, Marina A.; Metz, Thomas O.; Pounds, Joel G.; Rodland, Karin D.; Shukla, Anil K.; Smith, Richard D.; Waters, Katrina M.; McDermott, Jason E.; Webb-Robertson, Bobbie-Jo M.

    2013-02-01

    Liquid chromatography coupled with mass spectrometry (LC-MS) is widely used to identify and quantify peptides in complex biological samples. In particular, label-free shotgun proteomics is highly effective for the identification of peptides and subsequently obtaining a global protein profile of a sample. As a result, this approach is widely used for discovery studies. Typically, the objective of these discovery studies is to identify proteins that are affected by some condition of interest (e.g. disease, exposure). However, for complex biological samples, label-free LC-MS proteomics experiments measure peptides and do not directly yield protein quantities. Thus, protein quantification must be inferred from one or more measured peptides. In recent years, many computational approaches to relative protein quantification of label-free LC-MS data have been published. In this review, we examine the most commonly employed quantification approaches to relative protein abundance from peak intensity values, evaluate their individual merits, and discuss challenges in the use of the various computational approaches.

  8. Caregivers’ burden in patients with COPD

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Objective Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. Methods We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. Results A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. Conclusion The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions. PMID:25709429

  9. The comparative analysis and improvement of theoretic-methodical approaches concerning the estimation of strategy of the large enterprises on the markets with the intensive competition

    Directory of Open Access Journals (Sweden)

    O.A. Bilovodska

    2010-12-01

    Full Text Available In this article the comparative analysis of existent approaches concerning to the estimation of strategies of enterprises is made. Besides, the theoretic-methodical approach concerning the estimation of strategy of the enterprises is improved on the basis of accounting of the strategic aim of the enterprise and also interests of the manufacturer and goods consumer.

  10. Comparative study of the fatty acid binding process of a new FABP from Cherax quadricarinatus by fluorescence intensity, lifetime and anisotropy.

    Directory of Open Access Journals (Sweden)

    Jiayao Li

    Full Text Available Fatty acid-binding proteins (FABPs are small cytosolic proteins, largely distributed in invertebrates and vertebrates, which accomplish uptake and intracellular transport of hydrophobic ligands such as fatty acids. Although long chain fatty acids play multiple crucial roles in cellular functions (structural, energy metabolism, regulation of gene expression, the precise functions of FABPs, especially those of invertebrate species, remain elusive. Here, we have identified and characterized a novel FABP family member, Cq-FABP, from the hepatopancreas of red claw crayfish Cherax quadricarinatus. We report the characterization of fatty acid-binding affinity of Cq-FABP by four different competitive fluorescence-based assays. In the two first approaches, the fluorescent probe 8-Anilino-1-naphthalenesulfonate (ANS, a binder of internal cavities of protein, was used either by directly monitoring its fluorescence emission or by monitoring the fluorescence resonance energy transfer occurring between the single tryptophan residue of Cq-FABP and ANS. The third and the fourth approaches were based on the measurement of the fluorescence emission intensity of the naturally fluorescent cis-parinaric acid probe or the steady-state fluorescence anisotropy measurements of a fluorescently labeled fatty acid (BODIPY-C16, respectively. The four methodologies displayed consistent equilibrium constants for a given fatty acid but were not equivalent in terms of analysis. Indeed, the two first methods were complicated by the existence of non specific binding modes of ANS while BODIPY-C16 and cis-parinaric acid specifically targeted the fatty acid binding site. We found a relationship between the affinity and the length of the carbon chain, with the highest affinity obtained for the shortest fatty acid, suggesting that steric effects primarily influence the interaction of fatty acids in the binding cavity of Cq-FABP. Moreover, our results show that the binding affinities

  11. The humanistic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette

    2014-01-01

    and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical......Hereditary angioedema (HAE) is a rare but potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The broad range of consequences of HAE on patients? lives is not well understood. The study objective was to comprehensively characterize the burden of illness...

  12. Endoscopy as a novel method for assessing endoparasite burdens in free-ranging European shags (Phalacrocorax aristotelis)

    OpenAIRE

    2013-01-01

    1. Parasites are considered to be a key driver of evolutionary processes in wild animal populations. However, assessing host-endoparasite burdens non-destructively is problematic. Collection of faecal samples can be difficult, and faecal egg counts may not always be a reliable indicator of infection intensity. 2. Here we report on endoscopy as a method for assessing natural burdens of nematode parasites Contracaecum rudolphii Hartwich, 1964, in a wild seabird, the European shag (Phalacroco...

  13. [Comparative analysis of application of highly intensive laser irradiation and electrocoagulation during laparoscopic cholecystectomy performed for destructive forms of an acute calculous cholecystitis].

    Science.gov (United States)

    Nichitayio, M Yu; Bazyak, A M; Klochan, V V; Grusha, P K; Goman, A V

    2015-02-01

    Comparative analysis of results of the laser diode (the wave length 940 nm) and elec- trocoagulation application while performing laparoscopic cholecystectomy was con- ducted. For an acute calculous cholecystitis 52 patients were operated, in whom instead of electrocoagulation the laser was applied, provide for reduction of thermal impact on tissues, the complications absence, reduction of the patients stationary treatment duration postoperatively from (5.2 ± 1.2) to (4.9 ± 0.6) days.

  14. Dealing with uncertainties in environmental burden of disease assessment

    Directory of Open Access Journals (Sweden)

    van der Sluijs Jeroen P

    2009-04-01

    Full Text Available Abstract Disability Adjusted Life Years (DALYs combine the number of people affected by disease or mortality in a population and the duration and severity of their condition into one number. The environmental burden of disease is the number of DALYs that can be attributed to environmental factors. Environmental burden of disease estimates enable policy makers to evaluate, compare and prioritize dissimilar environmental health problems or interventions. These estimates often have various uncertainties and assumptions which are not always made explicit. Besides statistical uncertainty in input data and parameters – which is commonly addressed – a variety of other types of uncertainties may substantially influence the results of the assessment. We have reviewed how different types of uncertainties affect environmental burden of disease assessments, and we give suggestions as to how researchers could address these uncertainties. We propose the use of an uncertainty typology to identify and characterize uncertainties. Finally, we argue that uncertainties need to be identified, assessed, reported and interpreted in order for assessment results to adequately support decision making.

  15. The burden of insomnia in Japan

    Directory of Open Access Journals (Sweden)

    Mishima K

    2015-01-01

    Full Text Available Kazuo Mishima,1 Marco daCosta DiBonaventura,2 Hillary Gross2 1Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 2Kantar Health, New York, NY, USA Objectives: Several studies have suggested that patients who experience insomnia report a number of significant impairments. However, despite this literature, fewer studies have focused on the burden of insomnia among patients in Japan. The objective of the current study is to extend this work in Japan to further understand the effect of insomnia on health-related quality of life (hrQOL. Further, another objective is to understand general predictors of hrQOL among patients with insomnia. Methods: Data from the 2012 Japan National Health and Wellness Survey, an annual, cross-sectional study of adults aged 18 years or older, were used (N=30,000. All National Health and Wellness Survey respondents were categorized based on the incidence of self-reported insomnia diagnosis and prescription medication usage (clinical insomniacs under treatment versus [vs] good sleepers without insomnia or insomnia symptoms. Comparisons among different groups were made using multiple regression models controlling for demographics and health history. Results: Clinical insomniacs (n=1,018; 3.4% reported significantly worse hrQOL compared with good sleepers (n=20,542 (mental component summary: 34.2 vs 48.0; physical component summary: 48.0 vs 52.8; health utilities: 0.61 vs 0.76; all P<0.05. Health behaviors (smoking, exercise, alcohol use and comorbidities were the strongest predictors of health utilities for clinical insomniacs. For all three clinical insomniac subgroups of interest, those with a physical comorbidity but not a psychiatric one, those with a psychiatric comorbidity but not a physical one, and those without either a physical or psychiatric comorbidity, large decrements in health utilities were observed for respondents who did

  16. Burden of disease due to cancer in Spain

    Directory of Open Access Journals (Sweden)

    Pérez-Gómez Beatriz

    2009-01-01

    Full Text Available Abstract Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs. Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models, duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function and disability (weights published in the literature for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population, 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability.

  17. A neurodegenerative vascular burden index and the impact on cognition

    Directory of Open Access Journals (Sweden)

    Sebastian eHeinzel

    2014-07-01

    Full Text Available A wide range of vascular burden factors have been identified to impact vascular function and structure as indicated by carotid intima-media thickness (IMT. On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI. Since many vascular factors increase the risk of Alzheimer's disease (AD, a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages.We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102 for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication and/or blood marker data were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT and the CERAD neuropsychological battery.IMT was significantly predicted by age (standardized β = .26, sex (.09; males > females and the factors included in the VBI: obesity (.18, hypertension (.14, smoking (.08, diabetes (.07, and atherosclerosis (.05, whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT (≥1.0 mm. The VBI showed an impact on executive control (log(TMT B-A, p = .047 and a trend towards decreased global cognitive function (CERAD total score, p = .057 independent of age, sex and education.A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and

  18. Clearance of Fungal Burden during Treatment of Disseminated Histoplasmosis with Liposomal Amphotericin B versus Itraconazole

    OpenAIRE

    Wheat, L. Joseph; Cloud, Gretchen; Johnson, Philip C.; Connolly,Patricia; Goldman, Mitchell; Le Monte, Ann; Fuller, Deanna E.; Davis, Thomas E.; Hafner, Richard

    2001-01-01

    Animal studies have shown that fungal burden correlates with survival during treatment with new antifungal therapies for histoplasmosis. The purpose of this report is to compare the clearance of fungal burden in patients with histoplasmosis treated with liposomal amphotericin B versus itraconazole. In two separate closed clinical trials that evaluated the efficacy of liposomal amphotericin B and itraconazole treatment of disseminated histoplasmosis in patients with AIDS, blood was cultured fo...

  19. Spousal role and caregiver burden in HIV affected families in Anhui Province, China.

    Science.gov (United States)

    Hsieh, Julie; Li, Li; Lin, Chunqing; Luo, Sitong; Ji, Guoping

    2017-03-09

    This study examined the burden experienced by various roles of family caregivers of people living with HIV (PLH), in particular spouses vs. non-spouses. A total of 475 family members of PLH were recruited from Anhui Province, China. Participants responded to a survey using the Computer Assisted Personal Interview method. The assessment collected data on demographic characteristics and their perceived caregiver burden, which was compared between spouses and non-spouses. Multiple regression models were built to identify factors associated with caregiver burden. About 64.4% of our study participants were female and the mean age was 42.1 years. Among various relationships to PLH, almost half reported being a spouse. Spouses reported significantly higher caregiver burden than non-spouses. In addition, older age and lower family income were significantly associated with higher level of caregiver burden. Among the subsample of spouses, significantly higher level of caregiver burden was identified among wives. Future studies should give special consideration to address the needs of female spouses in order to reduce their caregiver burden.

  20. Burden of Illness in Hereditary Angioedema

    DEFF Research Database (Denmark)

    Bygum, Anette; Aygören-Pürsün, Emel; Beusterien, Kathleen

    2015-01-01

    The objective of the Hereditary Angioedema Burden of Illness Study in Europe was to assess the real-world experience of HAE from the patient perspective. Based on open-ended qualitative interviews with 30 patients from Spain, Germany and Denmark, 5 key themes emerged characterizing the impact...

  1. 78 FR 42893 - Statement on Regulatory Burden

    Science.gov (United States)

    2013-07-18

    ... serve the credit needs of its customers, i.e., America's farmers, ranchers, aquatic producers and... CREDIT ADMINISTRATION 12 CFR Chapter VI RIN 3052-AC88 Statement on Regulatory Burden AGENCY: Farm Credit Administration. ACTION: Notice of intent; request for comment. SUMMARY: The Farm Credit Administration (FCA,...

  2. 77 FR 47328 - Reducing Regulatory Burden

    Science.gov (United States)

    2012-08-08

    ... health and safety, and other advantages; distributive impacts; and equity). The regulatory process... businesses and the public. Agencies consider low-cost approaches that reduce burdens and maintain flexibility...-regulatory-system . The Department is committed to maintaining a consistent culture of retrospective...

  3. Periodontal inflamed surface area : quantifying inflammatory burden

    NARCIS (Netherlands)

    Nesse, Willem; Abbas, Frank; van der Ploeg, Ids; Spijkervet, Frederik Karst Lucien; Dijkstra, Pieter Ubele; Vissink, Arjan

    2008-01-01

    Background: Currently, a large variety of classifications is used for periodontitis as a risk factor for other diseases. None of these classifications quantifies the amount of inflamed periodontal tissue, while this information is needed to assess the inflammatory burden posed by periodontitis. Aim:

  4. The Global Burden of Cancer 2013

    NARCIS (Netherlands)

    Fitzmaurice, C.; Geleijnse, J.M.; Naghavi, M.R.; et al.,

    2015-01-01

    Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs),

  5. [Comparative sensitivity of several laboratory animals to infection by nasal instillation of the saprophytic phase of Emmonsia crescens Emmons & Jellison, 1960: frequency and intensity of parasitism, histological reactions].

    Science.gov (United States)

    Boisseau-Lebreuil, M T

    1975-11-21

    Comparative observations were made on the development of Emmonsia crescens in the lungs of laboratory rats and mice, golden hamsters and guinea pigs after a nasal instillation of a heavy suspension of the saprophytic phase of the fungus. 95% of 80 experimental rats were found to be parasited against 80% of 200 inoculated mice, while only 30% of 70 hamsters and all of 4 guinea pigs showed an infection. The lungs of the mice, rats and guinea pigs were frequently more heavily infected than those of the hamsters. In addition, the adiaspores obtained from the mice and rats had, on average, a diameter double those from the hamsters and their walls were thicker. Thus, the laboratory mice and rats were shown to be better hosts of E. crescens than were golden hamsters.

  6. Burden of chikungunya in India: estimates of disability adjusted life years (DALY lost in 2006 epidemic

    Directory of Open Access Journals (Sweden)

    K. Krishnamoorthy

    2009-02-01

    Full Text Available Background & objectives: During 2006, chikungunya emerged as a major ever known epidemic in India. Disability adjusted life years (DALY is an appropriate summary measure of population health to express epidemiological burden of diseases. We estimated the burden due to suspected chikungunya using DALYs for the first time and compared between the states and also with the burden due to other vector-borne diseases in India. The economic burden was also assessed in terms of productivity loss.Methods: Data on the reported cases of fever/suspected cases of chikungunya from different states during 2006 in India were used. Years lived with disability (YLD were calculated for non-fatal cases to estimate DALY. Since the disability weight for chikungunya is not available, the weights available for rheumatic arthritis, comparable to the disease outcome of chikungunya were used for the estimation. The burden was estimated for both acute and chronic cases. It is considered that about 11.5% of cases were reported to have extended morbidity with persisting arthralgia. For acute disease, the average duration of illness was considered to be nine days and for chronic cases it was six months on an average. The productivity loss due to income foregone by the working class was calculated using minimum official wage.Results: National burden of chikungunya was estimated to be 25,588 DALYs lost during 2006 epidemic, with an overall burden of 45.26 DALYs per million. It varied from 0.01 to 265.62 per million in different states. Karnataka alone contributed as high as 55% of the national burden. Persistent arthralgia was found to impose heavy burden, accounting for 69% of the total DALYs. The productivity loss in terms of income foregone was estimated to be a minimum of Rs. 391 million. Interpretation & conclusion: The chikungunya epidemic in the year 2006 imposed heavy epidemiological burden and productivity loss to the community. The burden of chikungunya in terms of

  7. Power generation from chemically cleaned coals: do environmental benefits of firing cleaner coal outweigh environmental burden of cleaning?

    DEFF Research Database (Denmark)

    Ryberg, Morten W.; Owsianiak, Mikolaj; Laurent, Alexis;

    2015-01-01

    Power generation from high-ash coals is a niche technology for power generation, but coal cleaning is deemed necessary to avoid problems associated with low combustion efficiencies and to minimize environmental burdens associated with emissions of pollutants originating from ash. Here, chemical...... itself, it is demonstrated that for a wide range of cleaning procedures and types of coal, chemical cleaning generally performs worse than combustion of the raw coals and physical cleaning using dense medium separation. These findings apply for many relevant impact categories, including climate change....... Chemical cleaning can be optimized with regard to electricity, heat and methanol use for the hydrothermal washing step, and could have environmental impact comparable to that of physical cleaning if the overall resource intensiveness of chemical cleaning is reduced by a factor 5 to 10, depending...

  8. Comparative studies of peak intensities and chromatographic separation of proteolytic digests, PTMs, and intact proteins obtained by nanoLC-ESI MS analysis at room and elevated temperatures.

    Science.gov (United States)

    Moskovets, Eugene V; Ivanov, Alexander R

    2016-06-01

    This work demonstrates that the chromatographic separation performed at highly stabilized elevated temperature results in significant improvements in sensitivity, quantitative accuracy, chromatographic resolution, and run-to-run reproducibility of nanoLC-MS analysis of complex peptides mixtures. A newly developed platform was shown to provide conditions for accurate temperature stabilization and temperature homogeneity when performing nanoLC-ESI MS analysis. We quantitatively assessed and compared the recovery of peptides and small proteins from nanoLC columns at room and elevated temperatures. We found that analyses performed at highly stabilized elevated temperatures led to improved detection sensitivity, reproducibility, and chromatographic resolution in reversed-phase LC separation of unmodified peptides (both hydrophilic and hydrophobic), post-translationally modified peptides (O-phosphorylated), and small intact proteins. The analytical benefits of elevated temperatures for qualitative and quantitative proteomic LC-MS profiling were demonstrated using mixtures of synthetic peptides, tryptic digests of mixtures of model proteins, and digested total lysates of isolated rat kidney mitochondria. The effect of elevated temperature on the ion suppression was also demonstrated. Graphical Abstract A fragment of overlaid LC retention time-m/z planar views demonstrates the improved separation performance in the analysis of a complex peptide mixture at elevated temperature. Retention time-m/z 2D peptide features detected at 60 °C (magenta) were matched and aligned with features detected at room temperature (green).

  9. The Danish Intensive Care Database

    DEFF Research Database (Denmark)

    Christiansen, Christian Fynbo; Møller, Morten Hylander; Nielsen, Henrik

    2016-01-01

    AIM OF DATABASE: The aim of this database is to improve the quality of care in Danish intensive care units (ICUs) by monitoring key domains of intensive care and to compare these with predefined standards. STUDY POPULATION: The Danish Intensive Care Database (DID) was established in 2007...

  10. A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

    Science.gov (United States)

    Harde, Minal; Bhadade, Rakesh; Iyer, Hemlata; Jatale, Amol; Tiwatne, Sagar

    2016-01-01

    Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h) postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24), of them 7% (14) were from PACU and 5% (10) were from ward (P = 0.5285). Positive skin swab culture was 38% (150), of them 20% (80) were from PACU and 18% (70) were from ward (P = 0.3526). The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053–0.2289). The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary. PMID:27076712

  11. A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

    Directory of Open Access Journals (Sweden)

    Minal Harde

    2016-01-01

    Full Text Available Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24, of them 7% (14 were from PACU and 5% (10 were from ward (P = 0.5285. Positive skin swab culture was 38% (150, of them 20% (80 were from PACU and 18% (70 were from ward (P = 0.3526. The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053–0.2289. The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary.

  12. Burden of diseases estimates associated to different red meat cooking practices

    DEFF Research Database (Denmark)

    Berjia, Firew Lemma; Poulsen, Morten; Nauta, Maarten

    2014-01-01

    , affected population, intake and dose–response data are obtained by literature survey. The selected endpoints are four types of cancer: colorectal, prostate, breast and pancreatic. The burden of disease per cooking practice, endpoint, sex and age is estimated in the Danish population, using disability......The burden of disease estimate has been performed for diseases attributable to nutritional deficiency, foodborne pathogens, the environment, infection and other factors. However, the burden of disease estimate attributable to different food processing practices has not been investigated before....... The aim of this study is to compare the burden of disease estimate attributed to red meat consumption processed using different cooking practices.The red meat cooking practices were categorized into three: (A) barbecuing/grilling; (B) frying/broiling and (C) roasting/baking. The associated endpoints...

  13. Global Burden Of Disease Studies: Implications For Mental And Substance Use Disorders.

    Science.gov (United States)

    Whiteford, Harvey; Ferrari, Alize; Degenhardt, Louisa

    2016-06-01

    Global Burden of Disease studies have highlighted mental and substance use disorders as the leading cause of disability globally. Using the studies' findings for policy and planning requires an understanding of how estimates are generated, the required epidemiological data are gathered, disability and premature mortality are defined and counted, and comparative risk assessment for risk-factor analysis is undertaken. The high burden of mental and substance use disorders has increased their priority on the global health agenda, but not enough to prompt concerted action by governments and international agencies. Using Global Burden of Disease estimates in health policy and planning requires combining them with other information such as evidence on the cost-effectiveness of interventions designed to reduce the disorders' burden. Concerted action is required by mental health advocates and policy makers to assemble this evidence, taking into account the health, social, and economic challenges facing each country.

  14. 证明责任与举证责任的辨析%The Distinction between the Burden of Proof and Burden of Production

    Institute of Scientific and Technical Information of China (English)

    付奇艺

    2014-01-01

    学界对证明责任与举证责任的概念之争可以说从引进相关制度、概念以来就从未停止过。无论是从比较法角度,还是从证明责任的源流,还是从表意的精确和适用的频率上考究,证明责任与举证责任都是两个具有不同内涵的概念,不应将两者混为一谈。出于立法措辞惯例和现实司法实践的考虑,新刑事诉讼法采用了“举证责任”的措辞。证明责任天然涵盖举证责任和说服责任;美国严格区分证明责任和举证责任;坚持举证责任的措辞将导致损害犯罪嫌疑人、被告人合法权利的情况出现。因此,应将“举证责任”的立法措辞改为“证明责任”。%The dispute on the concepts of the burden of proof and burden of production has never stopped since relevant systems and concepts were introduced. Whether investigated from the angle of comparative law, or from origin and development, or from accuracy in expressing purport and frequency of application, they are two concepts with different connotations and should not be confused. Considered from the convention of legislative diction and judiciary practice in reality, the new Criminal Procedure Law employs the term“burden of production”. The burden of proof naturally incorporates burden of production;the burden of proof and burden of production are strictly distinguished from each other in America;the insistent use of the term“burden of production” will result in the situations of suspects and defendants’ legitimate rights being damaged. In view of this, the term“burden of production”should be changed into“the burden of proof”in the new Criminal Procedure Law.

  15. Caregiver Burden in Fragile X Families.

    Science.gov (United States)

    Iosif, Ana-Maria; Sciolla, Andres F; Brahmbhatt, Khyati; Seritan, Andreea L

    2013-02-01

    Complex caregiving issues occur in multigenerational families carrying the fragile X mutation and premutation. The same family members may care for children or siblings with fragile X syndrome (FXS) and for elderly parents with fragile X-associated tremor/ataxia syndrome (FXTAS). Family caregivers experience anxiety, depression, neglect of personal health care needs, employment difficulties, and loss of social support, leading to isolation and further psychiatric consequences. There is growing awareness of caregiver burden with regard to parents of children with FXS, but much less is known about the needs of informal caregivers of patients with FXTAS. In this paper, we review the available literature to date and provide suggestions for further exploration of caregivers' needs. Evidence-based strategies to address these needs are included. Many more research studies exploring caregiver burden in multigenerational fragile X families are needed, as well as studies aimed at investigating interventions and their impact on reduction.

  16. Marine Corps expeditionary rifle platoon energy burden

    OpenAIRE

    2014-01-01

    Approved for public release; distribution is unlimited In 2009, the Commandant of the Marine Corps declared energy a top priority and created the U.S. Marine Corps (USMC) Expeditionary Energy Office to develop an energy strategy to reduce and optimize energy usage throughout the Marine Corps. This thesis examines the operational tasks and capabilities that drive the current USMC rifle platoon’s energy burdens using an Expeditionary Warrior 2012 war-game scenario. The primary conclusion of ...

  17. Administrative burdens and dairy industry competitiveness

    OpenAIRE

    Bremmers, H.J.; Poppe, K.J.; Wijnands, J.H.M.; Meulen, van der, GG George

    2008-01-01

    The goal of this paper is to assess the effect of regulatory burdens in the European dairy industry on its competitiveness. A theoretical foundation is provided by transaction cost economics and total quality management insights. The effects of legislation on administrative requirements and competitiveness are supposed to be mediated by impacts on innovativeness, company strategy, food safety system availability, as well as the available information & communication capabilities. We will conne...

  18. Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: a comparative dosimetric planning study

    Energy Technology Data Exchange (ETDEWEB)

    Gorayski, Peter; Fitzgerald, Rhys; Barry, Tamara [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Burmeister, Elizabeth [Nursing Practice Development Unit, Princess Alexandra Hospital and Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Queensland (Australia); Foote, Matthew [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Diamantina Institute, University of Queensland, Brisbane, Queensland (Australia)

    2014-06-15

    Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN. Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared. IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose. Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI.

  19. Tobacco and the Escalating Global Cancer Burden

    Directory of Open Access Journals (Sweden)

    Richard F. Oppeltz

    2011-01-01

    Full Text Available The global burden of cancer is escalating as a result of dramatic increases in the use of tobacco in the developing world. The use of tobacco is linked to the development of a broad variety of cancers, mainly lung cancer, the single most common cancer in the world. Tobacco smoking-attributable deaths extends beyond cancer and include stroke, heart attack and COPD. Widening disparities in cancer-related mortality have shifted towards a more dramatic burden in the developing world. Appropriate interventions must be implemented to reduce tobacco use and prevent global mortality that has escalated to epidemic levels. Tobacco control policies, including public health advertisement campaigns, warning labels, adoption of smoke-free laws, comprehensive bans and tax policies are highly effective measures to control tobacco use. Clinicians and academic institutions have to be actively committed to support tobacco control initiatives. The reduction in cancer related morbidity and mortality should be viewed as a global crisis and definitive results will depend on a multilevel effort to effectively reduce the burden of cancer, particularly in underprivileged regions of the world.

  20. Intensive mobilities:

    DEFF Research Database (Denmark)

    Vannini, Phillip; Bissell, David; Jensen, Ole B.

    This paper explores the intensities of long distance commuting journeys as a way of exploring how bodily sensibilities are being changed by the mobilities that they undertake. The context of this paper is that many people are travelling further to work than ever before owing to a variety of facto....... By exploring how experiences of long-distance workers become constituted by a range of different material forces enables us to more sensitively consider the practical, technical, and political implications of this increasingly prevalent yet underexplored regime of work....... which relate to transport, housing and employment. Yet we argue that the experiential dimensions of long distance mobilities have not received the attention that they deserve within geographical research on mobilities. This paper combines ideas from mobilities research and contemporary social theory...... with fieldwork conducted in Canada, Denmark and Australia to develop our understanding of the experiential politics of long distance workers. Rather than focusing on the extensive dimensions of mobilities that are implicated in patterns and trends, our paper turns to the intensive dimensions of this experience...

  1. The Tax Burden on Tobacco Volume 49, 1970-2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1970-2014. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The Tax...

  2. The Tax Burden on Tobacco Volume 49, 1970-2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1970-2014. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The...

  3. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    Energy Technology Data Exchange (ETDEWEB)

    Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

    2016-11-15

    We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

  4. Family burden, quality of life and disability in obsessive compulsive disorder: An Indian perspective

    Directory of Open Access Journals (Sweden)

    Gururaj G

    2008-01-01

    Full Text Available Background: Obsessive compulsive disorder (OCD is a psychiatric disorder that often tends to run a chronic course. The lifetime prevalence of OCD is around 1-3%, which is twice as prevalent as schizophrenia and bipolar disorder. Aim: To asses the family burden, quality of life (QoL and disability in patients suffering from at least moderately ill OCD and then to compare them with schizophrenia patients of comparable severity. Settings and Design: We recruited 70 consecutive subjects (OCD=35, schizophrenia=35 who met study criteria between March 2005 and March 2006 from the psychiatric services of the National Institute of Mental Health and Neuro Sciences, Bangalore, India. Materials and Methods: The severity of illness was rated using the Clinical Global Impression-Severity (CGI-S. Instruments used in the current study were the Family Burden Schedule, the World Health Organization (WHO QoL (Bref and the WHO - Disability Assessment Schedule (DAS. Statistical Analysis: The Fisher′s exact test/chi-square test was used to compare categorical variables and the independent sample t test was used to analyze continuous variables. Analysis of covariance (ANCOVA was used to compare the groups after controlling for potential confounding variables. Pearson′s correlation was used for correlation analysis. Results: Overall family burden, financial burden and disruption of family routines were significantly higher in schizophrenia patients compared to OCD although the groups did not differ with respect to other domains of family burden. On the WHO QoL, OCD patients were comparable to schizophrenia patients with respect to the psychological and social domains. On the WHO - DAS, both the groups were similar in all the domains except getting around. Conclusion: Severe OCD is associated with significant disability, poor QoL and high family burden, often comparable to schizophrenia. Therefore, there is an urgent need to increase the sensitivity among healthcare

  5. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010.

    Science.gov (United States)

    Havelaar, Arie H; Kirk, Martyn D; Torgerson, Paul R; Gibb, Herman J; Hald, Tine; Lake, Robin J; Praet, Nicolas; Bellinger, David C; de Silva, Nilanthi R; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J; Devleesschauwer, Brecht

    2015-12-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne Disease Burden Epidemiology Reference Group (FERG), which here reports their first estimates of the incidence, mortality, and disease burden due to 31 foodborne hazards. We find that the global burden of FBD is comparable to those of the major infectious diseases, HIV/AIDS, malaria and tuberculosis. The most frequent causes of foodborne illness were diarrheal disease agents, particularly norovirus and Campylobacter spp. Diarrheal disease agents, especially non-typhoidal Salmonella enterica, were also responsible for the majority of deaths due to FBD. Other major causes of FBD deaths were Salmonella Typhi, Taenia solium and hepatitis A virus. The global burden of FBD caused by the 31 hazards in 2010 was 33 million Disability Adjusted Life Years (DALYs); children under five years old bore 40% of this burden. The 14 subregions, defined on the basis of child and adult mortality, had considerably different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than overestimates; further studies are needed to address the data gaps and limitations of the study. Nevertheless, all stakeholders can contribute to improvements in food safety

  6. Informal and Formal Social Support and Caregiver Burden: The AGES Caregiver Survey

    Directory of Open Access Journals (Sweden)

    Koichiro Shiba

    2016-12-01

    Full Text Available Background: We examined the associations of informal (eg, family members and friends and formal (eg, physician and visiting nurses social support with caregiver’s burden in long-term care and the relationship between the number of available sources of social support and caregiver burden. Methods: We conducted a mail-in survey in 2003 and used data of 2998 main caregivers of frail older adults in Aichi, Japan. We used a validated scale to assess caregiver burden. Results: Multiple linear regression demonstrated that, after controlling for caregivers’ sociodemographic and other characteristics, informal social support was significantly associated with lower caregiver burden (β = −1.59, P < 0.0001, while formal support was not (β = −0.30, P = 0.39. Evaluating the associations by specific sources of social support, informal social supports from the caregiver’s family living together (β = −0.71, P < 0.0001 and from relatives (β = −0.61, P = 0.001 were associated with lower caregiver burden, whereas formal social support was associated with lower caregiver burden only if it was from family physicians (β = −0.56, P = 0.001. Compared to caregivers without informal support, those who had one support (β = −1.62, P < 0.0001 and two or more supports (β = −1.55, P < 0.0001 had significantly lower burden. This association was not observed for formal support. Conclusions: Social support from intimate social relationships may positively affect caregivers’ psychological wellbeing independent of the receipt of formal social support, resulting in less burden.

  7. Caregiver burden and its determinants among the family members of patients with dementia in Iran

    Directory of Open Access Journals (Sweden)

    Ibrahim Abdollahpour

    2012-01-01

    Full Text Available Background: "Caregiver Burden" is actually an expression addressing the adverse consequences of the care provided to the patients′ with dementia. Review of the previous studies reveals a higher rate of depression and anxiety among the caregivers as compared to the general population. This study has been designed to evaluate the caregiver burden and then the factors influencing it among caregivers of patients with dementia in Iran. Methods: In this cross-sectional study, 153 patients and their caregivers registered in the Memory Clinic in Roozbeh Hospital and Iranian Alzheimer Association (IAA were included. Data collection scales were Iranian Version of Caregiver Burden, Global Deterioration scale and Barthel index. Multiple linear regression model was applied to determine the factors influencing the caregiver burden. Results: Out of the 153 patients, 90 were male. The mean age calculated for the patients and the caregivers was 77.1 and 53, respectively. The mean of caregiver burden was 55.2. Three variables, gender (P<0.01, education of the patient (P<0.005 for illiterate patients, and the patient′s dependence on the caregiver for his/her daily tasks (P<0.000 were correlated with a high level of burden on the caregiver. The recommended model explains 0.664% of the variance of the outcome variable. Conclusion: Presence of either moderate or higher levels of burden (58-116 in more than 50% of the caregivers of these patients′ highlights the need for more attention from health policy makers in Iran. Promoting the level of caregivers′ quality of life along with enabling the patients in performing their daily tasks in order to reduce the imposed burden on caregivers′ is recommended.

  8. The ordinary consumer: the burden of economic sanctions against Russia

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    Nureev Rustem, M.

    2015-09-01

    Full Text Available The main thrust of the paper - an attempt to assess how much the sanctions combined with the drop in oil prices hit the consumers. This paper provides an overview of the sanctions imposed by European Union, the United States and other countries (ban largest organizations in Russia to attract foreign capital of the European Union and the United States. The burden of economic sanctions against Russia for the average consumer is shown on the change in prices for food products, electronic products, analyzed Russian car market, the dynamics of small and medium-sized businesses in Russia. The results of import substitution - the balances of trade of consumer goods in Q1 2015 compared to Q1 2014. Dynamics of demand for electronic goods in the paper discusses the example of the effect of price changes in the popular Russian companies (Apple, Sony, etc. to sales. Rising prices for electronic goods has led Apple to a Giffen’s paradox in late 2014, the higher the price - the more sales. Despite the rapid rise in prices for the company's products (price of products apple Nov. 25 rose by 25% on December 22 for another 35%, sales growth was 80%. This is due to the fact that Russian consumers feared further rise in price of goods and the goods were afraid to lose, which has become for many of them a necessity. Car loans in Q1 2015 compared to Q1 2014 decreased by 4 times, car sales fell by 2 times, import cars from abroad fell almost 2-fold. Especially hard hit small businesses. If in 2013 in Russia was opened 490.7 thous. legal entities, and closed 419 thousand. Then for 11 months in 2014 opened 417.5 ths. legal entities and closed down 483.6 thousand. This means that if in 2013 opening of 70 thousand legal persons more, in 2014 almost 70 thousand legal persons shut more than open. Statistics show that the number of people wishing to sell his business in 2014 increased significantly. In Moscow, for example, in 2014, it was filed with the 14.5 times the

  9. Comparison of surgical hand scrub and alcohol surgical hand rub on reducing hand microbial burden.

    Science.gov (United States)

    Ghorbani, Azam; Shahrokhi, Akram; Soltani, Zahra; Molapour, Azam; Shafikhani, Mahin

    2012-02-01

    This study was performed to compare the effects of two hand decontamination methods on the microbial burden of operating room staff hands. The surgical hand washing methods compared were a traditional surgical hand scrub using a povidone iodine solution, and a social wash using a liquid non-antibacterial soap followed by the application of an alcoholic hand rub.

  10. Informal Caregiver Burden among Survivors of Prolonged Mechanical Ventilation

    OpenAIRE

    Van Pelt, David C.; Milbrandt, Eric B; Qin, Li; Weissfeld, Lisa A.; Rotondi, Armando J.; Schulz, Richard; Chelluri, Lakshmipathi; Angus, Derek C.; Michael R. Pinsky

    2006-01-01

    Rationale: Although caregiver burden is well described in chronic illness, few studies have examined burden among caregivers of survivors of critical illness. In existing studies, it is unclear whether the observed burden is a consequence of critical illness or of preexisting patient illness.

  11. 12 CFR 508.10 - Burden of persuasion.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden...

  12. 外商直接投资、产业内技术溢出与碳排放强度--基于不同耗能产业组的比较研究%FDI,Intra -industry Technology Spillover and Intensity of Carbon Emissions:Comparative Study between Different Energy -intensive Industries

    Institute of Scientific and Technical Information of China (English)

    王艳丽

    2015-01-01

    To improve the technology of energy utilization is an important way to achieve the carbon reduction goal of China government.The technology spillover of FDI cannot be ignored.This paper treats 37 industries of China from 1999 to 2012 as samples,and constructs two -way fixed panel data model on the basis of STIRPAT to make empirical study of the direct effect and intra -industry technology spillover effect of FDI on the intensity of carbon dioxide emissions.Furthermore,it al-so makes comparative study between different energy -intensive industries.The results show that in this period,the inten-sity of carbon dioxide emissions of China industries reveals declining tendency,and high energy -consuming industries de-cline more notably.FDI has a positive impact on carbon intensity reduction.Compared with low energy -intensive indus-tries,high energy -intensive industries have more technology spillover effect.About the path of FDI technology spillover, the energy intensity is the main way while energy structure is weak.%提高能源利用技术是实现我国碳减排目标的重要途径,FDI 的技术溢出效应不可忽视。以1999—2012年我国37个工业行业为样本,在 STIRPAT 模型的基础上构建双向固定效应面板数据模型,实证检验 FDI 对碳排放强度影响的直接效应和产业内技术溢出效应,并划分高耗能产业组和低耗能产业组进行比较研究。研究发现,样本期内我国工业行业碳排放强度呈逐年下降趋势,其中高耗能产业组下降幅度较为显著;FDI 对碳排放强度降低产生了积极的影响;与低耗能产业组相比,高耗能产业组 FDI 的技术溢出效应更大;在技术溢出路径上,FDI主要是通过降低工业行业能源强度从而对碳排放强度发挥作用,但能源结构这一渠道效果并不明显。

  13. Comparing two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the hypofractionated treatment of high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Yartsev Slav

    2008-01-01

    Full Text Available Abstract Background To compare two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the setting of hypofractionated high-risk prostate cancer treatment. Methods 3DCRT and dIMRT/Helical Tomotherapy(HT planning with 10 CT datasets was undertaken to deliver 68 Gy in 25 fractions (prostate and simultaneously delivering 45 Gy in 25 fractions (pelvic lymph node targets in a single phase. The paradigms of pelvic vessel targeting (iliac vessels with margin are used to target pelvic nodes and conformal normal tissue avoidance (treated soft tissues of the pelvis while limiting dose to identified pelvic critical structures were assessed compared to 3DCRT controls. Both dIMRT/HT and 3DCRT solutions were compared to each other using repeated measures ANOVA and post-hoc paired t-tests. Results When compared to conformal pelvic vessel targeting, conformal normal tissue avoidance delivered more homogenous PTV delivery (2/2 t-test comparisons; p dose, 1–3 Gy over 5/10 dose points; p Conclusion dIMRT/HT nodal and pelvic targeting is superior to 3DCRT in dose delivery and critical structure sparing in the setting of hypofractionation for high-risk prostate cancer. The pelvic targeting paradigm is a potential solution to deliver highly conformal pelvic radiation treatment in the setting of nodal location uncertainty in prostate cancer and other pelvic malignancies.

  14. Epidemiology and burden of nasal congestion

    Directory of Open Access Journals (Sweden)

    Michael Stewart

    2010-02-01

    Full Text Available Michael Stewart1, BJ Ferguson2, Len Fromer31Department of Otorhinolaryngology, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, USA; 2Department of Otolaryngology, University of Pittsburgh School of Medicine, USA; 3University of California, Los Angeles; David Geffen School of Medicine Los Angeles, California, USAAbstract: Nasal congestion, which may be described as fullness, obstruction, reduced airflow, or being “stuffed up,” is a commonly encountered symptom in clinical practice. Systematic study of congestion has largely considered it as a component of a disease state. Conditions associated with congestion include nasal polyposis, obstructive sleep apnea, and anatomic variation; however, most information on the burden of congestion comes from studies of allergic rhinitis and rhinosinusitis, diseases of which congestion is the major symptom. Congestion can be caused by other rhinologic conditions, such as non-allergic rhinitis, viral or bacterial rhinitis, and vasomotor rhinitis. Allergic rhinitis affects as much as one quarter of the population worldwide and imposes a significant economic burden. Additionally, allergic rhinitis significantly impairs quality of life; congestion causes allergic rhinitis sufferers decreased daytime productivity at work or school and reduces night-time sleep time and quality. Annually, rhinosinusitis affects tens of millions of Americans and leads to approximately $6 billion in overall health care expenditures; it has been found to be one of the most costly physical conditions for US employers. Given the high prevalence and significant social and economic burden of nasal congestion, this symptom should be a key consideration in treating patients with rhinologic disease, and there continues to be a significant unmet medical need for effective treatment options for this condition.Keywords: allergic rhinitis, congestion, epidemiology, obstruction, rhinosinusitis

  15. Burden of ketamine cystitis in Chinese society

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    Wai-Kit Ma

    2015-09-01

    Full Text Available Ketamine cystitis, also referred to as ketamine-induced uropathy, is a new clinical syndrome affecting primarily young to middle-aged ketamine abusers and has become a global phenomenon since its first reported series in 2007. A spectrum of urological destructions ranging from mild cystitis to severely contracted bladder, ureteric stricture, upper tract damage, and irreversible renal failure has been reported. This review considers the scope and burden of ketamine cystitis in the Chinese population in Asia, stating the current status of management pathway, and reviews our current understanding on the pathophysiology of ketamine-induced uropathy.

  16. National Burden of Eye Diseases in Iran, 1990–2010; findings from the global burden of diseases study 2010

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    Elham Hatef

    2016-01-01

    Conclusions: Epidemiologic transition is reflected in major ophthalmic and blinding diseases in the GBD data for Iran. The burden of macular degeneration is rising, followed by glaucoma. The burden of presbyopia affected individuals past their middle age. The burden of cataract manifested as a slower increase that could be attributable to better access to treatment.

  17. Chinese Caregiving Burden and the Future Burden of Elder Care in Life-Course Perspective

    Science.gov (United States)

    Zhan, Heying Jenny

    2002-01-01

    This article uses the life course perspective to combine micro- and macro-levels of analysis of caregiving burdens experienced by Chinese baby-boom cohort and then explores their elder care prospects. Based on survey interviews during 1997 and 1998 with 110 caregivers providing care to dependent parents or parents-in-law, this study finds that…

  18. Hepatitis B virus burden in developing countries.

    Science.gov (United States)

    Zampino, Rosa; Boemio, Adriana; Sagnelli, Caterina; Alessio, Loredana; Adinolfi, Luigi Elio; Sagnelli, Evangelista; Coppola, Nicola

    2015-11-14

    Hepatitis B virus (HBV) infection has shown an intermediate or high endemicity level in low-income countries over the last five decades. In recent years, however, the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen chronic carriers have decreased in several countries because of the HBV universal vaccination programs started in the nineties. Some countries, however, are still unable to implement these programs, particularly in their hyperendemic rural areas. The diffusion of HBV infection is still wide in several low-income countries where the prevention, management and treatment of HBV infection are a heavy burden for the governments and healthcare authorities. Of note, the information on the HBV epidemiology is scanty in numerous eastern European and Latin-American countries. The studies on molecular epidemiology performed in some countries provide an important contribution for a more comprehensive knowledge of HBV epidemiology, and phylogenetic studies provide information on the impact of recent and older migratory flows.

  19. Reviewing disease burden among rural Indian women

    Directory of Open Access Journals (Sweden)

    Ramanakumar AV

    2004-08-01

    Full Text Available The disease burden of rural Indian women is reviewed by utilizing the data from the 'Survey of Causes of Death (rural' annual reports of Registrar General of India supplemented with National family health survey (NFHS-II. The review indicates that bronchitis and asthma are the leading causes while prematurity and heart attacks are second and third respectively. Most of the maternal deaths are concentrated in the age group 20-24 and bleeding is the main cause of maternal death. Tuberculosis of the lungs, malaria and burns are also important causes of death in the early reproductive ages. Rate of suicide, burn, and anaemia diminishes with age. Though nationwide health plans have succeeded in reducing the fatality of women's diseases to a entrain extent, there is however, a great need for improved and effective area-specific health programs to achieve the desired goals.

  20. The global burden of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul E; Ogawa, Hiroshi

    2012-01-01

    status) and oral health systems. National public health initiatives for the control and prevention of periodontal disease should include oral health promotion and integrated disease-prevention strategies based on common risk-factor approaches. Capacity building of oral health systems must consider......Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases...

  1. Epidemiology and Burden of Chronic Constipation

    Directory of Open Access Journals (Sweden)

    Maria Ines Pinto Sanchez

    2011-01-01

    Full Text Available Chronic constipation is an important component of clinical gastroenterology practice worldwide. Based on the definition, either self-reported or using Rome criteria, chronic constipation can affect from 2% to 27% of the population. Constipation is physically and mentally troublesome for many patients, and can significantly interfere with their daily living and well-being. Although only a proportion of patients with constipation seek medical care, most of them use prescribed or over-the-counter medication to improve their condition. The health care costs of constipation are significant as evidenced by the hundreds of million dollars spent yearly on laxatives alone. Because constipation is more common in older patients and life expectancy is increasing, an increase in the prevalence of constipation is expected in the years to come, with the associated impact on quality of life and socioeconomic burden.

  2. Economic burden of cervical cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Sharifa E.W. Puteh

    2008-12-01

    Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

  3. What is left behind when the lights go off? Comparing the abundance and composition of litter in urban areas with different intensity of nightlife use in Mar del Plata, Argentina.

    Science.gov (United States)

    Becherucci, Maria Eugenia; Seco Pon, Juan Pablo

    2014-08-01

    Nightlife activities represents an important source of urban litter; the latter often being left behind or abandoned in public places and streets. Mar del Plata is a very important city on the Atlantic coast of Argentina and is the main tourism destination in the South Atlantic region of South America. However, few studies on urban litter related to nightlife activities have been conducted in the area. Here we assessed (i) the abundance and composition of litter, and (ii) the spatial and temporal variations of its abundance, diversity, richness and evenness in urbanized areas with different intensity of nightlife activities from April 2008 to March 2009. An overall of 13,503 items were counted. Around 92% of the total litter was comprised by cigarette butts, papers and plastics. We found significant spatial differences in the abundance of litter between sampling sites, with the greatest amounts of litter at the Alem site followed by the Hipólito site (both with an intensive nightlife activity) compared with the Chauvin site (a quiet high-income neighborhood). The composition of litter of the Alem and the Hipólito sites was relatively similar and both sites differ with respect to the Chauvin site. Cigarette butts, papers, and plastics were the items that contributed most to the dissimilarity between sampling sites. The diversity of litter was the single community parameter that significantly differed from the other seasons. We discussed the potential effect of nightlife activities on the amounts and quality of urban litter in the city of Mar del Plata.

  4. [The comparative effectiveness of high-intensity dynamic training with the use of exercise machines and therapeutic gymnastics for the joints in the patients presenting with early rheumatoid arthritis].

    Science.gov (United States)

    Orlova, E V; Karateev, D E; Kochetkov, A V; Mozhar, T E

    2013-01-01

    The objective of the present work was to compare the effectiveness of two therapeutic exercise programs for the patients presenting with early rheumatoid arthritis (RA). The study included 51 patients. Fifteen of them (group 1) were given conventional medicamental therapy in combination with high-intensity dynamic physical exercises with the use of the Enraf-Nonius training devices (45-60 min). Eighteen patients of group 2 were offered 10 sessions of remedial gymnastics for the joints (45 min each) under the guidance of an instructor that were continued under the domestic conditions (45 min each session thrice weekly for 3 months). Eighteen patients of group 3 were given medicamental therapy alone (control). The parameters estimated in the study included the mean strength of knee joint extension and ankle joint flexion measured with the use of En-TreeM devices, articular pain (100 mm BAHI), DAS28, HAQ, and RAPID3 indices. It was shown that both programs of therapeutic exercises reduced the severity of the disease, improved the functional and motor activity of the patients and their quality of life. The majority of these characteristics were significantly different from those documented in the control group (pexercise machines was higher than without them (articular pain was reduced by 57.9% (pexercises during 3 months was higher (83.3%) than with high-intensity dynamic training with the use of exercise machines (60%). It is concluded that the latter modality should be recommended to the younger patients with RA (below 40 years), a short history of the disease, and its low activity.

  5. The burden of diagnosed and undiagnosed diabetes in Native Hawaiian and Asian American hospitalized patients

    Directory of Open Access Journals (Sweden)

    T.L. Sentell

    2015-12-01

    Conclusions: Hospitalized Native Hawaiians (41% and Asian subgroups had significantly higher overall diabetes burdens compared to Whites (23%. Potentially undiagnosed diabetes was associated with poor outcomes. Hospitalized patients, irrespective of race/ethnicity, may require more effective inpatient identification and management of previously undiagnosed diabetes to improve clinical outcomes.

  6. The size and burden of mental disorders and other disorders of the brain in Europe 2010

    DEFF Research Database (Denmark)

    Wittchen, H U; Jacobi, F; Rehm, J

    2011-01-01

    To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range...

  7. The global burden of foodborne parasitic diseases: an update.

    Science.gov (United States)

    Torgerson, Paul R; de Silva, Nilanthi R; Fèvre, Eric M; Kasuga, Fumiko; Rokni, Mohammad B; Zhou, Xiao-Nong; Sripa, Banchob; Gargouri, Neyla; Willingham, Arve Lee; Stein, Claudia

    2014-01-01

    Foodborne diseases (FBDs) are a major cause of morbidity and mortality in the human population. Accurate information on the burden of FBDs is needed to inform policy makers and allocate appropriate resources for food safety control and intervention. Consequently, in 2006 the WHO launched an initiative to estimate the global burden of FBDs in terms of Disability Adjusted Life Years (DALYs). This review gives an update of the progress on evaluating the burden of foodborne parasitic diseases that has been generated by this study. Results to date indicate that parasitic diseases that can be transmitted through food make a substantial contribution to the global burden of disease.

  8. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

    Science.gov (United States)

    Charara, Raghid; Forouzanfar, Mohammad; Naghavi, Mohsen; Moradi-Lakeh, Maziar; Afshin, Ashkan; Vos, Theo; Daoud, Farah; Wang, Haidong; El Bcheraoui, Charbel; Khalil, Ibrahim; Hamadeh, Randah R.; Khosravi, Ardeshir; Rahimi-Movaghar, Vafa; Khader, Yousef; Al-Hamad, Nawal; Makhlouf Obermeyer, Carla; Rafay, Anwar; Asghar, Rana; Rana, Saleem M.; Shaheen, Amira; Abu-Rmeileh, Niveen M. E.; Husseini, Abdullatif; Abu-Raddad, Laith J.; Khoja, Tawfik; Al Rayess, Zulfa A.; AlBuhairan, Fadia S.; Hsairi, Mohamed; Alomari, Mahmoud A.; Ali, Raghib; Roshandel, Gholamreza; Terkawi, Abdullah Sulieman; Hamidi, Samer; Refaat, Amany H.; Westerman, Ronny; Kiadaliri, Aliasghar Ahmad; Akanda, Ali S.; Ali, Syed Danish; Bacha, Umar; Badawi, Alaa; Bazargan-Hejazi, Shahrzad; Faghmous, Imad A. D.; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Jonas, Jost B.; Kuate Defo, Barthelemy; Mehari, Alem; Omer, Saad B.; Pourmalek, Farshad; Uthman, Olalekan A.; Mokdad, Ali A.; Maalouf, Fadi T.; Abd-Allah, Foad; Akseer, Nadia; Arya, Dinesh; Borschmann, Rohan; Brazinova, Alexandra; Brugha, Traolach S.; Catalá-López, Ferrán; Degenhardt, Louisa; Ferrari, Alize; Haro, Josep Maria; Horino, Masako; Hornberger, John C.; Huang, Hsiang; Kieling, Christian; Kim, Daniel; Kim, Yunjin; Knudsen, Ann Kristin; Mitchell, Philip B.; Patton, George; Sagar, Rajesh; Satpathy, Maheswar; Savuon, Kim; Seedat, Soraya; Shiue, Ivy; Skogen, Jens Christoffer; Stein, Dan J.; Tabb, Karen M.; Whiteford, Harvey A.; Yip, Paul; Yonemoto, Naohiro; Murray, Christopher J. L.; Mokdad, Ali H.

    2017-01-01

    The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of

  9. Burden among caregivers of children living with human immunodeficiency virus in North India

    Directory of Open Access Journals (Sweden)

    Ramesh Chand Chauhan

    2016-01-01

    Full Text Available Background: Due to wider access to and free antiretroviral therapy (ART program, the number of children dying due to acquired immune deficiency syndrome (AIDS-related causes has declined and the nature and duration of human immunodeficiency virus (HIV/AIDS caregiving has also dramatically altered. The care of children living with HIV/AIDS (CLHA places a significant additional burden on the caregivers. Aims: This study was conducted to assess the perceived burden among caregivers of children living with HIV in North India. Materials and Methods: A hospital-based cross-sectional study among 156 CLHA-caregiver dyads in North India was conducted from June 2010 to May 2011. Data were collected by using a pretested structured interview schedule. The caregiver burden was measured with a 36-item scale adapted from Burden Assessment Schedule of Schizophrenia Research Foundation (BASS. Child characteristics, caregiver characteristics, caregiving burden, the knowledge of caregivers, and issues related to health care, nutrition, education, and psychological aspects were studied. Results: Caregivers had a mean age of 35.9 ± 10.2 years. Women accounted for over three-fourth (76.9% of the caregivers. Nearly two-third of them (65.4% reported as living with HIV. The mean caregiver burden score was 68.7 ± 2.9. A majority of the caregivers reported either low or moderate burden. Standardized percentage score was high in the domains of physical and mental health, external support, patients′ behavior, and caregivers′ strategy and seemed to be comparatively less in the other domains such as support of the patient and taking responsibility. Conclusions: Caring of children is a universal practice but there is a need of special care for children living with HIV. The majority of caregivers who were usually the mothers perceived the burden and need to be assisted in caring for the child. Stigma and discrimination with HIV infection further increased the burden as

  10. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013.

    Science.gov (United States)

    Charara, Raghid; Forouzanfar, Mohammad; Naghavi, Mohsen; Moradi-Lakeh, Maziar; Afshin, Ashkan; Vos, Theo; Daoud, Farah; Wang, Haidong; El Bcheraoui, Charbel; Khalil, Ibrahim; Hamadeh, Randah R; Khosravi, Ardeshir; Rahimi-Movaghar, Vafa; Khader, Yousef; Al-Hamad, Nawal; Makhlouf Obermeyer, Carla; Rafay, Anwar; Asghar, Rana; Rana, Saleem M; Shaheen, Amira; Abu-Rmeileh, Niveen M E; Husseini, Abdullatif; Abu-Raddad, Laith J; Khoja, Tawfik; Al Rayess, Zulfa A; AlBuhairan, Fadia S; Hsairi, Mohamed; Alomari, Mahmoud A; Ali, Raghib; Roshandel, Gholamreza; Terkawi, Abdullah Sulieman; Hamidi, Samer; Refaat, Amany H; Westerman, Ronny; Kiadaliri, Aliasghar Ahmad; Akanda, Ali S; Ali, Syed Danish; Bacha, Umar; Badawi, Alaa; Bazargan-Hejazi, Shahrzad; Faghmous, Imad A D; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Jonas, Jost B; Kuate Defo, Barthelemy; Mehari, Alem; Omer, Saad B; Pourmalek, Farshad; Uthman, Olalekan A; Mokdad, Ali A; Maalouf, Fadi T; Abd-Allah, Foad; Akseer, Nadia; Arya, Dinesh; Borschmann, Rohan; Brazinova, Alexandra; Brugha, Traolach S; Catalá-López, Ferrán; Degenhardt, Louisa; Ferrari, Alize; Haro, Josep Maria; Horino, Masako; Hornberger, John C; Huang, Hsiang; Kieling, Christian; Kim, Daniel; Kim, Yunjin; Knudsen, Ann Kristin; Mitchell, Philip B; Patton, George; Sagar, Rajesh; Satpathy, Maheswar; Savuon, Kim; Seedat, Soraya; Shiue, Ivy; Skogen, Jens Christoffer; Stein, Dan J; Tabb, Karen M; Whiteford, Harvey A; Yip, Paul; Yonemoto, Naohiro; Murray, Christopher J L; Mokdad, Ali H

    2017-01-01

    The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost-YLLs) and nonfatal outcomes (years lived with disability-YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25-49 age group, with a peak in the 35-39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of

  11. Burden differentiation of greenhouse gas abatement: Criteria for evaluation and development of burden-sharing rules

    OpenAIRE

    Torvanger, Asbjørn; RINGIUS, Lasse

    2000-01-01

    This article discusses nine criteria for evaluation of potential Burden Sharing Rules (BSRs) in climate policy agreements. Three of the criteria reflect fairness principles while six of them are operational requirements. These criteria are useful for identifying potential BSRs that could be promising in future climate policy negotiations. The two sector approaches, Multi-sector Convergence Approach and Triptych, received the highest score according to the criteria presented in this article. T...

  12. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

    OpenAIRE

    2015-01-01

    Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and mu...

  13. Burden differentiation. GHG emissions, undercurrents and mitigation costs. The joint CICERO-ECN project on sharing the burden greenhouse gas reduction among countries

    Energy Technology Data Exchange (ETDEWEB)

    Ybema, J.R.; Battjes, J.J.; Jansen, J.C.; Ormel, F.T. [ECN Policy Studies, Petten (Netherlands)

    2000-02-01

    . Moreover, since the First World War, CO2 emissions per capita increased from less than 2 tonnes CO2 eq. per capita to over 4 tonnes CO2 eq. per capita. This increase is mainly the result of an increasing per capita demand for fossil fuels. In contrast, methane emissions seem to be closely related to agricultural and waste emissions and have shown a relatively steady level of emissions per capita over the past 150 years. Differences between countries in the structure of their respective economy and energy supply do importantly contribute to the explanation of the variance of emissions per capita over countries of comparable per capita income levels. Moreover, in contrast to the decreasing energy intensities of most OECD countries, many non-industrialised countries are still associated with high and sometimes even rising energy intensities. On the other hand, economies in transition are presently showing rapidly decreasing energy intensities. These phenomena can also attributed for a large part to structural developments of the economies of these respective groups of countries. Therefore, the structure of national or regional (viz. the EU) economies should be an important consideration in designing burden sharing rules. Certain factors are of crucial importance to the direct incremental cost bill of a country, notably: - Prevailing levels of energy efficiency throughout the country's energy system. If, generally, the gap with international 'best practices' benchmarks is small (wide), the scope for improving energy-efficiency levels is correspondingly small (large) and expensive (cheap). - The carbon intensity of energy supply. If a country's energy supply is relatively carbon-extensive (carbon-intensive), the scope for shifts to carbon-extensive primary energy carriers, including notably renewable sources of energy, will be correspondingly small (large) and expensive (cheap). - The country's relative endowments of renewable sources of energy and

  14. The burden of disease and injury in Iran 2003

    Directory of Open Access Journals (Sweden)

    Vaseghi Sanaz

    2009-06-01

    Full Text Available Abstract Background The objective of this study was to estimate the burden of disease and injury in Iran for the year 2003, using Disability-Adjusted Life Years (DALYs at the national level and for six selected provinces. Methods Methods developed by the World Health Organization for National Burden of Disease (NBD studies were applied to estimate disease and injury incidence for the calculation of Years of Life Lost due to premature mortality (YLL, Years Lived with Disability (YLD, and DALYs. The following adjustments of the NBD methodology were made in this study: a revised list with 213 disease and injury causes, development of new and more specific disease modeling templates for cancers and injuries, and adjustment for dependent comorbidity. We compared the results with World Health Organization (WHO estimates for Eastern Mediterranean Region, sub-region B in 2002. Results We estimated that in the year 2003, there were 21,572 DALYs due to all diseases and injuries per 100,000 Iranian people of all ages and both sexes. From this total number of DALYs, 62% were due to disability premature deaths (YLD and 38% were due to premature deaths (YLL; 58% were due to noncommunicable diseases, 28% – to injuries, and 14% – to communicable, maternal, perinatal, and nutritional conditions. Fifty-three percent of the total number of 14.349 million DALYs in Iran were in males, with 36.5% of the total due to intentional and unintentional injuries, 15% due to mental and behavioral disorders, and 10% due to circulatory system diseases; and 47% of DALYs were in females, with 18% of the total due to mental and behavioral disorders, 18% due to intentional and unintentional injuries, and 12% due to circulatory system diseases. The disease and injury causes leading to the highest number of DALYs in males were road traffic accidents (1.071 million, natural disasters (548 thousand, opioid use (510 thousand, and ischemic heart disease (434 thousand. The leading

  15. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the intensive care unit

    Science.gov (United States)

    YAZDANI, MAJID; SABETIAN, GOLNAR; RA'OFI, SHAHIN; ROUDGARI, AMIR; FEIZI, MONIREH

    2015-01-01

    Introduction Ventilator-associated pneumonia (VAP) is one of the most popular nosocomial infections in the intensive care units and the nurse's role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses) and workshops (40 nurses) by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by self-report questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001). But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands. PMID:25927070

  16. Burden of Disease Attributable to Suboptimal Breastfeeding in Iran during 1990-2010; Findings from the Global Burden of Disease Study 2010

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2016-09-01

    Full Text Available Background: This study uses data of the global burden of diseases (GBD study 2010 to report death, disability-adjusted life year (DALYs, years of life lived with disability (YLDs and years of life lost due to premature mortality (YLLs, attributed to suboptimal breastfeeding by age and gender during 1990 to 2010 in Iran. Materials and Methods:The GBD assessments were used, together with estimates of death and DALYs due to specific risk factors to calculate the attributed burden of each risk factor exposure compared with the theoretical-minimum-risk exposure. Uncertainties in the distribution of exposure, relative risks, and relevant outcomes were incorporated into estimates of mortality attributable and burden and were presented as 95 % uncertainty interval (UI. Results:In both genders, the age standardized DALYs rates and the age standardized death rate [(from 5 (95% UI: 2-8 to 1 (95% UI: 0-2 per 100,000 populations], attributed to breastfeeding, had a decreasing trends. The age standardized YLD rate increased from 7 (95% UI: 2-15 to 10 (95% UI: 3-23 per 100,000 populations in boys and, from 7(95% UI: 2-16 to 11(95% UI: 3-26 per 100,000 populations in girls. The YLD changes showed some variation according to age categories. For both genders, the age standardizes YLL rate decreased from 395 (95% UI: 185-681 per 100,000 populations to 111(95% UI: 42-213 per 100,000 populations. Conclusion: The burden attributed to suboptimal breastfeeding had a considerable reduction rate from 1990 to 2010. Additional studies on burden of exclusive breastfeeding with more accurate data are recommended for policies make decision.

  17. Pulmonary impairment after tuberculosis and its contribution to TB burden

    Directory of Open Access Journals (Sweden)

    Munguia Guadalupe

    2010-05-01

    Full Text Available Abstract Background The health impacts of pulmonary impairment after tuberculosis (TB treatment have not been included in assessments of TB burden. Therefore, previous global and national TB burden estimates do not reflect the full consequences of surviving TB. We assessed the burden of TB including pulmonary impairment after tuberculosis in Tarrant County, Texas using Disability-adjusted Life Years (DALYs. Methods TB burden was calculated for all culture-confirmed TB patients treated at Tarrant County Public Health between January 2005 and December 2006 using identical methods and life tables as the Global Burden of Disease Study. Years of life-lost were calculated as the difference between life expectancy using standardized life tables and age-at-death from TB. Years lived-with-disability were calculated from age and gender-specific TB disease incidence using published disability weights. Non-fatal health impacts of TB were divided into years lived-with-disability-acute and years lived-with-disability-chronic. Years lived-with-disability-acute was defined as TB burden resulting from illness prior to completion of treatment including the burden from treatment-related side effects. Years lived-with-disability-chronic was defined as TB burden from disability resulting from pulmonary impairment after tuberculosis. Results There were 224 TB cases in the time period, of these 177 were culture confirmed. These 177 subjects lost a total of 1189 DALYs. Of these 1189 DALYs 23% were from years of life-lost, 2% were from years lived-with-disability-acute and 75% were from years lived-with-disability-chronic. Conclusions Our findings demonstrate that the disease burden from TB is greater than previously estimated. Pulmonary impairment after tuberculosis was responsible for the majority of the burden. These data demonstrate that successful TB control efforts may reduce the health burden more than previously recognized.

  18. High burden of impetigo and scabies in a tropical country.

    Directory of Open Access Journals (Sweden)

    Andrew C Steer

    Full Text Available BACKGROUND: Impetigo and scabies are endemic diseases in many tropical countries; however the epidemiology of these diseases is poorly understood in many areas, particularly in the Pacific. METHODOLOGY/PRINCIPAL FINDINGS: We conducted three epidemiological studies in 2006 and 2007 to determine the burden of disease due to impetigo and scabies in children in Fiji using simple and easily reproducible methodology. Two studies were performed in primary school children (one study was a cross-sectional study and the other a prospective cohort study over ten months and one study was performed in infants (cross-sectional. The prevalence of active impetigo was 25.6% (95% CI 24.1-27.1 in primary school children and 12.2% (95% CI 9.3-15.6 in infants. The prevalence of scabies was 18.5% (95% CI 17.2-19.8 in primary school children and 14.0% (95% CI 10.8-17.2 in infants. The incidence density of active impetigo, group A streptococcal (GAS impetigo, Staphylococcus aureus impetigo and scabies was 122, 80, 64 and 51 cases per 100 child-years respectively. Impetigo was strongly associated with scabies infestation (odds ratio, OR, 2.4, 95% CI 1.6-3.7 and was more common in Indigenous Fijian children when compared with children of other ethnicities (OR 3.6, 95% CI 2.7-4.7. The majority of cases of active impetigo in the children in our study were caused by GAS. S. aureus was also a common cause (57.4% in school aged children and 69% in infants. CONCLUSIONS/SIGNIFICANCE: These data suggest that the impetigo and scabies disease burden in children in Fiji has been underestimated, and possibly other tropical developing countries in the Pacific. These diseases are more than benign nuisance diseases and consideration needs to be given to expanded public health initiatives to improve their control.

  19. The prevalence, management and burden of asthma - a Nigerian study.

    Science.gov (United States)

    Oni, Alexander O; Erhabor, G E; Egbagbe, E E

    2010-03-01

    Inadequate attention given to the management of asthma and ways of improving treatment could be a significant factor for the increase morbidity and mortality from asthma despite major advances in our understanding of the pathophysiology of the disease. There seems to be paucity of data concerning the management pattern and burden of asthma in Africa. This study was under taken to determine the prevalence, management pattern and the burden of asthma. This study was a cross sectional design involving clinical and lung function assessment. The diagnosis of asthma was made using the clinical features of asthma and lung function parameters (Forced expiratory volume in one second, Peak expiratory flow rate, Reversibility tests). Totally, 120 asthma patients participated in this study. All subjects completed the clinical asthma control questionnaires. All items were rated with the calculation of their mean and percentages. Student t-test was used to calculate the difference between the mean of the lung function tests for subjects and control. The prevalence of asthma among respiratory unit patients was 6.6% and higher in the first three decades of life with female preponderance (F:M=1.5-1).There is a strong family history of asthma(81.7%). Associated allergies include rhinitis (75%), pharyngitis (54%), conjunctivitis (54%) and dermatitis (30%). Percentage of asthma patients treated with bronchodilators alone (70%), combined inhaled bronchodilators and steroid (28.3%). Impaired daily activities include sports (84%), Job career (60%), Physical activity (55%), Social activity (54%), Household chores (61%), Disturbed sleep (53%), Daytime symptoms (51%), Hospitalized(50%). Subjects had significant low lung function values when compared with control (P asthma is very high despite the advanced knowledge of the pathophysiology and management of asthma.

  20. The economic burden of sunscreen usage.

    Science.gov (United States)

    Johal, Ritika; Leo, Michael S; Ma, Brian; Sivamani, Raja K

    2014-06-15

    Excessive sun exposure is known to be the leading cause of skin cancer. The direct cellular damage inflicted by the ultraviolet (UV) radiation from the sun results in premature aging, DNA damage, and mutations that ultimately lead to skin cancer. Sunscreens are highly recommended to protect against UV radiation. However, little research has been conducted on the economic burden of sunscreen use. In this study, we aimed to evaluate the annual cost of sunscreen under both ideal and actual use conditions while stratifying for the sun protection factor (SPF) and by the name brand or equivalent store brand sunscreen. Pricing data was collected for sunscreens of SPF 30, 50, 70, and 100. For each type of sunscreen, the size and price of the container were recorded. Our results demonstrated that sunscreen prices increased with SPF but purchasing a generic sunscreen resulted in savings of 40%-50%. Our estimates reveal that sunscreens are affordable with annual expenditures ranging from $30.21 to $61.94, depending on brand, for SPF 50 sunscreens used with minimal application density for the average person.

  1. Prediction of Hepatitis C Burden in Canada

    Directory of Open Access Journals (Sweden)

    Shimian Zou

    2000-01-01

    Full Text Available To assess the risk of hepatitis C in Canada and to predict the burden that this disease may pose to the Canadian society in the near future, expected numbers of persons at different stages of the disease currently and in the next decade were estimated by simulation using a published hepatitis C natural history model with no treatment effect being applied. Based on the estimate of 240,000 persons who are currently infected with the hepatitis C virus in Canada, the simulation analysis demonstrated that the number of hepatitis C cirrhosis cases would likely increase by 92% from 1998 to the year 2008. It was also projected that the number of liver failures and hepatocellular carcinomas related to hepatitis C would increase by 126% and 102%, respectively, in the next decade. The number of liver-related deaths associated with hepatitis C is expected to increase by 126% in 10 years. The medical and social care systems in Canada may not be ready to support these large increases. These results highlight the importance of both the control of disease progression of hepatitis C virus-infected persons and the primary prevention of hepatitis C infections in Canada.

  2. Burden of fungal infections in Algeria.

    Science.gov (United States)

    Chekiri-Talbi, M; Denning, D W

    2017-02-21

    We report for the first time in Algeria and provide burden estimates. We searched for existing data and estimated the incidence and prevalence of fungal diseases based on the population at risk and available epidemiological data. Demographic data were derived from the National Office of Statistics (Office National des Statistiques: ONS), World Health Organization (WHO), The Joint Nations Programme on HIV/AIDS (UNAIDS) and national published reports. When no data existed, risk populations were used to estimate frequencies of fungal infections, using previously described methodology. Algeria has 40.4 million inhabitants, and probably at least 568,900 (1.41%) of Algerians have a serious fungal infection each year. Recurrent vulvovaginal candidiasis (485,000) and fungal asthma (72,000) are probably the commonest problems, as there are over 1 million adult asthmatics. Candidaemia is estimated in 2,020 people, invasive aspergillosis in 2,865 people, and intra-abdominal candidiasis in 303 people; these are the most common life-threatening problems. AIDS is uncommon, but cancer is not (45,000 new cases of cancer including 1,500 in children), nor is COPD (an estimated 317,762 patients, of whom 20.3% are admitted to hospital each year). A focus on improving the diagnosis and epidemiological data related to fungal infection is necessary in Algeria.

  3. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Stanaway, Jeffrey D; Flaxman, Abraham D; Naghavi, Mohsen; Fitzmaurice, Christina; Vos, Theo; Abubakar, Ibrahim; Abu-Raddad, Laith J; Assadi, Reza; Bhala, Neeraj; Cowie, Benjamin; Forouzanfour, Mohammad H; Groeger, Justina; Hanafiah, Khayriyyah Mohd; Jacobsen, Kathryn H; James, Spencer L; MacLachlan, Jennifer; Malekzadeh, Reza; Martin, Natasha K; Mokdad, Ali A; Mokdad, Ali H; Murray, Christopher J L; Plass, Dietrich; Rana, Saleem; Rein, David B; Richardus, Jan Hendrik; Sanabria, Juan; Saylan, Mete; Shahraz, Saeid; So, Samuel; Vlassov, Vasiliy V; Weiderpass, Elisabete; Wiersma, Steven T; Younis, Mustafa; Yu, Chuanhua; Zaki, Maysaa El Sayed; Cooke, Graham S

    2016-01-01

    Summary Background With recent improvements in vaccines and treatments against viral hepatitis, an improved understanding of the burden of viral hepatitis is needed to inform global intervention strategies. We used data from the Global Burden of Disease (GBD) Study to estimate morbidity and mortality for acute viral hepatitis, and for cirrhosis and liver cancer caused by viral hepatitis, by age, sex, and country from 1990 to 2013. Methods We estimated mortality using natural history models for acute hepatitis infections and GBD’s cause-of-death ensemble model for cirrhosis and liver cancer. We used meta-regression to estimate total cirrhosis and total liver cancer prevalence, as well as the proportion of cirrhosis and liver cancer attributable to each cause. We then estimated cause-specific prevalence as the product of the total prevalence and the proportion attributable to a specific cause. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs). Findings Between 1990 and 2013, global viral hepatitis deaths increased from 0·89 million (95% uncertainty interval [UI] 0·86–0·94) to 1·45 million (1·38–1·54); YLLs from 31·0 million (29·6–32·6) to 41·6 million (39·1–44·7); YLDs from 0·65 million (0·45–0·89) to 0·87 million (0·61–1·18); and DALYs from 31·7 million (30·2–33·3) to 42·5 million (39·9–45·6). In 2013, viral hepatitis was the seventh (95% UI seventh to eighth) leading cause of death worldwide, compared with tenth (tenth to 12th) in 1990. Interpretation Viral hepatitis is a leading cause of death and disability worldwide. Unlike most communicable diseases, the absolute burden and relative rank of viral hepatitis increased between 1990 and 2013. The enormous health loss attributable to viral hepatitis, and the availability of effective vaccines and treatments, suggests an important opportunity to improve public health. Funding Bill & Melinda

  4. Systematic review of general burden of disease studies using disability-adjusted life years

    Directory of Open Access Journals (Sweden)

    Polinder Suzanne

    2012-11-01

    Full Text Available Abstract Objective To systematically review the methodology of general burden of disease studies. Three key questions were addressed: 1 what was the quality of the data, 2 which methodological choices were made to calculate disability adjusted life years (DALYs, and 3 were uncertainty and risk factor analyses performed? Furthermore, DALY outcomes of the included studies were compared. Methods Burden of disease studies (1990 to 2011 in international peer-reviewed journals and in grey literature were identified with main inclusion criteria being multiple-cause studies that quantified the burden of disease as the sum of the burden of all distinct diseases expressed in DALYs. Electronic database searches included Medline (PubMed, EMBASE, and Web of Science. Studies were collated by study population, design, methods used to measure mortality and morbidity, risk factor analyses, and evaluation of results. Results Thirty-one studies met the inclusion criteria of our review. Overall, studies followed the Global Burden of Disease (GBD approach. However, considerable variation existed in disability weights, discounting, age-weighting, and adjustments for uncertainty. Few studies reported whether mortality data were corrected for missing data or underreporting. Comparison with the GBD DALY outcomes by country revealed that for some studies DALY estimates were of similar magnitude; others reported DALY estimates that were two times higher or lower. Conclusions Overcoming “error” variation due to the use of different methodologies and low-quality data is a critical priority for advancing burden of disease studies. This can enlarge the detection of true variation in DALY outcomes between populations or over time.

  5. The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

    Directory of Open Access Journals (Sweden)

    Deribe Kebede

    2012-10-01

    Full Text Available Abstract Background Neglected tropical diseases (NTDs are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2·7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward. Results This review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA, the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway. Conclusion Ethiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of

  6. Reflections on the global burden of disease 2010 estimates

    DEFF Research Database (Denmark)

    Byass, Peter; de Courten, Maximilian; Graham, Wendy J;

    2013-01-01

    Peter Byass and colleagues raise questions about the recent, high-profile Global Burden of Disease estimates. Please see later in the article for the Editors' Summary.......Peter Byass and colleagues raise questions about the recent, high-profile Global Burden of Disease estimates. Please see later in the article for the Editors' Summary....

  7. Tuberculous Pericarditis is Multibacillary and Bacterial Burden Drives High Mortality

    Directory of Open Access Journals (Sweden)

    Jotam G. Pasipanodya

    2015-11-01

    Interpretation: Patients with culture confirmed tuberculous pericarditis have a high bacillary burden, and this bacterial burden drives mortality. Thus proven tuberculosis pericarditis is not a paucibacillary disease. Moreover, the severe immunosuppression suggests limited inflammation. There is a need for the design of a highly bactericidal regimen for this condition.

  8. Tackling burden in ART: an integrated approach for medical staff

    NARCIS (Netherlands)

    Boivin, J.; Domar, A.D.; Shapiro, D.B.; Wischmann, T.H.; Fauser, B.C.J.M.; Verhaak, C.M.

    2012-01-01

    Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can

  9. Tackling burden in ART: an integrated approach for medical staff.

    Science.gov (United States)

    Boivin, Jacky; Domar, Alice D; Shapiro, Daniel B; Wischmann, Tewes H; Fauser, Bart C J M; Verhaak, Christianne

    2012-04-01

    Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been attributed to the burden of treatment. The causes of burden can be broadly classified according to whether they originate in the patient, clinic or treatment. Interventions to alleviate these burdens include provision of comprehensive educational material, screening to identify highly distressed patients, provision of tailored coping tools and improvements in the clinic environment and medical interventions. Practical interventions to reduce the different causes of burden in ART exist, but further development and evaluation of the efficacy of these interventions requires more precise definition of terms and theory. In this paper, we propose a general integrated approach to cover different perspectives in dealing with burden in ART clinics. We firstly describe the integrated approach and present common sources of burden. We then describe interventions that could help reduce the burden in ART. Our paper is aimed at fertility clinic staff because of their day-to-day involvement with patients. However, this discussion should also be relevant to companies that develop treatments and to psychosocial experts. Reducing the burden of treatment should lead to improved outcomes, namely better quality of life during treatment and lower discontinuation rates.

  10. Family rituals, financial burden, and mothers' adjustment in pediatric cancer.

    Science.gov (United States)

    Santos, Susana; Crespo, Carla; Canavarro, M Cristina; Alderfer, Melissa A; Kazak, Anne E

    2016-12-01

    The financial burden of childhood cancer may contribute to the distress that parents experience during and after treatment. Inconsistent relationships between financial burden and parental psychological distress highlight the need to identify psychosocial factors that may moderate this relationship. In this study, we aimed to determine if family ritual meaning moderates the relationship between financial burden and anxiety and depression symptoms among mothers of children with cancer. Portuguese mothers of children with cancer on-treatment and off-treatment (N = 244) completed measures of financial burden, anxiety and depression symptoms, and family ritual meaning. Moderating effects were tested using hierarchical multiple regression analyses. Family ritual meaning buffered the effect of financial burden on anxiety, but not on depression symptoms. The relationship between financial burden and anxiety symptoms was not significant when mothers endorsed higher levels of family ritual meaning. Although preliminary, the current findings suggest that high levels of perceived family ritual meaning may constitute a protective factor against the effect of financial burden on mothers' anxiety symptoms. Promoting family ritual meaning might be an effective approach to reducing anxiety symptoms of mothers of children with cancer in the context of financial burden. (PsycINFO Database Record

  11. Yellow Fever in Africa: estimating the burden of disease and impact of mass vaccination from outbreak and serological data.

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    Tini Garske

    2014-05-01

    Full Text Available Yellow fever is a vector-borne disease affecting humans and non-human primates in tropical areas of Africa and South America. While eradication is not feasible due to the wildlife reservoir, large scale vaccination activities in Africa during the 1940s to 1960s reduced yellow fever incidence for several decades. However, after a period of low vaccination coverage, yellow fever has resurged in the continent. Since 2006 there has been substantial funding for large preventive mass vaccination campaigns in the most affected countries in Africa to curb the rising burden of disease and control future outbreaks. Contemporary estimates of the yellow fever disease burden are lacking, and the present study aimed to update the previous estimates on the basis of more recent yellow fever occurrence data and improved estimation methods.Generalised linear regression models were fitted to a dataset of the locations of yellow fever outbreaks within the last 25 years to estimate the probability of outbreak reports across the endemic zone. Environmental variables and indicators for the surveillance quality in the affected countries were used as covariates. By comparing probabilities of outbreak reports estimated in the regression with the force of infection estimated for a limited set of locations for which serological surveys were available, the detection probability per case and the force of infection were estimated across the endemic zone. The yellow fever burden in Africa was estimated for the year 2013 as 130,000 (95% CI 51,000-380,000 cases with fever and jaundice or haemorrhage including 78,000 (95% CI 19,000-180,000 deaths, taking into account the current level of vaccination coverage. The impact of the recent mass vaccination campaigns was assessed by evaluating the difference between the estimates obtained for the current vaccination coverage and for a hypothetical scenario excluding these vaccination campaigns. Vaccination campaigns were estimated to

  12. [Caregivers of individuals with spinal cord injury: caregiver burden].

    Science.gov (United States)

    Nogueira, Paula Cristina; Rabeh, Soraia Assad Nasbine; Caliri, Maria Helena Larcher; Haas, Vanderlei José

    2013-06-01

    A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.

  13. Quality of life of caregivers for patients of cerebrovascular accidents: association of (socio-demographic characteristics and burden

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    Tatiana Ferreira da Costa

    2015-04-01

    Full Text Available OBJECTIVE Investigating the association between quality of life with socio-demographic characteristics and the burden of caregivers for individuals with cerebrovascular accident sequelae. METHOD A descriptive, cross-sectional study with a sample composed of 136 caregivers. For data collection, a semi-structured questionnaire, the Barthel, Burden Interview and Short-Form-36 scales were used. Correlation analysis, t-Student test and F-test were used for the analysis in order to compare averages. RESULTS Significant averages in quality of life were demonstrated in association with female caregivers and those over 60 years in the field 'functional capacity,' and in the domains of 'mental health' and 'vitality' for those with higher income. Regarding burden association, the highlighted areas were 'functional capacity,' 'physical aspects,' 'emotional aspects' and 'pain.' CONCLUSION The creation of public policies and social support to effectively reduce the burden on caregivers is a necessity.

  14. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

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    Mehta, Chitra; Dara, Babita; Mehta, Yatin; Tariq, Ali M.; Joby, George V.; Singh, Manish K.

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study. PMID:27052066

  15. Single vs composite measures of pain intensity: relative sensitivity for detecting treatment effects.

    Science.gov (United States)

    Jensen, Mark P; Hu, Xiaojun; Potts, Susan L; Gould, Errol M

    2013-04-01

    Assay sensitivity remains a significant issue in pain clinical trials. One possible method for increasing assay sensitivity for detecting changes in pain intensity is to increase the reliability of pain intensity assessment by increasing the number of intensity ratings obtained, and combining these ratings into composite scores. The current study performed secondary analyses from a published clinical trial to test this possibility. The reliability and assay sensitivity pain intensity scores made up of 1 to 9 24-hour pain intensity recall ratings were compared. Although the reliability of the outcome measures improved as the number of items increased, this increase in reliability was not associated with an increase in assay sensitivity. A single 24-hour recall rating was about as valid (sensitive) for detecting treatment effects as composite scores made up of 2 to 9 different ratings. If this finding replicates in other pain populations, it has significant implications for the design and conduct of pain clinical trials. Specifically, it suggests the possibility that assessment burden (and associated costs and problems related to missing data) might be greatly reduced by specifying a single recall rating as the primary outcome variable. Research is needed to explore this possibility further.

  16. Arsenic burden survey among refuse incinerator workers

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    Chao Chung-Liang

    2005-01-01

    Full Text Available Background: Incinerator workers are not considered to have arsenic overexposure although they have the risk of overexposure to other heavy metals. Aim: To examine the relationship between arsenic burden and risk of occupational exposure in employees working at a municipal refuse incinerator by determining the concentrations of arsenic in the blood and urine. Settings and Design: The workers were divided into three groups based on their probability of contact with combustion-generated residues, namely Group 1: indirect contact, Group 2: direct contact and Group 3: no contact. Healthy age- and sex-matched residents living in the vicinity were enrolled as the control group. Materials and Methods: Heavy metal concentrations were measured by atomic absorption spectrophotometer. Downstream rivers and drinking water of the residents were examined for environmental arsenic pollution. A questionnaire survey concerning the contact history of arsenic was simultaneously conducted. Statistical analysis: Non-parametric tests, cross-tabulation and multinomial logistic regression. Results: This study recruited 122 incinerator workers. The urine and blood arsenic concentrations as well as incidences of overexposure were significantly higher in the workers than in control subjects. The workers who had indirect or no contact with combustion-generated residues had significantly higher blood arsenic level. Arsenic contact history could not explain the difference. Airborne and waterborne arsenic pollution were not detected. Conclusion: Incinerator workers run the risk of being exposed to arsenic pollution, especially those who have incomplete protection in the workplace even though they only have indirect or no contact with combustion-generated pollutants.

  17. Comparation of Two Different Intensive Insulin Treatment for Type 2 Diabetes Patients%两种胰岛素强化方案治疗2型糖尿病的疗效比较

    Institute of Scientific and Technical Information of China (English)

    薛云; 胡继红; 成金罗; 杨科春

    2013-01-01

    Objective:To compare the efficacy and safety of two intensive insulin treatment (aspart 30 injection before three meals and aspart R injection before three meals combined with one lantus injection). Methods: A total of 180 type 2 diabetes pa tients were divided into Group A and Group B. There were 82 patients in Group A and they received subcutaneous injection of aspart 30 before three meals. There were 98 patients in Group B and they received subcutaneous injection of aspart R before three meals combined with lantus at bed time. The levels of fasting plasma glucose(FBG) , 2- hour postprandial plasma glucose (2hPBG)before or after the treatment, the daily insulin dose, the incidence of hypoglycemia, glycosylated hemoglobin(HbAlc) after 3 months in the two groups were compared. Results: Both therapies can decrease blood glucose(P0. 05). After 3 months, the drop out rate of Group B was higher than that of Group A(P0. 05). Conclusions: Both intensive therapies can control blood glucose effectively and safely, but the therapy of as part 30 injection before three meals is more easy to apply.%目的:比较采用两种胰岛素强化方案治疗2型糖尿病的有效性及安全性.方法:2型糖尿病患者180例,随机分为A、B两组.A组82例,每日三餐前10 min皮下注射双时相门冬胰岛素30;B组98例,三餐前10 min皮下注射门冬胰岛素注射液,并在睡前皮下注射甘精胰岛素注射液.比较两组治疗前后空腹血糖、餐后2h血糖、每日胰岛素用量、低血糖发生率、随访3个月后两组脱落率及糖化血红蛋白(HbA1C).结果:A、B组患者的日胰岛素平均用量分别为(38.65±7.77)U、(40.27±11.72)U(P>0.05);A组在治疗期间发生低血糖11例(13.41%),B组发生低血糖10例(10.20%),两组差异无统计学意义(P>0.05);两组治疗后空腹血糖、餐后2h血糖水平均较治疗前显著下降(P<0.01),但组间比较差异无统计学意义;随访3个月后A、B组的HbA1C

  18. Development of the Assessment of Burden of COPD tool : an integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    Slok, Annerika H. M.; in 't Veen, Johannes C. C. M.; Chavannes, Niels H.; van der Molen, Thys; Rutten-van Molken, Maureen P. M. H.; Kerstjens, Huib A. B.; Salome, Philippe L.; Holverda, Sebastiaan; Dekhuijzen, P. N. Richard; Schuiten, Denise; Asijee, Guus M.; van Schayck, Onno C. P.

    2014-01-01

    In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communicatio

  19. Development of the assessment of burden of COPD tool: An integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    A.H.M. Slok (Annerika); J.C.C.M. in 't Veen (Johannes); N.H. Chavannes (Nicolas); T. van der Molen (Thys); M.P.M.H. Rutten-van Mölken (Maureen); H.A.M. Kerstjens (Huib); J. Salomé; S. Holverda (Sebastiaan); P.N.R. Dekhuijzen (Richard); D. Schuiten (Denise); G.M. Asijee (Guus); O.C.P. Schayck (Onno)

    2014-01-01

    textabstractIn deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate

  20. Development of the Assessment of Burden of COPD tool: an integrated tool to measure the burden of COPD

    NARCIS (Netherlands)

    Slok, A.H.; Veen, J.C. In 't; Chavannes, N.H.; Molen, T. van der; Molken, M.P. Rutten-van; Kerstjens, H.A.; Salome, P.L.; Holverda, S.; Dekhuijzen, P.N.R.; Schuiten, D.; Asijee, G.M.; Schayck, O.C.P. van

    2014-01-01

    In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communicatio

  1. A comparative study of teaching clinical guideline for prevention of ventilator-associated pneumonia in two ways: face-to-face and workshop training on the knowledge and practice of nurses in the Intensive Care Unit

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    MAJID YAZDANI

    2015-04-01

    Full Text Available Introduction: Ventilator-associated pneumonia (VAP is one of the most popular nosocomial infections in the intensive care units and the nurse’s role in preventing it is very important. The aim of this study was to compare the effect of two methods of face to face training and work- shop clinical guidelines in prevention of VAP. Methods: In this experimental randomized clinical trial, the knowledge and practice of nurses in ICUs were studied in two groups: face to face training (35 nurses and workshops (40 nurses by using clinical guidelines in prevention of VAP in one of the hospitals of Shiraz University of Medical Sciences. The level of knowledge and practice in each group was assessed by selfreport questionnaire, knowledge questionnaire and also direct observation of practice, before and after training. Data were analyzed with descriptive statistics, paired t-test, independent t-test, McNemar test, Fisher’s exact, sign and Chi-square test, using SPSS 14. Results: This study demonstrated that both methods of face to face training and workshop were very effective. The incidence of inappropriate pressure of cuff in the tracheal tubes and tracheostomy tubes was significantly reduced after training (p=0.001. But, by comparison of these two methods and the relationship between the variables revealed that no significant difference was found between the two groups of face to face training and workshop. Conclusion: Training the nurses is highly effective in preventing VAP, particularly for appropriate cuff pressure, suctioning and disinfecting hands.

  2. Comparative genomics of an IncA/C multidrug resistance plasmid from Escherichia coli and Klebsiella isolates from intensive care unit patients and the utility of whole-genome sequencing in health care settings.

    Science.gov (United States)

    Hazen, Tracy H; Zhao, LiCheng; Boutin, Mallory A; Stancil, Angela; Robinson, Gwen; Harris, Anthony D; Rasko, David A; Johnson, J Kristie

    2014-08-01

    The IncA/C plasmids have been implicated for their role in the dissemination of β-lactamases, including gene variants that confer resistance to expanded-spectrum cephalosporins, which are often the treatment of last resort against multidrug-resistant, hospital-associated pathogens. A bla(FOX-5) gene was detected in 14 Escherichia coli and 16 Klebsiella isolates that were cultured from perianal swabs of patients admitted to an intensive care unit (ICU) of the University of Maryland Medical Center (UMMC) in Baltimore, MD, over a span of 3 years. Four of the FOX-encoding isolates were obtained from subsequent samples of patients that were initially negative for an AmpC β-lactamase upon admission to the ICU, suggesting that the AmpC β-lactamase-encoding plasmid was acquired while the patient was in the ICU. The genomes of five E. coli isolates and six Klebsiella isolates containing bla(FOX-5) were selected for sequencing based on their plasmid profiles. An ∼ 167-kb IncA/C plasmid encoding the FOX-5 β-lactamase, a CARB-2 β-lactamase, additional antimicrobial resistance genes, and heavy metal resistance genes was identified. Another FOX-5-encoding IncA/C plasmid that was nearly identical except for a variable region associated with the resistance genes was also identified. To our knowledge, these plasmids represent the first FOX-5-encoding plasmids sequenced. We used comparative genomics to describe the genetic diversity of a plasmid encoding a FOX-5 β-lactamase relative to the whole-genome diversity of 11 E. coli and Klebsiella isolates that carry this plasmid. Our findings demonstrate the utility of whole-genome sequencing for tracking of plasmid and antibiotic resistance gene distribution in health care settings.

  3. The socioeconomic burden of parasitic zoonoses: global trends.

    Science.gov (United States)

    Torgerson, Paul R; Macpherson, Calum N L

    2011-11-24

    Diseases resulting from zoonotic transmission of parasites are common. Humans become infected through food, water, soil and close contact with animals. Most parasitic zoonoses are neglected diseases despite causing a considerable global burden of ill health in humans and having a substantial financial burden on livestock industries. This review aims to bring together the current data available on global burden estimates of parasitic zoonoses and indicate any changes in the trends of these diseases. There is a clear need of such information as interventions to control zoonoses are often in their animal hosts. The costs of such interventions together with animal health issues will drive the cost effectiveness of intervention strategies. What is apparent is that collectively, parasitic zoonoses probably have a similar human disease burden to any one of the big three human infectious diseases: malaria, tuberculosis or HIV in addition to animal health burden. Although the global burden for most parasitic zoonoses is not yet known, the major contributors to the global burden of parasitic zoonoses are toxoplasmosis, food borne trematode infections, cysticercosis, echinococcosis, leishmaniosis and zoonotic schistosomosis. In addition, diarrhoea resulting from zoonotic protozoa may have a significant impact.

  4. Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases.

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    Charles H King

    Full Text Available The disability-adjusted life year (DALY initially appeared attractive as a health metric in the Global Burden of Disease (GBD program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs, in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities.

  5. Intensive statin therapy for Indians: Part-I. Benefits.

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    Enas, Enas A; Pazhoor, Hancy Chennikkara; Kuruvila, Arun; Vijayaraghavan, Krishnaswami

    2011-01-01

    The underlying disorder in the vast majority of cases of cardiovascular disease (CVD) is atherosclerosis, for which low-density lipoprotein cholesterol (LDL-C) is recognized as the first and foremost risk factor. HMG-CoA reductase inhibitors, popularly called statins, are highly effective and remarkably safe in reducing LDL-C and non-HDL-C levels. Evidence from clinical trials have demonstrated that statin therapy can reduce the risk of myocardial infarction (MI), stroke, death, and the need for coronary artery revascularization procedures (CARPs) by 25-50%, depending on the magnitude of LDL-C lowering achieved. Benefits are seen in men and women, young and old, and in people with and without diabetes or prior diagnosis of CVD. Clinical trials comparing standard statin therapy to intensive statin therapy have clearly demonstrated greater benefits in CVD risk reduction (including halting the progression and even reversing coronary atherosclerosis) without any corresponding increase in risk. Numerous outcome trials of intensive statin therapy using atorvastatin 80 mg/d have demonstrated the safety and the benefits of lowering LDL-C to very low levels. This led the USNCEP Guideline Committee to standardize 40 mg/dL as the optimum LDL-C level, above which the CVD risk begins to rise. Recent studies have shown intensive statin therapy can also lower CVD events even in low-risk individuals with LDL-C Asian Indians, the LDL-C target is set at 30 mg/dL lower than that recommended by NCEP. Accordingly, the LDL-C goal is or = 50% reduction in LDL-C. Broader acceptance of this lower LDL-C targets and its implementation could reduce the CVD burden in the Indian population by 50% in the next 25 years. Clinical trial data support an extremely favorable benefit-to-risk ratio of intensive statin therapy with some but not all statins. Atorvastatin 80 mg/d is 100 times safer than aspirin 81 mg/d and 10 times safer than diabetic medications. Intensive statin therapy is more effective

  6. Burden of virus-associated liver cancer in the Arab world, 1990-2010.

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    Khan, Gulfaraz; Hashim, M Jawad

    2015-01-01

    Hepatocellular carcinoma (HCC) is amongst the top three cancer causes of death worldwide with hepatitis B and C viruses (HBV/HCV) as the main etiological agents. An up-to-date descriptive epidemiology of the burden of HBV/HCV-associated HCC in the Arab world is lacking. We therefore determined the burden of HBV/HCV- associated HCC deaths in the Arab world using the Global Burden of Disease (GBD) 2010 dataset. GBD 2010 provides, for the first time, deaths specifically attributable to viral-associated HCC. We analyzed the data for the 22 Arab countries by age, sex and economic status from 1990 to 2010 and compared the findings to global trends. Our analysis revealed that in 2010, an estimated 752,101 deaths occurred from HCC worldwide. Of these 537,093 (71%) were from HBV/HCV-associated HCC. In the Arab world, 17,638 deaths occurred from HCC of which 13,558 (77%) were HBV/HCV-linked. From 1990 to 2010, the burden of HBV and HCV-associated HCC deaths in the Arab world increased by 137% and 216% respectively, compared to global increases of 62% and 73%. Age-standardized death rates also increased in most of the Arab countries, with the highest rates noted in Mauritania and Egypt. Male gender and low economic status correlated with higher rates. These findings indicate that the burden of HBV/HCV-associated HCC in the Arab world is rising at a much faster rate than rest of the world and urgent public health measures are necessary to abate this trend and diminish the impact on already stretched regional healthcare systems.

  7. Liver Disease Burden of Hepatitis C Virus Infection in Iran and the Potential Impact of Various Treatment Strategies on the Disease Burden

    Science.gov (United States)

    Hajarizadeh, Behzad; Razavi-Shearer, Devin; Merat, Shahin; Alavian, Seyed Moayed; Malekzadeh, Reza; Razavi, Homie

    2016-01-01

    Background Chronic hepatitis C virus (HCV) infection is emerging as the leading cause of viral hepatitis-related liver disease in Iran. Objectives This study estimated the current and future disease burden of HCV infection in Iran and assessed the impact of various strategies in access to HCV treatment on reducing the disease burden. Materials and Methods A modelling approach was used to estimate the size of HCV infected population, and disease progression from 2014 to 2030. Literature review and expert consensus informed the model parameters. Base case scenario assumed the currently utilized Interferon (IFN)-based treatment. Five other scenarios assumed utilizing IFN-free direct acting anti-viral regimens with 1, the base case diagnosis and treatment uptake; 2, restricting treatment to severe liver fibrosis; 3, treatment uptake being doubled; 4, stepwise increase in treatment uptake (doubled by 2017, quadrupled thereafter); 5, targeting at least 90% reduction in HCV infections by 2030. Results In 2014, an estimated 186,500 individuals are living with HCV infection in Iran (median age: 30 years). By 2030, this number will increase to 213,700, while three to four fold increase is expected in the case numbers of decompensated cirrhosis (DC, n = 620), hepatocellular carcinoma (HCC, n = 510), and liver disease death (n = 400), assuming the current diagnosis/treatment settings. As compared with the base case scenario, scenarios 1 and 2 will have a limited impact on HCV disease burden, while scenarios 3 and 4 will result in 45% - 49% decrease in the number of individuals living with HCV infection and 60% - 69% decrease in DC, HCC and liver disease deaths by 2030. For at least 90% reduction in HCV infections by 2030 (scenario 5), diagnosis and treatment rates should be increased to 12,000 and 9,000 individuals per year in 2016, respectively and to 24,000 and 18,000 individuals per year, respectively in 2018 onward. Conclusions An increasing burden of HCV-related liver

  8. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.

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    Alize J Ferrari

    2013-11-01

    Full Text Available BACKGROUND: Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease. METHODS AND FINDINGS: Burden was calculated for major depressive disorder (MDD and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs and disability adjusted life years (DALYs. Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8% of global YLDs and dysthymia for 1.4% (0.9%-2.0%. Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2% of global DALYs and dysthymia for 0.5% (0.3%-0.6%. There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8% to 3.8% (3.0%-4.7% of global DALYs. CONCLUSIONS: GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive

  9. Burden, Anger and Physical Health among Men and Women Caregivers of Dementia

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    Sidra Ali

    2015-06-01

    Full Text Available The study aimed to evaluate the efficacy of cognitive behavior therapy (CBT across gender in alleviating burden, anger and enhancing the physical health of the caregivers of patients diagnosed with dementia in the sociocultural context of Pakistan. Independent groups design was employed and a sample of ten participants was screened through purposive sampling from neurological and psychiatric clinics in Lahore, Pakistan. Ten therapeutic sessions were conducted twice weekly over a period of five weeks. The main techniques included verbal reattribution, triple column, pie chart, advantage-disadvantage analysis, progressive muscle relaxation, sleep hygiene and time management grid. The participants were assessed on General Health Questionnaire-28 (GHQ-28, Burden Assessment Scale (BAS and State-Trait Anger Expression Inventory-2 (STAXI-2 at pre and post treatment levels. Statistical analyses comprised descriptive statistics along with independent samples t-test. The results showed that the caregiver burden (t = 3.41, df= 8, p = 0.01 was significantly different as women tend to have low scores on burden level as compared to men. The findings indicate the need to devise gender sensitive therapeutic intervention.

  10. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China.

    Science.gov (United States)

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA.

  11. Murine model of disseminated fusariosis: evaluation of the fungal burden by traditional CFU and quantitative PCR.

    Science.gov (United States)

    González, Gloria M; Márquez, Jazmín; Treviño-Rangel, Rogelio de J; Palma-Nicolás, José P; Garza-González, Elvira; Ceceñas, Luis A; Gerardo González, J

    2013-10-01

    Systemic disease is the most severe clinical form of fusariosis, and the treatment involves a challenge due to the refractory response to antifungals. Treatment for murine Fusarium solani infection has been described in models that employ CFU quantitation in organs as a parameter of therapeutic efficacy. However, CFU counts do not precisely reproduce the amount of cells for filamentous fungi such as F. solani. In this study, we developed a murine model of disseminated fusariosis and compared the fungal burden with two methods: CFU and quantitative PCR. ICR and BALB/c mice received an intravenous injection of 1 × 10(7) conidia of F. solani per mouse. On days 2, 5, 7, and 9, mice from each mice strain were killed. The spleen and kidneys of each animal were removed and evaluated by qPCR and CFU determinations. Results from CFU assay indicated that the spleen and kidneys had almost the same fungal burden in both BALB/c and ICR mice during the days of the evaluation. In the qPCR assay, the spleen and kidney of each mouse strain had increased fungal burden in each determination throughout the entire experiment. The fungal load determined by the qPCR assay was significantly greater than that determined from CFU measurements of tissue. qPCR could be considered as a tool for quantitative evaluation of fungal burden in experimental disseminated F. solani infection.

  12. WHO Initiative to Estimate the Global Burden of Foodborne Diseases

    DEFF Research Database (Denmark)

    Havelaar, Arie H.; Cawthorne, Amy; Angulo, Fred

    2013-01-01

    appropriate, evidence-informed priorities in the area of food safety. MethodsThe Initiative aims to provide estimates on the global burden of foodborne diseases by age, sex, and region; strengthen country capacity for conducting burden of foodborne disease assessments in parallel with food safety policy...... of foodborne diseases, based on national and international studies. Systematic reviews to support estimates of the incidence and mortality of food-related diseases are being completed. Results will be used to update and refine global burden estimates for relevant food-related hazards, in the context of other...

  13. The pathogen- and incidence-based DALY approach: an appropriate [corrected] methodology for estimating the burden of infectious diseases.

    Directory of Open Access Journals (Sweden)

    Marie-Josée J Mangen

    Full Text Available In 2009, the European Centre for Disease Prevention and Control initiated the 'Burden of Communicable Diseases in Europe (BCoDE' project to generate evidence-based and comparable burden-of-disease estimates of infectious diseases in Europe. The burden-of-disease metric used was the Disability-Adjusted Life Year (DALY, composed of years of life lost due to premature death (YLL and due to disability (YLD. To better represent infectious diseases, a pathogen-based approach was used linking incident cases to sequelae through outcome trees. Health outcomes were included if an evidence-based causal relationship between infection and outcome was established. Life expectancy and disability weights were taken from the Global Burden of Disease Study and alternative studies. Disease progression parameters were based on literature. Country-specific incidence was based on surveillance data corrected for underestimation. Non-typhoidal Salmonella spp. and Campylobacter spp. were used for illustration. Using the incidence- and pathogen-based DALY approach the total burden for Salmonella spp. and Campylobacter spp. was estimated at 730 DALYs and at 1,780 DALYs per year in the Netherlands (average of 2005-2007. Sequelae accounted for 56% and 82% of the total burden of Salmonella spp. and Campylobacter spp., respectively. The incidence- and pathogen-based DALY methodology allows in the case of infectious diseases a more comprehensive calculation of the disease burden as subsequent sequelae are fully taken into account. Not considering subsequent sequelae would strongly underestimate the burden of infectious diseases. Estimates can be used to support prioritisation and comparison of infectious diseases and other health conditions, both within a country and between countries.

  14. Epidemiology, clinical characteristics and resource implications of pandemic (H1N1) 2009 in intensive care units in Ireland.

    LENUS (Irish Health Repository)

    Nicolay, Nathalie

    2010-12-01

    To describe the incidence, clinical characteristics and outcomes of critically ill patients in Ireland with pandemic (H1N1) 2009 infection, and to provide a dynamic assessment of the burden of such cases on Irish intensive care units.

  15. Comparative Study on the Dosimetric Veriifcation of Intensity-Modulated Radiation Therapy of Monaco and Xio Treatment Planning Systems%Monaco与Xio治疗计划系统调强放疗剂量验证的比较研究

    Institute of Scientific and Technical Information of China (English)

    王宁; 陈阿龙; 夏景涛

    2014-01-01

    Objective To evaluate the clinical accuracy of Monaco and Xio treatment planning systems (TPS) by comparing the dose verification results of intensity-modulated radiation therapy (IMRT) of the two treatment planning systems.Methods The dose veriifcation of IMRT plans for nasopharyngeal carcinoma formulated by Xio TPS (n=20) and Monaco TPS (n=20) was conducted by IBA Matrixx. Then Gamma pass rate analysis was conducted according to various criterias including 2%/2 mm, 3%/3 mm and 5%/3 mm.Results The average Gamma pass rate of IMRT plans of Monaco TPS was higher than that of Xio TPS according to all the criterias. There were signiifcant differences between Monaco TPS and Xio TPS on the Gamma pass rate according to 2%/2 mm and 3%/3 mm criterias (P0.05).Conclusion Both of Monaco and Xio treatment planning systems can be applied to clinical IMRT while the accuracy of Monaco TPS is higher than that of Xio TPS.%目的:通过比较调强放疗剂量验证的结果,评价Monaco和Xio治疗计划系统的临床治疗准确性。方法选取Xio治疗计划系统20例鼻咽癌调强治疗计划,Monaco治疗计划系统20例鼻咽癌调强治疗计划,用IBA二维电离室矩阵Matrixx进行剂量验证,分别以2%/2 mm、3%/3 mm、5%/3 mm为标准进行Gamma通过率分析。结果 Monaco系统在3种标准下的Gamma平均通过率均高于Xio系统。差异在2%/2 mm、3%/3 mm下具有统计学意义(P<0.05),5%/3 mm下无统计学意义(P>0.05)。结论两种治疗计划系统都能应用于临床调强放疗,但Monaco计划系统的准确性要优于Xio计划系统。

  16. Double burden of malnutrition: A silent driver of double burden of disease in low– and middle–income countries

    Directory of Open Access Journals (Sweden)

    Ivana Kolcˇic´

    2012-09-01

    Full Text Available Double burden of malnutrition, characterised by undernutrition among poor children and obesity among deprived adults, is a serious global problem and an important promoter of ‘double burden of disease’ which is currently affecting low– and middle–income countries. Possible ways to reduce this burden is through education on the importance of equilibrium between energy intake and expenditure; ensuring conditions for optimal fetal and early child development; and reducing poverty as one of the main drivers of both undernutrition and obesity, through empowering local communities.

  17. Opioid Overdoses Burden U.S. Hospitals: Report

    Science.gov (United States)

    ... Burden U.S. Hospitals: Report Admissions due to heroin, painkillers rose 64 percent over decade To use the ... a government report shows. As misuse of prescription painkillers and street opioids climbed nationwide, related hospital stays ...

  18. Depression and caregiver burden among rural elder caregivers.

    Science.gov (United States)

    Butler, Sandra S; Turner, Winston; Kaye, Lenard W; Ruffin, Leah; Downey, Roberta

    2005-01-01

    Family caregivers of older adults frequently experience feelings of burden and depression though they may not come to the attention to health and service providers until they are at a point of crisis. Through a simple screening tool, the Maine Primary Partners in Caring (MPPC) project identified individuals providing care to older adults through rural primary care practices, in order to provide upstream interventions before caregivers were in crisis. This paper describes a sample (n=62) of rural family caregivers identified through their physicians' offices. High levels of caregiver burden and depression were reported. Family support and knowledge of caregiver tasks predicted decreased caregiver burden and depression, while isolation predicted increased caregiver burden. Implications of these results for gerontological social workers are outlined.

  19. Tumor burden talks in cancer treatment with PEGylated liposomal drugs.

    Directory of Open Access Journals (Sweden)

    Yi-Yu Lin

    Full Text Available PURPOSE: PEGylated liposomes are important drug carriers that can passively target tumor by enhanced permeability and retention (EPR effect in neoplasm lesions. This study demonstrated that tumor burden determines the tumor uptake, and also the tumor response, in cancer treatment with PEGylated liposomal drugs in a C26/tk-luc colon carcinoma-bearing mouse model. METHODS: Empty PEGylated liposomes (NanoX and those encapsulated with VNB (NanoVNB were labeled with In-111 to obtain InNanoX and InVNBL in high labeling yield and radiochemical purity (all >90%. BALB/c mice bearing either small (58.4±8.0 mm(3 or large (102.4±22.0 mm(3 C26/tk-luc tumors in the right dorsal flank were intravenously administered with NanoVNB, InNanoX, InVNBL, or NanoX as a control, every 7 days for 3 times. The therapeutic efficacy was evaluated by body weight loss, tumor growth inhibition (using calipers and bioluminescence imaging and survival fraction. The scintigraphic imaging of tumor mouse was performed during and after treatment. RESULTS: The biodistribution study of InVNBL revealed a clear inverse correlation (r (2 = 0.9336 between the tumor uptake and the tumor mass ranged from 27.6 to 623.9 mg. All three liposomal drugs showed better therapeutic efficacy in small-tumor mice than in large-tumor mice. Tumor-bearing mice treated with InVNBL (a combination drug showed the highest tumor growth inhibition rate and survival fraction compared to those treated with NanoVNB (chemodrug only and InNanoX (radionuclide only. Specific tumor targeting and significantly increased tumor uptake after periodical treatment with InVNBL were evidenced by scintigraphic imaging, especially in mice bearing small tumors. CONCLUSION: The significant differences in the outcomes of cancer treatment and molecular imaging between animals bearing small and large tumors revealed that tumor burden is a critical and discriminative factor in cancer therapy using PEGylated liposomal drugs.

  20. Burden of celiac disease in the Mediterranean area

    Institute of Scientific and Technical Information of China (English)

    Luigi Greco; Zrinjka Mi(s)ak; Eleftheria Roma; Raanan Shamir; Selma Terzic; Laura Timpone; Abdelhak Abkari; Mona Abu-Zekry; Thomas Attard; Faouzi Bouguerrà; Paskal Cullufi; Aydan Kansu; Dusanka Micetic-Turk

    2011-01-01

    AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available confidence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic profiles amongst Mediterranean countries.RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortal ity: about 600 000 celiac

  1. Burden of Self-reported Acute Gastrointestinal Illness in Cuba

    OpenAIRE

    Prieto, Pablo Aguiar; Finley, Rita L; Muchaal, P.K.; Guerin, Michele T; Isaacs, Sandy; Domínguez, Arnaldo Castro; Marie, Gisele Coutín; Perez, Enrique

    2009-01-01

    Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a ...

  2. National Economic Burden Associated with Management of Periodontitis in Malaysia

    OpenAIRE

    Tuti Ningseh Mohd Dom; Rasidah Ayob; Khairiyah Abd Muttalib; Syed Mohamed Aljunid

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to es...

  3. Outdoor air dominates burden of disease from indoor exposures

    DEFF Research Database (Denmark)

    Hänninen, O.; Asikainen, A.; Carrer, P.

    2014-01-01

    Both indoor and outdoor sources of air pollution have significant public health impacts in Europe. Based on quantitative modelling of the burden of disease the outdoor sources dominate the impacts by a clear margin.......Both indoor and outdoor sources of air pollution have significant public health impacts in Europe. Based on quantitative modelling of the burden of disease the outdoor sources dominate the impacts by a clear margin....

  4. Does I-131-MIBG underestimate skeletal disease burden in neuroblastoma?

    Directory of Open Access Journals (Sweden)

    Barai Sukanta

    2004-10-01

    Full Text Available Background: Controversy persists as to the need for both MIBG and bone scanning in routine evaluation of neuroblastoma. Aim: To compare the efficacy of I-131- metaiodobenzylguanidine (MIBG scan against that of conventional Tc99m- methylene diphosphonate (MDP bone scan for the detection of skeletal deposition of neuroblastoma. Methods and Material: The study included 57 patients (36 boys, 21 girls: age range 1-14 years of neuroblastoma who underwent both bone scan with Tc99m-MDP and I-131-MIBG scan within 15 days of each other at presentation and during follow-up. Results: At presentation 11(19.2% patients had evidence of skeletal metastases on MDP scan against 7 patients who showed bony secondaries on MIBG scan. Of the 7 patients, with positive MIBG and MDP scans, MDP scan detected 11 sites whereas MIBG scan detected 7 sites. On follow-up study, 3 patients with initial abnormal MDP scan but normal MIBG scan, developed skeletal metastases detectable on MIBG scan, whereas 3 of the 46 patients who had normal MDP and MIBG scan at presentation; developed skeletal metastases detectable on MDP scan. MIBG scan was concordant in 2 of them but was normal in the third patient. Conclusion: I-131-MIBG underestimates skeletal disease burden in neuroblastoma. Therefore, Tc99m-MDP bone scan should remain a part of routine assessment of patients with neuroblastoma.

  5. The size and burden of mental disorders and other disorders of the brain in Europe 2010

    DEFF Research Database (Denmark)

    Wittchen, H U; Jacobi, F; Rehm, J;

    2011-01-01

    To provide 12-month prevalence and disability burden estimates of a broad range of mental and neurological disorders in the European Union (EU) and to compare these findings to previous estimates. Referring to our previous 2005 review, improved up-to-date data for the enlarged EU on a broader range...... of disorders than previously covered are needed for basic, clinical and public health research and policy decisions and to inform about the estimated number of persons affected in the EU....

  6. 20 CFR 498.215 - The hearing and burden of proof.

    Science.gov (United States)

    2010-04-01

    ... burden of going forward and the burden of persuasion with respect to affirmative defenses and any... persuasion with respect to all other issues. (c) The burden of persuasion will be judged by a...

  7. Lead Burden as a Factor for Higher Complication Rate in Patients With Implantable Cardiac Devices

    Directory of Open Access Journals (Sweden)

    Christopher Kolibash

    2015-01-01

    Full Text Available Purpose: Lead revisions have increased over the last decade. Patients who do not undergo lead extraction face an increased lead burden. Consequences of increased lead burden have not been fully defined. We sought to characterize the complication rate and outcomes in patients with sterile redundant leads. Methods: We retrospectively reviewed 242 consecutive patients [mean age 74 ± 12 years; 66.9% male] who underwent lead revision that resulted in an abandoned lead from January 2005 to June 2010. Patients were placed in a cohort based on number of leads after last recorded procedure (Group A: ≤2 [n=58]; Group B: 3-4 [n=168]; Group C: ≥5 [n=16]. Prespecified inhospital and long-term follow-up events were compared. Mortality rates were obtained from Social Security Death Index. Median follow-up was 2 years. Results: Baseline age, gender and race demographics were similar among the three groups. Increasing lead burden was associated with more adverse periprocedural events (A: 3.4%, B: 10.1%, C: 25.0%; P=0.031 and long-term device-related events (A: 1.7%, B: 13.0%, C: 18.8%; P=0.031. Device-related readmissions increased in frequency as lead burden increased (A: 3.5%, B: 18.5%, C: 37.5%; P=0.002. Combined periprocedural and late events also increased with more redundant leads (A: 5.2%, B: 23.2%, C: 44.0%; P=0.001. Total major events were infrequent (3.3%. There was no procedure-related mortality. Long-term all-cause mortality was not significantly different (A: 17.2%, B: 23.8%, C: 25.0%; P=0.567. Conclusions: Greater lead burden was associated with increased number of periprocedural and long-term minor events. It did not significantly impact major events or mortality.

  8. [Burden of cancer in China: data on disability-adjusted life years].

    Science.gov (United States)

    Shi, Jufang; Zhang, Yue; Qu, Chunfeng; Zhang, Kai; Guo, Lanwei; Dai, Min; He, Jie

    2015-04-01

    Disability-adjusted life years (DALYs) has been increasingly used to estimate burden of disease worldwide. By giving a particular attention to DALYs, the objectives of the study were to review various data sources and to conduct an extended estimation on the burden of cancer in China. Based on the publications released by the GLOBOCAN 2008 program and the Global Burden of Disease 2010 (GBD 2010) program, we reviewed the methodological information and gathered DALY data associated with burden of cancer in China, and then we extracted and summarized the data and conducted an extended analysis. From a methodological perspective, both of the programs applied the utility weights mainly from populations other than China. The data from GLOBOCAN 2008 suggests that liver cancer has replaced lung cancer and became the leading cancer in males in China when using DALY rather than mortality rate as the indicator (6.3 million and 5.4 million DALYs, respectively); although the ranking is different, data from the GBD 2010 project shows DALYs caused by liver cancer is comparable to that associated with lung cancer (7.9 million and 8.0 million, respectively). The years lived with disability (YLDs) comprised 26% and 12% of the total DALYs associated with breast cancer and colorectal cancer in China. Both projects suggest that liver cancer might have become or is becoming the leading contributor to males' DALYs in China. There are indications that, along with economic development, YLD will play a more important role in estimation of burden of cancer in China; it suggests that China should consider introducing DALY into the estimation system as early as possible. It also suggests that research on quality of life and utility associated with the major cancers in China need to be systematically conducted to facilitate more accurate DALY estimation.

  9. Estimating the true global burden of mental illness.

    Science.gov (United States)

    Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

    2016-02-01

    We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness.

  10. Ventilators in ICU: A boon or burden

    Directory of Open Access Journals (Sweden)

    Man Mohan Mehndiratta

    2016-01-01

    Full Text Available Background and Aims: Ventilator-associated pneumonia (VAP is a major challenge in intensive care units (ICUs. This challenge is even more discernible in a neurological setting owing to the predispositions of patients. Data on VAP in the neurology and neurosurgery ICUs (NNICUs are scanty in developing countries. This study was conducted to find out the occurrence of VAP, its risk factors, microbiological profile, and antibiotic resistance in patients admitted to the NNICU of a tertiary care institute in India. Materials and Methods: Endotracheal aspirate and blood samples were collected from 100 patients admitted to the NNICU. Complete blood count, microscopic examination, culture and sensitivity testing of aspirate were done. Chest x-ray was also performed to aid in the diagnosis of VAP. Results: Incidence rate of VAP was found to be 24%. Acinetobacter baumannii was the most common pathogen (24.3% isolated from patients with VAP, and all of these isolates were sensitive to meropenem. Duration of mechanical ventilation (P < 0.0001 and associated comorbid illness (P = 0.005 were found to be significantly associated with VAP, and the duration of mechanical ventilation was found to be the only independent risk factor (P < 0.0001. Conclusions: This study highlights the risks and microbiological perspective of ventilator use among neurology patients so that adequate preventive strategies can be adopted on time.

  11. Acinetobacter baumannii Infection in the Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    AMK AL Jarousha

    2008-09-01

    Full Text Available Background: To perform a prospective case control study of blood stream infection to determine the infection rate of Acine­tobac­ter baumannii and the risk factors associated with mortality."nMethods:   From February 2004 to January 2005, 579 consecutive episodes of blood stream infection were obtained at two neo­na­tal intensive care units Al Nasser and Al Shifa hospitals in Gaza City. Forty (6.9% isolates of A. baumannii were ob­tained from the neonates under 28 d. Most of the isolates (92% were from hospitalized patients in the intensive care units."nResults: Community acquired infection was 8%.  Sixty three percent of the patients were males. The isolates of A. bauman­nii were resistant to commonly used antibiotics while being sensitive to meropenem (92.5%, imipenem (90%, chloram­pheni­col (80%, ciprofloxacin (75%, gentamicin (57.5%, ceftriaxone (50%, amikacin (37.5%, cefuroxime and ce­fo­taxime (35%. Over all crude mortality rate was 20% with much higher crude mortality among patients with noso­co­mial infec­tion.  Based on logistic regression, the following factors were statistically significant: weight < 1500g, age < 7 d, mean of hospitalization equal 20 days, antibiotic use, and mechanical ventilation, when compared to the control group (P< 0.05."nConclusion:  Infection rate of nosocomial blood stream infection was considerable and alarming in neonatal intensive care unit infants and associated with a significant excess length of NICU stay and a significant economic burden.  

  12. Cadmium burden and the risk and phenotype of prostate cancer

    Directory of Open Access Journals (Sweden)

    Wu Tony T

    2009-12-01

    Full Text Available Abstract Background Studies on the association between prostate cancer and cadmium exposure have yielded conflicting results. This study explored cadmium burden on the risk and phenotype of prostate cancer in men with no evident environmental exposure. Methods Hospital-based 261 prostate cancer cases and 267 controls with benign diseases were recruited from four hospitals in Taiwan. Demographic, dietary and lifestyle data were collected by standardized questionnaires. Blood cadmium (BCd and creatinine-adjusted urine cadmium (CAUCd levels were measured for each participant. Statistical analyses measured the prostate cancer risk associated with BCd and CAUCd separately, controlling for age, smoking and institution. BCd and CAUCd levels within cases were compared in relation to the disease stage and the Gleason score. Results High family income, low beef intake, low dairy product consumption and positive family history were independently associated with the prostate carcinogenesis. There was no difference in BCd levels between cases and controls (median, 0.88 versus 0.87 μg/l, p = 0.45. Cases had lower CAUCd levels than controls (median, 0.94 versus 1.40 μg/g creatinine, p = 0.001. However, cases with higher BCd and CAUCd levels tended to be at more advanced stages and to have higher Gleason scores. The prostate cancer cases with Gleason scores of ≥ 8 had an odds ratio of 2.89 (95% confidence interval 1.25-6.70, compared with patients with scores of 2-6. Conclusion Higher CAUCd and BCd levels may be associated with advanced cancer phenotypes, but there was only a tenuous association between cadmium and prostate cancer.

  13. Assessment of severity and burden of pruritus

    Directory of Open Access Journals (Sweden)

    Manuel Pedro Pereira

    2017-01-01

    Full Text Available Chronic pruritus is a complex multifactorial symptom associated with many different diseases that represents a diagnostic and therapeutic challenge for physicians. In order to better manage chronic pruritus, a detailed medical history, individualized diagnostic procedures and treatment approaches are necessary. Treatment should not only take itch into consideration, but also scratching-induced skin lesions and accompanying disorders such as anxiety, depression and insomnia. Various standardized questionnaires and scales have been developed to assist in the characterization and assessment of these parameters. Monodimensional scales (e.g. the visual analogue scale represent a simple method for assessing pruritus intensity and are frequently used; however, they can easily be confounded and may indicate the level of satisfaction regarding the medical care provided rather than the itch course. The Dynamic Pruritus Score and Itch-Free Days questionnaire enable a closer assessment of patient responses to treatment. Because chronic pruritus has the potential to greatly impact the quality of life, it is important that physicians recognize it as a major issue. The Dermatology Quality of Life Index is an instrument that is used in a variety of dermatological conditions, but may be unsuitable for measuring pruritus of extracutaneous origin. The ItchyQol is a tool designed specifically for those suffering from pruritus. Additional tools, such as the Hospital Anxiety and Depression Scale, take psychiatric comorbidities into consideration. Recommendations from European (EADV-based Task Force Pruritus and international (International Forum for the Study of Itch expert groups focusing on assessment instruments for chronic pruritus are also provided in this article.

  14. Comparative investigation on the effect of alkaline earth oxides on the intensity of absorption bands due to Cu2+, Mn3+ and Cr3+ ions in ternary silicate glasses

    Indian Academy of Sciences (India)

    S P Singh; Aman; Anal Tarafder

    2004-06-01

    Absorption characteristics of Cu2+, Mn3+ and Cr3+ ions in ternary silicate (20Na2O.10RO.70SiO2, where R=Ca, Sr, Ba) glasses were investigated. The intensities of absorption bands due to Cu2+ ion was found to increase with increasing ionic radii of the alkaline earth ions whereas it was found to decrease in case of Mn3+ and Cr3+ ions with increasing ionic radii of the alkaline earth ions. The results were discussed in the light of relation between linear extinction coefficients of these ions and coulombic force of alkaline earth ions. The change in intensities of Cu2+, Mn3+ and Cr3+ ion is attributed due to change in silicate glass compositions.

  15. Economic Burden for Lung Cancer Survivors in Urban China

    Directory of Open Access Journals (Sweden)

    Xin Zhang

    2017-03-01

    Full Text Available Background: With the rapid increase in the incidence and mortality of lung cancer, a growing number of lung cancer patients and their families are faced with a tremendous economic burden because of the high cost of treatment in China. This study was conducted to estimate the economic burden and patient responsibility of lung cancer patients and the impact of this burden on family income. Methods: This study uses data from a retrospective questionnaire survey conducted in 10 communities in urban China and includes 195 surviving lung cancer patients diagnosed over the previous five years. The calculation of direct economic burden included both direct medical and direct nonmedical costs. Indirect costs were calculated using the human capital approach, which measures the productivity lost for both patients and family caregivers. The price index was applied for the cost calculation. Results: The average economic burden from lung cancer was $43,336 per patient, of which the direct cost per capita was $42,540 (98.16% and the indirect cost per capita was $795 (1.84%. Of the total direct medical costs, 35.66% was paid by the insurer and 9.84% was not covered by insurance. The economic burden for diagnosed lung cancer patients in the first year following diagnosis was $30,277 per capita, which accounted for 171% of the household annual income, a percentage that fell to 107% after subtracting the compensation from medical insurance. Conclusions: The economic burden for lung cancer patients is substantial in the urban areas of China, and an effective control strategy to lower the cost is urgently needed.

  16. Estimating the burden of paratyphoid a in Asia and Africa.

    Directory of Open Access Journals (Sweden)

    Michael B Arndt

    2014-06-01

    Full Text Available Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi and serovar Paratyphi (S. Paratyphi cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa. We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study. A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden. While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention

  17. Estimating the global burden of endemic canine rabies.

    Directory of Open Access Journals (Sweden)

    Katie Hampson

    2015-04-01

    Full Text Available Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries.We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000 human deaths, over 3.7 million (95% CIs: 1.6-10.4 million disability-adjusted life years (DALYs and 8.6 billion USD (95% CIs: 2.9-21.5 billion economic losses annually. The largest component of the economic burden is due to premature death (55%, followed by direct costs of post-exposure prophylaxis (PEP, 20% and lost income whilst seeking PEP (15.5%, with only limited costs to the veterinary sector due to dog vaccination (1.5%, and additional costs to communities from livestock losses (6%.This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts.

  18. Economic and disease burden of dengue in Southeast Asia.

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    Donald S Shepard

    Full Text Available BACKGROUND: Dengue poses a substantial economic and disease burden in Southeast Asia (SEA. Quantifying this burden is critical to set policy priorities and disease-control strategies. METHODS AND FINDINGS: We estimated the economic and disease burden of dengue in 12 countries in SEA: Bhutan, Brunei, Cambodia, East-Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam. We obtained reported cases from multiple sources--surveillance data, World Health Organization (WHO, and published studies--and adjusted for underreporting using expansion factors from previous literature. We obtained unit costs per episode through a systematic literature review, and completed missing data using linear regressions. We excluded costs such as prevention and vector control, and long-term sequelae of dengue. Over the decade of 2001-2010, we obtained an annual average of 2.9 million (m dengue episodes and 5,906 deaths. The annual economic burden (with 95% certainty levels was US$950m (US$610m-US$1,384m or about US$1.65 (US$1.06-US$2.41 per capita. The annual number of disability-adjusted life years (DALYs, based on the original 1994 definition, was 214,000 (120,000-299,000, which is equivalent to 372 (210-520 DALYs per million inhabitants. CONCLUSION: Dengue poses a substantial economic and disease burden in SEA with a DALY burden per million inhabitants in the region. This burden is higher than that of 17 other conditions, including Japanese encephalitis, upper respiratory infections, and hepatitis B.

  19. Intensive integrated therapy of type 2 diabetes

    DEFF Research Database (Denmark)

    Gaede, Peter; Pedersen, Oluf

    2004-01-01

    effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome...... of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy......The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial...

  20. Burden of Ischemic Heart Disease Attributable to Low Omega-3 Fatty Acids Intake in Iran: Findings from the Global Burden of Disease Study 2010

    Directory of Open Access Journals (Sweden)

    Sara Nejatinamini

    2016-07-01

    Full Text Available Background: Dietary risk factors constitute some of the leading risk factors for cardiovascular disease in Iran. The current study reports the burden of ischemic heart disease (IHD attributable to a low omega-3 fatty acids intake in Iran using the data of the Global Burden of Disease (GBD Study 2010.Methods: We used data on Iran for the years 1990, 2005, and 2010 derived from the GBD Study conducted by the Institute for Health Metrics and Evaluation (IHME in 2010. Using the comparative risk assessment, we calculated the proportion of death, years of life lost, years lived with disability, and disability-adjusted life years (DALYs caused by IHD attributable to a low omega-3 fatty acids intake in the GBD studies from 1990 to 2010. Results: In 1990, a dietary pattern low in seafood omega-3 fatty acids intake was responsible for 423 (95% uncertainty interval [UI], 300 to 559, 3000 (95% UI, 2182 to 3840, and 4743 (95% UI, 3280 to 6047 DALYs per 100000 persons in the age groups of 15 to 49 years, 50 to 69 years, and 70+ years — respectively — in both sexes.  The DALY rates decreased to 250 (95% UI, 172 to 331, 2078 (95% UI, 1446 to 2729, and 3911 (95% UI, 2736 to 5142 in 2010. The death rates per 100000 persons in the mentioned age groups were 9 (95% UI, 6 to 12, 113 (95% UI, 82 to 144, and 366 (95% UI, 255 to 469 in 1990 versus 6 (95% UI, 4 to 7, 76 (95% UI, 53 to 99, and 344 (95% UI, 241 to 453 in 2010. The burden of IHD attributable to diet low in seafood omega-3 was 1.3% (95% UI, 0.97 to 1.7 of the total DALYs in 1990 and 2.0% (95% UI, 1.45 to 2.63 in 2010 for Iran.Conclusion: The findings of the GBD Study 2010 showed a declining trend in the burden of IHD attributable to a low omega-3 fatty acids intake in a period of 20 years. Additional disease burden studies at national and sub-national levels in Iran using more data sources are suggested for public health priorities and planning public health strategies.

  1. Estimating the hidden burden of bovine tuberculosis in Great Britain.

    Directory of Open Access Journals (Sweden)

    Andrew J K Conlan

    Full Text Available The number of cattle herds placed under movement restrictions in Great Britain (GB due to the suspected presence of bovine tuberculosis (bTB has progressively increased over the past 25 years despite an intensive and costly test-and-slaughter control program. Around 38% of herds that clear movement restrictions experience a recurrent incident (breakdown within 24 months, suggesting that infection may be persisting within herds. Reactivity to tuberculin, the basis of diagnostic testing, is dependent on the time from infection. Thus, testing efficiency varies between outbreaks, depending on weight of transmission and cannot be directly estimated. In this paper, we use Approximate Bayesian Computation (ABC to parameterize two within-herd transmission models within a rigorous inferential framework. Previous within-herd models of bTB have relied on ad-hoc methods of parameterization and used a single model structure (SORI where animals are assumed to become detectable by testing before they become infectious. We study such a conventional within-herd model of bTB and an alternative model, motivated by recent animal challenge studies, where there is no period of epidemiological latency before animals become infectious (SOR. Under both models we estimate that cattle-to-cattle transmission rates are non-linearly density dependent. The basic reproductive ratio for our conventional within-herd model, estimated for scenarios with no statutory controls, increases from 1.5 (0.26-4.9; 95% CI in a herd of 30 cattle up to 4.9 (0.99-14.0 in a herd of 400. Under this model we estimate that 50% (33-67 of recurrent breakdowns in Britain can be attributed to infection missed by tuberculin testing. However this figure falls to 24% (11-42 of recurrent breakdowns under our alternative model. Under both models the estimated extrinsic force of infection increases with the burden of missed infection. Hence, improved herd-level testing is unlikely to reduce recurrence

  2. Elevated burden for caregivers of children with persistent asthma and a developmental disability.

    Science.gov (United States)

    Koehler, Alana D; Fagnano, Maria; Montes, Guillermo; Halterman, Jill S

    2014-11-01

    To evaluate how having a child with both persistent asthma and a developmental disability (DD) affects caregiver burden and quality of life (QOL). 3-10 year old children with persistent asthma in urban Rochester, NY. Cross-sectional baseline survey (2006-2009). Parent report of autism spectrum disorder or other behavioral disorder requiring medication. Caregiver burden and QOL as measured by scores on previously validated depression, parenting confidence, and asthma-related QOL scales as well as an assessment of competing demands on the caregiver. Bivariate and multivariate regression analyses controlling for caregiver age, education, marital status, race, ethnicity, and child asthma symptom severity. We enrolled 530 children as part of a larger study (response rate: 74; 63 % Black, 73 % Medicaid). Of this sample, 70 children (13 %) were defined as having a DD. There were no differences in asthma symptom severity between children with and without a DD diagnosis. However, even after adjusting for potential confounders, caregivers of children with a DD reported worse scores on the depression (p = .003), parenting confidence (p asthma-related QOL (p = .035) compared to caregivers of typically developing children with asthma. Despite having similar asthma symptom severity, caregivers of children with both persistent asthma and a DD diagnosis report more burden and lower QOL compared to that of caregivers of typically developing children and persistent asthma. Further attention to this subgroup is needed to promote optimal support for caregivers.

  3. Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S;

    2007-01-01

    with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... size [slope = -0.12 (95% CI -0.17 to -0.07); P type-2 diabetes mellitus. CONCLUSION: Lesions in type-2 diabetic patients are different from previous reports in non-diabetics. Lesions in type-2 diabetics are characterized by a large reference segment plaque burden......AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...

  4. BURDEN OF ABNORMAL HEMATOPOIETIC CLONE IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the role of the burden of abnormal hematopoietic clone in the development of myelodys plastic syndromes (MDS).Methods The ratio of the bone marrow cells with abnormal chromosomes to the total counted bone marrow cells was regarded as the index of MDS clone burden. The disease severity related parameters including white blood cell count, hemoglobin, platelet count, lactate dehydrogenase level, bone marrow blast, myeloid differentiation index, micromegakaryocyte, transfusion, interleukin-2, tumor necrosis factor ( TNF), CD4 + and CD8 + T cells of MDS patients were assayed, and the correlations between those parameters and MDS clone burden were also analyzed.Results The clone burden of MDS patients was 67.4% ± 36. 2%. MDS clone burden positively correlated with bone marrow blasts (r=0.483, P<0.05), negatively with hemoglobin level (r=-0.445, P<0.05). The number of blasts, hemoglobin, and erythrocytes in high clone burden (>50%) and low clone burden (≤50%) groups were 7.78%±5.51% and 3.45%±3.34%, 56.06±14. 28 g/L and 76.40±24.44 g/L, (1.82±0.48)×1012/L and (2. 32±0.66)×1012/L, respectively (all P <0.05). CD4 + T lymphocytes of MDS patients and normal controls were (0. 274±0.719)×109/L and (0.455±0.206)×109/L, respectively (P<0.05). CD8 ± T lymphocytes of MDS patients and normal controls were (0.240±0.150)×109/L and (0.305 ±0.145)×109/L, respectively. The serum level of interleukin-2 of MDS patients (6.29±3.58 ng/mL) was significantly higher than normal control (3.11±1.40ng/mL, P<0.05). The serum level of TNF of MDS patients and normal control group were 2.42±1.79 ng/mL and 1.68 ±0.69 ng/mL, respectively. The ratio of CD4 to CD8 was higher in high clone burden MDS patients (1.90 ±0.52) than that in low clone burden patients (0.97±0.44, P<0.05).Conclusion The quantitive clonal karyotype abnormalities and deficient T cell immunity are important parameters for evaluating MDS severity and predicting its

  5. Global economic burden of schizophrenia: a systematic review

    Directory of Open Access Journals (Sweden)

    Chong HY

    2016-02-01

    Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

  6. Iowa Intensive Archaeological Survey

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This shape file contains intensive level archaeological survey areas for the state of Iowa. All intensive Phase I surveys that are submitted to the State Historic...

  7. Rainfed intensive crop systems

    DEFF Research Database (Denmark)

    Olesen, Jørgen E

    2014-01-01

    This chapter focuses on the importance of intensive cropping systems in contributing to the world supply of food and feed. The impact of climate change on intensive crop production systems is also discussed....

  8. Primary caregivers of schizophrenia outpatients: burden and predictor variables.

    Science.gov (United States)

    Grandón, Pamela; Jenaro, Cristina; Lemos, Serafín

    2008-04-15

    This article explores family burden in relation to relatives' coping strategies and social networks, as well as in relation to the patients' severity of positive and negative symptoms. Data on the severity of symptoms (Positive and Negative Syndrome Scale for Schizophrenia [PANSS]), social functioning (Social Functioning Scale [SFS]), caregivers burden (Interview on Objective and Subjective Family Burden or Entrevista de Carga Familiar Objetiva y Subjetiva [ECFOS]), coping skills (Family Coping Questionnaire [FCQ]), and social support (Social Network Questionnaire [SNQ]) were gathered from a randomized sample of 101 Chilean outpatients and their primary caregivers, mostly mothers. Low levels of burden were typically found, with the exception of moderate levels on general concerns for the ill relative. A hierarchical regression analysis with four blocks showed that clinical characteristics, such as higher frequency of relapses, more positive symptoms and lower independence-performance, together with lower self-control attributed to the patient, decrease in social interests, and less affective support, predict burden. The results support the relevance of psychoeducational interventions where families' needs are addressed.

  9. Large orthotopic reservoir stone burden: Role of open surgery

    Directory of Open Access Journals (Sweden)

    Madbouly Khaled

    2010-01-01

    Full Text Available Purpose: To present our experience in open poucholithotomy as a primary management of large orthotopic reservoir stone burden and discuss different management options. Materials and Methods: Records of men underwent radical cystectomy and orthotopic urinary diversion were retrospectively reviewed as regards pouch stone formation. Patients with large reservoir stone burden managed by open poucholithotomy were further selected. Results: Large reservoir stone burden was encountered in 12 post radical cystectomy men. All underwent open poucholithotomy as a primary management of their reservoir stones. Median age at cystectomy was 46 (range: 32-55 years with a median total follow up period of 214.15 (range: 147-257 months and a median interval to stone detection of 99 (range: 63-132 months. The median stone burden was 5260 (range: 3179-20410 mm 2 . All patients were continent during the day while 5 showed nocturnal enuresis; 2 of them became continent after removal of the stones. Post poucholithotomy, all patients had sterile urine cultures except one who showed occasional colonization. None of the 12 patients showed stone recurrence after poucholithotomy. Two patients underwent revision of a dessuscepted nipple valve in association with stone removal. Conclusions: Open poucholithotomy for large reservoir stone burden is a feasible and safe option. It saves the reservoir mesentery and adjacent bowel. It allows complete removal of the stone(s leaving no residual fragments. Furthermore, it permits correction of concomitant reservoir abnormalities.

  10. Expressed emotion and caregiver burden in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    B P Nirmala

    2011-01-01

    Full Text Available Background: Family′s expressed emotion has been shown to be predictive of outcome in mental and physical illnesses in a variety of cultural settings. The relationship between caregiver burden and high level of expressed emotions has demonstrated a high level of relapse among the psychiatric patients in the West. Aim: The current study explores the relationship between caregivers′ burden and level of expressed emotions by the patients with schizophrenia in Indian setting. Materials and Methods : The sample for the study consisted of totally 70 subjects comprising 35 schizophrenic patients and 35 caregivers. The schizophrenic patients who were attending the Day Care Center run by Department of Psychiatric and Neuro Rehabilitation Unit at National Institute of Mental Health and Neuro Sciences (NIMHANS in Bangalore, India (a tertiary care center and their primary caregivers were included. Family emotional involvement and criticism scale and The burden assessment schedule were administered to assess the expressed emotions and caregivers′ burden. Carl Pearson Correlation test used to study the relationship between the variables. Results and Conclusion: The study highlighted the need for addressing expressed emotion in comprehensive psychosocial intervention plan. More attention should be paid to the needs of the caregivers in order to alleviate their burden in managing mentally ill patients.

  11. FEATURES OF DEFINITION OF TAX BURDEN OF AN ECONOMIC ENTITY

    Directory of Open Access Journals (Sweden)

    Sobchenko N. V.

    2015-12-01

    Full Text Available The results of an analytical assessment of the developed frame of reference on concepts of tax planning, tax burden, tax burden of the enterprise are presented in article. Tax planning is the most important part of financial planning of the organization. A basis of this process is possibility of each taxpayer to use legislatively resolved means, receptions and ways directed on minimization of tax payments. Minimization of taxes is directed not only on absolute decrease in volumes of tax payments, but also on purposeful transfer of business to more favorable conditions of managing. Tax planning is connected with recognition of the right of each taxpayer to apply all legislatively resolved means, receptions and ways to decrease in tax payments. The analysis of a condition of tax burden of an economic entity of real sector of economy is carried out. It is noted, that by means of various techniques of its assessment it is possible to receive contradictory data on dynamics of change of level of tax burden. As one of factors of increasing the efficiency of business activity is optimization of tax payments and implementation of tax planning acts. Importance of realization of tax planning and optimization of tax payments is defined by desire of taxpayers to lower tax burden and explainable aspiration of the state to prevent it

  12. [The current perspectives regarding the burden on mental health caregivers].

    Science.gov (United States)

    Cardoso, Lucilene; Vieira, Mariana Verderoce; Ricci, Maira Aparecida Malagutti; Mazza, Rafael Severio

    2012-04-01

    A systematic literature review was performed regarding the burden on mental health caregivers. The studies were selected from the Virtual Health Library - Biblioteca Virtual de Saúde (BVS), using the keyword caregiver burden. The main criteria for this study were: full-text articles published between 2000 and 2010, in Portuguese, English or Spanish; indexed on the BVS databases; which investigated the burden of mental health caregivers, and had caregivers as the main subject. The analysis was performed considering the following: title, year of publication, objectives, methodological approach, instruments and main results. The analysis of 114 full-text articles showed the predominant objectives were the burden on informal caregivers and the validation of psychometric scales, particularly the Zarit Scale. Some studies showed an association between high levels of burden, feelings of guilt and depressive symptoms. On the other hand, psycho-educational interventions were indicated as having a positive impact. This theme has a growing scientific interest and there is a need for deeper studies addressing formal caregivers.

  13. Body burdens: an integrated approach to health risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Gasper, J. R.; Dauzvardis, P. A.

    1979-01-01

    Monitoring, modeling, and laboratory data are being integrated with physiological data in order to assess the impact of the release of environmental contaminants on the human receptor. The methodology described in this paper is intended primarily for use as a screening method to identify relative health risks. Comparison of body burdens and critical organ burdens can identify the relative contribution from different sources of exposure, exposure pathways, and routes of entry. These two burdens may be used in conjunction with monitoring data and environmental modeling techniques to assess the relative risk of effluent releases from natural and industrial sources or from different effluent control technologies or waste disposal methods. The relative impact of different levels of regional economic growth or regulatory plans can also be assessed. Body burdens may also serve to indicate where effluent control efforts will be most successful in reducing impacts on humans. The example projects the relative contributions to body burdens of arsenic, cadmium, chromium, mercury and lead resulting from background air and water quality, effluent releases from a coal-fired steam electric power plant, and from diet.

  14. Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013: Findings from the Global Burden of Disease Study 2013.

    Science.gov (United States)

    Khalil, Ibrahim; Colombara, Danny V; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; Bcheraoui, Charbel El; Rao, Puja C; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; Razek, Mohammed Magdy Abd El; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A; Alomari, Mahmoud A; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Abdulhak, Aref A Bin; Butt, Zahid A; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D A; Farid, Talha; Farvid, Maryam S; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L; Hedayati, Mohammad T; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; Razek, Hassan Magdy Abd El; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B; Nguyen, Quyen Le; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rana, Saleem M; Ranabhat, Chhabi L; Rao, Sowmya R; Refaat, Amany H; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R; Sawhney, Monika; Sepanlou, Sadaf G; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T; Sykes, Bryan L; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S; Ukwaja, Kingsley; Uthman, Olalekan A; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A; Yonemoto, Naohiro; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Rabeeah, Abdullah A Al; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D; Murray, Christopher J L; Mokdad, Ali H

    2016-12-07

    Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.

  15. Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; El Razek, Mohammed Magdy Abd; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Bin Abdulhak, Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D. A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B.; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B.; Le Nguyen, Quyen; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Al Rabeeah, Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.; Mokdad, Ali H.

    2016-01-01

    Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520–989) in Syria to 40,869 (95% UI = 21,540–65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. PMID:27928080

  16. Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population

    Directory of Open Access Journals (Sweden)

    Duan Yinghui

    2011-01-01

    Full Text Available Abstract Background Rotavirus gastroenteritis (RVGE is the most common cause of severe childhood diarrhea worldwide. Objectives were to estimate the burden of RVGE among children less than five years old in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, UAE, Yemen, North Africa (Algeria, Egypt, Libya, Morocco, Tunisia and Turkey. Methods A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared. Results The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to $4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%. G2P[4] was most prevalent in 4 countries (26%-48%. G9P[8] and G4P[8] were also frequently detected. Conclusions RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.

  17. 强脉冲光脱毛和半导体激光脱毛临床疗效分析%Comparative evaluation of intense pulsed light and diode (810 nm) laser for hair removal

    Institute of Scientific and Technical Information of China (English)

    姜莉; 苏明山; 涂平

    2011-01-01

    目的 评价强脉冲光脱毛及半导体激光脱毛临床疗效.方法 61例随机分为两组,36例为强脉冲光进行脱毛治疗组,25例为半导体激光进行脱毛治疗组.每次治疗间隔8周,总计治疗3次,治疗3个月后评价总疗效.结果 强脉冲光和半导体激光都使毛发数量明显减少.强脉冲光治疗组的有效率为80.6%,半导体激光治疗组的有效率为76.0%,经x2检验,两组治疗方法 有效率间比较差异无统计学意义(P>0.05).结论 强脉冲光脱毛与半导体激光脱毛同样有效.%Objective To evaluate the efficacy and safety of intense pulsed light and diode laser for axillary hair removal. Methods Clinical trials on 61 persons using intense pulsed light and diode laser to depilate axillary hairs were conducted. 36 persons were treated by IPL and 25 persons by diode laser.Treatments were carried out in three times at 8-week intervals, and a final assessment was made 3 months following the third theatment. Results Both IPL and diode laser reduced the hair count substantially! the IPL group effective rates were 80. 6 % and the diode laser group, 76. 0 %. They had no statistical significance was (P>0. 05)). Conclusions Intense pulsed light and diode laser are effiective and safe for hair removal.

  18. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    OpenAIRE

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

  19. Everyday burden of musculoskeletal conditions among villagers in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie;

    2016-01-01

    with an interpreter. Audio recordings were transcribed verbatim, with Setswana contextually translated into English. The theoretical lens included Bury's biographical disruption, in which he distinguishes between "meaning as consequence" and "meaning as significance". RESULTS: Interviews revealed co-existing accounts...... for the consequences and significance of musculoskeletal burden related to 3 themes: (i) hard work for traditional lives; (ii) bearing the load of a rugged landscape; and, (iii) caring for others with disrupted lives. Physical labour with musculoskeletal symptoms had economic and subsistence consequences. The loss...... of independence and social identity to fulfil traditional roles held meaning as significance. Outmigration for wage labour and other shifts in family structure compounded everyday musculoskeletal burden. CONCLUSION: Uncovering burden is an important first step to address musculoskeletal care needs in developing...

  20. 重症监护病房与母婴同室新生儿听力筛查比较%Comparative study of newborn hearing screening between the neonatal intensive care unit and well-baby nursery

    Institute of Scientific and Technical Information of China (English)

    张恩东; 李大建; 苗乐杰

    2011-01-01

    Objective To investigate the hearing screening situation of newborns in the neonatal intensive care unit (NICU) and compare it with that of newborns in the well-baby nursery.Methods Hearing screening was carded out in 927 newborns in the NICU and 16 353 newborns in the well-baby nursery.All newborns were screened and rescreened with transient evoked otoacoustic emission.Positive cases were evaluated by a diagnostic audiology test.Results 28 cases of sensorineural deafness were founded in the NICU group, of which 11 had hyperbilirubinemias, 9 very low birth weight, 6 ischemic encephalopathy and 2 meningitis.The incidence rate of sensorineural deafness in the NICU group was 3.02% (28/927).There were 50 cases of sensorineural deafness in the well-baby nursery group, of which 23 had intrauterine infection, 12 hyperbilimbinemias, 10 family history of hearing loss, 3 meningitis and 2 ototoxic drug contact history.The incidence rate of sensorineural deafness was 0.31% (50/16 353).There was a significant difference between the two groups ( P < 0.05 ).Conclusions The incidence rate of sensorineural deafness is obviously higher in the NICU group than the well-baby nursery group.Hyperbilirubinemias, very low birth weight and ischemic encephalopathy are the main risk factors in the NICU group.Intrauterine infection, hyperbilirubinemias and family history of hearing loss are the main risk factors in the well-baby nursery group.More attention should be paid to newborn hearing screening in the NICU.%目的 探讨新生几重症监护病房患儿听力筛查情况并与母婴同室新生儿听力筛查情况进行比较.方法 对927例新生儿重症监护病房患儿和16353例母婴同室新生儿采用瞬态诱发耳声发射进行初筛和复筛,并对筛查阳性者进行诊断性听力学检测.结果 927例新生儿重症监护病房患儿中,通过筛查发现感音神经性听力障碍28例.其中高胆红素血症11例,极低体重儿9例,缺血缺氧性脑病6

  1. Burden of paediatric influenza in Western Europe: a systematic review

    Directory of Open Access Journals (Sweden)

    Antonova Evgeniya N

    2012-11-01

    Full Text Available Abstract Background Influenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden in children in Western Europe via a systematic literature review. Methods We conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011 and extracted data on influenza burden in children (defined as aged ≤ 18 years from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness. Results Children with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%, medical visits (1.7-2.8 visits per case, antibiotic prescriptions (7%-55%, and antipyretic or other medications for symptomatic relief (76%-99%; young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children. Conclusions Influenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in

  2. Brain burdens of aluminum, iron, and copper and their relationships with amyloid-β pathology in 60 human brains.

    Science.gov (United States)

    Exley, Christopher; House, Emily; Polwart, Anthony; Esiri, Margaret M

    2012-01-01

    The deposition in the brain of amyloid-β as beta sheet conformers associated with senile plaques and vasculature is frequently observed in Alzheimer’s disease. While metals, primarily aluminum, iron, zinc, and copper, have been implicated in amyloid-β deposition in vivo, there are few data specifically relating brain metal burden with extent of amyloid pathologies in human brains. Herein brain tissue content of aluminum, iron, and copper are compared with burdens of amyloid-β, as senile plaques and as congophilic amyloid angiopathy, in 60 aged human brains. Significant observations were strong negative correlations between brain copper burden and the degree of severity of both senile plaque and congophilic amyloid angiopathy pathologies with the relationship with the former reaching statistical significance. While we did not have access to the dementia status of the majority of the 60 brain donors, this knowledge for just 4 donors allowed us to speculate that diagnosis of dementia might be predicted by a combination of amyloid pathology and a ratio of the brain burden of copper to the brain burden of aluminum. Taking into account only those donor brains with either senile plaque scores ≥4 and/or congophilic amyloid angiopathy scores ≥12, a Cu:Al ratio of <20 would predict that at least 39 of the 60 donors would have been diagnosed as suffering from dementia. Future research should test the hypothesis that, in individuals with moderate to severe amyloid pathology, low brain copper is a predisposition to developing dementia.

  3. Dioxin body burden in women with long term residency near and away from major chemical industries in Teesside, UK

    Energy Technology Data Exchange (ETDEWEB)

    Pless-Mulloli, T.; Howel, D. [Univ. of Newcastle upon Tyne (United Kingdom); Edwards, R. [Univ. of Manchester (United Kingdom); Paepke, O. [ergo Forschungs Gesellschaft, Hamburg (Germany); Hermann, T.

    2004-09-15

    Retrospective exposure assessment poses a major challenge for environmental epidemiology studies. Body burden measures may act as markers for long-term exposure if biomarkers can be found with sufficiently long half lives in the human body. Some studies of human exposures have reported data from exposures over several years and before and after sources started production, however none have investigated the usefulness of such approach when exposure is estimated over more than a decade. Whilst for the general population food intake forms the major source of long term dioxin exposures other occupational and environmental sources can contribute to elevated body burdens. The UK has rich data sets for dioxin levels in food, but no body burden data are yet available for a general population sample. We tested the hypothesis that women with long term residence close to an industrial complex have a higher body burden and a distinct pattern of dioxins, furans (PCDD/F) and polychlorinated biphenyls (PCBs). We estimated exposure by recording residential history and food intakes and compared this information with body burden measurements as proxy for all forms of exposure.

  4. Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Maria Karanikola

    2015-10-01

    Full Text Available AbstractOBJECTIVETo systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs, with focus on anxiety and depressive symptoms and related factors.METHODA literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress".RESULTSThirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population.CONCLUSIONSStudies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

  5. Microbiological burden on the surfaces of Explorer 33 spacecraft.

    Science.gov (United States)

    Powers, E M

    1967-09-01

    The Explorer XXXIII Spacecraft (Anchored Interplanetary Monitoring Platform, or AIMP) was decontaminated to prevent gross contamination of the moon with terrestrial microorganisms. Assay of the total spacecraft surface before and after decontamination showed that the decontamination procedure reduced the viable microbiological burden from 1.40 x 10(6) to 3.60 x 10(4). However, assembly of parts which were not decontaminated for engineering reasons or were not assembled under cleanroom conditions increased the viable microbial burden at the time of launch to 2.62 x 10(5).

  6. Health burden of urban transport: The technical challenge

    Indian Academy of Sciences (India)

    Carlos Dora

    2007-08-01

    The burden on health-related issues due to unplanned urban policies is higher despite the present knowledge of interventions and availability of current technologies. This burden could increase substantially, given the rapid growth in urban populations and the application of partial or misguided solutions to urban transport problems. Part of the reason is the failure to consider holistically the health, social and environment consequences and the related costs of individual travel choices and government policies in the field of traffic and mobility. Urban transport-related issues and its impact on health, environment, costs and benefits are discussed in this paper.

  7. The economic burden of tuberculosis in Denmark 1998-2010

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wejse, Christian

    2015-01-01

    OBJECTIVE: To evaluate the economic burden of tuberculosis (TB) in Denmark, METHODS: 8,433 Danish TB-patients (1998-2010) were matched with 33,707 controls by age, gender, civil status and geography. Health-related costs (health system contacts and -procedures, medications) and socio-economic par......OBJECTIVE: To evaluate the economic burden of tuberculosis (TB) in Denmark, METHODS: 8,433 Danish TB-patients (1998-2010) were matched with 33,707 controls by age, gender, civil status and geography. Health-related costs (health system contacts and -procedures, medications) and socio...

  8. An approach to calculating childhood body burdens of dibenzodioxins and dibenzofurans which accounts for age-dependent biological half lives

    Energy Technology Data Exchange (ETDEWEB)

    Paustenbach, D. [ChemRisk, San Francisco, CA (United States); Leung, H.W. [Leung, H.W. Private Consultant, Danbury, CT (United States); Scott, P. [ChemRisk, Pittsburgh, PA (United States); Kerger, B. [HSRI, Tallahassee, FL (United States)

    2004-09-15

    The purpose of this study is to apply an age-dependent half life model to examine the range of child (ages 0-7) body burdens that correspond to selected exposure scenarios involving background dietary and environmental doses of dioxins. The scenarios examined include breast-fed and nonbreast- fed infants feeding for 6 months, other dioxin uptake from foods through age 7, and exposures to urban residential soils at 1 ppb TCDD toxic equivalents (TEQ). These body burden estimates in children are then compared to the adult body burden estimates corresponding to the range of tolerable daily intakes (1 to 4 pg TEQ/kg-day) proposed by some U.S. and international regulatory/advisory groups.

  9. Metabolic tumor burden as marker of outcome in advanced EGFR wild-type NSCLC patients treated with erlotinib

    DEFF Research Database (Denmark)

    Winther-Larsen, Anne; Fledelius, Joan; Sorensen, Boe Sandahl;

    2016-01-01

    OBJECTIVES: Accurate estimation of the prognosis of advanced non-small cell lung cancer (NSCLC) patients is essential before initiation of palliative treatment; especially in the second and third-line setting. This study was conducted in order to evaluate tumor burden measured on an 2'-deoxy-2...... a prospectively collected cohort. An F-18-FDG-PET/CT scan was conducted prior to erlotinib treatment and tumor burden was measured in terms of metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Median values of MTV and TLG were used for dichotomization of patients. Survival outcome was compared...... with shorter PFS and OS in advanced EGFR wild-type NSCLC patients treated with second or third-line erlotinib. Metabolic tumor burden is a highly promising clinical tool that may allow better patient selection for palliative treatment in the future....

  10. A Vaccine Therapy for Canine Visceral Leishmaniasis Promoted Significant Improvement of Clinical and Immune Status with Reduction in Parasite Burden

    Science.gov (United States)

    Roatt, Bruno Mendes; Aguiar-Soares, Rodrigo Dian de Oliveira; Reis, Levi Eduardo Soares; Cardoso, Jamille Mirelle de Oliveira; Mathias, Fernando Augusto Siqueira; de Brito, Rory Cristiane Fortes; da Silva, Sydnei Magno; Gontijo, Nelder De Figueiredo; Ferreira, Sidney de Almeida; Valenzuela, Jesus G.; Corrêa-Oliveira, Rodrigo; Giunchetti, Rodolfo Cordeiro; Reis, Alexandre Barbosa

    2017-01-01

    Herein, we evaluated the treatment strategy employing a therapeutic heterologous vaccine composed of antigens of Leishmania braziliensis associated with MPL adjuvant (LBMPL vaccine) for visceral leishmaniasis (VL) in symptomatic dogs naturally infected by Leishmania infantum. Sixteen dogs received immunotherapy with MPL adjuvant (n = 6) or with a vaccine composed of antigens of L. braziliensis associated with MPL (LBMPL vaccine therapy, n = 10). Dogs were submitted to an immunotherapeutic scheme consisting of 3 series composed of 10 subcutaneous doses with 10-day interval between each series. The animals were evaluated before (T0) and 90 days after treatment (T90) for their biochemical/hematological, immunological, clinical, and parasitological variables. Our major results showed that the vaccine therapy with LBMPL was able to restore and normalize main biochemical (urea, AST, ALP, and bilirubin) and hematological (erythrocytes, hemoglobin, hematocrit, and platelets) parameters. In addition, in an ex vivo analysis using flow cytometry, dogs treated with LBMPL vaccine showed increased CD3+ T lymphocytes and their subpopulations (TCD4+ and TCD8+), reduction of CD21+ B lymphocytes, increased NK cells (CD5−CD16+) and CD14+ monocytes. Under in vitro conditions, the animals developed a strong antigen-specific lymphoproliferation mainly by TCD4+ and TCD8+ cells; increasing in both TCD4+IFN-γ+ and TCD8+IFN-γ+ as well as reduction of TCD4+IL-4+ and TCD8+IL-4+ lymphocytes with an increased production of TNF-α and reduced levels of IL-10. Concerning the clinical signs of canine visceral leishmaniasis, the animals showed an important reduction in the number and intensity of the disease signs; increase body weight as well as reduction of splenomegaly. In addition, the LBMPL immunotherapy also promoted a reduction in parasite burden assessed by real-time PCR. In the bone marrow, we observed seven times less parasites in LBMPL animals compared with MPL group. The

  11. [Convalescence and decline in physical function level following intensive therapy

    DEFF Research Database (Denmark)

    Poulsen, J.B.; Moller, K.; Perner, A.

    2009-01-01

    More patients survive critical illness, which emphasises the need to assess outcome measures other than mortality. A prolonged decline in physical function is frequently observed after discharge in the critically ill. Neuromuscular dysfunction and muscle atrophy incurred during intensive care may...... prolong convalescence after discharge. Thus, strategies to counteract neuromuscular dysfunction and to improve physical outcome may reduce the overall burden of critical illness. This review describes the most common predisposing factors and discusses preventative measures and interventions Udgivelsesdato...

  12. Comparative Analysis of the Findings of Low-Field Intensity Magnetic Resonance Imaging and Arthroscopy in Knee Joint Injury%膝关节损伤低场MRI表现与关节镜检查的比较分析

    Institute of Scientific and Technical Information of China (English)

    蒋华平; 杨宏美; 徐荣泰

    2011-01-01

    [目的]比较分析膝关节损伤低场MRI表现与关节镜检查结果.[方法]对267例共295个膝关节低场MRI表现与关节镜检查作回顾性分析.[结果]低场MRI表现对膝关节损伤诊断有较高的敏感度、特异度及准确度,但较关节镜的检查结果,有一定的偏差率.[结论]低场MRI表现结合临床症状和关节解剖特点,对膝关节损伤有明确的术前诊断价值.%[Objective]To comparatively analyze the findings of low-field intensity magnetic resonance ima-ging(MRI) and arthroscopy in knee joint injury. [Methods] The findings of low-field intensity MRI and ar-throscopy in 267 cases(295 knee joints) of knee joint injury were analyzed retrospectively. [Results] The findings of low-field intensity MRI had a certain sensitivity, specificity and accuracy in the diagnosis of knee joint injury, but there was some deviation between low-field intensity MRI and arthroscopy. [Conclusion] Low-field intensity MRI combined with clinical symptoms and anatomic features of knee joints has certain value in the preoperative diagnosis of knee joint injury.

  13. Burden of Noise Induced Hearing Loss among Manufacturing Industrial Workers in Malaysia

    Directory of Open Access Journals (Sweden)

    Noraita TAHIR

    2015-10-01

    Full Text Available Background: Noise induced hearing loss (NIHL is the highest reported occupational disease among industrial workers but there is scarcity of data on disease burden in Malaysia. This study estimated the risks and burden of NIHL in manufacturing industries in Malaysia.Methods: This cross-sectional industrial survey was conducted by interviewing OSH practitioners at 26 industries categorized as food, tobacco, textile, wearing apparel, wood products except furniture, paper, refined petroleum, chemicals, non-metallic mineral, basic metal, fabricated metal, motor vehicle parts. The catchment population is imputed based on stratified sampling design involving 60% of workers diagnosed with NIHL.Results: A total of 18 industries exposed to noise level of 86-90dBA and 8 industries at more than 91dBA were identified. All industries provide regular awareness training and hearing protection device to their workers but none of them implement attenuation, majority of them (81% conduct onsite audiometric test annually. In overall, the risk of NIHL and incidence per 100,000 manufacturing workers projected is 8% (139 new cases, the highest risk and incidence is 32% (26 in motor vehicle parts industry; followed by 23% (1140 new cases in tobacco industry and 23% (269 new cases in fabricated metal industry. Male workers (89% were exposed to a greater risk compared to female (11%. It was estimated that 103,000 workers were potentially affected by NIHL in Malaysia.Conclusion: NIHL is a major burden among industrial workers in Malaysia. Implementation of effective hearing conservation program and self-enforcement of noise regulations by the employer could potentially reduce the burden. Keywords: Noise, Hearing loss, Manufacturing, Malaysia

  14. Burden analysis of rare microdeletions suggests a strong impact of neurodevelopmental genes in genetic generalised epilepsies.

    Directory of Open Access Journals (Sweden)

    Dennis Lal

    2015-05-01

    Full Text Available Genetic generalised epilepsy (GGE is the most common form of genetic epilepsy, accounting for 20% of all epilepsies. Genomic copy number variations (CNVs constitute important genetic risk factors of common GGE syndromes. In our present genome-wide burden analysis, large (≥ 400 kb and rare (< 1% autosomal microdeletions with high calling confidence (≥ 200 markers were assessed by the Affymetrix SNP 6.0 array in European case-control cohorts of 1,366 GGE patients and 5,234 ancestry-matched controls. We aimed to: 1 assess the microdeletion burden in common GGE syndromes, 2 estimate the relative contribution of recurrent microdeletions at genomic rearrangement hotspots and non-recurrent microdeletions, and 3 identify potential candidate genes for GGE. We found a significant excess of microdeletions in 7.3% of GGE patients compared to 4.0% in controls (P = 1.8 x 10-7; OR = 1.9. Recurrent microdeletions at seven known genomic hotspots accounted for 36.9% of all microdeletions identified in the GGE cohort and showed a 7.5-fold increased burden (P = 2.6 x 10-17 relative to controls. Microdeletions affecting either a gene previously implicated in neurodevelopmental disorders (P = 8.0 x 10-18, OR = 4.6 or an evolutionarily conserved brain-expressed gene related to autism spectrum disorder (P = 1.3 x 10-12, OR = 4.1 were significantly enriched in the GGE patients. Microdeletions found only in GGE patients harboured a high proportion of genes previously associated with epilepsy and neuropsychiatric disorders (NRXN1, RBFOX1, PCDH7, KCNA2, EPM2A, RORB, PLCB1. Our results demonstrate that the significantly increased burden of large and rare microdeletions in GGE patients is largely confined to recurrent hotspot microdeletions and microdeletions affecting neurodevelopmental genes, suggesting a strong impact of fundamental neurodevelopmental processes in the pathogenesis of common GGE syndromes.

  15. Relationship between serum antibodies and Taenia solium larvae burden in pigs raised in field conditions.

    Directory of Open Access Journals (Sweden)

    Cesar M Gavidia

    Full Text Available BACKGROUND: Serological tests have been used for the diagnosis of Taenia solium infection in pigs. However, those serological results do not necessarily correlate with the actual infection burden after performing pig necropsy. This study aimed to evaluate the Electro Immuno Transfer Blot (EITB seropositivity with infection burden in naturally infected pigs. METHODOLOGY/PRINCIPAL FINDINGS: In an endemic area of Peru, 476 pigs were sampled. Seroprevalence was 60.5 ± 4.5% with a statistically higher proportion of positive older pigs (>8 months than young pigs. The logistic model showed that pigs >8 month of age were 2.5 times more likely to be EITB-positive than ≤ 8 months. A subset of 84 seropositive pigs were necropsied, with 45.2% (38/84 positive to 1-2 bands, 46.4% (39/84 to 3 bands, and 8.3% (7/84 to 4+ bands. 41 out of 84 positive pigs were negative to necropsy (48.8% and 43 (51% had one or more cysts (positive predictive value. Older pigs showed more moderate and heavy infection burdens compared to younger pigs. In general, regardless of the age of the pig, the probability of having more cysts (parasite burden increases proportionally with the number of EITB bands. CONCLUSIONS/SIGNIFICANCE: The probability of being necropsy-positive increased with the number of bands, and age. Therefore, the EITB is a measure of exposure rather than a test to determine the real prevalence of cysticercosis infection.

  16. Burden Analysis of Rare Microdeletions Suggests a Strong Impact of Neurodevelopmental Genes in Genetic Generalised Epilepsies

    Science.gov (United States)

    Trucks, Holger; Schulz, Herbert; de Kovel, Carolien G.; Kasteleijn-Nolst Trenité, Dorothée; Sonsma, Anja C. M.; Koeleman, Bobby P.; Lindhout, Dick; Weber, Yvonne G.; Lerche, Holger; Kapser, Claudia; Schankin, Christoph J.; Kunz, Wolfram S.; Surges, Rainer; Elger, Christian E.; Gaus, Verena; Schmitz, Bettina; Helbig, Ingo; Muhle, Hiltrud; Stephani, Ulrich; Klein, Karl M.; Rosenow, Felix; Neubauer, Bernd A.; Reinthaler, Eva M.; Zimprich, Fritz; Feucht, Martha; Møller, Rikke S.; Hjalgrim, Helle; De Jonghe, Peter; Suls, Arvid; Lieb, Wolfgang; Franke, Andre; Strauch, Konstantin; Gieger, Christian; Schurmann, Claudia; Schminke, Ulf; Nürnberg, Peter; Sander, Thomas

    2015-01-01

    Genetic generalised epilepsy (GGE) is the most common form of genetic epilepsy, accounting for 20% of all epilepsies. Genomic copy number variations (CNVs) constitute important genetic risk factors of common GGE syndromes. In our present genome-wide burden analysis, large (≥ 400 kb) and rare (< 1%) autosomal microdeletions with high calling confidence (≥ 200 markers) were assessed by the Affymetrix SNP 6.0 array in European case-control cohorts of 1,366 GGE patients and 5,234 ancestry-matched controls. We aimed to: 1) assess the microdeletion burden in common GGE syndromes, 2) estimate the relative contribution of recurrent microdeletions at genomic rearrangement hotspots and non-recurrent microdeletions, and 3) identify potential candidate genes for GGE. We found a significant excess of microdeletions in 7.3% of GGE patients compared to 4.0% in controls (P = 1.8 x 10-7; OR = 1.9). Recurrent microdeletions at seven known genomic hotspots accounted for 36.9% of all microdeletions identified in the GGE cohort and showed a 7.5-fold increased burden (P = 2.6 x 10-17) relative to controls. Microdeletions affecting either a gene previously implicated in neurodevelopmental disorders (P = 8.0 x 10-18, OR = 4.6) or an evolutionarily conserved brain-expressed gene related to autism spectrum disorder (P = 1.3 x 10-12, OR = 4.1) were significantly enriched in the GGE patients. Microdeletions found only in GGE patients harboured a high proportion of genes previously associated with epilepsy and neuropsychiatric disorders (NRXN1, RBFOX1, PCDH7, KCNA2, EPM2A, RORB, PLCB1). Our results demonstrate that the significantly increased burden of large and rare microdeletions in GGE patients is largely confined to recurrent hotspot microdeletions and microdeletions affecting neurodevelopmental genes, suggesting a strong impact of fundamental neurodevelopmental processes in the pathogenesis of common GGE syndromes. PMID:25950944

  17. Association Between the Chromosome 9p21 Locus and Angiographic Coronary Artery Disease Burden

    Science.gov (United States)

    Chan, Kenneth; MPharm; Patel, Riyaz S.; Newcombe, Paul; Nelson, Christopher P.; Qasim, Atif; Epstein, Stephen E.; Burnett, Susan; Vaccarino, Viola L.; Zafari, A. Maziar; Shah, Svati H.; Anderson, Jeffrey L.; Carlquist, John F.; Hartiala, Jaana; Allayee, Hooman; Hinohara, Kunihiko; Lee, Bok-Soo; Erl, Anna; Ellis, Katrina L.; Goel, Anuj; Schaefer, Arne S.; El Mokhtari, Nour Eddine; Goldstein, Benjamin A.; Hlatky, Mark A.; Go, Alan S.; Shen, Gong-Qing; Gong, Yan; Pepine, Carl; Laxton, Ross C.; Whittaker, John C.; Tang, W.H. Wilson; Johnson, Julie A.; Wang, Qing K.; Assimes, Themistocles L.; Nöthlings, Ute; Farrall, Martin; Watkins, Hugh; Richards, A. Mark; Cameron, Vicky A.; Muendlein, Axel; Drexel, Heinz; Koch, Werner; Park, Jeong Euy; Kimura, Akinori; Shen, Wei-feng; Simpson, Iain A.; Hazen, Stanley L.; Horne, Benjamin D.; Hauser, Elizabeth R.; Quyyumi, Arshed A.; Reilly, Muredach P.; Samani, Nilesh J.; Ye, Shu

    2013-01-01

    Objectives This study sought to ascertain the relationship of 9p21 locus with: 1) angiographic coronary artery disease (CAD) burden; and 2) myocardial infarction (MI) in individuals with underlying CAD. Background Chromosome 9p21 variants have been robustly associated with coronary heart disease, but questions remain on the mechanism of risk, specifically whether the locus contributes to coronary atheroma burden or plaque instability. Methods We established a collaboration of 21 studies consisting of 33,673 subjects with information on both CAD (clinical or angiographic) and MI status along with 9p21 genotype. Tabular data are provided for each cohort on the presence and burden of angiographic CAD, MI cases with underlying CAD, and the diabetic status of all subjects. Results We first confirmed an association between 9p21 and CAD with angiographically defined cases and control subjects (pooled odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.20 to 1.43). Among subjects with angiographic CAD (n = 20,987), random-effects model identified an association with multivessel CAD, compared with those with single-vessel disease (OR: 1.10, 95% CI: 1.04 to 1.17)/copy of risk allele). Genotypic models showed an OR of 1.15, 95% CI: 1.04 to 1.26 for heterozygous carrier and OR: 1.23, 95% CI: 1.08 to 1.39 for homozygous carrier. Finally, there was no significant association between 9p21 and prevalent MI when both cases (n = 17,791) and control subjects (n = 15,882) had underlying CAD (OR: 0.99, 95% CI: 0.95 to 1.03)/risk allele. Conclusions The 9p21 locus shows convincing association with greater burden of CAD but not with MI in the presence of underlying CAD. This adds further weight to the hypothesis that 9p21 locus primarily mediates an atherosclerotic phenotype. PMID:23352782

  18. The burden of child maltreatment in the East Asia and Pacific region.

    Science.gov (United States)

    Fang, Xiangming; Fry, Deborah A; Brown, Derek S; Mercy, James A; Dunne, Michael P; Butchart, Alexander R; Corso, Phaedra S; Maynzyuk, Kateryna; Dzhygyr, Yuriy; Chen, Yu; McCoy, Amalee; Swales, Diane M

    2015-04-01

    This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region's per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region's GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally.

  19. Rural-urban differentials of premature mortality burden in south-west China

    Directory of Open Access Journals (Sweden)

    Chongsuvivatwong Virasakdi

    2006-10-01

    Full Text Available Abstract Background Yunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan. Methods Years of life lost (YLL rate per 1,000 and mortality rate per 100,000 were calculated from medical death certificates in 2003 and broken down by cause of death, age and gender among urban, suburban and rural regions. YLL was calculated without age-weighting and discounting rate. Rates were age-adjusted to the combined population of three regions. However, 3% discounting rate and a standard age-weighting function were included in the sensitivity analysis. Results Non-communicable diseases contributed the most YLL in all three regions. The rural region had about 50% higher premature mortality burden compared to the other two regions. YLL from infectious diseases and perinatal problems was still a major problem in the rural region. Among non-communicable diseases, YLL from stroke was the highest in the urban/suburban regions; COPD followed as the second and was the highest in the rural region. Mortality burden from injuries was however higher in the rural region than the other two regions, especially for men. Self-inflicted injuries were between 2–8 times more serious among women. The use of either mortality rate or YLL gives a similar conclusion regarding the order of priority. Reanalysis with age-weighting and 3% discounting rate gave similar results. Conclusion Urban south western China has already engaged in epidemiological pattern of developed countries. The rural region is additionally burdened by diseases of poverty and injury on top of the non-communicable diseases.

  20. [The future of intensive medicine].

    Science.gov (United States)

    Palencia Herrejón, E; González Díaz, G; Mancebo Cortés, J

    2011-05-01

    Although Intensive Care Medicine is a young specialty compared with other medical disciplines, it currently plays a key role in the process of care for many patients. Experience has shown that professionals with specific training in Intensive Care Medicine are needed to provide high quality care to critically ill patients. In Europe, important steps have been taken towards the standardization of training programs of the different member states. However, it is now necessary to take one more step forward, that is, the creation of a primary specialty in Intensive Care Medicine. Care of the critically ill needs to be led by specialists who have received specific and complete training and who have the necessary professional competences to provide maximum quality care to their patients. The future of the specialty presents challenges that must be faced with determination, with the main objective of meeting the needs of the population.

  1. Nanostructured intense-laser cleaner

    CERN Document Server

    Li, Xiao Feng; Kong, Qing; Wang, Ping Xiao; Yu, Qin; Gu, Yan Jan; Qu, Jun Fan

    2016-01-01

    A nanostructured target is proposed to enhance an intense-laser contrast: when a laser prepulse is injected on a nanostructured solid target surface, the prepulse is absorbed effectively by the nanostructured surface. The nanostructure size should be less than the laser wavelength. After the prepulse absorption, the front part of the main pulse destroys the microstructure and makes the surface a flat plasma mirror. The body of the main pulse is reflected almost perfectly. Compared with the plasma mirrors, the nanostructured surface is effective for the absorption of the intense laser prepulse, higher than 10^14 W/cm2. By the nanostructured laser cleaner, the laser pulse contrast increases about a hundredfold. The nanostructured laser cleaner works well for near-future intense lasers.

  2. Preparing to manage injury burden of Bihar

    Directory of Open Access Journals (Sweden)

    Vikas Verma

    2015-06-01

    Full Text Available Introduction: Trauma care in Bihar is beset by a number of problems namely lack of funds, one of the highest population densities in the country, far flung flood prone areas that remain inaccessible to healthcare for several months of an year, lack of formal pre-hospital care services and an organized system of trauma care.. EMS services are run by many different organizations such as government, police, fire, hospital or private organizations. There is lack of coordination between these organizations.  First response to the injured is very often provided by the police who tend to transfer the patient to the nearest government health care centre. There is no linkage with hospital trauma services. This paper presents the interim results of a plan developed and being implemented at AIIMS, Patna in collaboration with the government of Bihar and Adams Cowley shock trauma trauma centre, Baltimore, USA. Methods: Participants from the Bihar police and Bihar health services were nominated by the government of Bihar. One hundred fifty one participants were imparted a 3 day training that included basics for managing airway, breathing, circulation, extrication, fractures, and spine injuries. Incident managment, approach to mass casualty and safe transport were also part of the cirriculum. All participants were required to take a pre-test before the training, a post test at the end of the training and another post test after 6 months after the training. Whether participants attended to emergencies before and after the training was also soought.  Paired t tests were used to compare the means of tests. Independent t test was used to compare difference of means in the groups that attended to emergencies in the six months after the training with those that did not attend to emergencies during the 6 months after the training.  Results:One hundred fifty one participants were trained. Of the 151 participants 55 (36.4% belonged to Bihar police and 96 (73

  3. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013

    OpenAIRE

    Newton, John N; Briggs, Adam D. M.; Murray, Christopher J L; Dicker, Daniel; Foreman, Kyle J.; Wang, Haidong; Naghavi, Mohsen; Mohammad H Forouzanfar; Ohno, Summer Lockett; Barber, Ryan M; Vos, Theo; Stanaway, Jeffrey D.; Schmidt, Jürgen C; Hughes, Andrew J.; Fay, Derek F. J.

    2015-01-01

    Background\\ud \\ud In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in Engli...

  4. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

    OpenAIRE

    Newton, JN; Briggs, ADM; Murray, CJL; Dicker, D; Foreman, KJ; Wang, HD; Naghavi, M.; Forouzanfar, MH; Ohno, SL; Barber, RM; Vos, T; Stanaway, JRD; Schmidt, JC; Hughes, AJ; Fay, DFJ

    2015-01-01

    Background In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regi...

  5. The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study

    Directory of Open Access Journals (Sweden)

    Siemieniuk Reed AC

    2011-11-01

    Full Text Available Abstract Background The increasing use of highly active antiretroviral therapy (HAART and pneumococcal immunization along with shifting community exposures may have altered the burden of Streptococcus pneumoniae disease in HIV-infected persons. We describe the burden and risk factors for pneumococcal disease in the modern era of HIV care and evaluate the use of a 23-valent pneumococcal polysaccharide vaccine (PPV-23. Methods The incidence of invasive pneumococcal disease (IPD between January 1st, 2000 and January 1st, 2010 in a regional HIV population in Southern Alberta, Canada was determined by linking comprehensive laboratory and hospital surveillance data. Clinical and epidemiologic data including risk factors for S. pneumoniae, history of pneumococcal immunization, serotypes of infections, and length of any hospitalizations for pneumococcal disease were evaluated with multivariate analysis. CD4 count and viral load at immunization were evaluated with a nested case-control analysis. Results In 1946 HIV-patients with 11,099 person-years of follow up, there were 68 distinct episodes of pneumococcal disease occurring in 50 patients. Increased risk was seen if female, age >60, Aboriginal ethnicity, lower education, injection drug use, smoking, nadir CD4 Conclusions Despite universal access to intensive measures to prevent pneumococcal disease including the widespread use of HAART and PPV-23 immunization, the incidence of IPD remains high in HIV patients with its associated morbidity and mortality.

  6. Understanding the Determinants of Debt Burden among College Graduates

    Science.gov (United States)

    Chen, Rong; Wiederspan, Mark

    2014-01-01

    This article examines debt burden among college graduates and contributes to previous research by incorporating institutional and state characteristics. Utilizing a combination of national datasets and zero-one inflated beta regression, we find several major themes. First, family income and college experiences are strongly associated with the…

  7. Fiscal Restraints and the Burden of Local and State Taxes.

    Science.gov (United States)

    De Tray, Dennis; And Others

    Researchers gathered data on all state, city, and property taxes in ten cities in three states to find whether tax limitation measures have changed the distribution of tax burdens among income classes. The ten cities--representing a range of tax rates, economic bases, income levels, demographic characteristics, and revenue systems--comprised…

  8. Family Stigma and Caregiver Burden in Alzheimer's Disease

    Science.gov (United States)

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  9. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan

    Directory of Open Access Journals (Sweden)

    Jonathan Dworkin

    2014-10-01

    Discussion: Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp.

  10. Hidradenitis suppurativa : Pathogenesis, burden of disease and surgical strategies

    NARCIS (Netherlands)

    Janse, Ineke Christina

    2016-01-01

    The general aim of this thesis was to gain more knowledge about the cause, burden and surgical treatment of hidradenitis suppurativa (HS). HS is a chronic, debilitating inflammatory skin disease affecting the inguinal, axillary and gluteal regions. The disease usually develops after puberty, and the

  11. Disability weights for the Global Burden of Disease 2013 study

    NARCIS (Netherlands)

    Salomon, Joshua A; Haagsma, Juanita A; Davis, Adrian; de Noordhout, Charline Maertens; Polinder, Suzanne; Havelaar, Arie H; Cassini, Alessandro; Devleesschauwer, Brecht; Kretzschmar, MEE; Speybroeck, Niko; Murray, Christopher J L; Vos, Theo

    2015-01-01

    BACKGROUND: The Global Burden of Disease (GBD) study assesses health losses from diseases, injuries, and risk factors using disability-adjusted life-years, which need a set of disability weights to quantify health levels associated with non-fatal outcomes. The objective of this study was to estimate

  12. Disability weights for the Global Burden of Disease 2013 study

    NARCIS (Netherlands)

    Salomon, Joshua A.; Haagsma, Juanita A.; Davis, Adrian; de Noordhout, Charline Maertens; Polinder, Suzanne; Havelaar, Arie H.; Cassini, Alessandro; Devleesschauwer, Brecht; Kretzschmar, Mirjam; Speybroeck, Niko; Murray, Christopher J L; Vos, Theo

    2015-01-01

    Background: The Global Burden of Disease (GBD) study assesses health losses from diseases, injuries, and risk factors using disability-adjusted life-years, which need a set of disability weights to quantify health levels associated with non-fatal outcomes. The objective of this study was to estimate

  13. The Global Burden of Disease assessments--WHO is responsible?

    Directory of Open Access Journals (Sweden)

    Claudia Stein

    Full Text Available The Global Burden of Disease (GBD concept has been used by the World Health Organization (WHO for its reporting on health information for nearly 10 years. The GBD approach results in a single summary measure of morbidity, disability, and mortality, the so-called disability-adjusted life year (DALY. To ensure transparency and objectivity in the derivation of health information, WHO has been urged to use reference groups of external experts to estimate burden of disease. Under the leadership and coordination of WHO, expert groups have been appraising and abstracting burden of disease information. Examples include the Child Health Epidemiology Reference Group (CHERG, the Malaria Monitoring and Evaluation Reference Group (MERG, and the recently established Foodborne Disease Burden Epidemiology Reference Group (FERG. The structure and functioning of and lessons learnt by these groups are described in this paper. External WHO expert groups have provided independent scientific health information while operating under considerable differences in structure and functioning. Although it is not appropriate to devise a single "best practice" model, the common thread described by all groups is the necessity of WHO's leadership and coordination to ensure the provision and dissemination of health information that is to be globally accepted and valued.

  14. Burden of injuries and diseases in Yunnan Tin Miners

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ The burden of injuries is underestimated to an even greater extent in developing countries than in industrialized countries. The objective of this paper is to analyze injuries and diseases in the monitored work place of the world's largest tin mining operation in Yunnan, South China.

  15. The Hierarchical Clustering of Tax Burden in the EU27

    Directory of Open Access Journals (Sweden)

    Simkova Nikola

    2015-09-01

    Full Text Available The issue of taxation has become more important due to a significant share of the government revenue. There are several ways of expressing the tax burden of countries. This paper describes the traditional approach as a share of tax revenue to GDP which is applied to the total taxation and the capital taxation as a part of tax systems affecting investment decisions. The implicit tax rate on capital created by Eurostat also offers a possible explanation of the tax burden on capital, so its components are analysed in detail. This study uses one of the econometric methods called the hierarchical clustering. The data on which the clustering is based comprises countries in the EU27 for the period of 1995 – 2012. The aim of this paper is to reveal clusters of countries in the EU27 with similar tax burden or tax changes. The findings suggest that mainly newly acceding countries (2004 and 2007 are in a group of countries with a low tax burden which tried to encourage investors by favourable tax rates. On the other hand, there are mostly countries from the original EU15. Some clusters may be explained by similar historical development, geographic and demographic characteristics.

  16. Global and regional burden of stroke during 1990-2010

    DEFF Research Database (Denmark)

    Feigin, Valery L; Forouzanfar, Mohammad H; Krishnamurthi, Rita;

    2014-01-01

    Factors Study 2010 (GBD 2010) to estimate the global and regional burden of stroke during 1990-2010. METHODS: We searched Medline, Embase, LILACS, Scopus, PubMed, Science Direct, Global Health Database, the WHO library, and WHO regional databases from 1990 to 2012 to identify relevant studies published...

  17. The burden of rotavirus disease in Denmark 2009-2010

    DEFF Research Database (Denmark)

    Fischer, Thea Kølsen; Rungø, Christine; Jensen, Claus Sixtus

    2011-01-01

    BACKGROUND: This study sought to determine the incidence and the burden of severe diarrheal disease in Denmark with emphasis on rotavirus (RV) disease. METHODS: This study was designed as a national prospective disease surveillance of children <5 years of age hospitalized for acute gastroenteriti...

  18. Otitis media across nine countries : Disease burden and management

    NARCIS (Netherlands)

    Arguedas, A.; Kvaerner, K.; Liese, J.; Schilder, A. G. M.; Pelton, S. I.

    2010-01-01

    Objective: To assess the perceived disease burden and management of otitis media (OM) among an international cohort of experienced physicians. Methods: A cross-sectional survey conducted in France, Germany, Spain, Poland, Argentina, Mexico, South Korea, Thailand and Saudi Arabia. Face-to-face interv

  19. Disease burden of foodborne pathogens in the Netherlands, 2009

    NARCIS (Netherlands)

    Havelaar, Arie H.; Haagsma, Juanita A.; Mangen, Marie-Josee J.; Kemmeren, Jeanet M.; Verhoef, Linda P. B.; Vijgen, Sylvia M. C.; Wilson, Margaret; Friesema, Ingrid H. M.; Kortbeek, Laetitia M.; van Duynhoven, Yvonne T. H. P.; van Pelt, Wilfrid

    2012-01-01

    To inform risk management decisions on control, prevention and surveillance of foodborne disease, the disease burden of foodborne pathogens is estimated using Disability Adjusted Life Years as a summary metric of public health. Fourteen pathogens that can be transmitted by food are included in the s

  20. Burden of disease of dietary exposure to acrylamide in Denmark

    DEFF Research Database (Denmark)

    Jakobsen, Lea Sletting; Granby, Kit; Knudsen, Vibeke Kildegaard;

    2016-01-01

    makes it relevant to estimate the impact that exposure to chemical contaminants and other hazards in food have on health. In this study, we estimated the burden of disease (BoD) caused by dietary exposure to AA, using disability adjusted life years (DALY) as health metric.We applied an exposure...

  1. Interaction of ethanol and mercury body burden in the mouse

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, J.D.

    1978-01-01

    The interaction of ethanol with mercury in the body resulting in increased exhalation of the metal was studied in the mouse. A persistent elimination of the metal in the breath was demonstrated after single, sublethal (<1 mgHg/Kg body weight) exposures to mercury vapor (Hg/sup 0/) or mercury II chloride (HgCl/sub 2/). The amount of mercury exhaled per unit time was enhanced by oral or parenteral administration of ethanol solutions. These modifications were investigated in dose-response studies in which the drug was administered in doses ranging from 0.2g to 5.5g/Kg to mice pretreated with mercury. The EC/sub 50/ for blood ethanol with respect to mercury exhalation was determined to be approximately 200 mg/dl corresponding to an output rate of approximately 0.1% of the simultaneous body burden in 30 min several days after mercury. A hypothesis that mercury expired by these animals was proportional to the body burden after mercury administration was addressed in experiments whereby mice given one of several doses of mercuric chloride (0.16 to 500 ..mu..g/Kg) were monitored for pulmonary mercury elimination for a fifteen day period. The high correlation obtained between the amount of mercury exhaled in a standard time period and the body burden by group indicated that breath sampling could be applied as an indicator of the mercury body burden which may not be limited to the mouse.

  2. Sharing the burden of financing adaptation to climate change

    NARCIS (Netherlands)

    Dellink, R.; Elzen, M.; Aiking, H.; Bergsma, E.; Berkhout, F.; Dekker, T.; Gupta, J.

    2009-01-01

    Climate change may cause most harm to countries that have historically contributed the least to greenhouse gas emissions and land-use change. This paper identifies consequentialist and non-consequentialist ethical principles to guide a fair international burden-sharing scheme of climate change adapt

  3. Epidemiological and Economic Burden of Pneumococcal Disease in Canadian Children

    Directory of Open Access Journals (Sweden)

    Geneviève Petit

    2003-01-01

    Full Text Available BACKGROUND: With the arrival of a new conjugate pneumococcal vaccine, it is important to estimate the burden of pneumococcal diseases in Canadian children. The epidemiological data and the economic cost of these diseases are crucial elements in evaluating the relevance of a vaccination program.

  4. Humanistic and economic burden of fibromyalgia in Japan [Corrigendum

    Directory of Open Access Journals (Sweden)

    Lee LK

    2016-12-01

    Full Text Available Lee LK, Ebata N, Hlavacek P, DiBonaventura M, Cappelleri JC, Sadosky A. Humanistic and economic burden of fibromyalgia in Japan. Journal of Pain Research. 2016;9:967–978.Figures 3, 4, 5, and 6 contain errors in the key. Fibromyalgia should be dark gray and matched controls should be light gray.Read the original article.

  5. Disease burden of selected gastrointestinal pathogens in Australia, 2010

    Directory of Open Access Journals (Sweden)

    Katherine B. Gibney

    2014-11-01

    Conclusions: The pathogen causing the greatest disease burden varied according to the metric used, however DALYs are considered most useful given the incorporation of morbidity, mortality, and sequelae. These results can be used to prioritize public health interventions toward Salmonella and Campylobacter infections and to measure the impact of these interventions.

  6. Stochastic conditional intensity processes

    DEFF Research Database (Denmark)

    Bauwens, Luc; Hautsch, Nikolaus

    2006-01-01

    In this article, we introduce the so-called stochastic conditional intensity (SCI) model by extending Russell’s (1999) autoregressive conditional intensity (ACI) model by a latent common dynamic factor that jointly drives the individual intensity components. We show by simulations that the proposed...... model allows for a wide range of (cross-)autocorrelation structures in multivariate point processes. The model is estimated by simulated maximum likelihood (SML) using the efficient importance sampling (EIS) technique. By modeling price intensities based on NYSE trading, we provide significant evidence...

  7. [Prevention of cardiovascular diseases through sport and physical activity: A question of intensity?].

    Science.gov (United States)

    Wernhart, S; Dinic, M; Pressler, A; Halle, M

    2015-05-01

    Coronary artery disease is the leading cause of death worldwide. A sedentary lifestyle accounts for 9% of premature mortality and creates a substantial health economic burden. Measurement of physical activity in daily practice refers to metabolic equivalent tasks and assessment of cardiopulmonary fitness to measurements of peak oxygen uptake during ergometry, which can be used to classify an individual's physical activity and maximum exercise capacity. Physical activity is a multifunctional intervention tool in prevention, which exerts its effects on multiple biochemical pathways, in contrast to conventional drug therapy. These changes reduce cardiovascular morbidity and mortality. Moderate physical exercise reduces blood pressure, improves insulin sensitivity and dyslipidemia, improves body composition and enhances weight reduction. Exercise of higher intensity seems to have superior effects compared to moderate intensity training; however, the training volume also seems to be important, as negative effects of long-term intensive training have been reported, e.g. atrial fibrillation or coronary sclerosis. Overall, exercise training has a major role in primary prevention of cardiovascular disease but seems to have a maximum threshold for benefit, which may be exceeded by some individuals.

  8. Financial burden in recipients of allogeneic hematopoietic cell transplantation.

    Science.gov (United States)

    Khera, Nandita; Chang, Yu-hui; Hashmi, Shahrukh; Slack, James; Beebe, Timothy; Roy, Vivek; Noel, Pierre; Fauble, Veena; Sproat, Lisa; Tilburt, Jon; Leis, Jose F; Mikhael, Joseph

    2014-09-01

    Although allogeneic hematopoietic cell transplantation (HCT) is an expensive treatment for hematological disorders, little is known about the financial consequences for the patients who undergo this procedure. We analyzed factors associated with its financial burden and its impact on health behaviors of allogeneic HCT recipients. A questionnaire was retrospectively mailed to 482 patients who underwent allogeneic HCT from January 2006 to June 2012 at the Mayo Clinic, to collect information regarding current financial concerns, household income, employment, insurance, out-of-pocket expenses, and health and functional status. A multivariable logistic regression analysis identified factors associated with financial burden and treatment nonadherence. Of the 268 respondents (56% response rate), 73% reported that their sickness had hurt them financially. All patients for whom the insurance information was available (missing, n = 13) were insured. Forty-seven percent of respondents experienced financial burden, such as household income decreased by >50%, selling/mortgaging home, or withdrawing money from retirement accounts. Three percent declared bankruptcy. Younger age and poor current mental and physical functioning increased the likelihood of financial burden. Thirty-five percent of patients reported deleterious health behaviors because of financial constraints. These patients were likely to be younger, have lower education, and with a longer time since HCT. Being employed decreased the likelihood of experiencing financial burden and treatment nonadherence due to concern about costs. A significant proportion of allogeneic HCT survivors experience financial hardship despite insurance coverage. Future research should investigate potential interventions to help at-risk patients and prevent adverse financial outcomes after this life-saving procedure.

  9. Incremental increases in economic burden parallels cardiometabolic risk factors in the US

    Directory of Open Access Journals (Sweden)

    McQueen RB

    2016-08-01

    Full Text Available R Brett McQueen,1 Vahram Ghushchyan,1,2 Temitope Olufade,3 John J Sheehan,4 Kavita V Nair,1 Joseph J Saseen1,5 1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Anschutz Medical Campus, Aurora, CO, USA; 2College of Business and Economics, American University of Armenia, Yerevan, Armenia; 3AstraZeneca, Wilmington, DE, 4AstraZeneca, Fort Washington, PA, 5Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Objective: Estimate the economic burden associated with incremental increases in the number of cardiometabolic risk factors (CMRFs in the US. Methods: We used the nationally representative Medical Expenditure Panel Survey from 2010 to 2012 to create a retrospective cohort of people based on the number of CMRFs (one, two, and three or four, and a comparison cohort of people with zero CMRFs. CMRFs included abdominal obesity, elevated blood pressure, elevated triglycerides, and elevated glucose and were defined using diagnostic codes, prescribed medications, and survey responses. Adjusted regression analysis was developed to compare health expenditures, utilization, and lost-productivity differences between the cohorts. Generalized linear regression was used for health care expenditures, and negative binomial regression was used for utilization and productivity, controlling for individual characteristics. Results: The number of CMRFs was associated with significantly more annual utilization, health care expenditures, and reduced productivity. As compared with people with zero CMRFs, people with one, two, and three or four CMRFs had 1.15 (95% confidence interval [CI]: 1.06, 1.24, 1.37 (95% CI: 1.25, 1.51, and 1.39 (95% CI: 1.22, 1.57 times higher expected rate of emergency room visits, respectively. Compared with people with zero CMRFs, people with one, two, and three or four CMRFs had increased incremental health care expenditures of US$417 (95

  10. Whistler intensities above thunderstorms

    Directory of Open Access Journals (Sweden)

    J. Fiser

    2010-01-01

    Full Text Available We report a study of penetration of the VLF electromagnetic waves induced by lightning to the ionosphere. We compare the fractional hop whistlers recorded by the ICE experiment onboard the DEMETER satellite with lightning detected by the EUCLID detection network. To identify the fractional hop whistlers, we have developed software for automatic detection of the fractional-hop whistlers in the VLF spectrograms. This software provides the detection times of the fractional hop whistlers and the average amplitudes of these whistlers. Matching the lightning and whistler data, we find the pairs of causative lightning and corresponding whistler. Processing data from ~200 DEMETER passes over the European region we obtain a map of mean amplitudes of whistler electric field as a function of latitudinal and longitudinal difference between the location of the causative lightning and satellite magnetic footprint. We find that mean whistler amplitude monotonically decreases with horizontal distance up to ~1000 km from the lightning source. At larger distances, the mean whistler amplitude usually merges into the background noise and the whistlers become undetectable. The maximum of whistler intensities is shifted from the satellite magnetic footprint ~1° owing to the oblique propagation. The average amplitude of whistlers increases with the lightning current. At nighttime (late evening, the average amplitude of whistlers is about three times higher than during the daytime (late morning for the same lightning current.

  11. Pediatric intensive care.

    Science.gov (United States)

    Macintire, D K

    1999-07-01

    To provide optimal care, a veterinarian in a pediatric intensive care situation for a puppy or kitten should be familiar with normal and abnormal vital signs, nursing care and monitoring considerations, and probable diseases. This article is a brief discussion of the pediatric intensive care commonly required to treat puppies or kittens in emergency situations and for canine parvovirus type 2 enteritis.

  12. Combined life satisfaction of persons with stroke and their caregivers: associations with caregiver burden and the impact of stroke

    Directory of Open Access Journals (Sweden)

    von Koch Lena

    2011-01-01

    Full Text Available Abstract Background Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS. Results The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings

  13. Comparative studies of the chemiluminescent horseradish peroxidase-catalyzed peroxidation of acridan (GZ-11) and luminol reactions: Effect of pH and scavengers of reactive oxygen species on the light intensity of these systems

    NARCIS (Netherlands)

    Osman, A.M.; Zomer, G.; Laane, C.; Hilhorst, R.

    2000-01-01

    In this study, the chemiluminescent horseradish peroxidase/H2O2-catalysed oxidation of acridan (GZ-11) substrate was compared with the well-characterized light-producing luminol reaction. p-Iodophenol and p-phenylphenol were used as enhancers, respectively, for the luminol and acridan reactions. The

  14. Quantitative PCR analysis of salivary pathogen burden in periodontitis.

    Science.gov (United States)

    Salminen, Aino; Kopra, K A Elisa; Hyvärinen, Kati; Paju, Susanna; Mäntylä, Päivi; Buhlin, Kåre; Nieminen, Markku S; Sinisalo, Juha; Pussinen, Pirkko J

    2015-01-01

    Our aim was to investigate the value of salivary concentrations of four major periodontal pathogens and their combination in diagnostics of periodontitis. The Parogene study included 462 dentate subjects (mean age 62.9 ± 9.2 years) with coronary artery disease (CAD) diagnosis who underwent an extensive clinical and radiographic oral examination. Salivary levels of four major periodontal bacteria were measured by quantitative real-time PCR (qPCR). Median salivary concentrations of Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia, as well as the sum of the concentrations of the four bacteria, were higher in subjects with moderate to severe periodontitis compared to subjects with no to mild periodontitis. Median salivary Aggregatibacter actinomycetemcomitans concentrations did not differ significantly between the subjects with no to mild periodontitis and subjects with moderate to severe periodontitis. In logistic regression analysis adjusted for age, gender, diabetes, and the number of teeth and implants, high salivary concentrations of P. gingivalis, T. forsythia, and P. intermedia were significantly associated with moderate to severe periodontitis. When looking at different clinical and radiographic parameters of periodontitis, high concentrations of P. gingivalis and T. forsythia were significantly associated with the number of 4-5 mm periodontal pockets, ≥6 mm pockets, and alveolar bone loss (ABL). High level of T. forsythia was associated also with bleeding on probing (BOP). The combination of the four bacteria, i.e., the bacterial burden index, was associated with moderate to severe periodontitis with an odds ratio (OR) of 2.40 (95% CI 1.39-4.13). When A. actinomycetemcomitans was excluded from the combination of the bacteria, the OR was improved to 2.61 (95% CI 1.51-4.52). The highest OR 3.59 (95% CI 1.94-6.63) was achieved when P. intermedia was further excluded from the combination and only the levels of P. gingivalis and T

  15. Mercury (Hg) burden in children: the impact of dental amalgam.

    Science.gov (United States)

    Al-Saleh, Iman; Al-Sedairi, Al Anoud

    2011-07-15

    The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5-15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine (μg/g creatinine) and micrograms per liter (μg/L). We found that children with amalgam fillings (N=106) had significantly higher UHg-C levels than children without (N=76), with means of 3.763 μg/g creatinine versus 3.457 μg/g creatinine, respectively (P=0.019). The results were similar for UHg (P=0.01). A similar pattern was also seen for HHg, with means of 0.614 μg/g (N=97) for children with amalgam versus 0.242 μg/g (N=74) for those without amalgam fillings (P=0). Although the mean NHg was higher in children without amalgam (0.222 μg/g, N=61) versus those with (0.163 μg/g, N=101), the relationship was not significant (P=0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without (Pdental amalgam fillings (P=0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and/or nephrotoxic effects of such an increased Hg on children should be a cause of concern, and further investigation is warranted. Our

  16. Quantitative PCR analysis of salivary pathogen burden in periodontitis

    Directory of Open Access Journals (Sweden)

    Aino eSalminen

    2015-10-01

    Full Text Available Our aim was to investigate the value of salivary concentrations of four major periodontal pathogens and their combination in diagnostics of periodontitis. The Parogene study included 462 dentate subjects (mean age 62.9±9.2 years with coronary artery disease diagnosis who underwent an extensive clinical and radiographic oral examination. Salivary levels of four major periodontal bacteria were measured by quantitative real-time PCR. Median salivary concentrations of P. gingivalis, T. forsythia, and P. intermedia, as well as the sum of the concentrations of the four bacteria, were higher in subjects with moderate to severe periodontitis compared to subjects with no to mild periodontitis. Median salivary A. actinomycetemcomitans concentrations did not differ significantly between the subjects with no to mild periodontitis and subjects with moderate to severe periodontitis. In logistic regression analysis adjusted for age, gender, diabetes, and the number of teeth and implants, high salivary concentrations of P. gingivalis, T. forsythia, and P. intermedia were significantly associated with moderate to severe periodontitis. When looking at different clinical and radiographic parameters of periodontitis, high concentrations of P. gingivalis and T. forsythia were significantly associated with the number of 4-5 mm periodontal pockets, ≥ 6 mm pockets, and alveolar bone loss (ABL. High level of T. forsythia was associated also with bleeding on probing (BOP. The combination of the four bacteria, i.e. the bacterial burden index, was associated with moderate to severe periodontitis with an odds ratio (OR of 2.40 (95% CI 1.39–4.13. When A. actinomycetemcomitans was excluded from the combination of the bacteria, the OR was improved to 2.61 (95% CI 1.51–4.52. The highest odds ratio 3.59 (95% CI 1.94–6.63 was achieved when P. intermedia was further excluded from the combination and only the levels of P. gingivalis and T. forsythia were used. Salivary

  17. Magnetic resonance colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy: Patient burden and preferences

    Energy Technology Data Exchange (ETDEWEB)

    Paardt, M.P. van der, E-mail: m.p.vanderpaardt@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Boellaard, T.N., E-mail: t.n.boellaard@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Zijta, F.M., E-mail: fmzijta@yahoo.com [Department of Radiology, Medisch Centrum Haaglanden, Den Haag (Netherlands); Baak, L.C., E-mail: l.c.baak@olvg.nl [Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Depla, A.C.T.M., E-mail: actm.depla@slz.nl [Department of Gastroenterology and Hepatology, Slotervaartziekenhuis, Amsterdam (Netherlands); Dekker, E., E-mail: e.dekker@amc.uva.nl [Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Bipat, S., E-mail: s.bipat@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Department of Radiology, Academic Medical Center Amsterdam, Amsterdam (Netherlands)

    2015-01-15

    Highlights: • MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. • When discarding the bowel preparation, the examinations were rated equally burdensome. • The majority of patients preferred MR colonography over colonoscopy for their future examination of the bowel. - Abstract: Objectives: To evaluate patient burden and preferences for MR colonography with a limited bowel preparation and automated carbon dioxide insufflation in comparison to conventional colonoscopy. Methods: Symptomatic patients were consecutively recruited to undergo MR colonography with automated carbon dioxide insufflation and a limited bowel preparation followed within four weeks by colonoscopy with a standard bowel cleansing preparation. Four questionnaires regarding burden (on a five-point scale) and preferences (on a seven-point scale) were addressed after MR colonography and colonoscopy and five weeks after colonoscopy. Results: Ninety-nine patients (47 men, 52 women; mean age 62.3, SD 8.7) were included. None of the patients experienced severe or extreme burden from the MR colonography bowel preparation compared to 31.5% of the patients for the colonoscopy bowel preparation. Colonoscopy was rated more burdensome (25.6% severe or extreme burden) compared to MR colonography (5.2% severe or extreme burden) (P < 0.0001). When discarding the bowel preparations, the examinations were rated equally burdensome (P = 0.35). The majority of patients (61.4%) preferred MR colonography compared to colonoscopy (29.5%) immediately after the examinations and five weeks later (57.0% versus 39.5%). Conclusion: MR colonography with a limited bowel preparation and automated carbon dioxide insufflation demonstrated less burden compared to colonoscopy. The majority of patients preferred MR colonography over colonoscopy.

  18. Intensity Biased PSP Measurement

    Science.gov (United States)

    Subramanian, Chelakara S.; Amer, Tahani R.; Oglesby, Donald M.; Burkett, Cecil G., Jr.

    2000-01-01

    The current pressure sensitive paint (PSP) technique assumes a linear relationship (Stern-Volmer Equation) between intensity ratio (I(sub o)/I) and pressure ratio (P/P(sub o)) over a wide range of pressures (vacuum to ambient or higher). Although this may be valid for some PSPs, in most PSPs the relationship is nonlinear, particularly at low pressures (less than 0.2 psia when the oxygen level is low). This non-linearity can be attributed to variations in the oxygen quenching (de-activation) rates (which otherwise is assumed constant) at these pressures. Other studies suggest that some paints also have non-linear calibrations at high pressures; because of heterogeneous (non-uniform) oxygen diffusion and quenching. Moreover, pressure sensitive paints require correction for the output intensity due to light intensity variation, paint coating variation, model dynamics, wind-off reference pressure variation, and temperature sensitivity. Therefore to minimize the measurement uncertainties due to these causes, an insitu intensity correction method was developed. A non-oxygen quenched paint (which provides a constant intensity at all pressures, called non-pressure sensitive paint, NPSP) was used for the reference intensity (I(sub NPSP) with respect to which all the PSP intensities (I) were measured. The results of this study show that in order to fully reap the benefits of this technique, a totally oxygen impermeable NPSP must be available.

  19. Causal relationship between background radium burdens and osteonecrosis questioned

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.H. [Schmeltzer, Aptaker and Shepard, P.C., Northwest WA, D.C. (United States); Gannon, F.H. [Dept. of Orthopedic Pathology, Armed Forces Inst. of Pathology, WA, D.C. (United States)

    2005-07-01

    A pathologist's 1974 publication reported medical information for 42 radium workers, including identification of a variety of systemic diseases and other conditions putatively associated with osteonecrosis. In 1983, the same author prepared another article concluding that 6 of the 42 radium workers with background or below-background radium burdens had radium-induced osteonecrosis. The pathologist based this conclusion on the premise that none of the workers had the systemic diseases that had previously been reported in the 1974 publication. In 1992, the pathologist testified as an expert witness in civil litigation and acknowledged that the systemic diseases and other conditions reported in his 1974 article caused or could have caused the 6 workers' osteonecrosis. The purpose of this document is to reconcile the confusion created by the foregoing publications concerning the relationship between background radium burdens and osteonecrosis. (orig.)

  20. Optimizing the protection against the physiological burden of CBRN clothing.

    Science.gov (United States)

    Brasser, Paul

    2010-01-01

    Soldiers can wear chemical, biological, radiological and nuclear (CBRN) protective clothing to be protected against warfare agents. The disadvantage of that clothing is that higher protection introduces higher physiological burden. Therefore an optimum between comfort and protection must be found. Models of all relevant processes were created to find this optimum. The airflow profile around a cylinder with clothing-representing a dressed human body part-was modelled. This flow profile was used for calculating the agent vapour breakthrough through the clothing and for calculating the deposition of agents onto the skin (as indicators for protection). The flow profile was also used for calculating the temperature profile around the body part and the relative humidity underneath and in the clothing (as representative for physiological burden). As a result a tool was created, which can be used to identify the optimum properties of CBRN protective clothing, depending on the intended mission of the soldiers.

  1. Sharing the burden of climate change stabilization: An energysector perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Fabian; Sathaye, Jayant

    2006-05-01

    In this paper we discuss long-term least cost CO2stabilization scenarios based on the SRES AIM A1B scenario in the contextof an international burden-sharing regime. Starting from a stabilizationtarget, regional emission caps are formulated dynamically on the basis ofpast emissions. With these regional caps, the cost-optimal supply fuelmix in the energy sector in the four SRES world regions is calculated,and lower bounds on the volume of traded carbon are estimated. Theallocation scheme provides incentives for early mitigation action. Weestimate additional regional costs incurred by the allocation scheme, andassess the sensitivity of results to changes in the concentrationceiling, discount rates, and start date for burden sharing.

  2. Cystatin C is Associated With Plaque Phenotype and Plaque Burden

    Directory of Open Access Journals (Sweden)

    Yufeng Wen

    2016-03-01

    Full Text Available Background/Aims: The relationship between carotid artery plaque burden, phenotype and serum cystatin C at normal and impaired renal function is still unclear. Methods: Demographic characteristics, carotid ultrasonography and other relevant information of 1,477 patients were collected. The association of carotid artery plaque burden, plaque phenotype with serum cystatin C was evaluated by strategy analysis based on renal function. Results: Serum cystatin C (OR=2.05, 95% CI: 1.83-2.29, POR=1.60, 95%CI: 1.43-1.78, POR=1.21, 95%CI: 1.10-1.32, P Conclusion: In normal renal function, serum cystatin C may confer stability of plaques. In mildly impaired renal function, serum cystatin C is a risk predictor of plaques. In normal renal function circumstances, serum cystatin C may benefit to the stability of plaques. In mild impaired renal function circumstances, serum cystatin C are a risk predictors of plaques.

  3. Atlas of the Global Burden of Stroke (1990-2013)

    DEFF Research Database (Denmark)

    Feigin, Valery L; Mensah, George A; Norrving, Bo;

    2015-01-01

    (through April 2014) and stroke incidence, prevalence, case fatality and severity through 2013. Death was estimated using an ensemble modeling approach. A new software package, DisMod-MR 2.0, was used as part of a custom modeling process to estimate YLDs. All rates were age-standardized to new GBD...... estimates of global population. All estimates have been computed with 95% uncertainty intervals. RESULTS: Age-standardized incidence, mortality, prevalence and DALYs/YLDs declined over the period from 1990 to 2013. However, the absolute number of people affected by stroke has substantially increased across....... CONCLUSIONS: Global burden of stroke has continued to increase in spite of dramatic declines in age-standardized incidence, prevalence, mortality rates and disability. Population growth and aging have played an important role in the observed increase in stroke burden....

  4. Drinking Water in Nigeria: A Public Health Threat and Burden

    Science.gov (United States)

    2009-04-01

    assistance of the Russian space program (2003).13 This history of Nigeria has impacted its current democracy and the violence , poverty, and corruption that...is the unrest and violence between different groups; this places additional burdens on the government to maintain security and stability. A disease...diarrhea, fever, nausea, cramps, and vomiting.58 The Shigella genus of bacteria is made up of three other different types of species or serogroups

  5. The Burden of Age-Related Macular Degeneration

    OpenAIRE

    Jordana K. Schmier; Mechelle L. Jones; Halpern, Michael T.

    2006-01-01

    As age-related macular degeneration (AMD) becomes more prevalent as a result of longer life expectancy and the number of elderly people worldwide, it will become increasingly important to understand its potential health and economic impact for appropriate healthcare planning. This review identified published literature on costs and resource use associated with AMD. Despite the increasing prevalence of AMD, the worldwide burden of illness is unknown. Several studies of direct medical costs, bo...

  6. HOW TO MOTIVATE ENGLISH LEARNERS FACED WITH PSYCHOLOGICAL BURDEN

    Directory of Open Access Journals (Sweden)

    Himpun Panggabean

    2007-01-01

    Full Text Available The misleading assumptions of Indonesian-speaking learners of English on the nature of English results in psychological burden inhibiting the process of teaching and learning. The assumptions should be eliminated at the beginning of English class. Besides, the instructor should extensively motivate and encourage the learners to maximize their potentials in learning process. Such approach will gradually lead the learners to self-confidence and self-discovery.

  7. Soft Budget Constraint and Policy Burdens of China'SOEs

    Institute of Scientific and Technical Information of China (English)

    缪文卿

    2002-01-01

    In this paper,we have analyzed the SBC problem in China' SOEs ,and think that the policy burdens for SOEs is the root of the SBC problem . Unless the government does not ask enterprises to employ more workers, to provide below market-clearing prices of goods, and to take other actions that increase the enterprise's costs, the SBC phenomenon will exist for a long term.

  8. Coprological tests underestimate Macracanthorhynchus hirudinaceus burden in wild boar.

    Science.gov (United States)

    Gassó, Diana; Serrano, Emmanuel; Castillo-Contreras, Raquel; Aguilar, Xavier Fernández; Cadena, Andreu Colom; Velarde, Roser; Mentaberre, Gregorio; López-Olvera, Jorge Ramón; Risco, David; Gonçalves, Pilar; Lavín, Santiago; Fernandez-Llário, Pedro; Segalés, Joaquim; Ferrer, David

    2016-05-01

    The present study evaluated the limitations of the coprological sedimentation test to assess Macracanthorhynchus hirudinaceus infestation in 59 wild boars (Sus scrofa) from central Spain. The coprological sedimentation test appeared to be a poor predictor of both prevalence of infestation and the real parasite burden due to the high number of false negative results (prevalence was reduced from 61 to 16 %). Because of the potential increased risk of this zoonosis, it is suggested that alternative techniques be used in wildlife surveillance programmes.

  9. Strategic Culture and Burden Sharing in NATO: False Friends?

    Science.gov (United States)

    2012-01-01

    first, developed by Mancur Olson and Richard Zeckhauser in 1966, 14 describes security of Alliance members as a public good, and therefore defines...Alliance burden sharing as a collective action problem. Olson and Zeckhauser therefore hypothesize that NATO members with higher GDPs would contribute...theoretical perspective. First, as Olson and Zeckhauser articulated nearly 50 years ago, an alliance that includes a member that is distinctly larger and

  10. Melanoma Surveillance in the US: The Economic Burden of Melanoma

    Centers for Disease Control (CDC) Podcasts

    2011-10-19

    This podcast accompanies the publication of a series of articles on melanoma surveillance in the United States, available in the November supplement edition of the Journal of the American Academy of Dermatology. Dr. Gery Guy, from the CDC’s Division of Cancer Prevention and Control, discusses the economic burden of melanoma.  Created: 10/19/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/19/2011.

  11. Factors that lessen the burden of treatment in complex patients with chronic conditions: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ridgeway JL

    2014-03-01

    maintaining a positive attitude, focusing on other life priorities, and spirituality/faith; 3 questioning the notion of treatment burden as a function of adapting to self-care and comparing oneself to others; 4 social support (informational, tangible, and emotional assistance; and 5 positive aspects of health care, like coordination of care and beneficial relationships with providers. Additional subthemes arising from focus groups included preserving autonomy/independence and being proactive with providers. Conclusion: Patients attempt to lessen the experience of treatment burden using a variety of personal, social, and health care resources. Assessing these factors in tandem with patient perceptions of treatment burden can provide a more complete picture of how patients fit complex self-care into their daily lives. Keywords: adherence, patient-centered, minimally disruptive medicine, patient preferences

  12. Use of vaccines as probes to define disease burden.

    Science.gov (United States)

    Feikin, Daniel R; Scott, J Anthony G; Gessner, Bradford D

    2014-05-17

    Vaccine probe studies have emerged in the past 15 years as a useful way to characterise disease. By contrast, traditional studies of vaccines focus on defining the vaccine effectiveness or efficacy. The underlying basis for the vaccine probe approach is that the difference in disease burden between vaccinated and unvaccinated individuals can be ascribed to the vaccine-specific pathogen. Vaccine probe studies can increase understanding of a vaccine's public health value. For instance, even when a vaccine has a seemingly low efficacy, a high baseline disease incidence can lead to a large vaccine-preventable disease burden and thus that population-based vaccine introduction would be justified. So far, vaccines have been used as probes to characterise disease syndromes caused by Haemophilus influenzae type b, pneumococcus, rotavirus, and early infant influenza. However, vaccine probe studies have enormous potential and could be used more widely in epidemiology, for example, to define the vaccine-preventable burden of malaria, typhoid, paediatric influenza, and dengue, and to identify causal interactions between different pathogens.

  13. Cost and disease burden of Dengue in Cambodia

    Directory of Open Access Journals (Sweden)

    Beauté Julien

    2010-08-01

    Full Text Available Abstract Background Dengue is endemic in Cambodia (pop. estimates 14.4 million, a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs. Methods Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation. Results The mean cost per dengue case varied from US$36 - $75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality. Conclusion Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.

  14. Improving the estimation of the tuberculosis burden in India.

    Science.gov (United States)

    Cowling, Krycia; Dandona, Rakhi; Dandona, Lalit

    2014-11-01

    Although India is considered to be the country with the greatest tuberculosis burden, estimates of the disease's incidence, prevalence and mortality in India rely on sparse data with substantial uncertainty. The relevant available data are less reliable than those from countries that have recently improved systems for case reporting or recently invested in national surveys of tuberculosis prevalence. We explored ways to improve the estimation of the tuberculosis burden in India. We focused on case notification data - among the most reliable data available - and ways to investigate the associated level of underreporting, as well as the need for a national tuberculosis prevalence survey. We discuss several recent developments - i.e. changes in national policies relating to tuberculosis, World Health Organization guidelines for the investigation of the disease, and a rapid diagnostic test - that should improve data collection for the estimation of the tuberculosis burden in India and elsewhere. We recommend the implementation of an inventory study in India to assess the underreporting of tuberculosis cases, as well as a national survey of tuberculosis prevalence. A national assessment of drug resistance in Indian strains of Mycobacterium tuberculosis should also be considered. The results of such studies will be vital for the accurate monitoring of tuberculosis control efforts in India and globally.

  15. [Predictive value of Hodgkin's lymphoma tumor burden in present].

    Science.gov (United States)

    Kulyova, S A; Karitsky, A P

    2014-01-01

    Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated 15 years ago for the first time, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin's lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement is conducted which allows excluding a reactive component.

  16. One world health: socioeconomic burden and parasitic disease control priorities.

    Science.gov (United States)

    Torgerson, Paul R

    2013-08-01

    Parasitic diseases present a considerable socio-economic impact to society. Zoonotic parasites can result in a considerable burden of disease in people and substantive economic losses to livestock populations. Ameliorating the effects of these diseases may consist of attempts at eradicating specific diseases at a global level, eliminating them at a national or local level or controlling them to minimise incidence. Alternatively with some parasitic zoonoses it may only be possible to treat human and animal cases as they arise. The choice of approach will be determined by the potential effectiveness of a disease control programme, its cost and the cost effectiveness or cost benefit of undertaking the intervention. Furthermore human disease burden is being increasingly measured by egalitarian non-financial measures which are difficult to apply to livestock. This adds additional challenges to the assessment of socio-economic burdens of zoonotic diseases. Using examples from the group of neglected zoonotic diseases, information regarding the socio-economic effects is reviewed together with how this information is used in decision making with regard to disease control and treatment.

  17. Evaluation of the economic burden of Herpes Zoster (HZ) infection.

    Science.gov (United States)

    Panatto, Donatella; Bragazzi, Nicola Luigi; Rizzitelli, Emanuela; Bonanni, Paolo; Boccalini, Sara; Icardi, Giancarlo; Gasparini, Roberto; Amicizia, Daniela

    2015-01-01

    The main objective of this systematic review was to evaluate the economic burden of Herpes Zoster (HZ) infection.   The review was conducted in accordance with the standards of the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The following databases were accessed: ISI/Web of Knowledge (WoS), MEDLINE/PubMed, Scopus, ProQuest, the Cochrane Library and EconLit. Specific literature on health economics was also manually inspected. Thirty-three studies were included. The quality of the studies assessed in accordance with the Consolidated Health Economic Evaluation Reporting Standards checklist was good. All studies evaluated direct costs, apart from one which dealt only with indirect costs. Indirect costs were evaluated by 12 studies. The economic burden of HZ has increased over time. HZ management and drug prescriptions generate the highest direct costs. While increasing age, co-morbidities and drug treatment were found to predict higher direct costs, being employed was correlated with higher indirect costs, and thus with the onset age of the disease. Despite some differences among the selected studies, particularly with regard to indirect costs, all concur that HZ is a widespread disease which has a heavy social and economic burden.

  18. [Intensive medicine in Spain].

    Science.gov (United States)

    2011-03-01

    Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient. It also describes the development of reference registries due to the need for reliable data on the care process for the most prevalent diseases, such as ischemic heart disease or ICU-acquired infections, based on long-term experience (more than 15 years), which results in the availability of epidemiological information and characteristics of care that may affect the practical patient's care. Moreover, features of its scientific society (SEMICYUC) are reported, an organization that agglutinates the interests of more than 280 ICUs and more than 2700 intensivists, with reference to the journal Medicina Intensiva, the official journal of the society and the Panamerican and Iberian Federation of Critical Medicine and Intensive Care Societies. Medicina Intensiva is indexed in the Thompson Reuters products of Science Citation Index Expanded (Scisearch(®)) and Journal Citation Reports, Science Edition. The important contribution of the Spanish intensive care medicine to the scientific community is also analyzed, and in relation to

  19. TO COMPARE THE EFFECTIVENESS OF THERAPEUTIC KINESIO TAPING AND EXERCISES AND ULTRASOUND WITH THERAPEUTIC KINESIO TAPING AND EXERCISES AND LOW INTENSITY LASER IN TREATING PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME

    Directory of Open Access Journals (Sweden)

    Ravish

    2015-05-01

    Full Text Available BACKGROUND AND OBJECTIVES: Subacromial impingement syndrome (SIAS is a painful condition resulting from the entrapment of anatomical structures between the anterioinferior corner of the acromion and the greater tuberosity of the humerus . Subacromial impingement syndrome (SAIS of the shoulder is the most common disorder of the shoulder , accounting for 44 - 65% of all complaints of shoulder . SAIS is usually treated conservatively , but sometimes it is treated with arthroscopic surgery or open surgery . Conservatively treatment includes rest , cessation of painful activity , ultrasound therapy , laser and physiotherapy focused at maintaining range of movement and avoids shoulder stiffness . NSAIDS’s and ice packs may be u sed for pain relief . Therapeutic injections of corticosteroid and local anesthetic may be used for persistent impingement syndrome . Hence this study aimed to compare and see the effectiveness of ultrasound , kinesio taping and exercises with low level laser , kinesio taping and exercises . STUDY DESIGN : Comparative study design SETTING: Out p atient Department of Orthopedics , Kempegowda Institute of Medical Science Hospital and Research Center , Bangalore. Out p atient Department of Physiotherapy , Kempegowda institute of Physiotherapy , Bangalore . OUTCOME MEASURES: Visual analog scale (VAS for pain , Shoulder ROM , Shoulder pain and disability index (SPADI . METHOD: For this study 60 patients with chronic SAIS of both the sex were randomly divided into group A and group B . Group A were treated with Ultra sound therapy for 5 minutes along with shoulder exercise and kinesio taping 5 times per week . Group B were treated with LLLT for 3 minutes along with exercises and kinesio taping 3 times per week . Both the groups were treated for 3 weeks . Patients were evaluated with VAS , ROM and SPADI score on 1 st day , 1 st week , 2 nd week and 3 rd week . RESULT: Both groups showed clinically and statistically significant

  20. Tuberculosis DALY-Gap: Spatial and Quantitative Comparison of Disease Burden Across Urban Slum and Non-slum Census Tracts.

    Science.gov (United States)

    Marlow, Mariel A; Maciel, Ethel Leonor Noia; Sales, Carolina Maia Martins; Gomes, Teresa; Snyder, Robert E; Daumas, Regina Paiva; Riley, Lee W

    2015-08-01

    To quantitatively assess disease burden due to tuberculosis between populations residing in and outside of urban informal settlements in Rio de Janeiro, Brazil, we compared disability-adjusted life years (DALYs), or "DALY-gap." Using the 2010 Brazilian census definition of informal settlements as aglomerados subnormais (AGSN), we allocated tuberculosis (TB) DALYs to AGSN vs non-AGSN census tracts based on geocoded addresses of TB cases reported to the Brazilian Information System for Notifiable Diseases in 2005 and 2010. DALYs were calculated based on the 2010 Global Burden of Disease methodology. DALY-gap was calculated as the difference between age-adjusted DALYs/100,000 population between AGSN and non-AGSN. Total TB DALY in Rio in 2010 was 16,731 (266 DALYs/100,000). DALYs were higher in AGSN census tracts (306 vs 236 DALYs/100,000), yielding a DALY-gap of 70 DALYs/100,000. Attributable DALY fraction for living in an AGSN was 25.4%. DALY-gap was highest for males 40-59 years of age (501 DALYs/100,000) and in census tracts with <60% electricity (12,327 DALYs/100,000). DALY-gap comparison revealed spatial and quantitative differences in TB burden between slum vs non-slum census tracts that were not apparent using traditional measures of incidence and mortality. This metric could be applied to compare TB burden or burden for other diseases in mega-cities with large informal settlements for more targeted resource allocation and evaluation of intervention programs.

  1. Data-intensive science

    CERN Document Server

    Critchlow, Terence

    2013-01-01

    Data-intensive science has the potential to transform scientific research and quickly translate scientific progress into complete solutions, policies, and economic success. But this collaborative science is still lacking the effective access and exchange of knowledge among scientists, researchers, and policy makers across a range of disciplines. Bringing together leaders from multiple scientific disciplines, Data-Intensive Science shows how a comprehensive integration of various techniques and technological advances can effectively harness the vast amount of data being generated and significan

  2. Low-intensity laser coupled with photosensitizer to reduce bacteria in root canals compared to chemical control; Laser em baixa intensidade associado a fotosensibilizador para reducao bacteriana intracanal comparado ao controle quimico

    Energy Technology Data Exchange (ETDEWEB)

    Garcez Segundo, Aguinaldo Silva

    2002-07-01

    The photodynamic therapy is a process in which a dye is associate with an appropriate wavelength of light and this dye goes to an excited state. The excited reacts with oxygen to form the highly reactive compound singlet oxygen, and this compound can kill bacteria and tumor cells. The purpose of this study was to evaluate the bactericidal reduction in root canal contaminated with E. Faecalis. Thirty teeth with their root canals prepared were contaminated with E. faecalis. The teeth have received the chemical substance sodium hypochlorite for 30 minutes; ten teeth have received the azulene dye paste for 5 minutes and have been irradiated with a diode laser, output power 10 mW and {lambda}= 685 nm for 3 minutes. Ten teeth have not received treatment (control group). The bacterial reduction was significantly higher for laser group when compared to chemical and control groups. These results indicate photodynamic therapy as an effective method to kill bacteria. (author)

  3. Towards higher intensities

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Over the past 2 weeks, commissioning of the machine protection system has advanced significantly, opening up the possibility of higher intensity collisions at 3.5 TeV. The intensity has been increased from 2 bunches of 1010 protons to 6 bunches of 2x1010 protons. Luminosities of 6x1028 cm-2s-1 have been achieved at the start of fills, a factor of 60 higher than those provided for the first collisions on 30 March.   The recent increase in LHC luminosity as recorded by the experiments. (Graph courtesy of the experiments and M. Ferro-Luzzi) To increase the luminosity further, the commissioning crews are now trying to push up the intensity of the individual proton bunches. After the successful injection of nominal intensity bunches containing 1.1x1011 protons, collisions were subsequently achieved at 450 GeV with these intensities. However, half-way through the first ramping of these nominal intensity bunches to 3.5 TeV on 15 May, a beam instability was observed, leading to partial beam loss...

  4. Mercury (Hg) burden in children: The impact of dental amalgam

    Energy Technology Data Exchange (ETDEWEB)

    Al-Saleh, Iman, E-mail: iman@kfshrc.edu.sa [Biological and Medical Research Department, King Faisal Specialist Hospital and Research Centre, PO Box: 3354, Riyadh 11211 (Saudi Arabia); Al-Sedairi, Al anoud [Department of Zoology, College of Science, King Saud University, PO Box: 24452, Riyadh 11495 (Saudi Arabia)

    2011-07-15

    The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5-15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine ({mu}g/g creatinine) and micrograms per liter ({mu}g/L). We found that children with amalgam fillings (N = 106) had significantly higher UHg-C levels than children without (N = 76), with means of 3.763 {mu}g/g creatinine versus 3.457 {mu}g/g creatinine, respectively (P = 0.019). The results were similar for UHg (P = 0.01). A similar pattern was also seen for HHg, with means of 0.614 {mu}g/g (N = 97) for children with amalgam versus 0.242 {mu}g/g (N = 74) for those without amalgam fillings (P = 0). Although the mean NHg was higher in children without amalgam (0.222 {mu}g/g, N = 61) versus those with (0.163 {mu}g/g, N = 101), the relationship was not significant (P = 0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without (P < 0.01). In contrast, a significant inverse relationship was seen between NHg levels and dental amalgam fillings (P = 0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and

  5. STUDY ON SOFTENING AND DROPPING PROPERTIES OF METALIZED BURDEN INSIDE BLAST FURNACE

    Directory of Open Access Journals (Sweden)

    Bi-yang Tuo

    2014-12-01

    Full Text Available The inferences of burden metallization rate on softening-melting dropping properties were investigated through softening-melting dropping test of three kinds of metalized burden pressure drop. The results indicated that the softeningmelting temperature interval of pre-reduction mixed burden is bigger than primeval mixed burden, the melting interval narrow with the rise of metallization rate of ferric burden as well as dropping temperature interval. The average pressure drop, maximum pressure drop and softening-melting dropping properties eigenvalue decrease with the rise of metallization rate of ferric burden. Besides, the dropping temperature of burden reduces with the rise of carbon content of molten iron. The combination high metalized burden and higher carbon content of molten iron is benefit to decreasing thickness of cohesive zone and improve permeability of cohesive zone.

  6. Study of factors determining caregiver burden among primary caregivers of patients with intracranial tumors

    Directory of Open Access Journals (Sweden)

    Manju Dhandapani

    2015-01-01

    Conclusions: Behavioral changes in patients (especially irritability and financial constraints had a significant independent impact on the burden experienced by primary caregivers of patients operated for intracranial tumors. Identifying and managing, these are essential for reducing caregiver burden.

  7. Mathematical modeling of the burden distribution in the blast furnace shaft

    Science.gov (United States)

    Park, Jong-In; Jung, Hun-Je; Jo, Min-Kyu; Oh, Han-Sang; Han, Jeong-Whan

    2011-06-01

    Process efficiency in the blast furnace is influenced by the gas flow pattern, which is dictated by the burden profile. Therefore, it is important to control the burden distribution so as to achieve reasonable gas flow in the blast furnace operation. Additionally, the charging pattern selection is important as it affects the burden trajectory and stock profile. For analysis of the burden distribution, a new analysis model was developed by use of the spreadsheet program, Microsoft® Office Excel, based on visual basic. This model is composed of the falling burden trajectory and a stock model. The burden trajectory is determined by the burden type, batch weight, rotating velocity of the chute, tilting angle, and friction coefficient. After falling, stock lines are formed by the angle of repose, which is affected by the burden trajectory and the falling velocity. The mathematical formulas for developing this model were modified by a scaled model experiment and DEM simulation.

  8. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010.

    Directory of Open Access Journals (Sweden)

    Harvey A Whiteford

    Full Text Available The Global Burden of Disease Study 2010 (GBD 2010, estimated that a substantial proportion of the world's disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders.For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs. Years lost to premature mortality (YLLs were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs were computed as the sum of YLDs and YLLs.In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%, followed by neurological disorders (28.6% and substance use disorders (14.7%. DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson's disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific.Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the research necessary to develop

  9. Effectiveness Comparative Study of Tobacco Curing on Different Alternative Energy Intensive Barn%不同替代能源密集烤房烟叶烘烤效能对比研究

    Institute of Scientific and Technical Information of China (English)

    郭大仰; 刘尚钱; 肖志新; 刘芮; 彭坚强; 胡志明; 曹娜; 李丽

    2016-01-01

    [目的]探索烟叶烘烤燃煤的替代能源。[方法]对生物质压块、生物质颗粒和醇基3类燃料与常规燃料(褐煤)的烟叶烘烤效能进行对比研究。[结果]3种替代能源在燃烧烟气中主要污染物的排放明显低于常规燃料,烘烤过程中升温速度、稳温性能明显提高(除生物质压块外),整个烘烤工艺时间可缩短6~14 h,对初烤烟叶外观质量无明显影响;醇基燃料成本较高,烘烤综合成本约是褐煤成本的2.4倍,经济效益较差。[结论]生物质颗粒燃料可作为常规燃料(褐煤)的替代能源应用于烟叶实际烘烤工艺中。%Objective] The aim was to explore alternative energy of coal for baking.[Method] The baking efficiency of biomass briquetting, biomass particles, alcohol and conventional fuel (lignite) was comparatively studied.[Result] The results showed that alternative energy dur-ing combustion flue gas emissions of major pollutants were significantly lower than conventional fuel, heating speed, stable temperature per-formance was improved significantly (except fot biomass briquetting), baking process could be shorten 6-14 hours, no significant effect on the appearance quality of cured tobacco leaves, alcohol baking overall costs were increased by approximately 2.4-fold compared with lignite. [Conclusion] Biomass particles can be used as alternative energy of conventional fuel(lignite).

  10. Survival Advantage and Comparable Toxicity in Reduced-Toxicity Treosulfan-Based versus Reduced-Intensity Busulfan-Based Conditioning Regimen in Myelodysplastic Syndrome and Acute Myeloid Leukemia Patients after Allogeneic Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Sakellari, Ioanna; Mallouri, Despina; Gavriilaki, Eleni; Batsis, Ioannis; Kaliou, Maria; Constantinou, Varnavas; Papalexandri, Apostolia; Lalayanni, Chrysavgi; Vadikolia, Chrysanthi; Athanasiadou, Anastasia; Yannaki, Evangelia; Sotiropoulos, Damianos; Smias, Christos; Anagnostopoulos, Achilles

    2017-03-01

    Treosulfan has been incorporated in conditioning regimens for sustained remission without substantial toxicity and treatment-related mortality (TRM). We aimed to analyze the safety and efficacy of a fludarabine 150 mg/m(2) and treosulfan 42 g/m(2) (FluTreo) conditioning regimen in medically infirm patients. Outcomes were compared with those of a similar historical group treated with fludarabine 150 mg/m(2) to 180 mg/m(2), busulfan 6.4 mg/kg, and antithymocyte globulin (ATG) 5 mg/kg to 7.5 mg/kg (FluBuATG). Thirty-one consecutive patients with acute myeloid leukemia (AML; n = 21), myelodysplastic syndrome (MDS; n = 6), or treatment-related AML (n = 4) received FluTreo conditioning. The historical group consisted of 26 consecutive patients treated with FluBuATG. In the FluTreo group, engraftment was prompt in all patients and 74% achieved >99% donor chimerism by day +30. No grades III or IV organ toxicities were noted. One-year cumulative incidences (CI) of acute and chronic graft-versus-host disease (GVHD) were 19.4% and 58.4%. The groups were similar for age, disease risk, lines of treatment, hematopoietic cell transplantation-specific comorbidity index, and acute or chronic GVHD incidence, except that there were more matched unrelated donor recipients in the FluTreo group (P < .001). With 20 (range, 2 to 36) months follow-up for FluTreo and 14 (range, 2 to 136) for FluBuATG, the 1-year cumulative overall survival (OS) probability was 76% versus 57%, respectively (P = .026); 1-year disease-free survival (DFS) was 79% versus 38% (P < .001). In multivariate analysis, the only significantly favorable factor for OS and DFS was FluTreo (P = .010 and P = .012). The CI of relapse mortality was markedly decreased in FluTreo versus FluBuATG (7.4% versus 42.3%, P < .001). In conclusion, the treosulfan-based regimen resulted in favorable OS and DFS with acceptable toxicity and low relapse rates compared with busulfan-based conditioning.

  11. [Disease burden attributable to household air pollution in 1990 and 2013 in China].

    Science.gov (United States)

    Yin, P; Cai, Y; Liu, J M; Liu, Y N; Qi, J L; Wang, L J; You, J L; Zhou, M G

    2017-01-06

    Objective: To assess the disease burden attributable to household air pollution in 1990 and 2013 in China. Methods: Based on data from the Global Burden of Disease Study 2013 in China (GBD 2013), we used population attributable fractions (PAF) to analyze the burden of different diseases attributable to solid-fuel household pollution in 2013 in China(not inclnding HongKang, Macao, Taiwan). We compared PAF, mortality, and disability-adjusted life years (DALY) for diseases attributable to solid-fuel household pollution in 31 provinces in mainland China in 1990 and 2013, and stratified the burden by age group. The estimated world average population during 2000- 2025 was used to calculate age-standardized mortality and DALY rates. Results: In 2013, 14.9% of lower respiratory infections in children pollution. In addition, 807 000 deaths were attributable to solid-fuel household pollution, including 296 000 from COPD, 169 000 from hemorrhagic stroke, 152 000 from ischemic heart disease, 88 000 from ischemic stroke, 75 000 from lung cancer, and 28 000 from lower respiratory infections in children pollution decreased by 59.3% from 158.8/100 000 in 1990 to 64.6/100 000 in 2013. The age-standardized mortality rate from solid-fuel household pollution decreased in all 31 provinces, with the highest decline observed in Shanghai (96.3%), and lowest in Xinjiang (39.9%). In 2013, the age-standardized DALY rate from solid-fuel household pollution was highest in Guizhou (2 233.0/100 000) and lowest in Shanghai (27.0/100 000). The DALY rate was the highest for the >70 age group (7 006.0/100 000). Compared with 1990, the 2013 mortality rate and DALY rate from solid-fuel household pollution decreased in all age groups, with the highest decline observed in the air pollution decreased notably between 1990 and 2013, household pollution caused a high number of deaths and DALY loss in certain western provinces.

  12. Estimating the burden of disease from water, sanitation, and hygiene at a global level.

    OpenAIRE

    Prüss, Annette; Kay, David; Fewtrell, Lorna; Bartram, Jamie

    2002-01-01

    We estimated the disease burden from water, sanitation, and hygiene at the global level taking into account various disease outcomes, principally diarrheal diseases. The disability-adjusted life year (DALY) combines the burden from death and disability in a single index and permits the comparison of the burden from water, sanitation, and hygiene with the burden from other risk factors or diseases. We divided the world's population into typical exposure scenarios for 14 geographical regions. W...

  13. Caregiver Burden in Patients Receiving Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

    OpenAIRE

    Rishma Gohil; Roxanne Crosby-Nwaobi; Angus Forbes; Ben Burton; Phil Hykin; Sobha Sivaprasad

    2015-01-01

    Purpose To assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD). Methods This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA). Objective caregiver burden was determined by the caregiver tasks and level of ...

  14. CIM—Compact intensity modulation

    Science.gov (United States)

    Bleuel, M.; Lang, E.; Gähler, R.; Lal, J.

    2008-07-01

    Compact intensity modulation (CIM), a new method to modulate the intensity of a neutron beam is demonstrated. CIM allows the production of arbitrary signals where the focus point can be chosen and changed without any constraints. A novel feature in this technique compared to spin echo techniques is that the neutron polarization is kept parallel or anti-parallel to the static fields during the passage through the magnetic fields and the beating pattern at the detector is produced by an amplitude modulation (AM) of the adiabatic RF-spin flippers rather than Larmor precession like in neutron spin echo (NSE) instruments; thus, the achievable contrast is very high and the instrument resolution can be changed very quickly. This gives the fascinating possibility at pulsed neutron sources to sweep the modulation frequency of the flippers in order to increase dynamic resolution range during the same neutron pulse.

  15. IN DEFENCE OF INTENSIVE READING

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    In his article‘Why Intensive Reading Hinders the Development of Both English Language Teachingand English Language Learning in China’.Ian Cotton.a British lecturer in Chongqing University,concludes thai the teaching method of Intensive Reading(IR)in China is mainly responsible for the,comparatively low level of Chinese students skills in listening and speaking.He believes IRcontributes nothing to the development of English language teaching and learning in China.Such aconclusion,in my.opinion,is extreme and does not reflect the actual situation of ELT in China.Infact.IR has proved to be an effective teaching method to improve students’English.The question ishow to use the method effectively.

  16. Quality of life in patients with urticaria and angioedema: assessing burden of disease.

    Science.gov (United States)

    Weldon, David

    2014-01-01

    Patients with urticaria and/or angioedema have several reasons to have a poor quality of life (QoL). The intensity of pruritus and density of involvement compromise a patient's lifestyle as well as aggravate stressors that affect physical and psychiatric conditions. The burden of illness is significant in not only costs for emergent practitioner visits, but, often, unnecessary laboratory testing and medication expenses. Questionnaires that assess a patient's QoL serve to document benefit to therapies. Objectively documenting changes that are important to patients with urticaria and/or angioedema allows the patients and clinician to accurately assess effectiveness of therapies over long periods of time. Specific surveys that address urticaria (CU-Q2oL and UAS) and angioedema (AE-QoL questionnaire) allow simplified and sensitive assessments for patients with the corresponding condition. Common components of appropriate surveys assess not only intensity of pruritus and wheals but also impact on sleep, interpersonal relationships, and appearances. In considering the most important aspects of several surveys, an example of a survey is provided that focuses on the patient's perception of how their urticaria and/or angioedema impacts their QoL.

  17. Long-term outcomes of a phase II randomized controlled trial comparing intensity-modulated radiotherapy with or without weekly cisplatin for the treatment of locally recurrent nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ying Guan; Shuai Liu; HanYu Wang; Ying Guo; WeiWei Xiao; ChunYan Chen; Chong Zhao; TaiXiang Lu; Fei Han

    2016-01-01

    Background: Salvage treatment for locally recurrent nasopharyngeal carcinoma (NPC) is complicated and relatively limited. Radiotherapy, combined with effective concomitant chemotherapy, may improve clinical treatment out‑comes. We conducted a phase II randomized controlled trial to evaluate the efcacy of intensity‑modulated radio‑therapy with concomitant weekly cisplatin on locally recurrent NPC. Methods: Between April 2002 and January 2008, 69 patients diagnosed with non‑metastatic locally recurrent NPC were randomly assigned to either concomitant chemoradiotherapy group (n = 34) or radiotherapy alone group(n= 35). All patients received intensity‑modulated radiotherapy. The radiotherapy dose for both groups was 60 Gy in 27 fractions for 37 days (range 23–53 days). The concomitant chemotherapy schedule was cisplatin 30 mg/m2 by intravenous infusion weekly during radiotherapy. Results: The median follow‑up period of all patients was 35 months (range 2–112 months). Between concomitant chemoradiotherapy and radiotherapy groups, there was only significant difference in the 3‑year and 5‑year overall survival (OS) rates (68.7% vs. 42.2%, P = 0.016 and 41.8% vs. 27.5%, P = 0.049, respectively). Subgroup analysis showedthat concomitant chemoradiotherapy significantly improved the 5‑year OS rate especially for patients in stage rT3–4 (33.0% vs. 13.2%, P = 0.009), stages III–IV (34.3% vs. 13.2%, P = 0.006), recurrence interval >30 months (49.0% vs. 20.6%,P= 0.017), and tumor volume >26 cm3 (37.6% vs. 0%, P = 0.006). Conclusion: Compared with radiotherapy alone, concomitant chemoradiotherapy can improve OS of the patients with locally recurrent NPC, especially those with advanced T category (rT3–4) and stage (III–IV) diseases, recurrence intervals >30 months, and tumor volume >26 cm3.

  18. 中外中长跑训练负荷强度安排特征比较研究%Comparative Study of the Characteristics of Load Intensity Arrangements in Middle-distance Race Training in China and Abroad

    Institute of Scientific and Technical Information of China (English)

    李栋

    2012-01-01

    通过对中外学者关于耐力项目运动强度研究得出的生理实验数据和中外教练在耐力项目-/OIl练强度上的安排特征进行比较分析发现:中外生理实验数据指标都与两极化训练研究得出的结论一致;国外教练员在体能类耐力项目训练强度的安排上采用两极化训练模式。使运动员长期保持良好的竞技状态,从而创造出个人最佳成绩;中国教练把提高无氧乳酸能力作为训练重点,易造成运动员肌体交感神经系统活动能力下降而伴随有激素疲劳综合征,从而缩短了其运动员竞技生涯.%Through the comparative analysis of the physiological experimental data from the study of endurance sports and the characteristics of arrangements on the strength endurance training of Chinese and foreign scholars, the author finds out that the physiological experimental data in China and abroad are consistent with the findings of "bipolar training" reseach. Foreign coaches in the arrangement of such strength endurance training applied the "polarization training" mode so as to keep players in good form, thereby creating a personal best record; Chinese coaches put an emphasis on the ability to improve anaerobic lactic acid, prone to decline the activities of the sympathetic nervous system of athletes, accompanied by the hormone fatigue syndrome, reducing their athletic career.

  19. Mortality profile across our Intensive Care Units: A 5-year database report from a Singapore restructured hospital.

    Science.gov (United States)

    Siddiqui, Shahla

    2015-12-01

    Intensive care remains an area of high acuity and high mortality across the globe. With a rapidly aging population, the disease burden requiring intensive care is growing. The cost of critical care also is rising with new technology becoming available rapidly. We present the all-cause mortality results of 5 years database established in a restructured, large public hospital in Singapore, looking at all three types of Intensive Care Units present in our hospital. These include medical, surgical, and coronary care units.

  20. 40 CFR 154.5 - Burden of persuasion in determinations under this part.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Burden of persuasion in determinations... (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES General Provisions § 154.5 Burden of persuasion in... principle that the burden of persuasion that a pesticide product is entitled to registration or...

  1. The impact of dementia severity on caregiver burden in frontotemporal dementia and Alzheimer disease.

    Science.gov (United States)

    Mioshi, Eneida; Foxe, David; Leslie, Felicity; Savage, Sharon; Hsieh, Sharpley; Miller, Laurie; Hodges, John R; Piguet, Olivier

    2013-01-01

    Caregiver burden is greater in frontotemporal dementia (FTD) than in Alzheimer disease (AD). However, little is known of the impact of the 3 main clinical variants of FTD- behavioral-variant frontotemporal dementia (bvFTD), semantic dementia (SemDem), and progressive nonfluent aphasia (PNFA)-or the role of disease severity in caregiver burden. The Zarit Burden Inventory was used to measure caregiver burden of bvFTD (n=17), SemDem (n=20), PNFA (n=20), and AD (n=19) patients. Symptom duration, caregiver age, and relationship type were matched across groups. Moreover, a number of caregiver (mood, social network) and patient variables (functional disability, behavioral changes, relationship with caregiver, and dementia stage) were addressed to investigate their impact on caregiver burden. Caregivers of bvFTD patients reported the highest burden, whereas SemDem and PNFA caregivers reported burden similar to AD. A regression analysis revealed that caregiver burden in FTD, regardless of subtype, was explained by a model combining disease staging, relationship changes, and caregiver depression. Burden increased with disease severity in FTD. This study is the first to show that caregivers of SemDem, PNFA, and AD patients show similar burden, while confirming that bvFTD caregivers show higher burden than AD caregivers. More importantly, this study demonstrates that burden worsens with disease progression in FTD.

  2. Healthy Ageing: tackling the burden of disease and disability in an ageing population

    NARCIS (Netherlands)

    B. Klijs (Bart)

    2012-01-01

    textabstractHealthy ageing of individuals is crucial to prevent strong increases in the burden of disease and disability due to population ageing. We aimed to quantify the current burden of disease and disability and assessed which determinants explain the burden of disability. The occurrence of dis

  3. Disability weights for the burden of oral disease in South Australia

    Directory of Open Access Journals (Sweden)

    Spencer A John

    2004-09-01

    Full Text Available Abstract Background Australian burden of disease estimates appeared inconsistent with the reported repetitive and ubiquitous nature of dental problems. The aims of the study were to measure the nature, severity and duration of symptoms for specific oral conditions, and calculate disability weights from these measures. Methods Data were collected in 2001–02 from a random sample of South Australian dentists using mailed self-complete questionnaires. Dentists recorded the diagnosis of dental problems and provided patients with self-complete questionnaires to record the nature, severity and duration of symptoms using the EuroQol instrument. Data were available from 378 dentists (response rate = 60%. Results Disability weights were highest for pulpal infection (0.069, caries (0.044 and dentinal sensitivity (0.040, followed by denture problems (0.026, periodontal disease (0.023, failed restorations (0.019, tooth fractures (0.014 and tooth wear (0.011. Aesthetic problems had a low disability weight (0.002, and both recall/maintenance care and oral hygiene had adjusted weights of zero. Conclusions Disability weights for caries (0.044, periodontal disease (0.023 and denture problems (0.026 in this study were higher than comparable oral health conditions in the Australian Burden of Disease and Injury Study (0.005 for caries involving a filling and 0.014 for caries involving an extraction, 0.007 for periodontal disease, and 0.004 for edentulism. A range of common problems such as pulpal infection, failed restorations and tooth fracture that were not included in the Australian Burden of Disease and Injury Study had relatively high disability weights. The inclusion of a fuller range of oral health problems along with revised disability weights would result in oral health accounting for a larger amount of disability than originally estimated.

  4. Psychosocial burden of abnormal pap smears among HIV-infected women at Chon Buri hospital, Thailand.

    Science.gov (United States)

    Jayathunge, Mangala P H; Bowanwatanuwong, Chureeratana; Maek-A-nantawat, Wirach; Pitisuttithum, Benjaluck Phonratland Punnee

    2010-01-01

    This retrospective case-control study assessed the psychological burden of abnormal Pap smears, and their prevalence and characteristics among HIV-infected women attending an HIV clinic. Women with positive (n = 73) and negative Pap-smear results (n = 317) were assessed for psychosocial burden using 4 questionnaires: Psycho-Social Impact of Abnormal Pap Smears (PEAPS-Q), Hospital Anxiety and Depression Scale (HADS), Work Productivity and Impairment (WPAI) and the EURO-Qol Thermometer. The prevalence of pre-cervical cancer lesions in HIV infected woman was 17.5% (ASCUS 2.9%, LSIL 3.8%, HSIL 7.4%, SCC 1.7%, and atypical glandular cells including adenocarcinoma 1.7%). HIV infected women with abnormal Pap smears showed higher anxiety levels on the HADS questionnaire (p = 0.015); this had a significant effect on regular daily activities (p = 0.009) per the WPAI questionnaire compared to HIV positive women with normal Pap smear. Ever married HIV infected woman with an abnormal Pap smear had a significantly lower psychosocial burden using the PEAPS-Q questionnaire (p < 0.001). After adjusting for age and duration since last Pap smear, the education level of the patient was a strong predictor for anxiety. Patients, with a college education had significantly lower anxiety (p = 0.001, 95% CI -5.74 to -1.37) than those with lower or higher education. Women with HSIL were more anxious (p = 0.014, 95% CI 0.49 -4.39) than those with low grade or normal lesions.

  5. Socio-economic burden of rare diseases: A systematic review of cost of illness evidence.

    Science.gov (United States)

    Angelis, Aris; Tordrup, David; Kanavos, Panos

    2015-07-01

    Cost-of-illness studies, the systematic quantification of the economic burden of diseases on the individual and on society, help illustrate direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. In the context of the BURQOL-RD project ("Social Economic Burden and Health-Related Quality of Life in patients with Rare Diseases in Europe") we studied the evidence on direct and indirect costs for 10 rare diseases (Cystic Fibrosis [CF], Duchenne Muscular Dystrophy [DMD], Fragile X Syndrome [FXS], Haemophilia, Juvenile Idiopathic Arthritis [JIA], Mucopolysaccharidosis [MPS], Scleroderma [SCL], Prader-Willi Syndrome [PWS], Histiocytosis [HIS] and Epidermolysis Bullosa [EB]). A systematic literature review of cost of illness studies was conducted using a keyword strategy in combination with the names of the 10 selected rare diseases. Available disease prevalence in Europe was found to range between 1 and 2 per 100,000 population (PWS, a sub-type of Histiocytosis, and EB) up to 42 per 100,000 population (Scleroderma). Overall, cost evidence on rare diseases appears to be very scarce (a total of 77 studies were identified across all diseases), with CF (n=29) and Haemophilia (n=22) being relatively well studied, compared to the other conditions, where very limited cost of illness information was available. In terms of data availability, total lifetime cost figures were found only across four diseases, and total annual costs (including indirect costs) across five diseases. Overall, data availability was found to correlate with the existence of a pharmaceutical treatment and indirect costs tended to account for a significant proportion of total costs. Although methodological variations prevent any detailed comparison between conditions and based on the evidence available, most of the rare diseases examined are associated with significant economic burden, both direct and indirect.

  6. Determinants of Power in Gene-Based Burden Testing for Monogenic Disorders.

    Science.gov (United States)

    Guo, Michael H; Dauber, Andrew; Lippincott, Margaret F; Chan, Yee-Ming; Salem, Rany M; Hirschhorn, Joel N

    2016-09-01

    Whole-exome sequencing has enabled new approaches for discovering genes associated with monogenic disorders. One such approach is gene-based burden testing, in which the aggregate frequency of "qualifying variants" is compared between case and control subjects for each gene. Despite substantial successes of this approach, the genetic causes for many monogenic disorders remain unknown or only partially known. It is possible that particular genetic architectures lower rates of discovery, but the influence of these factors on power has not been rigorously evaluated. Here, we leverage large-scale exome-sequencing data to create an empirically based simulation framework to evaluate the impact of key parameters (background variation rates, locus heterogeneity, mode of inheritance, penetrance) on power in gene-based burden tests in the context of monogenic disorders. Our results demonstrate that across genes, there is a wide range in sample sizes needed to achieve power due to differences in the background rate of rare variants in each gene. Increasing locus heterogeneity results in rapid increases in sample sizes needed to achieve adequate power, particularly when individual genes contribute to less than 5% of cases under a dominant model. Interestingly, incomplete penetrance as low as 10% had little effect on power due to the low prevalence of monogenic disorders. Our results suggest that moderate incomplete penetrance is not an obstacle in this gene-based burden testing approach but that dominant disorders with high locus heterogeneity will require large sample sizes. Our simulations also provide guidance on sample size needs and inform study design under various genetic architectures.

  7. Health disparities from economic burden of diabetes in middle-income countries: evidence from Mexico.

    Directory of Open Access Journals (Sweden)

    Armando Arredondo

    Full Text Available The rapid growth of diabetes in middle-income countries is generating disparities in global health. In this context we conducted a study to quantify the health disparities from the economic burden of diabetes in México. Evaluative research based on a longitudinal design, using cost methodology by instrumentation. For the estimation of epidemiological changes during the 2010-2012 period, several probabilistic models were developed using the Box-Jenkins technique. The financial requirements were obtained from expected case management costs by disease and the application of an econometric adjustment factor to control the effects of inflation. Comparing the economic impact in 2010 versus 2012 (p<0.05, there was a 33% increase in financial requirements. The total amount for diabetes in 2011 (US dollars was $7.7 billion. It includes $3.4 billion in direct costs and $4.3 in indirect costs. The total direct costs were $.4 billion to the Ministry of Health (SSA, serving the uninsured population; $1.2 to the institutions serving the insured population (Mexican Institute for Social Security-IMSS-, and Institute for Social Security and Services for State Workers-ISSSTE-; $1.8 to users; and $.1 to Private Health Insurance (PHI. If the risk factors and the different health care models remain as they currently are in the analyzed institutions, health disparities in terms of financial implications will have the greatest impact on users' pockets. In middle-income countries, health disparities generated by the economic burden of diabetes is one of the main reasons for catastrophic health expenditure. Health disparities generated by the economic burden of diabetes suggests the need to design and review the current organization of health systems and the relevance of moving from biomedical models and curative health care to preventive and socio-medical models to meet expected challenges from diseases like diabetes in middle-income countries.

  8. 浙江省劳动密集型产品比较优势的动态演化——经验分析%Dynamic Evolution of Comparative Advantage of Labor-intensive Products in Zhejiang:An Empirical Study

    Institute of Scientific and Technical Information of China (English)

    罗堃; 邓娟

    2011-01-01

    This paper calculates the RSCA indices of labor-intensive products which occupy an important position in export commodities in Zhejiang, and establishes the Markov transmission matrix.Empirical results show as follows: the comparative advantage of labor-intensive products in Zhejiang is neither strong on the whole nor distributed evenly;aa for various products with strong or weak comparative advantage or comparative disadvantage, the evolution of comparative advantage takes on different characteristics of persistency and mobility as well as different enhancement potential Furthermore,it probes into the evolution mechanisms of comparative advantage of labor-intesive products with different comparative advantage from the micro,meso and macro perspectives.%针对在浙江省出口商品结构中居于重要地位的劳动密集型产品,计算RSCA指数并构造马尔可夫转移矩阵.实证分析结果表明:整体上看,浙江省劳动密集型产品的比较优势并不强,且分布不均匀;处于强、弱比较优势以及比较劣势三种状态的不同细类产品的比较优势动态变化呈现出不同的持续性、流动性特征,亦具有不同的提升潜力.在此基础上,针对处于不同比较优势状态的劳动密集型产品,从微观、中现、宏观三个层面剖析了比较优势动态演化的深层机理.

  9. The intense neutron generator

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, W.B

    1966-07-01

    The presentation discusses both the economic and research contexts that would be served by producing neutrons in gram quantities at high intensities by electrical means without uranium-235. The revenue from producing radioisotopes is attractive. The array of techniques introduced by the multipurpose 65 megawatt Intense Neutron Generator project includes liquid metal cooling, superconducting magnets for beam bending and focussing, super-conductors for low-loss high-power radiofrequency systems, efficient devices for producing radiofrequency power, plasma physics developments for producing and accelerating hydrogen, ions at high intensity that are still far out from established practice, a multimegawatt high voltage D.C. generating machine that could have several applications. The research fields served relate principally to materials science through neutron-phonon and other quantum interactions as well as through neutron diffraction. Nuclear physics is served through {mu}-, {pi}- and K-meson production. Isotope production enters many fields of applied research. (author)

  10. Incremental increases in economic burden parallels cardiometabolic risk factors in the US

    Science.gov (United States)

    McQueen, R Brett; Ghushchyan, Vahram; Olufade, Temitope; Sheehan, John J; Nair, Kavita V; Saseen, Joseph J

    2016-01-01

    Objective Estimate the economic burden associated with incremental increases in the number of cardiometabolic risk factors (CMRFs) in the US. Methods We used the nationally representative Medical Expenditure Panel Survey from 2010 to 2012 to create a retrospective cohort of people based on the number of CMRFs (one, two, and three or four), and a comparison cohort of people with zero CMRFs. CMRFs included abdominal obesity, elevated blood pressure, elevated triglycerides, and elevated glucose and were defined using diagnostic codes, prescribed medications, and survey responses. Adjusted regression analysis was developed to compare health expenditures, utilization, and lost-productivity differences between the cohorts. Generalized linear regression was used for health care expenditures, and negative binomial regression was used for utilization and productivity, controlling for individual characteristics. Results The number of CMRFs was associated with significantly more annual utilization, health care expenditures, and reduced productivity. As compared with people with zero CMRFs, people with one, two, and three or four CMRFs had 1.15 (95% confidence interval [CI]: 1.06, 1.24), 1.37 (95% CI: 1.25, 1.51), and 1.39 (95% CI: 1.22, 1.57) times higher expected rate of emergency room visits, respectively. Compared with people with zero CMRFs, people with one, two, and three or four CMRFs had increased incremental health care expenditures of US$417 (95% CI: $70, $763), US$2,326 (95% CI: $1,864, $2,788), and US$4,117 (95% CI: $3,428, $4,807), respectively. Those with three or four CMRFs reported employment of 60%, compared with 80% in patients with zero CMRFs. People with three or four CMFRs had 1.75 (95% CI: 1.42, 2.17) times higher expected rate of days missed at work due to illness, compared with people with zero CMRFs. Conclusion Our findings demonstrate a direct association between economic burden and number of CMRFs. Although this was expected, the increase in burden

  11. The burden and quality of life of caregivers of sickle cell anemia patients taking hydroxyurea versus those not taking hydroxyurea

    Directory of Open Access Journals (Sweden)

    Luiz Bernardino Lima da Silva

    2012-01-01

    Full Text Available OBJECTIVE: To assess the burden and quality of life of caregivers of patients with sickle cell anemia taking hydroxyurea versus those of patients not taking hydroxyurea. METHODS: A cross-sectional study was performed of caregivers of outpatients with sickle cell anemia in two public hospitals in Campo Grande, MS, from January through June 2010. The World Health Organization Quality of Life-BREF Scale and the Caregiver Burden Scale were used. RESULTS: Of the 37 caregivers in this study, 81.1% were women, 73.0% were mothers, 59.5% were married, 54.1%were mulattos, 48.6% were housewives, 54.1% had family incomes of up to one minimum wage and 75.7% had onlycompleted elementary education. The mean duration of care provided (time after diagnosis was 16.08 ± 9.88 yearsand 89.2% reported that they provided 24-hour care. Regarding health, 27.0% of study participants reported having physical and 13.5% emotional problems. There were no significant relationships between these variables either with the different domains or the total score of the WHOQOL-BREF comparing caregivers of patients taking hydroxyurea versusthose of patients not taking hydroxyurea. There was a moderate negative linear correlation between the WHOQOL-BREF and the Caregiver Burden Scale scores (linear correlation test of Pearson: p-value = 0.003, r = -0.477. The burden of caregivers of patients who did not take hydroxyurea was significantly higher than those of patients who took the medication in terms of general tension, disappointment, environment and total score (student t-test: p-value < 0.05. CONCLUSION: In the perception of the caregiver, looking after sickle cell anemia patients represents a moderate negative burden.

  12. Epidemiology and burden of alopecia areata: a systematic review

    Directory of Open Access Journals (Sweden)

    Villasante Fricke AC

    2015-07-01

    Full Text Available Alexandra C Villasante Fricke, Mariya MitevaDepartment of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USABackground: Alopecia areata (AA is an autoimmune disorder characterized by patches of non-scarring alopecia affecting scalp and body hair that can be psychologically devastating. AA is clinically heterogenous, and its natural history is unpredictable. There is no preventative therapy or cure.Objective: The objective of this study is to provide an evidence-based systematic review on the epidemiology and the burden of AA.Methods and selection criteria: A search was conducted of the published, peer-reviewed literature via PubMed, Embase, and Web of Science. Studies published in English within the last 51 years that measured AA’s incidence, prevalence, distribution, disability-adjusted life years (DALYs, quality of life, and associated psychiatric and medical comorbidities were included. Two authors assessed studies and extracted the data.Results: The lifetime incidence of AA is approximately 2% worldwide. Both formal population studies found no sex predominance. First onset is most common in the third and fourth decades of life but may occur at any age. An earlier age of first onset corresponds with an increased lifetime risk of extensive disease. Global DALYs for AA were calculated at 1,332,800 in 2010. AA patients are at risk for depression and anxiety, atopy, vitiligo, thyroid disease, and other autoimmune conditions.Conclusion: AA is the most prevalent autoimmune disorder and the second most prevalent hair loss disorder after androgenetic alopecia, and the lifetime risk in the global population is approximately 2%. AA is associated with psychiatric and medical comorbidities including depression, anxiety, and several autoimmune disorders, and an increased global burden of disease.Keywords: hair loss, hair, prevalence, incidence, burden of disease

  13. Metallic Burden of Deciduous Teeth and Childhood Behavioral Deficits

    Directory of Open Access Journals (Sweden)

    Tony J.H. Chan

    2015-06-01

    Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD affects 5%–8% of children in the U.S. (10% of males and 4% of females. The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 6.1 ± 5.7 µg/g, 22.7 ± 24.1 µg/g, 0.9 ± 1.4 µg/g, and 6.0 × 105 ± 1.6 × 105 µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles.

  14. The geographical distribution and burden of trachoma in Africa.

    Directory of Open Access Journals (Sweden)

    Jennifer L Smith

    Full Text Available There remains a lack of epidemiological data on the geographical distribution of trachoma to support global mapping and scale up of interventions for the elimination of trachoma. The Global Atlas of Trachoma (GAT was launched in 2011 to address these needs and provide standardised, updated and accessible maps. This paper uses data included in the GAT to describe the geographical distribution and burden of trachoma in Africa.Data assembly used structured searches of published and unpublished literature to identify cross-sectional epidemiological data on the burden of trachoma since 1980. Survey data were abstracted into a standardised database and mapped using geographical information systems (GIS software. The characteristics of all surveys were summarized by country according to data source, time period, and survey methodology. Estimates of the current population at risk were calculated for each country and stratified by endemicity class.At the time of writing, 1342 records are included in the database representing surveys conducted between 1985 and 2012. These data were provided by direct contact with national control programmes and academic researchers (67%, peer-reviewed publications (17% and unpublished reports or theses (16%. Prevalence data on active trachoma are available in 29 of the 33 countries in Africa classified as endemic for trachoma, and 1095 (20.6% districts have representative data collected through population-based prevalence surveys. The highest prevalence of active trachoma and trichiasis remains in the Sahel area of West Africa and Savannah areas of East and Central Africa and an estimated 129.4 million people live in areas of Africa confirmed to be trachoma endemic.The Global Atlas of Trachoma provides the most contemporary and comprehensive summary of the burden of trachoma within Africa. The GAT highlights where future mapping is required and provides an important planning tool for scale-up and surveillance of trachoma

  15. Quantification of source region influences on the ozone burden

    Energy Technology Data Exchange (ETDEWEB)

    Treffeisen, R. [Alfred Wegener Inst. fuer Meeres- und Polarforschung, Potsdam (Germany); Grunow, K. [Freie Univ., Berlin (Germany). Inst. fuer Meteorologie; Moeller, D. [Brandenburgische Technische Universitaet Cottbus (Germany). Lehrstule fuer Luftchemie und Luftreinhaltung; Hainsch, A. [Technische Univ., Berlin (Germany). Lehrstule Luftreinhaltung

    2002-08-01

    A project was performed to quantify different influences on the ozone burden. It could be shown that large-scale meteorological influences determine a very large percentage of the ozone concentration. Local measures intended to reduce peak ozone concentrations in summer turn out to be not very effective as a result. The aim of this paper is to quantify regional emission influences on the ozone burden. The investigation of these influences is possible by comparison of the ozone (O{sub 3}) and oxidant (O{sub x}=O{sub 3}+NO{sub 2}) concentrations at high-elevation sites downwind and upwind of a source region by using back trajectories. It has been shown that a separation between large-scale influenced meteorological and regional ozone burdens at these sites is possible. This method is applied for an important emission area in Germany-the Ruhrgebiet. On average, no significant ozone contribution of this area to the regional ozone concentration could be found. A large part of the ozone concentration is highly correlated with synoptic weather systems, which exhibit a dominant influence on the local ozone concentrations. Significant contributions of related photochemical ozone formation of the source area of 13-15% have been found only during favourable meteorological situations, identified by the hourly maximum day temperature being above 25{sup o}C. This is important with respect to the EU daughter directive to EU96/62/EC (Official Journal L296 (1996) 55) because Member States should explore the possibilities of local measures to avoid the exceedance of threshold values and, if effective local measures exist, to implement them. (author)

  16. Microphysical simulations of sulfur burdens from stratospheric sulfur geoengineering

    Directory of Open Access Journals (Sweden)

    J. M. English

    2012-01-01

    Full Text Available Recent microphysical studies suggest that geoengineering by continuous stratospheric injection of SO2 gas may be limited by the growth of the aerosols. We study the efficacy of SO2, H2SO4 and aerosol injections on aerosol mass and optical depth using a three-dimensional general circulation model with sulfur chemistry and sectional aerosol microphysics (WACCM/CARMA. We find increasing injection rates of SO2 in a narrow band around the equator to have limited efficacy while broadening the injecting zone as well as injecting particles instead of SO2 gas increases the sulfate burden for a given injection rate, in agreement with previous work. We find that injecting H2SO4 gas instead of SO2 does not discernibly alter sulfate size or mass, in contrast with a previous study using a plume model with a microphysical model. However, the physics and chemistry in aircraft plumes, which are smaller than climate model grid cells, need to be more carefully considered. We find equatorial injections increase aerosol optical depth in the Northern Hemisphere more than the Southern Hemisphere, potentially inducing regional climate changes. We also find significant perturbations to tropospheric aerosol for all injections studied, particularly in the upper troposphere and near the poles, where sulfate burden increases by up to 100 times. This enhanced burden could have implications for tropospheric radiative forcing and chemistry. These results highlight the need to mitigate greenhouse gas emissions through means other than geoengineering, and to further study geoengineering before it can be seriously considered as a climate intervention option.

  17. Microphysical simulations of sulfur burdens from stratospheric sulfur geoengineering

    Directory of Open Access Journals (Sweden)

    J. M. English

    2012-05-01

    Full Text Available Recent microphysical studies suggest that geoengineering by continuous stratospheric injection of SO2 gas may be limited by the growth of the aerosols. We study the efficacy of SO2, H2SO4 and aerosol injections on aerosol mass and optical depth using a three-dimensional general circulation model with sulfur chemistry and sectional aerosol microphysics (WACCM/CARMA. We find increasing injection rates of SO2 in a narrow band around the equator to have limited efficacy while broadening the injecting zone as well as injecting particles instead of SO2 gas increases the sulfate burden for a given injection rate, in agreement with previous work. We find that injecting H2SO4 gas instead of SO2 does not discernibly alter sulfate size or mass, in contrast with a previous study using a plume model with a microphysical model. However, the physics and chemistry in aircraft plumes, which are smaller than climate model grid cells, need to be more carefully considered. We also find significant perturbations to tropospheric aerosol for all injections studied, particularly in the upper troposphere and near the poles, where sulfate burden increases by up to 100 times. This enhanced burden could have implications for tropospheric radiative forcing and chemistry. These results highlight the need to mitigate greenhouse gas emissions rather than attempt to cool the planet through geoengineering, and to further study geoengineering before it can be seriously considered as a climate intervention option.

  18. The legacy of the Olympics: economic burden or boon?

    OpenAIRE

    Ricketts, Lowell R.; Wolla, Scott A.

    2012-01-01

    Competition, sportsmanship, and national pride are the foundations of the Olympics, but how much do the Olympics cost the host city and country? What are some of the economic benefits and costs? Is the investment in the Olympics worth it in the end? Read about previous host experiences with the economic side of the Olympics in this month's Page One Economics Newsletter “The Legacy of the Olympics: Economic Burden or Boon?” (see related graph: "Olympics-Related Temporary Increase in Employment...

  19. Regional brain hypometabolism is unrelated to regional amyloid plaque burden

    Science.gov (United States)

    Altmann, Andre; Ng, Bernard; Landau, Susan M.; Jagust, William J.

    2015-01-01

    while correcting in addition for cortex-wide florbetapir uptake. P-values for each setting were Bonferroni corrected