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Sample records for care hidden morbidity

  1. Hidden psychiatric morbidity. Part II: Training health care workers in detection: a pre- and post-study at Karanda Mission Hospital.

    Science.gov (United States)

    Hall, A; Williams, H

    1987-11-01

    A simple 5-session training program covering basic mental health problems, and instruction in the use of the Harding Self Report Questionaire, was instituted at Karanda Mission Hospital to help medical students recognise hidden psychiatric morbidity in somatically presenting patients. The Harding Self Report Questionaire was used as both a detection and training instrument, together with a Health Staff Rating Scale. Medical Assistants were assessed pre- and post-training on 2 measures--specificity and sensitivity. The training program demonstrated that health care workers can be trained to more accurately detect and diagnose hidden psychiatric disorder in this group of patients. An additional benefit was that workers developed an increased interest in this difficult area of patient care. In a previous study, the prevalence of hidden psychiatric morbidity in a general medical outpatient population in Bindura Provincial was found to be in line with other developing countries (i.e., in excess of 10%) and detection rate by health care workers (4.25%) was low, although comparable to that found in other studies. One of the conclusions reached after the Bindura study was that a simple program was needed to alert workers to recognise underlying psychiatric disorder in somatically presenting patients. With this in mind, the training program was devised and given at Karanda Mission Hospital which is situated about 220 km from Harare, Zimbabwe. It has 120 beds and is staffed by 2 doctors, 3 locally trained SRNs, several American trained SRNs, and 3 locally trained medical assistants. It also runs a nursing school for medical assistants. The hospital serves a population drawn from both subsistence and purchase area farmers, but is less diverse that that of Bindura. The training program was shown to be effective, as demonstrated in the improved accuracy in detection and diagnosis by medical assistants. The improvement post-training is perhaps all the more remarkable when the

  2. The hidden cost of 'free' maternity care in Dhaka, Bangladesh.

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    Nahar, S; Costello, A

    1998-12-01

    We studied the cost and affordability of 'free' maternity services at government facilities in Dhaka, Bangladesh, to assess whether economic factors may contribute to low utilization. We conducted a questionnaire survey and in-depth interviews among 220 post-partum mothers and their husbands, selected from four government maternity facilities (three referral hospitals and one Mother and Child Health hospital) in Dhaka. Mothers with serious complications were excluded. Information was collected on the costs of maternity care, household income, the sources of finance used to cover the costs, and the family's willingness to pay for maternity services. The mean cost for normal delivery was 1275 taka (US$31.9) and for caesarean section 4703 taka (US$117.5). Average monthly household income was 4933 taka (US$123). Twenty-one per cent of families were spending 51-100% of monthly income, and 27% of families 2-8 times their monthly income for maternity care. Overall, 51% of the families (and 74% of those having a caesarean delivery) did not have enough money to pay; of these, 79% had to borrow from a money lender or relative. Surprisingly, 72% of the families said they were willing to pay a government-levied user charge, though this was less popular among low-income families (61%). 'Free' maternity care in Bangladesh involves considerable hidden costs which may be a major contributor to low utilization of maternity services, especially among low-income groups. To increase utilization of safer motherhood services, policy-makers might consider introducing fixed user charges with clear exemption guidelines, or greater subsidies for existing services, especially caesarean section.

  3. Managing social awkwardness when caring for morbidly obese patients in intensive care: A focused ethnography.

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    Hales, Caz; de Vries, Kay; Coombs, Maureen

    2016-06-01

    Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges in the intensive care setting. These are resultant from specific physiological responses to critical illness in this population and the nature of the interventional therapies used in the intensive care environment. An additional challenge arises for this population when considering the social stigma that is attached to being obese. Intensive care staff therefore not only attend to the physical and care needs of the critically ill morbidly obese patient but also navigate, both personally and professionally, the social terrain of stigma when providing care. To explore the culture and influences on doctors and nurses within the intensive care setting when caring for critically ill morbidly obese patients. A focused ethnographic approach was adopted to elicit the 'situated' experiences of caring for critically ill morbidly obese patients from the perspectives of intensive care staff. Participant observation of care practices and interviews with intensive care staff were undertaken over a four month period. Analysis was conducted using constant comparison technique to compare incidents applicable to each theme. An 18 bedded tertiary intensive care unit in New Zealand. Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40kg/m(2). Interactions between intensive care staff and morbidly obese patients were challenging due to the social stigma surrounding obesity. Social awkwardness and managing socially awkward moments were evident when caring for morbidly obese patients. Intensive care staff used strategies of face-work and mutual pretence to alleviate feelings of discomfort when engaged in aspects of care and caring. This was a strategy used to prevent embarrassment and distress for both the patients and staff. This study has brought new understandings

  4. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

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    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  5. The influence of specific chronic somatic conditions on the care for co-morbid depression in general practice

    NARCIS (Netherlands)

    Nuyen, J.; Spreeuwenberg, P.M.; Dijk, L. van; Bos, G.A.M. van den; Groenewegen, P.P.; Schellevis, F.G.

    Background. Limited information exists on the relationship between specific chronic somatic conditions and care for co-morbid depression in primary care settings. Therefore, the present prospective, general practice-based study examined this relationship. Method. Longitudinal data on morbidity,

  6. Association between fee-for-service expenditures and morbidity burden in primary care

    DEFF Research Database (Denmark)

    Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik

    2014-01-01

    BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

  7. Review: An Australian model of care for co-morbid diabetes and chronic kidney disease.

    Science.gov (United States)

    Lo, Clement; Zimbudzi, Edward; Teede, Helena; Cass, Alan; Fulcher, Greg; Gallagher, Martin; Kerr, Peter G; Jan, Stephen; Johnson, Greg; Mathew, Tim; Polkinghorne, Kevan; Russell, Grant; Usherwood, Tim; Walker, Rowan; Zoungas, Sophia

    2018-02-05

    Diabetes and chronic kidney disease (CKD) are two of the most prevalent co-morbid chronic diseases in Australia. The increasing complexity of multi-morbidity, and current gaps in health-care delivery for people with co-morbid diabetes and CKD, emphasise the need for better models of care for this population. Previously, proposed published models of care for co-morbid diabetes and CKD have not been co-designed with stake-holders or formally evaluated. Particular components of health-care shown to be effective in this population are interventions that: are structured, intensive and multifaceted (treating diabetes and multiple cardiovascular risk factors); involve multiple medical disciplines; improve self-management by the patient; and upskill primary health-care. Here we present an integrated patient-centred model of health-care delivery incorporating these components and co-designed with key stake-holders including specialist health professionals, general practitioners and Diabetes and Kidney Health Australia. The development of the model of care was informed by focus groups of patients and health-professionals; and semi-structured interviews of care-givers and health professionals. Other distinctives of this model of care are routine screening for psychological morbidity; patient-support through a phone advice line; and focused primary health-care support in the management of diabetes and CKD. Additionally, the model of care integrates with the patient-centred health-care home currently being rolled out by the Australian Department of Health. This model of care will be evaluated after implementation across two tertiary health services and their primary care catchment areas. Copyright © 2018 John Wiley & Sons, Ltd. This article is protected by copyright. All rights reserved.

  8. Co-morbidities of COPD in primary care: frequency, relation to COPD, and treatment consequences.

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    van der Molen, Thys

    2010-12-01

    In the Western world, chronic obstructive pulmonary disease (COPD) is predominantly caused by long-term smoking, which results in pulmonary inflammation that is often associated with systemic inflammation. A number of co-morbid conditions, such as cardiovascular disease, muscle wasting, type 2 diabetes and asthma, may coexist with COPD; these and other co-morbidities not directly related to COPD are major causes of excess morbidity and mortality. This review sets out to explore the most frequent co-morbidities in COPD and their implications for treatment. Review of the literature on co-morbidities of COPD. Co-morbidities are frequent, but often remain undiagnosed in the COPD patient. In order to provide the best possible care for people with COPD, the physician should be aware of all potential co-morbidities that may arise, and the critical role that effective management of these co-morbidities can play in improving patient outcomes. Increased awareness of the potential co-morbidities of COPD, although potentially adding to the general practitioner's work burden, may provide insights into this difficult disease state and possibly improve each individual's prospects for effective management.

  9. How Communication Among Members of the Health Care Team Affects Maternal Morbidity and Mortality.

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    Brennan, Rita Allen; Keohane, Carol Ann

    In the United States, rates of severe maternal morbidity and mortality have escalated in the past decade. Communication failure among members of the health care team is one associated factor that can be modified. Nurses can promote effective communication. We provide strategies that incorporate team training principles and structured communication processes for use by providers and health care systems to improve the quality and safety of patient care and reduce the incidence of maternal mortality and morbidity. Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  10. ORIGINAL ARTICLES Primary care morbidity in Eastern Cape ...

    African Journals Online (AJOL)

    Research Department of Primary Care and Population Health, Royal Free and Uni- .... S - Skin. 842. (12.28) 147 (17.78). 563. (15.04). 132. (5.78). A - General unspecified. 823. (12). 108 (13.6). 428. (11.43). 287. (12.56). N - Neurological. 801. (11.68). 90 (10.58) .... absence of longitudinal follow-up data to monitor trends in.

  11. Severe maternal morbidity in Zanzibar's referral hospital: Measuring the impact of in-hospital care

    NARCIS (Netherlands)

    Herklots, T.; Acht, L. van; Meguid, T.; Franx, A.; Jacod, B.C.

    2017-01-01

    OBJECTIVE: to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital. SETTING: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. METHODS: We identified all

  12. Reduction of halo pin site morbidity with a new pin care regimen.

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    Kazi, Hussain Anthony; de Matas, Marcus; Pillay, Robin

    2013-06-01

    A retrospective analysis of halo device associated morbidity over a 4-year period. To assess the impact of a new pin care regimen on halo pin site related morbidity. Halo orthosis treatment still has a role in cervical spine pathology, despite increasing possibilities of open surgical treatment. Published figures for pin site infection range from 12% to 22% with pin loosening from 7% to 50%. We assessed the outcome of a new pin care regimen on morbidity associated with halo spinal orthoses, using a retrospective cohort study from 2001 to 2004. In the last two years, our pin care regimen was changed. This involved pin site care using chlorhexidene & regular torque checking as part of a standard protocol. Previously, povidone iodine was used as skin preparation in theatre, followed by regular sterile saline cleansing when pin sites became encrusted with blood. There were 37 patients in the series, the median age was 49 (range, 22-83) and 20 patients were male. The overall infection rate prior to the new pin care protocol was 30% (n=6) and after the introduction, it dropped to 5.9% (n=1). This difference was statistically significant (p<0.05). Pin loosening occurred in one patient in the group prior to the formal pin care protocol (3%) and none thereafter. Reduced morbidity from halo use can be achieved with a modified pin cleansing and tightening regimen.

  13. Association between pediatric asthma care quality and morbidity and English language proficiency in Ohio.

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    Montgomery, Martha P; Allen, Elizabeth D; Thomas, Olivia; Robinson, Byron F; Clark, Donnie; Connelly, Ann; Mott, Joshua A; Conrey, Elizabeth

    2018-05-08

    Limited English proficiency can be a barrier to asthma care and is associated with poor outcomes. This study examines whether pediatric patients in Ohio with limited English proficiency experience lower asthma care quality or higher morbidity. We used electronic health records for asthma patients aged 2-17 years from a regional, urban, children's hospital in Ohio during 2011-2015. Community-level demographics were included from U.S. Census data. By using chi-square and t-tests, patients with limited English proficiency and bilingual English-speaking patients were compared with English-only patients. Five asthma outcomes-two quality and three morbidity measures-were modeled using generalized estimating equations. The study included 15 352 (84%) English-only patients, 1744 (10%) patients with limited English proficiency, and 1147 (6%) bilingual patients. Pulmonary function testing (quality measure) and multiple exacerbation visits (morbidity measure) did not differ by language group. Compared with English-only patients, bilingual patients had higher odds of ever having an exacerbation visit (morbidity measure) (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.2-1.6) but lower odds of admission to intensive care (morbidity measure) (aOR, 0.3; 95% CI, 0.2-0.7), while patients with limited English proficiency did not differ on either factor. Recommended follow-up after exacerbation (quality measure) was higher for limited English proficiency (aOR, 1.8; 95% CI, 1.4-2.3) and bilingual (aOR, 1.6; 95% CI, 1.3-2.1), compared with English-only patients. In this urban, pediatric population with reliable interpreter services, limited English proficiency was not associated with worse asthma care quality or morbidity.

  14. Chronic morbidity and health care seeking behaviour amongst elderly population in rural areas of Uttarakhand

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    Surekha Kishore

    2015-06-01

    Full Text Available Background: Ageing is a natural process, always associated with physiological and biological decline. Global population is ageing; the proportion of older persons has been rising steadily, from 7% in 1950 to 11% in 2007, with an expected rise to reach 22 % in 2050. With improving knowledge and awareness the health care seeking behavior has shown an increasingly positive trend. With increasing age, morbidity,   especially those arising from chronic diseases also increases. On the contrary, health care delivered at household level has definitely   gone down due to financial constraints and increasing cost of living, thus posing a problem for the elderly.  Aims & Objective: To find out the prevalence of chronic morbidity and health care seeking behaviour amongst the elderly in rural areas of Uttarakhand. Material and Methods: A cross-sectional study was carried out in rural areas of Uttarakhand to assess the chronic morbidity amongst elderly population. All the persons above the age group of 60 years of the eight villages were interviewed using a pre-defined, pre-tested, semi-structured and indigenously developed questionnaire. Results: The study group suffered from various chronic morbidities like hypertension, diabetes, cardiovascular diseases. Men were greater in number (158, 62.2%. Participants belonging mostly to nuclear families (156, 61.9%. Below the poverty line were (98, 38.9%. Half of the study population had one or the other chronic morbid condition. Majority of the elderly men contacted the health care facility whereas majority of the elderly women chose to use remedies. Conclusion: There is definitely a need of   provision of health care services for poor geriatric population. In addition to this government should take up some program for social security of this population along with creating an awareness about the same.

  15. Primary tetralogy of Fallot repair: predictors of intensive care unit morbidity.

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    Egbe, Alexander C; Uppu, Santosh C; Mittnacht, Alexander J C; Joashi, Umesh; Ho, Deborah; Nguyen, Khanh; Srivastava, Shubhika

    2014-09-01

    Primary repair of tetralogy of Fallot has low surgical mortality, but some patients still experience significant postoperative morbidity. Our objectives were to review our institutional experience with primary tetralogy of Fallot repair, and identify predictors of intensive care unit morbidity. We reviewed all patients with tetralogy of Fallot who underwent primary repair in infancy from 2001 to 2012. Preoperative, operative, and postoperative demographic and morphologic data were analyzed. Intensive care unit morbidity was defined as prolonged intensive care unit stay (≥ 7 days) and/or prolonged duration of mechanical ventilation (≥ 48 h). 97 patients who underwent primary surgical repair during the study period were included in the study. The median age was 4.9 months (range 1-9 months) and the median weight was 5.3 kg (range 3.1-9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median intensive care unit stay was 6 days (range 2-21 days) and the median duration of mechanical ventilation was 19 h (range 0-136 h). Age and weight were independent predictors of intensive care unit stay, while surgical era predicted the duration of mechanical ventilation. Primary tetralogy of Fallot repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery were significant predictors of morbidity. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Antenatal care and morbidity profile of pregnant women in an urban resettlement colony of Delhi, India.

    Science.gov (United States)

    Rustagi, N; Prasuna, J G; Vibha, M D

    2011-06-01

    The burden of antenatal morbidities and health care services utilization during antenatal period serve an important role in defining service needs and to assess reproductive health status of women. To evaluate the burden of antenatal morbidities in women and to assess the health care utilization by study subjects during antenatal period. A community based follow up study was carried out in an urban resettlement colony of Delhi. All pregnant women in the study area were enrolled and followed for two more visits to collect information about morbidities suffered and health care services utilized during pregnancy. Appropriate tests of significance were applied. Of 358 women enrolled, three hundred could be followed for two more visits. Majority of women (80.3%) suffered one or more morbidities during their current pregnancy but overall care sought for illness during pregnancy was poor. Visits for routine preventive check up was made by most of women (95% and above) but recommended three antenatal visits was significantly low among women of age more than thirty (OR=16.6; 2.2-125.9), of lower middle socio economic status (OR=2.84; 1.16-6.93) and parity three or more (OR=4.37; 1.07-17.83). Women with education status of high school and above had significantly lower odd ratio (OR=0.33; 0.11-0.99) for having less than three antenatal visits. Care sought for antenatal morbidities is still poor among women of urban resettlement colonies and age, parity and education of women has a significant bearing on antenatal visits.

  17. Serum biochemistry and morbidity among runners presenting for medical care after an Australian mountain ultramarathon.

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    Reid, Stephen A; King, M Jonathan

    2007-07-01

    To determine if exercise-associated hyponatremia (EAH) was a cause of morbidity among runners requiring medical care at an Australian mountain ultramarathon. Case series. Six Foot Track mountain ultramarathon, New South Wales, Australia, March 2006. Runners presenting to the medical facility. Serum biochemistry. No cases of exercise-associated hyponatremia were identified among 9 athletes (from 775 starters) who were treated with intravenous fluid therapy. Unwell runners had a mean serum (Na) of 143 mmol/L (range 138-147 mmol/L). All runners tested had elevated serum urea and creatinine concentrations. In this setting, EAH was not a significant cause of morbidity.

  18. Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project

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    Àngels Betriu

    2016-07-01

    Conclusions: The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.

  19. Administrative encounters in general practice: low value or hidden value care?

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    Trevena, Lyndal J; Harrison, Christopher; Britt, Helena C

    2018-02-19

    To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. 1 568 100 GP-patient encounters in Australia, 2000-01 to 2015-16. An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015-16, we also examined other health care provided by GPs at these encounters. During 2015-16, 18.5% (95% CI, 17.7-19.3%) of 97 398 GP-patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0-7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5-4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4-13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7-3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

  20. Mediating words, mediating worlds: interpreting as hidden care work in a South African psychiatric institution.

    Science.gov (United States)

    Smith, Jénine; Swartz, Leslie; Kilian, Sanja; Chiliza, Bonginkosi

    2013-08-01

    Many mental health clinicians in South Africa use informal interpreters, who are employed to perform other functions, such as cleaners and security guards; there are no formally trained interpreters. Drawing on qualitative semistructured interviews, this paper examines the experiences of informal interpreters working within a psychiatric setting. Furthermore, this paper explores how working in this invisible capacity affects informal interpreters' views of themselves and the contribution they feel they are making by acting as interpreters. An interpretative phenomenological approach enabled an in-depth analysis of the experiences of the ad hoc interpreters. The results of this study reveal a dilemma. On the one hand, informal interpreters interviewed jeopardize ethical principles by breaching confidentiality and reporting on patient behaviour without their consent. On the other hand, they report fulfilling an additional beneficial role in terms of the overall care of patients which goes beyond the ambit of the interpreting session. The impact and extent of the informal interpreters' involvement in care could not be ascertained solely from the data obtained in this study, but it is clear that informal interpreting may usefully be viewed as a form of hidden care work. A detailed ethnographic study aimed at exploring this further is therefore recommended.

  1. Families and health-care professionals' perspectives and expectations of family-centred care: hidden expectations and unclear roles.

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    Coyne, Imelda

    2015-10-01

    Family-centred care (FCC) is viewed as a pivotal concept in the provision of high-quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives. Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7-16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland. Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under-staffing and inappropriate documentation as key factors which resulted in over-reliance on parents and hindered their efforts to negotiate and work alongside parents. Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family-centred care. © 2013 John Wiley & Sons Ltd.

  2. STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

    Science.gov (United States)

    Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

    2013-09-01

    To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

  3. Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care.

    Science.gov (United States)

    Mitchell, Stephanie J; Bilderback, Andrew L; Okelo, Sande O

    2016-01-01

    To elucidate whether there may be a higher morbidity threshold for African American versus white children to be referred to or seek asthma specialist care. Secondary analysis of registry data captured from children presenting for an initial routine outpatient asthma consultation. Parents completed standard survey instruments, and spirometry was conducted when deemed appropriate by the provider. Wilcoxon rank sum tests revealed that African American patients had been hospitalized twice as often and admitted to the intensive care unit or intubated significantly more than 1½ times more frequently than their white patient counterparts. t tests indicated African American patients' forced expiratory volume in 1 second (FEV1) percentage predicted was significantly worse than that of whites, but there was no significant difference for FEV1/forced vital capacity ratio. t tests suggested that African American patients had statistically worse asthma control than did white patients at the time of initial presentation to the pulmonologist, but there was no difference in the distribution of asthma severity categories. Multivariate regression models indicated that racial differences in parent education did not explain the disparities in asthma morbidity. African American patients had significantly worse asthma morbidity than their white counterparts, including higher rates of hospitalization and intensive care unit admission and poorer lung functioning. Given that receipt of asthma specialist care can improve those outcomes that are disparately experienced by African American children, methods of increasing their access to and use of asthma specialist care need to be developed. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

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    Omar Khairani

    2009-06-01

    Full Text Available Abstract Background Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ. Methods This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period. Results The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%, somatoform disorder (n = 32, 12.2%, panic and anxiety disorders (n = 17, 6.5%, binge eating disorder (n = 9, 3.4% and alcohol abuse (n = 6, 2.3%. Younger age (18 to 29 years and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively with PHQ positive scores. Conclusion These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.

  5. Hypertension Control and co-morbidities in primary health care centers in Riyadh

    Energy Technology Data Exchange (ETDEWEB)

    Al-Tuwijri, Abdulmohsin A [Dept. of Family Medicine, Ministry of Health, Riyadh (Saudi Arabia); Al-Rukban, Mohammed Othman [Dept. of Family and Community Medicine, Coll. of Medicine, King Saud Univ., Riyadh (Saudi Arabia)

    2006-07-01

    The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

  6. Hypertension Control and co-morbidities in primary health care centers in Riyadh

    International Nuclear Information System (INIS)

    Al-Tuwijri, Abdulmohsin A.; Al-Rukban, Mohammed Othman

    2006-01-01

    The prevalence of hypertension in Saudi Arabia has been assessed only in preliminary reports. The aim of this study was to determine the degree of control of blood pressure and the prevalence of common hypertension co-morbidities among hypertensive patients attending primary health care (PHC) centers in Riyadh. A cross sectional study was conducted by reviewing medical records of hypertensive patients during May and June 2001. Two hundred fifty-five medical records selected by a stratified randomization process according to the distribution of the 73 PHC centers in the city and the total number of hypertensive patients registered in the mini-clinic of each PHC-center. Trained mini-clinic nurses collected data using a data collection form developed for this purpose. Of 255 patients, 121 (47.5%) were males and 134 (52.5%) were females, the mean age was 57.2+-11.1 years and 8.3% were smokers. The majority 204 (85.7%) had greater than normal body weight. Only 101 (40.4%) had controlled systolic BP. The most common co-morbidity was diabetes mellitus found in 98 (38.4%), followed by dislipidemia in 50 (19.6%), bronchial asthma in 28 (11.0%) and renal diseases in 12 (4.7%). Except for osteoporosis, which was reported by females only (P=0.003), the occurrences of hypertensive co-morbidities did not vary from other demographic characteristics. This study demonstrated poor blood pressure control in the mini-clinics in the PHC-centers. To improve the quality of care for hypertensive patients, we recommend an improvement in PHC physician knowledge of and attitudes toward the importance of achieving targeted blood pressure levels. (author)

  7. Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants

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    Keerti Swarnkar

    2016-01-01

    Full Text Available Background: Kangaroo Mother Care (KMC is dened as skin-to-skin contact between a mother and her newborn baby derived from practical similarities to marsupial care giving, proximately exclusive breastfeeding and early discharge from hospital. This concept was proposed as an alternative to conventional methods of care for low birth weight (LBW infants, and in replication to quandaries of earnest overcrowding in Neonatal Intensive Care Units (NICUs. KMC essentially utilizes the mother as a natural incubator Aim and Objectives: The aim was to assess the feasibility, acceptability and the effectiveness of KMC in LBW infants. It avoids agitation routinely experienced in busy ward. Material and Methods: A pilot open-labeled quasi-randomised clinical trial was conducted in Level III NICU of a teaching institution. 60 newborn infants <2500 g, meeting inclusion criteria were alternatively randomised into two groups: Kangaroo Mother Care (KMC and Conventional Methods of Care (CMC. Kangaroo mother care was practiced with minimum total period of eight hours a day intermittently for the intervention group while the controls remained in incubators or cots. Weight, head circumference, length, morbidity episodes, hospital stay, feeding patterns were monitored for all infants till postmenstrual age of 42 weeks in preterm babies or till a weight of 2500 g is achieved in term SGA babies. Results: The pilot study conrmed that trial processes were efcient, the intervention was acceptable (to mothers and nurses and that the outcome measures were appropriate; KMC babies achieved signicantly better growth at the end of the study (For preterm babies, weight, length and head circumference gain were signicantly higher in the KMC group (weight 19.28±2.9g/day, length 0.99±0.56cm/week and head circumference 0.72±0.07 cm/week than in the CMC group (P <0.001. A signicantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and

  8. Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

    Science.gov (United States)

    Koh, Mervyn Yong Hwang; Chong, Poh Heng; Neo, Patricia Soek Hui; Ong, Yew Jin; Yong, Woon Chai; Ong, Wah Ying; Shen, Mira Li Juan; Hum, Allyn Yin Mei

    2015-07-01

    The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied. We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms. This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore. The study was conducted in hospital palliative care services, home hospice and inpatient hospices in Singapore. The participants were doctors, nurses and social workers. The prevalence of burnout among respondents in our study was 91 of 273 (33.3%) and psychological morbidity was 77 (28.2%). Working >60 h per week was significantly associated with burnout (odds ratio: 9.02, 95% confidence interval: 2.3-35.8, p = 0.002) and psychological morbidity (odds ratio: 7.21, 95% confidence interval: 1.8-28.8, p = 0.005). Home hospice care practitioners (41.5%) were more at risk of developing psychological morbidity compared to hospital-based palliative care (17.5%) or hospice inpatient care (26.0%) (p = 0.007). Coping mechanisms like physical well-being, clinical variety, setting boundaries, transcendental (meditation and quiet reflection), passion for one's work, realistic expectations, remembering patients and organisational activities were associated with less burnout. Our results reveal that burnout and psychological morbidity are significant in the palliative care community and demonstrate a need to look at managing long working hours and promoting the use of coping mechanisms to reduce burnout and psychological morbidity. © The Author(s) 2015.

  9. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    Science.gov (United States)

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  10. Changes in morbidity and medical care utilization after the recent economic crisis in the Republic of Korea.

    Science.gov (United States)

    Kim, Hanjoong; Chung, Woo Jin; Song, Young Jong; Kang, Dae Ryong; Yi, Jee Jeon; Nam, Chung Mo

    2003-01-01

    To examine and quantify the impact of the recent economic crisis on morbidity and medical care utilization in the Republic of Korea. 22 675 people from 6791 households and 43 682 people from 12 283 households were questioned for two nationwide surveys that took place in 1995 and 1998, respectively. A separate sample pretest-posttest design was used and we conducted c2 test and logistic regression analysis after controlling for the maturation effect of the morbidity and medical care utilization. The morbidity rates of chronic disease and acute disease increased significantly by 27.1% and 9.5%, respectively, whereas the utilization rates of outpatient and inpatient services decreased by 15.1% and 5.2%, respectively. In particular, the pace of decline in the utilization rate of outpatient services varied depending on the type of disease: morbidity rates for mental and behavioural disorders were 13.7%; for cardiovascular disease, 7.1%; and for injury, 31.6%. After the Republic of Korean economic crisis, the morbidity and medical care utilization rates changed significantly but the degree of change depended on the type of disease or service. The time-dependent relationship between the national economy and the morbidity and medical care utilization rates needs to be further investigated.

  11. Severe maternal morbidity in Zanzibar’s referral hospital : Measuring the impact of in-hospital care

    NARCIS (Netherlands)

    Herklots, Tanneke; Van Acht, Lieke; Meguid, Tarek; Franx, Arie; Jacod, Benoit

    2017-01-01

    Objective: to analyse the impact of in-hospital care on severe maternal morbidity using WHO’s near-miss approach in the low-resource, high mortality setting of Zanzibar’s referral hospital. Setting: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. Methods: We identified all

  12. [Preventable drug-related morbidity: determining valid indicators for primary care in Portugal].

    Science.gov (United States)

    Guerreiro, Mara Pereira; Cantrill, Judith A; Martins, Ana Paula

    2007-01-01

    Preventable drug-related morbidity (PDRM) indicators are operational measures of therapeutic risk management. These clinical indicators, which cover a wide range of drugs, combine process and outcome in the same instrument. They were developed in the US and have been validated for primary care settings in the US, UK and Canada. This study is part of a research programme; it aimed to determine a valid set of PDRM indicators for adult patients in primary care in Portugal. Face validity of 61 US and UK-derived indicators translated to Portuguese was preliminarily determined by means of a postal questionnaire using a purposive sample of four Portuguese pharmacists with different backgrounds. Preliminary content validity of indicators approved in the previous stage was determined by cross-checking each definition of PDRM with standard drug information sources in Portugal. Face and content validity of indicators yielded by preliminary work were then established by a 37 expert panel (20 community pharmacists and 17 general practitioners) using a two-round Delphi survey. Data were analysed using SPSS release 11.5. Nineteen indicators were ruled out in preliminary validation. Changes were made in the content of eight of the remaining 42 indicators; these were related to differences in the drugs being marketed and patterns of drug monitoring between countries. Thirty-five indicators were consensus approved as PDRM for adult patients in Portuguese primary care by the Delphi panel.

  13. Severe maternal morbidity in Zanzibar's referral hospital: Measuring the impact of in-hospital care.

    Directory of Open Access Journals (Sweden)

    Tanneke Herklots

    Full Text Available to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital.Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania.We identified all cases of morbidity and mortality in women admitted within 42 days after the end of pregnancy at Mnazi Mmoja Hospital in the period from April to October 2016. The severity of complications was classified using WHO's near-miss approach definitions: potentially life-threatening condition (PLTC, maternal near-miss (MNM or maternal death (MD. Quality of in-hospital care was assessed using the mortality index (MI defined as ratio between mortality and severe maternal outcome (SMO where SMO = MD + MNM, cause-specific case facility rates and comparison with predicted mortality based on the Maternal Severity Index model.5551 women were included. 569 (10.3% had a potentially life-threatening condition and 65 (1.2% a severe maternal outcome (SMO: 37 maternal near-miss cases and 28 maternal deaths. The mortality index was high at 0.43 and similar for women who developed a SMO within 12 hours of admission and women who developed a SMO after 12 hours. A standardized mortality ratio of 6.03 was found; six times higher than that expected in moderate maternal mortality settings given the same severity of cases. Obstetric haemorrhage was found to be the main cause of SMO. Ruptured uterus and admission to ICU had the highest case-fatality rates. Maternal death cases seemed to have received essential interventions less often.WHO's near-miss approach can be used in this setting. The high mortality index observed shows that in-hospital care is not preventing progression of disease adequately once a severe complication occurs. Almost one in two women experiencing life-threatening complications will die. This is six times higher than in moderate mortality settings.

  14. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

    Science.gov (United States)

    Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

    2015-10-28

    Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

  15. Hidden care: Revelations of a case-note audit of physical health care in a community mental health service.

    Science.gov (United States)

    Lawn, Sharon; Zabeen, Sara; Rowlands, Nikki; Picot, Sharon

    2018-05-24

    People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random sample of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records; however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers. © 2018 Australian College of Mental Health Nurses Inc.

  16. Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services.

    Directory of Open Access Journals (Sweden)

    Laura Senyonjo

    Full Text Available There is currently limited information as to which conditions are most prevalent in communities in developing countries. This makes effective planning of eye services difficult.3,899 eligible individuals were recruited and examined in a cross-sectional survey in Asa Local Government Area, Nigeria. Those who self-reported an ocular morbidity were also asked about their health-seeking behaviour. Health records of local facilities were reviewed to collect information on those presenting with ocular morbidities.25.2% (95% CI: 22.0-28.6 had an ocular morbidity in at least one eye. Leading causes were presbyopia and conditions affecting the lens and conjunctiva. The odds of having an ocular morbidity increased with age and lower educational attainment. 10.1% (7.7-13.0 self-reported ocular morbidity; 48.6% (40.4-56.8 of them reported seeking treatment. At the facility level, 344 patients presented with an ocular morbidity over one month, the most common conditions were red (26.3% or itchy (20.8% eyes.Ocular morbidities, including many non vision impairing conditions, were prevalent with a quarter of the population affected. The delivery of eye care services needs to be tailored in order to address this need and ensure delivery in a cost-effective and sustainable manner.

  17. FACTORS PREDICTING MORBIDITY IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL

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    Muhammad Imran Hasan Khan

    2013-02-01

    Full Text Available Introduction: Dengue virus (DENV affects over half the world’s population in 112 countries, and dengue fever (DF is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF and Dengue Shock Syndrome (DSS accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9, deranged liver function test OR 1.9 (CI 0.97-0.99, platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19, presence of urinary red blood cells OR 1.4 (CI 0.179-0.900 and presence of urinary protein OR 1.1 (CI 0.191-0.974 were related to development of DHF and DSS.

  18. A PROSPECTIVE OBSERVATIONAL STUDY OF SHORT TERM MORBIDITY PATTERN IN PRETERM NEWBORNS DELIVERED IN A TERTIARY CARE HOSPITAL

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    Harsha

    2015-08-01

    Full Text Available OBJECTIVE: To study the short term morbidity pattern in preterm new born babies delivered in a tertiary care hospital with level III neonatal intensive care unit (NICU. MATERIAL AND METHODS: A prospective observational study was conducted in a level III NICU betwee n November 2009 to July 2010 at Grant medical college and JJ Group of hospitals, Mumbai. All the in born preterm babies were assessed for morbidity pattern from the time of admission till discharge or death. RESULT: 156 preterm babies were included in the study. 83(54.21% were male and 73(46.79% were female. The major morbidities observed in the preterm neonates were hyperbilirubinemia in 50.54%, Respiratory distress syndrome (RDS in25.64% and severe birth asphyxia in13.46%. Other common morbidities seen were retinopathy of prematurity in 12.17%, apnoea in 11.54% and anaemia in 10.9%. Preterm neonates also had in 9.62% culture proven sepsis, in 8.33% hypoglycaemia, in 7.05% Intraventricular haemorrhage (IVH and in 6.41% various congenital anomalies. CONCL USION: Hyperbilirubinemia, respiratory distress syndrome and severe birth asphyxia are major preterm morbidity

  19. Listening to women's voices: the quality of care of women experiencing severe maternal morbidity, in Accra, Ghana.

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    Ozge Tunçalp

    Full Text Available BACKGROUND: Women who survive severe obstetric complications can provide insight into risk factors and potential strategies for prevention of maternal morbidity as well as maternal mortality. We interviewed 32 women, in an urban facility in Ghana, who had experienced severe morbidity defined using a standardized WHO near-miss definition and identification criteria. Women provided personal accounts of their experiences of severe maternal morbidity and perceptions of the care they received. METHODS AND FINDINGS: The study took place in a referral facility in urban Accra, and semi-structured interviews were conducted with women who had either a maternal near miss (n = 17 or a potentially life-threatening complication (n = 15. The most common themes surrounding the traumatic delivery were the fear of dying and concern over the potential (or actual loss of the baby. For many women, the loss of a baby negatively influenced how they viewed and coped with this experience. Women's perceptions of the quality of the care highlighted several key factors such as the importance of information, good communication and attitudes, and availability of human (i.e., more doctors and physical resources (i.e., more beds, water at the facility. CONCLUSIONS: Our results suggest that experiences of women with severe maternal morbidity may inform different aspects of quality improvement in the facilities, which in turn have a positive impact on future health seeking behavior, service utilization and reduction in maternal morbidity and mortality.

  20. Hidden Liquidity

    OpenAIRE

    Cebiroglu, Gökhan; Horst, Ulrich

    2012-01-01

    We cross-sectionally analyze the presence of aggregated hidden depth and trade volume in the S&P 500 and identify its key determinants. We find that the spread is the main predictor for a stock’s hidden dimension, both in terms of traded and posted liquidity. Our findings moreover suggest that large hidden orders are associated with larger transaction costs, higher price impact and increased volatility. In particular, as large hidden orders fail to attract (latent) liquidity to the market, hi...

  1. Co-morbidity and polypharmacy in Parkinson's disease: insights from a large Scottish primary care database.

    Science.gov (United States)

    McLean, Gary; Hindle, John V; Guthrie, Bruce; Mercer, Stewart W

    2017-07-01

    Parkinson's disease is complicated by comorbidity and polypharmacy, but the extent and patterns of these are unclear. We describe comorbidity and polypharmacy in patients with and without Parkinson's disease across 31 other physical, and seven mental health conditions. We analysed primary health-care data on 510,502 adults aged 55 and over. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated age, sex and deprivation adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for those with PD compared to those without, for the prevalence, and number of conditions. Two thousand six hundred forty (0.5%) had Parkinson's disease, of whom only 7.4% had no other conditions compared with 22.9% of controls (adjusted OR [aOR] 0.43, 95% 0.38-0.49). The Parkinson's group had more conditions, with the biggest difference found for seven or more conditions (PD 12.1% vs. controls 3.9%; aOR 2.08 95% CI 1.84-2.35). 12 of the 31 physical conditions and five of the seven mental health conditions were significantly more prevalent in the PD group. 44.5% with Parkinson's disease were on five to nine repeat prescriptions compared to 24.5% of controls (aOR 1.40; 95% CI 1.28 to 1.53) and 19.2% on ten or more compared to 6.2% of controls (aOR 1.90; 95% CI 1.68 to 2.15). Parkinson's disease is associated with substantial physical and mental co-morbidity. Polypharmacy is also a significant issue due to the complex nature of the disease and associated treatments.

  2. Children With Morbid Obesity Benefit Equally as Children With Overweight and Obesity From an Ongoing Care Program.

    Science.gov (United States)

    Rijks, J M; Plat, J; Mensink, R P; Dorenbos, E; Buurman, W A; Vreugdenhil, A C E

    2015-09-01

    Despite stabilization of childhood overweight and obesity prevalence, there is a shift toward more severe degrees of obesity, which results in an increasing prevalence of children with morbid obesity. Prior studies demonstrated that lifestyle modification without ongoing treatment has only a modest and not sustainable effect in children with morbid obesity. This suggests that a chronic care model is necessary for long-term effects on weight management and health. This study aimed to evaluate the effect of an ongoing lifestyle intervention in children with morbid obesity in comparison with children with overweight and obesity. This was a nonrandomized prospective intervention study with 12- and 24-month followup at the Centre for Overweight Adolescent and Children's Healthcare. Children and adolescents (n = 100 females and 72 males) with overweight, obesity, or morbid obesity were given long-term, outpatient, tailored lifestyle intervention. Body mass index (BMI) z score was measured. In children with morbid obesity, 12- and 24-month interventions resulted in a decrease of BMI z score of -0.13 ± 0.25 (P = .001) and -0.23 ± 0.32 (P = .01) respectively, whereas weight status category improved to obese in 21% and 25% of the children. Cardiovascular risk parameters including serum total cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and diastolic blood pressure significantly improved after 1-year intervention in the complete group. Most important, BMI z score as well as cardiovascular risk parameters improved to a similar degree in children with overweight, obesity, and morbid obesity. Children with overweight, obesity, and morbid obesity benefit equally from an ongoing, outpatient, tailored lifestyle intervention, and demonstrate significant weight loss and improvement of cardiovascular risk parameters.

  3. Privatisation & marketisation of post-birth care: the hidden costs for new mothers

    Directory of Open Access Journals (Sweden)

    Benoit Cecilia

    2012-10-01

    Full Text Available Abstract Retrenchment of government services has occurred across a wide range of sectors and regions. Care services, in particular, have been clawed away in the wake of fiscal policies of cost containment and neoliberal policies centred on individual responsibility and market autonomy. Such policies have included the deinstitutionalisation of care from hospitals and clinics, and early discharge from hospital, both of which are predicated on the notion that care can be provided informally within families and communities. In this paper we examine the post-birth "care crisis" that new mothers face in one region of Canada. Method The data are drawn from a larger study of social determinants of pregnant and new mothers' health in Victoria, Canada. Mixed methods interviews were conducted among a purposive sample of women at three points in time. This paper reports data on sample characteristics, length of stay in hospital and health service gaps. This data is contextualised via a more in-depth analysis of qualitative responses from Wave 2 (4-6 weeks postpartum. Results Out results show a significant portion of participants desired services that were not publically available to them during the post-birth period. Among those who reported a gap in care, the two most common barriers were: cost and unavailability of home care supports. Participants' open-ended responses revealed many positive features of the public health care system but also gaps in services, and economic barriers to receiving the care they wanted. The implications of these findings are discussed in relation to recent neoliberal reforms. Discussion & conclusions While Canada may be praised for its public provision of maternity care, mothers' reports of gaps in care during the early postpartum period and increasing use of private doulas is a worrying trend. To the extent that individual mothers or families rely on the market for care provision, issues of equity and quality of care are

  4. POSTPARTUM PHYSICAL MORBIDITIES AMONG POSTNATAL MOTHERS IN A TERTIARY CARE CENTRE

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    Deepa Mohandas

    2017-02-01

    Full Text Available BACKGROUND Puerperium refers to the six-week period following childbirth. This is a dynamic period when the physiological changes that occur during pregnancy resolve and the body system return to their pre-pregnant state. Many of the complications leading to postpartum maternal morbidity arise during labour and delivery and in the first 1-2 weeks following delivery. The complication during immediate postpartum periods is managed in hospital itself. But, there is a risk of persisting these complications and from the postnatal checkup, the magnitude of the postpartum morbidity of these women are assessed. The aim of the study is to assess the postpartum physical morbidities among postnatal mothers and determine the association of those with selected variables. MATERIALS AND METHODS This is a descriptive study. Sample in this study consists of 406 consecutive cases of postnatal mothers after 6 weeks of postpartum period who are visiting Family Planning Outpatient Department of Sree Avittom Thirunal Hospital, Thiruvananthapuram, for postnatal checkup. Each woman was assessed by using interview schedule. The findings were presented under the following headings. Sociodemographic data, postpartum morbidities and association between selected variable and postpartum morbidities. Study Setting and Design- The design adopted is descriptive research design. 406 postnatal mothers attending the Family Planning Outpatient Department of Sree Avittom Thirunal Hospital, Thiruvananthapuram, for postnatal checkup after 6 weeks postpartum are allocated. Each woman was assessed by interview schedule. The physical postpartum morbidities among postnatal women were assessed. RESULTS Data was analysed using SPSS software using descriptive and inferential statistics based on the objective using frequency and Chi-square test. CONCLUSION In the present study, 57.6% of women had morbidities of which 29.3% had postpartum anaemia, 45.5% had backache, 15% had perineal pain, 16

  5. Time trends in primary-care morbidity, hospitalization and mortality due to pneumonia.

    NARCIS (Netherlands)

    Gageldonk-Lafeber, A.B. van; Bogaerts, M.A.H.; Verheij, R.; Sande, M.A.B. van der

    2009-01-01

    Most studies reporting pneumonia morbidity are restricted to hospitalized patients, although only a minority of pneumonia patients are admitted to hospital. To get a better understanding of the burden of disease in the general population, we conducted a population-based retrospective study to

  6. Co-morbidities of COPD in primary care : frequency, relation to COPD, and treatment consequences

    NARCIS (Netherlands)

    van der Molena, Thys

    2010-01-01

    Introduction: In the Western world, chronic obstructive pulmonary disease (COPD) is predominantly caused by long-term smoking, which results in pulmonary inflammation that is often associated with systemic inflammation. A number of co-morbid conditions, such as cardiovascular disease, muscle

  7. The Hidden Roles That Management Partners Play In Accountable Care Organizations.

    Science.gov (United States)

    Lewis, Valerie A; D'Aunno, Thomas; Murray, Genevra F; Shortell, Stephen M; Colla, Carrie H

    2018-02-01

    Accountable care organizations (ACOs) are often discussed and promoted as driven by physicians, hospitals, and other health care providers. However, because of the flexible nature of ACO contracts, management organizations may also become partners in ACOs. We used data from 2013-15 on 276 ACOs from the National Survey of Accountable Care Organizations to understand the prevalence of nonprovider management partners' involvement in ACOs, the services these partners provide, and the structure of ACOs that have such partners. We found that 37 percent of ACOs reported having a management partner, and two-thirds of these ACOs reported that the partner shared in the financial risks or rewards. Among ACOs with partners, 94 percent had data services provided by the partner, 87 percent received administrative services, 68 percent received educational services, and 66 percent received care coordination services. Half received all four of these services from their partner. ACOs with partners were more heavily primary care than other ACOs. ACOs with and without partners had similar performance on costs and quality in Medicare ACO programs. Our findings suggest that management partners play a central role in many ACOs, perhaps supplying smaller and physician-run ACOs with services or expertise perceived as necessary for ACO success.

  8. Using a composite morbidity score and cultural survey to explore characteristics of high proficiency neonatal intensive care units.

    Science.gov (United States)

    Kaempf, Joseph W; Wang, Lian; Dunn, Michael

    2018-01-03

    Continuous quality improvement (CQI) collaboration has not eliminated the morbidity variability seen among neonatal intensive care units (NICUs). Factors other than inconstant application of potentially better practices (PBPs) might explain divergent proficiency. Measure a composite morbidity score and determine whether cultural, environmental and cognitive factors distinguish high proficiency from lower proficiency NICUs. Retrospective analysis using a risk-adjusted composite morbidity score (Benefit Metric) and cultural survey focusing on very low birth weight (VLBW) infants from 39 NICUs, years 2000-2014. The Benefit Metric and yearly variance from the group mean was rank-ordered by NICU. A comprehensive survey was completed by each NICU exploring whether morbidity variance correlated with CQI methodology, cultural, environmental and/or cognitive characteristics. 58 272 VLBW infants were included, mean (SD) age 28.2 (3.0) weeks, birth weight 1031 (301) g. The 39 NICU groups' Benefit Metric improved 40%, from 80 in 2000 to 112 in 2014 (Pexpectations of providers, enhanced learning opportunities, knowledge of CQI fundamentals and more generous staffing. Cultural, environmental and cognitive characteristics vary among NICUs perhaps more than traditional CQI methodology and PBPs, possibly explaining the inconstancy of VLBW infant morbidity reduction efforts. High proficiency NICUs foster spirited team work and camaraderie, sustained learning opportunities and support of favourable staffing that allows problem solving and widespread involvement in CQI activities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Total donor ischemic time: relationship to early hemodynamics and intensive care morbidity in pediatric cardiac transplant recipients.

    Science.gov (United States)

    Rodrigues, Warren; Carr, Michelle; Ridout, Deborah; Carter, Katherine; Hulme, Sara Louise; Simmonds, Jacob; Elliott, Martin; Hoskote, Aparna; Burch, Michael; Brown, Kate L

    2011-11-01

    Single-center studies have failed to link modest increases in total donor ischemic time to mortality after pediatric orthotopic heart transplant. We aimed to investigate whether prolonged total donor ischemic time is linked to pediatric intensive care morbidity after orthotopic heart transplant. Retrospective cohort review. Tertiary pediatric transplant center in the United Kingdom. Ninety-three pediatric orthotopic heart transplants between 2002 and 2006. Total donor ischemic time was investigated for association with early post-orthotopic heart transplant hemodynamics and intensive care unit morbidities. Of 43 males and 50 females with median age 7.2 (interquartile range 2.2, 13.0) yrs, 62 (68%) had dilated cardiomyopathy, 20 (22%) had congenital heart disease, and nine (10%) had restrictive cardiomyopathy. The mean total donor ischemic time was 225.9 (sd 65.6) mins. In the first 24 hrs after orthotopic heart transplant, age-adjusted mean arterial blood pressure increased (p total donor ischemic time was significantly associated with lower mean arterial blood pressure (p care unit (p = .004), and longer post-orthotopic heart transplant stay in hospital (p = .02). Total donor ischemic time was not related to levels of mean pulmonary arterial pressure (p = .62), left atrial pressure (p = .38), or central venous pressure (p = .76) early after orthotopic heart transplant. Prolonged total donor ischemic time has an adverse effect on the donor organ, contributing to lower mean arterial blood pressure, as well as more prolonged ventilation and intensive care unit and hospital stays post-orthotopic heart transplant, reflecting increased morbidity.

  10. Morbidity and mortality in reptiles presented to a wildlife care facility in Central Illinois

    OpenAIRE

    Rivas, Anne E.; Allender, Matthew C.; Mitchell, Mark; Whittington, Julia K.

    2014-01-01

    We examined morbidity and mortality of 200 reptiles, representing 13 different species that were presented to the University of Illinois Wildlife Medical Clinic (WMC) from 2003 to 2010. Snapping turtles (Chelydra serpentine; n = 46), box turtles (Terrapene sp.; n = 43), painted turtles (Chrysemys picta; n = 37), and red-eared slider turtles (Trachemys scripta elegans; n = 33) were the most frequently seen species. Turtles were significantly more likely to be presented to the WMC following col...

  11. Psychiatric morbidity in elderly patients attending OPD of tertiary care centre in western region of Nepal

    Directory of Open Access Journals (Sweden)

    Prakash Thapa

    2014-01-01

    Full Text Available Context: Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges. Aims: To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. Settings and Design: Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: Data for patients ≥ 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1 st January 2012 to 15 th January 2013 were collected retrospectively in a predesigned proforma. Statistical Analysis Used: Risk of having different psychiatric disorders was estimated using odds ratio. Results: The mean age of 120 patients included in this study was 69.67 (SD = 5.94 years. Depressive disorder (26.7% was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ≤75 years except for dementia [odd ratio (OR (≤75 years/>75 years=0.055, 95% confidence interval (CI=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female=3.394, 95% CI = 1.015;11.350] was more common in males. Conclusions: Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.

  12. Maternal morbidity in emergency versus elective caesarean section at tertiary care hospital

    International Nuclear Information System (INIS)

    Ghazi, A.; Karim, F.; Hussain, M.; Ali, T.; Jabbar, S.

    2012-01-01

    Background: In the past 30 years the rate of caesarean section (C/S) has steadily increased from 5% to more than 20% for many avoidable and unavoidable indications. The objective of this study was to compare maternal morbidity and determine its cause in elective and emergency caesarean section. Method: It was a cross-sectional comparative study conducted in Civil Hospital Karachi at Obs/Gyn Unit III. All mothers admitted through OPD or emergency during the study period, of any age or parity undergoing C/S were recruited in the study. Patients having previous myomectomy, hysterotomy or classical C/S were excluded from the study. Patients undergoing emergency C/S were placed in group A, and those delivered by elective C/S were included in group B. Study variables were general and obstetric parameters and complications observed intra-operatively. Any postoperative complications were recorded from recovery room till patient was discharged from the ward. Results: There were 50 patients in each group. In group A, 11 (22%) were booked and 33 (66%) were referred cases. In group B, 48 (96%) were booked. The mean age in both groups was 28 years. In both groups, multigravida compared to primigravida were 78% vs 22% in group A, and 92% vs 8% in group B. Indication for C/S was previous C/S in 10 (20%) patients in group A, and 39 (78%) patients in group B, placenta previa, chorioamionitis, obstructed labour (6, 12% each); pregnancy induced hypertension and eclampsia in 5 (10%) cases in group A only. Intra-operative complications in group A were 48 (96%) vs 15 (30%) in group B (p=0.000). Postoperative morbidity in group A was 50 (100%) and 26 (52%) in group B (p=0.000). Intra-operative complication was haemorrhage in 46 (92%) cases in group A and 11 (22%) in group B. Anaesthetic complications were 40 (80%); prolonged intubation 25 (50%), aspiration of gastric contents 8 (16%), and difficult intubation 7 (14%) in group A. Ten (20%) cases had anaesthetic complications in group B

  13. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

    Science.gov (United States)

    Cranwell, K; Polacsek, M; McCann, T V

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses

  14. Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014

    Science.gov (United States)

    Gebrehiwot, Yirgu; Fetters, Tamara; Gebreselassie, Hailemichael; Moore, Ann; Hailemariam, Mengistu; Dibaba, Yohannes; Bankole, Akinrinola; Getachew, Yonas

    2017-01-01

    CONTEXT In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time. METHODS Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014. RESULTS The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception. CONCLUSIONS Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved. PMID:28825903

  15. [Morbidity and mortality after intensive care management of hemorrhagic stroke in Djibouti].

    Science.gov (United States)

    Benois, A; Raynaud, L; Coton, T; Petitjeans, F; Hassan, A; Ilah, A; Sergent, H; Grassin, F; Leberre, J

    2009-02-01

    Prospective data on management and outcome of stroke in Africa is scarce. The purpose of this prospective descriptive study is to present epidemiologic, clinical and outcome data for a series of patients with hemorrhagic stroke in Djibouti. All patients admitted to the intensive care unit of the Bouffard Medical-Surgical Center in Djibouti for cerebral hemorrhage documented by CT-scan of the brain were recruited in this study. A total of 18 patients including 16 men were enrolled. The median patient age in this series was 51.5 years [range, 20-72]. The median duration of intensive care was 3 days [range, 1-38]. Mean Glasgow score at time of admission was 9 [range, 3-14]. Five patients were brought in by emergency medical airlift. The main risk factors for stroke were arterial hypertension, smoking, and regular khat use. Mechanical ventilation was performed in 10 patients with a survival rate of 40%. Six patients (33%) died in the intensive care unit. Hospital mortality within one month was 39% and mortality at 6 months was 44.4%. One-year survival for patients with a Glasgow score < or = 7 at the time of admission was 33%. Arterial hypertension, khat use, and smoking appeared to be major risk factors for male Djiboutians. Neurologic intensive care techniques provided hospital mortality rates similar to those reported in hospitals located in Western countries. Functional outcome in local survivors appeared to be good despite the absence of functional intensive care. These data argue against the passive, fatalistic approach to management of hemorrhagic stroke and for primary prevention of cardiovascular risk factors.

  16. Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre

    Directory of Open Access Journals (Sweden)

    Mini Joseph

    2017-09-01

    Full Text Available Background: Obesity is sweeping across continents and is a major public health concern of the modern society. Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake. Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them. Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039 and Energy (p=0.024. Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes. Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.

  17. Multi-morbidity: A patient perspective on navigating the health care system and everyday life

    DEFF Research Database (Denmark)

    Ørtenblad, Lisbeth; Meillier, Lucette Kirsten; Jønsson, Alexandra Brandt Ryborg

    2017-01-01

    and the management of their treatment burdens. Dilemmas were identified within three domains: family and social life; work life; agendas and set goals in appointments with health professionals. Individual resources and priorities in everyday life play a dominant role in resolving dilemmas and navigating the tension...... study using individual interviews and participant-observations. An inductive analytical approach was applied, moving from observations and results to broader generalisations. Results: People with multimorbidity experience dilemmas related to their individual priorities in everyday life...... between everyday life and the health care system. Discussion: People with multimorbidity are seldom supported by health professionals in resolving the dilemmas they must face. This study suggests an increased focus on patient-centeredness and argues in favour of planning health care through cooperation...

  18. Is stoma care effective in terms of morbidity in complicated ileostomies?

    Directory of Open Access Journals (Sweden)

    Sarkut P

    2015-08-01

    Full Text Available Pinar Sarkut, Halit Ziya Dundar, Ismail Tirnova, Ersin Ozturk, Tuncay Yilmazlar Department of General Surgery, Faculty of Medicine, Uludag University, Görükle, Turkey Background: Performing transient or permanent ileostomy is one of the common procedures involved in colorectal surgery. Complication rates up to 40% have been reported in ileostomies. In this report, the effect of specific stoma care unit on ileostomy and its complications were investigated. Methods: A total of 141 patients, who were operated and underwent ileostomy, due to different causes, at Department of General Surgery, Uludag University, Bursa, Turkey, between 2003 and 2006, were examined, retrospectively. Patient records were examined in terms of age, sex, surgery indications, urgent/elective state, benign/malign origin, ileostomy type, complications and stoma care, and education. Χ2 test was used to compare the categorical data. Results: Among the patients, 95 (67% were male and 46 (33% were female. The mean age was 47 years (17–67. Some of the subjects (49% were operated urgently and some (51% were under elective conditions. The ileostomy types used included the following: end ileostomy (43%, loop ileostomy (46%, and double-barrel ileostomy (11%. Permanent ileostomy was performed in 23 patients and transient ileostomy was performed in 118 patients. The patients were operated because of either benign (48% or malign (52% causes. Complications developed in 37 (26% patients. The rate of development of complication was markedly higher in ileostomies performed under urgent conditions (61% vs 39% (P<0.001. The complications included mucocutaneous separation (12 patients, maceration in the peristomal skin (ten patients, retraction (five patients, necrosis (three patients, prolapsus (three patients, and other metabolic complications (four patients. The complications were treated with care (68% and surgical revision (32%. Conclusion: The rate of ileostomy was found to be higher

  19. Morbidity, utilization of curative care and service entry point preferences in metropolitan Centro Habana, Cuba

    Directory of Open Access Journals (Sweden)

    Armando Rodríguez

    Full Text Available Abstract: First-line health services with a primary health care approach are a strong trigger for adequate health-care-seeking behavior. Research on the association between prevalence of chronic diseases and acute illnesses and use of health services emphasizes the importance of socioeconomic determinants in such patterns of utilization. In a cross-sectional study of 408 families in Centro Habana, Cuba, home interviews were conducted between April and June 2010 to analyze socio-demographic determinants of acute and chronic health problems and use of formal health services. Bivariate and logistic regression models were used. 529 persons reported a chronic disease. During the previous month, 155 of the latter reported an exacerbation and 50 experienced an unrelated acute health problem. 107 persons without chronic diseases reported acute health problems. Age was the strongest determinant of chronic disease prevalence. Adult women and the elderly were more likely to report acute problems. Acute patients with underlying chronic disease used formal services more often. No socio-demographic variable was associated with services use or consultation with the family physician. While the family physician is defined as the system's entry-point, this was the case for only 54% of patients that had used formal services, thus compromising the physician's role in counseling patients and summarizing their health issues. The importance of chronic diseases highlights the need to strengthen the family physician's pivotal role. New economic policies in Cuba, stimulating self-employment and private initiative, may increase the strain on the exclusively public health care system. Still, the Cuban health system has demonstrated its ability to adapt to new challenges, and the basic premises of Cuba's health policy are expected to be preserved.

  20. Child Health in the Peruvian Amazon: Prevalence and Factors Associated with Referred Morbidity and Health Care Access in the City of Iñapari

    Directory of Open Access Journals (Sweden)

    Maria Gabriela Silva Guimarães

    2015-01-01

    Full Text Available Introduction. Children under 5 years of age are more susceptible to developing morbidities such as diarrhea, respiratory infections, anemia, and malnutrition. The objective of the study is to evaluate the prevalence of reported morbidities in this age group in the city of Iñapari (Peru and the access to health services in this municipality. Methods. Data collection using interviews that assessed socioeconomic and demographic conditions, child morbidity, and access to health services was performed in 2011. Statistical analysis was performed using SPSS 13.0. Results. Regarding morbidities that occurred during lifetime, 39.8% reported previous anemia and intestinal parasite infection. About 53.7% of the children reported any type of morbidities in the last 15 days before interview, being most frequent respiratory symptoms (38.9%, diarrhea (23,4%, and fever (23,1%. Only 63.1% of those reporting recent morbidities sought health care. These morbidities were associated with precarious sanitation and lack of infrastructure, the presence of other comorbidities, and poor access to health services. Conclusion. The main referred morbidities in Amazonian Peruvian children were diarrhea, respiratory symptoms, anemia, and vomiting. Incentives and improvements in the health and sanitation conditions would be important measures to improve the quality of life of the Amazonian child population.

  1. Home-based care for reducing morbidity and mortality in people infected with HIV/AIDS

    CSIR Research Space (South Africa)

    Young

    2009-07-01

    Full Text Available stream_source_info Young_d1_2009.pdf.txt stream_content_type text/plain stream_size 6745 Content-Encoding UTF-8 stream_name Young_d1_2009.pdf.txt Content-Type text/plain; charset=UTF-8 HOME-BASED CARE FOR REDUCING... of results was done. Relevant effect measures and the 95% confidence intervals were reported. Young TN1, Busgeeth K2 1 South African Cochrane Centre, South African Medical Research Council, South Africa 2 Council for Scientific and Industrial Research...

  2. Morbidity, mortality and economic burden of renal impairment in cardiac intensive care.

    Science.gov (United States)

    Chew, D P; Astley, C; Molloy, D; Vaile, J; De Pasquale, C G; Aylward, P

    2006-03-01

    Moderate to severe impairment of renal function has emerged as a potent risk factor for adverse short- and long-term outcomes among patients presenting with cardiac disease. We sought to define the clinical, late mortality and economic burden of this risk factor among patients presenting to cardiac intensive care. A clinical audit of patients presenting to cardiac intensive care was undertaken between July 2002 and June 2003. All patients presenting with cardiac diagnoses were included in the study. Baseline creatinine levels were assessed in all patients. Late mortality was assessed by the interrogation of the National Death Register. Renal impairment was defined as estimated glomerular filtration rate modelling, adjusting for known confounders. A matched analysis and attributable risk calculation were undertaken to assess the proportion of late mortality accounted for by impairment of renal function and other known negative prognostic factors. The in-hospital total cost associated with renal impairment was assessed by linear regression. Glomerular filtration rate risk ratio 13.2; 95% CI 3.0-58.1; P risk, renal function accounts for a substantial proportion of the burden of late mortality. The burden of risk suggests a greater potential opportunity for improvement of outcomes through optimisation of therapeutic strategies.

  3. Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

    Science.gov (United States)

    Wade, Dorothy M; Hankins, Matthew; Smyth, Deborah A; Rhone, Elijah E; Mythen, Michael G; Howell, David C J; Weinman, John A

    2014-09-24

    The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT's concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3 months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P psychological morbidity was good (r =0.4, P psychological morbidity (AUC =0.7). The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.

  4. Assessment of psychiatric morbidity among health-care students in a teaching hospital, Telangana state: A cross-sectional questionnaire-based study

    Directory of Open Access Journals (Sweden)

    Udai Kiran

    2017-01-01

    Full Text Available Introduction: Professional education can be a stressful experience for health-care students and may impact negatively on emotional well-being and academic performance which leads to psychiatric morbidity. The aim of this study is to assess the prevalence of psychiatric morbidity among the professional health-care students. Materials and Methods: A cross-sectional study was conducted among professional health-care students in a tertiary care teaching hospital of Telangana state. The information regarding demographic data, academic achievements, and positive and negative events in the recent past was collected using semi-structured pro forma, and the General Health Questionnaire (GHQ-28 is used to assess the psychiatric morbidity. Descriptive analysis and Pearson's correlation analysis were done to analyze the data. Results: A total of 836 students participated in the study, and the overall mean GHQ total score in the study population was 26.8, which is above the cutoff (24 score. The prevalence of psychiatric morbidity among study population is about 58.7%. Academic achievement and negative events in the recent past had effect on psychological morbidity and showed high GHQ scores among study population which was found to be statistically significant. Conclusion: The poor academic performance and negative events had a strong impact on psychological morbidity of students. The higher level of psychological morbidity warrants need for intervention such as social and psychological support to improve the quality of life for the health-care students. Further, a creation of positive academic environment as a teamwork of faculty, administration, educational experts, and students helps to develop psychological healthy dental and medical professionals who can perform better in a coming future.

  5. Upper gastrointestinal symptoms, psychosocial co-morbidity and health care seeking in general practice: population based case control study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2009-09-01

    Full Text Available Abstract Background The pathophysiology of upper gastrointestinal (GI symptoms is still poorly understood. Psychological symptoms were found to be more common in patients with functional gastrointestinal complaints, but it is debated whether they are primarily linked to GI symptoms or rather represent motivations for health-care seeking. Purpose of our study was to compare co-morbidity, in particular psychological and social problems, between patients with and without upper GI symptoms. In addition, we investigated whether the prevalence of psychological and social problems is part of a broader pattern of illness related health care use. Methods Population based case control study based on the second Dutch National Survey of general practice (conducted in 2001. Cases (adults visiting their primary care physician (PCP with upper GI symptoms and controls (individuals not having any of these complaints, matched for gender, age, PCP-practice and ethnicity were compared. Main outcome measures were contact frequency, prevalence of somatic as well as psychosocial diagnoses, prescription rate of (psychopharmacological agents, and referral rates. Data were analyzed using odds ratios, the Chi square test as well as multivariable logistic regression analysis. Results Data from 13,389 patients with upper GI symptoms and 13,389 control patients were analyzed. Patients with upper GI symptoms visited their PCP twice as frequently as controls (8.6 vs 4.4 times/year. Patients with upper GI symptoms presented not only more psychological and social problems, but also more other health problems to their PCP (odds ratios (ORs ranging from 1.37 to 3.45. Patients with upper GI symptoms more frequently used drugs of any ATC-class (ORs ranging from 1.39 to 2.90, including psychotropic agents. The observed differences were less pronounced when we adjusted for non-attending control patients. In multivariate regression analysis, contact frequency and not psychological or

  6. Cardiac Risk Assessment, Morbidity Prediction, and Outcome in the Vascular Intensive Care Unit.

    LENUS (Irish Health Repository)

    Dover, Mary

    2013-09-17

    Objectives: The aim of this study is to examine the predictive value of the Lee revised cardiac risk index (RCRI) for a standard vascular intensive care unit (ICU) population as well as assessing the utility of transthoracic echocardiography and the impact of prior coronary artery disease (CAD) and coronary revascularization on patient outcome. Design: This is a retrospective review of prospectively maintained Vascubase and prospectively collected ICU data. Materials and Methods: Data from 363 consecutive vascular ICU admissions were collected. Findings were used to calculate the RCRI, which was then correlated with patient outcomes. All patients were on optimal medical therapy (OMT) in the form of cardioselective β-blocker, aspirin, statin, and folic acid. Results: There was no relationship found between a reduced ejection fraction and patient outcome. Mortality was significantly increased for patients with left ventricular hypertrophy (LVH) as identified on echo (14.9% vs 6.5%, P = .028). The overall complication rates were significantly elevated for patients with valvular dysfunction. Discrimination for the RCRI on receiver-operating characteristic analysis was poor, with an area under the receiver-operating characteristic curve of .621. Model calibration was reasonable with an Hosmer-Lemeshow Ĉ statistic of 2.726 (P = .256). Of those with known CAD, 41.22% of the patients receiving best medical treatment developed acute myocardial infarction (AMI) compared to 35.3% of those who previously underwent percutaneous cardiac intervention and 23.5% of those who had undergone coronary artery bypass grafting. There was 3-fold increase in major adverse clinical events in patients with troponin rise and LVH. Conclusions: The RCRI\\'s discriminatory capacity is low, and this raises difficulties in assessing cardiac risk in patients undergoing vascular intervention. The AMI is highest in the OMT group without prior cardiac intervention, which mandates protocols to

  7. The role of prenatal care and social risk factors in the relationship between immigrant status and neonatal morbidity: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    María Paz-Zulueta

    Full Text Available Literature evaluating association between neonatal morbidity and immigrant status presents contradictory results. Poorer compliance with prenatal care and greater social risk factors among immigrants could play roles as major confounding variables, thus explaining contradictions. We examined whether prenatal care and social risk factors are confounding variables in the relationship between immigrant status and neonatal morbidity.Retrospective cohort study: 231 pregnant African immigrant women were recruited from 2007-2010 in northern Spain. A Spanish population sample was obtained by simple random sampling at 1:3 ratio. Immigrant status (Spanish, Sub-Saharan and Northern African, prenatal care (Kessner Index adequate, intermediate or inadequate, and social risk factors were treated as independent variables. Low birth weight (LBW < 2500 grams and preterm birth (< 37 weeks were collected as neonatal morbidity variables. Crude and adjusted odds ratios (OR were estimated by unconditional logistic regression with 95% confidence intervals (95% CI.Positive associations between immigrant women and higher risk of neonatal morbidity were obtained. Crude OR for preterm births in Northern Africans with respect to nonimmigrants was 2.28 (95% CI: 1.04-5.00, and crude OR for LBW was 1.77 (95% CI: 0.74-4.22. However, after adjusting for prenatal care and social risk factors, associations became protective: adjusted OR for preterm birth = 0.42 (95% CI: 0.14-1.32; LBW = 0.48 (95% CI: 0.15-1.52. Poor compliance with prenatal care was the main independent risk factor associated with both preterm birth (adjusted OR inadequate care = 17.05; 95% CI: 3.92-74.24 and LBW (adjusted OR inadequate care = 6.25; 95% CI: 1.28-30.46. Social risk was an important independent risk factor associated with LBW (adjusted OR = 5.42; 95% CI: 1.58-18.62.Prenatal care and social risk factors were major confounding variables in the relationship between immigrant status and neonatal

  8. 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

  9. Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

    Science.gov (United States)

    Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

    2013-09-20

    Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about

  10. Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons

    Directory of Open Access Journals (Sweden)

    McKinnon IG

    2016-09-01

    Full Text Available Iain G McKinnon,1,2 Stuart DM Thomas,3–5 Heather L Noga,6 Jane Senior7 1Institute of Health and Society, Newcastle University, Academic Psychiatry, Campus for Ageing and Vitality, 2Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK; 3School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, 4Legal Intersections Research Centre, University of Wollongong, Wollongong, NSW, 5Southern Clinical School, Monash University, Clayton, VIC, Australia; 6School of Criminology, Simon Fraser University, Burnaby, BC, Canada; 7Offender Health Research Network, University of Manchester, Manchester, UK Abstract: This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia. There are significant health concerns among police detainees including acute injury, chronic physical health problems, mental and cognitive disorders, and the risks associated with drug and alcohol intoxication or withdrawal. There is some evidence that deaths in police custody have reduced where attention has been paid to the latter issue. Police personnel continue to experience difficulties identifying detainees with health issues relevant to their safe detention, but research shows that the use of evidence-based screening tools improves detection of such morbidities. Innovations in police custody health care mainly relate to detainees with mental disorders, including improved identification of illness

  11. Hidden loss

    DEFF Research Database (Denmark)

    Kieffer-Kristensen, Rikke; Johansen, Karen Lise Gaardsvig

    2013-01-01

    to participate. RESULTS: All children were affected by their parents' ABI and the altered family situation. The children's expressions led the authors to identify six themes, including fear of losing the parent, distress and estrangement, chores and responsibilities, hidden loss, coping and support. The main......PRIMARY OBJECTIVE: The purpose of this study was to listen to and learn from children showing high levels of post-traumatic stress symptoms after parental acquired brain injury (ABI), in order to achieve an in-depth understanding of the difficulties the children face in their everyday lives...... finding indicates that the children experienced numerous losses, many of which were often suppressed or neglected by the children to protect the ill parents. CONCLUSIONS: The findings indicated that the children seemed to make a special effort to hide their feelings of loss and grief in order to protect...

  12. Sequential Organ Failure Assessment Score for Evaluating Organ Failure and Outcome of Severe Maternal Morbidity in Obstetric Intensive Care

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    Antonio Oliveira-Neto

    2012-01-01

    Full Text Available Objective. To evaluate the performance of Sequential Organ Failure Assessment (SOFA score in cases of severe maternal morbidity (SMM. Design. Retrospective study of diagnostic validation. Setting. An obstetric intensive care unit (ICU in Brazil. Population. 673 women with SMM. Main Outcome Measures. mortality and SOFA score. Methods. Organ failure was evaluated according to maximum score for each one of its six components. The total maximum SOFA score was calculated using the poorest result of each component, reflecting the maximum degree of alteration in systemic organ function. Results. highest total maximum SOFA score was associated with mortality, 12.06 ± 5.47 for women who died and 1.87 ± 2.56 for survivors. There was also a significant correlation between the number of failing organs and maternal mortality, ranging from 0.2% (no failure to 85.7% (≥3 organs. Analysis of the area under the receiver operating characteristic (ROC curve (AUC confirmed the excellent performance of total maximum SOFA score for cases of SMM (AUC = 0.958. Conclusions. Total maximum SOFA score proved to be an effective tool for evaluating severity and estimating prognosis in cases of SMM. Maximum SOFA score may be used to conceptually define and stratify the degree of severity in cases of SMM.

  13. Hidden consequences of success in pediatrics: parental health-related quality of life—results from the Care Project

    NARCIS (Netherlands)

    Hatzmann, J.; Heymans, H.S.A.; Ferrer-i-Carbonell, A.; van Praag, B.M.S.; Grootenhuis, M.A.

    2008-01-01

    CONTEXT. The number of parents who care for a chronically ill child is increasing. Because of advances in medical care, parental caring tasks are changing. A detailed description of parental health-related quality of life will add to the understanding of the impact of caring for a chronically ill

  14. Hidden Consequences of Success in Pediatrics: Parental Health-Related Quality of Life-Results From the Care Project

    NARCIS (Netherlands)

    Hatzmann, Janneke; Heymans, Hugo S. A.; Ferrer-I-Carbonell, Ada; van Praag, Bernard M. S.; Grootenhuis, Martha A.

    2008-01-01

    CONTEXT. The number of parents who care for a chronically ill child is increasing. Because of advances in medical care, parental caring tasks are changing. A detailed description of parental health-related quality of life will add to the understanding of the impact of caring for a chronically ill

  15. Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

    Science.gov (United States)

    Toft, Tomas; Fink, Per; Oernboel, Eva; Christensen, Kaj; Frostholm, Lisbeth; Olesen, Frede

    2005-08-01

    Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.

  16. The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care

    DEFF Research Database (Denmark)

    Krag, Marlene Øhrberg; Hasselbalch, Lotte; Siersma, Volkert Dirk

    2016-01-01

    Aims/hypothesis: The aim of this study was to assess gender differences in mortality and morbidity during 13 follow-up years after 6 years of structured personal care in patients with type 2 diabetes mellitus. Methods: In the Diabetes Care in General Practice (DCGP) multicentre, cluster......-randomised, controlled trial (ClinicalTrials.gov registration no. NCT01074762), 1,381 patients newly diagnosed with type 2 diabetes were randomised to receive 6 years of either structured personal care or routine care. The intervention included regular follow-up, individualised goal setting and continuing medical...... = 0.005). Conclusions/interpretation: Compared with routine care, structured personal diabetes care reduced all-cause mortality and diabetes-related death in women but not in men. This gender difference was also observed for any diabetes-related outcome and stroke but was not statistically significant...

  17. Incidence of the acute renal failure in the intensive care unit at the General Hospital of Mexico: Risk factors and associated morbidity and mortality

    OpenAIRE

    Herrera-Méndez, J.; Sánchez-Velázquez, L.D.; González-Chávez, A.; Rodríguez-Terán, G.

    2015-01-01

    Background: The acute renal failure (ARF) contributes to a longer hospital stay, morbidity, mortality and use of resources in critical patients. The estimate of its incidence was difficult, mainly due to the lack of a generally accepted definition. Objective: To determine the incidence, risk factors and effects of the ARF in critical patients. Material and methods: Study of prospective cohort. Patients hospitalised in the Intensive Care Unit (ICU) were included. The population was di...

  18. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands.

    Science.gov (United States)

    Faber, Adrianne; Kalverdijk, Luuk J; de Jong-van den Berg, Lolkje T W; Hugtenburg, Jacqueline G; Minderaa, Ruud B; Tobi, Hilde

    2010-02-01

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified in 115 pharmacies and a questionnaire was sent to their stimulant prescribing physician. Of 773 questionnaires sent out, 556 were returned and were suitable for analysis (72%). The results are based on 510 questionnaires concerning stimulant-treated children for whom a diagnosis of ADHD was reported. Of the 510 children diagnosed with ADHD, 31% had also received one or more other psychiatric diagnoses, mainly pervasive developmental disorder or oppositional defiant disorder/conduct disorder. We found an association between the presence of co-morbidity and the use of psychosocial interventions for the child (P parents (P receive any form of additional interventions, while psychosocial interventions varied from 8 to 18% in children with ADHD and psychiatric co-morbidity. The presence of diagnostic co-morbidity was also associated with the use of psychotropic co-medication (overall, P = 0.012) and antipsychotics (P received more psychosocial interventions and psychotropic co-medication than children with ADHD-only. The type of psychosocial interventions and psychotropic co-medication received by the children and their parents, depended on the specific co-morbid psychiatric disorder being present.

  19. Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Luís Fernando S. Castro-de-Araújo

    2013-06-01

    Full Text Available Objectives: i To investigate studies published between 1991 and 2010 on the prevalence of depressive morbidity (major depressive disorder [MDD], dysthymia and clinically significant depressive symptoms [CSDS] among elderly Brazilians assisted at healthcare facilities; ii to establish the prevalence of depression and identify its related factors; and iii to conduct a meta-analysis to assess the prevalence of depressive syndrome among elderly individuals assisted or hospitalized at healthcare facilities. Methods: Studies were selected from articles dated between January 1991 and June 2010 and extracted from the MEDLINE, LILACS, and SciELO databases. Results: The final analysis consisted of 15 studies, distributed as follows: i four sampled hospitalized patients, totaling 299 individuals, and found a prevalence of CSDS varying between 20 and 56%; ii four sampled outpatients, totaling 1,454 individuals; the prevalence of CSDS varied between 11 and 65%, and the prevalence of MDD varied between 23 and 42%; and iii seven sampled elderly individuals residing in long-term care facilities (LTCF, totaling 839 individuals, and the prevalence of CSDS varied between 11 and 65%. Conclusion: The present review indicated a higher prevalence of both MDD and CSDS among elderly Brazilians assisted at healthcare facilities.

  20. Detection of psychiatric morbidity in the primary medical care setting in Brazil Distúrbios psiquiátricos e assistência primária à saúde no Brasil

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    Jair de Jesus Mari

    1987-12-01

    Full Text Available The aims of this study were a to assess the ability of primary care doctors to make accurate ratings of psychiatric disturbance and b to evaluate the use of a case-finding questionnaire in the detection of psychiatric morbidity. The estudy took place in three primary care clinics in the city of São Paulo, Brazil, during a six-month survey. A time sample of consecutive adult attenders were asked to complete a case-finding questionnaire for psychiatric disorders (the Self Report Questionnaire - SRQ and a subsample were selected for a semi-structured psychiatric interview (the Clinical Interview Schedule - CIS. At the end of the consultation the primary care doctors were asked to assess, in a standardized way, the presence or absence of psychiatric disorder; these assessments were then compared with that ratings obtained in the psychiatric interview. A considerable proportion of minor psychiatric morbidity remained undetected by the three primary care doctors: the hidden morbidity ranged from 22% to 79%. When these were compared to those of the case-finding questionnaire, they were consistently lower, indicating that the use of these instruments can enhance the recognition of psychiatric disorders in primary care settings. Four strategies for adopting the questionnaire are described, and some of the clinical consequences of its use are discussed.Objetivou-se avaliar a habilidade de clínicos gerais em diagnosticar distúrbios emocionais na assistência primária, e investigar a possibilidade de se introduzir um questionário de "screening" para auxiliar o diagnóstico de doenças psiquiátricas. O estudo foi realizado em dois centros de saúde e um ambulatório de clínica geral na cidade de São Paulo (Brasil, por um período de 6 meses. Uma amostra representativa de pacientes adultos (16 anos atendidos por clínico geral preencheu um questionário de "screening" para distúrbios psiquiátricos menores. Uma sub-amostra foi selecionada para

  1. Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

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    Alioum Ahmadou

    2011-06-01

    Full Text Available Abstract Background Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children. Methods All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation. Results 405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8 at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71 versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1 at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42. Conclusions Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.

  2. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

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    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

  3. Maternal health care initiatives: Causes of morbidities and mortalities in two rural districts of Upper West Region, Ghana.

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    Joshua Sumankuuro

    Full Text Available Maternal and neonatal morbidities and mortalities have received much attention over the years in sub-Saharan Africa; yet addressing them remains a profound challenge, no more so than in the nation of Ghana. This study focuses on finding explanations to the conditions which lead to maternal and neonatal morbidities and mortalities in rural Ghana, particularly the Upper West Region.Mixed methods approach was adopted to investigate the medical and non-medical causes of maternal and neonatal morbidities and mortalities in two rural districts of the Upper West Region of Ghana. Survey questionnaires, in-depth interviews and focus group discussions were employed to collect data from: a 80 expectant mothers (who were in their second and third trimesters, excluding those in their ninth month, b 240 community residents and c 13 healthcare providers (2 district directors of health services, 8 heads of health facilities and 3 nurses.Morbidity and mortality during pregnancy is attributed to direct causes such urinary tract infection (48%, hypertensive disorders (4%, mental health conditions (7%, nausea (4% and indirect related sicknesses such as anaemia (11%, malaria, HIV/AIDS, oedema and hepatitis B (26%. Socioeconomic and cultural factors are identified as significant underlying causes of these complications and to morbidity and mortality during labour and the postnatal period. Birth asphyxia and traditional beliefs and practices were major causes of neonatal deaths.These findings provide focused targets and open a window of opportunity for the community-based health services run by Ghana Health Service to intensify health education and promotion programmes directed at reducing risky economic activities and other cultural beliefs and practices affecting maternal and neonatal morbidity and mortality.

  4. A model for abnormal activity recognition and alert generation system for elderly care by hidden conditional random fields using R-transform and generalized discriminant analysis features.

    Science.gov (United States)

    Khan, Zafar Ali; Sohn, Won

    2012-10-01

    The growing population of elderly people living alone increases the need for automatic healthcare monitoring systems for elderly care. Automatic vision sensor-based systems are increasingly used for human activity recognition (HAR) in recent years. This study presents an improved model, tested using actors, of a sensor-based HAR system to recognize daily life activities of elderly people at home and generate an alert in case of abnormal HAR. Datasets consisting of six abnormal activities (falling backward, falling forward, falling rightward, falling leftward, chest pain, and fainting) and four normal activities (walking, rushing, sitting down, and standing up) are generated from different view angles (90°, -90°, 45°, -45°). Feature extraction and dimensions reduction are performed by R-transform followed by generalized discriminant analysis (GDA) methods. R-transform extracts symmetric, scale, and translation-invariant features from the sequences of activities. GDA increases the discrimination between different classes of highly similar activities. Silhouette sequences are quantified by the Linde-Buzo-Gray algorithm and recognized by hidden conditional random fields. Experimental results provide an average recognition rate of 94.2% for abnormal activities and 92.7% for normal activities. The recognition rate for the highly similar activities from different view angles shows the flexibility and efficacy of the proposed abnormal HAR and alert generation system for elderly care.

  5. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital.

    Science.gov (United States)

    Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

    2015-01-01

    Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  6. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

    NARCIS (Netherlands)

    Faber, Adrianne; Kalverdijk, Luuk J.; de Jong-van den Berg, Lolkje T. W.; Hugtenburg, Jacqueline G.; Minderaa, Ruud B.; Tobi, Hilde

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

  7. Co-morbidity and patterns of care in stimulant-treated children with ADHD in the Netherlands

    NARCIS (Netherlands)

    Faber, A.; Kalverdijk, L.J.; de Jong-van den Berg, L.T.W.; Hugtenburg, J.G.; Minderaa, R.B.; Tobi, H.

    2010-01-01

    This study aimed at investigating the use of psychosocial interventions and psychotropic co-medication among stimulant-treated children with attention-deficit hyperactivity disorder (ADHD) in relation to the presence of psychiatric co-morbidity. Stimulant users younger than 16 years were identified

  8. Hidden costs: the direct and indirect impact of user fees on access to malaria treatment and primary care in Mali.

    Science.gov (United States)

    Johnson, Ari; Goss, Adeline; Beckerman, Jessica; Castro, Arachu

    2012-11-01

    About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees. This ethnographic study aims to identify consequences of user fees on gender inequality, food insecurity, and household decision-making for a group of women living in poverty. Ethnographic life history interviews were conducted with 24 women in Yirimadjo, Mali in 2007. Purposive sampling selected participants across a broad socio-economic spectrum. Semi-structured interviews addressed participants' past medical history, socio-economic status, social and family history, and access to health care. Interview transcripts were coded using the guiding analytical framework of structural violence. Interviews revealed that user fees for health care not only decreased utilization of health services, but also resulted in delayed presentation for care, incomplete or inadequate care, compromised food security and household financial security, and reduced agency for women in health care decision making. The effects of user fees were amplified by conditions of poverty, as well as gender and health inequality; user fees in turn reinforced the inequalities created by those very conditions. The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization

  9. Social differentiation and embodied dispositions: a qualitative study of maternal care-seeking behaviour for near-miss morbidity in Bolivia

    Directory of Open Access Journals (Sweden)

    Liljestrand Jerker

    2009-07-01

    Full Text Available Abstract Background Use of maternal health care in low-income countries has been associated with several socioeconomic and demographic factors, although contextual analyses of the latter have been few. A previous study showed that 75% of women with severe obstetric morbidity (near-miss identified at hospitals in La Paz, Bolivia were in critical conditions upon arrival, underscoring the significance of pre-hospital barriers also in this setting with free and accessible maternal health care. The present study explores how health care-seeking behaviour for near-miss morbidity is conditioned in La Paz, Bolivia. Methods Thematic interviews with 30 women with a near-miss event upon arrival at hospital. Near-miss was defined based on clinical and management criteria. Modified analytic induction was applied in the analysis that was further influenced by theoretical views that care-seeking behaviour is formed by predisposing characteristics, enabling factors, and perceived need, as well as by socially shaped habitual behaviours. Results The self-perception of being fundamentally separated from "others", meaning those who utilise health care, was typical for women who customarily delivered at home and who delayed seeking medical assistance for obstetric emergencies. Other explanations given by these women were distrust of authority, mistreatment by staff, such as not being kept informed about their condition or the course of their treatment, all of which reinforced their dissociation from the health-care system. Conclusion The findings illustrate health care-seeking behaviour as a practise that is substantially conditioned by social differentiation. Social marginalization and the role health institutions play in shaping care-seeking behaviour have been de-emphasised by focusing solely on endogenous cultural factors in Bolivia.

  10. Enteral Nutrition Support for Abdominal Compartment Syndrome in Morbidly Obese Patient : A Case Report from a Medical Intensive Care Unit (ICU

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    Nurul Huda Razalli

    2018-01-01

    Full Text Available Compartment syndrome occurs when pressure within a closed muscle or bone compartment builds to dangerous levels. This pressure can decrease blood flow to nerve and muscle cells, leading to ischemia and organ dysfunction. Challenges in providing enteral nutrition for abdominal compartment syndrome (ACS patients include the increase risk for developing gastrointestinal symptoms such as diarrhea, constipation and distention. There are limited reports available on the nutritional management of ACS patients in the ICU especially those with morbid obesity condition to guide dietitians in providing nutritional support for these patients.  Here, we report the enteral nutrition management of a mechanically ventilated, morbidly obese patient with ACS in a critical care setting by adopting postpyloric feeding, using prokinetic agents and implementing PO2/FiO2 ratio calculation for prescription of most suitable enteral formula.

  11. THE HIDDEN POWER IN GAPS: COMMUNITY HOME CARE VOLUNTEER GROUP PARTICIPANT OF A CATHOLIC CHURCH IN CARIACICA – ES - BRAZIL

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    Clésio de Oliveira Venâncio

    2012-12-01

    Full Text Available Objective: To examine the voluntary community home care mode while a network of affective work in the region of Porto Santana in Cariacica – one of the municipalities of the Metropolitan Area of Greater Vitória – ES – Brazil. Method: an exploratory study, qualitative approach, held together with a group that develops community home care in the territory in which they live in the period April to October 2010. To obtain data group visits were made, targeted interviews and follow-up on their routines, if configuring a cartographic process. Results: the reports of the group's members and of the observations made during the trail pointed to the materialization of a practice where caring configures itself from the movement of living affections within a territory, having elements that make this natural alternative practice in an environment of constant motion.

  12. Sociology of Hidden Curriculum

    Directory of Open Access Journals (Sweden)

    Alireza Moradi

    2017-06-01

    Full Text Available This paper reviews the concept of hidden curriculum in the sociological theories and wants to explain sociological aspects of formation of hidden curriculum. The main question concentrates on the theoretical approaches in which hidden curriculum is explained sociologically.For this purpose it was applied qualitative research methodology. The relevant data include various sociological concepts and theories of hidden curriculum collected by the documentary method. The study showed a set of rules, procedures, relationships and social structure of education have decisive role in the formation of hidden curriculum. A hidden curriculum reinforces by existed inequalities among learners (based on their social classes or statues. There is, in fact, a balance between the learner's "knowledge receptions" with their "inequality proportion".The hidden curriculum studies from different major sociological theories such as Functionalism, Marxism and critical theory, Symbolic internationalism and Feminism. According to the functionalist perspective a hidden curriculum has a social function because it transmits social values. Marxists and critical thinkers correlate between hidden curriculum and the totality of social structure. They depicts that curriculum prepares learners for the exploitation in the work markets. Symbolic internationalism rejects absolute hegemony of hidden curriculum on education and looks to the socialization as a result of interaction between learner and instructor. Feminism theory also considers hidden curriculum as a vehicle which legitimates gender stereotypes.

  13. Decreased chronic morbidity but elevated HIV associated cytokine levels in HIV-infected older adults receiving HIV treatment: benefit of enhanced access to care?

    Directory of Open Access Journals (Sweden)

    Portia C Mutevedzi

    Full Text Available The association of HIV with chronic morbidity and inflammatory markers (cytokines in older adults (50+years is potentially relevant for clinical care, but data from African populations is scarce.To examine levels of chronic morbidity by HIV and ART status in older adults (50+years and subsequent associations with selected pro-inflammatory cytokines and body mass index.Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina, arthritis, stroke, hypertension, asthma and diabetes and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance.Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92 of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR of having elevated inflammation markers of IL6 (>1.56 pg/mL was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21 and not on (aPOR 1.94; 95%CI: 1.11-3.41 ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004 of having non-clinically significant raised hsCRP levels(>1 ug/mL; ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9 ug/mL;p=0.008.Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services through regular community chronic disease

  14. Hidden consequences of success in pediatrics: parental health-related quality of life--results from the Care Project.

    Science.gov (United States)

    Hatzmann, Janneke; Heymans, Hugo S A; Ferrer-i-Carbonell, Ada; van Praag, Bernard M S; Grootenhuis, Martha A

    2008-11-01

    The number of parents who care for a chronically ill child is increasing. Because of advances in medical care, parental caring tasks are changing. A detailed description of parental health-related quality of life will add to the understanding of the impact of caring for a chronically ill child. This will contribute to pediatric family care. Our goal was to determine the health-related quality of life of parents of chronically ill children compared with parents of healthy schoolchildren. A survey of 533 parents of children with chronic conditions (10 diagnosis groups, children aged 1-19 years, diagnosed >1 year ago, living at home) and 443 parents of schoolchildren was conducted between January 2006 and September 2007. Parents were approached through Emma Children's Hospital (which has a tertiary referral and a regional function) and through parent associations. The comparison group included parents of healthy schoolchildren. Health-related quality of life was assessed with the TNO-AZL Questionnaire for Adult's Health Related Quality of Life. Health-related quality of life measures gross and fine motor function, cognitive functioning, sleep, pain, social functioning, daily activities, sexuality, vitality, positive and depressive emotions, and aggressiveness. The health-related quality of life of the study group was compared with that of the comparison group, and effect sizes were estimated. The percentages of parents at risk for a low health-related quality of life were compared with the 25th percentile scores of the comparison group. RESULTS. Parents of chronically ill children had a significantly lower health-related quality of life. Subgroup analysis showed lower health-related quality of life on sleep, social functioning, daily activities, vitality, positive emotions, and depressive emotions in disease-specific groups. On average, 45% of the parents were at risk for health-related quality-of-life impairment. Parents of chronically ill children report a seriously

  15. A Depth Video-based Human Detection and Activity Recognition using Multi-features and Embedded Hidden Markov Models for Health Care Monitoring Systems

    Directory of Open Access Journals (Sweden)

    Ahmad Jalal

    2017-08-01

    Full Text Available Increase in number of elderly people who are living independently needs especial care in the form of healthcare monitoring systems. Recent advancements in depth video technologies have made human activity recognition (HAR realizable for elderly healthcare applications. In this paper, a depth video-based novel method for HAR is presented using robust multi-features and embedded Hidden Markov Models (HMMs to recognize daily life activities of elderly people living alone in indoor environment such as smart homes. In the proposed HAR framework, initially, depth maps are analyzed by temporal motion identification method to segment human silhouettes from noisy background and compute depth silhouette area for each activity to track human movements in a scene. Several representative features, including invariant, multi-view differentiation and spatiotemporal body joints features were fused together to explore gradient orientation change, intensity differentiation, temporal variation and local motion of specific body parts. Then, these features are processed by the dynamics of their respective class and learned, modeled, trained and recognized with specific embedded HMM having active feature values. Furthermore, we construct a new online human activity dataset by a depth sensor to evaluate the proposed features. Our experiments on three depth datasets demonstrated that the proposed multi-features are efficient and robust over the state of the art features for human action and activity recognition.

  16. Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries

    Science.gov (United States)

    Taylor, Melanie M.; Nurse-Findlay, Stephen; Zhang, Xiulei; Hedman, Lisa; Kamb, Mary L.; Broutet, Nathalie; Kiarie, James

    2016-01-01

    Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Methods Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Results Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases. Conclusion Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment

  17. [Hypothermia risk factors in the very low weight newborn and associated morbidity and mortality in a neonatal care unit].

    Science.gov (United States)

    García-Muñoz Rodrigo, F; Rivero Rodríguez, S; Siles Quesada, C

    2014-03-01

    Heat loss in the newborn after delivery could interfere with post-natal adaptation due to metabolic and hemodynamic instability. Associated perinatal factors and their relationship with morbidity and mortality during the neonatal period have not been systematically studied in our unit. To determine the temperature of very low birth weight (VLBW) infants on admission to our NICU, and to determine the associated perinatal variables, and the association of temperature with morbidity and mortality. Infants born in our maternity from January 2006 to November 2012, with birth weights (BW) 401 g to 1,499 g and/or less than 30 weeks gestational age, were included. A multivariate analysis was performed using the perinatal variables and the temperature on admission, as well as a logistic regression between these and the morbidity-mortality variables, in order to detect any independent associations. A total of 635 infants were included, with a mean (± SD) birth weight and gestational age of 1,137.6 ± 257.6g, and 29.5 ± 2.0 weeks, respectively. The mean admission temperature was 35.8 ± 0.6°C (range: 33.0-37.8°C). The proportion of infants with a temperature < 36°C was 44.4%. Independently associated perinatal variables were chorioamnionitis, birth weight, vaginal delivery, and advanced cardiopulmonary resuscitation (CPR). Admission hypothermia was associated with severe intraventricular haemorrhage (IVH) (grades 3 and 4) (OR: 0.377; 95% CI: 0.221-0.643; P<.001), and mortality (OR: 0.329; 95% CI: 0.208-0.519; P=.012). Hypothermia on admission is frequent among our VLBW infants. Birth weight, vaginal delivery, and advanced CPR were the principal variables associated with hypothermia. A low temperature on admission was related to an increased risk of IVH and mortality. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Child-care attendance and common morbidity: evidence of association in the literature and questions of design

    Directory of Open Access Journals (Sweden)

    Barros Aluísio J. D.

    1999-01-01

    Full Text Available Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

  19. Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives.

    Science.gov (United States)

    Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash

    2013-12-01

    The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.

  20. [Comparison of development and mortality under domestic or institutional care with and without medical rehabilitation : The Hannover morbidity and mortality long-term care study].

    Science.gov (United States)

    Seger, W; Sittaro, N-A; Lohse, R; Rabba, J

    2013-12-01

    Empirical data, representative of the total population, are necessary for medico-actuarial risk calculations. Our study compares mortalities of long-term care (LTC) patients who are covered by statutory health insurance with regard to age and distribution of care levels when in home or institutional care with a special focus on whether rehabilitative care was performed. The data of 88,575 LTC patients were analyzed longitudinally for 10 years, using routine data analyses on the files of the German Federal Health Insurance fund (average observation period 2.5 years, a total of 221,625 observation years). The numbers of LTC patients and their care levels while in home or institutional care were calculated, as were any changes to another care level or discontinuation of LTC benefits (as a result of the need for care falling below the eligibility criteria for care leveI or to death) during 1-10 years after the onset of LTC, always with respect to whether rehabilitative care had taken place or not. For the evaluation of care factors an indicator was developed. Total mortality was found to decline and reactivation to increase considerably for LTC patients after rehabilitation, basically irrespective of their age or care level and in home or institutional care settings as well. Ten years after the onset of care, 30.7 % of the patients with rehabilitation were still in nursing care, 9.8 % were reactivated and 59.5 % deceased. In contrast, only 9.2 % were still in nursing care, 3.7 % reactivated and 87.1 % deceased without rehabilitation. These results are irrespective of age distribution, care level, and residence in home or institutional care settings. The care status of patients, measured by the percentage in reactivation, care level I-III, and death, substantially depends on age at onset and care level and in addition on rehabilitative procedures. Hypotheses for further research are outlined. Rehabilitation has a clear-cut potential for life extension as

  1. Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis.

    Science.gov (United States)

    Walker, Patrick G T; White, Michael T; Griffin, Jamie T; Reynolds, Alison; Ferguson, Neil M; Ghani, Azra C

    2015-07-01

    The ongoing Ebola epidemic in parts of west Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved over the past decade. We quantified this additional indirect burden of Ebola virus disease. We estimated the number of cases and deaths from malaria in Guinea, Liberia, and Sierra Leone from Demographic and Health Surveys data for malaria prevalence and coverage of malaria interventions before the Ebola outbreak. We then removed the effect of treatment and hospital care to estimate additional cases and deaths from malaria caused by reduced health-care capacity and potential disruption of delivery of insecticide-treated bednets. We modelled the potential effect of emergency mass drug administration in affected areas on malaria cases and health-care demand. If malaria care ceased as a result of the Ebola epidemic, untreated cases of malaria would have increased by 45% (95% credible interval 43-49) in Guinea, 88% (83-93) in Sierra Leone, and 140% (135-147) in Liberia in 2014. This increase is equivalent to 3·5 million (95% credible interval 2·6 million to 4·9 million) additional untreated cases, with 10,900 (5700-21,400) additional malaria-attributable deaths. Mass drug administration and distribution of insecticide-treated bednets timed to coincide with the 2015 malaria transmission season could largely mitigate the effect of Ebola virus disease on malaria. These findings suggest that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems. UK Medical Research Council, UK Department for International Development, Bill & Melinda Gates Foundation. Copyright © 2015 Walker et al. Open Access article distributed under the terms of CC BY

  2. POVMs and hidden variables

    International Nuclear Information System (INIS)

    Stairs, Allen

    2007-01-01

    Recent results by Paul Busch and Adan Cabello claim to show that by appealing to POVMs, non-contextual hidden variables can be ruled out in two dimensions. While the results of Busch and Cabello are mathematically correct, interpretive problems render them problematic as no hidden variable proofs

  3. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression where...

  4. The Fiscal Consequences Attributed to Changes in Morbidity and Mortality Linked to Investments in Health Care: A Government Perspective Analytic Framework.

    Science.gov (United States)

    Connolly, Mark P; Kotsopoulos, Nikolaos; Postma, Maarten J; Bhatt, Aomesh

    2017-02-01

    Governments have an enormous economic and political stake in the health of their populations. Population health is not only fundamental to economic growth but also affects short-term and long-term government expenditure on health care, disability, and other social programs and influences direct and indirect tax receipts. Fiscal transfers between citizen and state are mostly ignored in conventional welfare economics analyses based on the hypothesis that there are no winners or losers through transference of wealth. However, from the government perspective, this position is flawed, as disability costs and lost taxes attributed to poor health and reduced productive output represent real costs that pose budgetary and growth implications. To address the value of health and health care investments for government, we have developed a fiscal health analytic framework that captures how changes in morbidity and mortality influence tax revenue and transfer costs (e.g., disability, allowances, ongoing health costs). The framework can be used to evaluate the marginal impact of discrete investments or a mix of interventions in health care to inform governmental budgetary consequences. In this context, the framework can be considered as a fiscal budget impact and/or cost-benefit analysis model that accounts for how morbidity and mortality linked to specific programs represent both ongoing costs and tax revenue for government. Mathematical models identical to those used in cost-effectiveness analyses can be employed in fiscal analysis to reflect how disease progression influences public accounts (e.g., tax revenue and transfers). Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia: a cross-sectional study.

    Science.gov (United States)

    Ivanovs, R; Kivite, A; Ziedonis, D; Mintale, I; Vrublevska, J; Rancans, E

    2018-03-06

    Cardiovascular (CV) diseases (CVDs) are the leading cause of mortality worldwide. Globally, there is a growing interest in understanding and addressing modifiable psychosocial risk factors, particularly depression and anxiety, to prevent CVDs and to reduce morbidity and mortality. Despite the high premature mortality rate from CVDs in Latvia, this is the first Latvian study to examine the association of depression and anxiety with CVD morbidity in a primary care population. This cross-sectional study was carried out in 2015 within the framework of the National Research Program BIOMEDICINE at 24 primary care facilities throughout Latvia. Consecutive adult patients during a one-week time period at each facility were invited to join the study. Assessments onsite included a 9-item Patient Health Questionnaire (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7) followed by a socio-demographic questionnaire and measurements of height, weight, waist circumference, blood pressure, and total cholesterol. The diagnostic Mini International Neuropsychiatric Interview (MINI) was conducted over the telephone within 2 weeks after the visit to the general practitioner. A multivariate model was developed using binary logistic regression. From the 1565 subjects (31.2% male), CVD was detected in 17.1%. Depression screening was positive (PHQ-9 ≥ 10) for 14.7%, and anxiety screening was positive (GAD-7 ≥ 10) for 10.1% of the study subjects. According to the MINI, 10.3% had current and 28.1% had lifetime depressive episode, and 16.1% had an anxiety disorder. Depression, not anxiety, was statistically significantly related to CVDs with an odds ratio (OR) of 1.52 (p = 0.04) for current depressive symptoms (PHQ-9 ≥ 10) and 2.08 (p = 0.002) for lifetime depressive episode (MINI). Current depressive symptoms (PHQ-9 ≥ 10) and a lifetime depressive episode (according to the MINI) were significantly associated with increased risk of CV morbidity

  6. Assessing the link between health care utilisation in general practice and morbidity patterns in the elderly in the Nordic countries

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels; Ranstad, Karin

    important areas of healthcare utilisation in general practice in the Nordic countries. In the future, this demand for healthcare services among the elderly is expected to increase. For instance, it is likely that people live longer and advanced technologies continue to be developed, affecting demand...... and diabetes). Today we have limited information on the need for social services and health care services for the elderly in the Nordic countries. There is a need for improved understanding of variation in healthcare utilization and methods to measure the actual need for healthcare services among older......Objectives: The objective is to describe and analyze the prevalence of comorbidity and multimorbidity among older people with extensive and complex care needs. Next, the main objective is to present and discuss papers on the association between healthcare utilisation in general practice...

  7. Hidden gauge symmetry

    International Nuclear Information System (INIS)

    O'Raifeartaigh, L.

    1979-01-01

    This review describes the principles of hidden gauge symmetry and of its application to the fundamental interactions. The emphasis is on the structure of the theory rather than on the technical details and, in order to emphasise the structure, gauge symmetry and hidden symmetry are first treated as independent phenomena before being combined into a single (hidden gauge symmetric) theory. The main application of the theory is to the weak and electromagnetic interactions of the elementary particles, and although models are used for comparison with experiment and for illustration, emphasis is placed on those features of the application which are model-independent. (author)

  8. The hidden universe

    International Nuclear Information System (INIS)

    Disney, M.

    1985-01-01

    Astronomer Disney has followed a somewhat different tack than that of most popular books on cosmology by concentrating on the notion of hidden (as in not directly observable by its own radiation) matter in the universe

  9. Locating Hidden Servers

    National Research Council Canada - National Science Library

    Oeverlier, Lasse; Syverson, Paul F

    2006-01-01

    .... Announced properties include server resistance to distributed DoS. Both the EFF and Reporters Without Borders have issued guides that describe using hidden services via Tor to protect the safety of dissidents as well as to resist censorship...

  10. Hidden charged dark matter

    International Nuclear Information System (INIS)

    Feng, Jonathan L.; Kaplinghat, Manoj; Tu, Huitzu; Yu, Hai-Bo

    2009-01-01

    Can dark matter be stabilized by charge conservation, just as the electron is in the standard model? We examine the possibility that dark matter is hidden, that is, neutral under all standard model gauge interactions, but charged under an exact (\\rm U)(1) gauge symmetry of the hidden sector. Such candidates are predicted in WIMPless models, supersymmetric models in which hidden dark matter has the desired thermal relic density for a wide range of masses. Hidden charged dark matter has many novel properties not shared by neutral dark matter: (1) bound state formation and Sommerfeld-enhanced annihilation after chemical freeze out may reduce its relic density, (2) similar effects greatly enhance dark matter annihilation in protohalos at redshifts of z ∼ 30, (3) Compton scattering off hidden photons delays kinetic decoupling, suppressing small scale structure, and (4) Rutherford scattering makes such dark matter self-interacting and collisional, potentially impacting properties of the Bullet Cluster and the observed morphology of galactic halos. We analyze all of these effects in a WIMPless model in which the hidden sector is a simplified version of the minimal supersymmetric standard model and the dark matter is a hidden sector stau. We find that charged hidden dark matter is viable and consistent with the correct relic density for reasonable model parameters and dark matter masses in the range 1 GeV ∼ X ∼< 10 TeV. At the same time, in the preferred range of parameters, this model predicts cores in the dark matter halos of small galaxies and other halo properties that may be within the reach of future observations. These models therefore provide a viable and well-motivated framework for collisional dark matter with Sommerfeld enhancement, with novel implications for astrophysics and dark matter searches

  11. Effects of a Birth Hospital's Neonatal Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight Infant Deliveries on Morbidity and Mortality.

    Science.gov (United States)

    Jensen, Erik A; Lorch, Scott A

    2015-08-01

    The annual volume of deliveries of very low-birth-weight (VLBW) infants has a greater effect on mortality risk than does neonatal intensive care unit (NICU) level. The differential effect of these hospital factors on morbidity among VLBW infants is uncertain. To assess the independent effects of a birth hospital's annual volume of VLBW infant deliveries and NICU level on the risk of several neonatal morbidities and morbidity-mortality composite outcomes that are predictive of future neurocognitive development. Retrospective, population-based cohort study (performed in 2014) of all VLBW infants without severe congenital anomalies delivered in all hospitals in California, Missouri, and Pennsylvania between January 1, 1999, and December 31, 2009 (N = 72,431). Risk-adjusted odds ratios and risk-adjusted probabilities were determined by logistic regression. The primary study outcomes were the individual composites of death or bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, and severe intraventricular hemorrhage. Among the 72,431 VLBW infants in the present study, birth at a hospital with 10 or less deliveries of VLBW infants per year was associated with the highest risk-adjusted probability of death (15.3% [95% CI, 14.4%-16.3%]), death or severe intraventricular hemorrhage (17.5% [95% CI, 16.5%-18.6%]), and death or necrotizing enterocolitis (19.3% [95% CI, 18.1%-20.4%]). These complications were also more common among infants born at hospitals with a level I or II NICU compared with infants delivered at hospitals with a level IIIB/C NICU. The risk-adjusted probability of death or retinopathy of prematurity was highest among infants born at hospitals with a level IIIB/C NICU and lowest among infants born at hospitals with a level IIIA NICU. When the effects of NICU level and annual volume of VLBW infant deliveries were evaluated simultaneously, the annual volume of deliveries was the stronger contributor to the risk of death, death or

  12. Social determinants and maternal exposure to intimate partner violence of obstetric patients with severe maternal morbidity in the intensive care unit: a systematic review protocol.

    Science.gov (United States)

    Ayala Quintanilla, Beatriz Paulina; Taft, Angela; McDonald, Susan; Pollock, Wendy; Roque Henriquez, Joel Christian

    2016-11-28

    Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU. This study aimed to conduct a systematic review of the social determinants and exposure to intimate partner violence of obstetric patients admitted to an ICU. A systematic search will be conducted in MEDLINE, CINAHL, ProQuest, LILACS and SciELO from 2000 to 2016. Studies published in English and Spanish will be identified in relation to data reporting on social determinants of health and/or exposure to intimate partner violence of obstetric women, treated in the ICU during pregnancy, childbirth or within 42 days of the end of pregnancy. Two reviewers will independently screen for study eligibility and data extraction. Risk of bias and assessment of the quality of the included studies will be performed by using the Critical Appraisal Skills Programme (CASP) checklist. Data will be analysed and summarised using a narrative description of the available evidence across studies. This systematic review protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Since this systematic review will be based on published studies, ethical approval is not required. Findings will be presented at La Trobe University, in Conferences and Congresses, and published in a peer-reviewed journal. CRD42016037492. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. A chart review of morbidity patterns among adult patients attending primary care setting in urban Odisha, India: An International Classification of Primary Care experience

    Directory of Open Access Journals (Sweden)

    Subhashisa Swain

    2017-01-01

    Full Text Available Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities. Data collection spanned from May to October 2012. At each center, patients' information on age, sex, religion, and presenting illness was extracted from the outpatient records over these time period. Data were entered and analyzed in SPSS version 20, and the International Classification of Primary Care-2 was used for coding the illnesses. Results: In total, 2249 patient's records were extracted over 12 weeks. Out of them, 1241 (55.2% were male with mean age of 41.8 (±15.8 years vis-à -vis 38.2 (±14.1 years for females. Around 151 (6.7% had 2 or more symptoms or conditions. Overall, the most common categories were general and unspecified followed by digestive-related symptoms in both sexes. The most common symptoms among males were fever (11.4%, heart burn (8.1%, and vertigo or dizziness (3.6%. Similar pattern was seen among females. Respiratory (17.0% and cardiovascular (10.2% problems were the most common RFEs among males and females. The most common RFEs for acute care among males and females were fever, allergic rhinitis, upper respiratory tract infection, and acute bronchitis. Leading RFEs for chronic care among males were hypertension uncomplicated, heart burn, low back pain, whereas among females, hypertension and heartburn were mostly seen. Conclusion: Primary care settings are experiencing both communicable

  14. Search for Hidden Particles

    CERN Multimedia

    Solovev, V

    The SHiP Experiment is a new general-purpose fixed target facility at the SPS to search for hidden particles as predicted by a very large number of recently elaborated models of Hidden Sectors which are capable of accommodating dark matter, neutrino oscillations, and the origin of the full baryon asymmetry in the Universe. Specifically, the experiment is aimed at searching for very weakly interacting long lived particles including Heavy Neutral Leptons - right-handed partners of the active neutrinos; light supersymmetric particles - sgoldstinos, etc.; scalar, axion and vector portals to the hidden sector. The high intensity of the SPS and in particular the large production of charm mesons with the 400 GeV beam allow accessing a wide variety of light long-lived exotic particles of such models and of SUSY. Moreover, the facility is ideally suited to study the interactions of tau neutrinos.

  15. Interventions targeted at primary care practitioners to improve the identification and referral of patients with co-morbid obesity: a realist review protocol.

    Science.gov (United States)

    Blane, David N; Macdonald, Sara; Morrison, David; O'Donnell, Catherine A

    2015-05-01

    Obesity is one of the most significant public health challenges in the developed world. Recent policy has suggested that more can be done in primary care to support adults with obesity. In particular, general practitioners (GPs) and practice nurses (PNs) could improve the identification and referral of adults with obesity to appropriate weight management services. Previous interventions targeted at primary care practitioners in this area have had mixed results, suggesting a more complex interplay between patients, practitioners, and systems. The objectives of this review are (i) to identify the underlying 'programme theory' of interventions targeted at primary care practitioners to improve the identification and referral of adults with obesity and (ii) to explore how and why GPs and PNs identify and refer individuals with obesity, particularly in the context of weight-related co-morbidity. This protocol will explain the rationale for using a realist review approach and outline the key steps in this process. Realist review is a theory-led approach to knowledge synthesis that provides an explanatory analysis aimed at discerning what works, for whom, in what circumstances, how, and why. In this review, scoping interviews with key stakeholders involved in the planning and delivery of adult weight management services in Scotland helped to inform the identification of formal theories - from psychology, sociology, and implementation science - that will be tested as the review progresses. A comprehensive search strategy is described, including scope for iterative searching. Data analysis is outlined in three stages (describing context-mechanism-outcome configurations, exploring patterns in these configurations, and developing and testing middle-range theories, informed by the formal theories previously identified), culminating in the production of explanatory programme theory that considers individual, interpersonal, and institutional/systems-level components. This is the

  16. Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006).

    Science.gov (United States)

    Mohamed Zaki, Lily R; Hairi, Noran N

    2014-12-01

    The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population. This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report. Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service. Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Influence of educational attainments on long term glucose control and morbid events in patients with type 2 diabetes receiving integrated care from 15 China urban communities: The Beijing Community Diabetes Study 11.

    Science.gov (United States)

    Yang, Guang-Ran; Yuan, Shen-Yuan; Fu, Han-Jing; Wan, Gang; Zhu, Liang-Xiang; Yuan, Ming-Xia; Lv, Yu-Jie; Zhang, Jian-Dong; Du, Xue-Ping; Li, Yu-Ling; Ji, Yu; Zhou, Li; Li, Yue

    2015-12-01

    To investigate the effects of educational attainment on glucose control and morbid events in patients with type 2 diabetes in Beijing communities. In this prospective multi-center study, 2866 type 2 diabetes patients receiving integrated care from 15 Beijing urban communities were investigated. Educational attainment was categorized into three levels: low, medium, and high. After a 42-month management, glucose control parameters and morbid events were analyzed. At baseline, the percentages of patients with good glucose control (HbA1c ≤ 7.0%) in the low, medium and high educational groups were 49.09%, 54.82% and 62.59%, respectively (Peducational group (7.51 ± 2.05 mmol/l and 7.20 ± 1.27%, respectively). Percentages of patients with good glucose control in the three groups were 49.6%, 55.83% and 67.23%, respectively, and the incidences of combined morbid events were 4.5%, 2.4% and 1.5%, respectively. Cox regression analysis showed that educational level was related to the incidence of combined morbid events (medium level, HR=0.572; high level, HR=0.351; PEducational level was associated with long-term glucose control, and seemed to be related to the incidence of combined morbid events in people with type 2 diabetes. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  18. The hidden values

    DEFF Research Database (Denmark)

    Rasmussen, Birgitte; Jensen, Karsten Klint

    “The Hidden Values - Transparency in Decision-Making Processes Dealing with Hazardous Activities”. The report seeks to shed light on what is needed to create a transparent framework for political and administrative decisions on the use of GMOs and chemical products. It is our hope that the report...

  19. Clostridium difficile infection in patients hospitalized with type 2 diabetes mellitus and its impact on morbidity, mortality, and the costs of inpatient care.

    Science.gov (United States)

    Olanipekun, Titilope O; Salemi, Jason L; Mejia de Grubb, Maria C; Gonzalez, Sandra J; Zoorob, Roger J

    2016-06-01

    Type 2 diabetes mellitus (T2DM) is often complicated by infections leading to hospitalization, increased morbidity, and mortality. Not much is known about the impact of Clostridium difficile infection (CDI) on health outcomes in hospitalized patients with T2DM. We estimated the prevalence and temporal trends of CDI; evaluated the associations between CDI and in-hospital mortality, length of stay (LOS), and the costs of inpatient care; and compared the impact of CDI with that of other infections commonly seen in patients with T2DM. We conducted a cross-sectional analysis using data from the Nationwide Inpatient Sample among patients ⩾18years with T2DM and generalized linear regression was used to analyze associations and jointpoint regression for trends. The prevalence of CDI was 6.8 per 1000 hospital discharges. Patients with T2DM and CDI had increased odds of in-hospital mortality (OR, 3.63; 95% CI 3.16, 4.17). The adjusted mean LOS was higher in patients with CDI than without CDI (11.9 vs. 4.7days). That translated to average hospital costs of $23,000 and $9100 for patients with and without CDI, respectively. The adjusted risk of mortality in patients who had CDI alone (OR 3.75; 95% CI 3.18, 4.41) was similar to patients who had CDI in addition to other common infections (OR 3.25; 95% CI 2.58, 4.10). CDI is independently associated with poorer health outcomes in patients with T2DM. We recommend close surveillance for CDI in hospitalized patients and further studies to determine the cost effectiveness of screening for CDI among patients with T2DM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Hidden neural networks

    DEFF Research Database (Denmark)

    Krogh, Anders Stærmose; Riis, Søren Kamaric

    1999-01-01

    A general framework for hybrids of hidden Markov models (HMMs) and neural networks (NNs) called hidden neural networks (HNNs) is described. The article begins by reviewing standard HMMs and estimation by conditional maximum likelihood, which is used by the HNN. In the HNN, the usual HMM probability...... parameters are replaced by the outputs of state-specific neural networks. As opposed to many other hybrids, the HNN is normalized globally and therefore has a valid probabilistic interpretation. All parameters in the HNN are estimated simultaneously according to the discriminative conditional maximum...... likelihood criterion. The HNN can be viewed as an undirected probabilistic independence network (a graphical model), where the neural networks provide a compact representation of the clique functions. An evaluation of the HNN on the task of recognizing broad phoneme classes in the TIMIT database shows clear...

  1. A hidden history

    OpenAIRE

    Peppers, Emily

    2008-01-01

    The Cultural Collections Audit project began at the University of Edinburgh in 2004, searching for hidden treasures in its 'distributed heritage collections' across the university. The objects and collections recorded in the Audit ranged widely from fine art and furniture to historical scientific and teaching equipment and personalia relating to key figures in the university's long tradition of academic excellence. This information was gathered in order to create a central database of informa...

  2. Distinguishing Hidden Markov Chains

    OpenAIRE

    Kiefer, Stefan; Sistla, A. Prasad

    2015-01-01

    Hidden Markov Chains (HMCs) are commonly used mathematical models of probabilistic systems. They are employed in various fields such as speech recognition, signal processing, and biological sequence analysis. We consider the problem of distinguishing two given HMCs based on an observation sequence that one of the HMCs generates. More precisely, given two HMCs and an observation sequence, a distinguishing algorithm is expected to identify the HMC that generates the observation sequence. Two HM...

  3. Coupling of Hidden Sector

    OpenAIRE

    Królikowski, Wojciech

    2016-01-01

    A hypothetic Hidden Sector of the Universe, consisting of sterile fer\\-mions (``sterinos'') and sterile mediating bosons (``sterons'') of mass dimension 1 (not 2!) --- the last described by an antisymmetric tensor field --- requires to exist also a scalar isovector and scalar isoscalar in order to be able to construct electroweak invariant coupling (before spontaneously breaking its symmetry). The introduced scalar isoscalar might be a resonant source for the diphoton excess of 750 GeV, sugge...

  4. Discovering hidden sectors with monophoton Z' searches

    International Nuclear Information System (INIS)

    Gershtein, Yuri; Petriello, Frank; Quackenbush, Seth; Zurek, Kathryn M.

    2008-01-01

    In many theories of physics beyond the standard model, from extra dimensions to Hidden Valleys and models of dark matter, Z ' bosons mediate between standard model particles and hidden sector states. We study the feasibility of observing such hidden states through an invisibly decaying Z ' at the LHC. We focus on the process pp→γZ ' →γXX † , where X is any neutral, (quasi-) stable particle, whether a standard model neutrino or a new state. This complements a previous study using pp→ZZ ' →l + l - XX † . Only the Z ' mass and two effective charges are needed to describe this process. If the Z ' decays invisibly only to standard model neutrinos, then these charges are predicted by observation of the Z ' through the Drell-Yan process, allowing discrimination between Z ' decays to standard model ν's and invisible decays to new states. We carefully discuss all backgrounds and systematic errors that affect this search. We find that hidden sector decays of a 1 TeV Z ' can be observed at 5σ significance with 50 fb -1 at the LHC. Observation of a 1.5 TeV state requires super-LHC statistics of 1 ab -1 . Control of the systematic errors, in particular, the parton distribution function uncertainty of the dominant Zγ background, is crucial to maximize the LHC search reach.

  5. Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: Clinical article.

    Science.gov (United States)

    Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A; Lokhnygina, Yuliya V; Friedman, Allan H; Gottfried, Oren N; Isaacs, Robert E; Boakye, Maxwell; Patil, Chirag G; Bagley, Carlos A; Haglund, Michael M; Lad, Shivanand P

    2014-10-01

    The Accreditation Council for Graduate Medical Education (ACGME) implemented resident duty-hour restrictions on July 1, 2003, in concern for patient and resident safety. Whereas studies have shown that duty-hour restrictions have increased resident quality of life, there have been mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay (LOS), and charges in patients who underwent spine surgery. The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, LOS, and charges by comparing the prereform (2000-2002) and postreform (2005-2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. Results A total of 693,058 patients were included in the study. The overall complication rate was 8.6%, with patients in the postreform era having a significantly higher rate than those in the pre-duty-hour restriction era (8.7% vs. 8.4%, p duty-hour reform era. The DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching institutions to had a significantly greater increase in complications during the postreform era (p = 0.0002). The overall mortality rate was 0.37%, with no significant difference between the pre- and post-duty-hour eras (0.39% vs. 0.36%, p = 0.12). However, the mortality rate significantly decreased in nonteaching hospitals in the postreform era (0.30% vs. 0.23%, p = 0.0008), while remaining the same in teaching institutions (0.46% vs. 0.46%, p = 0.75). The DID analysis to compare the changes in mortality between groups revealed that the difference between the effects approached significance (p = 0.069). The mean LOS for all patients was 4.2 days, with hospital stay decreasing in nonteaching hospitals (3.7 vs. 3.5 days, p duty-hour reform era, increasing from $40,000 in

  6. Anaesthetic and Obstetric challenges of morbid obesity in ...

    African Journals Online (AJOL)

    Anaesthetic and Obstetric challenges of morbid obesity in caesarean ... in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre. ... This mirrors a World Health Organisation report published in the World Health ...

  7. Localization of hidden Chua's attractors

    International Nuclear Information System (INIS)

    Leonov, G.A.; Kuznetsov, N.V.; Vagaitsev, V.I.

    2011-01-01

    The classical attractors of Lorenz, Rossler, Chua, Chen, and other widely-known attractors are those excited from unstable equilibria. From computational point of view this allows one to use numerical method, in which after transient process a trajectory, started from a point of unstable manifold in the neighborhood of equilibrium, reaches an attractor and identifies it. However there are attractors of another type: hidden attractors, a basin of attraction of which does not contain neighborhoods of equilibria. In the present Letter for localization of hidden attractors of Chua's circuit it is suggested to use a special analytical-numerical algorithm. -- Highlights: → There are hidden attractors: basin doesn't contain neighborhoods of equilibria. → Hidden attractors cannot be reached by trajectory from neighborhoods of equilibria. → We suggested special procedure for localization of hidden attractors. → We discovered hidden attractor in Chua's system, L. Chua in his work didn't expect this.

  8. Estimation of morbidity effects

    International Nuclear Information System (INIS)

    Ostro, B.

    1994-01-01

    Many researchers have related exposure to ambient air pollution to respiratory morbidity. To be included in this review and analysis, however, several criteria had to be met. First, a careful study design and a methodology that generated quantitative dose-response estimates were required. Therefore, there was a focus on time-series regression analyses relating daily incidence of morbidity to air pollution in a single city or metropolitan area. Studies that used weekly or monthly average concentrations or that involved particulate measurements in poorly characterized metropolitan areas (e.g., one monitor representing a large region) were not included in this review. Second, studies that minimized confounding ad omitted variables were included. For example, research that compared two cities or regions and characterized them as 'high' and 'low' pollution area were not included because of potential confounding by other factors in the respective areas. Third, concern for the effects of seasonality and weather had to be demonstrated. This could be accomplished by either stratifying and analyzing the data by season, by examining the independent effects of temperature and humidity, and/or by correcting the model for possible autocorrelation. A fourth criterion for study inclusion was that the study had to include a reasonably complete analysis of the data. Such analysis would include an careful exploration of the primary hypothesis as well as possible examination of te robustness and sensitivity of the results to alternative functional forms, specifications, and influential data points. When studies reported the results of these alternative analyses, the quantitative estimates that were judged as most representative of the overall findings were those that were summarized in this paper. Finally, for inclusion in the review of particulate matter, the study had to provide a measure of particle concentration that could be converted into PM10, particulate matter below 10

  9. Hidden Liquidity: Determinants and Impact

    OpenAIRE

    Gökhan Cebiroglu; Ulrich Horst

    2012-01-01

    We cross-sectionally analyze the presence of aggregated hidden depth and trade volume in the S&P 500 and identify its key determinants. We find that the spread is the main predictor for a stock’s hidden dimension, both in terms of traded and posted liquidity. Our findings moreover suggest that large hidden orders are associated with larger transaction costs, higher price impact and increased volatility. In particular, as large hidden orders fail to attract (latent) liquidity to the market, ...

  10. Re-offending in forensic patients released from secure care: the role of antisocial/borderline personality disorder co-morbidity, substance dependence and severe childhood conduct disorder.

    Science.gov (United States)

    Howard, Rick; McCarthy, Lucy; Huband, Nick; Duggan, Conor

    2013-07-01

    Research suggests that a particular externalising phenotype, manifested in a developmental trajectory from severe childhood conduct disorder through early-onset substance abuse to adult antisocial/borderline personality disorder co-morbidity, may increase risk of antisocial behaviour in general and criminal recidivism in particular. This study aims to test the hypothesis that antisocial/borderline co-morbidity together with the triad of substance dependence, severe conduct disorder and borderline pathology would result in an increased risk of criminal recidivism. Fifty-three men who had been assessed and treated in a secure hospital unit were followed up after they had returned to the community. They were assessed for severity of the following: (i) antisocial personality disorder; (ii) borderline personality disorder; (iii) drug/alcohol dependence; and (iv) high Psychopathy Checklist Revised scores (factors 1 and 2). Patients with antisocial/borderline co-morbidity took significantly less time to re-offend compared with those without such co-morbidity. Both Psychopathy Checklist Revised factor 2 and the tripartite risk measure significantly predicted time to re-offence; the former largely accounted for the predictive accuracy of the latter. Risk of criminal recidivism can be adequately assessed without recourse to the pejorative term 'psychopath'. It is sufficient to assess the presence of the three elements of our risk measure: borderline and antisocial personality disorders in the context of drug/alcohol dependence and severe childhood conduct disorder. Practical implications of the study are as follows. (i) Sound assessment of personality, inclusive of a detailed history of childhood conduct disorder as well as adolescent and adult substance misuse, yields good enough information about risk of recidivism without recourse to the pejorative concept of 'psychopathy'. (ii) Given the high risk of alcohol-related violence in individuals with antisocial/borderline co-morbidity

  11. Hidden Risk Factors for Women

    Science.gov (United States)

    ... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women Need To Know About The Hidden Risk Factors ... 2012) This year, more than 100,000 U.S. women under 65 will have a stroke. Stroke is ...

  12. Higgs Portal into Hidden Sectors

    CERN Multimedia

    CERN. Geneva

    2007-01-01

    Several attractive theoretical ideas suggest the existence of one or more 'hidden sectors' consisting of standard model singlet fields, some of which may not be too heavy. There is a profound reason to think that the Higgs sector might provide the first access to these hidden sectors. This scenario could affect Higgs phenomenology in drastic ways.

  13. An analysis of England's nursing policy on compassion and the 6Cs: the hidden presence of M. Simone Roach's model of caring.

    Science.gov (United States)

    Bradshaw, Ann

    2016-03-01

    In 2012, chief nursing officers (CNO) in England published a policy on compassion in response to serious criticisms of patients' care. Because their objective is fundamentally to shape nursing, this study argues, following Popper, that the policy should be analysed. An appraisal tool, developed from Popper, Gadamer, Jauss and Thiselton, is the framework for this analysis. The CNO policy document identified six values and behaviours, termed '6Cs', required by all nurses, midwives and care staff. The document contains no data, references or acknowledgements, but is similar to the 6Cs defined by the Canadian nursing nun, Sister M. Simone Roach, in her theory of caring published 30 years earlier. Roach considered caring and the components of it, including compassion, to be moral virtues, an inner motivation to care. This study suggests that without explicit reference to Roach's ideas, and her underlying theoretical base, the CNO requirement has the effect of turning virtues into commodities and a form of external control, described by Ritzer as a McDonaldized dehumanization. This study, which has international relevance beyond England and the UK, suggests that the CNO revise their policy by acknowledging Roach's 6Cs and openly discuss the implications of her work for their policy. © 2015 John Wiley & Sons Ltd.

  14. A Hidden History: A Survey of the Teaching of Eugenics in Health, Social Care and Pedagogical Education and Training Courses in Europe

    Science.gov (United States)

    Atherton, H. L.; Steels, S. L.

    2016-01-01

    Knowledge and understanding of how eugenics has historically affected the lives of people with intellectual disabilities is vital if professionals are to mount an effective defence against its contemporary influences. An online survey of European providers of health, social care and pedagogical education and training courses was undertaken to find…

  15. Hidden attractors in dynamical systems

    Science.gov (United States)

    Dudkowski, Dawid; Jafari, Sajad; Kapitaniak, Tomasz; Kuznetsov, Nikolay V.; Leonov, Gennady A.; Prasad, Awadhesh

    2016-06-01

    Complex dynamical systems, ranging from the climate, ecosystems to financial markets and engineering applications typically have many coexisting attractors. This property of the system is called multistability. The final state, i.e., the attractor on which the multistable system evolves strongly depends on the initial conditions. Additionally, such systems are very sensitive towards noise and system parameters so a sudden shift to a contrasting regime may occur. To understand the dynamics of these systems one has to identify all possible attractors and their basins of attraction. Recently, it has been shown that multistability is connected with the occurrence of unpredictable attractors which have been called hidden attractors. The basins of attraction of the hidden attractors do not touch unstable fixed points (if exists) and are located far away from such points. Numerical localization of the hidden attractors is not straightforward since there are no transient processes leading to them from the neighborhoods of unstable fixed points and one has to use the special analytical-numerical procedures. From the viewpoint of applications, the identification of hidden attractors is the major issue. The knowledge about the emergence and properties of hidden attractors can increase the likelihood that the system will remain on the most desirable attractor and reduce the risk of the sudden jump to undesired behavior. We review the most representative examples of hidden attractors, discuss their theoretical properties and experimental observations. We also describe numerical methods which allow identification of the hidden attractors.

  16. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm

    Directory of Open Access Journals (Sweden)

    Palanivelu Praveenraj

    2016-01-01

    Full Text Available Background: Laparoscopic sleeve gastrectomy (LSG is the most commonly performed 'standalone' bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution. Patients and Methods: From February 2008 to 2014, 650 patients with different degrees of morbid obesity underwent LSG. Among these, all those diagnosed with a gastric leak were included in the study. Patients referred to our institution with gastric leak after LSG were also included. The time of presentation, site of leak, investigations performed, treatment given and time of closure of all leaks were analysed. Results: Among the 650 patients who underwent LSG, 3 (0.46% developed a gastric leak. Two patients were referred after LSG was performed at another institution. The mean age was 45.60 ± 15.43 years. Mean body mass index (BMI was 44.79 ± 5.35. Gastric leak was diagnosed 24 h to 7 months after surgery. One was early, two were intermediate and two were late leaks. Two were type I and three were type II gastric leaks. Endoscopic oesophageal stenting was used variably before or after re-surgery. Re-surgery was performed in all and included stapled fistula excision (re-sleeve, suture repair only or with conversion to roux-en-Y gastric bypass or fistula jujenostomy. There was no mortality. Conclusion: Leakage closure time may be shorter with intervention than expectant management. Sequence and choice of endoscopic oesophageal stenting and/or surgical re-intervention should be individualized according to clinical presentation.

  17. The Use of a Bayesian Hierarchy to Develop and Validate a Co-Morbidity Score to Predict Mortality for Linked Primary and Secondary Care Data from the NHS in England.

    Science.gov (United States)

    Crooks, Colin J; Card, Tim R; West, Joe

    2016-01-01

    We have assessed whether the linkage between routine primary and secondary care records provided an opportunity to develop an improved population based co-morbidity score with the combined information on co-morbidities from both health care settings. We extracted all people older than 20 years at the start of 2005 within the linkage between the Hospital Episodes Statistics, Clinical Practice Research Datalink, and Office for National Statistics death register in England. A random 50% sample was used to identify relevant diagnostic codes using a Bayesian hierarchy to share information between similar Read and ICD 10 code groupings. Internal validation of the score was performed in the remaining 50% and discrimination was assessed using Harrell's C statistic. Comparisons were made over time, age, and consultation rate with the Charlson and Elixhauser indexes. 657,264 people were followed up from the 1st January 2005. 98 groupings of codes were derived from the Bayesian hierarchy, and 37 had an adjusted weighting of greater than zero in the Cox proportional hazards model. 11 of these groupings had a different weighting dependent on whether they were coded from hospital or primary care. The C statistic reduced from 0.88 (95% confidence interval 0.88-0.88) in the first year of follow up, to 0.85 (0.85-0.85) including all 5 years. When we stratified the linked score by consultation rate the association with mortality remained consistent, but there was a significant interaction with age, with improved discrimination and fit in those under 50 years old (C = 0.85, 0.83-0.87) compared to the Charlson (C = 0.79, 0.77-0.82) or Elixhauser index (C = 0.81, 0.79-0.83). The use of linked population based primary and secondary care data developed a co-morbidity score that had improved discrimination, particularly in younger age groups, and had a greater effect when adjusting for co-morbidity than existing scores.

  18. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  19. Variational Infinite Hidden Conditional Random Fields

    NARCIS (Netherlands)

    Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja; Ghahramani, Zoubin

    2015-01-01

    Hidden conditional random fields (HCRFs) are discriminative latent variable models which have been shown to successfully learn the hidden structure of a given classification problem. An Infinite hidden conditional random field is a hidden conditional random field with a countably infinite number of

  20. Managing Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Larsen, Marcus M.; Pedersen, Torben

    2014-01-01

    This chapter investigates the concept of the ‘hidden costs’ of offshoring, i.e. unexpected offshoring costs exceeding the initially expected costs. Due to the highly undefined nature of these costs, we position our analysis towards the strategic responses of firms’ realisation of hidden costs....... In this regard, we argue that a major response to the hidden costs of offshoring is the identification and utilisation of strategic mechanisms in the organisational design to eventually achieving system integration in a globally dispersed and disaggregated organisation. This is heavily moderated by a learning......-by-doing process, where hidden costs motivate firms and their employees to search for new and better knowledge on how to successfully manage the organisation. We illustrate this thesis based on the case of the LEGO Group....

  1. The Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Manning, Stephan; Pedersen, Torben

    2011-01-01

    of offshoring. Specifically, we propose that hidden costs can be explained by the combination of increasing structural, operational and social complexity of offshoring activities. In addition, we suggest that firm orientation towards organizational design as part of an offshoring strategy and offshoring......This study seeks to explain hidden costs of offshoring, i.e. unexpected costs resulting from the relocation of business tasks and activities outside the home country. We develop a model that highlights the role of complexity, design orientation and experience in explaining hidden costs...... experience moderate the relationship between complexity and hidden costs negatively i.e. reduces the cost generating impact of complexity. We develop three hypotheses and test them on comprehensive data from the Offshoring Research Network (ORN). In general, we find support for our hypotheses. A key result...

  2. Child Abuse: The Hidden Bruises

    Science.gov (United States)

    ... for Families - Vietnamese Spanish Facts for Families Guide Child Abuse - The Hidden Bruises No. 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ...

  3. Psychiatric morbidity in perimenopausal women

    Directory of Open Access Journals (Sweden)

    Biswajit L Jagtap

    2016-01-01

    Full Text Available Background: Women in the perimenopausal period are reported to be vulnerable to psychiatric disorders. Aim: To assess the psychiatric morbidity in perimenopausal women aged 45–55 years. Materials and Methods: This cross-sectional, observational, hospital-based study was conducted at the Department of Psychiatry in a tertiary care hospital attached to a medical college. The study sample consisted of consecutive women in perimenopause as diagnosed by a gynecologist and written informed consent for inclusion in the study. Women with a previous history of psychiatric illnesses, with a major medical illness, or who had undergone surgical menopause were excluded from the study. All women were evaluated with a brief questionnaire for collecting demographic and clinical information and the Mini International Neuropsychiatric Interview for assessing psychiatric disorders. Results: Of the 108 women in perimenopause included in the study, 31% had depressive disorder, 7% had anxiety, while 5% had depressive disorder with anxiety features. Psychiatric morbidity was significantly more in women having lesser education, from rural background, with a history of psychiatric illness in the family, a later age of menarche, and in the late stage of perimenopause. Conclusions: Women in the perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. As perimenopause is a time of vulnerability in women, attention to signs and symptoms of depression may be required so that they may lead a more productive life.

  4. Hidden Statistics of Schroedinger Equation

    Science.gov (United States)

    Zak, Michail

    2011-01-01

    Work was carried out in determination of the mathematical origin of randomness in quantum mechanics and creating a hidden statistics of Schr dinger equation; i.e., to expose the transitional stochastic process as a "bridge" to the quantum world. The governing equations of hidden statistics would preserve such properties of quantum physics as superposition, entanglement, and direct-product decomposability while allowing one to measure its state variables using classical methods.

  5. Hidden Curriculum: An Analytical Definition

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Andarvazh

    2018-03-01

    Full Text Available Background: The concept of hidden curriculum was first used by Philip Jackson in 1968, and Hafferty brought this concept to the medical education. Many of the subjects that medical students learn are attributed to this curriculum. So far several definitions have been presented for the hidden curriculum, which on the one hand made this concept richer, and on the other hand, led to confusion and ambiguity.This paper tries to provide a clear and comprehensive definition of it.Methods: In this study, concept analysis of McKenna method was used. Using keywords and searching in the databases, 561 English and 26 Persian references related to the concept was found, then by limitingthe research scope, 125 abstracts and by finding more relevant references, 55 articles were fully studied.Results: After analyzing the definitions by McKenna method, the hidden curriculum is defined as follows: The hidden curriculum is a hidden, powerful, intrinsic in organizational structure and culture and sometimes contradictory message, conveyed implicitly and tacitly in the learning environment by structural and human factors and its contents includes cultural habits and customs, norms, values, belief systems, attitudes, skills, desires and behavioral and social expectations can have a positive or negative effect, unplanned, neither planners nor teachers, nor learners are aware of it. The ultimate consequence of the hidden curriculum includes reproducing the existing class structure, socialization, and familiarizing learners for transmission and joining the professional world.Conclusion: Based on the concept analysis, we arrived at an analytical definition of the hidden curriculum that could be useful for further studies in this area.Keywords: CONCEPT ANALYSIS, HIDDEN CURRICULUM, MCKENNA’S METHOD

  6. La medida de la morbilidad atendida en una organización sanitaria integrada Measurement of morbidity attended in an integrated health care organization

    Directory of Open Access Journals (Sweden)

    José M. Inoriza

    2009-02-01

    Full Text Available Introducción: La comprensión de la calidad, los costes y los resultados de los servicios de salud obliga a conocer con precisión la morbilidad de la población. La medida de la morbilidad atendida en una población y su relación con los servicios recibidos es una tarea pendiente. El objetivo de este artículo es presentar la experiencia de utilización de los grupos de riesgo clínico (clinical risk groups [CRG] como sistema de medida de la morbilidad atendida en una organización sanitaria integrada (OSI. Métodos: Se estudia la población de una comarca (unas 120.000 personas atendida por una OSI durante los años 2002-2005. Se utilizan los CRG como sistema de medida de la morbilidad poblacional. Se efectúa un análisis descriptivo de las diferentes posibilidades de utilización que ofrece este sistema. Resultados: El 15,5% de la población presenta una o más enfermedades crónicas dominantes, un 9% presenta enfermedades agudas significativas, un 7% presenta enfermedades crónicas menores y un 0,5% enfermedades muy graves. Entre 2002 y 2005, en un 8% de la población se identifica la aparición de alguna enfermedad crónica. La carga de enfermedad se incrementa con la edad, pero en cualquier grupo de edad al menos un 40% de las personas permanecen sanas. La comorbilidad en enfermedades crónicas es un factor determinante en la explicación del consumo de recursos sanitarios. Conclusiones: Los CRG son una herramienta que facilita el análisis a diferentes niveles para la gestión clínica y, por su configuración, permiten una mejor comprensión de la utilización, los costes y la calidad del conjunto de servicios recibidos por una población.Introduction: Understanding the quality, costs and outcomes of healthcare services requires precise determination of the morbidity in a population. Measurement of morbidity in a population and its association with the services provided remains to be performed. The aim of this article was to present

  7. A hidden history: A survey of the teaching of eugenics in health, social care and pedagogical education and training courses in Europe.

    Science.gov (United States)

    Atherton, H L; Steels, S L

    2016-12-01

    Knowledge and understanding of how eugenics has historically affected the lives of people with intellectual disabilities is vital if professionals are to mount an effective defence against its contemporary influences. An online survey of European providers of health, social care and pedagogical education and training courses was undertaken to find out how the history of eugenics is taught to those wishing to work in services for people with intellectual disabilities. Two hundred and six educational providers were contacted with a response rate of 35.9% (n = 74). Findings showed that the majority of educational providers recognize the importance of including the history of eugenics in their courses, although fewer feel confident that it is sufficiently well covered to prepare future professionals for their role as protector. Course content differs on both the emphasis given to the different components of this history, time dedicated to its delivery and the extent to which it is used to inform legal and ethical debate. Specific recommendations for developing the way in which this subject area is taught are outlined. © The Author(s) 2015.

  8. Morbidity and Mortality Patterns among Neurological Patients in the ...

    African Journals Online (AJOL)

    Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin ...

  9. Hidden ion population: Revisited

    International Nuclear Information System (INIS)

    Olsen, R.C.; Chappell, C.R.; Gallagher, D.L.; Green, J.L.; Gurnett, D.A.

    1985-01-01

    Satellite potentials in the outer plasmasphere range from near zero to +5 to +10 V. Under such conditions ion measurements may not include the low energy core of the plasma population. In eclipse, the photoelectron current drops to zero, and the spacecraft potential can drop to near zero volts. In regions where the ambient plasma density is below 100 cm -3 , previously unobserved portions of the ambient plasma distribution function can become visible in eclipse. A survey of the data obtained from the retarding ion mass spectrometer (RIMS) on Dynamics Explorer 1 shows that the RIMS detector generally measured the isotropic background in both sunlight and eclipse in the plasma-sphere. Absolute density measurements for the ''hidden'' ion population are obtained for the first time using the plasma wave instrument observations of the upper hybrid resonance. Agreement in total density is found in sunlight and eclipse measurements at densities above 80 cm -3 . In eclipse, agreement is found at densities as low as 20 cm -3 . The isotropic plasma composition is primarily H + , with approx.10% He + , and 0.1 to 1.0% O + . A low energy field-aligned ion population appears in eclipse measurements outside the plasmasphere, which is obscured in sunlight. These field-aligned ions can be interpreted as field-aligned flows with densities of a few particles per cubic centimeter, flowing at 5-20 km/s. The problem in measuring these field-aligned flows in sunlight is the masking of the high energy tail of the field-aligned distribution by the isotropic background. Effective measurement of the core of the magnetospheric plasma distribution awaits satellites with active means of controlling the satellite potential

  10. Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia.

    Science.gov (United States)

    Swarna Nantha, Yogarabindranath

    2014-10-01

    The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research. "Food addiction" could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory-based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete. Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country. Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities. © The Author(s) 2014.

  11. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  12. Stargate of the Hidden Multiverse

    Directory of Open Access Journals (Sweden)

    Alexander Antonov

    2016-02-01

    Full Text Available Concept of Monoverse, which corresponds to the existing broad interpretation of the second postulate of the special theory of relativity, is not consistent with the modern astrophysical reality — existence of the dark matter and the dark energy, the total mass-energy of which is ten times greater than the mass-energy of the visible universe (which has been considered as the entire universe until very recent . This concept does not allow to explain their rather unusual properties — invisibility and lack of baryon content — which would seem to even destroy the very modern understanding of the term ‘matter’. However, all numerous alternative concepts of Multiverses, which have been proposed until today, are unable to explain these properties of the dark matter and dark energy. This article describes a new concept: the concept of the hidden Multiverse and hidden Supermultiverse, which mutual invisibility of parallel universes is explained by the physical reality of imaginary numbers. This concept completely explains the phenomenon of the dark matter and the dark energy. Moreover, it is shown that the dark matter and the dark energy are the experimental evidence for the existence of the hidden Multiverse. Described structure of the hidden Multiverse is fully consistent with the data obtained by the space stations WMAP and Planck. An extremely important property of the hidden Multiverse is an actual possibility of its permeation through stargate located on the Earth.

  13. Hidden photons in connection to dark matter

    Energy Technology Data Exchange (ETDEWEB)

    Andreas, Sarah; Ringwald, Andreas [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Goodsell, Mark D. [CPhT, Ecole Polytechnique, Palaiseau (France)

    2013-06-15

    Light extra U(1) gauge bosons, so called hidden photons, which reside in a hidden sector have attracted much attention since they are a well motivated feature of many scenarios beyond the Standard Model and furthermore could mediate the interaction with hidden sector dark matter.We review limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay. In addition, we study the possibility of having dark matter in the hidden sector. A simple toy model and different supersymmetric realisations are shown to provide viable dark matter candidates in the hidden sector that are in agreement with recent direct detection limits.

  14. Hidden photons in connection to dark matter

    International Nuclear Information System (INIS)

    Andreas, Sarah; Ringwald, Andreas; Goodsell, Mark D.

    2013-06-01

    Light extra U(1) gauge bosons, so called hidden photons, which reside in a hidden sector have attracted much attention since they are a well motivated feature of many scenarios beyond the Standard Model and furthermore could mediate the interaction with hidden sector dark matter.We review limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay. In addition, we study the possibility of having dark matter in the hidden sector. A simple toy model and different supersymmetric realisations are shown to provide viable dark matter candidates in the hidden sector that are in agreement with recent direct detection limits.

  15. Hidden worlds in quantum physics

    CERN Document Server

    Gouesbet, Gérard

    2014-01-01

    The past decade has witnessed a resurgence in research and interest in the areas of quantum computation and entanglement. This new book addresses the hidden worlds or variables of quantum physics. Author Gérard Gouesbet studied and worked with a former student of Louis de Broglie, a pioneer of quantum physics. His presentation emphasizes the history and philosophical foundations of physics, areas that will interest lay readers as well as professionals and advanced undergraduate and graduate students of quantum physics. The introduction is succeeded by chapters offering background on relevant concepts in classical and quantum mechanics, a brief history of causal theories, and examinations of the double solution, pilot wave, and other hidden-variables theories. Additional topics include proofs of possibility and impossibility, contextuality, non-locality, classification of hidden-variables theories, and stochastic quantum mechanics. The final section discusses how to gain a genuine understanding of quantum mec...

  16. Detecting hidden particles with MATHUSLA

    Science.gov (United States)

    Evans, Jared A.

    2018-03-01

    A hidden sector containing light long-lived particles provides a well-motivated place to find new physics. The recently proposed MATHUSLA experiment has the potential to be extremely sensitive to light particles originating from rare meson decays in the very long lifetime region. In this work, we illustrate this strength with the specific example of a light scalar mixed with the standard model-like Higgs boson, a model where MATHUSLA can further probe unexplored parameter space from exotic Higgs decays. Design augmentations should be considered in order to maximize the ability of MATHUSLA to discover very light hidden sector particles.

  17. Hidden Crises and Communication: An Interactional Analysis of Hidden Crises

    NARCIS (Netherlands)

    dr. Annette Klarenbeek

    2011-01-01

    In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

  18. Hidden Crises and Communication : An Interactional Analysis of Hidden Crises

    NARCIS (Netherlands)

    dr. Annette Klarenbeek

    2011-01-01

    In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in

  19. Maternal morbidities affect tens of millions.

    Science.gov (United States)

    Finger, W R

    1994-02-01

    Various separate studies indicate maternal morbidity is more common than had been believed. A Safe Motherhood Survey was conducted in 1993 in the Philippines among 9000 women, as part of efforts to study women's language and perceptions about pregnancy and symptoms of morbidity. In El Salvador, interviews were conducted among 2000 women on morbidity issues. Preliminary results from a Family Health International (FHI) five-country survey of 16,000 women revealed that 7 out of every 10 women reported a health problem related to maternity or chronic conditions stemming from pregnancy or childbirth. Conditions ranged from obstructed labor, complications from unsafe abortions, and bacterial infections, to anemia, hemorrhage, and eclampsia. The quality of care determines whether the health problems are life threatening. Less serious morbidity cases involve fatigue or back pain, which is exacerbated by poor nutrition and hard physical labor. Other reproductive morbidities are sexually transmitted diseases, side effects from contraceptives, and general gynecological problems. The FHI results from Ghana, Indonesia, and Egypt showed 240-300 morbidities for every maternal death; maternal mortality worldwide is estimated at 500,000 annually. A study of fistula (an injury during labor to the vagina and bladder that results in urinary or fecal incontinence) found that Nigerian community norms and limited access to emergency health care were factors. The women reported costs, poor roads, and transportation problems. A study in Ethiopia found that, in an Addis Ababa hospital between 1983-88, 600 fistulas were repaired every year, of which almost 66% occurred at first delivery. A study in Cairo in 1988 found that nearly 6 out of every 10 women reported a prolapsed uterus. Women in the studies were able to talk openly and willingly about their problems, when concepts and language were appropriate and interviewers were trained. A small study in India confirmed the correlation between

  20. Entry deterrence and hidden competition

    NARCIS (Netherlands)

    Lavrutich, Maria; Huisman, Kuno; Kort, Peter

    This paper studies strategic investment behavior of firms facing an uncertain demand in a duopoly setting. Firms choose both investment timing and the capacity level while facing additional uncertainty about market participants, which is introduced via the concept of hidden competition. We focus on

  1. Adaptive Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rasmussen, Tage

    1996-01-01

    Partially Hidden Markov Models (PHMM) have recently been introduced. The transition and emission probabilities are conditioned on the past. In this report, the PHMM is extended with a multiple token version. The different versions of the PHMM are applied to bi-level image coding....

  2. The Hidden Dimensions of Databases.

    Science.gov (United States)

    Jacso, Peter

    1994-01-01

    Discusses methods of evaluating commercial online databases and provides examples that illustrate their hidden dimensions. Topics addressed include size, including the number of records or the number of titles; the number of years covered; and the frequency of updates. Comparisons of Readers' Guide Abstracts and Magazine Article Summaries are…

  3. Endovascular Interventions for the Morbidly Adherent Placenta

    Directory of Open Access Journals (Sweden)

    Claire Kaufman

    2018-05-01

    Full Text Available Morbidly adherent placentas are a spectrum of abnormalities ranging from placental invasion of the myometrium to invasion past the myometrium and muscular layers into adjacent structures. This entity is becoming more prevalent recently with increased number of cesarean deliveries. Given the high risk of morbidity and mortality, this was traditionally treated with pre-term planned cesarean hysterectomy. However, recently, uterine preservation techniques have been implemented for those women wishing to preserve future fertility or their uterus. Early identification is crucial as studies have shown better outcomes for women treated at tertiary care facilities by a dedicated multidisciplinary team. Interventional radiologists are frequently included in the care of these patients as there are several different endovascular techniques which can be implemented to decrease morbidity in these patients both in conjunction with cesarean hysterectomy and in the setting of uterine preservation. This article will review the spectrum of morbidly adherent placentas, imaging, as well as the surgical and endovascular interventions implemented in the care of these complex patients.

  4. [Morbidity among forestry workers].

    Science.gov (United States)

    Rafalski, H; Bernacki, K

    1981-01-01

    The past and presently diagnosed diseases (excluding vibration disease and occupational hearing impairment) were analysed in 1105 sawers operating combustion drive mechanic saws and in 295 controls. The greatest rate, both in the sawers and controls, was that of the diseases of respiratory tract, circulatory system and osseo -- articulo -- muscular system, nervous system and sense organs. These constituted 86% of all diseases that afflicted sawers and controls. No specific general morbidity accompanying vibration disease or occupational hearing impairment was found in the sawers exposed to noise and vibration.

  5. Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes: a case-control study protocol in a tertiary healthcare facility in Lima, Peru.

    Science.gov (United States)

    Ayala Quintanilla, Beatriz Paulina; Pollock, Wendy E; McDonald, Susan J; Taft, Angela J

    2018-03-14

    Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a sample size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random sampling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  6. Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes: a case–control study protocol in a tertiary healthcare facility in Lima, Peru

    Science.gov (United States)

    Ayala Quintanilla, Beatriz Paulina; Pollock, Wendy E; McDonald, Susan J; Taft, Angela J

    2018-01-01

    Introduction Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. Methods and analysis This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a sample size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random sampling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethics and dissemination Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals. PMID:29540421

  7. Severe acute maternal morbidity and maternal death audit - a rapid ...

    African Journals Online (AJOL)

    Severe acute maternal morbidity and maternal death audit - a rapid diagnostic tool for evaluating maternal care. L Cochet, R.C. Pattinson, A.P. Macdonald. Abstract. Objective. To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000 - 2001). Setting.

  8. Child Morbidity and Mortality in Slum Environments along Nairobi ...

    African Journals Online (AJOL)

    The problem that guided this study was that child mortality and morbidity disparities continue to be observed in the era of improved expansion of the provision of health care services. Some areas have low mortality and morbidity while others such as the slums of Nairobi have high. Various factors may account for this ...

  9. Hidden supersymmetry and large N

    International Nuclear Information System (INIS)

    Alfaro, J.

    1988-01-01

    In this paper we present a new method to deal with the leading order in the large-N expansion of a quantum field theory. The method uses explicitly the hidden supersymmetry that is present in the path-integral formulation of a stochastic process. In addition to this we derive a new relation that is valid in the leading order of the large-N expansion of the hermitian-matrix model for any spacetime dimension. (orig.)

  10. Hipertensão arterial sistêmica e morbidade psiquiátrica em ambulatório de hospital terciário Hypertension and psychiatric morbidity: a tertiary care setting experience

    Directory of Open Access Journals (Sweden)

    ISABELA M. BENSEÑOR

    1998-09-01

    Full Text Available A hipertensão arterial sistêmica representa um dos principais fatores de risco para as doenças cardiovasculares que são a principal causa de morte em nosso meio. Hipertensos que frequentam hospital terciário apresentam elevada co-morbidade incluindo distúrbios psiquiátricos. O objetivo deste estudo é avaliar a morbidade psiquiátrica em hipertensos graves. Este estudo foi realizado em ambulatório geral de hospital terciário: 41 pacientes (26 mulheres e 15 homens foram submetidos a consulta médica com aplicação do PRIME-MD, um questionário específico para diagnóstico de alterações psiquiátricas a ser realizado pelo clínico. A frequência de distúrbios psiquiátricos diferiu em homens e mulheres: 63,4% das mulheres na pesquisa apresentavam algum tipo de distúrbio contra 36,6% dos homens (p=0,012. A maior parte dos diagnósticos foi de distúrbios do humor representados pela depressão associada ou não a distúrbios ansiosos. A média de idade dos pacientes com distúrbio psiquiátrico foi 47,1 anos contra 59,3 anos dos pacientes sem distúrbio psiquiátrico (p=0,0049, mostrando a presença dos distúrbios psiquiátricos em pacientes mais jovens. Outros fatores pesquisados, como a pressão arterial sistólica, a pressão arterial diastólica e índice de massa corpórea não apresentaram diferenças em função dos distúrbios psiquiátricos apresentados. Concluímos que há grande co-morbidade psiquiátrica em hipertensos que frequentam ambulatórios de hospital terciário e que esses distúrbios são mais frequentes em mulheres e em pacientes jovens.Arterial hypertension is one of the most important risk factor for cardiovascular disease, the main cause of death in Brazil. Hypertensive patients that have treated in tertiary care hospitals have shown elevated co-morbidity including psychiatric disturbances. Our objective is to study psychiatric co-morbidity among severe hypertensive patients. This study was performed in an

  11. Impact of morbid obesity on medical expenditures in adults.

    Science.gov (United States)

    Arterburn, D E; Maciejewski, M L; Tsevat, J

    2005-03-01

    Morbid obesity (body mass index (BMI) > or =40 kg/m2) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly

  12. Hidden particle production at the ILC

    International Nuclear Information System (INIS)

    Fujii, Keisuke; Itoh, Hideo; Okada, Nobuchika; Hano, Hitoshi; Yoshioka, Tamaki

    2008-01-01

    In a class of new physics models, the new physics sector is completely or partly hidden, namely, a singlet under the standard model (SM) gauge group. Hidden fields included in such new physics models communicate with the standard model sector through higher-dimensional operators. If a cutoff lies in the TeV range, such hidden fields can be produced at future colliders. We consider a scalar field as an example of the hidden fields. Collider phenomenology on this hidden scalar is similar to that of the SM Higgs boson, but there are several features quite different from those of the Higgs boson. We investigate productions of the hidden scalar at the International Linear Collider (ILC) and study the feasibility of its measurements, in particular, how well the ILC distinguishes the scalar from the Higgs boson, through realistic Monte Carlo simulations.

  13. Social exclusion, health and hidden homelessness.

    Science.gov (United States)

    Watson, J; Crawley, J; Kane, D

    2016-10-01

    Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. The purpose of this study was to explore and expand the concept of social exclusion within the social determinants of health perspective - to understand how the social environment, health behaviours and health status are associated with material and social deprivation. Fundamental qualitative description with tones of focused ethnography. Participants who identified as hidden homeless described their everyday living conditions and how these everyday conditions were impacted and influenced by their social environments, coping/health behaviours and current health status. Research Ethics Board approval was granted and informed consents were obtained from 21 participants prior to the completion of individual interviews. Qualitative content analysis examined the descriptions of men and women experiencing hidden homelessness. Participants described the 'lack of quality social interactions and supports' and their 'daily struggles of street life'. They also shared the 'pain of addiction' and how coping strategies influenced health. Participants were hopeful that their insights would 'better the health of homeless people' by helping shape public policy and funding of community resources that would reduce barriers and improve overall health. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments can provide more comprehensive and holistic care. The findings of this study can be used to support the importance of housing as a key factor in the health and well-being of people experiencing poverty, homelessness and social exclusion; and consequently, reinforces the need for a national housing strategy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Hidden measurements, hidden variables and the volume representation of transition probabilities

    OpenAIRE

    Oliynyk, Todd A.

    2005-01-01

    We construct, for any finite dimension $n$, a new hidden measurement model for quantum mechanics based on representing quantum transition probabilities by the volume of regions in projective Hilbert space. For $n=2$ our model is equivalent to the Aerts sphere model and serves as a generalization of it for dimensions $n \\geq 3$. We also show how to construct a hidden variables scheme based on hidden measurements and we discuss how joint distributions arise in our hidden variables scheme and th...

  15. Dissipative hidden sector dark matter

    Science.gov (United States)

    Foot, R.; Vagnozzi, S.

    2015-01-01

    A simple way of explaining dark matter without modifying known Standard Model physics is to require the existence of a hidden (dark) sector, which interacts with the visible one predominantly via gravity. We consider a hidden sector containing two stable particles charged under an unbroken U (1 )' gauge symmetry, hence featuring dissipative interactions. The massless gauge field associated with this symmetry, the dark photon, can interact via kinetic mixing with the ordinary photon. In fact, such an interaction of strength ε ˜10-9 appears to be necessary in order to explain galactic structure. We calculate the effect of this new physics on big bang nucleosynthesis and its contribution to the relativistic energy density at hydrogen recombination. We then examine the process of dark recombination, during which neutral dark states are formed, which is important for large-scale structure formation. Galactic structure is considered next, focusing on spiral and irregular galaxies. For these galaxies we modeled the dark matter halo (at the current epoch) as a dissipative plasma of dark matter particles, where the energy lost due to dissipation is compensated by the energy produced from ordinary supernovae (the core-collapse energy is transferred to the hidden sector via kinetic mixing induced processes in the supernova core). We find that such a dynamical halo model can reproduce several observed features of disk galaxies, including the cored density profile and the Tully-Fisher relation. We also discuss how elliptical and dwarf spheroidal galaxies could fit into this picture. Finally, these analyses are combined to set bounds on the parameter space of our model, which can serve as a guideline for future experimental searches.

  16. Neonatal morbidity associated with shoulder dystocia maneuvers.

    Science.gov (United States)

    Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

    2015-03-01

    We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. MAXimising Involvement in MUltiMorbidity (MAXIMUM) in primary care: protocol for an observation and interview study of patients, GPs and other care providers to identify ways of reducing patient safety failures.

    Science.gov (United States)

    Daker-White, Gavin; Hays, Rebecca; Esmail, Aneez; Minor, Brian; Barlow, Wendy; Brown, Benjamin; Blakeman, Thomas; Bower, Peter

    2014-08-18

    Increasing numbers of older people are living with multiple long-term health conditions but global healthcare systems and clinical guidelines have traditionally focused on the management of single conditions. Having two or more long-term conditions, or 'multimorbidity', is associated with a range of adverse consequences and poor outcomes and could put patients at increased risk of safety failures. Traditionally, most research into patient safety failures has explored hospital or inpatient settings. Much less is known about patient safety failures in primary care. Our core aims are to understand the mechanisms by which multimorbidity leads to safety failures, to explore the different ways in which patients and services respond (or fail to respond), and to identify opportunities for intervention. We plan to undertake an applied ethnographic study of patients with multimorbidity. Patients' interactions and environments, relevant to their healthcare, will be studied through observations, diary methods and semistructured interviews. A framework, based on previous studies, will be used to organise the collection and analysis of field notes, observations and other qualitative data. This framework includes the domains: access breakdowns, communication breakdowns, continuity of care errors, relationship breakdowns and technical errors. Ethical approval was received from the National Health Service Research Ethics Committee for Wales. An individual case study approach is likely to be most fruitful for exploring the mechanisms by which multimorbidity leads to safety failures. A longitudinal and multiperspective approach will allow for the constant comparison of patient, carer and healthcare worker expectations and experiences related to the provision, integration and management of complex care. This data will be used to explore ways of engaging patients and carers more in their own care using shared decision-making, patient empowerment or other relevant models. Published by

  18. Morbidity among Israeli paediatric travellers.

    Science.gov (United States)

    Rabinowicz, Shira; Schwartz, Eli

    2017-09-01

    International travel, particularly to developing countries, is becoming increasingly common among the Israeli population, including an increase in the number of travelling children. Since children are a distinct travellers' population, data about their post-travel morbidity are needed. A retrospective study which examined all children (0-19 years old) who presented to our centre after international travel from 1999 to 2015. About 314 children were seen. The mean age was 10 years (SD ± 5.8). Most of the patients (80.6%) were tourists, and the rest were expatriates. The main destinations visited were South-Asia (46.5%), Sub-Saharan Africa (33.4%), Latin-America (7%) and Europe (6.4%). Overall, the most common diagnoses were gastrointestinal (GI) (mainly chronic) disorders (30.6%), followed by febrile diseases (26.4%), among which 18.1% of patients were diagnosed with dengue fever and 12% with malaria. Dermatologic conditions accounted for 25.2%. Additional diagnoses were schistosomiasis (6.4%) and neuropsychiatric symptoms (2.2%). A substantial part, 10.8%, had eosinophilia, either symptomatic or asymptomatic. Travellers to Asia, compared to travellers to Africa, presented more commonly with GI illness (OR 2.02, 95% confidence interval 1.13-3.61), and dermatologic conditions (OR 1.94, 95% confidence interval 1.05-3.61). Morbidity was associated with a variety of transmission modes, such as food-borne illnesses (30.9%), bite and sting wounds (10.2%), mosquito-borne infections (8%), freshwater contact (6.7%) and tick-borne infections (2.2%). The main conditions seen in paediatric returning travellers were GI, febrile and dermatologic illnesses, some may be rare in their country of origin. Targeting care for the suspected pathogens based on updated knowledge of epidemiology and thorough travel history is essential. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  19. Hidden inventory and safety considerations

    International Nuclear Information System (INIS)

    Anderson, A.R.; James, R.H.; Morgan, F.

    1976-01-01

    Preliminary results are described of the evaluation of residual plutonium in a process line used for the production of experimental fast reactor fuel. Initial attention has been focussed on a selection of work boxes used for processing powders and solutions. Amounts of material measured as ''hidden inventory'' are generally less than 0.1 percent of throughput but in one box containing very complex equipment the amount was exceptionally about 0.5 percent. The total surface area of the box and the installed equipment appears to be the most significant factor in determining the amount of plutonium held-up as ''hidden inventory,'' representing an average of about 4 x 10 -4 g cm -2 . Present results are based on gamma spectrometer measurements but neutron techniques are being developed to overcome some of the inherent uncertainties in the gamma method. It is suggested that the routine use of sample plates of known surface area would be valuable in monitoring the deposition of plutonium in work boxes

  20. Hidden costs of nuclear power

    International Nuclear Information System (INIS)

    England, R.W.

    1979-01-01

    Mr. England contends that these hidden costs add up to a figure much higher than those that appear in the electric utilities' profit and loss account - costs that are borne by Federal taxpayers, by nuclear industry workers, and by all those people who must share their environment with nuclear facilities. Costs he details are additional deaths and illnesses resulting from exposure to radiation, and the use of tax dollars to clean up the lethal garbage produced by those activities. He asserts that careless handling of uranium ore and mill tailings in past years has apparently resulted in serious public health problems in those mining communities. In another example, Mr. England states that the failure to isolate uranium tailings physically from their environment has probably contributed to an acute leukemia rate in Mesa County, Colorado. He mentions much of the technology development for power reactors being done by the Federal government, not by private reactor manufacturers - thus, again, hidden costs that do not show up in electric bills of customers. The back end of the nuclear fuel cycle as a place for Federally subsidized research and development is discussed briefly. 1 figure, 2 tables

  1. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2017-01-01

    for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  2. The Hidden Reason Behind Children's Misbehavior.

    Science.gov (United States)

    Nystul, Michael S.

    1986-01-01

    Discusses hidden reason theory based on the assumptions that: (1) the nature of people is positive; (2) a child's most basic psychological need is involvement; and (3) a child has four possible choices in life (good somebody, good nobody, bad somebody, or severely mentally ill.) A three step approach for implementing hidden reason theory is…

  3. Hidden neural networks: application to speech recognition

    DEFF Research Database (Denmark)

    Riis, Søren Kamaric

    1998-01-01

    We evaluate the hidden neural network HMM/NN hybrid on two speech recognition benchmark tasks; (1) task independent isolated word recognition on the Phonebook database, and (2) recognition of broad phoneme classes in continuous speech from the TIMIT database. It is shown how hidden neural networks...

  4. Insight: Exploring Hidden Roles in Collaborative Play

    Directory of Open Access Journals (Sweden)

    Tricia Shi

    2015-06-01

    Full Text Available This paper looks into interaction modes between players in co-located, collaborative games. In particular, hidden traitor games, in which one or more players is secretly working against the group mission, has the effect of increasing paranoia and distrust between players, so this paper looks into the opposite of a hidden traitor – a hidden benefactor. Rather than sabotaging the group mission, the hidden benefactor would help the group achieve the end goal while still having a reason to stay hidden. The paper explores what games with such a role can look like and how the role changes player interactions. Finally, the paper addresses the divide between video game and board game interaction modes; hidden roles are not common within video games, but they are of growing prevalence in board games. This fact, combined with the exploration of hidden benefactors, reveals that hidden roles is a mechanic that video games should develop into in order to match board games’ complexity of player interaction modes.

  5. Hidden variables and locality in quantum theory

    International Nuclear Information System (INIS)

    Shiva, Vandana.

    1978-12-01

    The status of hidden variables in quantum theory has been debated since the 1920s. The author examines the no-hidden-variable theories of von Neumann, Kochen, Specker and Bell, and finds that they all share one basic assumption: averaging over the hidden variables should reproduce the quantum mechanical probabilities. Von Neumann also makes a linearity assumption, Kochen and Specker require the preservation of certain functional relations between magnitudes, and Bell proposes a locality condition. It has been assumed that the extrastatistical requirements are needed to serve as criteria of success for the introduction of hidden variables because the statistical condition is trivially satisfied, and that Bell's result is based on a locality condition that is physically motivated. The author shows that the requirement of weak locality, which is not physically motivated, is enough to give Bell's result. The proof of Bell's inequality works equally well for any pair of commuting magnitudes satisfying a condition called the degeneracy principle. None of the no-hidden-variable proofs apply to a class of hidden variable theories that are not phase-space reconstructions of quantum mechanics. The author discusses one of these theories, the Bohm-Bub theory, and finds that hidden variable theories that re all the quantum statistics, for single and sequential measurements, must introduce a randomization process for the hidden variables after each measurement. The philosophical significance of this theory lies in the role it can play in solving the conceptual puzzles posed by quantum theory

  6. Hidden supersymmetry and Fermion number fractionalization

    International Nuclear Information System (INIS)

    Akhoury, R.

    1985-01-01

    This paper discusses how a hidden supersymmetry of the underlying field theories can be used to interpret and to calculate fermion number fractionalization in different dimensions. This is made possible by relating it to a corresponding Witten index of the hidden supersymmetry. The closely related anomalies in odd dimensions are also discussed

  7. Helioscope bounds on hidden sector photons

    International Nuclear Information System (INIS)

    Redondo, J.

    2008-01-01

    The flux of hypothetical ''hidden photons'' from the Sun is computed under the assumption that they interact with normal matter only through kinetic mixing with the ordinary standard model photon. Requiring that the exotic luminosity is smaller than the standard photon luminosity provides limits for the mixing parameter down to χ -14 , depending on the hidden photon mass. Furthermore, it is pointed point out that helioscopes looking for solar axions are also sensitive to hidden photons. The recent results of the CAST collaboration are used to further constrain the mixing parameter χ at low masses (m γ' <1 eV) where the luminosity bound is weaker. In this regime the solar hidden photon ux has a sizable contribution of longitudinally polarized hidden photons of low energy which are invisible for current helioscopes. (orig.)

  8. Hidden scale invariance of metals

    DEFF Research Database (Denmark)

    Hummel, Felix; Kresse, Georg; Dyre, Jeppe C.

    2015-01-01

    Density functional theory (DFT) calculations of 58 liquid elements at their triple point show that most metals exhibit near proportionality between the thermal fluctuations of the virial and the potential energy in the isochoric ensemble. This demonstrates a general “hidden” scale invariance...... of metals making the condensed part of the thermodynamic phase diagram effectively one dimensional with respect to structure and dynamics. DFT computed density scaling exponents, related to the Grüneisen parameter, are in good agreement with experimental values for the 16 elements where reliable data were...... available. Hidden scale invariance is demonstrated in detail for magnesium by showing invariance of structure and dynamics. Computed melting curves of period three metals follow curves with invariance (isomorphs). The experimental structure factor of magnesium is predicted by assuming scale invariant...

  9. Hidden Valley Search at ATLAS

    CERN Document Server

    Verducci, M

    2011-01-01

    A number of extensions of the Standard Model result in neutral and weakly-coupled particles that decay to multi hadrons or multi leptons with macroscopic decay lengths. These particles with decay paths that can be comparable with ATLAS detector dimensions represent, from an experimental point of view, a challenge both for the trigger and for the reconstruction capabilities of the ATLAS detector. We will present a set of signature driven triggers for the ATLAS detector that target such displaced decays and evaluate their performances for some benchmark models and describe analysis strategies and limits on the production of such long-lived particles. A first estimation of the Hidden Valley trigger rates has been evaluated with 6 pb-1 of data collected at ATLAS during the data taking of 2010.

  10. The morbidity, mortality, and costs associated with Clostridium difficile infection.

    Science.gov (United States)

    Kwon, Jennie H; Olsen, Margaret A; Dubberke, Erik R

    2015-03-01

    Clostridium difficile infection (CDI) is the most common cause of infectious health care-associated diarrhea and is a major burden to patients and the health care system. The incidence and severity of CDI remain at historically high levels. This article reviews the morbidity, mortality, and costs associated with CDI. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  12. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

  13. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    Jeevan Acharya

    Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

  14. New morbidity of the young

    OpenAIRE

    Stanković Biljana

    2002-01-01

    In the present phase of epidemiological transition, the most frequent causes of youth morbidity are disorders in reproductive health, mental disorders and injuries which are not life threatening. This, so-called new youth morbidity, is most often caused by their risky behavior, which in the field of sexuality often leads to unplanned pregnancies and abortions, as well as sexually transmitted infections. Misuse of tobacco, alcohol and narcotics, which is most commonly started in adolescence, h...

  15. Morbidade em creche de Brasília: estudo longitudinal de incidência de enfermidades no ano de 1977 Morbidity in a Brasilia day care center: a longitudinal study of disease incidence in 1977

    Directory of Open Access Journals (Sweden)

    Ana Maria Low

    1980-12-01

    Full Text Available Foi feito estudo longitudinal de morbidade em creche de Brasília (Brasil freqüentada por crianças com bom estado nutricional. Foram admitidas na creche durante o ano de 1977 o total de 67 crianças (34 do sexo masculino e 33 do sexo feminino, com idade entre 3 e 21 meses. Infecções de vias aéreas superiores (25,4%, diarréia (23,6% e febre não esclarecida (18,4% representaram dois terços dos diagnósticos. A seguir, em ordem de freqüência, apareceram conjuntivite (15,5%, viroses da infância (7,9%, doenças de pele (3,8%, pequenos acidentes (2,6%, hepatite (2,6% e meningococcemia (0,3%. Houve um total de 343 episódios agudos, dando uma taxa de incidência de 14 enfermidades por criança por ano, independente de sexo e idade.A longitudinal morbidity study was carried out in a day care center in Brasilia (Brazil on a sample of 67 (34 male and 33 female, 3 to 21 months of age well-fed children from middle-class families. A pediatrician was on duty daily in the center. The incidence of disease was: upper respiratory, 25.4%; diarrhea, 23.6%; and undetermined fever, 18.4%. These represented 2/3 of the diagnoses. The other diseases found (and here listed in order of frequency were: conjunctivitis, 15.5%; childhood infections, 7.9%; skin diseases, 3.8%; accidents, 2.6%; hepatitis, 2.6%; and meningitis, 0.3%. There were a total of 343 acute illnesses, giving a mean incidence rate of 14 illnesses per child per year, independent of sex and age. Perhaps the incidence of illnesses would have been lower if the children had not been attending the center, a natural factor in the dissemination of communicable diseases.

  16. Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes.

    Science.gov (United States)

    Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

    2013-10-17

    eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify emergent ethical issues. This study

  17. A survey of hidden-variables theories

    CERN Document Server

    Belinfante, F J

    1973-01-01

    A Survey of Hidden-Variables Theories is a three-part book on the hidden-variable theories, referred in this book as """"theories of the first kind"""". Part I reviews the motives in developing different types of hidden-variables theories. The quest for determinism led to theories of the first kind; the quest for theories that look like causal theories when applied to spatially separated systems that interacted in the past led to theories of the second kind. Parts II and III further describe the theories of the first kind and second kind, respectively. This book is written to make the literat

  18. A classification of hidden-variable properties

    International Nuclear Information System (INIS)

    Brandenburger, Adam; Yanofsky, Noson

    2008-01-01

    Hidden variables are extra components added to try to banish counterintuitive features of quantum mechanics. We start with a quantum-mechanical model and describe various properties that can be asked of a hidden-variable model. We present six such properties and a Venn diagram of how they are related. With two existence theorems and three no-go theorems (EPR, Bell and Kochen-Specker), we show which properties of empirically equivalent hidden-variable models are possible and which are not. Formally, our treatment relies only on classical probability models, and physical phenomena are used only to motivate which models to choose

  19. UV Photography Shows Hidden Sun Damage

    Science.gov (United States)

    ... mcat1=de12", ]; for (var c = 0; c UV photography shows hidden sun damage A UV photograph gives ... developing skin cancer and prematurely aged skin. Normal photography UV photography 18 months of age: This boy's ...

  20. Coding with partially hidden Markov models

    DEFF Research Database (Denmark)

    Forchhammer, Søren; Rissanen, J.

    1995-01-01

    Partially hidden Markov models (PHMM) are introduced. They are a variation of the hidden Markov models (HMM) combining the power of explicit conditioning on past observations and the power of using hidden states. (P)HMM may be combined with arithmetic coding for lossless data compression. A general...... 2-part coding scheme for given model order but unknown parameters based on PHMM is presented. A forward-backward reestimation of parameters with a redefined backward variable is given for these models and used for estimating the unknown parameters. Proof of convergence of this reestimation is given....... The PHMM structure and the conditions of the convergence proof allows for application of the PHMM to image coding. Relations between the PHMM and hidden Markov models (HMM) are treated. Results of coding bi-level images with the PHMM coding scheme is given. The results indicate that the PHMM can adapt...

  1. Hidden costs, value lost: uninsurance in America

    National Research Council Canada - National Science Library

    Committee on the Consequences of Uninsurance

    2003-01-01

    Hidden Cost, Value Lost , the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining...

  2. The hidden epidemic: confronting sexually transmitted diseases

    National Research Council Canada - National Science Library

    Eng, Thomas R; Butler, William T

    .... In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis...

  3. Perspective: Disclosing hidden sources of funding.

    Science.gov (United States)

    Resnik, David B

    2009-09-01

    In this article, the author discusses ethical and policy issues related to the disclosure of hidden sources of funding in research. The author argues that authors have an ethical obligation to disclose hidden sources of funding and that journals should adopt policies to enforce this obligation. Journal policies should require disclosure of hidden sources of funding that authors know about and that have a direct relation to their research. To stimulate this discussion, the author describes a recent case: investigators who conducted a lung cancer screening study had received funding from a private foundation that was supported by a tobacco company, but they did not disclose this relationship to the journal. Investigators and journal editors must be prepared to deal with these issues in a manner that promotes honesty, transparency, fairness, and accountability in research. The development of well-defined, reasonable policies pertaining to hidden sources of funding can be a step in this direction.

  4. Health after childbirth: patterns of reported postpartum morbidity from Lebanon.

    Science.gov (United States)

    Kabakian-Khasholian, Tamar; Shayboub, Rawan; Ataya, Alexandra

    2014-03-01

    The postpartum period is under-researched in low and middle income countries. The scarce literature reveals heavy burden of ill health experienced in that period and under utilisation of health services. Understanding the postpartum morbidity burden and identifying the care-seeking behaviours is essential to improve service delivery. This paper examines reported postpartum morbidity, care seeking behaviour and whether postpartum morbidity is associated with method of birth. A cross sectional study of women delivering in 18 private hospitals from two regions in Lebanon was undertaken. Women in their second or third trimester of pregnancy, visiting private obstetric clinics affiliated with participating hospitals were interviewed for baseline information. Reported postpartum morbidity was assessed in an interview conducted at women's homes from 40 days up to six months postpartum. Of the 269 women recruited, physical postpartum health problems were reported by 93.6% and psychological health problems by 84.4% of women, with more health problems being reported beyond two months postpartum. Women were less likely to seek professional care for psychological health problems. Reporting postpartum health problems was not associated with method of birth. A heavy burden of postpartum morbidity is experienced by women with gaps in utilisation of relevant health services. Efforts should be directed towards the organisation and delivery of comprehensive maternity care services. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Petro Rents, Political Institutions, and Hidden Wealth

    DEFF Research Database (Denmark)

    Andersen, Jørgen Juel; Johannesen, Niels; Lassen, David Dreyer

    2017-01-01

    Do political institutions limit rent seeking by politicians? We study the transformation of petroleum rents, almost universally under direct government control, into hidden wealth using unique data on bank deposits in offshore financial centers that specialize in secrecy and asset protection. Our...... rulers is diverted to secret accounts. We find very limited evidence that shocks to other types of income not directly controlled by governments affect hidden wealth....

  6. Hidden charm molecules in a finite volume

    International Nuclear Information System (INIS)

    Albaladejo, M.; Hidalgo-Duque, C.; Nieves, J.; Oset, E.

    2014-01-01

    In the present paper we address the interaction of charmed mesons in hidden charm channels in a finite box. We use the interaction from a recent model based on heavy quark spin symmetry that predicts molecules of hidden charm in the infinite volume. The energy levels in the box are generated within this model, and several methods for the analysis of these levels ("inverse problem") are investigated. (author)

  7. Workplace ageism: discovering hidden bias.

    Science.gov (United States)

    Malinen, Sanna; Johnston, Lucy

    2013-01-01

    BACKGROUND/STUDY CONTEXT: Research largely shows no performance differences between older and younger employees, or that older workers even outperform younger employees, yet negative attitudes towards older workers can underpin discrimination. Unfortunately, traditional "explicit" techniques for assessing attitudes (i.e., self-report measures) have serious drawbacks. Therefore, using an approach that is novel to organizational contexts, the authors supplemented explicit with implicit (indirect) measures of attitudes towards older workers, and examined the malleability of both. This research consists of two studies. The authors measured self-report (explicit) attitudes towards older and younger workers with a survey, and implicit attitudes with a reaction-time-based measure of implicit associations. In addition, to test whether attitudes were malleable, the authors measured attitudes before and after a mental imagery intervention, where the authors asked participants in the experimental group to imagine respected and valued older workers from their surroundings. Negative, stable implicit attitudes towards older workers emerged in two studies. Conversely, explicit attitudes showed no age bias and were more susceptible to change intervention, such that attitudes became more positive towards older workers following the experimental manipulation. This research demonstrates the unconscious nature of bias against older workers, and highlights the utility of implicit attitude measures in the context of the workplace. In the current era of aging workforce and skill shortages, implicit measures may be necessary to illuminate hidden workplace ageism.

  8. Hidden slow pulsars in binaries

    Science.gov (United States)

    Tavani, Marco; Brookshaw, Leigh

    1993-01-01

    The recent discovery of the binary containing the slow pulsar PSR 1718-19 orbiting around a low-mass companion star adds new light on the characteristics of binary pulsars. The properties of the radio eclipses of PSR 1718-19 are the most striking observational characteristics of this system. The surface of the companion star produces a mass outflow which leaves only a small 'window' in orbital phase for the detection of PSR 1718-19 around 400 MHz. At this observing frequency, PSR 1718-19 is clearly observable only for about 1 hr out of the total 6.2 hr orbital period. The aim of this Letter is twofold: (1) to model the hydrodynamical behavior of the eclipsing material from the companion star of PSR 1718-19 and (2) to argue that a population of binary slow pulsars might have escaped detection in pulsar surveys carried out at 400 MHz. The possible existence of a population of partially or totally hidden slow pulsars in binaries will have a strong impact on current theories of binary evolution of neutron stars.

  9. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...... in morbidly obese patients and should be followed by actions to counteract atelectasis formation. The decision as to weather to use a rapid sequence induction, an awake intubation or a standard induction with hypnotics should depend on the thorough airway examination and comorbidity and should not be based...... solely on whether morbid obesity is present or not. It is important to ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. The intubating laryngeal mask airway is more...

  10. Maternal age and child morbidity

    DEFF Research Database (Denmark)

    Hviid, Malene Meisner; Skovlund, Charlotte Wessel; Mørch, Lina Steinrud

    2017-01-01

    the association between maternal age and overall child morbidity according to main diagnosis groups. MATERIAL AND METHODS: We conducted a national cohort study including 352 027 live firstborn singleton children. The children were born between Jan 1994 and Dec 2009 and followed to Dec 2012. Children were divided...... into groups according to maternal age: 15-24, 25-29, 30-34, and 35+ years. Poisson regression analyses calculated adjusted incidence rate ratios (IRR) of child morbidities according to main diagnoses groups A-Q of the International Classification of Disease 10 with adjustment for year of birth, body mass...... index, smoking, and mother's level of education. RESULTS: Average follow-up time was 11 years. Compared to children born to women 25-29 years, firstborn children to mothers aged 35+ had higher child morbidity in 8 of 19 main diagnosis groups and firstborn children to mothers 15-24 years had higher child...

  11. [Remuneration distribution - should morbidity-dependent overall remuneration also be distributed after adjustments for morbidity?].

    Science.gov (United States)

    Walendzik, A; Trottmann, M; Leonhardt, R; Wasem, J

    2013-04-01

    In the 2009 reform of the German collective remuneration system for outpatient medical care, on the level of overall remuneration, the morbidity risk was transferred to the health funds fulfilling a long-term demand of physicians. Nevertheless not transferring morbidity adjustment to the levels of physician groups and singular practices can lead to budgets not related to patient needs and to incentives for risk selection for individual doctors. The systematics of the distribution of overall remuneration in the German remuneration system for outpatient care are analysed focusing on the aspect of morbidity adjustment. Using diagnostic and pharmaceutical information of about half a million insured subjects, a risk adjustment model able to predict individual expenditures for outpatient care for different provider groups is presented. This model enables to additively split the individual care burden into several parts attributed to different physician groups. Conditions for the use of the model in the distribution of overall remuneration between physician groups are developed. A simulation of the use of diagnoses-based risk adjustment in standard service volumes then highlights the conditions for a successfull installation of standard service volumes representing a higher degree of risk adjustment. The presented estimation model is generally applicable for the distribution of overall remuneration to different physician groups. The simulation of standard service volumes using diagnosis-based risk adjustment does not provide a more accurate prediction of the expenditures on the level of physician practices than the age-related calculation currently used in the German remuneration system for outpatient medical care. Using elements of morbidity-based risk adjustment the current German collective system for outpatient medical care could be transformed towards a higher degree of distributional justice concerning medical care for patients and more appropriate incentives

  12. Preoperative factors influencing mortality and morbidity in peptic ulcer perforation.

    Science.gov (United States)

    Sivaram, P; Sreekumar, A

    2018-04-01

    Perforated peptic ulcer is one of the most common surgical emergencies worldwide. With the improvement in medical therapy for peptic ulcers, the number of elective surgical procedures has come down. However, the incidence of perforated peptic ulcer is still increasing and remains as a substantial health problem with significant postoperative morbidity and mortality. This study aimed to find out the association between various preoperative and intraoperative factors with the postoperative mortality and morbidity in patients operated for peptic ulcer perforation. This prospective observational study had a time based sample of 101 perforation peritonitis cases admitted to the surgical wards of a tertiary care center from February 2015 to January 2016 who underwent laparotomy, diagnosed to have peptic ulcer perforation and underwent simple closure with an omental patch. Data regarding age, gender, presenting complaints, time elapsed from the onset of symptoms to surgery, physical examination findings, comorbid diseases, laboratory and imaging findings, intraoperative findings, length of hospital stay, postoperative morbidity, and mortality were recorded and analyzed. Female gender, older age group, perforation surgery interval more than 36 h, and size of perforation more than 1 cm 2 were found to be significant factors influencing postoperative mortality and morbidity. Postoperative morbidity was also associated with comorbid diseases. Abnormal renal function on presentation was identified as an additional risk factor for postoperative morbidity and longer hospital stay. An understanding of these factors, identification of patients at risk and early intervention can help in reducing the postoperative morbidity and mortality in peptic ulcer perforation.

  13. Geographic Variation in Morbidity and Mortality of Cerebrovascular Diseases in Korea during 2011-2015.

    Science.gov (United States)

    Lee, Juyeon; Bahk, Jinwook; Kim, Ikhan; Kim, Yeon-Yong; Yun, Sung-Cheol; Kang, Hee-Yeon; Lee, Jeehye; Park, Jong Heon; Shin, Soon-Ae; Khang, Young-Ho

    2018-03-01

    Little is known about within-country variation in morbidity and mortality of cerebrovascular diseases (CVDs). Geographic differences in CVD morbidity and mortality have yet to be properly examined. This study examined geographic variation in morbidity and mortality of CVD, neighborhood factors for CVD morbidity and mortality, and the association between CVD morbidity and mortality across the 245 local districts in Korea during 2011-2015. District-level health care utilization and mortality data were obtained to estimate age-standardized CVD morbidity and mortality. The bivariate Pearson correlation was used to examine the linear relationship between district-level CVD morbidity and mortality Z-scores. Simple linear regression and multivariate analyses were conducted to investigate the associations of area characteristics with CVD morbidity, mortality, and discrepancies between morbidity and mortality. Substantial variation was found in CVD morbidity and mortality across the country, with 1074.9 excess CVD inpatients and 73.8 excess CVD deaths per 100,000 between the districts with the lowest and highest CVD morbidity and mortality, respectively. Higher rates of CVD admissions and deaths were clustered in the noncapital regions. A moderate geographic correlation between CVD morbidity and mortality was found (Pearson correlation coefficient = .62 for both genders). Neighborhood level indicators for socioeconomic disadvantages, undersupply of health care resources, and unhealthy behaviors were positively associated with CVD morbidity and mortality and the relative standing of CVD mortality vis-à-vis morbidity. Policy actions targeting life-course socioeconomic conditions, equitable distribution of health care resources, and behavioral risk factors may help reduce geographic differences in CVD morbidity and mortality in Korea. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Probing hidden sector photons through the Higgs window

    International Nuclear Information System (INIS)

    Ahlers, M.

    2008-07-01

    We investigate the possibility that a (light) hidden sector extra photon receives its mass via spontaneous symmetry breaking of a hidden sector Higgs boson, the so-called hidden-Higgs. The hidden-photon can mix with the ordinary photon via a gauge kinetic mixing term. The hidden-Higgs can couple to the Standard Model Higgs via a renormalizable quartic term - sometimes called the Higgs Portal. We discuss the implications of this light hidden-Higgs in the context of laser polarization and light-shining-through-the-wall experiments as well as cosmological, astrophysical, and non-Newtonian force measurements. For hidden-photons receiving their mass from a hidden-Higgs we find in the small mass regime significantly stronger bounds than the bounds on massive hidden sector photons alone. (orig.)

  15. Probing hidden sector photons through the Higgs window

    International Nuclear Information System (INIS)

    Ahlers, Markus; Jaeckel, Joerg; Redondo, Javier; Ringwald, Andreas

    2008-01-01

    We investigate the possibility that a (light) hidden sector extra photon receives its mass via spontaneous symmetry breaking of a hidden sector Higgs boson, the so-called hidden-Higgs. The hidden-photon can mix with the ordinary photon via a gauge kinetic mixing term. The hidden-Higgs can couple to the standard model Higgs via a renormalizable quartic term - sometimes called the Higgs portal. We discuss the implications of this light hidden-Higgs in the context of laser polarization and light-shining-through-the-wall experiments as well as cosmological, astrophysical, and non-Newtonian force measurements. For hidden-photons receiving their mass from a hidden-Higgs, we find in the small mass regime significantly stronger bounds than the bounds on massive hidden sector photons alone.

  16. Psychiatric morbidity and non-participation in breast cancer screening.

    Science.gov (United States)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Bech, Bodil Hammer; Andersen, Berit; Vedsted, Peter

    2016-02-01

    Organised breast cancer screening is currently one of the best strategies for early-stage breast cancer detection. However, early detection has proven challenging for women with psychiatric disease. This study aims to investigate psychiatric morbidity and non-participation in breast cancer screening. We conducted an observational cohort study including women invited to the first organised screening round in the Central Denmark Region. Data on psychiatric diagnosis, psychoactive prescription medicine and consultation with private psychiatrists were obtained from Danish registries and assessed for a period of up to 10 years before the screening date. The cohort comprised 144,264 women whereof 33.0% were registered with an indication of psychiatric morbidity. We found elevated non-participation propensity among women with a psychiatric diagnosis especially for women with schizophrenia and substance abuse. Also milder psychiatric morbidity was associated with higher non-participation likelihood as women who had redeemed psychoactive prescription medicine or have had minimum one consultation with a private psychiatrist were more likely not to participate. Finally, we found that the chronicity of psychiatric morbidity was associated with non-participation and that woman who had a psychiatric morbidity defined as 'persistent' had higher likelihood of non-participation than women with recently active morbidity or inactive psychiatric morbidity. This study showed a strong association between psychiatric morbidity and an increased likelihood of non-participation in breast cancer screening in a health care system with universal and tax-funded health services. This knowledge may inform interventions targeting women with psychiatric morbidity as they have poorer breast cancer prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Fitting Hidden Markov Models to Psychological Data

    Directory of Open Access Journals (Sweden)

    Ingmar Visser

    2002-01-01

    Full Text Available Markov models have been used extensively in psychology of learning. Applications of hidden Markov models are rare however. This is partially due to the fact that comprehensive statistics for model selection and model assessment are lacking in the psychological literature. We present model selection and model assessment statistics that are particularly useful in applying hidden Markov models in psychology. These statistics are presented and evaluated by simulation studies for a toy example. We compare AIC, BIC and related criteria and introduce a prediction error measure for assessing goodness-of-fit. In a simulation study, two methods of fitting equality constraints are compared. In two illustrative examples with experimental data we apply selection criteria, fit models with constraints and assess goodness-of-fit. First, data from a concept identification task is analyzed. Hidden Markov models provide a flexible approach to analyzing such data when compared to other modeling methods. Second, a novel application of hidden Markov models in implicit learning is presented. Hidden Markov models are used in this context to quantify knowledge that subjects express in an implicit learning task. This method of analyzing implicit learning data provides a comprehensive approach for addressing important theoretical issues in the field.

  18. Geometric phases and hidden local gauge symmetry

    International Nuclear Information System (INIS)

    Fujikawa, Kazuo

    2005-01-01

    The analysis of geometric phases associated with level crossing is reduced to the familiar diagonalization of the Hamiltonian in the second quantized formulation. A hidden local gauge symmetry, which is associated with the arbitrariness of the phase choice of a complete orthonormal basis set, becomes explicit in this formulation (in particular, in the adiabatic approximation) and specifies physical observables. The choice of a basis set which specifies the coordinate in the functional space is arbitrary in the second quantization, and a subclass of coordinate transformations, which keeps the form of the action invariant, is recognized as the gauge symmetry. We discuss the implications of this hidden local gauge symmetry in detail by analyzing geometric phases for cyclic and noncyclic evolutions. It is shown that the hidden local symmetry provides a basic concept alternative to the notion of holonomy to analyze geometric phases and that the analysis based on the hidden local gauge symmetry leads to results consistent with the general prescription of Pancharatnam. We however note an important difference between the geometric phases for cyclic and noncyclic evolutions. We also explain a basic difference between our hidden local gauge symmetry and a gauge symmetry (or equivalence class) used by Aharonov and Anandan in their definition of generalized geometric phases

  19. Morbidity and mortality associated with obstetric hysterectomy

    International Nuclear Information System (INIS)

    Shaikh, N.B.; Shaikh, S.; Shaikh, J.M.

    2010-01-01

    Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

  20. Cultural competence in medical education: aligning the formal, informal and hidden curricula.

    Science.gov (United States)

    Paul, David; Ewen, Shaun C; Jones, Rhys

    2014-12-01

    The concept of cultural competence has become reified by inclusion as an accreditation standard in the US and Canada, in New Zealand it is demanded through an Act of Parliament, and it pervades discussion in Australian medical education discourse. However, there is evidence that medical graduates feel poorly prepared to deliver cross-cultural care (Weissman et al. in J Am Med Assoc 294(9):1058-1067, 2005) and many commentators have questioned the effectiveness of cultural competence curricula. In this paper we apply Hafferty's taxonomy of curricula, the formal, informal and hidden curriculum (Hafferty in Acad Med 73(4):403-407, 1998), to cultural competence. Using an example across each of these curricular domains, we highlight the need for curricular congruence to support cultural competence development among learners. We argue that much of the focus on cultural competence has been in the realm of formal curricula, with existing informal and hidden curricula which may be at odds with the formal curriculum. The focus of the formal, informal and hidden curriculum, we contend, should be to address disparities in health care outcomes. In conclusion, we suggest that without congruence between formal, informal and hidden curricula, approaches to addressing disparity in health care outcomes in medical education may continue to represent reform without change.

  1. Morbidity figures from general practice: sex differences in traumatology.

    Science.gov (United States)

    Lagro-Janssen, Toine; Grosicar, Janja

    2010-08-01

    Trauma prevention starts with to find out the extent of the problem and who it affects. Insight into morbidity figures is therefore necessary. To explore sex differences in traumatology and secondary medical care utilization in primary care related to age and socio-economic status (SES). Data were obtained from an academic continuous morbidity registration project in the Netherlands in the period from 1996 to 2006, in which 13,000 patients were followed in 10 successive years. Sex differences showed a male excess from childhood to 45 years and women showing almost double trauma rates in the elderly. Low SES was associated with the greatest incidence of traumas. The largest sex difference in incidence above 65 years appeared in the high SES with more traumas in women compared with men. From this age on, female morbidity in traumatology outnumbered male morbidity regardless of SES. Considering use of referrals, we found that in the age group 15-45 years men made a greater use of secondary medical care. However, the vastest gender influence in medical care utilization was noticed in the age group over 65 years, outnumbered with women. Young men and old women are the most at risk for traumatic health problems: men presenting with traumata of the skull, the tibia and ocular trauma's and women with fractures of the femur, humerus and wrist. For both men and women the greatest incidence is in the low SES. Family physicians can play a pivotal role in prevention to focus on their patients with high risks.

  2. Management of co-morbidity of depression and chronic non ...

    African Journals Online (AJOL)

    Methods: The study used an action research design involving a research team of 14 health care professionals to collaboratively identify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus group discussion using a structured interview guide was used to collect qualitative ...

  3. A study of geriatric depression and co- morbidities among primary ...

    African Journals Online (AJOL)

    Depression in the elderly is very common but diagnostic rates among primary care physicians is poor. This is attributed to both patient and physician related factors. The patient factors include co-morbidities, aging and psychological mindedness which is culture related. Generally, there's paucity of psychological complaints ...

  4. Massive hidden photons as lukewarm dark matter

    International Nuclear Information System (INIS)

    Redondo, Javier; Postma, Marieke

    2008-11-01

    We study the possibility that a keV-MeV mass hidden photon (HP), i.e. a hidden sector U(1) gauge boson, accounts for the observed amount of dark matter. We focus on the case where the HP interacts with the standard model sector only through kinetic mixing with the photon. The relic abundance is computed including all relevant plasma effects into the photon's self-energy, which leads to a resonant yield almost independent of the HP mass. The HP can decay into three photons. Moreover, if light enough it can be copiously produced in stars. Including bounds from cosmic photon backgrounds and stellar evolution, we find that the hidden photon can only give a subdominant contribution to the dark matter. This negative conclusion may be avoided if another production mechanism besides kinetic mixing is operative. (orig.)

  5. Massive hidden photons as lukewarm dark matter

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, Javier [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Postma, Marieke [Nationaal Inst. voor Kernfysica en Hoge-Energiefysica (NIKHEF), Amsterdam (Netherlands)

    2008-11-15

    We study the possibility that a keV-MeV mass hidden photon (HP), i.e. a hidden sector U(1) gauge boson, accounts for the observed amount of dark matter. We focus on the case where the HP interacts with the standard model sector only through kinetic mixing with the photon. The relic abundance is computed including all relevant plasma effects into the photon's self-energy, which leads to a resonant yield almost independent of the HP mass. The HP can decay into three photons. Moreover, if light enough it can be copiously produced in stars. Including bounds from cosmic photon backgrounds and stellar evolution, we find that the hidden photon can only give a subdominant contribution to the dark matter. This negative conclusion may be avoided if another production mechanism besides kinetic mixing is operative. (orig.)

  6. Religious Tolerance in the Hidden Curriculum

    Directory of Open Access Journals (Sweden)

    Kevin Nobel Kurniawan

    2018-03-01

    Full Text Available Religious intolerance is spreading within the Indonesian institution of education. Previous studies have shown that the growth of intolerance is due to the state’s regulation and pedagogical apparatus. In contrast to the previous studies, I argue that the intolerance is related to hidden curriculum applied by the institution of education.  Normatively, the hidden curriculum contains the value of religious tolerance. However, factually, the author found that there are practices of intolerance, through the formal and informal spheres in the school’s structure, within the hidden curriculum. This article applies a qualitative approach with a mixed method research strategy to analyze data collected from students, teachers, and alumnis through field observation, in-depth interview, and survey.

  7. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re......-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more...

  8. Liver morphology in morbid obesity

    DEFF Research Database (Denmark)

    Andersen, T; Gluud, C

    1984-01-01

    Literature on liver morphology in untreated obesity reveals varying prevalences of various pathological findings. The purpose of this literature study was to summarize and evaluate the published observations and to discuss discrepant findings. A complete search was aimed at utilizing bibliographic...... methods including a computerized survey. Forty-one original articles were included, comprising information on liver morphology in 1515 morbidly obese patients. Liver biopsy was considered normal in 12 per cent of the cases. The most frequent abnormality reported was fatty change, present in 80 per cent...... of obesity, age, sex, alcohol consumption, diabetes mellitus) does not point towards a single causal factor. Co-influence of additional pathogenetic factors are likely in the development of liver changes in morbid obesity....

  9. Laryngeal morbidity after tracheal intubation

    DEFF Research Database (Denmark)

    Sørensen, M K; Rasmussen, N; Kristensen, M S

    2013-01-01

    BACKGROUND: Tracheal intubation may cause vocal fold damage. The trial was designed to assess laryngeal morbidity comparing the Endoflex(®) tube with a conventional endotracheal tube with stylet. We hypothesised that laryngeal morbidity within the first 24 h after extubation would be lower...... with the Endoflex tube than with the conventional endotracheal tube with stylet because of less rigidity. METHODS: This randomised trial included 130 elective surgical patients scheduled for general anaesthesia with endotracheal intubation. Pre- and post-operative assessment of hoarseness, vocal fold pathology......% with the Endoflex tube and 55% with the endotracheal tube with stylet at 24 h after extubation (P = 0.44). Post-operative vocal fold injury was present in 23% in the Endoflex tube group and in 36% in the endotracheal tube with stylet group (P = 0.13). The increase in shimmer, the voice analysis variable reflecting...

  10. Hidden treasures - 50 km points of interests

    Science.gov (United States)

    Lommi, Matias; Kortelainen, Jaana

    2015-04-01

    Tampere is third largest city in Finland and a regional centre. During 70's there occurred several communal mergers. Nowadays this local area has both strong and diversed identity - from wilderness and agricultural fields to high density city living. Outside the city center there are interesting geological points unknown for modern city settlers. There is even a local proverb, "Go abroad to Teisko!". That is the area the Hidden Treasures -student project is focused on. Our school Tammerkoski Upper Secondary School (or Gymnasium) has emphasis on visual arts. We are going to offer our art students scientific and artistic experiences and knowledge about the hidden treasures of Teisko area and involve the Teisko inhabitants into this project. Hidden treasures - Precambrian subduction zone and a volcanism belt with dense bed of gold (Au) and arsenic (As), operating goldmines and quarries of minerals and metamorphic slates. - North of subduction zone a homogenic precambrian magmastone area with quarries, products known as Kuru Grey. - Former ashores of post-glasial Lake Näsijärvi and it's sediments enabled the developing agriculture and sustained settlement. Nowadays these ashores have both scenery and biodiversity values. - Old cattle sheds and dairy buildings made of local granite stones related to cultural stonebuilding inheritance. - Local active community of Kapee, about 100 inhabitants. Students will discover information of these "hidden" phenomena, and rendering this information trough Enviromental Art Method. Final form of this project will be published in several artistic and informative geocaches. These caches are achieved by a GPS-based special Hidden Treasures Cycling Route and by a website guiding people to find these hidden points of interests.

  11. Cancer morbidity in alcohol abusers

    DEFF Research Database (Denmark)

    Tønnesen, H; Møller, Henrik; Andersen, J R

    1994-01-01

    Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared with th...... and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers.......Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared...... with that of the total Danish population. On average the 15,214 men were observed for 12.9 years and the 3,093 women for 9.4 years. The overall morbidity of cancer was increased significantly. Of the men, 1,441 developed cancer [relative risk (RR) = 1.6; 95% confidence interval (CI) = 1.5-1.7], while 182 women did (RR...

  12. Ocular morbidity among porters at high altitudes.

    Science.gov (United States)

    Gnyawali, Subodh; Shrestha, Gauri Shankar; Khanal, Safal; Dennis, Talisa; Spencer, John C

    2017-01-01

    High altitude, often characterized by settings over 2400m, can be detrimental to the human body and pose a significant risk to ocular health. Reports concerning various ocular morbidities occurring as a consequence of high altitude are limited in the current literature. This study was aimed at evaluating the ocular health of porters working at high altitudesof Himalayas in Nepal. A mobile eye clinic was set up in Ghat and patient data were collected from its out- patient unit by a team of seven optometrists which was run for five days. Ghat is a small village in north-eastern Nepal, located at 2860 m altitude. Travellers walking through the trekking route were invited to get their eyes checked at the clinic. Comprehensive ocular examinations were performed, including visual acuities, objective and subjective refraction, anterior and posterior segment evaluations, and intraocular pressure measurements; blood pressure and blood glucose levels were also measured as required. Ocular therapeutics, prescription glasses, sunglasses and ocular health referrals were provided free of cost as necessary. A total of 1890 people visited the eye clinic, among which 57.4% (n=1084) were porters. Almost half of the porters had an ocular morbidity. Correctable refractive error was most prevalent, with other ocular health-related complications, including dry eye disease, infectious disorders, glaucoma and cataract. Proper provision of regular and effective eye care services should be made more available for those residing at these high altitudes in Nepal. © NEPjOPH.

  13. The origin of the hidden supersymmetry

    International Nuclear Information System (INIS)

    Jakubsky, Vit; Nieto, Luis-Miguel; Plyushchay, Mikhail S.

    2010-01-01

    The hidden supersymmetry and related tri-supersymmetric structure of the free particle system, the Dirac delta potential problem and the Aharonov-Bohm effect (planar, bound state, and tubule models) are explained by a special nonlocal unitary transformation, which for the usual N=2 supercharges has a nature of Foldy-Wouthuysen transformation. We show that in general case, the bosonized supersymmetry of nonlocal, parity even systems emerges in the same construction, and explain the origin of the unusual N=2 supersymmetry of electron in three-dimensional parity even magnetic field. The observation extends to include the hidden superconformal symmetry.

  14. Signatures of a hidden cosmic microwave background.

    Science.gov (United States)

    Jaeckel, Joerg; Redondo, Javier; Ringwald, Andreas

    2008-09-26

    If there is a light Abelian gauge boson gamma' in the hidden sector its kinetic mixing with the photon can produce a hidden cosmic microwave background (HCMB). For meV masses, resonant oscillations gammagamma' happen after big bang nucleosynthesis (BBN) but before CMB decoupling, increasing the effective number of neutrinos Nnu(eff) and the baryon to photon ratio, and distorting the CMB blackbody spectrum. The agreement between BBN and CMB data provides new constraints. However, including Lyman-alpha data, Nnu(eff) > 3 is preferred. It is tempting to attribute this effect to the HCMB. The interesting parameter range will be tested in upcoming laboratory experiments.

  15. Hidden simplicity of gauge theory amplitudes

    Energy Technology Data Exchange (ETDEWEB)

    Drummond, J M, E-mail: drummond@lapp.in2p3.f [LAPTH, Universite de Savoie, CNRS, B.P. 110, F-74941 Annecy-le-Vieux, Cedex (France)

    2010-11-07

    These notes were given as lectures at the CERN Winter School on Supergravity, Strings and Gauge Theory 2010. We describe the structure of scattering amplitudes in gauge theories, focussing on the maximally supersymmetric theory to highlight the hidden symmetries which appear. Using the Britto, Cachzo, Feng and Witten (BCFW) recursion relations we solve the tree-level S-matrix in N=4 super Yang-Mills theory and describe how it produces a sum of invariants of a large symmetry algebra. We review amplitudes in the planar theory beyond tree level, describing the connection between amplitudes and Wilson loops, and discuss the implications of the hidden symmetries.

  16. Searching for hidden sectors in multiparticle production at the LHC

    CERN Document Server

    Sanchis-Lozano, Miguel-Angel; Moreno-Picot, Salvador

    2016-01-01

    We study the impact of a hidden sector beyond the Standard Model, e.g. a Hidden Valley model, on factorial moments and cumulants of multiplicity distributions in multiparticle production with a special emphasis on the prospects for LHC results.

  17. Compressing the hidden variable space of a qubit

    OpenAIRE

    Montina, Alberto

    2010-01-01

    In previously exhibited hidden variable models of quantum state preparation and measurement, the number of continuous hidden variables describing the actual state of a single realization is never smaller than the quantum state manifold dimension. We introduce a simple model for a qubit whose hidden variable space is one-dimensional, i.e., smaller than the two-dimensional Bloch sphere. The hidden variable probability distributions associated with the quantum states satisfy reasonable criteria ...

  18. Hidden Markov Models for Human Genes

    DEFF Research Database (Denmark)

    Baldi, Pierre; Brunak, Søren; Chauvin, Yves

    1997-01-01

    We analyse the sequential structure of human genomic DNA by hidden Markov models. We apply models of widely different design: conventional left-right constructs and models with a built-in periodic architecture. The models are trained on segments of DNA sequences extracted such that they cover com...

  19. The Hidden Cost of Buying a Computer.

    Science.gov (United States)

    Johnson, Michael

    1983-01-01

    In order to process data in a computer, application software must be either developed or purchased. Costs for modifications of the software package and maintenance are often hidden. The decision to buy or develop software packages should be based upon factors of time and maintenance. (MLF)

  20. Hidden symmetries in five-dimensional supergravity

    International Nuclear Information System (INIS)

    Poessel, M.

    2003-05-01

    This thesis is concerned with the study of hidden symmetries in supergravity, which play an important role in the present picture of supergravity and string theory. Concretely, the appearance of a hidden G 2(+2) /SO(4) symmetry is studied in the dimensional reduction of d=5, N=2 supergravity to three dimensions - a parallel model to the more famous E 8(+8) /SO(16) case in eleven-dimensional supergravity. Extending previous partial results for the bosonic part, I give a derivation that includes fermionic terms. This sheds new light on the appearance of the local hidden symmetry SO(4) in the reduction, and shows up an unusual feature which follows from an analysis of the R-symmetry associated with N=4 supergravity and of the supersymmetry variations, and which has no parallel in the eleven-dimensional case: The emergence of an additional SO(3) as part of the enhanced local symmetry, invisible in the dimensional reduction of the gravitino, and corresponding to the fact that, of the SO(4) used in the coset model, only the diagonal SO(3) is visible immediately upon dimensional reduction. The uncovering of the hidden symmetries proceeds via the construction of the proper coset gravity in three dimensions, and matching it with the Lagrangian obtained from the reduction. (orig.)

  1. Hidden Markov models for labeled sequences

    DEFF Research Database (Denmark)

    Krogh, Anders Stærmose

    1994-01-01

    A hidden Markov model for labeled observations, called a class HMM, is introduced and a maximum likelihood method is developed for estimating the parameters of the model. Instead of training it to model the statistics of the training sequences it is trained to optimize recognition. It resembles MMI...

  2. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...... airway and the function of the lungs (decreased residual capacity and aggravated ventilation perfusion mismatch) worse than in lean patients. Proper planning and preparation of airway management is essential, including elevation of the patient's upper body, head and neck. Preoxygenation is mandatory...

  3. Evaluation of morbidity from mortality.

    Science.gov (United States)

    Damiani, P; Massé, H; Aubenque, M

    1983-01-01

    The authors have attempted to measure morbidity involved in mortality, from French regional statistics of causes of death, for the 1968-1970 period. Particularly, they have estimated prevalence rates (proportion of patients at a given moment) and incidence rates (annual proportion of new patients). These rates have been assessed by sex, and for age groups: 15-44 years, 45-64 years, 65-74 years, 75 years and more, and for 18 leading causes of death, according to the International Classification of Diseases (1965). Statistics of causes of deaths have been corrected to take into account non specified causes of death.

  4. Cocaine addiction: the hidden dimension.

    Science.gov (United States)

    Oswald, L M

    1989-06-01

    There is growing awareness within the nursing profession that nurses need to expand their knowledge about addiction and develop expertise in providing care for substance abusing clients. This report presents a discussion about cocaine abuse that is focused on evolving knowledge about the physiology of addiction. Researchers have recently described cocaine-induced neurochemical changes in the brain that may form the underpinnings for the behavioral manifestations and symptomatology that have been associated with cocaine addiction. These neurochemical alterations are described at the cellular level, and treatment implications for nurses are presented.

  5. Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-01-01

    Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 - 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.

  6. The hidden crime: human trafficking.

    Science.gov (United States)

    Clause, Kristen J; Lawler, Kate Byrnes

    2013-01-01

    As the primary contact in the health care system, nurses can play a role in combating this crime and assisting the victims. Assessment for abuse, neglect, trauma, recurrent sexually transmitted infections (STIs) and fear of a controlling partner is critical. Following up on "red flags" and understanding methods of safe questioning can make the difference between slavery and recovery for victims. Nurses must also know the professional referrals in their areas once a potential victim has been identified. This may be a very dangerous undertaking and must be handled by experienced personnel. Referrals to forensic nurses or physicians, domestic violence professionals or law enforcement may be indicated. Initially, a nurse may want to consult with the agency social worker for guidance. Human trafficking is a human rights crime. Unfortunately, it is more prevalent in all types of communities than most people suspect. Nurses can be heroes to the victims through understanding of this crime and vigilance in the assessment and care of all people they encounter in their practices.

  7. The benefits of reduced morbidity

    Energy Technology Data Exchange (ETDEWEB)

    Krupnick, A; Hood, C; Harrison, K

    1994-07-01

    Morbidity benefits refer to increases in utility arising from reductions in incidents of acute health impairments and from increases in the probability of developing chronic diseases. The impairments would run the gamut from a cough-day to a bed-disability-day, while the chronic diseases include classic pollution-related diseases, such as cancer, to in utero effects and learning disabilities. As with mortality benefits, there could be benefits to oneself and family and friends as well as benefits based on altruism. A major difference between the mortality and morbidity valuation literatures is that while estimates of the former are always based on risk (one is never trying to obtain values for avoiding certain death), estimates of the latter generally are not. That is, most of the theory and empirical estimates are based on models where the effect to be avoided is certain. This assumption holds reasonably well for estimating common acute effects, for example, the willingness to pay (WTP) for one less cough-day. It works less well, if at all, for chronic illness endpoints, where benefits seem to be appropriately expressed in terms of reduced risk of developing a disease or impairment.

  8. The benefits of reduced morbidity

    International Nuclear Information System (INIS)

    Krupnick, A.; Hood, C.; Harrison, K.

    1994-01-01

    Morbidity benefits refer to increases in utility arising from reductions in incidents of acute health impairments and from increases in the probability of developing chronic diseases. The impairments would run the gamut from a cough-day to a bed-disability-day, while the chronic diseases include classic pollution-related diseases, such as cancer, to in utero effects and learning disabilities. As with mortality benefits, there could be benefits to oneself and family and friends as well as benefits based on altruism. A major difference between the mortality and morbidity valuation literatures is that while estimates of the former are always based on risk (one is never trying to obtain values for avoiding certain death), estimates of the latter generally are not. That is, most of the theory and empirical estimates are based on models where the effect to be avoided is certain. This assumption holds reasonably well for estimating common acute effects, for example, the willingness to pay (WTP) for one less cough-day. It works less well, if at all, for chronic illness endpoints, where benefits seem to be appropriately expressed in terms of reduced risk of developing a disease or impairment

  9. Jealous love and morbid jealousy.

    Science.gov (United States)

    Maggini, Carlo; Lundgren, Eva; Leuci, Emanuela

    2006-12-01

    Jealous love and morbid jealousy, although inextricably linked, cannot be considered the same: jealous love (trait jealousy) is the behavioral and cognitive-affective precondition of morbid jealousy (state jealousy). Love is jealous when it is devoured by the desire for the exclusive and total possession of the partner, whose unconditional and continued presence is avidly requested. This type of love, in addition, is permeated by the need to know what the other is thinking, in order to scrutinize every minimal flaw in the faithfulness of the partner even in his or her innermost thoughts and fantasies; in it, jealousy is virtually always present, even in the absence of a triggering event, because captative love, by its very nature, includes the expectation of a conflict which inevitably actually takes place in reality. Finally, jealousy emerges as an emotional event (jealous flash) in response to a more or less significant change in the behavior of the partner, and reveals to the jealous individual a dimension which was previously latent or inexistent. This intense and brief experience, leaves a more or less blurred memory behind, and tends to progressively repeat itself and take root as a feeling.

  10. Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

    Science.gov (United States)

    Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

    "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

  11. Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

    DEFF Research Database (Denmark)

    Stage, E; Mathiesen, E R; Emmersen, P B

    2010-01-01

    As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity....

  12. Estimating morbidity rates from electronic medical records in general practice: evaluation of a grouping system.

    NARCIS (Netherlands)

    Biermans, M.C.J.; Verheij, R.A.; Bakker, D.H. de; Zielhuis, G.A.; Vries Robbé, P.F. de

    2008-01-01

    Objectives: In this study, we evaluated the internal validity of EPICON, an application for grouping ICPCcoded diagnoses from electronic medical records into episodes of care. These episodes are used to estimate morbidity rates in general practice. Methods: Morbidity rates based on EPICON were

  13. Mindfulness and eating behaviour styles in morbidly obese males and females

    NARCIS (Netherlands)

    Ouwens, M.A.; Schiffer, A.A.J.; Visser, L.I.; Raaijmakers, L.J.C.; Nyklicek, I.

    2015-01-01

    Background: Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions

  14. Morbidity pattern and its sociodemographic determinants among elderly population of Raichur district, Karnataka, India

    Directory of Open Access Journals (Sweden)

    Leyanna Susan George

    2017-01-01

    Full Text Available Context: India is an “aging nation” with 7.7% of its population being above 60 years of age. It has resulted in a rise of both physical and mental health morbidities. Aims: This study aimed to gather information regarding the morbidity pattern and its sociodemographic determinants among the elderly residing in the rural villages of Raichur, to understand the need for geriatric health-care facilities. Settings and Design: This community-based cross-sectional study was carried out in six rural villages of Raichur District, of which 230 elderly were selected randomly. Subjects and Methods: The data were collected using a questionnaire, clinical history, examination, and cross-checking of medical records. Statistical Analysis Used: Data were analyzed using Epi Info version-3.5.3. Results: The prevalence of morbidity was 91.7% with an average of 3/person. Females (58.9% had more morbidities than men (41.1%. The 3 most common morbidities were orthopedic (50.5%, cataract (50.4%, and respiratory (31.3%. 26.6% suffered from gastrointestinal morbidities while 23.9% had dental problems. 20.9% had hypertension with equal prevalence among both sexes. Only 17.4% were diabetics with majority being women. Central nervous system morbidities were 14.2% while 9.6% suffered from hearing loss and varicose veins. 8.2% had genitourinary-urinary morbidities and incontinence (1.7% was common among both sexes. Depression (71.1% and dermatological morbidities (4.7% were prevalent among women. Only 3.5% suffered from cardiac morbidity and 0.4% from cancer. Significant association was found between age and morbidity and also between socioeconomic class and morbidity pattern. Conclusions: Geriatric care should become an integral part of primary health care. Regular screening and Information, Education, and Communication activities need to be provided early in life for ensuring healthy aging.

  15. Co-morbid disorders in Tourette syndrome

    DEFF Research Database (Denmark)

    Debes, Nanette Marinette Monique

    2013-01-01

    in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co......-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS...

  16. Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

    Directory of Open Access Journals (Sweden)

    Shamsa Zafar

    Full Text Available For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective and psychological morbidities in two different low-income countries.Cross sectional study with assessment of morbidity in early pregnancy (34%, late pregnancy (35% and the postnatal period (31% among 3459 women from two rural communities in Pakistan (1727 and Malawi (1732. Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective. Both infective (Pakistan and non-infective morbidity (Pakistan and Malawi was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon ( 9. Complications during a previous pregnancy, infective morbidity (p <0.001, intra or postpartum haemorrhage (p <0.02 were associated with psychological morbidity in both settings.Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

  17. Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

    Science.gov (United States)

    Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P; van den Broek, Nynke R

    2015-01-01

    For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

  18. Cancer morbidity in alcohol abusers

    DEFF Research Database (Denmark)

    Tønnesen, H; Møller, Henrik; Andersen, J R

    1994-01-01

    Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared...... colonic (RR = 1.0; 95% CI 0.8-1.3) or rectal cancer (RR = 1.0; CI 0.7-1.3) than expected. The risk of breast cancer in women was slightly increased (RR = 1.3; 95% CI 0.9-1.7), but not statistically significant. Thus, the associations between alcohol and cancer of the upper digestive and respiratory tract...... and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers....

  19. Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) - Smoking-Attributable Expenditures (SAE)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures...

  20. Extended abstract of a hidden agenda

    Energy Technology Data Exchange (ETDEWEB)

    Goguen, J.; Malcolm, G. [Oxford Univ. (United Kingdom)

    1996-12-31

    The initial goal of our hidden research programme was both straightforward and ambitious: give a semantics for software engineering, and in particular for the object paradigm, supporting correctness proofs that are as simple and mechanical as possible. This emphasizes proofs rather than models, and thus suggests an equational approach, rather than one based on higher order logic, denotational semantics, or any kind of model, because equational proofs achieve maximal simplicity and mechanization, and yet are fully expressive. We introduce powerful coinduction techniques for proving behavioral properties of complex systems. We make the no doubt outrageous claim that our hidden approach gives simpler proofs than other formalisms; this is because we exploit algebraic structure that most other approaches discard.

  1. Laser experiments explore the hidden sector

    International Nuclear Information System (INIS)

    Ahlers, M.

    2007-11-01

    Recently, the laser experiments BMV and GammeV, searching for light shining through walls, have published data and calculated new limits on the allowed masses and couplings for axion-like particles. In this note we point out that these experiments can serve to constrain a much wider variety of hidden-sector particles such as, e.g., minicharged particles and hidden-sector photons. The new experiments improve the existing bounds from the older BFRT experiment by a factor of two. Moreover, we use the new PVLAS constraints on a possible rotation and ellipticity of light after it has passed through a strong magnetic field to constrain pure minicharged particle models. For masses -7 times the electron electric charge. This is the best laboratory bound and comparable to bounds inferred from the energy spectrum of the cosmic microwave background. (orig.)

  2. Quantum mechanics and hidden superconformal symmetry

    Science.gov (United States)

    Bonezzi, R.; Corradini, O.; Latini, E.; Waldron, A.

    2017-12-01

    Solvability of the ubiquitous quantum harmonic oscillator relies on a spectrum generating osp (1 |2 ) superconformal symmetry. We study the problem of constructing all quantum mechanical models with a hidden osp (1 |2 ) symmetry on a given space of states. This problem stems from interacting higher spin models coupled to gravity. In one dimension, we show that the solution to this problem is the Vasiliev-Plyushchay family of quantum mechanical models with hidden superconformal symmetry obtained by viewing the harmonic oscillator as a one dimensional Dirac system, so that Grassmann parity equals wave function parity. These models—both oscillator and particlelike—realize all possible unitary irreducible representations of osp (1 |2 ).

  3. Hidden Costs and the Role of Modularity

    DEFF Research Database (Denmark)

    Larsen, Marcus M.

    2013-01-01

    that the inability to effectively estimate the costs of implementing an activity in a foreign location has a negative impact on the process performance of that activity. Performance is deterred as operations are likely to be disrupted by opportunity costs and managerial responses. However, this relationship......This paper addresses estimation errors in strategic decision-making processes due to hidden costs. While previous research has investigated the antecedents of hidden costs, this paper investigates performance consequences. Using unique data on 221 offshoring implementations, it is argued...... is mitigated by the degree of modularity in the activity as it reduces the need for costly coordination in offshoring. This paper contributes to research on offshoring and strategic decision-making by emphasizing the importance of organizational design and of estimating the costs of internal organizational...

  4. The Hidden Gifts of Quiet Kids

    Science.gov (United States)

    Trierweiler, Hannah

    2006-01-01

    The author relates that she was an introvert child. It has always taken her time and energy to find her place in a group. As a grown-up, she still needed quiet time to regroup during a busy day. In this article, the author presents an interview with Marti Olsen Laney, author of "The Hidden Gifts of the Introverted Child." During the interview,…

  5. Hidden neuronal correlations in cultured networks

    International Nuclear Information System (INIS)

    Segev, Ronen; Baruchi, Itay; Hulata, Eyal; Ben-Jacob, Eshel

    2004-01-01

    Utilization of a clustering algorithm on neuronal spatiotemporal correlation matrices recorded during a spontaneous activity of in vitro networks revealed the existence of hidden correlations: the sequence of synchronized bursting events (SBEs) is composed of statistically distinguishable subgroups each with its own distinct pattern of interneuron spatiotemporal correlations. These findings hint that each of the SBE subgroups can serve as a template for coding, storage, and retrieval of a specific information

  6. A masking index for quantifying hidden glitches

    OpenAIRE

    Berti-Equille, Laure; Loh, J. M.; Dasu, T.

    2015-01-01

    Data glitches are errors in a dataset. They are complex entities that often span multiple attributes and records. When they co-occur in data, the presence of one type of glitch can hinder the detection of another type of glitch. This phenomenon is called masking. In this paper, we define two important types of masking and propose a novel, statistically rigorous indicator called masking index for quantifying the hidden glitches. We outline four cases of masking: outliers masked by missing valu...

  7. Cold dark matter from the hidden sector

    International Nuclear Information System (INIS)

    Arias, Paola; Pontificia Univ. Catolica de Chile, Santiago

    2012-02-01

    Weakly interacting slim particles (WISPs) such as hidden photons (HP) and axion-like particles (ALPs) have been proposed as cold dark matter candidates. They might be produced non-thermally via the misalignment mechanism, similarly to cold axions. In this talk we review the main processes of thermalisation of HP and we compute the parameter space that may survive as cold dark matter population until today. Our findings are quite encouraging for experimental searches in the laboratory in the near future.

  8. Completing Quantum Mechanics with Quantized Hidden Variables

    OpenAIRE

    van Enk, S. J.

    2015-01-01

    I explore the possibility that a quantum system S may be described completely by the combination of its standard quantum state $|\\psi\\rangle$ and a (hidden) quantum state $|\\phi\\rangle$ (that lives in the same Hilbert space), such that the outcome of any standard projective measurement on the system S is determined once the two quantum states are specified. I construct an algorithm that retrieves the standard quantum-mechanical probabilities, which depend only on $|\\psi\\rangle$, by assuming t...

  9. Cold dark matter from the hidden sector

    Energy Technology Data Exchange (ETDEWEB)

    Arias, Paola [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Pontificia Univ. Catolica de Chile, Santiago (Chile). Facultad de Fisica

    2012-02-15

    Weakly interacting slim particles (WISPs) such as hidden photons (HP) and axion-like particles (ALPs) have been proposed as cold dark matter candidates. They might be produced non-thermally via the misalignment mechanism, similarly to cold axions. In this talk we review the main processes of thermalisation of HP and we compute the parameter space that may survive as cold dark matter population until today. Our findings are quite encouraging for experimental searches in the laboratory in the near future.

  10. Hidden histories: challenges for pedagogy and participation

    OpenAIRE

    Morrice, Linda

    2013-01-01

    Higher Education has become and an increasingly diverse and globalised system in which the binaries between ‘traditional’ and ‘non-traditional’ students, exclusion and inclusion have less resonance and analytical purchase. Drawing on research with refugees Linda will suggest that higher education can be marked simultaneously by belonging and recognition, deficit and exclusion. Complex differences and inequalities remain hidden and unspoken, raising new questions and challenges for pedagogy an...

  11. Hidden hunger in South Asia: a review of recent trends and persistent challenges.

    Science.gov (United States)

    Harding, Kassandra L; Aguayo, Víctor M; Webb, Patrick

    2018-03-01

    'Hidden hunger' is a term used to describe human deficiencies of key vitamins and minerals, also known as micronutrients. While global in scale, the prevalence of micronutrient deficiencies is particularly high in South Asia despite recent successes in economic growth, agricultural output and health care. The present paper reviews the most recent evidence on patterns and trends of hidden hunger across the region, with a focus on the most significant deficiencies - iodine, Fe, vitamin A and Zn - and interprets these in terms of health and economic consequences. The challenge for South Asian policy makers is to invest in actions that can cost-effectively resolve chronic nutrient gaps facing millions of households. Appropriate solutions are available today, so governments should build on evidence-based successes that combine targeted health system delivery of quality services with carefully designed multisector actions that help promote healthier diets, reduce poverty and ensure social protection simultaneously.

  12. Hidden sector behind the CKM matrix

    Science.gov (United States)

    Okawa, Shohei; Omura, Yuji

    2017-08-01

    The small quark mixing, described by the Cabibbo-Kobayashi-Maskawa (CKM) matrix in the standard model, may be a clue to reveal new physics around the TeV scale. We consider a simple scenario that extra particles in a hidden sector radiatively mediate the flavor violation to the quark sector around the TeV scale and effectively realize the observed CKM matrix. The lightest particle in the hidden sector, whose contribution to the CKM matrix is expected to be dominant, is a good dark matter (DM) candidate. There are many possible setups to describe this scenario, so that we investigate some universal predictions of this kind of model, focusing on the contribution of DM to the quark mixing and flavor physics. In this scenario, there is an explicit relation between the CKM matrix and flavor violating couplings, such as four-quark couplings, because both are radiatively induced by the particles in the hidden sector. Then, we can explicitly find the DM mass region and the size of Yukawa couplings between the DM and quarks, based on the study of flavor physics and DM physics. In conclusion, we show that DM mass in our scenario is around the TeV scale, and the Yukawa couplings are between O (0.01 ) and O (1 ). The spin-independent DM scattering cross section is estimated as O (10-9) [pb]. An extra colored particle is also predicted at the O (10 ) TeV scale.

  13. [Multiple chronic conditions and morbidity burden: challenges and considerations for an organizational strategy].

    Science.gov (United States)

    Balicer, Ran; Bitterman, Haim; Shadmi, Efrat

    2012-07-01

    Technological advances combined with the aging of the population bring about an increasingly growing number of patients with chronic conditions and multi-morbidity. Multi-morbidity, the co-occurrence of chronic and/or non-chronic conditions in an individual, is the norm among elderly patients, and is becoming increasingly common among younger adults. The Israeli health system, like other systems worldwide, is faced with the challenges posed by the increase in complex multi-morbidity, in an era of growing fiscal constraints, a situation that can induce financial and organizational crises. To effectively cope with such circumstances, a paradigm shift is needed. Health systems need to focus on overall morbidity burden and multi-morbidity (rather than the prevailing one disease at a time approach) and on better care integration. The Israeli health system entails many of the essential elements for addressing the challenges of integrated care, including universal health coverage and advanced health information technology systems. Yet, like other health systems, there is a need for care management support mechanisms that are more effectively tailored to meet the needs of the highly multimorbid patients. This review outlines the organizational approach required to better align care for the main customers of health care in the 21st century: patients with multi-morbidity. We focus on four domains: assessment of morbidity burden according to measures that account for the interaction and synergism amongst conditions; integration across the care continuum; enhancement of primary care and self-management support approaches; and provision of uniquely tailored care management solutions for the highest risk multi-morbid patients.

  14. Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh.

    Science.gov (United States)

    Hamadani, J D; Tofail, F; Hilaly, A; Mehrin, F; Shiraji, S; Banu, S; Huda, S N

    2012-06-01

    Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development.

  15. Study Protocol. IDUS -- Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-09-13

    AbstractBackgroundInstrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.Methods\\/DesignA multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha.DiscussionIt is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries.Trial registrationCurrent Controlled Trials ISRCTN72230496

  16. Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

    Directory of Open Access Journals (Sweden)

    Murphy Deirdre J

    2012-09-01

    Full Text Available Abstract Background Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. Methods/Design A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. Discussion It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Trial registration Current Controlled Trials ISRCTN72230496

  17. Biting the Hands that Feed "the Alligators": A Case Study in Morbid Obesity Extremes, End-of-Life Care, and Prohibitions on Harming and Accelerating the End of Life.

    Science.gov (United States)

    Malinowski, Michael J

    2018-03-01

    Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high risk for EMO patients. Individuals in this state have impeded mobility and are partially, if not entirely, bedridden, highly vulnerable, and dependent upon caregivers who often are enablers feeding their food addictions. The article draws from existing Centers for Medicare and Medicaid Services ("CMS") and Social Security Administration ("SSA") policies and procedures for severe obesity treatment and disability benefits. The discussion also encompasses myriad areas in which the law imposes a duty to report on professionals to protect vulnerable individuals from harm from others, and constraints and prohibitions on accelerating the end of life. The article proposes, among other law and policy measures, to introduce an obligation on medical professionals to investigate and report instances of enablement when food addiction has put the lives of individuals at risk of imminent death. The objectives of the proposals are to give providers more leverage to prevent food addiction enablers from impeding treatment and to enable EMO patients to comply with treatment protocols, to save lives and, ironically, to empower enablers to stand firm against the demands of individuals whose lives have been consumed by their food addictions.

  18. [Mortality and morbidity in surgery for abdominal aortic aneurysm

    DEFF Research Database (Denmark)

    Banke, A.B.; Andersen, Jakob Steen; Heslet, L.

    2008-01-01

    Care Unit's (ICU) Critical Information System, a blood bank and the database of a vascular surgery unit. RESULTS: The perioperative mortality was 8%, ICU mortality 22%, postoperative mortality 33% and 30-day mortality 39%. The ICU mortality for patients with renal failure and septic shock...... was significantly higher than the overall ICU mortality. The ICU mortality and morbidity increased with the amount of postoperative blood loss. Patients with an initial serum creatinine concentration of

  19. [Morbidity observed in a health area: Impact on professionals and funding].

    Science.gov (United States)

    de Miguel, Pablo; Caballero, Isabel; Rivas, Francisco Javier; Manera, Jaime; de Vicente, María Auxiliadora; Gómez, Ángel

    2015-05-01

    To analyze morbidity, in the context of a health area, and broken down by health centre, of patients who made contact with healthcare services, in order to propose an adjustment to finance the payment per capita. A descriptive study of morbidity observed in citizens assigned a health area during year 2010. SITE: Health Area 9. Autonomous Community of Madrid. Formed by the municipalities of Fuenlabrada, Humanes, and Moraleja de Enmedio. All levels of health care included. All citizens with health card assigned to a health center in the area who has maintained contact with the public health service's own area. Coded contact of patients are grouped using the Population Grouping Clinical Risk 3M TM Software (CRG). Each patient is included in a homogeneous and exclusive group with a numerical morbidity and clinical sense. Through the health card is known primary care centre, physician, age and sex. The distribution of morbidity is obtained by primary care centre, primary care physician, age and sex analyzing differences and combinations. It was found that the average values of the population morbidity are different in each primary care centre. In order to maintain the principle of equity in health care, it is suggested that an adjustment is made to the per capita payment based on the morbidity rate of the population. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  20. Laparoscopic surgery for morbid obesity.

    Science.gov (United States)

    Hallerbäck, B; Glise, H; Johansson, B; Johnson, E

    1998-01-01

    Morbid obesity, defined as a body mass index (BMI), i.e. weight (kg)/height (m2) over 36 for males and 38 for females, is a common condition and a threat for health, life and individual well being. Hitherto, surgery is the only effective treatment for weight reduction. Surgical methods can be malabsorptive, reducing the patients ability to absorb nutrients, or restrictive, reducing the capacity of food intake. Exclusively malabsorptive methods have been abandoned due to severe side effects. Restrictive methods, gastroplasties, reduces the compliance capacity of the stomach. Two types are performed laparoscopically, the vertical banded gastroplasty and the adjustable gastric banding. The proximal gastric by pass is also performed laparoscopically and is a combination of a restrictive proximal gastroplasty and a malabsorptive Roux-en-Y gastro-jejunal anastomosis. With laparoscopic adjustable gastric banding mean BMI was reduced from 41 kg/m2 to 33 kg/m2 (n = 43) after one year. Two years after surgery mean BMI was 30 kg/m2 (n = 16). The different operative techniques are further discussed in this paper.

  1. Co-morbidities of vertiginous diseases

    OpenAIRE

    Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

    2009-01-01

    Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes ...

  2. Morbidity and GH deficiency: a nationwide study

    DEFF Research Database (Denmark)

    Stochholm, K.; Laursen, T.; Green, A.

    2008-01-01

    identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD. Method: Sex- and cause-specific hazard ratios (HRs) in CO and AO......Objective: To estimate morbidity in Denmark in all patients with GH deficiency (GHD). Design: Morbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were...

  3. Microwave background constraints on mixing of photons with hidden photons

    International Nuclear Information System (INIS)

    Mirizzi, Alessandro; Redondo, Javier; Sigl, Guenter

    2008-12-01

    Various extensions of the Standard Model predict the existence of hidden photons kinetically mixing with the ordinary photon. This mixing leads to oscillations between photons and hidden photons, analogous to the observed oscillations between different neutrino flavors. In this context, we derive new bounds on the photon-hidden photon mixing parameters using the high precision cosmic microwave background spectral data collected by the Far Infrared Absolute Spectrophotometer instrument on board of the Cosmic Background Explorer. Requiring the distortions of the CMB induced by the photon-hidden photon mixing to be smaller than experimental upper limits, this leads to a bound on the mixing angle χ 0 -7 - 10 -5 for hidden photon masses between 10 -14 eV and 10 -7 eV. This low-mass and low-mixing region of the hidden photon parameter space was previously unconstrained. (orig.)

  4. Microwave background constraints on mixing of photons with hidden photons

    Energy Technology Data Exchange (ETDEWEB)

    Mirizzi, Alessandro [Max-Planck-Institut fuer Physik, Muenchen (Germany); Redondo, Javier [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Sigl, Guenter [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik

    2008-12-15

    Various extensions of the Standard Model predict the existence of hidden photons kinetically mixing with the ordinary photon. This mixing leads to oscillations between photons and hidden photons, analogous to the observed oscillations between different neutrino flavors. In this context, we derive new bounds on the photon-hidden photon mixing parameters using the high precision cosmic microwave background spectral data collected by the Far Infrared Absolute Spectrophotometer instrument on board of the Cosmic Background Explorer. Requiring the distortions of the CMB induced by the photon-hidden photon mixing to be smaller than experimental upper limits, this leads to a bound on the mixing angle {chi}{sub 0} hidden photon masses between 10{sup -14} eV and 10{sup -7} eV. This low-mass and low-mixing region of the hidden photon parameter space was previously unconstrained. (orig.)

  5. Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs

    Directory of Open Access Journals (Sweden)

    J. González-Enríquez

    2002-08-01

    smokers would have on smoking-related morbidity, mortality and healthcare costs. Methods: We adopted the model Health and Economic Consequences of Smoking sponsored by the WHO Health Organization and developed by the The Lewin Group. The smoking cessation intervention proposed incluides pharmacological treatment to 35% of smokers who are trying to quit smoking and obtains a quit rate of 7.2%. The diseases studied are: lung cancer, heart disease, stroke, chronic obstructive pulmonary disease, asthma exacerbation, and low birth weight. The smoking-related cases of disease and of averted death and the reduction in healthcare expenditure due to the intervention were estimated. Results: Without intervention, at year 1 of the model, 2,136,094 smokers would be affected by some smoking-related disease; healthcare expenditure would be 4,286 million € and deaths attributable to smoking would total 26,537. The proposed intervention would prevent 2,613, 9,192, 17,415 and 23,837 cases of smoking-related disease at years 2, 5, 10 and 20 of the model, respectively. The saving in accumulated healthcare costs would amount to 3.5 million € at year 2 and 386 million € over 20 years. The accumulated prevented deaths are 284 at year 2 and 9,205 over 20 years. The intervention would save a total of 78,173 life-years by the end of the period considered. Conclusions: The availability of new effective smoking cessation interventions and the increase in accessibility to such interventions may contribute significantly to reducing morbidity, mortality and healthcare costs associated with smoking in Spain.

  6. New morbidity of the young

    Directory of Open Access Journals (Sweden)

    Stanković Biljana

    2002-01-01

    Full Text Available In the present phase of epidemiological transition, the most frequent causes of youth morbidity are disorders in reproductive health, mental disorders and injuries which are not life threatening. This, so-called new youth morbidity, is most often caused by their risky behavior, which in the field of sexuality often leads to unplanned pregnancies and abortions, as well as sexually transmitted infections. Misuse of tobacco, alcohol and narcotics, which is most commonly started in adolescence, has an unfavorable short-term and long-term influence on the psycho-physical health of the young. All research, in the world and in our country, indicate gradual yet constant growth of sexual activity of the youth and the age decrease of its starting point, especially when girls are in question. Due to insufficient maturity and inadequate knowledge and consciousness on the necessity of protecting reproductive health, sexual behavior of young people can often be characterized as insufficiently responsible and not supplemented with the usage of adequate protective measures. The result is frequently abortion, which terminates 90% of unplanned and unwanted pregnancies in this age. This creates health and psychosocial risks, as well as giving birth in adolescence which is contrary to the modern health concepts that giving birth should not be performed too early, while the young are still developing. A significant increase in the frequency of sexually transmitted diseases is also present, to which the youth are especially susceptible due to the specific development period in which they are in. A serious medical and sociopathological problem of contemporary society represents the greater and greater misuse of psychoactive substances among the young people, with a tendency of decreasing the average age they are consumed for the first time, as well as the use of drugs and alcohol. With the increase of the anti-smoking campaign and restrictive measures in highly

  7. VISIBLE COSTS AND HIDDEN COSTS IN THE BAKING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Criveanu Maria

    2013-04-01

    Full Text Available Hidden costs are present in the activity of any company, hardly identified in the traditional administrative accounting. The high levels of the hidden costs and their unknown presence have serious consequences on the decisions made by the managers. This paper aims at presenting some aspects related to the hidden costs that occur in the activity of the companies in the baking industry and the possibilities to reduce their level.

  8. Premenstrual Syndrome and Psychiatric Co-morbidities.

    Directory of Open Access Journals (Sweden)

    Ziba Taghizadeh

    2009-04-01

    Full Text Available "n    "nObjective: Premenstrual syndrome (PMS is a common disorder with prevalence rate of approximately 30%; its concurrence with psychiatric symptoms will make it a disabling condition that resists usual treatment. Objective: This study was enrolled to assess the co-morbidity of PMS and psychiatric disorders in a sample of girls with PMS compared to those without PMS. "n    "nMaterial and method : This study was conducted through a cross sectional method with 362 participants (166 with PMS and 196 healthy girls who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R. "n    "nResult: According to the result of the independent t test, the mean score of all the psychiatric symptoms in the PMS group was significantly higher than those in healthy group (P<0.001. According to SCL-90-R measurement, most of the participants in the PMS group were categorized as extremely sick for somatization (44% ,obsessive-compulsive (59%, depression (58.4%, anxiety (64.5%, hostility (47% and psychoticism (69.3%; most of the participants were diagnosed as having borderline severity of disorders for interpersonal sensitivity (44.6% and paranoid (42.8% and most of the respondents with PMS (46.4% were diagnosed as healthy only for phobic anxiety. "n    "nConclusion: There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for the health care providers. Therefore, all health care providers who are in contact with women in their reproductive age should be sensitive to mental health status in women with PMS.

  9. The hidden and implicit curricula in cultural context: new insights from Doha and New York.

    Science.gov (United States)

    Fins, Joseph J; Rodríguez del Pozo, Pablo

    2011-03-01

    The authors report their longitudinal experience teaching a clerkship in clinical ethics and palliative care at the Weill Cornell Medical College campuses in New York and Doha. This course uses participant observation and reflective practice to counteract the hidden curriculum when learning about clinical ethics and end-of-life care. The authors consider how this formal element of the curriculum is influenced by the implicit and hidden curricula in different cultural contexts and how these differing venues affect communication and information exchange, using the anthropological concept of high- and low-context societies. The authors' analysis provides additional information on Weill Cornell's educational efforts in the medical humanities, bioethics, and palliative care across the curriculum and across cultural settings. By contrasting high-context Doha, where much information is culturally embedded and seemingly hidden, with low-context New York, where information is made overt, the authors theorize that in each setting, the proportion of implicit and explicit curricular elements is determined by the extramural cultural environment. They argue that there are many hidden and implicit curricula and that each is dependent on modes of communication in any given setting. They assert that these variations can be seen not only across differing societies but also, for example, among individual U.S. medical schools because of local custom, history, or mission. Because these contextual factors influence the relative importance of what is implicit and explicit in the student's educational experience, medical educators need to be aware of their local cultural contexts in order to engage in effective pedagogy.

  10. Compressing the hidden variable space of a qubit

    International Nuclear Information System (INIS)

    Montina, Alberto

    2011-01-01

    In previously exhibited hidden variable models of quantum state preparation and measurement, the number of continuous hidden variables describing the actual state of single realizations is never smaller than the quantum state manifold dimension. We introduce a simple model for a qubit whose hidden variable space is one-dimensional, i.e., smaller than the two-dimensional Bloch sphere. The hidden variable probability distributions associated with quantum states satisfy reasonable criteria of regularity. Possible generalizations of this shrinking to an N-dimensional Hilbert space are discussed.

  11. Zipf exponent of trajectory distribution in the hidden Markov model

    Science.gov (United States)

    Bochkarev, V. V.; Lerner, E. Yu

    2014-03-01

    This paper is the first step of generalization of the previously obtained full classification of the asymptotic behavior of the probability for Markov chain trajectories for the case of hidden Markov models. The main goal is to study the power (Zipf) and nonpower asymptotics of the frequency list of trajectories of hidden Markov frequencys and to obtain explicit formulae for the exponent of the power asymptotics. We consider several simple classes of hidden Markov models. We prove that the asymptotics for a hidden Markov model and for the corresponding Markov chain can be essentially different.

  12. Zipf exponent of trajectory distribution in the hidden Markov model

    International Nuclear Information System (INIS)

    Bochkarev, V V; Lerner, E Yu

    2014-01-01

    This paper is the first step of generalization of the previously obtained full classification of the asymptotic behavior of the probability for Markov chain trajectories for the case of hidden Markov models. The main goal is to study the power (Zipf) and nonpower asymptotics of the frequency list of trajectories of hidden Markov frequencys and to obtain explicit formulae for the exponent of the power asymptotics. We consider several simple classes of hidden Markov models. We prove that the asymptotics for a hidden Markov model and for the corresponding Markov chain can be essentially different

  13. Hidden acoustic information revealed by intentional nonlinearity

    Science.gov (United States)

    Dowling, David R.

    2017-11-01

    Acoustic waves are omnipresent in modern life and are well described by the linearized equations of fluid dynamics. Once generated, acoustic waves carry and collect information about their source and the environment through which they propagate, respectively, and this information may be retrieved by analyzing recordings of these waves. Because of this, acoustics is the primary means for observation, surveillance, reconnaissance, and remote sensing in otherwise opaque environments, such as the Earth's oceans and crust, and the interior of the human body. For such information-retrieval tasks, acoustic fields are nearly always interrogated within their recorded frequency range or bandwidth. However, this frequency-range restriction is not general; acoustic fields may also carry (hidden) information at frequencies outside their bandwidth. Although such a claim may seem counter intuitive, hidden acoustic-field information can be revealed by re-introducing a marquee trait of fluid dynamics: nonlinearity. In particular, an intentional quadratic nonlinearity - a form of intra-signal heterodyning - can be used to obtain acoustic field information at frequencies outside a recorded acoustic field's bandwidth. This quadratic nonlinearity enables a variety of acoustic remote sensing applications that were long thought to be impossible. In particular, it allows the detrimental effects of sparse recordings and random scattering to be suppressed when the original acoustic field has sufficient bandwidth. In this presentation, the topic is developed heuristically, with a just brief exposition of the relevant mathematics. Hidden acoustic field information is then revealed from simulated and measured acoustic fields in simple and complicated acoustic environments involving frequencies from a few Hertz to more than 100 kHz, and propagation distances from tens of centimeters to hundreds of kilometers. Sponsored by ONR, NAVSEA, and NSF.

  14. Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

    LENUS (Irish Health Repository)

    Murphy, Cliona M

    2012-02-01

    OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

  15. Post-Traumatic Stress Disorder and severe maternal morbidity: is there an association?

    Science.gov (United States)

    Angelini, Carina R; Pacagnella, Rodolfo C; Parpinelli, Mary A; Silveira, Carla; Andreucci, Carla B; Ferreira, Elton C; Santos, Juliana P; Zanardi, Dulce M; Souza, Renato T; Cecatti, Jose G

    2018-01-01

    To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored. Data analysis was carried out by using χ2, Fisher's Exact test, and logistic regression analysis. There was no significant change in the prevalence of Post-Traumatic Stress Disorder related to a previous severe maternal morbidity experience. There were also no differences in diagnostic criteria for severe maternal morbidity (hypertensive syndromes, hemorrhage, surgical intervention or intensive care unit admission required, among other management criteria). Low parity (2.5-fold risk) and increasing age were factors associated with Post-Traumatic Stress Disorder. A severe maternal morbidity episode is not associated with Post-Traumatic Stress Disorder symptoms within five years of the severe maternal morbidity event and birth. However, a more advanced maternal age and primiparity increased the risk of Post-Traumatic Stress Disorder. This does not imply that women who had experienced a severe maternal morbidity event did not suffer or need differentiated care.

  16. Recovering a hidden polarization by ghost polarimetry.

    Science.gov (United States)

    Janassek, Patrick; Blumenstein, Sébastien; Elsäßer, Wolfgang

    2018-02-15

    By exploiting polarization correlations of light from a broadband fiber-based amplified spontaneous emission source we succeed in reconstructing a hidden polarization in a ghost polarimetry experiment in close analogy to ghost imaging and ghost spectroscopy. Thereby, an original linear polarization state in the object arm of a Mach-Zehnder interferometer configuration which has been camouflaged by a subsequent depolarizer is recovered by correlating it with light from a reference beam. The variation of a linear polarizer placed inside the reference beam results in a Malus law type second-order intensity correlation with high contrast, thus measuring a ghost polarigram.

  17. Pruning Boltzmann networks and hidden Markov models

    DEFF Research Database (Denmark)

    Pedersen, Morten With; Stork, D.

    1996-01-01

    We present sensitivity-based pruning algorithms for general Boltzmann networks. Central to our methods is the efficient calculation of a second-order approximation to the true weight saliencies in a cross-entropy error. Building upon previous work which shows a formal correspondence between linear...... Boltzmann chains and hidden Markov models (HMMs), we argue that our method can be applied to HMMs as well. We illustrate pruning on Boltzmann zippers, which are equivalent to two HMMs with cross-connection links. We verify that our second-order approximation preserves the rank ordering of weight saliencies...

  18. Hidden Scale Invariance in Condensed Matter

    DEFF Research Database (Denmark)

    Dyre, J. C.

    2014-01-01

    . This means that the phase diagram becomes effectively one-dimensional with regard to several physical properties. Liquids and solids with isomorphs include most or all van der Waals bonded systems and metals, as well as weakly ionic or dipolar systems. On the other hand, systems with directional bonding...... (hydrogen bonds or covalent bonds) or strong Coulomb forces generally do not exhibit hidden scale invariance. The article reviews the theory behind this picture of condensed matter and the evidence for it coming from computer simulations and experiments...

  19. Uncovering the Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Larsen, Marcus M.; Manning, Stephan; Pedersen, Torben

    2013-01-01

    This study investigates estimation errors due to hidden costs—the costs of implementation that are neglected in strategic decision-making processes—in the context of services offshoring. Based on data from the Offshoring Research Network, we find that decision makers are more likely to make cost......-estimation errors given increasing configuration and task complexity in captive offshoring and offshore outsourcing, respectively. Moreover, we show that experience and a strong orientation toward organizational design in the offshoring strategy reduce the cost-estimation errors that follow from complexity. Our...

  20. The hidden face of the petroleum

    International Nuclear Information System (INIS)

    Laurent, E.

    2006-02-01

    For the first time, a book reveals what that was hidden to the public opinions: why the petroleum crisis of 1973 what only a manipulation, an arrangement between the OPEC and the petroleum companies, why the data concerning the petroleum reserves are wrong and increased by the producers countries, how Washington used the Saudi petroleum weapon to create the Soviet Union fall, and why from march 2001 maps of the Iraq (where were drawn the future petroleum explorations) were working documents for the vice President Cheney and petroleum managers for the ''secret society''. (A.L.B.)

  1. Evolving the structure of hidden Markov Models

    DEFF Research Database (Denmark)

    won, K. J.; Prugel-Bennett, A.; Krogh, A.

    2006-01-01

    A genetic algorithm (GA) is proposed for finding the structure of hidden Markov Models (HMMs) used for biological sequence analysis. The GA is designed to preserve biologically meaningful building blocks. The search through the space of HMM structures is combined with optimization of the emission...... and transition probabilities using the classic Baum-Welch algorithm. The system is tested on the problem of finding the promoter and coding region of C. jejuni. The resulting HMM has a superior discrimination ability to a handcrafted model that has been published in the literature....

  2. The hidden costs of nuclear power

    International Nuclear Information System (INIS)

    Keough, C.

    1981-01-01

    The two basic hidden costs of nuclear power are public money and public health. Nuclear power appears to be economical because many of the costs of producins electricity in these plants are paid by the federal government. So, like it or not, the citizens are footing the bill with their taxes. Design and development of plants have been paid for with public money, and disposal and cleanup costs will also be paid in this manner. The economic and health costs associated with nuclear accidents are staggering

  3. Genetic Algorithms Principles Towards Hidden Markov Model

    Directory of Open Access Journals (Sweden)

    Nabil M. Hewahi

    2011-10-01

    Full Text Available In this paper we propose a general approach based on Genetic Algorithms (GAs to evolve Hidden Markov Models (HMM. The problem appears when experts assign probability values for HMM, they use only some limited inputs. The assigned probability values might not be accurate to serve in other cases related to the same domain. We introduce an approach based on GAs to find
    out the suitable probability values for the HMM to be mostly correct in more cases than what have been used to assign the probability values.

  4. Detecting Structural Breaks using Hidden Markov Models

    DEFF Research Database (Denmark)

    Ntantamis, Christos

    Testing for structural breaks and identifying their location is essential for econometric modeling. In this paper, a Hidden Markov Model (HMM) approach is used in order to perform these tasks. Breaks are defined as the data points where the underlying Markov Chain switches from one state to another....... The estimation of the HMM is conducted using a variant of the Iterative Conditional Expectation-Generalized Mixture (ICE-GEMI) algorithm proposed by Delignon et al. (1997), that permits analysis of the conditional distributions of economic data and allows for different functional forms across regimes...

  5. Assistência ao paciente obeso mórbido submetido à cirurgia bariátrica: dificuldades do enfermeiro Asistencia al paciente obeso mórbido sometido a la cirugía bariátrica: dificultades del enfermero Perioperative care for morbid obese patient undergoing bariatric surgery: challenges for nurses

    Directory of Open Access Journals (Sweden)

    Denise Spósito Tanaka

    2009-10-01

    Full Text Available OBJETIVO: Identificar as dificuldades de enfermeiros de centro cirúrgico ao assistir pacientes obesos mórbidos submetidos à cirurgia bariátrica no período transoperatório. MÉTODOS: A amostra constou de 70 enfermeiros com experiência em assistência ao paciente obeso mórbido. Os dados foram coletados durante o 7º Congresso Brasileiro de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização por meio de um questionário. RESULTADOS: A análise dos resultados apontou como dificuldades aquelas relacionadas ao espaço físico, materiais e equipamentos e à assistência de enfermagem específica ao paciente obeso mórbido. CONCLUSÃO: O conhecimento específico, a especialização e a experiência em Centro Cirúrgico darão o conforto, a segurança física e emocional necessárias a estes pacientes.OBJETIVO: Identificar las dificultades de enfermeros de centro quirúrgico en el cuidado a pacientes obesos mórbidos sometidos a cirugía bariátrica en el período transoperatorio. MÉTODOS: La muestra constó de 70 enfermeros con experiencia en asistencia al paciente obeso mórbido. Los datos fueron recolectados por medio de un cuestionario durante el 7º Congreso Brasileño de Enfermeros de Centro Quirúrgico, Recuperación Anestésica y Centro de Material y Esterilización. RESULTADOS: El análisis de los resultados identificó como dificultades aquellas relacionadas al espacio físico, materiales y equipos y a la asistencia de enfermería específica al paciente obeso mórbido. CONCLUSIÓN: El conocimiento específico, la especialización y la experiencia en Centro Quirúrgico darán el confort, la seguridad física y emocional que necesitan estos pacientes.OBJECTIVE: To identify the challenges for nurses during the perioperative for patients undergoing bariatric surgery. METHODS: The sample consisted of 70 nurses who had experience in providing care for morbid obese patients. Data were collected

  6. Sexual Activity and Urological Morbidities Among Nigerian ...

    African Journals Online (AJOL)

    Background: Menopause represents the end of women reproductive career and it is at this time they begin to manifest morbidities such as urinary incontinence. Aim: To document proximate determinants of sexual activity and urological morbidities of menopausal women. Subjects and Methods: This was a community survey ...

  7. Intubation of the morbidly obese patient

    DEFF Research Database (Denmark)

    Ydemann, Mogens; Rovsing, Marie Louise; Lindekaer, A L

    2012-01-01

    Several potential problems can arise from airway management in morbidly obese patients, including difficult mask ventilation and difficult intubation. We hypothesised that endotracheal intubation of morbidly obese patients would be more rapid using the GlideScope(®) (GS) (Verathon Inc Corporate H...... Headquarters, Bothell, WA, USA) than with the Fastrach™ (FT) (The Laryngeal Mask Company Ltd, Le Rocher, Victoria, Mahe, Seychelles)....

  8. Self-reported skin morbidity in Denmark

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Zarchi, Kian; Ellervik, Christina

    2016-01-01

    Skin diseases are thought to be common in the general population. In 2004, a cross-sectional study in Norway, using a validated questionnaire for 18,770 individuals, revealed a high prevalence of skin diseases in the general population. To describe the prevalence of self-reported skin morbidities...... questionnaire. In total, 17.2% self-reported skin complaints. The most prominent self-reported skin complaint was itch with an overall prevalence of 6.5%. The skin morbidity most influenced by age was pimples. There was a uniform pattern showing fewer skin complaints with increasing education. Women reported...... skin morbidities more frequently than men. Participants in employment reported fewer skin morbidities compared to unemployed participants. Skin morbidities in Denmark are common, and the distribution of prevalence estimates in the Danish population parallel those of the Norwegian population, although...

  9. Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index

    Science.gov (United States)

    Stevens, Gretchen A.; Ezzati, Majid; Black, Robert E.; Kraemer, Klaus

    2015-01-01

    Background Deficiencies in essential vitamins and minerals–also termed hidden hunger–are pervasive and hold negative consequences for the cognitive and physical development of children. Methods This analysis evaluates the change in hidden hunger over time in the form of one composite indicator–the Hidden Hunger Index (HHI)–using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency). Net changes from 1995–2011 and population weighted regional means for various time periods are measured. Findings Globally, hidden hunger improved (-6.7 net change in HHI) from 1995–2011. Africa was the only region to see a deterioration in hidden hunger (+1.9) over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0), while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased. Interpretation This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs). However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda. Funding Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish. PMID:26673631

  10. Global Update and Trends of Hidden Hunger, 1995-2011: The Hidden Hunger Index.

    Directory of Open Access Journals (Sweden)

    Julie C Ruel-Bergeron

    Full Text Available Deficiencies in essential vitamins and minerals-also termed hidden hunger-are pervasive and hold negative consequences for the cognitive and physical development of children.This analysis evaluates the change in hidden hunger over time in the form of one composite indicator-the Hidden Hunger Index (HHI-using an unweighted average of prevalence estimates from the Nutrition Impact Model Study for anemia due to iron deficiency, vitamin A deficiency, and stunting (used as a proxy indicator for zinc deficiency. Net changes from 1995-2011 and population weighted regional means for various time periods are measured.Globally, hidden hunger improved (-6.7 net change in HHI from 1995-2011. Africa was the only region to see a deterioration in hidden hunger (+1.9 over the studied time period; East Asia and the Pacific performed exceptionally well (-13.0, while other regions improved only slightly. Improvements in HHI were mostly due to reductions in zinc and vitamin A deficiencies, while anemia due to iron deficiency persisted and even increased.This analysis is critical for informing and tracking the impact of policy and programmatic efforts to reduce micronutrient deficiencies, to advance the global nutrition agenda, and to achieve the Millennium Development Goals (MDGs. However, there remains an unmet need to invest in gathering frequent, nationally representative, high-quality micronutrient data as we renew our efforts to scale up nutrition, and as we enter the post-2015 development agenda.Preparation of this manuscript was funded by Sight and Life. There was no funding involved in the study design, data collection, analysis, or decision to publish.

  11. Hidden in plain sight: the formal, informal, and hidden curricula of a psychiatry clerkship.

    Science.gov (United States)

    Wear, Delese; Skillicorn, Jodie

    2009-04-01

    To examine perceptions of the formal, informal, and hidden curricula in psychiatry as they are observed and experienced by (1) attending physicians who have teaching responsibilities for residents and medical students, (2) residents who are taught by those same physicians and who have teaching responsibilities for medical students, and (3) medical students who are taught by attendings and residents during their psychiatry rotation. From June to November 2007, the authors conducted focus groups with attendings, residents, and students in one midwestern academic setting. The sessions were audiotaped, transcribed, and analyzed for themes surrounding the formal, informal, and hidden curricula. All three groups offered a similar belief that the knowledge, skills, and values of the formal curriculum focused on building relationships. Similarly, all three suggested that elements of the informal and hidden curricula were expressed primarily as the values arising from attendings' role modeling, as the nature and amount of time attendings spend with patients, and as attendings' advice arising from experience and intuition versus "textbook learning." Whereas students and residents offered negative values arising from the informal and hidden curricula, attendings did not, offering instead the more positive values they intended to encourage through the informal and hidden curricula. The process described here has great potential in local settings across all disciplines. Asking teachers and learners in any setting to think about how they experience the educational environment and what sense they make of all curricular efforts can provide a reality check for educators and a values check for learners as they critically reflect on the meanings of what they are learning.

  12. Morbidity, including fatal morbidity, throughout life in men entering adult life as obese

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Holst, Claus; Sørensen, Thorkild I A

    2011-01-01

    The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult...... life as obese....

  13. Atlas of solar hidden photon emission

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, Javier [Departamento de Física Teórica, Universidad de Zaragoza,Pedro Cerbuna 12, E-50009, Zaragoza (Spain); Max-Planck-Institut für Physik, Werner-Heisenberg-Institut,Föhringer Ring 6, 80805 München (Germany)

    2015-07-20

    Hidden photons, gauge bosons of a U(1) symmetry of a hidden sector, can constitute the dark matter of the universe and a smoking gun for large volume compactifications of string theory. In the sub-eV mass range, a possible discovery experiment consists on searching the copious flux of these particles emitted from the Sun in a helioscope setup à la Sikivie. In this paper, we compute in great detail the flux of HPs from the Sun, a necessary ingredient for interpreting such experiments. We provide a detailed exposition of transverse photon-HP oscillations in inhomogenous media, with special focus on resonance oscillations, which play a leading role in many cases. The region of the Sun emitting HPs resonantly is a thin spherical shell for which we justify an averaged-emission formula and which implies a distinctive morphology of the angular distribution of HPs on Earth in many cases. Low mass HPs with energies in the visible and IR have resonances very close to the photosphere where the solar plasma is not fully ionised and requires building a detailed model of solar refraction and absorption. We present results for a broad range of HP masses (from 0–1 keV) and energies (from the IR to the X-ray range), the most complete atlas of solar HP emission to date.

  14. Atlas of solar hidden photon emission

    Energy Technology Data Exchange (ETDEWEB)

    Redondo, Javier, E-mail: redondo@mpp.mpg.de [Departamento de Física Teórica, Universidad de Zaragoza, Pedro Cerbuna 12, E-50009, Zaragoza, España (Spain)

    2015-07-01

    Hidden photons, gauge bosons of a U(1) symmetry of a hidden sector, can constitute the dark matter of the universe and a smoking gun for large volume compactifications of string theory. In the sub-eV mass range, a possible discovery experiment consists on searching the copious flux of these particles emitted from the Sun in a helioscope setup à la Sikivie. In this paper, we compute in great detail the flux of HPs from the Sun, a necessary ingredient for interpreting such experiments. We provide a detailed exposition of transverse photon-HP oscillations in inhomogenous media, with special focus on resonance oscillations, which play a leading role in many cases. The region of the Sun emitting HPs resonantly is a thin spherical shell for which we justify an averaged-emission formula and which implies a distinctive morphology of the angular distribution of HPs on Earth in many cases. Low mass HPs with energies in the visible and IR have resonances very close to the photosphere where the solar plasma is not fully ionised and requires building a detailed model of solar refraction and absorption. We present results for a broad range of HP masses (from 0–1 keV) and energies (from the IR to the X-ray range), the most complete atlas of solar HP emission to date.

  15. Bayesian structural inference for hidden processes

    Science.gov (United States)

    Strelioff, Christopher C.; Crutchfield, James P.

    2014-04-01

    We introduce a Bayesian approach to discovering patterns in structurally complex processes. The proposed method of Bayesian structural inference (BSI) relies on a set of candidate unifilar hidden Markov model (uHMM) topologies for inference of process structure from a data series. We employ a recently developed exact enumeration of topological ɛ-machines. (A sequel then removes the topological restriction.) This subset of the uHMM topologies has the added benefit that inferred models are guaranteed to be ɛ-machines, irrespective of estimated transition probabilities. Properties of ɛ-machines and uHMMs allow for the derivation of analytic expressions for estimating transition probabilities, inferring start states, and comparing the posterior probability of candidate model topologies, despite process internal structure being only indirectly present in data. We demonstrate BSI's effectiveness in estimating a process's randomness, as reflected by the Shannon entropy rate, and its structure, as quantified by the statistical complexity. We also compare using the posterior distribution over candidate models and the single, maximum a posteriori model for point estimation and show that the former more accurately reflects uncertainty in estimated values. We apply BSI to in-class examples of finite- and infinite-order Markov processes, as well to an out-of-class, infinite-state hidden process.

  16. Hidden Markov Model for Stock Selection

    Directory of Open Access Journals (Sweden)

    Nguyet Nguyen

    2015-10-01

    Full Text Available The hidden Markov model (HMM is typically used to predict the hidden regimes of observation data. Therefore, this model finds applications in many different areas, such as speech recognition systems, computational molecular biology and financial market predictions. In this paper, we use HMM for stock selection. We first use HMM to make monthly regime predictions for the four macroeconomic variables: inflation (consumer price index (CPI, industrial production index (INDPRO, stock market index (S&P 500 and market volatility (VIX. At the end of each month, we calibrate HMM’s parameters for each of these economic variables and predict its regimes for the next month. We then look back into historical data to find the time periods for which the four variables had similar regimes with the forecasted regimes. Within those similar periods, we analyze all of the S&P 500 stocks to identify which stock characteristics have been well rewarded during the time periods and assign scores and corresponding weights for each of the stock characteristics. A composite score of each stock is calculated based on the scores and weights of its features. Based on this algorithm, we choose the 50 top ranking stocks to buy. We compare the performances of the portfolio with the benchmark index, S&P 500. With an initial investment of $100 in December 1999, over 15 years, in December 2014, our portfolio had an average gain per annum of 14.9% versus 2.3% for the S&P 500.

  17. Hidden ion population of the magnetosphere

    International Nuclear Information System (INIS)

    Olsen, R.C.

    1982-01-01

    Particle data from two geosynchronous satellites (Applied Technology Satellite 6 and SCATHA) show a normally hidden ion population appearing when the satellites are in the earth's shadow. Ion and electron data show the spacecraft potential dropping from +10 V in sunlight to +4 and +5 V in eclipse at local midnight, in low-energy (T/sub e/ -2 ), isotropic ion population appears which was invisible in sunlight because of the larger positive spacecraft potential. Higher-energy populations generally cover the tails of the hidden ion populations, so they cannot be inferred from daylight data. The isotropic populations appears only in a few percent of the spacecraft eclipse events, appearing only at times of low Kp (2 or less, preceded by a day with Σ Kp< or =20). A low-energy (T = 1--2 eV) field-aligned population often appears with and without the isotropic population, at slightly higher flux levels. These fluxes are visible in sunlight, but again the distribution functions obtained in eclipse differ from those that would be inferred from daylight data. Measurement of the thermal plasma population on a consistent basis, particularly in the plasma sheet, will require some method of controlling the detector potential with respect to the ambient plamsa

  18. ESO's Hidden Treasures Brought to Light

    Science.gov (United States)

    2011-01-01

    ESO's Hidden Treasures 2010 astrophotography competition attracted nearly 100 entries, and ESO is delighted to announce the winners. Hidden Treasures gave amateur astronomers the opportunity to search ESO's vast archives of astronomical data for a well-hidden cosmic gem. Astronomy enthusiast Igor Chekalin from Russia won the first prize in this difficult but rewarding challenge - the trip of a lifetime to ESO's Very Large Telescope at Paranal, Chile. The pictures of the Universe that can be seen in ESO's releases are impressive. However, many hours of skilful work are required to assemble the raw greyscale data captured by the telescopes into these colourful images, correcting them for distortions and unwanted signatures of the instrument, and enhancing them so as to bring out the details contained in the astronomical data. ESO has a team of professional image processors, but for the ESO's Hidden Treasures 2010 competition, the experts decided to give astronomy and photography enthusiasts the opportunity to show the world what they could do with the mammoth amount of data contained in ESO's archives. The enthusiasts who responded to the call submitted nearly 100 entries in total - far exceeding initial expectations, given the difficult nature of the challenge. "We were completely taken aback both by the quantity and the quality of the images that were submitted. This was not a challenge for the faint-hearted, requiring both an advanced knowledge of data processing and an artistic eye. We are thrilled to have discovered so many talented people," said Lars Lindberg Christensen, Head of ESO's education and Public Outreach Department. Digging through many terabytes of professional astronomical data, the entrants had to identify a series of greyscale images of a celestial object that would reveal the hidden beauty of our Universe. The chance of a great reward for the lucky winner was enough to spur on the competitors; the first prize being a trip to ESO's Very Large

  19. Epitope discovery with phylogenetic hidden Markov models.

    LENUS (Irish Health Repository)

    Lacerda, Miguel

    2010-05-01

    Existing methods for the prediction of immunologically active T-cell epitopes are based on the amino acid sequence or structure of pathogen proteins. Additional information regarding the locations of epitopes may be acquired by considering the evolution of viruses in hosts with different immune backgrounds. In particular, immune-dependent evolutionary patterns at sites within or near T-cell epitopes can be used to enhance epitope identification. We have developed a mutation-selection model of T-cell epitope evolution that allows the human leukocyte antigen (HLA) genotype of the host to influence the evolutionary process. This is one of the first examples of the incorporation of environmental parameters into a phylogenetic model and has many other potential applications where the selection pressures exerted on an organism can be related directly to environmental factors. We combine this novel evolutionary model with a hidden Markov model to identify contiguous amino acid positions that appear to evolve under immune pressure in the presence of specific host immune alleles and that therefore represent potential epitopes. This phylogenetic hidden Markov model provides a rigorous probabilistic framework that can be combined with sequence or structural information to improve epitope prediction. As a demonstration, we apply the model to a data set of HIV-1 protein-coding sequences and host HLA genotypes.

  20. Pentaquarks with hidden charm as hadroquarkonia

    Energy Technology Data Exchange (ETDEWEB)

    Eides, Michael I. [University of Kentucky, Department of Physics and Astronomy, Lexington, KY (United States); Petersburg Nuclear Physics Institute, St. Petersburg (Russian Federation); Petrov, Victor Yu. [Petersburg Nuclear Physics Institute, St. Petersburg (Russian Federation); Polyakov, Maxim V. [Petersburg Nuclear Physics Institute, St. Petersburg (Russian Federation); Ruhr-Universitaet Bochum, Institut fuer Theoretische Physik II, Bochum (Germany)

    2018-01-15

    We consider hidden charm pentaquarks as hadroquarkonium states in a QCD inspired approach. Pentaquarks arise naturally as bound states of quarkonia excitations and ordinary baryons. The LHCb P{sub c}(4450) pentaquark is interpreted as a ψ{sup '}-nucleon bound state with spin-parity J{sup P} = 3/2{sup -}. The partial decay width Γ(P{sub c}(4450) → J/ψ + N) ∼ 11 MeV is calculated and turned out to be in agreement with the experimental data for P{sub c}(4450). The P{sub c}(4450) pentaquark is predicted to be a member of one of the two almost degenerate hidden-charm baryon octets with spin-parities J{sup P} = 1/2{sup -}, 3/2{sup -}. The masses and decay widths of the octet pentaquarks are calculated. The widths are small and comparable with the width of the P{sub c}(4450) pentaquark, and the masses of the octet pentaquarks satisfy the Gell-Mann-Okubo relation. Interpretation of pentaquarks as loosely bound Σ{sub c} anti D* and Σ{sub c}{sup *} anti D* deuteronlike states is also considered. We determine quantum numbers of these bound states and calculate their masses in the one-pion exchange scenario. The hadroquarkonium and molecular approaches to exotic hadrons are compared and the relative advantages and drawbacks of each approach are discussed. (orig.)

  1. Low energy theorems of hidden local symmetries

    International Nuclear Information System (INIS)

    Harada, Masayasu; Kugo, Taichiro; Yamawaki, Koichi.

    1994-01-01

    We prove to all orders of the loop expansion the low energy theorems of hidden local symmetries in four-dimensional nonlinear sigma models based on the coset space G/H, with G and H being arbitrary compact groups. Although the models are non-renormalizable, the proof is done in an analogous manner to the renormalization proof of gauge theories and two-dimensional nonlinear sigma models by restricting ourselves to the operators with two derivatives (counting a hidden gauge boson field as one derivative), i.e., with dimension 2, which are the only operators relevant to the low energy limit. Through loop-wise mathematical induction based on the Ward-Takahashi identity for the BRS symmetry, we solve renormalization equation for the effective action up to dimension-2 terms plus terms with the relevant BRS sources. We then show that all the quantum corrections to the dimension-2 operators, including the finite parts as well as the divergent ones, can be entirely absorbed into a re-definition (renormalization) of the parameters and the fields in the dimension-2 part of the tree-level Lagrangian. (author)

  2. Black holes, hidden symmetries, and complete integrability.

    Science.gov (United States)

    Frolov, Valeri P; Krtouš, Pavel; Kubizňák, David

    2017-01-01

    The study of higher-dimensional black holes is a subject which has recently attracted vast interest. Perhaps one of the most surprising discoveries is a realization that the properties of higher-dimensional black holes with the spherical horizon topology and described by the Kerr-NUT-(A)dS metrics are very similar to the properties of the well known four-dimensional Kerr metric. This remarkable result stems from the existence of a single object called the principal tensor. In our review we discuss explicit and hidden symmetries of higher-dimensional Kerr-NUT-(A)dS black hole spacetimes. We start with discussion of the Killing and Killing-Yano objects representing explicit and hidden symmetries. We demonstrate that the principal tensor can be used as a "seed object" which generates all these symmetries. It determines the form of the geometry, as well as guarantees its remarkable properties, such as special algebraic type of the spacetime, complete integrability of geodesic motion, and separability of the Hamilton-Jacobi, Klein-Gordon, and Dirac equations. The review also contains a discussion of different applications of the developed formalism and its possible generalizations.

  3. A model for morbidity after lung resection in octogenarians.

    Science.gov (United States)

    Berry, Mark F; Onaitis, Mark W; Tong, Betty C; Harpole, David H; D'Amico, Thomas A

    2011-06-01

    Age is an important risk factor for morbidity after lung resection. This study was performed to identify specific risk factors for complications after lung resection in octogenarians. A prospective database containing patients aged 80 years or older, who underwent lung resection at a single institution between January 2000 and June 2009, was reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed. Morbidity was measured as a patient having any perioperative event as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. A multivariable risk model for morbidity was developed using a panel of established preoperative and operative variables. Survival was calculated using the Kaplan-Meier method. During the study period, 193 patients aged 80 years or older (median age 82 years) underwent lung resection: wedge resection in 77, segmentectomy in 13, lobectomy in 96, bilobectomy in four, and pneumonectomy in three. Resection was accomplished via thoracoscopy in 149 patients (77%). Operative mortality was 3.6% (seven patients) and morbidity was 46% (89 patients). A total of 181 (94%) patients were discharged directly home. Postoperative events included atrial arrhythmia in 38 patients (20%), prolonged air leak in 24 patients (12%), postoperative transfusion in 22 patients (11%), delirium in 16 patients (8%), need for bronchoscopy in 14 patients (7%), and pneumonia in 10 patients (5%). Significant predictors of morbidity by multivariable analysis included resection greater than wedge (odds ratio 2.98, p=0.006), thoracotomy as operative approach (odds ratio 2.6, p=0.03), and % predicted forced expiratory volume in 1s (odds ratio 1.28 for each 10% decrement, p=0.01). Octogenarians can undergo lung resection with low mortality. Extent of resection, use of a thoracotomy, and impaired lung function increase the risk of complications. Careful evaluation is necessary to select the most appropriate approach in

  4. The perception of the hidden curriculum on medical education: an exploratory study

    Directory of Open Access Journals (Sweden)

    Murakami Manabu

    2009-12-01

    Full Text Available Abstract Background Major curriculum reform of undergraduate medical education occurred during the past decades in the United Kingdom (UK; however, the effects of the hidden curriculum, which influence the choice of primary care as a career, have not been sufficiently recognized. While Japan, where traditionally few institutions systematically foster primary care physicians and very few have truly embraced family medicine as their guiding discipline, has also experienced meaningful curriculum reform, the effect of the hidden curriculum is not well known. The aim of this study is to identify themes pertaining to the students' perceptions of the hidden curriculum affecting undergraduate medical education in bedside learning in Japan. Methods Semi-structured interviews with thematic content analysis were implemented. Undergraduate year-5 students from a Japanese medical school at a Japanese teaching hospital were recruited. Interview were planned to last between 30 to 60 minutes each, over an 8-month period in 2007. The interviewees' perceptions concerning the quality of teaching in their bedside learning and related experiences were collected and analysed thematically. Results Twenty five medical students (18 males and 7 females, mean age 25 years old consented to participate in the interviews, and seven main themes emerged: "the perception of education as having a low priority," "the prevalence of positive/negative role models," "the persistence of hierarchy and exclusivity," "the existence of gender issues," "an overburdened medical knowledge," "human relationships with colleagues and medical team members," and "first experience from the practical wards and their patients." Conclusions Both similarities and differences were found when comparing the results to those of previous studies in the UK. Some effects of the hidden curriculum in medical education likely exist in common between the UK and Japan, despite the differences in their demographic

  5. An introduction to hidden Markov models for biological sequences

    DEFF Research Database (Denmark)

    Krogh, Anders Stærmose

    1998-01-01

    A non-matematical tutorial on hidden Markov models (HMMs) plus a description of one of the applications of HMMs: gene finding.......A non-matematical tutorial on hidden Markov models (HMMs) plus a description of one of the applications of HMMs: gene finding....

  6. Asymptotics for Estimating Equations in Hidden Markov Models

    DEFF Research Database (Denmark)

    Hansen, Jørgen Vinsløv; Jensen, Jens Ledet

    Results on asymptotic normality for the maximum likelihood estimate in hidden Markov models are extended in two directions. The stationarity assumption is relaxed, which allows for a covariate process influencing the hidden Markov process. Furthermore a class of estimating equations is considered...

  7. Secret Codes: The Hidden Curriculum of Semantic Web Technologies

    Science.gov (United States)

    Edwards, Richard; Carmichael, Patrick

    2012-01-01

    There is a long tradition in education of examination of the hidden curriculum, those elements which are implicit or tacit to the formal goals of education. This article draws upon that tradition to open up for investigation the hidden curriculum and assumptions about students and knowledge that are embedded in the coding undertaken to facilitate…

  8. Searching for hidden sector in multiparticle production at LHC

    Directory of Open Access Journals (Sweden)

    Miguel-Angel Sanchis-Lozano

    2016-03-01

    Full Text Available We study the impact of a hidden sector beyond the Standard Model, e.g. a Hidden Valley model, on factorial moments and cumulants of multiplicity distributions in multiparticle production with a special emphasis on the prospects for LHC results.

  9. Hidden Agendas in Marriage: Affective and Longitudinal Dimensions.

    Science.gov (United States)

    Krokoff, Lowell J.

    1990-01-01

    Examines how couples' discussions of troublesome problems reveal hidden agendas (issues not directly discussed or explored). Finds disgust and contempt are at the core of both love and respect agendas for husbands and wives. Finds that wives' more than husbands' hidden agendas are directly predictive of how negatively they argue at home. (SR)

  10. Hidden symmetries in minimal five-dimensional supergravity

    International Nuclear Information System (INIS)

    Poessel, Markus; Silva, Sebastian

    2004-01-01

    We study the hidden symmetries arising in the dimensional reduction of d=5, N=2 supergravity to three dimensions. Extending previous partial results for the bosonic part, we give a derivation that includes fermionic terms, shedding light on the appearance of the local hidden symmetry SO(4) in the reduction

  11. Maternal morbid obesity and obstetric outcomes.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

  12. Morbidity of curative cancer surgery and suicide risk.

    Science.gov (United States)

    Jayakrishnan, Thejus T; Sekigami, Yurie; Rajeev, Rahul; Gamblin, T Clark; Turaga, Kiran K

    2017-11-01

    Curative cancer operations lead to debility and loss of autonomy in a population vulnerable to suicide death. The extent to which operative intervention impacts suicide risk is not well studied. To examine the effects of morbidity of curative cancer surgeries and prognosis of disease on the risk of suicide in patients with solid tumors. Retrospective cohort study using Surveillance, Epidemiology, and End Results data from 2004 to 2011; multilevel systematic review. General US population. Participants were 482 781 patients diagnosed with malignant neoplasm between 2004 and 2011 who underwent curative cancer surgeries. Death by suicide or self-inflicted injury. Among 482 781 patients that underwent curative cancer surgery, 231 committed suicide (16.58/100 000 person-years [95% confidence interval, CI, 14.54-18.82]). Factors significantly associated with suicide risk included male sex (incidence rate [IR], 27.62; 95% CI, 23.82-31.86) and age >65 years (IR, 22.54; 95% CI, 18.84-26.76). When stratified by 30-day overall postoperative morbidity, a significantly higher incidence of suicide was found for high-morbidity surgeries (IR, 33.30; 95% CI, 26.50-41.33) vs moderate morbidity (IR, 24.27; 95% CI, 18.92-30.69) and low morbidity (IR, 9.81; 95% CI, 7.90-12.04). Unit increase in morbidity was significantly associated with death by suicide (odds ratio, 1.01; 95% CI, 1.00-1.03; P = .02) and decreased suicide-specific survival (hazards ratio, 1.02; 95% CI, 1.00-1.03, P = .01) in prognosis-adjusted models. In this sample of cancer patients in the Surveillance, Epidemiology, and End Results database, patients that undergo high-morbidity surgeries appear most vulnerable to death by suicide. The identification of this high-risk cohort should motivate health care providers and particularly surgeons to adopt screening measures during the postoperative follow-up period for these patients. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Abelian hidden sectors at a GeV

    International Nuclear Information System (INIS)

    Morrissey, David E.; Poland, David; Zurek, Kathryn M.

    2009-01-01

    We discuss mechanisms for naturally generating GeV-scale hidden sectors in the context of weak-scale supersymmetry. Such low mass scales can arise when hidden sectors are more weakly coupled to supersymmetry breaking than the visible sector, as happens when supersymmetry breaking is communicated to the visible sector by gauge interactions under which the hidden sector is uncharged, or if the hidden sector is sequestered from gravity-mediated supersymmetry breaking. We study these mechanisms in detail in the context of gauge and gaugino mediation, and present specific models of Abelian GeV-scale hidden sectors. In particular, we discuss kinetic mixing of a U(1) x gauge force with hypercharge, singlets or bi-fundamentals which couple to both sectors, and additional loop effects. Finally, we investigate the possible relevance of such sectors for dark matter phenomenology, as well as for low- and high-energy collider searches.

  14. Lower mortality but higher neonatal morbidity over a decade in very preterm infants

    NARCIS (Netherlands)

    Kleine, M.J.K. de; Ouden, A.L. den; Kollée, L.A.A.; Ilsen, A.; Wassenaer, A.G. van; Brand, R.; Verloove-Vanhorick, S.P.

    2007-01-01

    Better perinatal care has led to better survival of very preterm children, but may or may not have increased the number of children with cerebral and pulmonary morbidity. We therefore investigated the relationship between changes in perinatal care during one decade, and short-term outcome in very

  15. Identifying hidden sexual bridging communities in Chicago.

    Science.gov (United States)

    Youm, Yoosik; Mackesy-Amiti, Mary Ellen; Williams, Chyvette T; Ouellet, Lawrence J

    2009-07-01

    Bridge populations can play a central role in the spread of human immunodeficiency virus (HIV) by providing transmission links between higher and lower prevalence populations. While social network methods are well suited to the study of bridge populations, analyses tend to focus on dyads (i.e., risk between drug and/or sex partners) and ignore bridges between distinct subpopulations. This study takes initial steps toward moving the analysis of sexual network linkages beyond individual and risk group levels to a community level in which Chicago's 77 community areas are examined as subpopulations for the purpose of identifying potential bridging communities. Of particular interest are "hidden" bridging communities; that is, areas with above-average levels of sexual ties with other areas but whose below-average AIDS prevalence may hide their potential importance for HIV prevention. Data for this analysis came from the first wave of recruiting at the Chicago Sexual Acquisition and Transmission of HIV Cooperative Agreement Program site. Between August 2005 through October 2006, respondent-driven sampling was used to recruit users of heroin, cocaine, or methamphetamine, men who have sex with men regardless of drug use, the sex partners of these two groups, and sex partners of the sex partners. In this cross-sectional study of the sexual transmission of HIV, participants completed a network-focused computer-assisted self-administered interview, which included questions about the geographic locations of sexual contacts with up to six recent partners. Bridging scores for each area were determined using a matrix representing Chicago's 77 community areas and were assessed using two measures: non-redundant ties and flow betweenness. Bridging measures and acquired immunodeficiency syndrome (AIDS) case prevalence rates were plotted for each community area on charts representing four conditions: below-average bridging and AIDS prevalence, below-average bridging and above

  16. Associations between vascular co-morbidities and depression in insulin-naive diabetes patients

    DEFF Research Database (Denmark)

    Koopmans, B; Pouwer, F; de Bie, Rob A

    2009-01-01

    AIMS/HYPOTHESIS: The aim of the study was to determine the prevalence of depression in insulin-naive diabetes patients and to investigate the associations between different forms of vascular co-morbidity and depression. METHODS: Cross-sectional data were used from a primary-care sample of 1......,269 insulin-naive (i.e. not using insulin therapy) diabetes patients participating in the DIAZOB Primary Care Diabetes study. Demographics, vascular co-morbidities, clinical and lifestyle characteristics, and psychosocial factors were assessed. Depression symptoms were measured with the Edinburgh Depression.......2% vs 10.0%). Single vascular co-morbidities were not associated with increased rates of depression. The final model predicting depression included: having multiple vascular co-morbidities compared with none; having less social support; having experienced a recent stressful life event; female sex...

  17. CDC WONDER: Sexually Transmitted Disease (STD) morbidity

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Sexually Transmitted Disease (STD) Morbidity online databases on CDC WONDER contain case reports reported from the 50 United States and D.C., Puerto Rico, Virgin...

  18. CDC WONDER: Sexually Transmitted Disease (STD) Morbidity

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Sexually Transmitted Disease (STD) Morbidity online databases on CDC WONDER contain case reports reported from the 50 United States and D.C., Puerto Rico, Virgin...

  19. Morbidity And Mortality Following Emergency Obstetric ...

    African Journals Online (AJOL)

    Morbidity And Mortality Following Emergency Obstetric Hysterectomy In Calabar, Nigeria. ... Nigerian Journal of Clinical Practice ... in 15 (33.3%) of the case and hysterectomy for puerperal sepsis was an indication in 3 (6.7%) of the cases

  20. … To be hidden does not mean to be merely revealed – Part 1 Artistic research on hidden curriculum

    Directory of Open Access Journals (Sweden)

    Annette Krause

    2015-09-01

    Full Text Available This text revisits the long-term project Hidden Curriculum, initiated by Annette Krauss. The project addresses unquestioned routines, hierarchies of knowledge (part 1, and the role of the body in learning processes (part 2 from the perspective of secondary/high school education (in the research on a hidden curriculum. A deeper analysis of educational studies on the phenomenon of ‘hidden curriculum’ in relation to the feminist and critical pedagogies of bell hooks, Paulo Freire, and Jacques Rancière brings forward important insights generated through the artistic research within hidden curriculum. The aim of this text is to address academic canons, corporeality, and investigate everyday norms through revisiting the framework, results, and processes of the collaborative research into hidden curriculum with secondary high school students.

  1. Dynamic portfolio optimization across hidden market regimes

    DEFF Research Database (Denmark)

    Nystrup, Peter; Madsen, Henrik; Lindström, Erik

    2017-01-01

    Regime-based asset allocation has been shown to add value over rebalancing to static weights and, in particular, reduce potential drawdowns by reacting to changes in market conditions. The predominant approach in previous studies has been to specify in advance a static decision rule for changing...... the allocation based on the state of financial markets or the economy. In this article, model predictive control (MPC) is used to dynamically optimize a portfolio based on forecasts of the mean and variance of financial returns from a hidden Markov model with time-varying parameters. There are computational...... than a buy-and-hold investment in various major stock market indices. This is after accounting for transaction costs, with a one-day delay in the implementation of allocation changes, and with zero-interest cash as the only alternative to the stock indices. Imposing a trading penalty that reduces...

  2. Supersymmetric leptogenesis with a light hidden sector

    International Nuclear Information System (INIS)

    De Simone, Andrea

    2010-04-01

    Supersymmetric scenarios incorporating thermal leptogenesis as the origin of the observed matter-antimatter asymmetry generically predict abundances of the primordial elements which are in conflict with observations. In this paper we pro- pose a simple way to circumvent this tension and accommodate naturally ther- mal leptogenesis and primordial nucleosynthesis. We postulate the existence of a light hidden sector, coupled very weakly to the Minimal Supersymmetric Standard Model, which opens up new decay channels for the next-to-lightest supersymmetric particle, thus diluting its abundance during nucleosynthesis. We present a general model-independent analysis of this mechanism as well as two concrete realizations, and describe the relevant cosmological and astrophysical bounds and implications for this dark matter scenario. Possible experimental signatures at colliders and in cosmic-ray observations are also discussed. (orig.)

  3. Nuclear scissors modes and hidden angular momenta

    Energy Technology Data Exchange (ETDEWEB)

    Balbutsev, E. B., E-mail: balbuts@theor.jinr.ru; Molodtsova, I. V. [Joint Institute for Nuclear Research (Russian Federation); Schuck, P. [Université Paris-Sud, Institut de Physique Nucléaire, IN2P3–CNRS (France)

    2017-01-15

    The coupled dynamics of low-lying modes and various giant resonances are studied with the help of the Wigner Function Moments method generalized to take into account spin degrees of freedom and pair correlations simultaneously. The method is based on Time-Dependent Hartree–Fock–Bogoliubov equations. The model of the harmonic oscillator including spin–orbit potential plus quadrupole–quadrupole and spin–spin interactions is considered. New low-lying spin-dependent modes are analyzed. Special attention is paid to the scissors modes. A new source of nuclear magnetism, connected with counter-rotation of spins up and down around the symmetry axis (hidden angular momenta), is discovered. Its inclusion into the theory allows one to improve substantially the agreement with experimental data in the description of energies and transition probabilities of scissors modes.

  4. Neuroevolution Mechanism for Hidden Markov Model

    Directory of Open Access Journals (Sweden)

    Nabil M. Hewahi

    2011-12-01

    Full Text Available Hidden Markov Model (HMM is a statistical model based on probabilities. HMM is becoming one of the major models involved in many applications such as natural language
    processing, handwritten recognition, image processing, prediction systems and many more. In this research we are concerned with finding out the best HMM for a certain application domain. We propose a neuroevolution process that is based first on converting the HMM to a neural network, then generating many neural networks at random where each represents a HMM. We proceed by
    applying genetic operators to obtain new set of neural networks where each represents HMMs, and updating the population. Finally select the best neural network based on a fitness function.

  5. Improved hidden Markov model for nosocomial infections.

    Science.gov (United States)

    Khader, Karim; Leecaster, Molly; Greene, Tom; Samore, Matthew; Thomas, Alun

    2014-12-01

    We propose a novel hidden Markov model (HMM) for parameter estimation in hospital transmission models, and show that commonly made simplifying assumptions can lead to severe model misspecification and poor parameter estimates. A standard HMM that embodies two commonly made simplifying assumptions, namely a fixed patient count and binomially distributed detections is compared with a new alternative HMM that does not require these simplifying assumptions. Using simulated data, we demonstrate how each of the simplifying assumptions used by the standard model leads to model misspecification, whereas the alternative model results in accurate parameter estimates. © The Authors 2013. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

  6. The elliptic genus and Hidden symmetry

    International Nuclear Information System (INIS)

    Jaffe, A.

    2001-01-01

    We study the elliptic genus (a partition function) in certain interacting, twist quantum field theories. Without twists, these theories have N=2 supersymmetry. The twists provide a regularization, and also partially break the supersymmetry. In spite of the regularization, one can establish a homotopy of the elliptic genus in a coupling parameter. Our construction relies on a priori estimates and other methods from constructive quantum field theory; this mathematical underpinning allows us to justify evaluating the elliptic genus at one endpoint of the homotopy. We obtain a version of Witten's proposed formula for the elliptic genus in terms of classical theta functions. As a consequence, the elliptic genus has a hidden SL(2,Z) symmetry characteristic of conformal theory, even though the underlying theory is not conformal. (orig.)

  7. Hidden conformal symmetry of extremal black holes

    International Nuclear Information System (INIS)

    Chen Bin; Long Jiang; Zhang Jiaju

    2010-01-01

    We study the hidden conformal symmetry of extremal black holes. We introduce a new set of conformal coordinates to write the SL(2,R) generators. We find that the Laplacian of the scalar field in many extremal black holes, including Kerr(-Newman), Reissner-Nordstrom, warped AdS 3 , and null warped black holes, could be written in terms of the SL(2,R) quadratic Casimir. This suggests that there exist dual conformal field theory (CFT) descriptions of these black holes. From the conformal coordinates, the temperatures of the dual CFTs could be read directly. For the extremal black hole, the Hawking temperature is vanishing. Correspondingly, only the left (right) temperature of the dual CFT is nonvanishing, and the excitations of the other sector are suppressed. In the probe limit, we compute the scattering amplitudes of the scalar off the extremal black holes and find perfect agreement with the CFT prediction.

  8. Exact solution of the hidden Markov processes

    Science.gov (United States)

    Saakian, David B.

    2017-11-01

    We write a master equation for the distributions related to hidden Markov processes (HMPs) and solve it using a functional equation. Thus the solution of HMPs is mapped exactly to the solution of the functional equation. For a general case the latter can be solved only numerically. We derive an exact expression for the entropy of HMPs. Our expression for the entropy is an alternative to the ones given before by the solution of integral equations. The exact solution is possible because actually the model can be considered as a generalized random walk on a one-dimensional strip. While we give the solution for the two second-order matrices, our solution can be easily generalized for the L values of the Markov process and M values of observables: We should be able to solve a system of L functional equations in the space of dimension M -1 .

  9. Systemic lupus erythematosus presenting as morbid jealousy.

    Science.gov (United States)

    Ravindran, A.; Carney, M. W.; Denman, A. M.

    1980-01-01

    A patient fulfilling the diagnostic criteria for systemic lupus erythematosus and presenting with morbid jealousy is described. There was evidence of cerebral lupus. Her physical and mental symptoms responded to a combination of chlorpromazine and steroids. The morbid mental process was probably caused by her physical condition while the content of her disordered thought and behaviour was determined by her introverted premorbid personality, religiosity, unhappy childhood experiences and frustrated desire for children. PMID:7413541

  10. Environmental Pollution: Causing High Morbidity and Mortality

    OpenAIRE

    , E. Laho; , G. Koduzi; , D. Osmanlli; , F. Aliu

    2016-01-01

    The environmental pollution which is increasing, it is a concerning issue for the community, and when it comes to big cities like Elbasan this is a hot spot. The relevant experience has shown that the more industrial and urban pollution an area has, the higher the pulmonary morbidity is and more cases of mortality from tumoral diseases are. To investigate and show the morbidity and mortality rate from respiratory diseases, cancer etc In our investigation which is a retrospective statistical r...

  11. Co-morbidity in Attention-Deficit Hyperactivity Disorder: A Clinical Study from India.

    Science.gov (United States)

    Jacob, P; Srinath, S; Girimaji, S; Seshadri, S; Sagar, J V

    2016-12-01

    To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre. A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale. All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder. Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

  12. Skyrmions with holography and hidden local symmetry

    International Nuclear Information System (INIS)

    Nawa, Kanabu; Hosaka, Atsushi; Suganuma, Hideo

    2009-01-01

    We study baryons as Skyrmions in holographic QCD with D4/D8/D8 multi-D brane system in type IIA superstring theory, and also in the nonlinear sigma model with hidden local symmetry. Comparing these two models, we find that the extra dimension and its nontrivial curvature can largely change the role of (axial) vector mesons for baryons in four-dimensional space-time. In the hidden local symmetry approach, the ρ-meson field as a massive Yang-Mills field has a singular configuration in Skyrmion, which gives a strong repulsion for the baryon as a stabilizer. When the a 1 meson is added in this approach, the stability of Skyrmion is lost by the cancellation of ρ and a 1 contributions. On the contrary, in holographic QCD, the ρ-meson field does not appear as a massive Yang-Mills field due to the extra dimension and its nontrivial curvature. We show that the ρ-meson field has a regular configuration in Skyrmion, which gives a weak attraction for the baryon in holographic QCD. We argue that Skyrmion with π, ρ, and a 1 mesons become stable due to the curved extra dimension and also the presence of the Skyrme term in holographic QCD. From this result, we also discuss the features of our truncated-resonance analysis on baryon properties with π and ρ mesons below the cutoff scale M KK ∼1 GeV in holographic QCD, which is compared with other 5D instanton analysis.

  13. [Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

    Science.gov (United States)

    Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

    2014-01-01

    To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

  14. Clustering Multivariate Time Series Using Hidden Markov Models

    Directory of Open Access Journals (Sweden)

    Shima Ghassempour

    2014-03-01

    Full Text Available In this paper we describe an algorithm for clustering multivariate time series with variables taking both categorical and continuous values. Time series of this type are frequent in health care, where they represent the health trajectories of individuals. The problem is challenging because categorical variables make it difficult to define a meaningful distance between trajectories. We propose an approach based on Hidden Markov Models (HMMs, where we first map each trajectory into an HMM, then define a suitable distance between HMMs and finally proceed to cluster the HMMs with a method based on a distance matrix. We test our approach on a simulated, but realistic, data set of 1,255 trajectories of individuals of age 45 and over, on a synthetic validation set with known clustering structure, and on a smaller set of 268 trajectories extracted from the longitudinal Health and Retirement Survey. The proposed method can be implemented quite simply using standard packages in R and Matlab and may be a good candidate for solving the difficult problem of clustering multivariate time series with categorical variables using tools that do not require advanced statistic knowledge, and therefore are accessible to a wide range of researchers.

  15. Adaptive filtering for hidden node detection and tracking in networks.

    Science.gov (United States)

    Hamilton, Franz; Setzer, Beverly; Chavez, Sergio; Tran, Hien; Lloyd, Alun L

    2017-07-01

    The identification of network connectivity from noisy time series is of great interest in the study of network dynamics. This connectivity estimation problem becomes more complicated when we consider the possibility of hidden nodes within the network. These hidden nodes act as unknown drivers on our network and their presence can lead to the identification of false connections, resulting in incorrect network inference. Detecting the parts of the network they are acting on is thus critical. Here, we propose a novel method for hidden node detection based on an adaptive filtering framework with specific application to neuronal networks. We consider the hidden node as a problem of missing variables when model fitting and show that the estimated system noise covariance provided by the adaptive filter can be used to localize the influence of the hidden nodes and distinguish the effects of different hidden nodes. Additionally, we show that the sequential nature of our algorithm allows for tracking changes in the hidden node influence over time.

  16. Hidden gauge structure of supersymmetric free differential algebras

    Energy Technology Data Exchange (ETDEWEB)

    Andrianopoli, Laura [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); INFN - Sezione di Torino,Torino (Italy); D’Auria, Riccardo [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); Ravera, Lucrezia [DISAT, Politecnico di Torino,Corso Duca degli Abruzzi 24, I-10129 Turin (Italy); INFN - Sezione di Torino,Torino (Italy)

    2016-08-16

    The aim of this paper is to clarify the role of the nilpotent fermionic generator Q{sup ′} introduced in http://dx.doi.org/10.1016/0550-3213(82)90376-5 and appearing in the hidden supergroup underlying the free differential algebra (FDA) of D=11 supergravity. We give a physical explanation of its role by looking at the gauge properties of the theory. We find that its presence is necessary, in order that the extra 1-forms of the hidden supergroup give rise to the correct gauge transformations of the p-forms of the FDA. This interpretation is actually valid for any supergravity containing antisymmetric tensor fields, and any supersymmetric FDA can always be traded for a hidden Lie superalgebra containing extra fermionic nilpotent generators. As an interesting example we construct the hidden superalgebra associated with the FDA of N=2, D=7 supergravity. In this case we are able to parametrize the mutually non local 2- and 3-form B{sup (2)} and B{sup (3)} in terms of hidden 1-forms and find that supersymmetry and gauge invariance require in general the presence of two nilpotent fermionic generators in the hidden algebra. We propose that our approach, where all the invariances of the FDA are expressed as Lie derivatives of the p-forms in the hidden supergroup manifold, could be an appropriate framework to discuss theories defined in enlarged versions of superspace recently considered in the literature, such us double field theory and its generalizations.

  17. Beyond the hidden curriculum: The challenging search for authentic values in medical ethics education

    Directory of Open Access Journals (Sweden)

    Gerald Ssebunnya

    2013-11-01

    Full Text Available Since the practice of medicine is a moral enterprise, medical ethics education aims to produce ‘good’ doctors who are capable of self-reflective discernment of the many values at play in the clinical encounter, and of re-affirming the patient’s human dignity. However, the caring and compassionate physician envisaged as the end-product of medical ethics curricula evidently remains elusive. I argue that this apparent failure of medical ethics education is traceable to a systematic de-emphasis of humanistic values since the pioneering stages of formal medical ethics curricula. The idea of ‘the hidden curriculum’ connotes a distinctive value-laden medical morality that is transmissible through socialisation and role-modelling in the medical school moral ecosystem. Further, the hidden curriculum is hampered by the challenging medical school workload, bad role models, and lack of appropriate evaluation and assessment methods, as well as the lack of consensus in bioethics on the key concept of human dignity. Properly conceived, the dignity of the human person is the ultimate source of human values. Optimising the hidden curriculum, therefore, demands an authentic and comprehensive enquiry into the concept of human dignity, as well as the nature of the human person, the true human good and what constitutes the unitary good of the patient.

  18. Psychological Co-morbidity in Children with Specific Learning Disorders.

    Science.gov (United States)

    Sahoo, Manoj K; Biswas, Haritha; Padhy, Susanta Kumar

    2015-01-01

    Children under 19 years of age constitute over 40% of India's population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs) exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder) is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common) to depression, anxiety, suicide etc., to substance abuse (least common). Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most) given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

  19. Sociocultural Dimension of Hidden Content in a Professional Language Curriculum

    Directory of Open Access Journals (Sweden)

    Ekaterina E. Shishlova

    2017-12-01

    Full Text Available Introduction: studying curriculum as a pedagogical problem has traditionally been reduced to the analysis of its explicit content, set in official educational documents. However, a much less studied hidden content plays a significant role in education. So, what is the role of the hidden curriculum during professional language training? The purpose of the article is to determine the potential impact of hidden curriculum on students’ conceptual worldview. Comparing the worldview presented in textbooks with students’ one has allowed us to estimate the rate of influence of hidden curr iculum. Materials and Methods: the methodological basis of the work is the cultural concept of personalityoriented education. The methodology for studying the role of hidden curriculum includes four stages: at the first stage, the authors set the criteria for selecting textbooks for analysis and do the selection; at the second stage, the authors select sociocultural concepts for analysis; at the third stage, the scheme of analysis is designed and the analysis of textbooks is done; at the fourth stage, the authors identify the potential influence of hidden curriculum on students’ conceptual worldview. Results: the structure of hidden curriculum has been determined and the scheme for analysing its subject component has been developed. The authors have identified a significant influence of hidden curriculum on students’ worldview, which represents the scientific novelty of the article. Discussion and Conclusions: the article gives the definition of a hidden curriculum which is new for Russian pedagogy and presents a methodology for its analysis in EFL textbooks. That analysis is recommended to be conducted when selecting teaching materials both i n languages and other humanities.

  20. Pain Catastrophizing in Borderline Morbidly Obese and Morbidly Obese Individuals with Osteoarthritic Knee Pain

    Directory of Open Access Journals (Sweden)

    Tamara J Somers

    2008-01-01

    Full Text Available OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m2 or greater OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m2 and 34 kg/m2. Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients.

  1. Multilayer Neural Networks with Extensively Many Hidden Units

    International Nuclear Information System (INIS)

    Rosen-Zvi, Michal; Engel, Andreas; Kanter, Ido

    2001-01-01

    The information processing abilities of a multilayer neural network with a number of hidden units scaling as the input dimension are studied using statistical mechanics methods. The mapping from the input layer to the hidden units is performed by general symmetric Boolean functions, whereas the hidden layer is connected to the output by either discrete or continuous couplings. Introducing an overlap in the space of Boolean functions as order parameter, the storage capacity is found to scale with the logarithm of the number of implementable Boolean functions. The generalization behavior is smooth for continuous couplings and shows a discontinuous transition to perfect generalization for discrete ones

  2. Update on hidden sectors with dark forces and dark matter

    Energy Technology Data Exchange (ETDEWEB)

    Andreas, Sarah

    2012-11-15

    Recently there has been much interest in hidden sectors, especially in the context of dark matter and ''dark forces'', since they are a common feature of beyond standard model scenarios like string theory and SUSY and additionally exhibit interesting phenomenological aspects. Various laboratory experiments place limits on the so-called hidden photon and continuously further probe and constrain the parameter space; an updated overview is presented here. Furthermore, for several hidden sector models with light dark matter we study the viability with respect to the relic abundance and direct detection experiments.

  3. Hidden photon dark matter search with large metallic mirror

    International Nuclear Information System (INIS)

    Doebrich, Babette; Lindner, Axel; Daumiller, Kai; Engel, Ralph; Roth, Markus; Kowalski, Marek

    2014-10-01

    If Dark Matter is composed of hidden-sector photons that kinetically mix with photons of the visible sector, then Dark Matter has a tiny oscillating electric field component. Its presence would lead to a small amount of visible radiation being emitted from a conducting surface, with the photon frequency given approximately by the mass of the hidden photon. Here, we report on experimental efforts that have started recently to search for such hidden photon Dark Matter in the (sub-)eV regime with a prototype mirror for the Auger fluorescence detector at the Karlsruhe Institute for Technology.

  4. Naturally light hidden photons in LARGE volume string compactifications

    International Nuclear Information System (INIS)

    Goodsell, M.; Jaeckel, J.; Redondo, J.; Ringwald, A.

    2009-09-01

    Extra ''hidden'' U(1) gauge factors are a generic feature of string theory that is of particular phenomenological interest. They can kinetically mix with the Standard Model photon and are thereby accessible to a wide variety of astrophysical and cosmological observations and laboratory experiments. In this paper we investigate the masses and the kinetic mixing of hidden U(1)s in LARGE volume compactifications of string theory. We find that in these scenarios the hidden photons can be naturally light and that their kinetic mixing with the ordinary electromagnetic photon can be of a size interesting for near future experiments and observations. (orig.)

  5. Hidden Area and Mechanical Nonlinearities in Freestanding Graphene

    Science.gov (United States)

    Nicholl, Ryan J. T.; Lavrik, Nickolay V.; Vlassiouk, Ivan; Srijanto, Bernadeta R.; Bolotin, Kirill I.

    2017-06-01

    We investigated the effect of out-of-plane crumpling on the mechanical response of graphene membranes. In our experiments, stress was applied to graphene membranes using pressurized gas while the strain state was monitored through two complementary techniques: interferometric profilometry and Raman spectroscopy. By comparing the data obtained through these two techniques, we determined the geometric hidden area which quantifies the crumpling strength. While the devices with hidden area ˜0 % obeyed linear mechanics with biaxial stiffness 428 ±10 N /m , specimens with hidden area in the range 0.5%-1.0% were found to obey an anomalous nonlinear Hooke's law with an exponent ˜0.1 .

  6. Context Tree Estimation in Variable Length Hidden Markov Models

    OpenAIRE

    Dumont, Thierry

    2011-01-01

    We address the issue of context tree estimation in variable length hidden Markov models. We propose an estimator of the context tree of the hidden Markov process which needs no prior upper bound on the depth of the context tree. We prove that the estimator is strongly consistent. This uses information-theoretic mixture inequalities in the spirit of Finesso and Lorenzo(Consistent estimation of the order for Markov and hidden Markov chains(1990)) and E.Gassiat and S.Boucheron (Optimal error exp...

  7. Local models and hidden nonlocality in Quantum Theory

    OpenAIRE

    Guerini, Leonardo

    2014-01-01

    This Master's thesis has two central subjects: the simulation of correlations generated by local measurements on entangled quantum states by local hidden-variables models and the revelation of hidden nonlocality. We present and detail the Werner's local model and the hidden nonlocality of some Werner states of dimension $d\\geq5$, the Gisin-Degorre's local model for a Werner state of dimension $d=2$ and the local model of Hirsch et al. for mixtures of the singlet state and noise, all of them f...

  8. Suppressing the QCD axion abundance by hidden monopoles

    International Nuclear Information System (INIS)

    Kawasaki, Masahiro

    2015-11-01

    We study the Witten effect of hidden monopoles on the QCD axion dynamics, and show that its abundance as well as isocurvature perturbations can be significantly suppressed if there is a sufficient amount of hidden monopoles. When the hidden monopoles make up a significant fraction of dark matter, the Witten effect suppresses the abundance of axion with the decay constant smaller than 10 12 GeV. The cosmological domain wall problem of the QCD axion can also be avoided, relaxing the upper bound on the decay constant when the Peccei-Quinn symmetry is spontaneously broken after inflation.

  9. Morbidity and injury recurrence in victims of firearm injuries.

    Science.gov (United States)

    Ponzer, S; Bergman, B; Brismar, B

    1996-01-01

    Civilian violence has become an increasing problem in the industrial world. Gunshot wounds, fatal or non-fatal, are often considered as acute trauma episodes. However, our previous study, based on 820 firearm injuries, showed that this group of patients was characterized by a high mortality rate and a pronounced involvement in criminality when compared to a control group. The aim of this study was to determine the general morbidity in the same group of firearm victims. Our hypotheses were that these patients consume a considerable amount of hospital care due to recurring trauma episodes and that their general morbidity is raised. Information was collected concerning all episodes of in-patient care for victims of firearm injuries from 1972-1992 in Stockholm, Sweden. The victims were compared with a sex- and age-matched control group. During the study period, 69.9% of the 820 firearm victims were treated for other reasons than gunshot injuries, compared to 45.5% of the 820 controls. The former group was hospitalized 3,703 times and the latter on 1,512 occasions. The firearm injury group showed an higher morbidity in almost all diagnostic subgroups according to ICD-9. The trauma recurrence rate was high and suicide, homicide and assault were relatively more common in this group. We suggest that the gunshot episode may be regarded as one expression of a "chronic trauma syndrome'. Patients exhibiting this "syndrome' are characterized by recurrent episodes of trauma, a risk-taking and destructive behavior, high morbidity and mortality as well as anti-social traits. Medical, social and legal complications are common making these patients extremely costly for society and their identification a matter of concern. It is probable that this "syndrome' also exists in other groups of trauma patients. Since hospitalization affords a unique opportunity of reaching patients who have a "chronic trauma syndrome' risk profile, we believe, that these patients should not only be treated

  10. Morbidity and mortality patterns of admissions into the special care ...

    African Journals Online (AJOL)

    The four leading causes of admissions were low birth weight (LBW) 32.7%, neonatal sepsis (NNS) 19.1%, severe birth asphyxia (SBA) 12.7%, and neonatal jaundice (NNJ) 8.7%. Eighty one (37.9%) of the LBW were term and small for gestational (SGA), while 133 (62.1%) were preterm. Of the 87 (13.3%) deaths recorded ...

  11. Use of evidence based practices to improve survival without severe morbidity for very preterm infants

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie

    2016-01-01

    for which they were eligible. Infants with low gestational age, growth restriction, low Apgar scores, and who were born on the day of maternal admission to hospital were less likely to receive evidence based care. After adjustment, evidence based care was associated with lower in-hospital mortality (risk...... ratio 0.72, 95% confidence interval 0.60 to 0.87) and in-hospital mortality or severe morbidity, or both (0.82, 0.73 to 0.92), corresponding to an estimated 18% decrease in all deaths without an increase in severe morbidity if these interventions had been provided to all infants. CONCLUSIONS: More......OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. DESIGN: Prospective multinational...

  12. Improving perinatal outcome: towards individualized care

    NARCIS (Netherlands)

    Kazemier, B.M.

    2015-01-01

    Unfortunately not all pregnancies and deliveries take place without complications. Complications during pregnancy or delivery can lead to maternal morbidity and poor perinatal outcomes such as perinatal mortality or (severe) neonatal morbidity. First assessment in antenatal care is to distinguish

  13. Co-morbidities of vertiginous diseases.

    Science.gov (United States)

    Warninghoff, Jan C; Bayer, Otmar; Ferrari, Uta; Straube, Andreas

    2009-07-07

    Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD), vestibular migraine and phobic vertigo (PPV)) have also different spectrums of co-morbidities. All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index), migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

  14. Co-morbidities of vertiginous diseases

    Directory of Open Access Journals (Sweden)

    Ferrari Uta

    2009-07-01

    Full Text Available Abstract Background Co-morbidities of vertiginous diseases have so far not been investigated systematically. Thus, it is still unclear whether the different vertigo syndromes (e.g. benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD, vestibular migraine and phobic vertigo (PPV have also different spectrums of co-morbidities. Methods All patients from a cohort of 131 participants were surveyed using a standardised questionnaire about the co-morbidities hypertension, diabetes mellitus, BMI (body mass index, migraine, other headache, and psychiatric diseases in general and the likelihood of a depression in particular. Results We noted hypertension in 29.0% of the cohort, diabetes mellitus in 6.1%, migraine in 8.4%, other headache in 32.1%, psychiatric diseases in 16.0%, overweight and obesity in 33.6% and 13.7% respectively, as well as a clinical indication for depression in 15.9%. Conclusion In general, we did not detect an increased prevalence of the co-morbidities diabetes mellitus, arterial hypertension, migraine, other headache and obesity compared to the general population. There was an increased prevalence of psychiatric co-morbidity in patients with PPV, and the prevalence of hypertension was elevated in patients with MD.

  15. High Energy Colliders and Hidden Sectors

    Science.gov (United States)

    Dror, Asaf Jeff

    This thesis explores two dominant frontiers of theoretical physics, high energy colliders and hidden sectors. The Large Hadron Collider (LHC) is just starting to reach its maximum operational capabilities. However, already with the current data, large classes of models are being put under significant pressure. It is crucial to understand whether the (thus far) null results are a consequence of a lack of solution to the hierarchy problem around the weak scale or requires expanding the search strategy employed at the LHC. It is the duty of the current generation of physicists to design new searches to ensure that no stone is left unturned. To this end, we study the sensitivity of the LHC to the couplings in the Standard Model top sector. We find it can significantly improve the measurements on ZtRtR coupling by a novel search strategy, making use of an implied unitarity violation in such models. Analogously, we show that other couplings in the top sector can also be measured with the same technique. Furthermore, we critically analyze a set of anomalies in the LHC data and how they may appear from consistent UV completions. We also propose a technique to measure lifetimes of new colored particles with non-trivial spin. While the high energy frontier will continue to take data, it is likely the only collider of its kind for the next couple decades. On the other hand, low-energy experiments have a promising future with many new proposed experiments to probe the existence of particles well below the weak scale but with small couplings to the Standard Model. In this work we survey the different possibilities, focusingon the constraints as well as possible new hidden sector dynamics. In particular, we show that vector portals which couple to an anomalous current, e.g., baryon number, are significantly constrained from flavor changing meson decays and rare Z decays. Furthermore, we present a new mechanism for dark matter freezeout which depletes the dark sector through an

  16. Alleviating hidden hunger. Approaches that work

    International Nuclear Information System (INIS)

    Kennedy, E.; Mannar, V.; Iyengar, V.

    2003-01-01

    The world has come a long way in understanding the nature, magnitude and range of solutions to micronutrient malnutrition - often called 'hidden hunger'. The most sustainable solutions - that is those that are likely to be maintained in the long term - almost surely will include food-based approaches including diet diversity, food fortification and biofortification. Food fortification and biofortification could be some of the most cost-effective of all public health interventions and thus within the economic reach of even the world's poorest. In order to implement them in a sustainable manner, a combination of technical, operational, economic, behavioural and political factors need to be addressed. In some ways the technological issues are the easiest. Because of attention to research, we now have a variety of ways for both single and multiple micronutrients to reach the target population. We also know what is needed in order to ensure delivery systems. The key factor for continued success in reducing micronutrient malnutrition through fortification is a political commitment at the national and international level and creating effective public-private partnerships at the national level. The payoff for eliminating hidden hunger through nutrient fortification is enormous and few other public health interventions offer such a promising health, nutrition and economic success story. Nuclear and isotopic techniques are valuable tools in helping to meet the multifaceted challenges posed by nutritional disorders affecting the entire human life span (embryonic to elderly). Among the numerous applications available, isotopic techniques are uniquely well suited for targeting and tracking progress in food and nutrition development programmes (See box: How Nutrients are Tracked). These include: use of the stable isotopes of iron (Fe) and zinc (Zn) as a kind of gold standard in studies of their bioavailability from foods; trace element bioavailability and pool sizes for

  17. Severe maternal morbidity: A population-based study of an expanded measure and associated factors.

    Directory of Open Access Journals (Sweden)

    Victoria Lazariu

    Full Text Available Severe maternal morbidity conditions such as sepsis, embolism and cardiac arrest during the delivery hospitalization period can lead to extended length of hospital stays, life-long maternal health problems, and high medical costs. Most importantly, these conditions also contribute to the risk of maternal death. This population-based observational study proposed and evaluated the impact of expanding the Centers for Disease Control and Prevention (CDC measure of severe maternal morbidity by including additional comorbidities and intensive care admissions during delivery hospitalizations and examined associated factors. A New York State linked hospitalization and birth record database was used. Study participants included all New York State female residents, ages 10 to 55 years, who delivered a live infant in a New York acute care hospital between 2008 and 2013, inclusive. Incidence trends for both severe maternal morbidity measures were evaluated longitudinally. Associations between covariates and the two severe maternal morbidity measures were examined with logistic regression models, solved using generalized estimating equations and stratified by method of delivery. The New York expanded severe maternal morbidity measure identified 34,478 cases among 1,352,600 hospital deliveries (estimated incidence 2.55% representing a 3% increase in the number of cases compared to the CDC measure. Both estimates increased over the study period (p 1.5 included most measured comorbidities (e.g., pregnancy-induced hypertension, placentation disorder, multiple births, preterm birth, no prenatal care, hospitalization prior to delivery, higher levels of perinatal care birthing facilities and race/ethnicity. Expanding the measure for severe maternal morbidity during delivery to capture intensive care admissions provides a more sensitive estimate of disease burden. Perinatal regionalization in New York appears effective in routing high risk pregnancies to higher

  18. What Lies Within: Using Radiopharmaceuticals to Reveal and Target Diseases Hidden Inside the Human Body

    International Nuclear Information System (INIS)

    Jawerth, Nicole

    2014-01-01

    The ability to pinpoint the location and size of a cancerous mass hidden inside of a patient’s body was unthinkable less than 100 years ago. Today, with the help of special scanning machines, doctors are able to use radioactive drugs known as radiopharmaceuticals to get a glimpse inside the human body, and these pharmaceuticals can even be used in treating many health conditions. In nuclear medicine, radiopharmaceuticals play an essential role for minimally invasive diagnostic, treatment and care management procedures for many diseases, especially cancer, as well as for relieving pain associated with certain cancers

  19. Co-morbidities in severe asthma

    DEFF Research Database (Denmark)

    Porsbjerg, Celeste; Menzies-Gow, Andrew

    2017-01-01

    Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma...... to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical...... impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD...

  20. Explaining excess morbidity amongst homeless shelter users

    DEFF Research Database (Denmark)

    Benjaminsen, Lars; Birkelund, Jesper Fels

    2018-01-01

    AIMS: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. METHODS: Data set...... includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk...... of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. RESULTS: The excess morbidity associated with shelter use is substantially lower than in studies that did not include...

  1. Prediction of Annual Rainfall Pattern Using Hidden Markov Model ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Hidden Markov model is very influential in stochastic world because of its ... the earth from the clouds. The usual ... Rainfall modelling and ... Markov Models have become popular tools ... environment sciences, University of Jos, plateau state,.

  2. New limits on hidden photons from past electron beam dumps

    International Nuclear Information System (INIS)

    Andreas, Sarah; Niebuhr, Carsten; Ringwald, Andreas

    2012-09-01

    Hidden sectors with light extra U(1) gauge bosons, so called hidden photons, have recently attracted some attention because they are a common feature of physics beyond the Standard Model like string theory and SUSY and additionally are phenomenologically of great interest regarding recent astrophysical observations. The hidden photon is already constrained by various laboratory experiments and presently searched for in running as well as upcoming experiments. We summarize the current status of limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay that have so far not been considered. All our limits take into account the experimental acceptances obtained from Monte Carlo simulations.

  3. Search for hidden particles with the SHiP experiment

    Energy Technology Data Exchange (ETDEWEB)

    Hagner, Caren; Bick, Daniel; Bieschke, Stefan; Ebert, Joachim; Schmidt-Parzefall, Walter [Universitaet Hamburg, Institut fuer Experimentalphysik, Luruper Chaussee 149, 22761 Hamburg (Germany)

    2016-07-01

    Many theories beyond the standard model predict long lived neutral (hidden) particles. There might be a whole Hidden Sector (HS) of weakly interacting particles, which cannot be detected in existing high energy experiments. The SHiP experiment (Search for Hidden Particles) requires a high intensity beam dump, which could be realized by a new facility at the CERN SPS accelerator. New superweakly interacting particles with masses below O(10) GeV could be produced in the beam dump and detected in a general purpose Hidden Sector (HS) detector. In addition there will be a dedicated tau neutrino subdetector. I present the major requirements and technical challenges for the HS detector and discuss how the HS can be accessed through several portals: neutrino portal, scalar portal, vector portal and many more.

  4. Cosmological abundance of the QCD axion coupled to hidden photons

    Science.gov (United States)

    Kitajima, Naoya; Sekiguchi, Toyokazu; Takahashi, Fuminobu

    2018-06-01

    We study the cosmological evolution of the QCD axion coupled to hidden photons. For a moderately strong coupling, the motion of the axion field leads to an explosive production of hidden photons by tachyonic instability. We use lattice simulations to evaluate the cosmological abundance of the QCD axion. In doing so, we incorporate the backreaction of the produced hidden photons on the axion dynamics, which becomes significant in the non-linear regime. We find that the axion abundance is suppressed by at most O (102) for the decay constant fa =1016GeV, compared to the case without the coupling. For a sufficiently large coupling, the motion of the QCD axion becomes strongly damped, and as a result, the axion abundance is enhanced. Our results show that the cosmological upper bound on the axion decay constant can be relaxed by a few hundred for a certain range of the coupling to hidden photons.

  5. Dopamine reward prediction errors reflect hidden state inference across time

    Science.gov (United States)

    Starkweather, Clara Kwon; Babayan, Benedicte M.; Uchida, Naoshige; Gershman, Samuel J.

    2017-01-01

    Midbrain dopamine neurons signal reward prediction error (RPE), or actual minus expected reward. The temporal difference (TD) learning model has been a cornerstone in understanding how dopamine RPEs could drive associative learning. Classically, TD learning imparts value to features that serially track elapsed time relative to observable stimuli. In the real world, however, sensory stimuli provide ambiguous information about the hidden state of the environment, leading to the proposal that TD learning might instead compute a value signal based on an inferred distribution of hidden states (a ‘belief state’). In this work, we asked whether dopaminergic signaling supports a TD learning framework that operates over hidden states. We found that dopamine signaling exhibited a striking difference between two tasks that differed only with respect to whether reward was delivered deterministically. Our results favor an associative learning rule that combines cached values with hidden state inference. PMID:28263301

  6. Optimisation of Hidden Markov Model using Baum–Welch algorithm ...

    Indian Academy of Sciences (India)

    The present work is a part of development of Hidden Markov Model. (HMM) based ... the Himalaya. In this work, HMMs have been developed for forecasting of maximum and minimum ..... data collection teams of Snow and Avalanche Study.

  7. On the LHC sensitivity for non-thermalised hidden sectors

    Science.gov (United States)

    Kahlhoefer, Felix

    2018-04-01

    We show under rather general assumptions that hidden sectors that never reach thermal equilibrium in the early Universe are also inaccessible for the LHC. In other words, any particle that can be produced at the LHC must either have been in thermal equilibrium with the Standard Model at some point or must be produced via the decays of another hidden sector particle that has been in thermal equilibrium. To reach this conclusion, we parametrise the cross section connecting the Standard Model to the hidden sector in a very general way and use methods from linear programming to calculate the largest possible number of LHC events compatible with the requirement of non-thermalisation. We find that even the HL-LHC cannot possibly produce more than a few events with energy above 10 GeV involving states from a non-thermalised hidden sector.

  8. Risk from the frontlines of a hidden epidemic sexuality, masculinities ...

    African Journals Online (AJOL)

    Risk from the frontlines of a hidden epidemic sexuality, masculinities and social pressures ... It frames risk in the context of the dynamics governing sexuality, underlined ... MSM risk and practice, in these contexts, are consequently shaped by ...

  9. New limits on hidden photons from past electron beam dumps

    Energy Technology Data Exchange (ETDEWEB)

    Andreas, Sarah; Niebuhr, Carsten; Ringwald, Andreas

    2012-09-15

    Hidden sectors with light extra U(1) gauge bosons, so called hidden photons, have recently attracted some attention because they are a common feature of physics beyond the Standard Model like string theory and SUSY and additionally are phenomenologically of great interest regarding recent astrophysical observations. The hidden photon is already constrained by various laboratory experiments and presently searched for in running as well as upcoming experiments. We summarize the current status of limits on hidden photons from past electron beam dump experiments including two new limits from such experiments at KEK and Orsay that have so far not been considered. All our limits take into account the experimental acceptances obtained from Monte Carlo simulations.

  10. Thromboxane production in morbidly obese subjects.

    Science.gov (United States)

    Graziani, Francesca; Biasucci, Luigi M; Cialdella, Pio; Liuzzo, Giovanna; Giubilato, Simona; Della Bona, Roberta; Pulcinelli, Fabio M; Iaconelli, Amerigo; Mingrone, Geltrude; Crea, Filippo

    2011-06-01

    Postmortem studies have demonstrated that morbidly obese subjects, surprisingly, have less coronary atherosclerosis than obese subjects. However, the reasons for this apparent protection from atherosclerosis are not yet clear. Thromboxane A2, a marker of platelet activation, is greater in obese subjects than in lean subjects, and this might be a clue to their increased cardiovascular risk. However, data on thromboxane A2 in morbidly obese subjects are lacking; therefore, we hypothesized that lower levels of thromboxane A2 in morbidly obese subjects might play a role in their lower atherothrombotic burden. We measured the serum levels of thromboxane B2 (TxB2), a stable metabolite of thromboxane A2, high-sensitivity C-reactive protein (hs-CRP) and leptin in 17 lean subjects (body mass index [BMI] 22.9 ± 1.6 kg/m(2)), 25 obese subjects (BMI 32.6 ± 2.4 kg/m(2)), and 23 morbidly obese subjects (BMI 48.6 ± 7.1 kg/m(2)), without insulin resistance, diabetes, or overt cardiovascular disease. The serum TxB2 levels were lower in the lean subjects than in the obese subjects (p = 0.046) and in the morbidly obese subjects than in the lean and obese subjects (p = 0.015 and p lean subjects (hs-CRP, p lean subjects (p lean subjects, suggesting that reduced platelet activation could play a role in the paradoxical protection of morbidly obese subjects from atherosclerosis, despite the greater levels of leptin. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. A Novel Method for Decoding Any High-Order Hidden Markov Model

    Directory of Open Access Journals (Sweden)

    Fei Ye

    2014-01-01

    Full Text Available This paper proposes a novel method for decoding any high-order hidden Markov model. First, the high-order hidden Markov model is transformed into an equivalent first-order hidden Markov model by Hadar’s transformation. Next, the optimal state sequence of the equivalent first-order hidden Markov model is recognized by the existing Viterbi algorithm of the first-order hidden Markov model. Finally, the optimal state sequence of the high-order hidden Markov model is inferred from the optimal state sequence of the equivalent first-order hidden Markov model. This method provides a unified algorithm framework for decoding hidden Markov models including the first-order hidden Markov model and any high-order hidden Markov model.

  12. A two particle hidden sector and the oscillations with photons

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez, Pedro D. [Universidad de Antofagasta, Departamento de Fisica, Antofagasta (Chile); Arias, Paola; Maldonado, Carlos [Universidad de Santiago de Chile, Departmento de Fisica, Santiago (Chile)

    2018-01-15

    We present a detailed study of the oscillations and optical properties for vacuum, in a model for the dark sector that contains axion-like particles and hidden photons. We provide bounds for the couplings versus the mass, using current results from ALPS-I and PVLAS. We also discuss the challenges for the detection of models with more than one hidden particle in light shining trough wall-like experiments. (orig.)

  13. Rare Z boson decays to a hidden sector

    Science.gov (United States)

    Blinov, Nikita; Izaguirre, Eder; Shuve, Brian

    2018-01-01

    We demonstrate that rare decays of the Standard Model Z boson can be used to discover and characterize the nature of new hidden-sector particles. We propose new searches for these particles in soft, high-multiplicity leptonic final states at the Large Hadron Collider. The proposed searches are sensitive to low-mass particles produced in Z decays, and we argue that these striking signatures can shed light on the hidden-sector couplings and mechanism for mass generation.

  14. Anticipating hidden text salting in emails (extended abstract)

    OpenAIRE

    Lioma, Christina; Moens, Marie-Francine; Gomez, Juan Carlos; De Beer, Jan; Bergholz, Andre; Paass, Gerhard; Horkan, Patrick

    2008-01-01

    Salting is the intentional addition or distortion of content, aimed to evade automatic filtering. Salting is usually found in spam emails. Salting can also be hidden in phishing emails, which aim to steal personal information from users. We present a novel method that detects hidden salting tricks as visual anomalies in text. We solely use these salting tricks to successfully classify emails as phishing (F-measure >90%).

  15. Hidden twelve-dimensional super Poincare symmetry in eleven dimensions

    International Nuclear Information System (INIS)

    Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2004-01-01

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional super Poincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven-dimensional superparticle, taken off-shell, we discover a hidden twelve-dimensional super Poincare symmetry that governs the theory

  16. Hidden charged dark matter and chiral dark radiation

    Science.gov (United States)

    Ko, P.; Nagata, Natsumi; Tang, Yong

    2017-10-01

    In the light of recent possible tensions in the Hubble constant H0 and the structure growth rate σ8 between the Planck and other measurements, we investigate a hidden-charged dark matter (DM) model where DM interacts with hidden chiral fermions, which are charged under the hidden SU(N) and U(1) gauge interactions. The symmetries in this model assure these fermions to be massless. The DM in this model, which is a Dirac fermion and singlet under the hidden SU(N), is also assumed to be charged under the U(1) gauge symmetry, through which it can interact with the chiral fermions. Below the confinement scale of SU(N), the hidden quark condensate spontaneously breaks the U(1) gauge symmetry such that there remains a discrete symmetry, which accounts for the stability of DM. This condensate also breaks a flavor symmetry in this model and Nambu-Goldstone bosons associated with this flavor symmetry appear below the confinement scale. The hidden U(1) gauge boson and hidden quarks/Nambu-Goldstone bosons are components of dark radiation (DR) above/below the confinement scale. These light fields increase the effective number of neutrinos by δNeff ≃ 0.59 above the confinement scale for N = 2, resolving the tension in the measurements of the Hubble constant by Planck and Hubble Space Telescope if the confinement scale is ≲1 eV. DM and DR continuously scatter with each other via the hidden U(1) gauge interaction, which suppresses the matter power spectrum and results in a smaller structure growth rate. The DM sector couples to the Standard Model sector through the exchange of a real singlet scalar mixing with the Higgs boson, which makes it possible to probe our model in DM direct detection experiments. Variants of this model are also discussed, which may offer alternative ways to investigate this scenario.

  17. Hidden Markov models in automatic speech recognition

    Science.gov (United States)

    Wrzoskowicz, Adam

    1993-11-01

    This article describes a method for constructing an automatic speech recognition system based on hidden Markov models (HMMs). The author discusses the basic concepts of HMM theory and the application of these models to the analysis and recognition of speech signals. The author provides algorithms which make it possible to train the ASR system and recognize signals on the basis of distinct stochastic models of selected speech sound classes. The author describes the specific components of the system and the procedures used to model and recognize speech. The author discusses problems associated with the choice of optimal signal detection and parameterization characteristics and their effect on the performance of the system. The author presents different options for the choice of speech signal segments and their consequences for the ASR process. The author gives special attention to the use of lexical, syntactic, and semantic information for the purpose of improving the quality and efficiency of the system. The author also describes an ASR system developed by the Speech Acoustics Laboratory of the IBPT PAS. The author discusses the results of experiments on the effect of noise on the performance of the ASR system and describes methods of constructing HMM's designed to operate in a noisy environment. The author also describes a language for human-robot communications which was defined as a complex multilevel network from an HMM model of speech sounds geared towards Polish inflections. The author also added mandatory lexical and syntactic rules to the system for its communications vocabulary.

  18. Search algorithms, hidden labour and information control

    Directory of Open Access Journals (Sweden)

    Paško Bilić

    2016-06-01

    Full Text Available The paper examines some of the processes of the closely knit relationship between Google’s ideologies of neutrality and objectivity and global market dominance. Neutrality construction comprises an important element sustaining the company’s economic position and is reflected in constant updates, estimates and changes to utility and relevance of search results. Providing a purely technical solution to these issues proves to be increasingly difficult without a human hand in steering algorithmic solutions. Search relevance fluctuates and shifts through continuous tinkering and tweaking of the search algorithm. The company also uses third parties to hire human raters for performing quality assessments of algorithmic updates and adaptations in linguistically and culturally diverse global markets. The adaptation process contradicts the technical foundations of the company and calculations based on the initial Page Rank algorithm. Annual market reports, Google’s Search Quality Rating Guidelines, and reports from media specialising in search engine optimisation business are analysed. The Search Quality Rating Guidelines document provides a rare glimpse into the internal architecture of search algorithms and the notions of utility and relevance which are presented and structured as neutral and objective. Intertwined layers of ideology, hidden labour of human raters, advertising revenues, market dominance and control are discussed throughout the paper.

  19. Hidden Structural Codes in Protein Intrinsic Disorder.

    Science.gov (United States)

    Borkosky, Silvia S; Camporeale, Gabriela; Chemes, Lucía B; Risso, Marikena; Noval, María Gabriela; Sánchez, Ignacio E; Alonso, Leonardo G; de Prat Gay, Gonzalo

    2017-10-17

    Intrinsic disorder is a major structural category in biology, accounting for more than 30% of coding regions across the domains of life, yet consists of conformational ensembles in equilibrium, a major challenge in protein chemistry. Anciently evolved papillomavirus genomes constitute an unparalleled case for sequence to structure-function correlation in cases in which there are no folded structures. E7, the major transforming oncoprotein of human papillomaviruses, is a paradigmatic example among the intrinsically disordered proteins. Analysis of a large number of sequences of the same viral protein allowed for the identification of a handful of residues with absolute conservation, scattered along the sequence of its N-terminal intrinsically disordered domain, which intriguingly are mostly leucine residues. Mutation of these led to a pronounced increase in both α-helix and β-sheet structural content, reflected by drastic effects on equilibrium propensities and oligomerization kinetics, and uncovers the existence of local structural elements that oppose canonical folding. These folding relays suggest the existence of yet undefined hidden structural codes behind intrinsic disorder in this model protein. Thus, evolution pinpoints conformational hot spots that could have not been identified by direct experimental methods for analyzing or perturbing the equilibrium of an intrinsically disordered protein ensemble.

  20. Dietary phytate, zinc and hidden zinc deficiency.

    Science.gov (United States)

    Sandstead, Harold H; Freeland-Graves, Jeanne H

    2014-10-01

    Epidemiological data suggest at least one in five humans are at risk of zinc deficiency. This is in large part because the phytate in cereals and legumes has not been removed during food preparation. Phytate, a potent indigestible ligand for zinc prevents it's absorption. Without knowledge of the frequency of consumption of foods rich in phytate, and foods rich in bioavailable zinc, the recognition of zinc deficiency early in the illness may be difficult. Plasma zinc is insensitive to early zinc deficiency. Serum ferritin concentration≤20μg/L is a potential indirect biomarker. Early effects of zinc deficiency are chemical, functional and may be "hidden". The clinical problem is illustrated by 2 studies that involved US Mexican-American children, and US premenopausal women. The children were consuming home diets that included traditional foods high in phytate. The premenopausal women were not eating red meat on a regular basis, and their consumption of phytate was mainly from bran breakfast cereals. In both studies the presence of zinc deficiency was proven by functional responses to controlled zinc treatment. In the children lean-mass, reasoning, and immunity were significantly affected. In the women memory, reasoning, and eye-hand coordination were significantly affected. A screening self-administered food frequency questionnaire for office might help caregiver's identify patients at risk of zinc deficiency. Copyright © 2014 Elsevier GmbH. All rights reserved.

  1. Natural inflation with hidden scale invariance

    Directory of Open Access Journals (Sweden)

    Neil D. Barrie

    2016-05-01

    Full Text Available We propose a new class of natural inflation models based on a hidden scale invariance. In a very generic Wilsonian effective field theory with an arbitrary number of scalar fields, which exhibits scale invariance via the dilaton, the potential necessarily contains a flat direction in the classical limit. This flat direction is lifted by small quantum corrections and inflation is realised without need for an unnatural fine-tuning. In the conformal limit, the effective potential becomes linear in the inflaton field, yielding to specific predictions for the spectral index and the tensor-to-scalar ratio, being respectively: ns−1≈−0.025(N⋆60−1 and r≈0.0667(N⋆60−1, where N⋆≈30–65 is a number of efolds during observable inflation. This predictions are in reasonable agreement with cosmological measurements. Further improvement of the accuracy of these measurements may turn out to be critical in falsifying our scenario.

  2. Detecting hidden sources-STUK/HUT team

    Energy Technology Data Exchange (ETDEWEB)

    Nikkinen, M.; Aarnio, P. [Helsinki Univ. of Technology, Espoo (Finland); Honkamaa, T.; Tiilikainen, H. [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland)

    1997-12-31

    The task of the team was to locate and to identify hidden sources in a specified area in Padasjoki Auttoinen village. The team used AB-420 helicopter of the Finnish Frontier Guard. The team had two measuring systems: HPGe system (relative efficiency 18%) and 5`x5` NaI system. The team found two sources in real-time and additional two sources after 24 h analysis time. After the locations and characteristics of the sources were announced it was found out that altogether six sources would have been possible to find using the measured data. The total number of sources was ten. The NaI detector was good at detecting and locating the sources and HPGe was most useful in identification and calculation of the activity estimates. The following development should be made: 1) larger detectors are needed, 2) the software has to be improved. (This has been performed after the exercise) and 3) the navigation must be based on DGPS. visual navigation causes easily gaps between the flight lines and some sources may not be detected. (au).

  3. Gauging hidden symmetries in two dimensions

    International Nuclear Information System (INIS)

    Samtleben, Henning; Weidner, Martin

    2007-01-01

    We initiate the systematic construction of gauged matter-coupled supergravity theories in two dimensions. Subgroups of the affine global symmetry group of toroidally compactified supergravity can be gauged by coupling vector fields with minimal couplings and a particular topological term. The gauge groups typically include hidden symmetries that are not among the target-space isometries of the ungauged theory. The gaugings constructed in this paper are described group-theoretically in terms of a constant embedding tensor subject to a number of constraints which parametrizes the different theories and entirely encodes the gauged Lagrangian. The prime example is the bosonic sector of the maximally supersymmetric theory whose ungauged version admits an affine e 9 global symmetry algebra. The various parameters (related to higher-dimensional p-form fluxes, geometric and non-geometric fluxes, etc.) which characterize the possible gaugings, combine into an embedding tensor transforming in the basic representation of e 9 . This yields an infinite-dimensional class of maximally supersymmetric theories in two dimensions. We work out and discuss several examples of higher-dimensional origin which can be systematically analyzed using the different gradings of e 9

  4. Academic mobbing: hidden health hazard at workplace.

    Science.gov (United States)

    Khoo, Sb

    2010-01-01

    Academic mobbing is a non-violent, sophisticated, 'ganging up' behaviour adopted by academicians to "wear and tear" a colleague down emotionally through unjustified accusation, humiliation, general harassment and emotional abuse. These are directed at the target under a veil of lies and justifications so that they are "hidden" to others and difficult to prove. Bullies use mobbing activities to hide their own weaknesses and incompetence. Targets selected are often intelligent, innovative high achievers, with good integrity and principles. Mobbing activities appear trivial and innocuous on its own but the frequency and pattern of their occurrence over long period of time indicates an aggressive manipulation to "eliminate" the target. Mobbing activities typically progress through five stereotypical phases that begins with an unsolved minor conflict between two workers and ultimately escalates into a senseless mobbing whereby the target is stigmatized and victimized to justify the behaviours of the bullies. The result is always physical, mental, social distress or illness and, most often, expulsion of target from the workplace. Organizations are subjected to great financial loss, loss of key workers and a tarnished public image and reputation. Public awareness, education, effective counselling, establishment of anti-bullying policies and legislations at all levels are necessary to curb academic mobbing. General practitioners (GPs) play an important role in supporting patients subjected to mental and physical health injury caused by workplace bullying and mobbing.

  5. Detecting hidden sources-STUK/HUT team

    Energy Technology Data Exchange (ETDEWEB)

    Nikkinen, M; Aarnio, P [Helsinki Univ. of Technology, Espoo (Finland); Honkamaa, T; Tiilikainen, H [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland)

    1998-12-31

    The task of the team was to locate and to identify hidden sources in a specified area in Padasjoki Auttoinen village. The team used AB-420 helicopter of the Finnish Frontier Guard. The team had two measuring systems: HPGe system (relative efficiency 18%) and 5`x5` NaI system. The team found two sources in real-time and additional two sources after 24 h analysis time. After the locations and characteristics of the sources were announced it was found out that altogether six sources would have been possible to find using the measured data. The total number of sources was ten. The NaI detector was good at detecting and locating the sources and HPGe was most useful in identification and calculation of the activity estimates. The following development should be made: 1) larger detectors are needed, 2) the software has to be improved. (This has been performed after the exercise) and 3) the navigation must be based on DGPS. visual navigation causes easily gaps between the flight lines and some sources may not be detected. (au).

  6. Hidden-Sector Dynamics and the Supersymmetric Seesaw

    CERN Document Server

    Campbell, Bruce A; Maybury, David W

    2008-01-01

    In light of recent analyses that have shown that nontrivial hidden-sector dynamics in models of supersymmetry breaking can lead to a significant impact on the predicted low-energy supersymmetric spectrum, we extend these studies to consider hidden-sector effects in extensions of the MSSM to include a seesaw model for neutrino masses. A dynamical hidden sector in an interval of mass scales below the seesaw scale would yield renormalization-group running involving both the anomalous dimension from the hidden sector and the seesaw-extended MSSM renormalization group equations (RGEs). These effects interfere in general, altering the generational mixing of the sleptons, and allowing for a substantial change to the expected level of charged-lepton flavour violation in seesaw-extended MSSM models. These results provide further support for recent theoretical observations that knowledge of the hidden sector is required in order to make concrete low-energy predictions, if the hidden sector is strongly coupled. In parti...

  7. Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

    Science.gov (United States)

    Hsu, Joy; Chen, Jessica; Mirabelli, Maria C

    Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control. Data were obtained from 14,076 older adults ≥65 years with active asthma participating in the 2006-2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey (a random-digit dialed survey) in 40 US states, the District of Columbia, and Puerto Rico, representative of >2.6 million persons. Weighted, adjusted logistic regression was conducted. One or more asthma-related hospitalizations in the past year were reported by 5.7% (95% confidence interval [95% CI] = 5.0% to 6.4%) of participants; 10.6% (95% CI = 9.7% to 11.5%) reported ≥1 asthma-related ED/UCV. Compared with older adults without asthma-related hospitalizations, adjusted odds were higher among those with ≥1 asthma-related hospitalization for chronic obstructive pulmonary disease (COPD), coronary artery disease, depression, cockroaches or mold in the home, and cost barriers to asthma-related health care or medication. All these factors, except for cockroaches, were associated with asthma-related ED/UCV. Compared with males, adjusted odds were higher among females for COPD, depression, obesity, and cost barriers to asthma-related health care or medication. Among older adults, asthma-related hospitalizations and ED/UCV were associated with clinical comorbidities, mold in the home, and financial barriers to asthma-related health care. Interventions addressing modifiable factors could reduce asthma morbidity among older adults. Published by Elsevier Inc.

  8. A single hidden layer feedforward network with only one neuron in the hidden layer can approximate any univariate function

    OpenAIRE

    Guliyev , Namig; Ismailov , Vugar

    2016-01-01

    The possibility of approximating a continuous function on a compact subset of the real line by a feedforward single hidden layer neural network with a sigmoidal activation function has been studied in many papers. Such networks can approximate an arbitrary continuous function provided that an unlimited number of neurons in a hidden layer is permitted. In this paper, we consider constructive approximation on any finite interval of $\\mathbb{R}$ by neural networks with only one neuron in the hid...

  9. PPO.02 Severe maternal morbidity in Ireland

    NARCIS (Netherlands)

    Manning, E.; Lutomski, J.E.; O'Connor, L.; Corcoran, P.; Greene, R.

    2014-01-01

    OBJECTIVE: To assess the incidence of severe maternal morbidity (SMM) and examine associated factors in Ireland. METHODS: In 2011, 67,806 maternities were reported from 19 maternity units, representing 93% of maternities in Ireland. SMM was classified as the presence of one or more of 15 categories

  10. Childhood respiratory morbidity and cooking practices among ...

    African Journals Online (AJOL)

    Background: Household air pollution is a leading risk factor for respiratory morbidity and mortality in developing countries where biomass fuel is mainly used for cooking. Materials and Method: A household cross-sectional survey was conducted in a predominantly rural area of Ghana in 2007 to determine the prevalence of ...

  11. Morbidity and Infant Development: A Hypothesis.

    Science.gov (United States)

    Pollitt, Ernesto

    1983-01-01

    Results of a study conducted in 14 villages of Sui Lin Township, Taiwan, suggest the hypothesis that, under conditions of extreme economic impoverishment and among children within populations where energy protein malnutrition is endemic, there is an inverse relationship between incidence of morbidity in infancy and measures of motor and mental…

  12. Sexual Activity and Urological Morbidities Among Nigerian ...

    African Journals Online (AJOL)

    factors, quality of information at their disposal as well as economic factors.[3] Studies have shown a wide range of opinion of women on the interpretation of menopause, associated morbidities and possible intervention to cope with the state.[4,5] Sexual activity during menopause has been reported with conflicting results.

  13. General morbidity prevalence in the Delhi slums

    Directory of Open Access Journals (Sweden)

    Marimuthu P

    2009-01-01

    Full Text Available Research Question: What is the sickness prevalence in the slums of a metropolitan city? Objectives: To estimate the morbidity prevalence with reference to a socio-economic and demographic perspective of the slum population of Delhi. Study Design: A cross-sectional study was conducted and data were collected by a two-stage random sampling method. In the first stage, slum locations were selected and in the second stage households were selected. Participants: Data were collected from 1049 households consisting of 5358 individuals′ information. Results: The overall morbidity prevalence is 15.4%. It is 14.7 and 16.3% for males and females, respectively but the differences are not statistically significant. The reported higher morbidity prevalence and the illiteracy status are significantly associated. Diseases of the respiratory system appear to be very high among slum dwellers. Conclusion: From this study, it can be concluded that the number of years of staying in the slum area, presence of a separate kitchen, type of house, it being Pucca or Kuccha, types of toilet pits or open defecation are the important environmental factors for the reports of higher morbidity patterns from the slum area.

  14. Site of delivery contribution to black-white severe maternal morbidity disparity.

    Science.gov (United States)

    Howell, Elizabeth A; Egorova, Natalia N; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

    2016-08-01

    The black-white maternal mortality disparity is the largest disparity among all conventional population perinatal health measures, and the mortality gap between black and white women in New York City has nearly doubled in recent years. For every maternal death, 100 women experience severe maternal morbidity, a life-threatening diagnosis, or undergo a life-saving procedure during their delivery hospitalization. Like maternal mortality, severe maternal morbidity is more common among black than white women. A significant portion of maternal morbidity and mortality is preventable, making quality of care in hospitals a critical lever for improving outcomes. Hospital variation in risk-adjusted severe maternal morbidity rates exists. The extent to which variation in hospital performance on severe maternal morbidity rates contributes to black-white disparities in New York City hospitals has not been studied. We examined the extent to which black-white differences in severe maternal morbidity rates in New York City hospitals can be explained by differences in the hospitals in which black and white women deliver. We conducted a population-based study using linked 2011-2013 New York City discharge and birth certificate datasets (n = 353,773 deliveries) to examine black-white differences in severe maternal morbidity rates in New York City hospitals. A mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital (n = 40). We then assessed differences in the distributions of black and white deliveries among these hospitals. Severe maternal morbidity occurred in 8882 deliveries (2.5%) and was higher among black than white women (4.2% vs 1.5%, P rates among New York City hospitals ranged from 0.8 to 5.7 per 100 deliveries. White deliveries were more likely to be delivered in low-morbidity hospitals: 65% of white vs 23% of black deliveries occurred in hospitals in the lowest

  15. Special report on taxation and reimbursement. Recovering excess funds from a defined-benefit pension plan: don't forget the hidden costs!

    Science.gov (United States)

    Renas, D A; Hoffman, S F

    1989-10-01

    In light of the pitfalls and hidden costs associated with recovering excess pension plan funds, providers may consider examining more conventional sources of raising capital before proceeding. In any event, the process should always be initiated by a careful cost-benefit analysis conducted by the employer, with the help of pension consultants and counsel.

  16. Hidden burden of malaria in Indian women

    Directory of Open Access Journals (Sweden)

    Sharma Vinod P

    2009-12-01

    Full Text Available Abstract Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP; of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state, that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tragic outcome can be averted by following the Roll Back Malaria/WHO recommendations of the use of malaria prevention i.e. indoor residual spraying (IRS/insecticide-treated bed nets (ITN preferably long-lasting treated bed nets (LLIN; intermittent preventive therapy (IPT; early diagnosis, prompt and complete treatment using microscopic/malaria rapid diagnostics test (RDT and case management. High incidence in pregnancy has arisen because of malaria surveillance lacking coverage, lack of age and sex wise data, staff shortages, and intermittent preventive treatment (IPT applicable in high transmission states/pockets is not included in the national drug policy- an essential component of fighting malaria in pregnancy in African settings. Inadequate surveillance and gross under-reporting has been highlighted time and again for over three decades. As a result the huge problem of malaria in pregnancy reported occasionally by researchers has remained hidden. Malaria in pregnancy may quicken severity in patients with drug resistant parasites, anaemia, endemic poverty, and malnutrition. There is, therefore, urgent need to streamline malaria control strategies to make a difference in tackling this grim scenario in human health.

  17. Hydrogeophysical investigations at Hidden Dam, Raymond, California

    Science.gov (United States)

    Minsley, Burke J.; Burton, Bethany L.; Ikard, Scott; Powers, Michael H.

    2011-01-01

    Self-potential and direct current resistivity surveys are carried out at the Hidden Dam site in Raymond, California to assess present-day seepage patterns and better understand the hydrogeologic mechanisms that likely influence seepage. Numerical modeling is utilized in conjunction with the geophysical measurements to predict variably-saturated flow through typical two-dimensional dam cross-sections as a function of reservoir elevation. Several different flow scenarios are investigated based on the known hydrogeology, as well as information about typical subsurface structures gained from the resistivity survey. The flow models are also used to simulate the bulk electrical resistivity in the subsurface under varying saturation conditions, as well as the self-potential response using petrophysical relationships and electrokinetic coupling equations.The self-potential survey consists of 512 measurements on the downstream area of the dam, and corroborates known seepage areas on the northwest side of the dam. Two direct-current resistivity profiles, each approximately 2,500 ft (762 m) long, indicate a broad sediment channel under the northwest side of the dam, which may be a significant seepage pathway through the foundation. A focusing of seepage in low-topography areas downstream of the dam is confirmed from the numerical flow simulations, which is also consistent with past observations. Little evidence of seepage is identified from the self-potential data on the southeast side of the dam, also consistent with historical records, though one possible area of focused seepage is identified near the outlet works. Integration of the geophysical surveys, numerical modeling, and observation well data provides a framework for better understanding seepage at the site through a combined hydrogeophysical approach.

  18. 'Hidden messages' emerging from Afrocentric management perspectives

    Directory of Open Access Journals (Sweden)

    H. Van den Heuvel

    2008-12-01

    Full Text Available Purpose: This paper aims to examine how 'African management' discourse has emerged in South Africa. Altogether, it has stimulated debates - sometimes in controversial ways - on 'taboo issues', e.g. relating to 'cultural diversity' and 'ethnicity'. The stimulation of such debates within organisations is probably a more valuable contribution than a static, essentialised 'African identity' that it proclaims. Design/Methodology/Approach: The paper draws on a qualitative research project conducted in South Africa in 2003-2004. Its relevance lies in gaining in-depth insights into ('non-western' local management discourse. It seeks to contribute to the body of knowledge on political and cultural contexts in which South African organizations operate, and how they impact on local management perspectives, and vice versa. Findings: The research findings make clear how and under what circumstances 'African management' discourse has come about in South Africa, and how it could be interpreted. Implications: 'African management' advocates allegedly attempt to revise dominant management thinking and promote 'humane-ness' and participatory decision-making in South African organisations, in search of a contextualised management approach. Amongst others, it has produced new meanings of 'Africanness' and has opened up space for 'hidden messages', resentments and aspirations to become openly articulated. This throws another light on phenomena such as cultural diversity and ethnicity that usually tend to be 'neutralised'. This may turn out to be far healthier for blooming organisational cultures in South Africa than relentlessly hammering on prescribed 'corporate values'. Originality/Value: This paper informs the reader in detail about the emergence and evolvement of 'African management' discourse in South Africa. It is a unique attempt to develop an interpretative viewpoint on this intriguing phenomenon that offers a potentially valuable contribution in reading

  19. Identifying hidden voice and video streams

    Science.gov (United States)

    Fan, Jieyan; Wu, Dapeng; Nucci, Antonio; Keralapura, Ram; Gao, Lixin

    2009-04-01

    Given the rising popularity of voice and video services over the Internet, accurately identifying voice and video traffic that traverse their networks has become a critical task for Internet service providers (ISPs). As the number of proprietary applications that deliver voice and video services to end users increases over time, the search for the one methodology that can accurately detect such services while being application independent still remains open. This problem becomes even more complicated when voice and video service providers like Skype, Microsoft, and Google bundle their voice and video services with other services like file transfer and chat. For example, a bundled Skype session can contain both voice stream and file transfer stream in the same layer-3/layer-4 flow. In this context, traditional techniques to identify voice and video streams do not work. In this paper, we propose a novel self-learning classifier, called VVS-I , that detects the presence of voice and video streams in flows with minimum manual intervention. Our classifier works in two phases: training phase and detection phase. In the training phase, VVS-I first extracts the relevant features, and subsequently constructs a fingerprint of a flow using the power spectral density (PSD) analysis. In the detection phase, it compares the fingerprint of a flow to the existing fingerprints learned during the training phase, and subsequently classifies the flow. Our classifier is not only capable of detecting voice and video streams that are hidden in different flows, but is also capable of detecting different applications (like Skype, MSN, etc.) that generate these voice/video streams. We show that our classifier can achieve close to 100% detection rate while keeping the false positive rate to less that 1%.

  20. Women's experience of maternal morbidity: a qualitative analysis.

    LENUS (Irish Health Repository)

    Meaney, S

    2016-07-01

    Maternal morbidity refers to pregnancy-related complications, ranging in severity from acute to chronic. In Ireland one in 210 maternities will experience a severe morbidity. Yet, how women internalize their experience of morbidity has gone largely unexplored. This study aimed to explore women\\'s experiences of maternal morbidity.

  1. Detecting Seismic Events Using a Supervised Hidden Markov Model

    Science.gov (United States)

    Burks, L.; Forrest, R.; Ray, J.; Young, C.

    2017-12-01

    We explore the use of supervised hidden Markov models (HMMs) to detect seismic events in streaming seismogram data. Current methods for seismic event detection include simple triggering algorithms, such as STA/LTA and the Z-statistic, which can lead to large numbers of false positives that must be investigated by an analyst. The hypothesis of this study is that more advanced detection methods, such as HMMs, may decreases false positives while maintaining accuracy similar to current methods. We train a binary HMM classifier using 2 weeks of 3-component waveform data from the International Monitoring System (IMS) that was carefully reviewed by an expert analyst to pick all seismic events. Using an ensemble of simple and discrete features, such as the triggering of STA/LTA, the HMM predicts the time at which transition occurs from noise to signal. Compared to the STA/LTA detection algorithm, the HMM detects more true events, but the false positive rate remains unacceptably high. Future work to potentially decrease the false positive rate may include using continuous features, a Gaussian HMM, and multi-class HMMs to distinguish between types of seismic waves (e.g., P-waves and S-waves). Acknowledgement: Sandia National Laboratories is a multi-mission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA-0003525.SAND No: SAND2017-8154 A

  2. Hidden from view: coupled dark sector physics and small scales

    Science.gov (United States)

    Elahi, Pascal J.; Lewis, Geraint F.; Power, Chris; Carlesi, Edoardo; Knebe, Alexander

    2015-09-01

    We study cluster mass dark matter (DM) haloes, their progenitors and surroundings in a coupled dark matter-dark energy (DE) model and compare it to quintessence and Λ cold dark matter (ΛCDM) models with adiabatic zoom simulations. When comparing cosmologies with different expansions histories, growth functions and power spectra, care must be taken to identify unambiguous signatures of alternative cosmologies. Shared cosmological parameters, such as σ8, need not be the same for optimal fits to observational data. We choose to set our parameters to ΛCDM z = 0 values. We find that in coupled models, where DM decays into DE, haloes appear remarkably similar to ΛCDM haloes despite DM experiencing an additional frictional force. Density profiles are not systematically different and the subhalo populations have similar mass, spin, and spatial distributions, although (sub)haloes are less concentrated on average in coupled cosmologies. However, given the scatter in related observables (V_max,R_{V_max}), this difference is unlikely to distinguish between coupled and uncoupled DM. Observations of satellites of Milky Way and M31 indicate a significant subpopulation reside in a plane. Coupled models do produce planar arrangements of satellites of higher statistical significance than ΛCDM models; however, in all models these planes are dynamically unstable. In general, the non-linear dynamics within and near large haloes masks the effects of a coupled dark sector. The sole environmental signature we find is that small haloes residing in the outskirts are more deficient in baryons than their ΛCDM counterparts. The lack of a pronounced signal for a coupled dark sector strongly suggests that such a phenomena would be effectively hidden from view.

  3. Increased taxon sampling reveals thousands of hidden orthologs in flatworms

    Science.gov (United States)

    2017-01-01

    Gains and losses shape the gene complement of animal lineages and are a fundamental aspect of genomic evolution. Acquiring a comprehensive view of the evolution of gene repertoires is limited by the intrinsic limitations of common sequence similarity searches and available databases. Thus, a subset of the gene complement of an organism consists of hidden orthologs, i.e., those with no apparent homology to sequenced animal lineages—mistakenly considered new genes—but actually representing rapidly evolving orthologs or undetected paralogs. Here, we describe Leapfrog, a simple automated BLAST pipeline that leverages increased taxon sampling to overcome long evolutionary distances and identify putative hidden orthologs in large transcriptomic databases by transitive homology. As a case study, we used 35 transcriptomes of 29 flatworm lineages to recover 3427 putative hidden orthologs, some unidentified by OrthoFinder and HaMStR, two common orthogroup inference algorithms. Unexpectedly, we do not observe a correlation between the number of putative hidden orthologs in a lineage and its “average” evolutionary rate. Hidden orthologs do not show unusual sequence composition biases that might account for systematic errors in sequence similarity searches. Instead, gene duplication with divergence of one paralog and weak positive selection appear to underlie hidden orthology in Platyhelminthes. By using Leapfrog, we identify key centrosome-related genes and homeodomain classes previously reported as absent in free-living flatworms, e.g., planarians. Altogether, our findings demonstrate that hidden orthologs comprise a significant proportion of the gene repertoire in flatworms, qualifying the impact of gene losses and gains in gene complement evolution. PMID:28400424

  4. Psychological co-morbidity in children with specific learning disorders

    Directory of Open Access Journals (Sweden)

    Manoj K Sahoo

    2015-01-01

    Full Text Available Children under 19 years of age constitute over 40% of India′s population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common to depression, anxiety, suicide etc., to substance abuse (least common. Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.

  5. Prevalence and Morbidity of Late Preterm Infants: Current Status in a Medical Center of Northern Taiwan

    Directory of Open Access Journals (Sweden)

    Ming-Luen Tsai

    2012-06-01

    Conclusion: Late-preterm infants have increased risk of neonatal morbidities associated with organ immaturity. The results of this study emphasize the importance of judicious obstetrical decision-making when considering late preterm delivery, and the need to set up anticipatory clinical guidelines for the care of late preterm infants.

  6. Morbidity and mortality of low birth weight infants in the New Born ...

    African Journals Online (AJOL)

    Background: Morbidity and mortality of low birth weight (LBW) infants at Kenyatta National Hospital (KNH) has previously been found to be high. Other centres have shown that even with lack of neonatal intensive care facilities, selective interventions can be implemented that improve neonatal survival rates. It is important to ...

  7. Gender Differences in Co-Morbid Psychopathology and Clinical Management in Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Tsakanikos, Elias; Underwood, Lisa; Kravariti, Eugenia; Bouras, Nick; McCarthy, Jane

    2011-01-01

    The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N =…

  8. Maternal mortality and serious maternal morbidity in Jehovah's witnesses in The Netherlands

    NARCIS (Netherlands)

    van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; van Roosmalen, J.

    2009-01-01

    To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in The Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in The Netherlands. All

  9. Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

    NARCIS (Netherlands)

    Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

    To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

  10. Use of evidence based practices to improve survival without severe morbidity for very preterm infants

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie

    2016-01-01

    OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. DESIGN: Prospective multinational populat...

  11. Ethnic disparity in severe acute maternal morbidity: A nationwide cohort study in the Netherlands

    NARCIS (Netherlands)

    Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; Roosmalen, J. van

    2011-01-01

    Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

  12. Ethnic disparity in severe acute maternal morbidity: a nationwide cohort study in the Netherlands

    NARCIS (Netherlands)

    Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; van Roosmalen, J.

    2011-01-01

    Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

  13. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

  14. Infinite hidden conditional random fields for human behavior analysis.

    Science.gov (United States)

    Bousmalis, Konstantinos; Zafeiriou, Stefanos; Morency, Louis-Philippe; Pantic, Maja

    2013-01-01

    Hidden conditional random fields (HCRFs) are discriminative latent variable models that have been shown to successfully learn the hidden structure of a given classification problem (provided an appropriate validation of the number of hidden states). In this brief, we present the infinite HCRF (iHCRF), which is a nonparametric model based on hierarchical Dirichlet processes and is capable of automatically learning the optimal number of hidden states for a classification task. We show how we learn the model hyperparameters with an effective Markov-chain Monte Carlo sampling technique, and we explain the process that underlines our iHCRF model with the Restaurant Franchise Rating Agencies analogy. We show that the iHCRF is able to converge to a correct number of represented hidden states, and outperforms the best finite HCRFs--chosen via cross-validation--for the difficult tasks of recognizing instances of agreement, disagreement, and pain. Moreover, the iHCRF manages to achieve this performance in significantly less total training, validation, and testing time.

  15. Cardiac morbidity risk and depression and anxiety

    DEFF Research Database (Denmark)

    Tully, Phillip J; Pedersen, Susanne S.; Winefield, Helen R

    2011-01-01

    The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity....... Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom.......3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted...

  16. Leukaemia mortality and morbidity in Bavaria

    International Nuclear Information System (INIS)

    Grosche, B.; Hinz, G.; Tsavachidis, C.

    1987-01-01

    Two studies dealing with leukaemia in Bavaria/FRG are presented: a mortality study (1972-1978) and a morbidity study (1976-1981). Both were conducted as ecological studies, i.e. under inclusion of environmental factors. Major point of view is first the amount of natural background radiation and second the sites of nuclear reactors, which are six. Mortality and incidence is described. Calculations were made on the influence of migration on patterns of regional distribution. (author)

  17. [Employment during pregnancy and neonatal morbidity].

    Science.gov (United States)

    Fricker, H S; Bruppacher, R

    1984-01-01

    Neonatal morbidity was higher among the babies of 521 women who were gainfully employed during pregnancy compared to those of 475 non working women of the same area (Aarau, Switzerland). The difference was lower (6%) in the part time employed than in those working full time (11%.) It was almost entirely due to the higher number of primiparae and of smokers among those women who were working during pregnancy.

  18. Hidden Statistics Approach to Quantum Simulations

    Science.gov (United States)

    Zak, Michail

    2010-01-01

    Recent advances in quantum information theory have inspired an explosion of interest in new quantum algorithms for solving hard computational (quantum and non-quantum) problems. The basic principle of quantum computation is that the quantum properties can be used to represent structure data, and that quantum mechanisms can be devised and built to perform operations with this data. Three basic non-classical properties of quantum mechanics superposition, entanglement, and direct-product decomposability were main reasons for optimism about capabilities of quantum computers that promised simultaneous processing of large massifs of highly correlated data. Unfortunately, these advantages of quantum mechanics came with a high price. One major problem is keeping the components of the computer in a coherent state, as the slightest interaction with the external world would cause the system to decohere. That is why the hardware implementation of a quantum computer is still unsolved. The basic idea of this work is to create a new kind of dynamical system that would preserve the main three properties of quantum physics superposition, entanglement, and direct-product decomposability while allowing one to measure its state variables using classical methods. In other words, such a system would reinforce the advantages and minimize limitations of both quantum and classical aspects. Based upon a concept of hidden statistics, a new kind of dynamical system for simulation of Schroedinger equation is proposed. The system represents a modified Madelung version of Schroedinger equation. It preserves superposition, entanglement, and direct-product decomposability while allowing one to measure its state variables using classical methods. Such an optimal combination of characteristics is a perfect match for simulating quantum systems. The model includes a transitional component of quantum potential (that has been overlooked in previous treatment of the Madelung equation). The role of the

  19. Extrahepatic biliary obstruction; postoperative morbidity and mortality

    International Nuclear Information System (INIS)

    Hussain, Z.; Khan, K.I.; Vaseem, M.; Rana, S.H.

    2010-01-01

    The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at. the surgical. unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test-was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these (n 38) 15 patients (39.5%) suffered from benign diseases while those having malignant diseases were 23 (60.5%). 19 (50%) patients died within two years of follow up while 19 (50%) were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 (31.6%) occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment. (author)

  20. Morbidity follow-up feasibility study

    International Nuclear Information System (INIS)

    Carpenter, M.

    1988-02-01

    The report reviews the available sources of data within Canada for undertaking morbidity follow-up studies to both supplement and complement studies using Canadian mortality data. Such studies would permit earlier detection and more sensitive measures of differences in risk for exposures to radiation and allow timely measures to be taken to minimize any occupational and environmental health risk to radiation workers. The technical feasibility of using these sources was reviewed using the criteria of adequate personal identifying information, automation of data records, file size and the accuracy of the morbidity diagnosis information. At the present time certain of the provincial cancer registry files meet these criteria best. A work plan was prepared suggesting a morbidity pilot study to clarify the role of occupational factors in the incidence of cancer among radiation workers using the Alberta Cancer Registry file and the National Dose Registry (NDR) file of radiation workers. For the longer term a full cohort study using the National Cancer Incidence Reporting System (NCIRS) and the NDR workers as the study population would provide information on all radiation workers on a national basis. A work plan was prepared and some initial format conversion of historical data was undertaken to begin developing the NCIRS into a data base suitable for long-term health studies

  1. Minimization of heatwave morbidity and mortality.

    Science.gov (United States)

    Kravchenko, Julia; Abernethy, Amy P; Fawzy, Maria; Lyerly, H Kim

    2013-03-01

    Global climate change is projected to increase the frequency and duration of periods of extremely high temperatures. Both the general populace and public health authorities often underestimate the impact of high temperatures on human health. To highlight the vulnerable populations and illustrate approaches to minimization of health impacts of extreme heat, the authors reviewed the studies of heat-related morbidity and mortality for high-risk populations in the U.S. and Europe from 1958 to 2012. Heat exposure not only can cause heat exhaustion and heat stroke but also can exacerbate a wide range of medical conditions. Vulnerable populations, such as older adults; children; outdoor laborers; some racial and ethnic subgroups (particularly those with low SES); people with chronic diseases; and those who are socially or geographically isolated, have increased morbidity and mortality during extreme heat. In addition to ambient temperature, heat-related health hazards are exacerbated by air pollution, high humidity, and lack of air-conditioning. Consequently, a comprehensive approach to minimize the health effects of extreme heat is required and must address educating the public of the risks and optimizing heatwave response plans, which include improving access to environmentally controlled public havens, adaptation of social services to address the challenges required during extreme heat, and consistent monitoring of morbidity and mortality during periods of extreme temperatures. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Prevalence of cardiovascular morbidities in Myanmar.

    Science.gov (United States)

    Zaw, Ko Ko; Nwe, Nwe; Hlaing, Su Su

    2017-02-15

    Cardiovascular diseases (CVDs) are now in a rising trend in South East Asia including Myanmar due to increase in major cardiovascular risk factors in both urban and rural areas, such as smoking, obesity and diabetes mellitus. It is necessary to determine CVD morbidities in Myanmar for planning of prevention and control activities for CVDs. The cross-sectional household survey was conducted in 2012 with 600 people aged 40 years and above in four townships (Kyauk-Tan, Mawlamyaing, Pathein and Pyay) and used face-to-face interview with standard questionnaire [Rose Angina Questionnaire and Questionnaire by European Cardiovascular Indicators Surveillance Set (EUROCISS) Research Group] to determine the level of reported CVD morbidities in adult population. Age of the study population ranged from 40 to 99 years with the mean age of 56 years. Seventy-one percent of the study population was women. Nine percent of the study population have suffered from angina according to Rose Angina Questionnaire. Prevalence of possible heart attack, stroke and heart failure was 7.5, 1.5 and 2.8%. Prevalence of hypertension was 51%. The CVD morbidities are high. There is a need for strengthening prevention and control activities of CVDs.

  3. Hidden beauty baryon states in the local hidden gauge approach with heavy quark spin symmetry

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, C.W.; Oset, E. [Centro Mixto Universidad de Valencia-CSIC, Institutos de Investigacion de Paterna, Departamento de Fisica Teorica and IFIC, Valencia (Spain)

    2013-11-15

    Using a coupled-channel unitary approach, combining the heavy quark spin symmetry and the dynamics of the local hidden gauge, we investigate the meson-baryon interaction with hidden beauty and obtain several new states of N around 11 GeV. We consider the basis of states {eta}{sub b} N, {Upsilon};N, B {Lambda}{sub b}, B {Sigma}{sub b}, B{sup *}{Lambda}{sub b}, B{sup *}{Sigma}{sub b}, B{sup *}{Sigma}{sub b}{sup *} and find four basic bound states which correspond to B {Sigma}{sub b}, B {Sigma}{sub b}{sup *}, B{sup *}{Sigma}{sub b} and B{sup *}{Sigma}{sub b}{sup *}, decaying mostly into {eta}{sub b} N and {Upsilon}N and with a binding energy about 50-130 MeV with respect to the thresholds of the corresponding channel. All of them have isospin I = 1/2, and we find no bound states or resonances in I = 3/2. The B {Sigma}{sub b} state appears in J = 1/2, the B {Sigma}{sub b}{sup *} in J = 3/2, the B{sup *}{Sigma}{sub b} appears nearly degenerate in J = 1/2, 3/2 and the B{sup *}{Sigma}{sub b}{sup *} appears nearly degenerate in J = 1/2, 3/2, 5/2. These states have a width from 2-110 MeV, with conservative estimates of uncertainties, except for the one in J = 5/2 which has zero width since it cannot decay into any of the states of the basis chosen. We make generous estimates of the uncertainties and find that within very large margins these states appear bound. (orig.)

  4. Neonatal morbidity and early outcome of very preterm infants

    Directory of Open Access Journals (Sweden)

    Heljić Suada

    2013-03-01

    Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions. The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the most frequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm infants remain very vulnerable group of population, and interventions to reduce the morbidity and mortality of preterm babies include tertiary interventions such as regionalized care, transportation in uterus, and treatment with antenatal steroids.

  5. Residency education through the family medicine morbidity and mortality conference.

    Science.gov (United States)

    Kim, Curi; Fetters, Michael D; Gorenflo, Daniel W

    2006-09-01

    The value of the morbidity and mortality conference (M&MC) has received little examination in the primary care literature. We sought to understand the educational content of M&MCs by examining data from a family medicine training program. Archived morbidity and mortality conference data (July 2001-July 2003) were retrieved from two University of Michigan family medicine adult inpatient services (one community based and one university based). We used chi-square and t test to compare demographic variables and adverse events between hospital sites. We qualitatively analyzed written comments about adverse events. Both family medicine services shared similar diagnoses, patient volume, length of stay, and gender distribution of patients, but the community hospital had an older average patient age (67.9 years versus 52.9 years) and a higher outpatient complication rate. Analysis of the qualitative data revealed patterns of adverse events, such as an association between avoidable admissions and inadequate pain control, that could be improved through educational intervention. Although family medicine residents' experiences in university and community hospitals were comparable, there were differences in patient populations and case complexity. Modifying the M&MC format could enhance its effectiveness as an educational tool about adverse events.

  6. Does BMI influence hospital stay and morbidity after fast-track hip and knee arthroplasty?

    DEFF Research Database (Denmark)

    Husted, Henrik; Jørgensen, Christoffer C; Gromov, Kirill

    2016-01-01

    Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality in such pat......Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality...... in such patients who were operated with the fast-track methodology and compared the levels with those in patients with normal BMI. Patients and methods - This was a prospective observational study involving 13,730 procedures (7,194 THA and 6,536 TKA operations) performed in a standardized fast-track setting....... Complete 90-day follow-up was achieved using national registries and review of medical records. Patients were grouped according to BMI as being underweight, of normal weight, overweight, obese, very obese, and morbidly obese. Results - Median length of stay (LOS) was 2 (IQR: 2-3) days in all BMI groups. 30...

  7. A systematic review of the burden of neonatal mortality and morbidity in the ASEAN Region.

    Science.gov (United States)

    Tran, Hoang T; Doyle, Lex W; Lee, Katherine J; Graham, Stephen M

    2012-01-01

    Neonatal morbidity and mortality are major global public health challenges representing an increasing proportion of overall under-5 child mortality, with the vast majority of neonatal deaths occurring in resource-limited settings. In the Association of Southeast Asian Nations (ASEAN) region, it is estimated that approximately 200 000 neonatal deaths occur annually with reported estimates of the neonatal mortality rate ranging from 1 to over 30 per 1000 live-births, depending on the setting. The aim of this study is to conduct a systematic review of published data on neonatal morbidity and mortality from the ASEAN region over the last 10 years. Very few published studies reporting neonatal morbidity and mortality in this region were found. Importantly, data are available from just a few countries, with an underrepresentation of the most resource-limited settings. The majority of the studies describing mortality and morbidity were retrospective surveys or focussed on a specific cause of neonatal morbidity. Studies included findings from a range of settings, from neonatal intensive care to community settings utilizing verbal autopsy. Therefore, comprehensive and prospective data are needed to inform priorities and potential interventions to improve neonatal care and reduce neonatal mortality in this region.

  8. Gauge mediation scenario with hidden sector renormalization in MSSM

    International Nuclear Information System (INIS)

    Arai, Masato; Kawai, Shinsuke; Okada, Nobuchika

    2010-01-01

    We study the hidden sector effects on the mass renormalization of a simplest gauge-mediated supersymmetry breaking scenario. We point out that possible hidden sector contributions render the soft scalar masses smaller, resulting in drastically different sparticle mass spectrum at low energy. In particular, in the 5+5 minimal gauge-mediated supersymmetry breaking with high messenger scale (that is favored by the gravitino cold dark matter scenario), we show that a stau can be the next lightest superparticle for moderate values of hidden sector self-coupling. This provides a very simple theoretical model of long-lived charged next lightest superparticles, which imply distinctive signals in ongoing and upcoming collider experiments.

  9. Gauge mediation scenario with hidden sector renormalization in MSSM

    Science.gov (United States)

    Arai, Masato; Kawai, Shinsuke; Okada, Nobuchika

    2010-02-01

    We study the hidden sector effects on the mass renormalization of a simplest gauge-mediated supersymmetry breaking scenario. We point out that possible hidden sector contributions render the soft scalar masses smaller, resulting in drastically different sparticle mass spectrum at low energy. In particular, in the 5+5¯ minimal gauge-mediated supersymmetry breaking with high messenger scale (that is favored by the gravitino cold dark matter scenario), we show that a stau can be the next lightest superparticle for moderate values of hidden sector self-coupling. This provides a very simple theoretical model of long-lived charged next lightest superparticles, which imply distinctive signals in ongoing and upcoming collider experiments.

  10. Multivariate longitudinal data analysis with mixed effects hidden Markov models.

    Science.gov (United States)

    Raffa, Jesse D; Dubin, Joel A

    2015-09-01

    Multiple longitudinal responses are often collected as a means to capture relevant features of the true outcome of interest, which is often hidden and not directly measurable. We outline an approach which models these multivariate longitudinal responses as generated from a hidden disease process. We propose a class of models which uses a hidden Markov model with separate but correlated random effects between multiple longitudinal responses. This approach was motivated by a smoking cessation clinical trial, where a bivariate longitudinal response involving both a continuous and a binomial response was collected for each participant to monitor smoking behavior. A Bayesian method using Markov chain Monte Carlo is used. Comparison of separate univariate response models to the bivariate response models was undertaken. Our methods are demonstrated on the smoking cessation clinical trial dataset, and properties of our approach are examined through extensive simulation studies. © 2015, The International Biometric Society.

  11. Applications of hidden symmetries to black hole physics

    International Nuclear Information System (INIS)

    Frolov, Valeri

    2011-01-01

    This work is a brief review of applications of hidden symmetries to black hole physics. Symmetry is one of the most important concepts of the science. In physics and mathematics the symmetry allows one to simplify a problem, and often to make it solvable. According to the Noether theorem symmetries are responsible for conservation laws. Besides evident (explicit) spacetime symmetries, responsible for conservation of energy, momentum, and angular momentum of a system, there also exist what is called hidden symmetries, which are connected with higher order in momentum integrals of motion. A remarkable fact is that black holes in four and higher dimensions always possess a set ('tower') of explicit and hidden symmetries which make the equations of motion of particles and light completely integrable. The paper gives a general review of the recently obtained results. The main focus is on understanding why at all black holes have something (symmetry) to hide.

  12. Discovering Hidden Controlling Parameters using Data Analytics and Dimensional Analysis

    Science.gov (United States)

    Del Rosario, Zachary; Lee, Minyong; Iaccarino, Gianluca

    2017-11-01

    Dimensional Analysis is a powerful tool, one which takes a priori information and produces important simplifications. However, if this a priori information - the list of relevant parameters - is missing a relevant quantity, then the conclusions from Dimensional Analysis will be incorrect. In this work, we present novel conclusions in Dimensional Analysis, which provide a means to detect this failure mode of missing or hidden parameters. These results are based on a restated form of the Buckingham Pi theorem that reveals a ridge function structure underlying all dimensionless physical laws. We leverage this structure by constructing a hypothesis test based on sufficient dimension reduction, allowing for an experimental data-driven detection of hidden parameters. Both theory and examples will be presented, using classical turbulent pipe flow as the working example. Keywords: experimental techniques, dimensional analysis, lurking variables, hidden parameters, buckingham pi, data analysis. First author supported by the NSF GRFP under Grant Number DGE-114747.

  13. Supersymmetry, p-brane duality, and hidden spacetime dimensions

    International Nuclear Information System (INIS)

    Bars, I.

    1996-01-01

    A global superalgebra with 32 supercharges and all possible central extensions is studied in order to extract some general properties of duality and hidden dimensions in a theory that treats p-branes democratically. The maximal number of dimensions is 12, with signature (10,2), containing one space and one time dimension that are hidden from the point of view of perturbative ten-dimensional string theory or its compactifications. When the theory is compactified on R d-1,1 circle-times T c+1,1 with d+c+2=12, there are isometry groups that relate to the hidden dimensions as well as to duality. Their combined intersecting classification schemes provide some properties of nonperturbative states and their couplings. copyright 1996 The American Physical Society

  14. Analysing the hidden curriculum: use of a cultural web.

    Science.gov (United States)

    Mossop, Liz; Dennick, Reg; Hammond, Richard; Robbé, Iain

    2013-02-01

    Major influences on learning about medical professionalism come from the hidden curriculum. These influences can contribute positively or negatively towards the professional enculturation of clinical students. The fact that there is no validated method for identifying the components of the hidden curriculum poses problems for educators considering professionalism. The aim of this study was to analyse whether a cultural web, adapted from a business context, might assist in the identification of elements of the hidden curriculum at a UK veterinary school. A qualitative approach was used. Seven focus groups consisting of three staff groups and four student groups were organised. Questioning was framed using the cultural web, which is a model used by business owners to assess their environment and consider how it affects their employees and customers. The focus group discussions were recorded, transcribed and analysed thematically using a combination of a priori and emergent themes. The cultural web identified elements of the hidden curriculum for both students and staff. These included: core assumptions; routines; rituals; control systems; organisational factors; power structures, and symbols. Discussions occurred about how and where these issues may affect students' professional identity development. The cultural web framework functioned well to help participants identify elements of the hidden curriculum. These aspects aligned broadly with previously described factors such as role models and institutional slang. The influence of these issues on a student's development of a professional identity requires discussion amongst faculty staff, and could be used to develop learning opportunities for students. The framework is promising for the analysis of the hidden curriculum and could be developed as an instrument for implementation in other clinical teaching environments. © Blackwell Publishing Ltd 2013.

  15. QCD sum rule study of hidden-charm pentaquarks

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Hua-Xing; Cui, Er-Liang [Beihang University, School of Physics and Beijing Key Laboratory of Advanced Nuclear Materials and Physics, Beijing (China); Chen, Wei; Steele, T.G. [University of Saskatchewan, Department of Physics and Engineering Physics, Saskatoon, Saskatchewan (Canada); Liu, Xiang [Lanzhou University, School of Physical Science and Technology, Lanzhou (China); Lanzhou University and Institute of Modern Physics of CAS, Research Center for Hadron and CSR Physics, Lanzhou (China); Zhu, Shi-Lin [Peking University, School of Physics and State Key Laboratory of Nuclear Physics and Technology, Beijing (China); Collaborative Innovation Center of Quantum Matter, Beijing (China); Peking University, Center of High Energy Physics, Beijing (China)

    2016-10-15

    We study the mass spectra of hidden-charm pentaquarks having spin J = (1)/(2)/(3)/(2)/(5)/(2) and quark contents uudc anti c. We systematically construct all the relevant local hidden-charm pentaquark currents, and we select some of them to perform QCD sum rule analyses. We find that the P{sub c}(4380) and P{sub c}(4450) can be identified as hidden-charm pentaquark states composed of an anti-charmed meson and a charmed baryon. Besides them, we also find (a) the lowest-lying hidden-charm pentaquark state of J{sup P} = 1/2{sup -} has the mass 4.33{sup +0.17}{sub -0.13} GeV, while the one of J{sup P} = 1/2{sup +} is significantly higher, that is, around 4.7-4.9 GeV; (b) the lowest-lying hidden-charm pentaquark state of J{sup P} = 3/2{sup -} has the mass 4.37{sup +0.18}{sub -0.13} GeV, consistent with the P{sub c}(4380) of J{sup P} = 3/2{sup -}, while the one of J{sup P} = 3/2{sup +} is also significantly higher, that is, above 4.6 GeV; (c) the hidden-charm pentaquark state of J{sup P} = 5/2{sup -} has a mass around 4.5-4.6 GeV, slightly larger than the P{sub c}(4450) of J{sup P} = 5/2{sup +}. (orig.)

  16. Learning about gender on campus: an analysis of the hidden curriculum for medical students.

    Science.gov (United States)

    Cheng, Ling-Fang; Yang, Hsing-Chen

    2015-03-01

    Gender sensitivity is a crucial factor in the provision of quality health care. This paper explores acquired gendered values and attitudes among medical students through an analysis of the hidden curriculum that exists within formal medical classes and informal learning. Discourse analysis was adopted as the research method. Data were collected from the Bulletin Board System (BBS), which represented an essential communication platform among students in Taiwan before the era of Facebook. The study examined 197 gender-related postings on the BBS boards of nine of 11 universities with a medical department in Taiwan, over a period of 10 years from 2000 to 2010. The five distinctive characteristics of the hidden curriculum were as follows: (i) gendered stereotypes of physiological knowledge; (ii) biased treatment of women; (iii) stereotyped gender-based division of labour; (iv) sexual harassment and a hostile environment, and (v) ridiculing of lesbian, gay, bisexual and transgender (LGBT) people. Both teachers and students co-produced a heterosexual masculine culture and sexism, including 'benevolent sexism' and 'hostile sexism'. As a result, the self-esteem and learning opportunities of female and LGBT students have been eroded. The paper explores gender dynamics in the context of a hidden curriculum in which heterosexual masculinity and stereotyped sexism are prevalent as norms. Both teachers and students, whether through formal medical classes or informal extracurricular interactive activities, are noted to contribute to the consolidation of such norms. The study tentatively suggests three strategies for integrating gender into medical education: (i) by separating physiological knowledge from gender stereotyping in teaching; (ii) by highlighting the importance of gender sensitivity in the language used within and outside the classroom by teachers and students, and (iii) by broadening the horizons of both teachers and students by recounting examples of the lived

  17. Morbidity, including fatal morbidity, throughout life in men entering adult life as obese.

    Directory of Open Access Journals (Sweden)

    Esther Zimmermann

    Full Text Available BACKGROUND: The association between obesity in adults and excess morbidity and mortality is well established, but the health impact throughout adult life of being obese in early adulthood needs elucidation. We investigated somatic morbidity, including fatal morbidity, throughout adulthood in men starting adult life as obese. METHODS: Among 362,200 Danish young men, examined for military service between 1943 and 1977, all obese (defined as BMI≥31.0 kg/m(2, and, as controls, a random 1% sample of the others was identified. In the age range of 18-25 years, there were 1,862 obese, which encompass the men above the 99.5 percentile, and 3,476 controls. Information on morbidity was obtained via national registers. Cox regression models were used to estimate the relative morbidity assessed as first incidence of disease, occurrence of disease in the year preceding death and prevalent disease at time of death. RESULTS: From age 18 through 80 years the obese had an increased risk of becoming diseased by or die from a broad range of diseases. Generally, the incidence of first event, occurrence in the year prior to death, and prevalence at time of death showed the same pattern. As an example, the relative hazard of type 2 diabetes was constant throughout life at 4.9 (95% confidence intervals [CI]: 4.1-5.9, 5.2 (95% CI: 3.6-7.5, and 6.8 (95% CI: 4.6-10.1, respectively. CONCLUSIONS: Our findings strongly support the continued need to avoid beginning adult life as obese, as obese young men experience an increased morbidity, including fatal morbidity, from many diseases throughout life.

  18. Detecting Hidden Hierarchy of Non Hierarchical Terrorist Networks

    DEFF Research Database (Denmark)

    Memon, Nasrullah

    measures (and combinations of them) to identify key players (important nodes) in terrorist networks. Our recently introduced techniques and algorithms (which are also implemented in the investigative data mining toolkit known as iMiner) will be particularly useful for law enforcement agencies that need...... to analyze terrorist networks and prioritize their targets. Applying recently introduced mathematical methods for constructing the hidden hierarchy of "nonhierarchical" terrorist networks; we present case studies of the terrorist attacks occurred / planned in the past, in order to identify hidden hierarchy...

  19. Low-intensity interference effects and hidden-variable theories

    Energy Technology Data Exchange (ETDEWEB)

    Buonomano, V [Universidade Estadual de Campinas (Brazil). Inst. de Matematica

    1978-05-11

    The double-slit interference experiment and other similar experiments in the low-intensity limit (that is, one photon in the apparatus at a time) are examined in the spirit of Bell's work from the point of view of hidden-variable theories. It is found that there exists a class of hidden-variable theories which disagrees with quantum mechanics for a certain type of interference experiment. A manufactured conceptualization of this class, which is a particle view of interference, is described. An experiment, which appears to be feasible, is proposed to examine this disagreement.

  20. Application of Hidden Markov Models in Biomolecular Simulations.

    Science.gov (United States)

    Shukla, Saurabh; Shamsi, Zahra; Moffett, Alexander S; Selvam, Balaji; Shukla, Diwakar

    2017-01-01

    Hidden Markov models (HMMs) provide a framework to analyze large trajectories of biomolecular simulation datasets. HMMs decompose the conformational space of a biological molecule into finite number of states that interconvert among each other with certain rates. HMMs simplify long timescale trajectories for human comprehension, and allow comparison of simulations with experimental data. In this chapter, we provide an overview of building HMMs for analyzing bimolecular simulation datasets. We demonstrate the procedure for building a Hidden Markov model for Met-enkephalin peptide simulation dataset and compare the timescales of the process.

  1. Enhanced axion-photon coupling in GUT with hidden photon

    Science.gov (United States)

    Daido, Ryuji; Takahashi, Fuminobu; Yokozaki, Norimi

    2018-05-01

    We show that the axion coupling to photons can be enhanced in simple models with a single Peccei-Quinn field, if the gauge coupling unification is realized by a large kinetic mixing χ = O (0.1) between hypercharge and unbroken hidden U(1)H. The key observation is that the U(1)H gauge coupling should be rather strong to induce such large kinetic mixing, leading to enhanced contributions of hidden matter fields to the electromagnetic anomaly. We find that the axion-photon coupling is enhanced by about a factor of 10-100 with respect to the GUT-axion models with E / N = 8 / 3.

  2. Hidden Neural Networks: A Framework for HMM/NN Hybrids

    DEFF Research Database (Denmark)

    Riis, Søren Kamaric; Krogh, Anders Stærmose

    1997-01-01

    This paper presents a general framework for hybrids of hidden Markov models (HMM) and neural networks (NN). In the new framework called hidden neural networks (HNN) the usual HMM probability parameters are replaced by neural network outputs. To ensure a probabilistic interpretation the HNN is nor...... HMMs on TIMIT continuous speech recognition benchmarks. On the task of recognizing five broad phoneme classes an accuracy of 84% is obtained compared to 76% for a standard HMM. Additionally, we report a preliminary result of 69% accuracy on the TIMIT 39 phoneme task...

  3. Search for hidden Higgs decay in ATLAS detector

    International Nuclear Information System (INIS)

    Gabrielli, A.

    2013-01-01

    In this paper, a brief overview of the search for the Higgs boson in Hidden Valley models is given. Hidden Valley models predict Higgs decays to neutral particles, which can be also long lived with decay paths comparable to the LHC detectors dimensions. Decay final states consist of collimated leptons (Lepton Jets). Results are presented of a search for Higgs decays to long lived particles in the ATLAS detector at the LHC, based on 1.92 fb −1 data collected during 2011 at a 7TeV center-of-mass energy.

  4. Detecting Faults By Use Of Hidden Markov Models

    Science.gov (United States)

    Smyth, Padhraic J.

    1995-01-01

    Frequency of false alarms reduced. Faults in complicated dynamic system (e.g., antenna-aiming system, telecommunication network, or human heart) detected automatically by method of automated, continuous monitoring. Obtains time-series data by sampling multiple sensor outputs at discrete intervals of t and processes data via algorithm determining whether system in normal or faulty state. Algorithm implements, among other things, hidden first-order temporal Markov model of states of system. Mathematical model of dynamics of system not needed. Present method is "prior" method mentioned in "Improved Hidden-Markov-Model Method of Detecting Faults" (NPO-18982).

  5. From the solar system fo hidden cosmic structures

    Energy Technology Data Exchange (ETDEWEB)

    Benes, K

    1987-01-01

    The development of experimental astrophysics showed that in the evolution of planets, natural processes of a common nature take place. They include, e.g., radiogenic heat, the production of magmas, volcanic activity, degassing, etc. The solar system is a cosmic formation in an advanced stage of development and it is a realistic assumption that in the Galaxy other hidden planetary systems in various stages of development exist. The views on the possibility of the origination of life in other systems differ; life, however, is seen as a hidden property of cosmic matter. (M.D.).

  6. Wives, Husbands, and Hidden Power in Marriage

    Science.gov (United States)

    Zipp, John F.; Prohaska, Ariane; Bemiller, Michelle

    2004-01-01

    A recurrent theme in scholarship on gender and the family is the asymmetry between husbands and wives on decision making, the division of household labor, child care, and so forth. In this article, the authors tested to see if this asymmetry can be explained, in part, by taking into account the invisible power of men. Using data from the third…

  7. Hospital morbidity among Guarani Indians in Southeastern and Southern Brazil.

    Science.gov (United States)

    Cardoso, Andrey Moreira; Coimbra, Carlos E A; Tavares, Felipe Guimarães

    2010-03-01

    Studies on hospital morbidity among Brazilian indigenous peoples are relatively recent, show limited coverage, and lack data sources capable of generating specific indicators according to ethnic group. The current study describes hospital morbidity in the indigenous population living in 83 Guarani villages in Southern and Southeastern Brazil (N=6,483), based on primary data obtained from a hospital admissions surveillance system implemented in 2007-2008, specifically for a case-control study on acute respiratory infections (ARI) in Guarani children. During the study period there were 666 hospitalizations in a total of 497 individuals, the majority under 5 years of age (71.9%). Respiratory illnesses were the main causes of hospitalization (64.6%), especially in children (<5 years: 77.6%; <1 year: 83.4%) and exceeded the proportions of hospital admissions from these causes in other indigenous groups. The overall hospitalization rate (per 100 person-years) was 8.8, or 71.4 under 1 year and 21.0 from 1 to 4 years of age. The ARI hospitalization rate (5.3) was 6.5 and 2.0 times higher than for diarrhea and other causes, respectively, while in children under 5 years of age (ARI=23.7) these differences were 7.4 and 5.4 times, respectively. The standardized Guarani hospitalization rate exceeded the standardized rates for the South and Southeast of Brazil by 40% and 210%, respectively. Hospitalization for primary care sensitive conditions and the high ARI rates indicate the need for studies to understand the epidemiology of ARI and investments to upgrade primary health care for the Guarani.

  8. Morbidity and mortality of firearm injury in peshawar region

    International Nuclear Information System (INIS)

    Shah, M.M.; Arif, M.; Seema, N.

    2008-01-01

    Firearm injuries cause significant morbidity and mortality among its victims. The present study, carried out at a major tertiary care hospital of Peshawar, Pakistan was aimed at highlighting the extent and severity of firearm-related morbidity and resultant mortality despite expert medical care. All victims of firearm injury brought to the Lady Reading Hospital Peshawar Emergency Department and thereafter admitted to hospital wards during the period mid-2006 to mid- 2007 were included in the study prospectively regardless of age, gender or socio-economic status. Data relevant to the background of firearm use, type of firearm used, types and extents of injuries, clinical condition of the patients and final outcome were collected on performas and entered into SPSS 15.0 for analysis. Seventy-four cases of firearm injury were recorded during the study period, with a predominant male to female ratio (9.6:1). Most victims (79.7%) were in the age group of 15-35 years. Although there were more cases from Peshawar (28.4%), there was no major referral pattern noted. High velocity weapons were used in 95.9% of cases and homicide was the main motive for injury (60.8%). Injuries were sustained most frequently in the abdomen and pelvis (44.6%) and 67.6% of victims sustained internal injuries. There were only 5 (6.8%) deaths from firearm injuries. It is concluded, the young males of the population must be targeted for lifestyle adjustments such as training to refrain from anger or disputes (usually over petty things) and to prevent the easy access of firearms as a weapon to settle disputes. (author)

  9. Hidden Pair of Supermassive Black Holes

    Science.gov (United States)

    Kohler, Susanna

    2015-08-01

    Could a pair of supermassive black holes (SMBHs) be lurking at the center of the galaxy Mrk 231? A recent study finds that this may be the case and the unique spectrum of this galaxy could be the key to discovering more hidden binary SMBH systems.Where Are the Binary Supermassive Black Holes?Its believed that most, if not all, galaxies have an SMBH at their centers. As two galaxies merge, the two SMBHs should evolve into a closely-bound binary system before they eventually merge. Given the abundance of galaxy mergers, we would expect to see the kinematic and visual signatures of these binary SMBHs among observed active galactic nuclei yet such evidence for sub-parsec binary SMBH systems remains scarce and ambiguous. This has led researchers to wonder: is there another way that we might detect these elusive systems?A collaboration led by Chang-Shuo Yan (National Astronomical Observatories, Chinese Academy of Sciences) thinks that there is. The group suggests that these systems might have distinct signatures in their optical-to-UV spectra, and they identify a system that might be just such a candidate: Mrk 231.A Binary CandidateProposed model of Mrk 231. Two supermassive black holes, each with their own mini-disk, orbit each other in the center of a circumbinary disk. The secondary black hole has cleared gap in the circumbinary disk as a result of its orbit around the primary black hole. [Yan et al. 2015]Mrk 231 is a galaxy with a disturbed morphology and tidal tails strong clues that it might be in the final stages of a galactic merger. In addition to these signs, Mrk 231 also has an unusual spectrum for a quasar: its continuum emission displays an unexpected drop in the near-UV band.Yan and her collaborators propose that the odd behavior of Mrk 231s spectrum can be explained if the center of the galaxy houses a pair of SMBHs each with its own mini accretion disk surrounded by a circumbinary accretion disk. As the secondary SMBH orbits the primary SMBH (with a

  10. NEONATAL MORBIDITY AND EARLY OUTCOME OF VERY PRETERM INFANTS

    Directory of Open Access Journals (Sweden)

    Heljić Suada

    2013-01-01

    Full Text Available Background: Although the mortality rate for preterm infants and the gestational age-specific mortality rate have dramatically improved over the last 3 to 4 decades, infants born preterm remain vulnerable to many complications, including respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, a compromised immune system, cardiovascular disorders, hearing and vision problems, and brain lesions.The aim is to determine mortality and morbidity rates and selected outcome variables for preterm infant’s < 30 weeks’ gestation, who were admitted to the NICU. Patients and methods: This study enrolled 102 infants with gestational age less than 30 weeks’ gestation, hospitalized in Neonatal Intensive Care Unit, Pediatric Hospital, Clinical University Center Sarajevo, from Jan. 2010 to Dec. 2010. Parameters taken at admission were: birth weight, gestational age, Apgar score, excess base and CRIB score. Early outcome is considered as a survival at discharge or common preterm morbidities presented during hospitalizationResults: The mean BW of evaluated preterm infants was 1086 ± 250 g, the mean GA27.89 ± 1.97, Apgar score 5.41 ± 1.76, excess base at admission 6.39 ± 1.74 and mean CRIB score 3.72 ± 3.16. The overall survival rate was 70.5%. Selected outcomes at discharge were: RDS with 70.5% infants treated with natural surfactant, PDA treated with NSAIDS (23.5%, brain injury ( ≥ grade 3 IVH or PVL 16.6%, NEC Bell stages II or III 9.8%, BPD 25/72 (33.3% of infants who survived to 36 weeks postmenstrual age. In 38 (37.2% infants, episodes of infections were noticed (one or more episodes in 25 infants, half of them were caused by Gram positive bacteria, most frequent coagulasa negative staphylococci. Klebsiella pneumoniae was the mostfrequent organism among Gram negative bacteria. One patient had invasive candidiasis caused by Candida albicans. In 5 infants (4.9% early onset of sepsis was documented. Conclusion: Very preterm

  11. Colonoscopia: morbidade negligenciada Colonoscopy: neglected morbidity

    Directory of Open Access Journals (Sweden)

    Fernanda Bellotti Formiga

    2009-09-01

    Full Text Available OBJETIVO: Avaliar fatores de risco que determinam morbidade ao exame de colonoscopia. MÉTODOS: No período de março a junho de 2009 foram analisados prospectivamente 170 pacientes submetidos a exame colonoscópico. Fatores de risco como idade, sexo, indicação, exame ambulatorial/internado, efeitos adversos e qualidade do preparo intestinal, procedimento endoscópico, diagnóstico e intercorrência peri-procedimento foram relacionados. RESULTADOS: A média de idade da amostra foi 60,16 ± 14,69 anos, com predominância do sexo feminino. A indicação mais prevalente do exame foi seguimento pós-operatório. Três exames foram inconclusivos por mau preparo. Do restante, 36,53% foram normais e a maioria dos alterados apresentou pólipos, adenomatosos predominantemente. Quanto as comorbidades, 48,82% dos pacientes possuíam alguma comorbidade, sendo Hipertensão Arterial Sistêmica a mais prevalente. Apenas 22,94% dos pacientes apresentaram algum efeito adverso ao preparo. O preparo foi limpo em 65,88% dos exames, mostrando significância quando comparado a morbidade. Outro fator de significância estatística foi a realização de procedimentos (44,7% dos exames, sendo a maioria polipectomias. A morbidade chegou a 16,47%, sendo a desidratação a mais prevalente. Não houve mortalidade. CONCLUSÃO: A qualidade do preparo intestinal e a realização de procedimento endoscópico são fatores diretamente relacionados a morbidade do exame de colonoscopia.OBJECTIVE: The objective of this study is to analyze risks factors of morbidity on colonoscopy. METHOD: From March to June of 2009, 170 patients were examined and analyzed prospectively. Risks factors as age, sex, indication of exam, ambulatory or hospital exam, adverse events and quality of intestinal preparation, endoscopic procedure, diagnoses and incident before, during or after procedure were analyzed. RESULTS: The average age was 60,16±14,69 years old, with majority of female. The prevalent

  12. Co-morbidities of Interstitial Cystitis

    Directory of Open Access Journals (Sweden)

    Gisela eChelimsky

    2012-08-01

    Full Text Available Introduction: This study aimed to estimate the proportion of patients with Interstitial Cystitis/Painful Bladder Syndrome (IC/BPS with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS and fibromyalgia (FM. Material and Methods: Two groups of subjects with IC/BPS were included: 1 Physician diagnosed patients with IC/BPS and 2 Subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA. These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria > 11 times/24 hrs, and nocturia > 2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud’s syndrome and chronic aches and pains. Results: IC/BPS was diagnosed in 26 subjects (mean age 47 +/- 16 yrs, 92% females, 58 had symptoms of IC/BPS by NIDDK criteria, (mean age 40 +/- 17 yrs, 79% females and 48 were healthy controls (mean age 31+/- 14 yrs, mean age 77%. Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines and syncope. Discussion: Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic and sensory processing affecting multiple organs outside the bladder.

  13. Plasma fibronectin concentrations in morbidly obese patients

    DEFF Research Database (Denmark)

    Dejgaard, A; Andersen, T; Christoffersen, Pernille Yde

    1984-01-01

    Plasma fibronectin concentrations and liver morphology were investigated in 45 morbidly obese subjects (median overweight 88%) and in 42 normal weight controls, matched for sex and age. A significantly (P less than 0.01) raised plasma fibronectin concentration (median 464 mg/l, range 276-862 mg...... in their liver biopsies (r = 0.33, P less than 0.05). Significantly (P less than 0.05) elevated plasma fibronectin concentrations even in obese subjects without hepatic fatty change indicate that liver fat accumulation is no prerequisite of the obesity-related elevation of plasma fibronectin. Raised plasma...

  14. Morbidity and mortality of complex spine surgery

    DEFF Research Database (Denmark)

    Karstensen, Sven; Bari, Tanvir; Gehrchen, Martin

    2016-01-01

    requiring revision. METHODS: All patients undergoing spinal surgery at an academic tertiary referral center in the study period were prospectively included. The newest version of SAVES system was used, and a research coordinator collected all intraoperative and perioperative data prospectively. Once a week...... adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population. STUDY DESIGN: A prospective, consecutive cohort study...

  15. STUDY ON PSYCHIATRIC CO - MORBIDITY IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    Shrikant B.

    2015-06-01

    Full Text Available BACKGROUND: Psoriasis is relatively common , chronic inflammatory and hyper - proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching , chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co - morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves , with studies illustrating that the majority of patients believe that stress or psychological distress is a factor in the manifestations of their condition . Depression and anxiety are the most common disorders that are associated with psoriasis , but the proportion of patient also having other psychiatric co - morbid diseases which include social phobia , generalize anxiety disorder , panic disorder , psychotic diso rder , etc. Moreover , symptoms of psoriasis , especially pruritus , are related to depression. OBJECTIVES : To evaluate different psychiatric illnesses their prevalence and severity in psoriasis patients. METHODOLOGY : This was cross - sectional observational stu dy comprised of 70 consecutive patients of psoriasis attending the out - patient department of Dermatology. All the patients were subjected to detailed examinations including the elicitation of dermatological and psychiatric profile after getting written con sent for study . Data was collected using self - developed , pre tested , semi structured Pro format by interview method. RESULTS : The profile of psychiatric diagnoses obtained in the present study depressive disorder 31.4% {18.57% depression , 12.85% Depression with anxiety symptoms} , anxiety disorder 25.7% (7.14% GAD , 8.17% panic disorder , 5.71% social phobia , 4.28 specific phobia. Severity of major depressive disorder was determined with HAM - D score 53.8% had mild depression , 30.7% moderate depression and 15. 5% severe depression. Similarly when HAM - A scale was used to determined severity of generalized

  16. Photoacoustic imaging of hidden dental caries by using a fiber-based probing system

    Science.gov (United States)

    Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

    2017-04-01

    Photoacoustic method to detect hidden dental caries is proposed. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating laser light to occlusal surface of model tooth. By making a map of intensity of these high frequency components, photoacoustic images of hidden caries were successfully obtained. A photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for using clinical application, and clear photoacoustic image of hidden caries was also obtained by this system.

  17. Low-scale gravity mediation in warped extra dimension and collider phenomenology on hidden sector

    International Nuclear Information System (INIS)

    Itoh, H.; Okada, N.; Yamashita, T.

    2007-01-01

    We propose a new scenario of gravity-mediated supersymmetry breaking (gravity mediation) in a supersymmetric Randall-Sundrum model, where the gravity mediation takes place at a low scale due to the warped metric. We investigate collider phenomenology involving the hidden sector field, and find a possibility that the hidden sector field can be produced at the LHC and the ILC. The hidden sector may no longer be hidden. (author)

  18. A Multidisciplinary Clinical Pathway Decreases Rib Fracture-Associated Infectious Morbidity and Mortality in High-Risk Trauma Patients

    Science.gov (United States)

    2006-01-01

    RT respiratory therapy ; PT physical therapy ; OT occupational therapy ; GCS Glasgow Coma Scale. 808 S.R. Todd et al. / The American Journal of...Morbidity form rib fractures increases after age 45. J Am Coll Surg 2003;196:549–55. [14] Pierson DJ, Kacmarek R. Foundations of Respiratory Care. New...Papers presented A multidisciplinary clinical pathway decreases rib fracture –associated infectious morbidity and mortality in high-risk trauma

  19. Hidden sources of grapefruit in beverages: potential interactions with immunosuppressant medications.

    Science.gov (United States)

    Auten, Ashley A; Beauchamp, Lauren N; Joshua Taylor; Hardinger, Karen L

    2013-06-01

    The interaction between grapefruit-containing beverages and immunosuppressants is not well defined in the literature. This study was conducted to investigate possible sources of grapefruit juice or grapefruit extract in common US-manufactured beverages. The goal was to identify those products that might serve as hidden sources of dietary grapefruit intake, increasing a transplant patient's risk for drug interactions. A careful review of the ingredients of the 3 largest US beverage manufacturer's product lines was conducted through manufacturer correspondence, product labeling examination, and online nutrition database research. Focus was placed on citrus-flavored soft drinks, teas, and juice products and their impact on a patient's immunosuppressant regimens. Twenty-three beverages were identified that contained grapefruit. Five did not contain the word "grapefruit" in the product name. In addition to the confirmed grapefruit-containing products, 17 products were identified as possibly containing grapefruit juice or grapefruit extract. A greater emphasis should be placed upon properly educating patients regarding hidden sources of grapefruit in popular US beverages and the potential for food-drug interactions.

  20. Evidence of hidden leprosy in a supposedly low endemic area of Brazil.

    Science.gov (United States)

    Bernardes, Fred; Paula, Natália Aparecida de; Leite, Marcel Nani; Abi-Rached, Thania Loyola Cordeiro; Vernal, Sebastian; Silva, Moises Batista da; Barreto, Josafá Gonçalves; Spencer, John Stewart; Frade, Marco Andrey Cipriani

    2017-12-01

    Show that hidden endemic leprosy exists in a municipality of inner São Paulo state (Brazil) with active surveillance actions based on clinical and immunological evaluations. The study sample was composed by people randomly selected by a dermatologist during medical care in the public emergency department and by active surveillance carried out during two days at a mobile clinic. All subjects received a dermato-neurological examination and blood sampling to determine anti-PGL-I antibody titers by enzyme-linked immunosorbent assay (ELISA). From July to December 2015, 24 new cases of leprosy were diagnosed; all were classified as multibacillary (MB) leprosy, one with severe Lucio's phenomenon. Seventeen (75%) were found with grade-1 or 2 disability at the moment of diagnosis. Anti-PGL-I titer was positive in 31/133 (23.3%) individuals, only 6/24 (25%) were positive in newly diagnosed leprosy cases. During the last ten years before this study, the average new case detection rate (NCDR) in this town was 2.62/100,000 population. After our work, the NCDR was raised to 42.8/100,000. These results indicate a very high number of hidden leprosy cases in this supposedly low endemic area of Brazil.

  1. On the hidden maxwell superalgebra underlying D = 4 supergravity

    Energy Technology Data Exchange (ETDEWEB)

    Penafiel, D.M. [Departamento de Fisica, Universidad de Concepcion (Chile); DISAT, Politecnico di Torino (Italy); Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Torino (Italy); Ravera, L. [DISAT, Politecnico di Torino (Italy); Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Torino (Italy)

    2017-09-15

    In this work, we expand the hidden AdS-Lorentz superalgebra underlying D = 4 supergravity, reaching a (hidden) Maxwell superalgebra. The latter can be viewed as an extension involving cosmological constant of the superalgebra underlying D = 4 supergravity in flat spacetime. We write the Maurer-Cartan equations in this context and we find some interesting extensions of the antisymmetric 3-form A{sup (3)} appearing in the Free Differential Algebra in Minkowski space. The structure of Free Differential Algebras is obtained by considering the zero curvature equations. We write the parametrization of A{sup (3)} in terms of 1-forms and we rend the topological features of its extensions manifest. We interestingly find out that the structure of these extensions, and consequently the structure of the corresponding boundary contribution dA{sup (3)}, strongly depends on the form of the extra fermionic generator appearing in the hidden Maxwell superalgebra. The model we develop in this work is defined in an enlarged superspace with respect to the ordinary one, and the extra bosonic and fermionic 1-forms required for the closure of the hidden Maxwell superalgebra must be considered as physical fields in this enlarged superspace. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  2. Generalized inequalities for quantum correlations with hidden variables

    International Nuclear Information System (INIS)

    Vinduska, M.

    1991-01-01

    Renowned inequalities for quantum correlations are generalized for the case when quantum system cannot be described with an absolute independent measure of the probability. Such a formulation appears to be suitable for the formulation of the hidden variables theory in terms of non-Euclidean geometry. 10 refs

  3. Hidden conic quadratic representation of some nonconvex quadratic optimization problems

    NARCIS (Netherlands)

    Ben-Tal, A.; den Hertog, D.

    The problem of minimizing a quadratic objective function subject to one or two quadratic constraints is known to have a hidden convexity property, even when the quadratic forms are indefinite. The equivalent convex problem is a semidefinite one, and the equivalence is based on the celebrated

  4. Measurement problem and local hidden variables with entangled photons

    Directory of Open Access Journals (Sweden)

    Muchowski Eugen

    2017-12-01

    Full Text Available It is shown that there is no remote action with polarization measurements of photons in singlet state. A model is presented introducing a hidden parameter which determines the polarizer output. This model is able to explain the polarization measurement results with entangled photons. It is not ruled out by Bell’s Theorem.

  5. The incompatibility between local hidden variable theories and the ...

    Indian Academy of Sciences (India)

    I discuss in detail the result that the Bell's inequalities derived in the context of local hidden variable theories for discrete quantized observables can be satisfied only if a fundamental conservation law is violated on the average. This result shows that such theories are physically nonviable, and makes the demarcating criteria ...

  6. A novel design of hidden web crawler using ontology

    OpenAIRE

    Manvi; Bhatia, Komal Kumar; Dixit, Ashutosh

    2015-01-01

    Deep Web is content hidden behind HTML forms. Since it represents a large portion of the structured, unstructured and dynamic data on the Web, accessing Deep-Web content has been a long challenge for the database community. This paper describes a crawler for accessing Deep-Web using Ontologies. Performance evaluation of the proposed work showed that this new approach has promising results.

  7. Hidden symmetries of the Principal Chiral Model unveiled

    International Nuclear Information System (INIS)

    Devchand, C.; Schiff, J.

    1996-12-01

    By relating the two-dimensional U(N) Principal Chiral Model to a Simple linear system we obtain a free-field parametrization of solutions. Obvious symmetry transformations on the free-field data give symmetries of the model. In this way all known 'hidden symmetries' and Baecklund transformations, as well as a host of new symmetries, arise. (author). 21 refs

  8. A hidden bias in a common calorimeter calibration scheme

    International Nuclear Information System (INIS)

    Lincoln, Don; Morrow, Greg; Kasper, Peter

    1994-01-01

    In this paper, a common calorimeter calibration scheme is explored and a hidden bias found. Since this bias mimics a non-linearity in response in the calorimeter, it must be understood and removed from the calibration before true non-linearities are investigated. The effect and its removal are explored and understood through straightforward calculus and algebra. ((orig.))

  9. Exposing the Hidden-Web Induced by Ajax

    NARCIS (Netherlands)

    Mesbah, A.; Van Deursen, A.

    2008-01-01

    AJAX is a very promising approach for improving rich interactivity and responsiveness of web applications. At the same time, AJAX techniques increase the totality of the hidden web by shattering the metaphor of a web ‘page’ upon which general search engines are based. This paper describes a

  10. Crisis Entrepreneurs and Hidden Crises : Illustrative Examples of Interactional

    NARCIS (Netherlands)

    Prof. Cees van Woerkum; dr. Annette Klarenbeek

    2012-01-01

    We examine the ways in which a hidden crisis can be exposed from a communication point of view. In which way can organisations create general awareness of a crisis and try to understand the dynamic nature of interactions? With the help of discourse analysis, we have examined the interactional

  11. Hidden symmetry of the quantum Calogero-Moser system

    DEFF Research Database (Denmark)

    Kuzentsov, Vadim b

    1996-01-01

    The hidden symmetry of the quantum Calogero-Moser system with an inverse-square potential is algebraically demonstrated making use of Dunkl's operators. We find the underlying algebra explaining the super-integrability phenomenon for this system. Applications to related multi-variable Bessel...... functions are also discussed....

  12. Duality and hidden symmetries in interacting particle systems

    NARCIS (Netherlands)

    Giardinà, C.; Kurchan, J.; Redig, F.H.J.; Vafayi, K.

    2009-01-01

    In the context of Markov processes, both in discrete and continuous setting, we show a general relation between duality functions and symmetries of the generator. If the generator can be written in the form of a Hamiltonian of a quantum spin system, then the "hidden" symmetries are easily derived.

  13. A Constraint Model for Constrained Hidden Markov Models

    DEFF Research Database (Denmark)

    Christiansen, Henning; Have, Christian Theil; Lassen, Ole Torp

    2009-01-01

    A Hidden Markov Model (HMM) is a common statistical model which is widely used for analysis of biological sequence data and other sequential phenomena. In the present paper we extend HMMs with constraints and show how the familiar Viterbi algorithm can be generalized, based on constraint solving ...

  14. Is There Hidden Potential for Rural Population Growth in Sweden?

    Science.gov (United States)

    Niedomysl, Thomas; Amcoff, Jan

    2011-01-01

    Rural depopulation is a concern in many countries, and various policy initiatives have been taken to combat such trends. This article examines whether hidden potential for rural population growth can be found in Sweden. If such potential exists, it implies that the development prospects for many rural areas are not as unpromising as they may seem…

  15. Optimisation of Hidden Markov Model using Baum–Welch algorithm

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Earth System Science; Volume 126; Issue 1. Optimisation of Hidden Markov Model using Baum–Welch algorithm for prediction of maximum and minimum temperature over Indian Himalaya. J C Joshi Tankeshwar Kumar Sunita Srivastava Divya Sachdeva. Volume 126 Issue 1 February 2017 ...

  16. Hidden Markov Model for quantitative prediction of snowfall

    Indian Academy of Sciences (India)

    A Hidden Markov Model (HMM) has been developed for prediction of quantitative snowfall in Pir-Panjal and Great Himalayan mountain ranges of Indian Himalaya. The model predicts snowfall for two days in advance using daily recorded nine meteorological variables of past 20 winters from 1992–2012. There are six ...

  17. Light hidden-sector U(1)s in string compactifications

    Energy Technology Data Exchange (ETDEWEB)

    Goodsell, Mark; Ringwald, Andreas

    2010-02-15

    We review the case for light U(1) gauge bosons in the hidden-sector of heterotic and type II string compactifications, present estimates of the size of their kinetic mixing with the visible-sector hypercharge U(1), and discuss their possibly very interesting phenomenological consequences in particle physics and cosmology. (orig.)

  18. Book Review: "Hidden Markov Models for Time Series: An ...

    African Journals Online (AJOL)

    Hidden Markov Models for Time Series: An Introduction using R. by Walter Zucchini and Iain L. MacDonald. Chapman & Hall (CRC Press), 2009. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/saaj.v10i1.61717 · AJOL African Journals Online.

  19. TeraHertz imaging of hidden paint layers on canvas

    NARCIS (Netherlands)

    Adam, A.J.L.; Planken, P.C.M.; Meloni, S.; Dik, J.

    2009-01-01

    We show terahertz reflection images of hidden paint layers in a painting on canvas and compare the results with X-ray Radiography and Infrared Reflectography. Our terahertz measurements show strong reflections from both the canvas/paint interface and from the raw umber/lead white interface,

  20. K­MEANS CLUSTERING FOR HIDDEN MARKOV MODEL

    NARCIS (Netherlands)

    Perrone, M.P.; Connell, S.D.

    2004-01-01

    An unsupervised k­means clustering algorithm for hidden Markov models is described and applied to the task of generating subclass models for individual handwritten character classes. The algorithm is compared to a related clustering method and shown to give a relative change in the error rate of as