National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...
In this article an account is given of work undertaken by an internal organization development (OD) unit within the United Kingdom's National Health Service, in the area of joint consultation within a health authority. Some thoughts are also presented on the relationship between OD practice and the field of industrial relations. (SSH)
Piercy, Kathleen W.; Lee, Thomas R.
This paper discusses graduate distance education in family relations and related disciplines, using a case study approach. Challenges that occur in distance graduate programs are outlined and illustrated by examination of a new master's degree program in Family and Human Development. The program delivers courses by satellite broadcast and…
Maria Custódia Jorge Rocha
Full Text Available In this paper, based on a few authors who see power as a substantive element – instituted power – and others who consider it as an action verb – instituting power (ROCHA, 2007 –, highlighting some types of power relevant in sociological and organizational research on schools, we present empirical data and institutional discourses, enabled by a case study of qualitative nature. Thus, we can say that relations of power in schools both allow the strengthening of hierarchical and asymmetrical relations of power that exist between institutional players and enable the creation of new “circles of power” that can be promptly activated or can be object of a modernization process held in a more or less generalized manner. This may be reinforced and introduced to players/students, our main target of study, as the most legitimate object, superseding all others but not canceling them. The key objective is to present school organization as a highly complex environment, especially when considered in the light of the multiple and cumulative relations of power that emerge and are materialized.
Full Text Available Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited.Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b Self-rated wealth, and (c Peer-rated wealth. Activity participation data were collected using a modified 'Stylised Activity List' developed for the World Bank's Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06-3.78; p<0.0001, self-rated wealth (OR, 4.41, 95%CI, 2.75-7.07; p<0.0001 and peer-rated wealth (OR, 8.22, 95% CI, 4.59-14.72; p<0.0001. Cases had less access to latrines (57% v 76.5%, p = <0.0001 and higher person-to-room density (4.0 v 3.31; P = 0.0204 than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities.This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth
Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Zewdie, Zebideru; Callahan, Kelly; Emerson, Paul M.; Kuper, Hannah; Bailey, Robin L.; Mabey, David C. W.; Rajak, Saul N.; Polack, Sarah; Weiss, Helen A.; Burton, Matthew J.
Background Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. Methodology/Principal Findings Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified ‘Stylised Activity List’ developed for the World Bank’s Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06–3.78; pimpairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. Conclusions/Significance This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation. PMID:26600211
Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Zewdie, Zebideru; Callahan, Kelly; Emerson, Paul M; Kuper, Hannah; Bailey, Robin L; Mabey, David C W; Rajak, Saul N; Polack, Sarah; Weiss, Helen A; Burton, Matthew J
Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified 'Stylised Activity List' developed for the World Bank's Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06-3.78; ppoverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation.
Full Text Available This paper describes the process of implementation of a diffused relational database in the practical case of the academic tutorials of the Faculty of Engineering Sciences of the Equinoctial Technological University (UTE. For the implementation, the ANSI-SPARC database architecture was used as the methodology, which abstracts the information into levels, at the external level the functional requirements were obtained, at the conceptual level, the diffused relational model was obtained. To achieve this model, we performed the transformation of the diffuse data through mathematical models using the Fuzzy-Lookup tool and at the physical level the diffused relational database was implemented. In addition, an user interface was developed using Java through which data is entered and queries are made to the diffused relational database to verify its operation.
Kocourkova, Jana; Dudova, Iva; Koutek, Jiri
Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome.
Full Text Available Jana Kocourkova, Iva Dudova, Jiri Koutek Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome. Keywords: Asperger syndrome, suicidal behavior, adolescence
merely anti-Soviet neo -militarism forwarded by revanchist Japanese who are opposed to favorable relations 4 with the Soviet Union. The Japanese people...perpetrated by the Liberal Democratic Party (LDP), the conservative ruling party in Japan, as an instrument of neo -militarism.7 6 This neo -militarism is cited...Japan economic system; Malthusian resource constraints; trade protectionism; a return to nationalistic merchantilistic mentalities. (2) Political
The study examines strategies multilingual children use to interpret grammatical relations, focusing on their two primary languages, Lajamanu Warlpiri and Light Warlpiri. Both languages use mixed systems for indicating grammatical relations. In both languages ergative-absolutive case-marking indicates core arguments, but to different extents in…
Sarma, Manash Pratim; Asim, Mohammad; Medhi, Subhash; Bharathi, Thayumanavan; Kar, Premashis
Infection with hepatitis C virus (HCV) is a major risk factor for hepatocellular carcinoma (HCC) in India. The study was designed to investigate the clinical and molecular profiles of HCV related HCC cases in Indian patients. In a prospective study, 68 HCV related HCC, 55 HCV related chronic hepatitis, and 68 HCV related patients with cirrhosis were included. Glutathione S-transferase gene polymorphism was analyzed in all the cases. The sex ratios were 5.18:1, 1.39:1, and 0.83:1 with mean age of 50.57 ± 12.47, 39.41 ± 13.34, and 46.08 ± 15.06 years, respectively, in three groups. Amongst the HCV related HCC cases seen in India, 49.2% (30 out of 68) were with Okuda stage I while 34.4% (21 out of 68) cases were classified as stage II. Older age, poor standards of living, HCV genotype 4, smoking, and null genotypes of GST were the risk factors associated significantly with the development of HCC. In 55.9% cases (38 out of 68) the size of the tumor was ≥5 cm while in 38.2% cases (26 out of 68) the size was between 2 and 5 cm, indicating an advanced stage of the disease at presentation. Copyright © 2012 Wiley Periodicals, Inc.
de Medeiros, M A T; Zangirolani, Lia Thieme Oikawa; Cordeiro, Ricardo Carlos; da Costa, Proença Rossana Pacheco; Diez-Garcia, Rosa Wanda
Nutritional aspects are important for the prevention of diseases and disorders, and few studies have focused on the relationship between risk of work injury and nutritional variables. This study aimed to verify whether nutritional variables constitute risk factors for work-related accidents. 1,422 industrial workers (600 cases plus 822 controls). A case-control study was carried out in an industrial city in south-east Brazil. A multiple logistic regression model was adjusted using work-related accidents as the response variable and nutritional variables as predictors. The associations were assessed by Odds Ratio (OR), with a p-value work-related accidents were (a) attending formal education for an above average number of years (OR=0.91, pwork-related accidents. This indicates the need, during the formulation of policies for these kinds of government benefits, to include nutrition aspects in order to minimize work-related accidents risks.
Full Text Available The author intends to present a possibility of parametrising legal terminology in order to reveal semantic and systemic relations at the intralingual and interlingual levels. The scope of the research comprises selected legal terminology from the following legal systems: Polish, British, American and European Union. The research methods used include: (i the analysis of comparable texts, (ii the method of parametrisation of the legal linguistic reality, (iii the concept of adjusting translation to the communicative needs and requirements of the recipient community. The research hypothesis is that parametrisation of legal terminology in respect of semantic and systemic relations may be a useful tool in organising and comparing terminology for the purpose of legal translation. First the relation of synonymy binding terms at the intralingual and interlingual levels in the light of systemic and genre-related relations is discussed. The proposal is illustrated with examples of legal terms and the networks of relations binding them in English and Polish. The conclusions are that such an approach is systematic and provides a translator with information necessary to render communicatively efficient translations.
van Leeuwen, D. M.; Pedersen, Marie; Knudsen, Lisbeth E.
Mechanistically relevant information on responses of humans to xenobiotic exposure in relation to chemically induced biological effects, such as micronuclei (MN) formation can be obtained through large-scale transcriptomics studies. Network analysis may enhance the analysis and visualisation...... of such data. Therefore, this study aimed to develop a 'MN formation' network based on a priori knowledge, by using the pathway tool MetaCore. The gene network contained 27 genes and three gene complexes that are related to processes involved in MN formation, e.g. spindle assembly checkpoint, cell cycle...... checkpoint and aneuploidy. The MN-related gene network was tested against a transcriptomics case study associated with MN measurements. In this case study, transcriptomic data from children and adults differentially exposed to ambient air pollution in the Czech Republic were analysed and visualised...
Hewson, Peter W.
Results of a case study (one graduate physics tutor) demonstrate that a person's conceptions, which include metaphysical commitments, play a significant role in the way s/he understands complex subject matter such as Einstein's Special Theory of Relativity. (Author/SK)
Marckmann, Peter; Skov, Lone; Rossen, Kristian
.02). CONCLUSIONS: Increasing cumulative gadodiamide exposure, high-dose epoietin-beta treatment, and higher serum concentrations of ionized calcium and phosphate increase the risk of gadodiamide-related nephrogenic systemic fibrosis in renal failure patients. Severe cases seem to develop primarily among patients......BACKGROUND: Nephrogenic systemic fibrosis may be caused by gadolinium (Gd)-containing magnetic resonance imaging contrast agents. Most reported cases were associated with one particular agent, gadodiamide. Yet, unidentified cofactors might explain why only a minority of renal failure patients...... exposed to gadodiamide develop nephrogenic systemic fibrosis. METHODS: We conducted a case-control study of 19 histologically verified cases and 19 sex- and age-matched controls. All subjects had chronic renal failure when exposed to gadodiamide. Clinical, biochemical and pharmacological data were...
Cooke, R; Laing, S; Swerdlow, A J
Mobile phone use is now ubiquitous, and scientific reviews have recommended research into its relation to leukaemia risk, but no large studies have been conducted. In a case-control study in South East England to investigate the relation of acute and non-lymphocytic leukaemia risk to mobile phone use, 806 cases with leukaemia incident 2003-2009 at ages 18-59 years (50% of those identified as eligible) and 585 non-blood relatives as controls (provided by 392 cases) were interviewed about mobile phone use and other potentially aetiological variables. No association was found between regular mobile phone use and risk of leukaemia (odds ratio (OR)=1.06, 95% confidence interval (CI)=0.76, 1.46). Analyses of risk in relation to years since first use, lifetime years of use, cumulative number of calls and cumulative hours of use produced no significantly raised risks, and there was no evidence of any trends. A non-significantly raised risk was found in people who first used a phone 15 or more years ago (OR=1.87, 95% CI=0.96, 3.63). Separate analyses of analogue and digital phone use and leukaemia subtype produced similar results to those overall. This study suggests that use of mobile phones does not increase leukaemia risk, although the possibility of an effect after long-term use, while biologically unlikely, remains open.
Full Text Available Epidemiologists often use ratio-type indices (rate ratio, risk ratio and odds ratio to quantify the association between exposure and disease. By comparison, less attention has been paid to effect measures on a difference scale (excess rate or excess risk. The excess relative risk (ERR used primarily by radiation epidemiologists is of peculiar interest here, in that it involves both difference and ratio operations. The ERR index (but not the difference-type indices is estimable in case-control studies. Using the theory of sufficient component cause model, the author shows that when there is no mechanistic interaction (no synergism in the sufficient cause sense between the exposure under study and the stratifying variable, the ERR index (but not the ratio-type indices in a rare-disease case-control setting should remain constant across strata and can therefore be regarded as a common effect parameter. By exploiting this homogeneity property, the related attributable fraction indices can also be estimated with greater precision. The author demonstrates the methodology (SAS codes provided using a case-control dataset, and shows that ERR preserves the logical properties of the ratio-type indices. In light of the many desirable properties of the ERR index, the author advocates its use as an effect measure in case-control studies of rare diseases.
Becmeur, P H; Abry, F; Bourcier, T; Meyer, N; Sauer, A
Currently, the most feared complication by ophthalmologists of contact lens (CL) wear is microbial keratitis (MK), even though its incidence remains low. It is also a significant financial burden for society. This study aimed to identify the risk factors for CL-related MK especially with regard to hygiene and pattern of use, in a large, prospective, multicenter, case-control study. A multicenter retrospective case-control study was designed. The CL-related MK subpopulation (case) was compared with healthy CL wearers (control) using a 52-item anonymous questionnaire designed to determine subject demographics, lens wear history, lens type and disinfection solution, fitting, patient education, hygiene and maintenance of contact lenses, and patient history. Univariate logistic regression analysis was performed to compare both groups. The study included 497 cases and 364 controls. The risk factors associated with the greatest increased odds of CL-related MK were as follows: extended wear (OR=2.96 [1.65-5.33], P<0.001), occasional overnight lens use (OR=6.37 [4,55-8.90], P<0.001), fitting by an optician (OR=1.97 [1.38-2.83], P<0.001), absence of ophthalmologic exam (OR=6.56 [2-22], P<0.01) or no training in handling the contact lens (OR=4.47 [2.27-8.77], P<0.01), use of optician's disinfection solution (OR=5.55 [3.12-9.85], P<0.001), mixing solutions ("topping off") (OR=4.68 [2.73-8.04], P<0.001), no case replacement (OR=3.95 [2.28-6.82] P<0.01), no compliance with hygiene rules and smoking (OR=2.29 [1.67-3.14], P<0.01). The protective factors associated with the greatest reduction in OR were female gender (OR=0.49 [0.36-0.66], P<0.01), hypermetropia (OR=0.28 [0.16-0.48], P=0.01), rigid contact lens wear, fitting by an ophthalmologist, written and verbal instruction, and daily case maintenance. The knowledge of these risks factors incentivizes action at all levels to reduce the incidence of MK, from the prescriber to the patient, including the type of CL, case and
Shrestha, Mithila; Raitanen, Jani; Salminen, Tiina; Lahkola, Anna; Auvinen, Anssi
The number of mobile phone users has grown rapidly, which has generated mounting public concern regarding possible health hazards. This study aims to assess pituitary tumor risk, as it has rarely been investigated. A case-control study was conducted with 80 eligible cases identified from all five university hospitals in Finland and frequency-matched 240 controls from the national population register. Controls were matched to cases by age, sex, region of residence and date of interview. A detailed history of mobile phone use was obtained using a structured interview. Several indicators of mobile phone use were assessed using conditional logistic regression. A reduced odds ratio was seen among regular mobile phone users [OR 0.39, 95% confidence interval (CI) 0.21, 0.72] relative to never/non-regular users, possibly reflecting methodological limitations. Pituitary tumor risk was not increased after 10 or more years since first use (OR 0.69, 95% CI 0.25, 1.89). The risk was not increased in relation to duration, cumulative hours of use, or cumulative number of calls. The results were similar for analog and digital phones. We found no excess risk associated with self-reported short- or medium-term use of mobile phones. This is consistent with most of the published studies. However, uncertainties remained for longer duration of use, as a very small proportion of study participants reported use beyond 10 years.
Miller, Joseph H; Gill, Clarence; Kuhn, Elizabeth N; Rocque, Brandon G; Menendez, Joshua Y; O'Neill, Jilian A; Agee, Bonita S; Brown, Steven T; Crowther, Marshall; Davis, R Drew; Ferguson, Drew; Johnston, James M
OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in
Full Text Available Objective To summarize the clinical data and pathological features of 10 cases of cerebral lobar hemorrhage related with cerebral amyloid angiopathy (CAA diagnosed pathologically, thereby to improve the knowledge and diagnosis of the disease. Methods The clinical data of 10 cases of cerebral lobar hemorrhage related with CAA, collected in the General Hospital of Shenyang Command from 1983 up to now, were retrospectively analyzed, and the clinical and neuropathological features of these cases were summarized. Results Of the 10 patients, 2 suffered from single lobar hemorrhage and 8 multiple lobar hemorrhage, all of them were confirmed pathologically to have ruptured into the subarachnoid space. Pathological examination revealed microaneurysm in 2 cases, "double barrel" change in 4 cases, multiple arteriolar clusters in 5 cases, obliterative onion-liked intima change in 4 cases, and fibrinoid necrosis of vessel wall in 7 cases. In addition, neurofibrillary tangles were found in 8 cases, and senile plaque was observed in 5 cases. Conclusions Cerebral lobar hemorrhage related with CAA is mainly located in the parietal, temporal and occipital lobes, readily breaking into the subarachnoid space, and it is often multiple and recurrent. The CAA associated microvasculopathy was found frequently in the autopsy sample of CAA related cerebral lobar hemorrhage, and it may contribute to the pathogenesis of cerebral hemorrhage. DOI: 10.11855/j.issn.0577-7402.2015.07.04
Full Text Available Abstract Background We previously reported risk haplotypes for two genes related with serotonin and dopamine metabolism: MAOA in migraine without aura and DDC in migraine with aura. Herein we investigate the contribution to migraine susceptibility of eight additional genes involved in dopamine neurotransmission. Methods We performed a two-stage case-control association study of 50 tag single nucleotide polymorphisms (SNPs, selected according to genetic coverage parameters. The first analysis consisted of 263 patients and 274 controls and the replication study was composed by 259 cases and 287 controls. All cases were diagnosed according to ICHD-II criteria, were Spanish Caucasian, and were sex-matched with control subjects. Results Single-marker analysis of the first population identified nominal associations of five genes with migraine. After applying a false discovery rate correction of 10%, the differences remained significant only for DRD2 (rs2283265 and TH (rs2070762. Multiple-marker analysis identified a five-marker T-C-G-C-G (rs12363125-rs2283265-rs2242592-rs1554929-rs2234689 risk haplotype in DRD2 and a two-marker A-C (rs6356-rs2070762 risk haplotype in TH that remained significant after correction by permutations. These results, however, were not replicated in the second independent cohort. Conclusion The present study does not support the involvement of the DRD1, DRD2, DRD3, DRD5, DBH, COMT, SLC6A3 and TH genes in the genetic predisposition to migraine in the Spanish population.
Munjiza, Jasna; Britvic, Dolores; Radman, Maja; Crawford, Mike J
Exposure to war-related trauma has long been recognised to have an adverse effect on mental health. We attempted to investigate whether people who have clinically significant personality-related problems 15 years after a war are more likely to have been exposed to severe war-related trauma than those who do not have significant personality difficulties. A case -control study was conducted in southern Croatia, fifteen years after the 1991-1995 war. We recruited 268 participants: 182 cases who scored positively on the International Personality Disorder Examination scale (IPDE), and 86 controls who were IPDE negative. Severity of war-related trauma was assessed according to the 17 items on the Harvard Trauma Questionnaire (HTQ) trauma event scale, which were considered to be of severe (catastrophic) nature based on the ICD-10 description of catastrophic trauma and the opinion of trauma experts. All participants also completed measures of mental health (depression, anxiety and PTSD), social functioning and current substance misuse. Cases (IPDE positive) were eight times more likely to report exposure to severe war-related trauma than controls. This association increased after adjustments for demographic factors (OR = 10.1, 95% CI 5.0 to 20.4). The types of severe trauma most frequently reported were either the participants'own life being in direct danger or witnessing extreme violence inflicted on others or the result of violence towards others (murder, torture, seeing burned or disfigured bodies). Prevalences of depression, anxiety and PTSD were high among IPDE positive participants 15 years after exposure to war trauma. Their level of interpersonal dysfunction was considerably higher than that in controls (OR = 10.39, 95% CI 3.51 to 30.75). Alcohol consumption in cases was significantly higher with a mean of 14.24 units per week (sd = 11.03) when compared to controls whose mean number of alcohol units was 9.24 (sd = 7.25), t (73) = 2.16, p
Wells, Susan; Mullin, Bernadette; Norton, Robyn; Langley, John; Connor, Jennie; Lay-Yee, Roy; Jackson, Rod
To investigate whether the risk of motorcycle crash related injuries is associated with the conspicuity of the driver or vehicle. Population based case-control study. Auckland region of New Zealand from February 1993 to February 1996. 463 motorcycle drivers (cases) involved in crashes leading to hospital treatment or death; 1233 motorcycle drivers (controls) recruited from randomly selected roadside survey sites. Estimates of relative risk of motorcycle crash related injury and population attributable risk associated with conspicuity measures, including the use of reflective or fluorescent clothing, headlight operation, and colour of helmet, clothing, and motorcycle. Crash related injuries occurred mainly in urban zones with 50 km/h speed limit (66%), during the day (63%), and in fine weather (72%). After adjustment for potential confounders, drivers wearing any reflective or fluorescent clothing had a 37% lower risk (multivariate odds ratio 0.63, 95% confidence interval 0.42 to 0.94) than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk (multivariate odds ratio 0.76, 0.57 to 0.99). Self reported light coloured helmet versus dark coloured helmet was associated with a 19% lower risk. Three quarters of motorcycle riders had their headlight turned on during the day, and this was associated with a 27% lower risk (multivariate odds ratio 0.73, 0.53 to 1.00). No association occurred between risk and the frontal colour of drivers' clothing or motorcycle. If these odds ratios are unconfounded, the population attributable risks are 33% for wearing no reflective or fluorescent clothing, 18% for a non-white helmet, 11% for a dark coloured helmet, and 7% for no daytime headlight operation. Low conspicuity may increase the risk of motorcycle crash related injury. Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap interventions that
Full Text Available The aim of the methodologies described here is to propose measures and procedures for developing concepts and technological solutions, which are adapted to the local conditions, to build sustainable communities in developing countries and emerging economies. These methodologies are linked to the EcoCity framework outlined by VTT Technical Research Centre of Finland Ltd. for sustainable community and neighbourhood regeneration and development. The framework is the result of a long experience in numerous EcoCity related projects, mainly Nordic and European in scope, which has been reformulated in recent years to respond to the local needs in the previously mentioned countries. There is also a particular emphasis on close collaboration with local partners and major stakeholders. In order to illustrate how these methodologies can support EcoCity concept development and implementation, results from a case study in Egypt will be discussed. The referred case study relates to the transformation of New Borg El Arab (NBC, near Alexandria, into an EcoCity. The viability of the idea was explored making use of different methodologies (Roadmap, Feasibility Study, and Residents Energy Survey and Building Consumption Assessment and considering the Residential, Commercial/Public Facilities, Industrial, Services/Utilities, and Transport sectors.
Full Text Available AIM: Kocaeli is one of the most industrialized cities of Turkey. Many industrial facilities in terms of air pollution, constitute a risk. Because of Kocaelis location, which is on the junction of Turkeys whole motorway transport, increases the importance of this issue. The purpose of this study is to determine whether or not a relationship between air pollution measurement parameters (SO2 and PM and Myocard Infarction (MI related hospitalizations. METHOD: In this study, the relationship between MI related hospitalizations which occured in Kocaeli in 2004 and measurements of SO2 and PM were investigated. Study was analytical type and case-crossover (CCO design was used. RESULTS: Three hospitals (which have coronary intensive care units and which are located in Kocaeli patient records have been searched and a total of 428 MI related hospitalizations have been identified in data collecting phase, and its determined that these 428 hospitalizations were involving 417 individuals. Of the 428 hospitalization records, 318 were eligible for CCO analysis criteriae and included to analyze. CONCLUSION: In conclusion by investigating the relationship between MI related hospitalizations and measured SO2 and PM levels in Kocaeli, we found that a 10 μg/m3 increase in SO2 levels, significantly increase the risk of MI in cold season (October-March. [TAF Prev Med Bull 2009; 8(5.000: 381-388
Clemente, F.; Cole, J.; Kloman, E.; McCabe, J.; Sawicki, P.
Each of the six case studies documents public participation in Federal and/or state governmental decisions related to energy facility siting. Four of the cases involved decisions on specific facilities at specific sites, namely: (1) various state and federal licensing procedures for the Seabrook, New Hampshire nuclear facility; (2) the Maine Environmental Improvement Commission's denial of a permit for an oil refinery on Sears Island in Penobscot Bay; (3) the Atomic Energy Commission's amendment to the license for the Big Rock Point, Michigan, nuclear reactor to allow an increased level of plutonium-enriched fuel use; (4) the AEC's review, arising from disclosure of a geological fault, of the North Anna River, Virginia, nuclear facility. A fifth case documents a series of public meetings conducted in Pennsylvania by the Governor's Energy Council to consider the energy park concept. The sixth study was a narrative history and analysis of RM-50-1, a rulemaking proceeding conducted by the AEC in 1972 and 73 on emergency core cooling system operating standards.
Full Text Available Abstract Background Campylobacteriosis is a prominent bacterial gastrointestinal infection worldwide with several transmission pathways. Its non-foodborne routes have been less documented and quantified. The study aimed to quantitatively explore the role of potential risk factors not directly associated with food for sporadic cases of C. jejuni infection in Canada. Methods This retrospective matched case-control study was built on an enhanced campylobacteriosis surveillance system and on a survey of healthy people and their behaviour with regards to potential risk factors for gastrointestinal infections that occurred in the same area in Canada. Eighty-five cases were individually matched by age and season to 170 controls. Results Through conditional logistic regression, risk factors were found only among water-related factors (drinking untreated water, using tap filter, drinking water from well and swimming in natural water, whereas drinking bottled water was protective. Among the 32 non-water related factors explored, 12 were surprisingly ‘protective’ factors without relevant explanation for that effect (for example gardening, attending a barbecue, eating food from a fast-food restaurant, suggesting that human infection by Campylobacter may be more frequently acquired at home than outside the home. Conclusions This study confirms and quantifies the importance of the waterborne transmission of campylobacteriosis. People are encouraged to drink only treated water and to avoid the ingestion of natural water as much as possible while swimming or playing in water. Globally, general hygiene and proper food handling and cooking practices at home should continue to be encouraged.
Full Text Available PurposeTo investigate the relationship between human papillomavirus (HPV infection and prostatitis-related symptoms.Materials and MethodsAll young heterosexual patients with prostatitis-related symptoms attending the same Center from January 2005 to December 2010 were eligible for this case-control study. Sexually active asymptomatic men were considered as the control group. All subjects underwent clinical examination, Meares-Stamey test and DNA-HPV test. Patients with prostatitis-related symptoms and asymptomatic men were compared in terms of HPV prevalence. Moreover, multivariable Cox proportional hazards regression analysis was performed to determine the association between HPV infection and prostatitis-related symptoms.ResultsOverall, 814 out of 2,938 patients (27.7% and 292 out of 1,081 controls (27.0% proved positive to HPV. The HPV genotype distribution was as follows: HR-HPV 478 (43.3%, PHR-HPV 77 (6.9%, LR-HPV 187 (16.9% and PNG-HPV 364 (32.9%. The most common HPV genotypes were: 6, 11, 16, 26, 51, 53 and 81. No difference was found between the two groups in terms of HPV infection (OR 1.03; 95% CI 0.88-1.22; p = 0.66. We noted a statistically significant increase in HPV infection over the period 2005 to 2010 (p < 0.001 in both groups. Moreover, we found a statistically significant increase in HPV 16 frequency from 2005 to 2010 (p = 0.002.ConclusionsThis study highlights that prostatitis-like symptoms are unrelated to HPV infection. Secondary, we highlight the high prevalence of asymptomatic HPV infection among young heterosexual men.
This case study reports on chiropractic care for pregnancy-related heartburn. The purpose of this article is to relate the benefit of chiropractic treatment for one individual, to contrast chiropractic management with the biomedical standard of care for pregnancy-related heartburn, and to point to potential epigenetic implications of the standard of care. A 32-year-old woman who was 24 weeks pregnant presented with persistent heartburn that she was treating with ranitidine (Zantac®) and calcium carbonate (Tums®) daily at the initiation of chiropractic care. Findings of the initial examination were thoracic intersegmental dysfunction and pain upon palpation of the diaphragm, with hypertonicity noted. Therapy localization was positive for reflexes associated with the esophagus and lower esophageal sphincter, suggesting spasms. Emotional components also were identified in association with the symptoms by the use of a mind-body therapy called NeuroEmotional Technique. The patient was treated by adjusting the thoracic spine, manually releasing the diaphragm spasms, and releasing the esophageal spasm with an activator (a small hand-held instrument that creates a percussive force). The patient was symptom-free and did not use medication after the fifth treatment. She was followed throughout the remainder of her pregnancy and was asymptomatic and required no further treatment. A larger study should investigate the effectiveness of chiropractic care for the treatment of pregnancy-related heartburn. Copyright © 2012 Elsevier Inc. All rights reserved.
Dekkiche, Souad; de Vallière, Serge; D'Acremont, Valérie; Genton, Blaise
The number of immunocompromised persons travelling to tropical countries is increasing. The hypothesis is that this population is at increased risk of travel-related health problems but there are few data to support it. The objective was to assess the risk of travel-related health problems in immunocompromised persons when compared with the general population of travellers. A retrospective matched case-control study was performed. Cases were moderately or severely immunocompromised persons travelling to tropical countries and controls were non-immunocompromised persons, matched for demographic and travel characteristics. All participants responded to a phone questionnaire, asking them about any health problem they may have encountered while travelling or during the month following their return. The primary outcome was the incidence of a significant clinical event defined as repatriation, hospitalization during the travel or during the month following the return if due to a travel-related health problem and medical consultations during the trip. One hundred and sixteen moderately or severely immunocompromised cases [HIV infection (15), active cancer (25), splenectomized (20), solid organ transplant recipients (4) and use of systemic immunosuppressive medication (52)] and 116 controls were included. Incidence rates of significant clinical events were higher in immunocompromised travellers (9/116, 7.8%) than in controls (2/116, 1.7%) [OR = 4.8 , 95% CI 1.01-22.70; P = 0.048]. Most cases were related to infectious diseases (5/9, 55.5%), others were pulmonary embolism (2/9, 22%), inflammatory disease and trauma (1/9, 11.1% each). There was no significant difference between the two groups regarding common health problems. Moderately and severely immunocompromised travellers are at increased risk of developing a serious health problem during or after a trip in a tropical country. They should be well informed about the specific risks they are particularly prone to
Ayyappan, Ramalingam; Sankar, Sambandam; Rajkumar, Paramasivan; Balakrishnan, Kalpana
Work-related heat stress assessments, the quantification of thermal loads and their physiological consequences have mostly been performed in non-tropical developed country settings. In many developing countries (many of which are also tropical), limited attempts have been made to create detailed job-exposure profiles for various sectors. We present here a case study from Chennai in southern India that illustrates the prevalence of work-related heat stress in multiple processes of automotive industries and the efficacy of relatively simple controls in reducing prevalence of the risk through longitudinal assessments. We conducted workplace heat stress assessments in automotive and automotive parts manufacturing units according to the protocols recommended by NIOSH, USA. Sites for measurements included indoor locations with process-generated heat exposure, indoor locations without direct process-generated heat exposure and outdoor locations. Nearly 400 measurements of heat stress were made over a four-year period at more than 100 locations within eight units involved with automotive or automotive parts manufacturing in greater Chennai metropolitan area. In addition, cross-sectional measurements were made in select processes of glass manufacturing and textiles to estimate relative prevalence of heat stress. Results indicate that many processes even in organised large-scale industries have yet to control heat stress-related hazards adequately. Upwards of 28% of workers employed in multiple processes were at risk of heat stress-related health impairment in the sectors assessed. Implications of longitudinal baseline data for assessing efficacy of interventions as well as modelling potential future impacts from climate change (through contributions from worker health and productivity impairments consequent to increases in ambient temperature) are described. The study re-emphasises the need for recognising heat stress as an important occupational health risk in both formal
Burney, P; Potts, J; Makowska, J
BACKGROUND: There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. METHODS: The GA(2)LEN network has organized a multicentre case-control study...... in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12......-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally...
Suzuki, Naoko; Yagishita, Kazuyosi; Togawa, Seiichiro; Okazaki, Fumihiro; Shibayama, Masaharu; Yamamoto, Kazuo; Mano, Yoshihiro
Factors contributing to the pathogenesis of decompression sickness (DCS) in divers have been described in many studies. However, relative importance of these factors has not been reported. In this case-control study, we compared the diving profiles of divers experiencing DCS with those of a control group. The DCS group comprised 35 recreational scuba divers who were diagnosed by physicians as having DCS. The control group consisted of 324 apparently healthy recreational divers. All divers conducted their dives from 2009 to 2011. The questionnaire consisted of 33 items about an individual's diving profile, physical condition and activities before, during and just after the dive. To simplify dive parameters, the dive site was limited to Izu Osezaki. Odds ratios and multiple logistic regression were used for the analysis. Odds ratios revealed several items as dive and health factors associated with DCS. The major items were as follows: shortness of breath after heavy exercise during the dive (OR = 12.12), dehydration (OR = 10.63), and maximum dive depth > 30 msw (OR = 7.18). Results of logistic regression were similar to those by odds ratio analysis. We assessed the relative weights of the surveyed dive and health factors associated with DCS. Because results of several factors conflict with previous studies, future studies are needed.
Costa-Black, Kátia M; Durand, Marie-José; Imbeau, Daniel; Baril, Raymond; Loisel, Patrick
From both a social and cost-benefit perspective, disability prevention and associated management strategies for assisting employees with back pain are only successful if they address critical return-to-work (RTW) determining factors present in the workplace, including ergonomic factors. Despite our current knowledge of the importance of an integrated team approach targeting these factors, questions remain regarding the conceptual framework adopted by contemporary rehabilitation teams as it relates to work-oriented interventions to accommodate employees back to work. The purpose of this study was to explore and describe the work environment issues discussed by an interdisciplinary team engaged in the work rehabilitation process of low back disability cases. A qualitative content analysis was conducted for 10 sample cases that underwent a rehabilitation program in Quebec (Canada). Drawing on the results of these analyses, a framework representing a synopsis of practitioners' involvement in the person-environment dynamic is presented and discussed. This study makes a unique contribution to the understanding of the 'real-life' content of an interdisciplinary activity in disability management, thus, helping rehabilitation practitioners to build knowledge on the practical application of a cross-disciplinary framework to address work environment issues during the RTW process of those patients sick-listed due to back pain.
Kim, Il-Ho; Muntaner, Carles; Chung, Haejoo; Benach, Joan
The authors selected nine case studies, one country from each cluster of their labor market inequalities typology, to outline the macro-political and economic roots of employment relations and their impacts on health. These countries illustrate variations in labor markets and health, categorized into a global empirical typology. The case studies illustrated that workers' health is significantly connected with labor market characteristics and the welfare system. For a core country, the labor market is characterized by a formal sector. The labor institutions of Sweden traditionally have high union density and collective bargaining coverage and a universal health care system, which correlate closely with positive health, in comparison with Spain and the United States. For a semi-periphery country, the labor market is delineated by a growing informal economy. Although South Korea, Venezuela, and El Salvador provide some social welfare benefits, a high proportion of irregular and informal workers are excluded from these benefits and experience hazardous working conditions that adversely affect their health. Lastly, several countries in the global periphery--China, Nigeria, and Haiti--represent informal work and severe labor market insecurity. In the absence of labor market regulations, the majority of their workers toil in the informal sector in unsafe conditions with inadequate health care.
Full Text Available ERP systems integrate a major part of all business processes and organizations include them in their IT service management. Besides these formal systems, there are additional systems that are rather stand-alone and not included in the IT management tasks. These so-called ‘shadow systems’ also support business processes but hinder a high enterprise integration. Shadow systems appear during their explicit detection or during software maintenance projects such as enhancements or release changes of enterprise systems. Organizations then have to decide if and to what extent they integrate the identified shadow systems into their ERP systems. For this decision, organizations have to compare the capabilities of each identified shadow system with their ERP systems. Based on multiple-case studies, we provide a dependency approach to enable their comparison. We derive categories for different stages of the dependency and base insights into integration possibilities on these stages. Our results show that 64% of the shadow systems in our case studies are related to ERP systems. This means that they share parts or all of their data and/or functionality with the ERP system. Our research contributes to the field of integration as well as to the discussion about shadow systems.
Wejdmark, A-K; Bonnett, B; Hedhammar, A; Fall, T
This study aims to investigate lifestyle risk factors for the development of progesterone-related diabetes mellitus in female elkhounds. Owners of 48 diabetic elkhounds and 58 healthy elkhounds were interviewed by phone concerning lifetime diet and exercise routines. A logistic model was developed to assess the impact of diet and exercise on diabetes diagnosis. The agreement between lifetime owner-perceived body condition score (BCS) and veterinary-perceived BCS at inclusion was estimated in healthy control dogs using the Kappa statistic. The model showed that diabetic dogs had increased odds for having been overweight (before diagnosis) compared with controls (OR=2·8, 95% confidence interval 1·1-7·5, P=0·034). Although feeding other food than commercial dog feed was associated with diabetes case status, the effect was not significant after BCS was entered into the model. The overall agreement between lifetime owner- and veterinary-perceived BCS at inclusion in the study was 75% and had a Kappa statistic of 0·16 (P=0·12). This study indicates that a high owner-perceived lifetime BCS is associated with progesterone-related diabetes in elkhounds. © 2011 British Small Animal Veterinary Association.
The ad hoc management of natural environmental features and inappropriate social interventions could cause vulnerability of thriving urban ecosystems. For instance sub-aerial exposure, water-related hazards, urban intrinsic sensitivity, urban adaptation ability or flexibility and urban transformability factors could contribute a potential danger. In spite of seasonal climatic changes, the exposure indicates a significant geographical determinism whereas the other factors express its antithesis. The present paper aims to adapt a vulnerability-resilience indicators' multicriteria analysis to show the variability and contribution rate with regard to local water-related risks. The municipality of al-Harrash from Algiers has been selected as a case study. The urban vulnerability-resilience closely tied up with a sum of relevant indicators confirmed by the diagnosis items, which are relevant to the local urban and hydro systems. The cumulative sums are obtained from a classification process referring to several criteria implied in the water-related risks. These were formulated here for the purpose of a multicriteria analysis with the objective of assessing the urban vulnerability-resilience index and subsequently orientating the preventive strategy towards different levels of sustainable measures. With this respect the exposure and sensitivity received a significant score while adaptation ability and transformability scored very low.
Edwards, Kasper; Lundstrøm, Sanne Lykke
This study presents results from an original empirical study of 11 organizational change projects in different wards at two Danish hospitals. The purpose of the study was to study was to study changes in relation coordination as a consequence of organizational change. We measured relational...
Ketkar, Nikhil S; Holder, Lawrence B; Cook, Diane J
The goal of this paper is to generate insights about the differences between graph-based and logic-based approaches to multi-relational data mining by performing a case study of the graph-based system...
Edwards, Kasper; Lundstrøm, Sanne Lykke
This study presents results from an original empirical study of 11 organizational change projects in different wards at two Danish hospitals. The purpose of the study was to study was to study changes in relation coordination as a consequence of organizational change. We measured relational...... coordination before and after the organizational change using the 7 question relational coordination questionnaire. A group of employees were interviewed after the change project to uncover the nature and extent of the changes. We find that organizations’ relational coordination score change very little – even...... for organizational change that introduces new work relations and new processes....
Dale Carolyn Mackrell
Full Text Available This qualitative case study explored farm management practices by women cotton growers who used computer-based information systems, most particularly the agricultural farm management software, CottonLOGIC, within the Australian cotton industry. This study found that, although gender differences and inequalities persist in rural parts of the region, the agency of women cotton growers ensures not only a sustainable future for themselves and their families, but also for the broader cotton industry as a whole. The use of farm management software by women cotton farmers was informed by Connell’s theoretical framework of gender relations (2002. The findings suggested that, women’s active participation in family farm partnerships and their acquisition of technological skills through the use of farm management software like CottonLOGIC, meant that all cotton growers benefit through the feminizing of specific farm management practices in family farm enterprises. This, therefore, has significant implications for developing the cotton industry into a truly sustainable entity.
Jeffrey A. Bennett
Full Text Available Prader-Willi syndrome (PWS, a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2, the Social Communication Questionnaire (SCQ, Social Responsiveness Scale-2 (SRS-2, Social Skills Improvement System-Rating Scales (SSIS-RS, and the Vineland Adaptive Behavioral Scales-II (VABS-II. General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL and eight uniparental disomy (UPD (with a total of 6 female UPD cases. Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS and observational assessment (ADOS-2 was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
Bennett, Jeffrey A; Hodgetts, Sandra; Mackenzie, Michelle L; Haqq, Andrea M; Zwaigenbaum, Lonnie
Prader-Willi syndrome (PWS), a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD) symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2), the Social Communication Questionnaire (SCQ), Social Responsiveness Scale-2 (SRS-2), Social Skills Improvement System-Rating Scales (SSIS-RS), and the Vineland Adaptive Behavioral Scales-II (VABS-II). General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE) diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL) and eight uniparental disomy (UPD) (with a total of 6 female UPD cases). Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS) and observational assessment (ADOS-2) was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
Relational features of the educational environment, such as positive teacher-student relationships, are important for students' academic success. This case study explores the relational practices of a teacher who negotiates educational relationships with students who have a history of school failure. "Gunilla", a secondary school teacher…
Hamid Zamani Moghadam
Full Text Available Introduction: Since most studies on ankle sprain are medical and sports-related and not much epidemiologic and etiologic data from the general population exist in this field, the present study evaluates the relationship between Q angle and anthropometric measures with ankle sprain in the general population.Methods: In the present case-control study, all of the patients over 18 years age presenting to emergency departments (ED of two educational Hospitals, complaining from ankle sprain, were evaluated during more than 1 year. A checklist consisting of demographic data, height, weight, body mass index (BMI, and history of ankle sprain, as well as degree of Q angle was filled for all participants. The correlation of mentioned variables with incidence of ankle sprain was calculated using SPSS 22.Results: 300 patients with ankle sprain were evaluated (53.5% male. Mean age of the patients was 37.03 ± 14.20 years. Mean weight, height, and BMI were 71.71 ± 11.26 (43 – 114, 168.74 ± 8.63 (143 – 190 and 25.14 ± 3.19 (18.41 – 38.95, respectively. Mean Q angle of the patients was 12.78 ± 3.19 degrees (5 – 23. There was a significant correlation between weight (p < 0.001, BMI (p = 0.001, history of sprain (r: 0.26, p < 0.001 and Q angle (p = 0.002 with incidence of ankle sprain. In addition, there was a significant statistical correlation between weight (p = 0.031, BMI (p = 0.020 and Q angle (p = 0.004 with history of ankle sprain. In patients with a history of ankle sprain, Q angle was wider by about 2 degrees.Conclusion: It seems that the prevalence of ankle sprain directly correlates with high weight, BMI, and Q angle and is more prevalent in those with a history of sprain. Although the findings of the present study show a statistically significant correlation between these factors and ankle sprain, the correlation is not clinically significant.
Full Text Available Research Question: To Study the risk factors of Breast cancer , Setting:All the newly registered cases of Breast cancer in one year from Ist May 2004. Study Design:A Hospital based case control study. Methodology:Data was collected by a face to face interview using the prestructured Questionnaire after taking informed consent. Results: 100 cases of Breast Cancer and 100 controls were analyzed. Mean age of breast cancer cases was 50.20 ± 12.49 years. Income (p >0.39, Educational Status (p>0.35 Age at Marriage (p>0.36 Age at First pregnancy (p>0.32 Total No of live Birth (p>0.09 Duration of Breast Feeding (P>0.07 Showed no statistically significant relationship to the risk of Breast Cancer. Dietary History (p<0.001 Smoking History (p<0.04 Physical Activity (p<0.001 Age at Menarche (p<0.002 History of Breast Feeding (p<0.04 History of Abortion (p<0.003 were shown to be Statistically Significant to the risk of Breast Cancer . Conclusion : The risk factor which are often implicated in the risk of Breast Cancer may not hold true in our settings.
Perotti, Luigi; Tankari Dan-Badjo, Abdourahamane; De Luca, Domenico Antonio; Antonella Dino, Giovanna; Lasagna, Manuela; Spadafora, Francesco; Yadji, Guero; Konaté, Moussa
The present contribution is about a preliminary study of the evolution of Niamey city (Niger) during last decades. Such research is part of an UNICOO project (funded by the University of Turin) and connected to the Edulink Cooperation Project (R.U.S.S.A.D.E.), a multidisciplinary project between Italy, Niger, Burkina Faso and Tchad funded on ACP- EU cooperation program in Higher Education. Recent advances in remote sensing, both in satellite hardware technology (i.e. image availability) and image processing algorithm development, provide opportunities for collection and analysis of multitemporal information on urban form and size that can be useful for policy and planning. In spite of these developments, there are also limitations to remote sensing and its application in practice. Some opportunities for, and limitations on, monitoring urban growth using remote sensing data are shown in the present contribution; moreover examples of environmental impacts of urban growth, as monitored with remote sensing, are provided. Niamey is the capital of Niger and is the first city in the country in size and economic importance. Its population increased gradually, from about 3,000 units in 1930 to about 30,000 in 1960, rising to 250,000 in 1980 and, according to estimates, to 800,000 units in 2000. Its patterns of population distribution, livelihoods, and its dominant role within the national economy of Niger make it a good representative case study for West Africa. This case study will consider the recent historical context of continued urban growth and will assess potential future impacts of settlement patterns. The rapid growth of Niamey in the last decades brought relative prosperity but it certainly affected patterns of land use within the city and the emerging urban system. After a preliminary sketch of the georesources in the city (qualitative and quantitative characterization of the surface water and groundwater, and of aggregates), an analyses of the urban growth and
Byrne, Jamie M.
This paper examines a study of the wastewater collection and treatment issues of Little Rock and North Little Rock, Arkansas by University of Arkansas at Little Rock personnel and how it constitutes dialogic public relations. The paper defines dialogic public relations using Kent and Taylor's work and then uses their criteria to describe how this…
An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.
International relations and disaster studies have much to gain by thinking critically about their respective theoretical and epistemological assumptions. Yet, few studies to date have sought to assess the potential value of linking these two disciplines. This paper begins to address this shortfall by examining the relationship between disasters and conflict as a research sphere that intersects international relations and disaster studies. Through an analysis of whether or not disasters contribute to intra-national and international conflict, this paper not only provides a review of the state of the art, but also serves to invite scholars to reflect on related concepts from other fields to strengthen their own approaches to the study of disasters in an international setting. An evaluation of the conceptual and theoretical contributions of each subject area provides useful heuristics for the development of disaster-conflict scholarship and encourages alternative modes of knowledge production through interdisciplinarity. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.
Godø, Helge; Nerdrum, Lars; Rapmund, Antje; Nygaard, Stian
This report presents the results of an analysis undertaken by NIFU on innovations in fuel cells and related hydrogen technology in Norway. This country study is part of a larger effort jointly organized by the OECD’s Working Group on Technology and Innovation Policy (TIP) and IEA’s Committee on Energy Research and Technology. Organized as a Focus Group, a number of national case studies have been made on different energy technologies and energy sources, fuel cells and related hydrogen technol...
Facheris, Maurizio F; Schneider, Nicole K; Lesnick, Timothy G; de Andrade, Mariza; Cunningham, Julie M; Rocca, Walter A; Maraganore, Demetrius M
An inverse association between coffee and Parkinson's disease (PD) has been reported. However, it remains uncertain why some but not all coffee drinkers are less susceptible to PD. We considered the possibility of a pharmacogenetic effect. In our study, we included 1,208 subjects (446 case-unaffected sibling pairs and 158 case-unrelated control pairs) recruited from an ongoing study of the molecular epidemiology of PD in the Upper Midwest (USA). We collected information on lifetime coffee drinking and we studied two genes: ADORA2A, which encodes the major receptor activity of caffeine in the brain (variants rs5751876 and rs3032740), and CYP1A2, which encodes the major rate-limiting step of caffeine metabolism (variants rs35694136 and rs762551). We did not observe significant associations of coffee drinking or of the genetic variants with PD susceptibility, either independently or jointly, in the sample overall and in most strata. Our study neither supports the hypothesis that coffee protects against PD nor provides evidence for a pharmacogenetic effect. (c) 2008 Movement Disorder Society.
Full Text Available Objectives: To establish the risk factors associatedwith infectious complications after vaginalor abdominal planned hysterectomy. Methodology:Study of cases and controls Place:Gynaecology Department and Septic Unit,Clinica San Pedro Claver, Bogotá, Colombia.SAMPLE: 565 patients (115 cases and 450 controlswho had planned hysterectomy for anybenign or pre-malign cause. The cases weredefined as patients who enter the septic service with diagnosis of any septic condition. Results:Among the analysed risk factors that werestatistically meaningful are the diagnosis ofdiabetes mellitus (OR 6.01 CI: 2.03-18.15,more than 3 deliveries (OR1.73 CI: 1.10-2.73,IUT use(OR3.94 CI: 2.42-6.43, vaginaldischarge (OR 5.13 CI: 3.16-8.33 or presenceof swelling previous to the surgery (OR 3.76IC: 2.37-5.97, and use of prophylactic anticoagulation(OR 3.37 CI: 2.15-5.28 Conclusion:The presence of vaginal discharge and swellingin vaginal cytology are the important predictorsof infectious morbidity that can be correctedprior to the surgery.
HIV infection has several oral manifestations, including oral candidiasis and oral hairy leucoplakia. Occasionally unusual presentations requiring rigorous investigations are seen, and in these cases the diagnosis sometimes remains a dilemma owing to limited investigation facilities.1-3 We present the case of a patient who.
Atos Prinz Falkenbach
Full Text Available This article is the result of an investigative process using Down’s syndrome children gathered with “normal” children in relational psychomotricity sessions. It aimed at studying the relationship among the protagonist children of the study with the other children, the teachers and the objects, as well as investigating their behavioral effects during regular relational psychomotricity sessions. It was a qualitative study that used different instruments for data collecting, such as: interviews, observations, descriptive memories, and the documents analysis. The analysis and interpretation of the results allowed the development of the following variables: a manifestations of Down’s syndrome and behaviors presented by the protagonist children of the study; b imitation and rhythm of the group as a stimulus for the development of the mental processes; c the pedagogical action as a mediator of children relationship. The study showed that the pedagogical intervention into the relational psychomotricity practice in an eclectic group allowed the extension of the social and affectionate relations of these children, as well as diversified and enriched their playing and exercising behavior.
Libia Patricia Peralta Agudelo
This work focuses on identifying deforestation patterns and relating these to social processes in an extractive reserve of Acre (western Amazonia). Using multitemporal satellite imagery deforestation is observed as a series of distinctive patches against the background of forest cover. The study of patterns emphasizes the important relationships existing between...
Sahin, Zulal; Aydogan Yenmez, Arzu; Erbas, Ayhan Kursat
The purpose of this study was to investigate three second-year graduate students' awareness and understanding of the relationships among the "big ideas" that underlie the concept of derivative through modeling tasks and Skemp's distinction between relational and instrumental understanding. The modeling tasks consisting of warm-up,…
Flores, Byron J; Pérez-Sánchez, Tania; Fuertes, Héctor; Sheleby-Elías, Jessica; Múzquiz, José Luis; Jirón, William; Duttmann, Christianne; Halaihel, Nabil
Leptospirosis is one of the most extended zoonosis worldwide and humans become infected most commonly through contact with the urine of carrier animals, either directly or via contaminated water or soil. The aim in this study was to analyse the epidemiological behaviour of Leptospira spp., from domestic animals around the sites of human leptospirosis cases in Nicaragua, from 2007 through 2013. We report the results of a cross-sectional epidemiological study with a non-probability sampling of blood (n=3050) and urine (n=299) from Domestic Animals (DA) around the sites of human leptospirosis cases in Nicaragua. We analysed data obtained through Microscopic Agglutination Test (MAT), in-vitro culture, real time PCR and sequencing of lfb1 locus. Frequencies of 30.31% (95% CI: 28.66-31.95) and 15.38% (95% CI: 11.12-19.64) were obtained from serological test and from in-vitro culture, respectively. Although similar frequencies from serology test (P≥0.05) were found in DA species, in-vitro culture frequencies were significantly higher from bovine, equine and sheep (P<0.05) in comparison with swine and canine species. Ten serogroups of pathogenic Leptospira spp. were encountered, with the highest presence of Icterohaemorrhagiae serogroup 34.65% (95% CI: 29.35-39.94). We identified 7 samples homologous to L. interrogans species Pyrogenes serovar and 3 samples as L. noguchii Louisiana or Panama serovars by analysis of lfb1 sequences. We were able to establish a temporal and spatial correlation from DA and cumulative incidence of human cases. Therefore an effective epidemiological surveillance should be implemented with a specific control program toward DA in order to reduce human leptospirosis incidence. Copyright © 2017 Elsevier B.V. All rights reserved.
To investigate possible risk factors for age-related nuclear and cortical cataracts in participants in the Age-Related Eye Disease Study (AREDS). Case-control study. Of the 4757 persons enrolled in AREDS, 4477 age 60 to 80 years are included in the study. Slit-lamp lens photographs were used to classify participants into one of three nuclear opacity groups (moderate nuclear, mild nuclear, and controls), ignoring cortical opacities. Retroillumination lens photographs were used to classify participants into one of three cortical opacity groups (moderate cortical, mild cortical, and controls), ignoring nuclear opacities. Persons with moderate nuclear opacities were more likely to be female, nonwhite, and smokers and to have large drusen. Moderate nuclear opacities were less common in persons with higher educational status, a history of diabetes, and among those taking nonsteroidal antiinflammatory drugs. Moderate cortical opacities were associated with dark iris color, large drusen, weight change, and, at a borderline level of significance, higher levels of sunlight exposure and use of thyroid hormones. Moderate cortical opacities were less common in persons with higher educational status. Consistent findings have now been reported across many studies for gender, educational status, sunlight exposure, and smoking. Our findings that use of nonsteroidal antiinflammatory drugs is inversely associated with nuclear cataract and that dark iris color and use of thyroid hormones may increase cortical cataract risk are less well substantiated and require further investigation.
Grievink, L.; Smit, H.A.; Veer, van 't P.; Brunekreef, B.; Kromhout, D.
The aim of this study was to investigate the relations between plasma levels of antioxidants, [beta]-carotene and [alpha]-tocopherol, and chronic respiratory symptoms in Dutch adults who never smoked or were long-term former smokers. Cases (who reported one or more respiratory symptoms) and controls
Full Text Available This article provides four responses from senior psychotherapists and supervisors to Erskine’s articleRelational Healing of Early Affect-Confusion. The authors approach the third part of case study trilogy from their particular perspective and provide both challenge and respect for the author’s work.
Niknam, Mahdieh; Saadatnia, Mohammad; Shakeri, Forough; Keshteli, Ammar Hassanzadeh; Saneei, Parvane; Esmaillzadeh, Ahmad
Despite the growing body of evidence from Western societies on the association between dietary patterns and stroke, limited data are available in this regard from developing countries. This study was conducted to examine the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and risk of stroke among the Iranian population. This hospital-based case-control study included 194 stroke patients and 194 controls and was conducted at the Alzahra University Hospital, Isfahan, Iran. The cases were stroke patients who were hospitalized in the neurology ward of the Alzahra University Hospital. Controls were randomly selected from among hospitalized patients in the orthopedic or surgical wards of this center. A validated food frequency questionnaire (FFQ) was used to assess the patients' usual dietary intake. We constructed the DASH diet score based on food and nutrients emphasized or minimized in the DASH diet. The prevalence of stroke among those in the top quartile of the DASH diet score was 40%, which was 15% lower than among those in the bottom quartile; this difference was marginally significant (p = 0.10). After controlling for age, sex, and total energy intake, adherence to the DASH diet was inversely associated with the risk of stroke (OR: 0.52; 95% CI: 0.28; 0.98). These associations remained significant even after additionally controlling for physical activity, smoking, hypertension, and diabetes, such that individuals in the highest quartile of the DASH diet score had a 58% lower risk of stroke than those in the lowest category (OR: 0.48; 95% CI: 0.24, 0.96). However, after further adjustment for body mass index (BMI), the association disappeared (OR: 0.62; 95% CI: 0.29, 1.31), indicating an obesity-dependent association. We found an inverse relationship between the DASH-style diet and prevalence of stroke. Prospective studies are needed to confirm this association.
Malmir, Hanieh; Shayanfar, Mehdi; Mohammad-Shirazi, Minoo; Tabibi, Hadi; Sharifi, Giuve; Esmaillzadeh, Ahmad
Data on the link between tea and coffee consumption and risk of glioma are controversial. We aimed to examine the association between tea and coffee consumption and glioma in Iranian adults. In this hospital-based case-control study, we enrolled 128 pathologically confirmed new cases of glioma and 256 age- and sex-matched controls. Dietary intakes of study participants including tea and coffee consumption was assessed using the validated Block-format 123-item semi-quantitative FFQ. Participants were categorized based on tertiles of tea and coffee consumption. Data on potential confounders were also collected through the use of pre-tested questionnaire. Individuals with the greatest tea consumption were less likely to have glioma compared with those with the lowest consumption (0.36; 0.20-0.68). This inverse association was not changed after controlling for energy intake. The association remained statistically significant even after taking other potential confounders, including dietary intakes of red and processed meats, legumes and nuts, fruits, salt and mutual effects of tea and coffee consumption, into account (0.33; 0.13-0.86). Additional adjustments for BMI did not alter the association. After controlling for potential confounders, including dietary intakes and BMI, coffee consumption was inversely associated with odds of glioma; such that individuals in the top category of coffee consumption were 91% less likely to have glioma compared with those in the bottom category (0.09; 0.03-0.24). Considering coffee and tea intake combined, those in the highest tertile were 65% less likely to have glioma compared with those in the lowest tertile (0.35; 0.15-0.83). We found an inverse association between tea and coffee consumption and odds of glioma, even after controlling for a wide range of confounders.
Full Text Available It was recently shown that calcification of the hippocampus can be detected on computed tomography (CT images and these calcifications occur in up to 20% of people over 50 years of age. However, little is known about hippocampal calcification and its relation to cognition and cognitive decline. Therefore, the aim of this study was to (1 determine the prevalence of hippocampal calcification on CT in memory clinic patients controls, and (2 to assess its relation with cognitive decline.67 patients from a memory clinic (cases were matched by age and gender to a control group. In both groups, hippocampal calcification was assessed by two raters on thin slice, non-contrast enhanced brain CT images. Calcifications were scored bilaterally on presence and severity (absent, mild, moderate, severe. Mini Mental State Exam (MMSE score was determined in cases.Hippocampal calcification presence was significantly higher in cases (N = 26, 38.8% compared to controls (N = 9, 13.4% (P < .01 with an odds ratio of 4.40 (95%CI: 1.63-14.87. In cases, MMSE score was significantly lower in those with hippocampal calcification compared to those without (21.6 vs 24.5, p = .02.In this case-control study we found significantly more hippocampal calcification in patients with cognitive decline as compared to controls. Furthermore, within the cases, MMSE score was significantly lower in those with hippocampal calcification.
vascular disease necessitating bilateral amputations at the knee. The patient had no ... patients on long-term treatment and those on protease inhibitor (PI) regimens.1,2 We present a rare case of atypical lipodystrophy, presenting as multiple subcutaneous lipomas, in a patient who had been on a non-PI. ARV regimen for 6 ...
Point mutations in the human fibroblast growth factor receptor 3 (FGFR3) gene are well documented in inherited skeletal anomalies, such as achondroplasia and thanatophoric dysplasia, that are associated in most cases of dwarfism.10 In addition, an oncogenic role has been proposed for mutant FGFR.11 Recently,.
Lecouffe-Desprets, M; Néel, A; Graveleau, J; Leux, C; Perrin, F; Visomblain, B; Artifoni, M; Masseau, A; Connault, J; Pottier, P; Agard, C; Hamidou, M
The risk of venous thromboembolism (VTE) during warm autoimmune hemolytic anemia (wAIHA) is apparent in several published series. Unlike proximate disorders (autoimmune thrombocytopenia, non-immune hemolytic diseases) little is known about the presentation and risk factors for VTE in this setting. To determine the frequency, presentation and risk factors for VTE associated with wAIHA. We performed a single center retrospective study of adult patients (>18years) followed for wAIHA between 2009 and 2013. VTE risk factors were systematically assessed. The characteristics of patients with or without VTE were compared. VTE presentation and precipitating factors were analyzed. The Padua VTE risk score was calculated in each case. Forty patients were included. wAIHA was idiopathic in 24 patients (60%). Twelve patients (30%) had Evans syndrome. Mean lowest hemoglobin level was 6.6g/dl [3.7-11.5]. Eight patients (20%) presented VTE after the appearance of wAIHA, at a mean age of 52.5years. All patients had pulmonary embolus, associated with a deep venous thrombosis in 4 cases. At the time of VTE 7/8 patients had frank hemolysis (median hemoglobin level: 7g/dL) and 6/8 were outpatients with a low Padua VTE risk score. The frequency of usual VTE risk factor was similar in cases and controls. By contrast, lowest hemoglobin level was significantly lower in patients that experienced VTE (5.3 vs 7.2g/dL, p=0.016). During the first episode of wAIHA, patients with concurrent VTE had a more pronounced anemia (5.3 vs 7.4g/dL, p=0.026). At the time of VTE, anemia was more severe when no other precipitating factor was present (6 vs 8.9g.dL, p=0.04). In our cohort, 20% of patients with wAIHA presented VTE. The vast majority of VTE occurred during severe hemolytic flares and were not attributable to usual VTE risk factors. VTE prophylaxis is advisable in any patient admitted for wAIHA, irrespective of Padua VTE risk score. Prophylaxis also seems reasonable for outpatients with marked
Bandara, Nilanthi J G J; Hettiaratchi, J Patrick A; Wirasinghe, S C; Pilapiiya, Sumith
To develop an effective waste management strategy for a given region, it is important to know the amount of waste generated and the composition of the waste stream. Past research has shown that the amount of waste generated is proportional to the population and the average mean living standards or the average income of the people. In addition, other factors may affect the amount and composition of waste. These are climate, living habits, level of education, religious and cultural beliefs, and social and public attitudes. This paper presents the findings of a study carried out in a suburban municipal area in Sri Lanka to determine the solid waste generation rate and waste composition based on field surveys and to determine the related socio-economic factors. A database was developed that included information on the quantity and composition of waste generated in a sample of households in the study area over a time period. The collected data was analysed to relate waste generation and composition data to various socio-economic factors. Over 400 sample households were selected for the study using a stratified random sampling methodology based on municipal wards and property values. A technique that considers both the number of households in a particular income group (property value range) and the standard deviation of property values within a given income group was used to determine the appropriate sample size for each municipal ward. Through category and regression analyses, the quantities of waste and waste composition were related to several socio-economic factors. The paper describes the basis for the sample selection, the methodology adopted for data collection, the socio-economic parameters used for the analysis, and the relationships developed from the analysis.
Rasul, I.; Bassi, V.
We study the persuasive impacts of non-informative communication on the short-run beliefs and long-run behavior of individuals. We do so in the context of the Papal visit to Brazil in October 1991, in which persuasive messages related to fertility were salient in Papal speeches during the visit. We use individual’s exposure to such messages to measure how persuasion shifts: (i) short-run beliefs such as intentions to contracept; (ii) long-term fertility outcomes, such as the timing and total ...
Hammond, Lorie A.
Researchers and policymakers agree that schools and parents must work together if they are to provide the sustenance, services, and support which children need to be successful in our increasingly complex society. (Clark, 1983; Comer, 1980, 1996; Clinton, 1995; Epstein, 1995, 1996). Unfortunately, the social and academic success of language minority students is often adversely affected by the alienation of parents from school culture and by the "deficit" view which teachers hold of language minority parents' academic and parenting skills (Boggs, 1985; Delgado-Gaitan, 1990; Heath, 1983; Lareau, 1987, 1989; Philips, 1983). This case study describes the attempts of one school site to build academic and social bridges between immigrant families from a Southeast Asian Hill Tribe, the Iu Mien, and a mainstream elementary school. This effort is facilitated by a constructivist approach to curriculum in which parents, teachers, and children create an intercultural space---a school community garden---as a context in which academic dialogue can occur. Various strategies which enable inter-cultural learning are described, including the use of students as ethnographers, of parents as expert teachers, and of teachers as cultural brokers. The study also considers the cultural conflicts and understandings which occurred when American teachers and Mien parents built a Mien field-house together: a structure which became symbolic of their blended lives. Through both a descriptive narration and interviews with various participants, the study analyzes (a) community-based curriculum development, led by practitioner reformers, as a way to enable language minority students to be academically successful within their own life worlds, as well as (b) the political and bureaucratic forces which make community-based reforms difficult to sustain. This study employs qualitative research strategies within an action-research context in which the author plays the dual role of practitioner reformer
Afshari, Laleh; Amani, Reza; Soltani, Farhad; Haghighizadeh, Mohammad Hossein; Afsharmanesh, Mohammad Reza
Background: Stroke is the second cause of death among elderly people. Oxidative stress plays an important role in brain damage after stroke. Currently, Vitamin D has been shown as an antioxidant. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between them in ischemic stroke patients. Materials and Methods: This case?control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fru...
Herreid, Clyde Freeman
This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.
Suzanne C Cannegieter
Full Text Available BACKGROUND: Recent studies have indicated an increased risk of venous thrombosis after air travel. Nevertheless, questions on the magnitude of risk, the underlying mechanism, and modifying factors remain unanswered. METHODS AND FINDINGS: We studied the effect of various modes and duration of travel on the risk of venous thrombosis in a large ongoing case-control study on risk factors for venous thrombosis in an unselected population (MEGA study. We also assessed the combined effect of travel and prothrombotic mutations, body mass index, height, and oral contraceptive use. Since March 1999, consecutive patients younger than 70 y with a first venous thrombosis have been invited to participate in the study, with their partners serving as matched control individuals. Information has been collected on acquired and genetic risk factors for venous thrombosis. Of 1,906 patients, 233 had traveled for more than 4 h in the 8 wk preceding the event. Traveling in general was found to increase the risk of venous thrombosis 2-fold (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.5-3.0. The risk of flying was similar to the risks of traveling by car, bus, or train. The risk was highest in the first week after traveling. Travel by car, bus, or train led to a high relative risk of thrombosis in individuals with factor V Leiden (OR 8.1; 95% CI 2.7-24.7, in those who had a body mass index of more than 30 kg/m(2 (OR 9.9; 95% CI 3.6-27.6, in those who were more than 1.90 m tall (OR 4.7; 95% CI 1.4-15.4, and in those who used oral contraceptives (estimated OR > 20. For air travel these synergistic findings were more apparent, while people shorter than 1.60 m had an increased risk of thrombosis after air travel (OR 4.9; 95% CI 0.9-25.6 as well. CONCLUSIONS: The risk of venous thrombosis after travel is moderately increased for all modes of travel. Subgroups exist in which the risk is highly increased.
Kushwah, Shivpal Singh
Full Text Available Purpose. The purpose of this paper is to analyze and evaluate discovery layer search tools for retrieval of legal information in Indian law libraries. This paper covers current practices in legal information retrieval with special reference to Indian academic law libraries, and analyses its importance in the domain of law.Design/Methodology/Approach. A web survey and observational study method are used to collect the data. Data related to the discovery tools were collected using email and further discussion held with the discovery layer/ tool /product developers and their representatives.Findings. Results show that most of the Indian law libraries are subscribing to bundles of legal information resources such as Hein Online, JSTOR, LexisNexis Academic, Manupatra, Westlaw India, SCC web, AIR Online (CDROM, and so on. International legal and academic resources are compatible with discovery tools because they support various standards related to online publishing and dissemination such as OAI/PMH, Open URL, MARC21, and Z39.50, but Indian legal resources such as Manupatra, Air, and SCC are not compatible with the discovery layers. The central index is one of the important components in a discovery search interface, and discovery layer services/tools could be useful for Indian law libraries also if they can include multiple legal and academic resources in their central index. But present practices and observations reveal that discovery layers are not providing facility to cover legal information resources. Therefore, in the present form, discovery tools are not very useful; they are an incomplete and half solution for Indian libraries because all available Indian legal resources available in the law libraries are not covered.Originality/Value. Very limited research or published literature is available in the area of discovery layers and their compatibility with legal information resources.
Full Text Available This paper examines how the temporal relation between a clause containing the experiential guo and an adjacent clause is determined. Mandarin is a language not morphologically marked for tenses (e.g., Lin 2006, and therefore, tenses cannot help in determining temporal relations in Mandarin. However, Mandarin has a rich aspectual system. This paper argues that the experiential guo indirectly influences temporal relations via rhetorical relations by either specifying a default rhetorical relation, or by constraining the circumstances under which a certain rhetorical relation can connect a clause with guo to an adjacent clause. This paper also argues that the default rhetorical relation and the constraints are determined by the aspectual properties of the experiential marker. Other information, such as discourse connectors, lexical information, etc., can override the default rhetorical relation indicated by guo and specifies a rhetorical relation. Therefore, this paper concludes that in Mandarin aspect markers can indirectly affect temporal relations by means of rhetorical relations, a result consistent with Wu’s (2005b paper on the perfective marker le in Mandarin, and Wu’s (2007b, 2004 work on the progressive marker zai and the durative marker zhe.
Shenker, Moshe; Harush, Daniella; Ben-Ari, Julius; Chefetz, Benny
Reclaimed wastewater is an important source of irrigation in semiarid and arid zones. Here we report data on carbamazepine (CBZ) uptake by cucumber plants in hydroponic culture and greenhouse experiments using different soil types irrigated with fresh water or reclaimed wastewater. Data obtained from the hydroponic culture experiments suggest that CBZ is mainly translocated by water mass flow, and thus it is concentrated and accumulated to the largest extent in the mature/older leaves. Carbamazepine concentration in cucumber fruits and leaves was negatively correlated with soil organic matter content. The concentrations of CBZ in the roots and stems were relatively low, and most CBZ in the plant (76-84% of total uptake) was detected in the leaves. A greenhouse experiment using fresh water and reclaimed wastewater spiked, or not, with CBZ at 1 μg L(-1) (typical concentration in effluents) revealed that CBZ can be taken up and bioaccumulated from its background concentration in reclaimed wastewater. Bioaccumulation factor (calculated as the ratio of CBZ concentration in the plant to that in the soil solution) for the fruits (0.8-1) was significantly lower than the value calculated for the leaves (17-20). This study emphasizes the potential uptake of active pharmaceutical compounds by crops in organic-matter-poor soils irrigated with reclaimed wastewater and highlights the potential risks associated with this agricultural practice. Copyright Â© 2010 Elsevier Ltd. All rights reserved.
The success of an overseas employment contract is significantly influenced by career related challenges. This paper presents the findings of a primary research conducted in the three GCC countries (Bahrain, Oman and the UAE) to comprehend the key career related challenges faced by professional Indian expatriates. This paper also explores the influence of demographic factors on career related challenges and concludes with the analysis of overall findings.
The success of an overseas employment contract is significantly influenced by career related challenges. This paper presents the findings of a primary research conducted in the three GCC countries (Bahrain, Oman and the UAE) to comprehendthe key career related challenges faced by professional Indian expatriates. This paper also explores the influence of demographic factors on career related challenges and concludes with the analysis of overall findings.
Full Text Available Abstract Background Asbestos related diseases include a number of conditions due to inhalation of asbestos fibres at work, at home or in the environment, such as pleural mesothelioma, asbestosis and calcified pleural plaques. Few epidemiological studies have established the incidence of asbestos related diseases in our area. The present proposal is based on a retrospective study externally funded in 2005 that is currently taking place in the same area and largely carried out by the same research team. The aim of the study is to achieve a comprehensive and coordinated detection of all new cases of Asbestos Related Diseases presenting to primary care practitioners. Methods/design This is a multicentre, multidisciplinary and pluri-institutional prospective study. Setting 12 municipalities in the Barcelona province within the catchment area of the health facilities that participate in the study. Sample This is a population based study, of all patients presenting with diseases caused by asbestos in the study area. Measurements A clinical and epidemiological questionnaire will be filled in by the trained researchers after interviewing the patients and examining their clinical reports. Discussion Data on the incidence of the different Asbestos Related Diseases in this area will be obtained and the most plausible exposure source and space-time-patient profile will be described. The study will also improve the standardization of patient management, the coordination between health care institutions and the development of preventive activities related with asbestos exposure and disease.
Zhimin, Luo; Chunlian, Chen; Xian, Wang
Good alumni relations are key to universities and colleges winning support from their graduates. With reference to social capital theory, an important problem in establishing strong alumni relations is how to turn alumni resources, an important university social network, into productive, public, and abundant capital. Based on the established…
Uhl, T.; Lisowski, W.
One of the important challenges present nowadays in the automotive industry is minimizing of a car components design time. Traditional manufacturing of a prototype is usually a time and a cost consuming process. Alternatively, rapid prototyping techniques can be used in such a case. In the reported research a brake caliper was investigated, since it is an example of an element, which should have very strictly defined structural dynamic properties. As a technique of rapid prototyping of the co...
Full Text Available Most available studies focusing on the association between neovascular age-related macular degeneration (AMD and dementia have conflicting results. This study aimed to investigate the association between previously diagnosed AMD and dementia using a population-based dataset in Taiwan.Data for this case-control study were retrospectively collected from the Taiwan National Health Insurance Research Database. We identified 13,402 subjects who had a diagnosis of dementia as cases, and 40,206 subjects without dementia as controls. A conditional logistic regression was used to examine the association of dementia with previously diagnosed neovascular AMD.We found that of the study sample of 53,608 subjects, 1.01% had previously diagnosed neovascular AMD, 1.35% and 0.90% for cases and the controls, respectively (p<0.001. The conditional logistic regression analysis suggested that the odds ratio of prior neovascular AMD for cases was 1.37 (95% confidence interval: 1.14~1.65 compared to the controls after adjusting for subjects' age, monthly income, geographic location, urbanization level, and hyperlipidemia, diabetes, hypertension, stroke, ischemic heart disease, and whether or not a subjects underwent cataract surgery prior to index date than controls.Dementia subjects were associated with a higher proportion of prior neovascular AMD than were the controls.
Salhofer, Stefan; Isaac, Nicole A
The separate collection of waste, and especially of recyclables with specific collection systems, would not be possible without the involvement of the users. Apart from the physical installations such as collection containers, collection points, etc., the motivation of the users is an essential component. Motivation can be reinforced through public relations work. In addition to the underlying technical considerations, this paper describes the difference between communication in general and public relations and specifically examines public involvement in recycling. Through the use of examples, we look at the targeted users and typical media employed. Furthermore, we analyzes the development of public involvement. The examples show that public relations for recycling strategies relies to a great extent on attitudes, habits, and access to the target group. Thus, standardized procedures cannot be developed. For these reasons, public relation activities must be planned carefully and professionally and include an analysis of the target group, choice of media, and verification of success.
Stuijver, Danka J. F.; Debeij, Jan; van Zaane, Bregje; Dekkers, Olaf M.; Smit, Jan W. A.; Büller, Harry R.; Rosendaal, Frits R.; Gerdes, Victor E. A.; Cannegieter, Suzanne C.
The pituitary hormone prolactin is thought to influence coagulation. We aimed to study the relation between prolactin levels, coagulation factors and risk of venous thrombosis (VT). We used data from a large population based case-control study into aetiology of first VT (MEGA-study). Prolactin
Yao, S. S.; Hiriart, R.; Barg, I.; Warner, P.; Gasson, D.
The NOAO Science Archive (NSA) team is developing a comprehensive domain model to capture the science data in the archive. Java and an object model derived from the domain model weil address the application layer of the archive system. However, since RDBMS is the best proven technology for data management, the challenge is the paradigm mismatch between the object and the relational models. Transparent object-relational mapping (ORM) persistence is a successful solution to this challenge. In the data modeling and persistence implementation of NSA, we are using Hibernate, a well-accepted ORM tool, to bridge the object model in the business tier and the relational model in the database tier. Thus, the database is isolated from the Java application. The application queries directly on objects using a DBMS-independent object-oriented query API, which frees the application developers from the low level JDBC and SQL so that they can focus on the domain logic. We present the detailed design of the NSA R3 (Release 3) data model and object-relational persistence, including mapping, retrieving and caching. Persistence layer optimization and performance tuning will be analyzed. The system is being built on J2EE, so the integration of Hibernate into the EJB container and the transaction management are also explored.
Krunsch, P.; Fiordalisa, A.; Fortemps, Ph.
This paper illustrates a fuzzy inference system (FIS) developed to assist the economic calculus in radioactive waste management (RWM). The extended time horizons and, in addition, the first-of-a-kind nature of many RWM systems induce large cost uncertainties in project funding. The traditional approach in economic calculus is to include contingency factors in basic cost estimates. A distinction is made between T-factors, used for technological uncertainties, and P-factors, used for project contingencies. In the particular case of nuclear projects, the Electric Power Research Institute (EPRI) has developed specific recommendations for defining both contingency factors. As a generalisation of the EPRI results, a new methodology using fuzzy inference rules is proposed. The inputs to the FIS are derived from the answers of experts regarding both the degrees of technological maturity and project advancement. Inferred T- and P-factors proposed by the FIS are given either as single estimates as possibility intervals. (authors)
Ligia Drovandi Braga Rotundo
Full Text Available Objectives: This study aimed to assess the hypothesis that recurrent denture-related sores association may be associated with the risk of oral cancer. Methods: We conducted a hospital-based case-control study comprising 71 new cases of oral cancer in two hospitals in São Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals. All cases had histologically confirmed squamous cell carcinoma in anatomic sites of the mouth that may be specifically consi-dered at risk of sores by ill-fitting dentures. Denture-related sores were assessed by the self-report of recurrent oral sores due to the use of ill-fitting complete removable dental prosthesis. Associations were assessed by multivariate logistic regression conditioned on socio-demographic and behavioral characteristics. Results: The association between ill-fitting dentures and oral cancer was statistically significant in the multivariate model: odds ratio 3.98; 95% confidence interval 1.06 - 14.96. The specific assessment of association between tumors in the lower jaw and sores by mandibular dentures confirmed this result: odds ratio 6.39; 95% confidence interval 1.49 - 29.52. Conclusion: The potential contribution of denture-related sores to oral carcinogenesis still fuels controversies. This study reinfor-ces the hypothesis that recurrent denture-related sores may be associated with the risk of oral cancer. Results reported here also suggest that an appropriate application and monitoring of dental prosthesis represent a non-negligible scope for cancer prevention.
Full Text Available Crime is a part of any social system and known to human communities since its origins. It differs from community to another, even within one community it doesn’t occur equally in all places and nor by the same way. It is also concentrated in some places more than others, sometimes increases, sometimes decreases, etc. Previous researches have proved that crime rate has significant correlation with different social factors: education levels, poverty rates and lack of social organization, while others have drawn the attention to its relation with the built environment. They proposed that crime occurs in places where both opportunities and criminals are available. The role of this paper is to identify urban circumstances related to crime occurrence within the Greater Cairo Region, and to propose different ways to reduce these crimes. Consecutively, agglomeration’s main districts were scrutinized according to social analysis, street-network pattern and land-use.
Ravuvu, Amerita; Friel, Sharon; Thow, Anne Marie; Snowdon, Wendy; Wate, Jillian
Despite the growing rates of obesity and diet-related non-communicable diseases, globally, public health attention has only relatively recently turned to the links between trade agreements and the nutritional risks associated with it. Specific trade agreements appear to have played an influential role in the volume and types of foods entering different countries, yet there is currently no systematic and objective monitoring of trade agreements for their impacts on food environments. Recently, INFORMAS was set up to monitor and benchmark food environments, government policies and private sector actions within countries and globally. One of its projects/modules focuses on trade policy and in particular the food-related aspects of trade agreements. This paper describes the INFORMAS trade protocol, an approach to collecting food-related information about four domains of trade: trade in goods; trade in services and foreign direct investment; domestic supports, and policy space. Specifically, the protocol is tested in Fiji. The development and testing of this protocol in Fiji represents the first effort to set out a framework and process for objectively monitoring trade agreements and their impacts on national food supply and the wider food environment. It has shown that entry into WTO trade agreements contributed to the nutrition transition in Fiji through the increased availability of imported foods with varying nutritional quality. We observed an increase in imports of both healthy and less healthy foods. The application of the monitoring protocol also highlights challenges for data collection associated with each trade domain that should be considered for future data collection and analysis in other low and middle income countries. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Dixon, John; Cakal, Huseyin; Khan, Waheeda; Osmany, Meena; Majumdar, Sramana; Hassan, Mudassir
Research on the contact hypothesis has highlighted the role of contact in improving intergroup relations. Most of this research has addressed the problem of transforming the prejudices of historically advantaged communities, thereby eroding wider patterns of discrimination and inequality. In the present research, drawing on evidence from a cross-sectional survey conducted in New Delhi, we explored an alternative process through which contact may promote social change, namely by fostering poli...
David, Bertrand; Yin, Chuantao; Chalon, René
M-learning (mobile learning) can take various forms. We are interested in contextualized M-learning, i.e. the training related to the situation physically or logically localized. Contextualization and pervasivity are important aspects of our approach. We propose in particular MOCOCO principles (Mobility - COntextualisation - COoperation) using IMERA platform (Mobile Interaction in the Augmented Real Environment) covering our university campus in which we prototype and test our approach. We ar...
Full Text Available Abstract Looking for intergovernmental relations management model is a consequence of the decentralization of government from local to central government provincial and district city. Delivery of affairs to the position of actors in the region more involved than ever before. The actor was instrumental in determining the center of attention authority patterns and methods of conflict resolution when to initiate and conduct a free educational program cooperation. Intergovernmental relations management effectiveness is determined by the role of actors in determining the center of attention establish a pattern of authority and choose a method of conflict resolution. Affairs of primary and secondary education is the authority of the district city. If the provincial government to initiate treatment in the free education program the pattern of intergovernmental relations management authority selected cooperation may or may be of assistance subsidy. For matters of primary and secondary education the choice of co-administration is not appropriate. Choices made during this cooperation needs to be reviewed with due regard to equality work together mutual benefit of all parties cooperate. When cooperation to lead to conflicts preferably selected pattern of relationships is the only province to provide subsidies allow the district city alone is conducting the affairs of a free education. Options cooperation dominated by actors and actors governor regent mayor refused to put forward its own program is an option for power from the owner of the sovereignty of the people as a constituent in the local elections in both provinces and districts cities.
Chen, Chen; Su, Meirong; Liu, Gengyuan; Yang, Zhifeng
With the growth of energy consumption, energy-related environmental pollution has become increasingly serious, which in turn causes enormous economic loss because of public health damage, corrosion of materials, crop yield reduction, and other factors. Evaluating economic loss caused by energy-related environmental pollution can contribute to decision making in energy management. A framework for evaluating economic loss from environmental pollution produced during energy production, transportation, and consumption is proposed in this paper. Regarding SO2, PM10, and solid waste as the main pollutants, economic losses from health damage, materials corrosion, crop yield reduction, and solid waste pollution are estimated based on multiple concentration-response relationships and dose-response functions. The proposed framework and evaluation methods are applied to Beijing, China. It is evident that total economic loss attributable to energy-related environmental pollution fluctuated during 2000-2011 but had a general growth trend, with the highest value reaching 2.3 × 108 CNY (China Yuan) in 2006. Economic loss caused by health damage contributes most to the total loss among the four measured damage types. The total economic loss strongly correlates with the amount of energy consumption, especially for oil and electricity. Our evaluation framework and methods can be used widely to measure the potential impact of environmental pollution in the energy lifecycle.
Z. Hafsa ORHAN ASTRÖM
Full Text Available Abstract The aim of this paper is to analyse credit-related practices of Islamic banks in Turkey in comparison with theory. Here, ‘credit-related practices’ are, first, the bank balance sheet item called ‘loans’ in general, and second, loans in terms of their types. By ‘theory’ we mean Islamic economics. In attaining the aim of this paper, we use comparative methodology depending on quantitative and qualitative research. In this context, we utilize quantitative methods like collecting calculating and representing -through figures and charts- relevant data, and qualitative methods such as searching through, selecting, summarizing and evaluating relevant literature and documents like agreements and reports concerning the subject. Some of the outstanding results of this paper are as follows; loans are the dominant use of funds for Turkish Islamic banks with changing ratios between 60-75% for the period of December 2005-June 2015 and the main method used for loans is murabahah with 99.7% as of June 2015. Secondly, 91% of household loans are in the form of consumer credits as of June 2015, among which house loans are sweepingly dominant. Credits by individual credit cards have been on the increase until the second half of 2013. Keywords: Islamic banking, credit-related practices, theory, Turkey.
Full Text Available New businesses arising at the market usually operate in the sector of small and medium-sized enterprises and account for a significant part of the whole global economy. Not only the success of a start-up company, but also its sequel within the SME sector are significantly influenced by entrepreneur's personality. The aim of this article is to explore the attitude to financial risk in relation to sociodemographic characteristics (gender, education, age and the most important personality traits of entrepreneurs (risk-taking, decisiveness, optimism. We have analyzed the data collected from 1141 respondents during 2015 in 14 regions of Czech Republic. Empirical results of our paper show that the researched entrepreneurs rather can't manage financial risks in their firms regardless their gender, education, age or personality traits. Most entrepreneurs consider the importance of financial risk to increase during the crisis period. These opinions differed in relation to age, gender and such personality traits as "decisiveness" and "optimism". The results also show that the entrepreneurs try to minimise the financial risk through building-up reserves in relation to such qualities as "risk-taking" and "decisiveness" in comparison to a rather negative attitude to "optimism".
Burns, Hadley; Chowdhry, Saeed; Lee, Thomas; Schulz, Steven; Wilhelmi, Bradon J.
Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue. Thoughtful planning and coordination between plastic surgery and urology were paramount to externalize the penis for an excellent functional and cosmetic result. Conclusions: Management of a buried, hidden penis is complex and difficult. Patients are often obese and have poor hygiene due to the inability to cleanse areas that are entrapped by excessive fat. Following removal of the overhanging panniculus, satisfactory reconstruction of a hidden penis is possible when proper care is taken to adhere the base of the penis to the pubis. Split-thickness skin grafts are often necessary but depend on the viability of the penile skin and whether it is restricting penile length. Complications with wound dehiscence and infection are not uncommon; however, patients generally recover well, are satisfied with results, and are reported to have fully regained urinary and sexual functions following surgical correction of the buried penis. PMID:29467914
Bagger Jørgensen, Rikke; Hauser, Thure Pavlo; D'Hertefeldt, T.
Background, aim, and scope We strive to predict consequences of genetically modified plants (GMPs) being cultivated openly in the environment, as human and animal health, biodiversity, agricultural practise and farmers’ economy could be affected. Therefore, it is unfortunate that the risk...... is a valuable tool in identifying key factors in the gene-flow process for which more knowledge is needed, and identifying parameters and processes which are relatively insensitive to change and therefore require less attention in future collections of data. But the interdependence between models...
Feibert, Diana Cordes; Jacobsen, Peter
The cost of healthcare is rising and reforms have been introduced across Europe to address the cost issue in healthcare. There is potential to improve logistical processes within healthcare to save costs and at the same time provide services that support high quality patient care. Re......-designing processes and implementing technology can improve the efficiency of processes and reduce costs. A relations diagram has been developed that identifies the effects between the constructs Logistics, Technology, Procedure and Structure. Knowledge about how these constructs affect each other is important when...
The study examines some of the operation of the oil industries and their effects on soils of surrounding farm land of Ubeji and Ekpan both in Warri South Local Government Area of Delta State of Nigeria. Soil samples were collected at four different points in the study area; two from soil which have had spillage and two from ...
Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz
Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Wylie, C E; Shaw, D J; Fordyce, F M; Lilly, A; McGorum, B C
Equine grass sickness (EGS) remains a frequently fatal disease of equids in Britain. Since previous investigations of signalment- and meteorology-related risk factors for EGS have yielded some conflicting data, further investigation is warranted. To identify signalment- and meteorology-related risk factors for EGS in Scotland. Retrospective time-matched case-control study. This study was undertaken using data for 455 EGS cases and 910 time-matched controls that were referred to the Royal (Dick) School of Veterinary Studies, and average UK Meteorological Office weather station meteorological values from the month of admission of the animal, from the 3, 6 and 12 months prior to admission, and for the entire 1990-2006 period. Signalment-related risk factors associated with an increased risk of EGS were native Scottish pure breeds compared with crossbreeds (odds ratio [OR] = 3.56, 95% confidence interval [CI] 2.43-5.43) and animals living on premises located further north within the study region (OR = 1.08, 95% CI 1.06-1.10). There was a decreased risk of EGS in animals aged 11-20 years compared with animals 2-10 years (OR = 0.32, 95% CI 0.22-0.45), non-native Scottish pure breeds compared with crossbreeds (OR = 0.71, 95% CI 0.54-0.94), and stallions compared with mares (OR = 0.43, 95% CI 0.22-0.86). Meteorology-related risk factors associated with an increased risk of EGS were (if Ordnance Survey northing is excluded) more sun hours (OR>1.43) and more frost days (OR>1.13), while there was a decreased risk of EGS with higher average maximum temperature (ORmeteorological risk factors may assist studies on the aetiology of EGS. © 2013 EVJ Ltd.
Romanov, Anton; Okamoto, Eiji
With the increasing demand for services provided by communication networks, quality and reliability of such services as well as confidentiality of data transfer are becoming ones of the highest concerns. At the same time, because of growing hacker's activities, quality of provided content and reliability of its continuous delivery strongly depend on integrity of data transmission and availability of communication infrastructure, thus on information security of a given IT landscape. But, the amount of resources allocated to provide information security (like security staff, technical countermeasures and etc.) must be reasonable from the economic point of view. This fact, in turn, leads to the need to employ a forecasting technique in order to make planning of IT budget and short-term planning of potential bottlenecks. In this paper we present an approach to make such a forecasting for a wide class of information security related incidents (ISRI) — unambiguously detectable ISRI. This approach is based on different auto regression models which are widely used in financial time series analysis but can not be directly applied to ISRI time series due to specifics related to information security. We investigate and address this specifics by proposing rules (special conditions) of collection and storage of ISRI time series, adherence to which improves forecasting in this subject field. We present an application of our approach to one type of unambiguously detectable ISRI — amount of spam messages which, if not mitigated properly, could create additional load on communication infrastructure and consume significant amounts of network capacity. Finally we evaluate our approach by simulation and actual measurement.
Mohammad Reza Lotfi
Full Text Available In this paper, we present an empirical study to measure the performance of a salt refinery named Seif cooperative mining. The study uses Political–Economical-Social– Technological Analysis (PEST technique to evaluate opportunities and threats associated with external as well as internal factors influencing the firm. The study designs a questionnaire in Liket scale and asks decision maker to evaluate internal/external threats. In terms of external factors, there are four opportunities and ten threats associated with External factor evaluation (EFE factors. In terms of opportunities, existing potential for export has received the highest priority followed by easy access to national transportation and government support. On the threats part, firm’s dependency on importing necessary parts, global price reduction and mineral reserve termination in near future are the most important issues. In addition, in terms of internal factors, on the opportunity part, access to necessary utilities is considered as the most important factor followed by availability of high level lab equipment and sufficient assets and equities. On the threats, depreciation is considered as the most important issue followed by lack of optimum utilization of equipment and lack of enterprise resource planning. In addition, the study uses balanced score card (BSC technique to look at the performance of the firm in terms of learning and growth, internal process, customer and financials. The study determines the present and ideal status of the firm.
Eyler, Amy A.; Brownson, Ross C.; Doescher, Mark P.; Evenson, Kelly R.; Fesperman, Carrie E.; Litt, Jill S.; Pluto, Delores; Steinman, Lesley E.; Terpstra, Jennifer L.; Troped, Philip J.; Schmid, Thomas L.
Active transportation to and from school (ATS) is a viable strategy to help increase physical activity among youth. ATS can be challenging because initiatives require transdisciplinary collaboration, are influenced by the built environment and are affected by numerous policies. The purpose of this study is to identify policies and factors that…
Introduction: This reported study is a part of a larger project. The research objective considered in the present paper is information behaviour and everyday hassles among youth in Taiwan. Method: The sample consisted of 133 children, including sixty-five girls and sixty eight boys, in fifth- and sixth-grade classrooms in a public elementary…
Mutagenicity has been found in several aquatic systems in the world; however, this activity usually is not associated with any of the compounds that are currently regulated. Attempting to identify these hazardous compounds, an integrated study was conducted, employing several dif...
Kim, Mijung; Roth, Wolff-Michael
Argumentation as a form of introducing children to science has received increasing attention over the past decade. Argumentation tends to be studied and theorized through the lens of individual speakers, who contribute to a conversation by means of opposing statements. M.M. Bakhtin and L.S. Vygotsky independently proposed a very different approach…
Durant, Sarah M; Bashir, Sultana; Maddox, Thomas; Laurenson, M Karen
Although detailed, long-term scientific studies provide potentially crucial information for conservation, they are rare. Moreover, there is often a disjunction between scientists and managers that can affect whether scientific results are applied to help solve conservation problems. Long-term studies can promote increased communication between scientists and managers and hence offer an opportunity for constructive engagement between the two groups. We examined direct and indirect impacts of a 30-year study, the Serengeti Cheetah Project (SCP). Much of what is currently known about wild cheetahs comes from the SCP. In particular, the SCP has demonstrated that cheetahs have a combination of semisociality and ranging patterns that is unique among mammals. This system arises because cheetahs need to be mobile to avoid predators and competitors, yet maintain access to prey; this results in densities much lower than for other large carnivores and a requirement for large areas of heterogenous and connected habitat. The SCP started as a research project, but expanded into a national program, developing capacity for carnivore conservation within Tanzania. Long-term studies such as the SCP are uniquely placed to establish effective working relationships between scientists and managers, engage local and national institutions, and strengthen national capacity for biodiversity conservation. This process is best realized through the establishment of frameworks for conservation that seek to align scientific research with management needs. Long-term studies also play an important role in identifying international priorities for conservation. Nonetheless, the integration of science and management in conservation is a two-way process that requires concerted efforts by both sides to improve and maintain dialogue. Ultimately, conservation depends on people, and maintaining a commitment to a particular area over many years-such as through implementation of a long-term research project
The primary purpose of seismic re-evaluation of any existing nuclear safety related structure is to review the adequacy of the structure to withstand the Postulated Initiation Events (PIEs) including earthquakes as per the current seismic design codes/standards. Structures designed in the past conform to the standards prevalent at the time of their construction. Since the aseismic design approach has been evolved only in past few decades or so, it is mandatory to re-evaluate the existing critical facilities so as to make sure that they will survive during a seismic event. Accordingly some of the existing structures for CIRUS Reactor Facility such as Dump Tank and Underground RCC Duct were identified for seismic re-evaluation. The structures have been analyzed for both static and seismic loads. Dynamic Analysis has been performed based on Response Spectrum technique. The design checks have been performed using available international standards (ACI 1985; ACI 2001; BIS 2000) and accordingly the safety margins have been evaluated. Wherever necessary, enhanced structural damping values and ductility factors have been utilized in accordance with the guidelines available for the seismic re-evaluation of existing structures as per various international practices (IAEA 1995a; IAEA 1995b; IAEA 2002). The structures have been found to possess sufficient safety margin under all the postulated design loadings and hence the structural integrity is ensured. (author)
Full Text Available Multiple observational studies have demonstrated that psoriasis is associated with nephropathy; however, the renal involvement in psoriasis remains largely a matter of debate. The current study was designed to investigate if psoriatic patients are at increased risk of renal abnormalities, in absence of any other comorbidities. Forty patients (11 women, 29 men, mean age 44.9 ± 15.45 years with moderate to severe chronic plaque type psoriasis who were not under systemic therapy and 40 age- and gender-matched control subjects were enrolled in the study. Patients and controls with history of diabetes, hypertension, and chronic renal disease were excluded. Urinalysis by dipstick and microscopic evaluation and 24 h proteinuria and albuminuria were measured in all patients and controls. Patients with psoriasis and controls were not significantly different with respect to the prevalence of abnormal urinalysis (7.5% versus 5%, P = 1.0, mean 24 h proteinuria (70.40 ± 24.38 mg/24 h versus 89.40 ± 26.78 mg/24 h, P = 0.30, and albuminuria (14.15 ± 8.12 mg/24 h versus 16.62 ± 8.21 mg/24 h, P = 0.18. The presence of abnormal urinalysis was not more common in patients with psoriasis than in controls. Our study demonstrated that psoriatic patients without any other comorbidities are not at increased risk of kidney disease.
Ruland, Cornelia M; Bakken, Suzanne; Røislien, Jo
Recently there has been a proliferation of interactive tailored patient assessment (ITPA) tools. However, evidence of the reliability and validity of these instruments is often missing, which makes their value in research studies questionable. Because several of the common methods to evaluate instrument reliability and validity are not applicable to interactive tailored patient assessments, informatics researchers may benefit from some guidance on which methods of reliability and validity ass...
Cole, T J; Stanojevic, S; Stocks, J; Coates, A L; Hankinson, J L; Wade, A M
Age-related reference ranges are useful for assessing growth in children. The LMS method is a popular technique for constructing growth charts that model the age-changing distribution of the measurement in terms of the median, coefficient of variation and skewness. Here the methodology is extended to references that depend on body size as well as age, by exploiting the flexibility of the generalised additive models for location, scale and shape (GAMLSS) technique. GAMLSS offers general linear predictors for each moment parameter and a choice of error distributions, which can handle kurtosis as well as skewness. A key question with such references is the nature of the age-size adjustment, additive or multiplicative, which is explored by comparing the identity link and log link for the median predictor.There are several measurements whose reference ranges depend on both body size and age. As an example, models are developed here for the first four moments of the lung function variables forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC) and FEV(1)/FVC in terms of height and age, in a data set of 3598 children and adults aged 4 to 80 years. The results show a strong multiplicative association between spirometry, height and age, with a large and nonlinear age effect across the age range. Variability also depends nonlinearly on age and to a lesser extent on height. FEV(1) and FVC are close to normally distributed, while FEV(1)/FVC is appreciably skew to the left. GAMLSS is a powerful technique for the construction of such references, which should be useful in clinical medicine. Copyright (c) 2008 John Wiley & Sons, Ltd.
Lund, Bodil; Holmlund, Anders; Wretlind, Bengt; Jalal, Shah; Rosén, Annika
The aim of this study was to find out if reactive arthritis was involved in the aetiology of chronic closed lock of the temporomandibular joint (TMJ) by looking for bacterial antigens in the synovial membrane of the TMJ, and by studying the antibody serology and carriage of human leucocyte antigen (HLA) B27 in patients with chronic closed lock. Patients with reciprocal clicking and healthy subjects acted as controls. We studied a total of 43 consecutive patients, 15 with chronic closed lock, 13 with reciprocal clicking, and 15 healthy controls with no internal derangements of the TMJ. Venous blood samples were collected from all subjects for measurement of concentrations of HLA tissue antigen and serology against Chlamydia trachomatis, Yersinia enterocolitica, Salmonella spp., Campylobacter jejuni, and Mycoplasma pneumoniae. Samples of synovial tissue from patients with closed lock and reciprocal clicking were obtained during discectomy and divided into two pieces, the first of which was tested by strand displacement amplification for the presence of C trachomatis, and the second of which was analysed for the presence of species-specific bacterial DNA using 16s rRNA pan-polymerase chain reaction (PCR). There were no significant differences between the groups in the incidence of antibodies against M pneumoniae, Salmonella spp. or Y enterocolitica. No patient had antibodies towards C trachomatis or C jejuni. We found no bacterial DNA in the synovial fluid from any patient. The HLA B27 antigen was present in 2/15 subjects in both the closed lock and control groups, and none in the reciprocal clicking group. In conclusion, reactive arthritis does not seem to be the mechanism of internal derangement of the TMJ. Copyright © 2015. Published by Elsevier Ltd.
Guo, Xiaopeng; Gao, Lu; Zhang, Shuo; Li, Yilin; Wu, Yue; Fang, Ligang; Deng, Kan; Yao, Yong; Lian, Wei; Wang, Renzhi; Xing, Bing
Background. Cardiovascular complications are known to be the main determinants of reduced life expectancy and decreased quality of life in acromegaly patients. Our study aimed to provide insight into the cardiovascular changes that occur in acromegaly patients and to investigate the correlative risk factors. Methods. A total of 108 patients definitively diagnosed with acromegaly and 108 controls matched for age and gender were recruited into study and control groups, respectively. Standard echocardiography was performed on all of the participants, and data were collected and analyzed. Results. All acromegaly patients presented with structural cardiac changes, including a larger heart cavity, thicker myocardial walls, and increased great vessel diameters compared with the control group. Additionally, the acromegaly patients presented with reduced diastolic function. Aging and increased body mass index (BMI) were correlated with myocardial hypertrophy and diastolic dysfunction; a longer disease duration was correlated with larger great vessel diameters. Conclusions. Ageing and increased BMI are independent risk factors for acromegalic cardiomyopathy, and a long disease duration results in the expansion of great vessels. Increased efforts should be made to diagnose acromegaly at an early stage and to advise acromegaly patients to maintain a healthy weight.
Akshaya, S.; Harish, S.; Arthy, R.; Muthu, D.; Venkatasubramanian, C.
Urban planners and stakeholders require knowledge about the effectiveness of city-scale climate adaptation measures in order to develop climate resilient cities and to push forward the political process for the implementation of climate adaptation strategies. This study examines the impact of modifications in orientation of buildings with respect to heat load. Heat load calculation is a mathematical process to determine the best capacity, application and style of HVAC system. The purpose is to ensure energy efficiency while also maximizing comfort inside the building. This study of load calculation is essential for a building because it helps to pick the best orientation and focuses to find an orientation that will reduce energy due to direct solar radiation. One of the factors affecting this assessment is the latitude of the location. The heat gain is effective through walls and fenestration. Improper management through ineffective orientation of the building’s natural heat gain leads to excessive consumption of energy in the form of CL. The total heat gain for the above factors is calculated with the equations and assumptions as per ASHRAE code. After the calculation of heat load for different orientations, the best suited orientation of the building is found. By altering the building to suitable orientation, the dependence on electrical equipment can be minimized and thereby helps in energy conservation.
Pottegård, Anton; Friis, Søren; Andersen, Morten
.02), liver 1.81 (95% CI 1.18, 2.80), lung 1.38 (95% CI 1.23, 1.54), pancreas 1.35 (95% CI 1.02, 1.79) and kidney 1.39 (95% CI 1.01, 1.91). For tobacco-related cancers, the OR was 1.15 (95% CI 1.09, 1.22) and for the remaining cancer sites 1.01 (95% CI 0.94, 1.08). Sub-group analyses revealed only small......AIM: Studies of the carcinogenic potential of benzodiazepines and related drugs (BZRD) have been equivocal. A recent study reported a 35% excess cancer risk among users of hypnotics, including benzodiazepines. METHOD: Using Danish nationwide registers, we conducted a matched case-control study...... of the association between BZRD and cancer risk. During 1 January 2002 and 31 December 2009, we identified 152 510 cases with a first time cancer who were matched (1:8) by age and gender to 1,220,317 cancer-free controls. A new-user design was applied by excluding all subjects who had used anxiolytics, hypnotics...
Ruano-Ravina, Alberto; García-Lavandeira, José Antonio; Torres-Durán, María; Prini-Guadalupe, Luciana; Parente-Lamelas, Isaura; Leiro-Fernández, Virginia; Montero-Martínez, Carmen; González-Barcala, Francisco Javier; Golpe-Gómez, Antonio; Martínez, Cristina; Castro-Añón, Olalla; Mejuto-Martí, María José
We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjusted also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years
Ruano-Ravina, Alberto, E-mail: firstname.lastname@example.org [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona (Spain); García-Lavandeira, José Antonio [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Department of Preventive Medicine, A Coruña University Hospital Complex, Coruña (Spain); Torres-Durán, María [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Service of Neumology, University Hospital Complex of Vigo, Vigo (Spain); Prini-Guadalupe, Luciana [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Parente-Lamelas, Isaura [Service of Neumology, Ourense Hospital Complex, Ourense (Spain); Leiro-Fernández, Virginia [Service of Neumology, University Hospital Complex of Vigo, Vigo (Spain); Montero-Martínez, Carmen [Service of Neumology, University Hospital Complex of A Coruña, Coruña (Spain); González-Barcala, Francisco Javier; Golpe-Gómez, Antonio [Service of Neumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela (Spain); Martínez, Cristina [National Institute of Silicosis, University Hospital of Asturias, Oviedo, Asturias (Spain); Castro-Añón, Olalla [Service of Neumology, Hospital Lucus Augusti, Lugo (Spain); Mejuto-Martí, María José [Service of Neumology, Hospital Arquitecto Marcide, Ferrol (Spain); and others
We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjusted also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years.
Melek Sarı GÜVEN
Full Text Available The concept of the content of communication between cultures consist essentially of culture and communication word and requires at least two components. Because it requires reciprocal communication. The definition of culture is very different uses in society and beha vioral studies will be used in the context of linguistic and intellectual norms. Given that a large number of cultures around the world must be in contact with each other as well cultures for each culture to communicate with each other. Advances in technol ogy, particularly in communications and transportation; increase of the world population; globalization; tourism and trade; migration and cross - country training programs focused on intercultural communication requirements of mobility. In this study, the di fferent cultural backgrounds of the two neighboring countries, Turkey and Armenia will focus on what is happening in intercultural communication barriers. Both the country's tangible and intangible cultural heritage of movement commonalities and difference s will be revealed by determining the level of communication situations. Elements that prevent contact between the two countries will be made in the solutions one by one. Departing from the point of revealing the communicative dimension of Turkey - Armenia c ommunication will be reviewed. Linguistic communication, nonverbal communication, communication with the two countries will be discussed in socio - cultural and strategic competencies will be examined through these support points. Historical societies, then linguistic communication, geographical, economic, socio - cultural and strategic nature of sameness and difference significant. Two different ethnic groups in the same territory for centuries have created, they are tangible and the two neighboring countries as of 1991, although the spiritual dimension common elements began a communication process. Hence Turkey and Armenia to communicate the judgment to have been
Kim N. Dirks
Full Text Available Walking School Buses (WSBs provide a safe alternative to being driven to school. Children benefit from the contribution the exercise provides towards their daily exercise target, it gives children practical experience with respect to road safety and it helps to relieve traffic congestion around the entrance to their school. Walking routes are designed largely based in road safety considerations, catchment need and the availability of parent support. However, little attention is given to the air pollution exposure experienced by children during their journey to school, despite the commuting microenvironment being an important contributor to a child’s daily air pollution exposure. This study aims to quantify the air pollution exposure experienced by children walking to school and those being driven by car. A school was chosen in Bradford, UK. Three adult participants carried out the journey to and from school, each carrying a P-Trak ultrafine particle (UFP count monitor. One participant travelled the journey to school by car while the other two walked, each on opposite sides of the road for the majority of the journey. Data collection was carried out over a period of two weeks, for a total of five journeys to school in the morning and five on the way home at the end of the school day. Results of the study suggest that car commuters experience lower levels of air pollution dose due to lower exposure and reduced commute times. The largest reductions in exposure for pedestrians can be achieved by avoiding close proximity to traffic queuing up at intersections, and, where possible, walking on the side of the road opposite the traffic, especially during the morning commuting period. Major intersections should also be avoided as they were associated with peak exposures. Steps to ensure that the phasing of lights is optimised to minimise pedestrian waiting time would also help reduce exposure. If possible, busy roads should be avoided altogether. By
Urrutia-Pereira, M; Solé, D; Rosario, N A; Neto, H J C; Acosta, V; Almendarez, C F; Avalos, M M; Badellino, H; Berroa, F; Álvarez-Castelló, M; Castillo, A J; Castro-Almarales, R L; De la Cruz, M M; Cepeda, A M; Fernandez, C; González-León, M; Lozano-Saenz, J; Sanchez-Silot, C; Sisul-Alvariza, J C; Valentin-Rostan, M; Sarni, R O S
Atopic dermatitis (AD) has been associated with impairment of sleep. The aim of this study was to evaluate sleep disorders in AD Latin-American children (4-10 years) from nine countries, and in normal controls (C). Parents from 454 C and 340 AD children from referral clinics answered the Children Sleep Habits Questionnaire (CSHQ), a one-week retrospective 33 questions survey under seven items (bedtime resistance, sleep duration, sleep anxiety, night awakening, parasomnias, sleep-disordered breathing and daytime sleepiness). Total CSHQ score and items were analysed in both C and AD groups. Spearman's correlation coefficient between SCORAD (Scoring atopic dermatitis), all subscales and total CSHQ were also obtained. C and AD groups were similar regarding age, however, significantly higher values for total CSHQ (62.2±16.1 vs 53.3±12.7, respectively) and items were observed among AD children in comparison to C, and they were higher among those with moderate (54.8%) or severe (4.3%) AD. Except for sleep duration (r=-0.02, p=0.698), there was a significant Spearman's correlation index for bedtime resistance (0.24, panxiety (0.29, pbreathing (0.42, pchildren with AD have sleep disorders despite treatment, and those with moderate to severe forms had marked changes in CSHQ. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.
This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.
Origer, Alain; Le Bihan, Etienne; Baumann, Michèle
To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case-control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Being professionally active [OR=0.66 (95% CI 0.45-0.99)], reporting salary as main legal income source [OR=0.42 (95% CI 0.26-0.67)] and education attainment higher than primary school [OR=0.50 (95% CI 0.34-0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. Copyright © 2014 Elsevier B.V. All rights reserved.
Dela Cruz Fajarito, Cariñez; De Guzman, Rosalito G
Few studies demonstrate how the index trauma may influence subsequent post-traumatic stress disorder (PTSD) symptoms, especially among soldiers. There is still no consensus on specific trauma types and their corresponding PTSD symptom profiles. Furthermore, varied PTSD symptom manifestations that may yield to PTSD trauma subtypes are yet to be known. Importantly, the significance of the military culture's possible influence on soldiers' PTSD has also been underexplored. And the dominant PTSD construct may possibly be unable to capture the essential aspects of the military context in understanding combat-related PTSD. Hence, this study aims to reach an understanding into how index trauma and military culture may possibly shape participants' PTSD expressions. Case study design was used, wherein multiple sources of data-such as PTSD assessments, and interviews with the participants and key informants-enabled data triangulation. The three case reports are the outcomes of the corroboration of evidences that reveal an enriched and holistic understanding of the phenomenon under study. The Ethics Review Board Committee of the Armed Forces of the Philippines Medical Center approved the study. The participants were three Filipino active duty combat soldiers. Although all participants had similar index traumas, their PTSD symptom expressions are unique from one another, in that they differ in terms of their most incapacitating PTSD symptoms and other symptoms that have been potentially shaped by military culture. Their most incapacitating symptoms: hypervigilance (case 1), negative belief in oneself and negative emotions (case 2), prolonged distress, and marked physiological reactions to trauma-related cues (case 3), may be understood in the light of how they personally experienced different circumstances of their index traumas. The way participants have anchored specific components of their sworn soldier's creed (i.e., not leaving a fallen comrade) into some of their PTSD
Michels, S D; McKenna, R W; Arthur, D C; Brunning, R D
This study consists of 65 patients (pts) who developed a myelodysplastic syndrome (MDS) (39 pts) or acute myeloid leukemia (AML) (26 pts) following chemotherapy and/or radiotherapy; the interval from the onset of therapy to bone marrow abnormality ranged from 11 to 192 months (median, 58). Thirty-three patients had been previously treated for lymphoproliferative diseases, 29 for carcinoma, and three for a nonneoplastic disorder. Approximately 30% of the cases presenting in the MDS phase evolved to AML in one to 12 months (median, 3.5). The AML in 49% of the cases was not readily classified according to French-American-British (FAB) criteria; the primary difficulty in classification related to the involvement of multiple cell lines. Among the cases that could be classified, all FAB types were represented except for M1; M2 was the most frequent type. Clonal chromosome abnormalities were found in marrow specimens from 22 of 24 (92%) patients studied with G banding; 11 had abnormalities of chromosomes 5 and/or 7. The median survival for all patients was four months with no significant difference between those treated and not treated with antileukemic therapy. The median survival was three months for the patients presenting with AML, six months for the patients with AML following an MDS, and four months for the patients with an MDS that did not evolve to AML. The findings in the present study suggest that there are three stages of therapy-related panmyelosis: (1) pancytopenia with associated myelodysplastic changes, (2) a frank MDS, and (3) overt AML. Many patients will present in the stage of overt AML that differs from de novo AML primarily by the high incidence of trilineage involvement, difficulty in classification, frequent cytogenetic abnormalities, and poor response to antileukemic therapy. The myelodysplastic phase, with or without evolution to acute leukemia, is a highly lethal disease with a median survival comparable to that of the patients who present with
Michels, S.D.; McKenna, R.W.; Arthur, D.C.; Brunning, R.D.
This study consists of 65 patients (pts) who developed a myelodysplastic syndrome (MDS) (39 pts) or acute myeloid leukemia (AML) (26 pts) following chemotherapy and/or radiotherapy; the interval from the onset of therapy to bone marrow abnormality ranged from 11 to 192 months (median, 58). Thirty-three patients had been previously treated for lymphoproliferative diseases, 29 for carcinoma, and three for a nonneoplastic disorder. Approximately 30% of the cases presenting in the MDS phase evolved to AML in one to 12 months (median, 3.5). The AML in 49% of the cases was not readily classified according to French-American-British (FAB) criteria; the primary difficulty in classification related to the involvement of multiple cell lines. Among the cases that could be classified, all FAB types were represented except for M1; M2 was the most frequent type. Clonal chromosome abnormalities were found in marrow specimens from 22 of 24 (92%) patients studied with G banding; 11 had abnormalities of chromosomes 5 and/or 7. The median survival for all patients was four months with no significant difference between those treated and not treated with antileukemic therapy. The median survival was three months for the patients presenting with AML, six months for the patients with AML following an MDS, and four months for the patients with an MDS that did not evolve to AML. The findings in the present study suggest that there are three stages of therapy-related panmyelosis: (1) pancytopenia with associated myelodysplastic changes, (2) a frank MDS, and (3) overt AML. Many patients will present in the stage of overt AML that differs from de novo AML primarily by the high incidence of trilineage involvement, difficulty in classification, frequent cytogenetic abnormalities, and poor response to antileukemic therapy.
Gomes, Tara; Juurlink, David N; Antoniou, Tony; Mamdani, Muhammad M; Paterson, J Michael; van den Brink, Wim
Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription. Although gabapentin is widely perceived as safe, drug-induced respiratory depression has been described when gabapentin is used alone or in combination with other medications. Because gabapentin and opioids are both commonly prescribed for pain, the likelihood of co-prescription is high. However, no published studies have examined whether concomitant gabapentin therapy is associated with an increased risk of accidental opioid-related death in patients receiving opioids. The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality. We conducted a population-based nested case-control study among opioid users who were residents of Ontario, Canada, between August 1, 1997, and December 31, 2013, using administrative databases. Cases, defined as opioid users who died of an opioid-related cause, were matched with up to 4 controls who also used opioids on age, sex, year of index date, history of chronic kidney disease, and a disease risk index. After matching, we included 1,256 cases and 4,619 controls. The primary exposure was concomitant gabapentin use in the 120 days preceding the index date. A secondary analysis characterized gabapentin dose as low (opioids and gabapentin was associated with a significantly increased odds of opioid-related death (odds ratio [OR] 1.99, 95% CI 1.61 to 2.47, p opioid prescription alone. In the dose-response analysis, moderate-dose (OR 2.05, 95% CI 1.46 to 2.87, p opioid-related death relative to no concomitant gabapentin use. As expected, we found no significant association between co-prescription of opioids and NSAIDs and opioid-related death (OR 1.11, 95% CI 0.98 to 1.27, p = 0.113; aOR 1.14, 95% CI 0.98 to 1.32, p = 0.083). In an
Plant, S.W.; Adler, D.G.
Ever since the US Department of Energy (DOE) created its Formerly Utilized Sites Remedial Action Program (FUSRAP) in 1974, there has been a community relations program. The community relations effort has grown as FUSRAP has grown. With 20 of 46 sites now cleaned up, considerable experience in working with FUSRAP stakeholders has been gained. Why not share that experience with others who labor on the Superfund sites? Many similarities exist between the Superfund sites and FUSRAP. FUSRAP is a large, multiple-site environmental restoration program. The challenges range from small sites requiring remedial actions measurable in weeks to major sites requiring the full remedial investigation/feasibility study process. The numerous Superfund sites throughout the United States offer the same diversity, both geographically and technically. But before DOE offers FUSRAP's community relations experience as a model, it needs to make clear that this will be a realistic model. As experiences are shared, DOE will certainly speak of the efforts that achieved its goals. But many of the problems that DOE encountered along the way will also be related. FUSRAP relies on a variety of one- and two-way communication techniques for involving stakeholders in the DOE decision-making process. Some of the techniques and experiences from the case studies are presented
Quick, Virginia M; McWilliams, Rita; Byrd-Bredbenner, Carol
Young adults with diet-related chronic health conditions (DRCHCs; i.e., type 1 diabetes, celiac disease, cystic fibrosis, inflammatory bowel diseases, irritable bowel syndrome) face challenges complying with dietary restrictions required to effectively manage their health condition. These restrictions could put them at risk for disturbed eating. The purpose of this study was to determine if young adults with and without DRCHCs differed with regard to disturbed eating behaviors and related psychographics characteristics (i.e., body image attributes, mental disorders, intrapersonal characteristics and sociocultural environment [i.e., media and family]). Each DRCHC participant (cases=166) was matched to 4 healthy participants (controls=664) based on gender and BMI (±0.50 BMI units). Conditional logistic regression analyses indicate cases were twice as likely to have been diagnosed by a healthcare provider with an eating disorder (p=0.08, OR=1.99, CI(90) [1.03-3.83]). Cases were significantly more likely to use Inappropriate Compensatory Behaviors to manage their weight, i.e., excessive exercise (p=0.04, OR=1.41, CI(95) [1.02-1.94]) and misuse medication (p=0.04, OR=1.14, CI(95) [1.00-1.29]) than controls. Depression and anxiety were significantly higher, and health status was significantly poorer in cases compared with controls. DRCHC participants were less likely to report feeling body image pressures from the media, placed a greater value on their health, used social diversion, and recalled a greater emphasis being placed on their mothers' weights and mealtimes being less structured than control participants. Findings indicate that nutrition and other healthcare professionals should incorporate screening DRCHC patients for disturbed eating behaviors and eating disorders in their standards of care. Published by Elsevier Ltd.
Nielsen, Ulla Schierup; Thomsen, Reimar Wernich; Cowan, Susan; Larsen, Carsten Schade; Petersen, Eskild
To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines. A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls. The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally. These results may support revision of current pre-travel vaccination guidelines. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Recent studies have shown that the number of women faculty in academic medicine is much lesser than the number of women that are graduating from medical schools. Many academic institutes face the challenge of retaining talented faculty and this attrition from academic medicine prevents career advancement of women faculty. This case study attempts to identify some of the reasons for dissatisfaction that may be related to the attrition of women medical faculty at the University of Pittsburgh, School of Medicine. Data was collected using a job satisfaction survey, which consisted of various constructs that are part of a faculty's job and proxy measures to gather the faculty's intent to leave their current position at the University of Pittsburgh or academic medicine in general. The survey results showed that although women faculty were satisfied with their job at the University of Pittsburgh, there are some important factors that influenced their decision of potentially dropping out. The main reasons cited by the women faculty were related to funding pressures, work-life balance, mentoring of junior faculty and the amount of time spent on clinical responsibilities. The analysis of proxy measures showed that if women faculty decided to leave University of Pittsburgh, it would most probably be due to better opportunity elsewhere followed by pressure to get funding. The results of this study aim to provide the School of Medicine at the University of Pittsburgh with information related to attrition of its women faculty and provide suggestions for implications for policy to retain their women faculty.
Full Text Available We study the problem of finding probability densities that match given European call option prices. To allow prior information about such a density to be taken into account, we generalise the algorithm presented in Neri and Schneider (Appl. Math. Finance 2013 to find the maximum entropy density of an asset price to the relative entropy case. This is applied to study the impact of the choice of prior density in two market scenarios. In the first scenario, call option prices are prescribed at only a small number of strikes, and we see that the choice of prior, or indeed its omission, yields notably different densities. The second scenario is given by CBOE option price data for S&P500 index options at a large number of strikes. Prior information is now considered to be given by calibrated Heston, Schöbel–Zhu or Variance Gamma models. We find that the resulting digital option prices are essentially the same as those given by the (non-relative Buchen–Kelly density itself. In other words, in a sufficiently liquid market, the influence of the prior density seems to vanish almost completely. Finally, we study variance swaps and derive a simple formula relating the fair variance swap rate to entropy. Then we show, again, that the prior loses its influence on the fair variance swap rate as the number of strikes increases.
Theunissen, Marie-José; de Man, Inge; Verdonk, Petra; Bosma, Hans; Feron, Frans
As school dropout is an important public health problem that needs to be addressed, we set out to examine whether and how, beyond the well-known effects of sex, gender beliefs and self-reported masculinity and femininity are related to school dropout. The study used a case-control design, consisting of 330 dropout cases and 330 controls still attending school. The respondents, aged between 18 and 23 years, living in the south-east of the Netherlands, were sent a self-administered questionnaire. Separate logistic regression analyses for the male and female participants were used to explore the relation between dropout and gender, controlling for sociodemographic determinants. As indicated by significant curvilinearity, young women were less likely to drop out when they occupied an intermediate positions on the gender variables. Odds of dropout were elevated among highly masculine women (odds ratio = 2.1, 95% confidence interval: 1.1-4.1), and, as indicated by significant interactions, also among highly masculine men with strong normative masculine beliefs and in feminine men who simultaneously considered themselves low on masculinity. Beyond sex, gender is important in the explanation of school dropout. To prevent dropout, public health professionals should assess, monitor and intervene on the basis of gender characteristics. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Bosma, Hans; Theunissen, Marie-José; Verdonk, Petra; Feron, Frans
There is cumulating evidence that health is compromised through adverse socioeconomic conditions negatively affecting how people think, feel, and behave. Low control beliefs might be a key mechanism. The reversed possibility that low control beliefs might set people on a pathway towards adverse socioeconomic and health-related outcomes is much less examined. A case-control design was used, consisting of 330 cases who dropped out of school in the 2010-2011 school year and 330 controls who still attended school at the end of that year. The respondents, aged between 18 and 23, came from Eindhoven and surrounding areas in the south-east of The Netherlands. A questionnaire asked for current health status, recalled socioeconomic and social background, and recalled control beliefs (mastery and general self-efficacy). Logistic regression analyses were used. Recalls of low mastery and low self-efficacy were strongly related to both dropout and less than good health. Low socioeconomic background was also associated to odds of dropout, but did not confound or moderate the associations of low control beliefs with dropout and health. Odds ratios of dropout and less than good health indicated at least twice the odds of a poor outcome with recalls of low control beliefs. Independent of the socioeconomic background, low control beliefs are related to heightened odds of both poor health and school dropout. Individual differences in control beliefs might thus be as fundamental as socioeconomic conditions in generating life-course socioeconomic and health-related pathways. Although the findings should first be cross-validated in prospective studies, public health professionals working with youth might already start considering early interventions in youth with all too fatalistic and powerless mind-sets.
Bakhtiari, Sedigheh; Toosi, Parviz; Azimi, Somayyeh; Esmaili, Nafiseh; Montazami, Ali; Rafieian, Nasrin
Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status) data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group "O" was found in 32.9% of patients and 38.2% of control group. Blood group "A" was found among 30.8% of patients and 34.2% of control group, while group "B" was reported in 27.4% of cases and 21.1% of controls and "AB" was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P = 0.46) or Rh (P = 0.76) between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.
Full Text Available Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group “O” was found in 32.9% of patients and 38.2% of control group. Blood group “A” was found among 30.8% of patients and 34.2% of control group, while group “B” was reported in 27.4% of cases and 21.1% of controls and “AB” was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P=0.46 or Rh (P=0.76 between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.
Al Subaey, Maha Khalid
Energy is considered as an important pillar in the establishment of international relations where it plays a heavy role in shaping the relations. In the light of this, an analysis of the Qatar-Japan relations will be studied through the case study of energy security along with the culture and diplomacy spectrum. The research aims to assess the bilateral relationship in terms of the projects and the Liquefied Natural Gas (LNG) trade and the further development in the energy sector. This will take into consideration the growing interdependence in the projects in different sectors: infrastructure, trade and cultural projects. Also, the direct involvement of the Qatari and Japanese societies in the relationship. The LNG trade along with view on the joint ventures and other types of contracts would be adopted to elaborate over the energy cooperation. The energy plays a significant role in the relationship and classifying it as an economically driven. Further more, the bilateral relationship is classified as complex interdependence approach' that was supported by the theory of soft power.
Butler, Joseph E.
The purpose of this qualitative case study is to understand the impact of instructor interaction on the facilitation of spiritual development in an online environment for undergraduate non-religion majors attending a distinctively evangelical university. The qualitative case study shadows and evaluates three sections of a required introductory…
Hasan Eftekhar Ardebili
Full Text Available Introduction: More than seventeen millions people die due to cardiovascular diseases which account for one third of death worldwide. Half of 60% of all mortality caused by acquired diseases throughout the world is due to heart disorders and this ratio will augment to 73% by 2020. It is known that individual lifestyle has a great influence on the well-being of cardiovascular system. Seven of the top ten etiologies leading to death are related to the pattern of lifestyle. This study explored various lifestyle-related factors affecting ischemic conditions. Method: This study was performed as a case control investigation on 65 subjects along with 65 controls who were all admitted at Sevome Shaaban hospital in Damavand town of Iran. All data demographic and life-style variables were gathered, using three different types of questionnaire obtained from each person. p< 0.05 was considered as significant. Results: Age, marriage status, smoking, physical activities, diet and mental health condition were shown to have a significant effect on ischemia (P <0.001. Insufficient physical activities, fatty and low fiber food as well as impaired psychology conditions were among the risk factors that contributed to Ischemic heart disease. Conclusion: Insufficient physical activities, fatty and low fiber food as well as impaired psychology conditions were among the risk factors that contribute to ischemic heart disease.
Feng, Chenchen; Chen, Lina; Li, Wan; Wang, Hong; Zhang, Liangcai; Jia, Xu; Miao, Zhengqiang; Qu, Xiaoli; Li, Weiguo; He, Weiming
The histological grade/stage of tumor is widely acknowledged as an important clinical prognostic factor for cancer progression. Recent experimental studies have explored the following two topics at the molecular level: (1) whether or not gene expression levels vary by different degrees among different tumor grades/stages, and (2) whether some well-defined modules could distinguish one grade/stage from another. In this article, using breast cancer as an example, we investigated this topic and identified grade/stage-related active modules under the framework of a weighted network integrated from a human protein interaction network and a transcriptional regulatory network. Our results enabled us to draw the conclusion that the gene expression profile could provide more clues about tumor grade, but reveals less evidence about tumor stage. In addition, we found that our modular biomarker method had additional advantages in identifying some tumor grade/stage-related genes with slightly altered expression. According to our case study, the framework we introduced could be used for other cancers to identify their modules during grading or staging.
Full Text Available Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription. Although gabapentin is widely perceived as safe, drug-induced respiratory depression has been described when gabapentin is used alone or in combination with other medications. Because gabapentin and opioids are both commonly prescribed for pain, the likelihood of co-prescription is high. However, no published studies have examined whether concomitant gabapentin therapy is associated with an increased risk of accidental opioid-related death in patients receiving opioids. The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality.We conducted a population-based nested case-control study among opioid users who were residents of Ontario, Canada, between August 1, 1997, and December 31, 2013, using administrative databases. Cases, defined as opioid users who died of an opioid-related cause, were matched with up to 4 controls who also used opioids on age, sex, year of index date, history of chronic kidney disease, and a disease risk index. After matching, we included 1,256 cases and 4,619 controls. The primary exposure was concomitant gabapentin use in the 120 days preceding the index date. A secondary analysis characterized gabapentin dose as low (<900 mg daily, moderate (900 to 1,799 mg daily, or high (≥1,800 mg daily. A sensitivity analysis examined the effect of concomitant nonsteroidal anti-inflammatory drug (NSAID use in the preceding 120 days. Overall, 12.3% of cases (155 of 1,256 and 6.8% of controls (313 of 4,619 were prescribed gabapentin in the prior 120 days. After multivariable adjustment, co-prescription of opioids and gabapentin was associated with a significantly increased odds of opioid-related death (odds ratio [OR] 1.99, 95% CI
Herreid, Clyde Freeman
This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)
Barona-Dorado, Cristina; Gutierrez-Bonet, Carmen; Leco-Berrocal, Isabel; Fernández-Cáliz, Fernando; Martínez-González, José-María
In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque.
Gutierrez-Bonet, Carmen; Leco-Berrocal, Isabel; Fernández-Cáliz, Fernando; Martínez-González, José-María
Background In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Material and Methods The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. Results For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). Conclusions The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque. Key words:Orthopantomography, atheromatous plaque, cerebrovascular accident, diabetes, arterial hypertension. PMID:26595828
Skaret, E; Weinstein, P; Milgrom, P; Kaakko, T; Getz, T
In this case-control study of rural adolescents we identified factors to discriminate those who have high levels of tooth decay and receive treatment from those with similar levels who receive no treatment. The sample was drawn from all 12-20-year-olds (n = 439) in a rural high school in Washington State, U.S. The criterion for being included was 5 or more decayed, missing or filled teeth. The questionnaire included structure, history, cognition and expectation variables based on a model by Grembowski, Andersen and Chen. No structural variable was related to the dependent variable. Two of 10 history variables were related: perceived poor own dental health and perceived poor mother's dental health. Four of eight cognition variables were also predictive: negative beliefs about the dentist, not planning to go to a dentist even if having severe problems, not being in any club or playing on a sports team and not having a best friend. No relationship was found for the expectation variable 'usual source of care'. These data are consistent with the hypothesis that untreated tooth decay is associated with avoidance of care and point to the importance of history and cognition variables in planning efforts to improve oral health of rural adolescents.
Full Text Available Establishing Protected Areas (PAs is considered one of the most appropriate ways to conserve nature and cultural landscapes. However, conservation constraints can generate social conflicts, especially at a local level. In small islands (SIs, local conflicts may escalate due to an increase in competition for limited space and resources. Pico island in the Azores Archipelago (Portugal, part of the Outermost European region, was considered a good case to study conservation-development conflicts due to the amount of designated protected land (> 35% of its surface and the approval of a new Azorean PA network in 2007. This paper presents a new approach to understanding and mapping local conflicts within PAs in SIs by integrating qualitative data and spatially explicit information. This research takes stock of the benefits, needs and constraints related to Pico Natural Park as perceived by local stakeholders through face-to-face semi-structured interviews; it subsequently identifies and transposes the conflicts distilled from stakeholder discourse into spatially representative visual maps via GIS. Research outcomes show that PAs are perceived mainly as constraints to local development, showing inconsistency between local expectations and regional conservation policy. This highlights the importance of including public participation processes prior to any implementation of conservation strategies. The proposed method provides a springboard towards effective conflict management for PAs on Pico island, showing a relatively low-cost and straightforward approach to minimising future local conflicts which could be adapted to other similar Outermost European regions and SIs.
Kerzner, Harold R
A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re
Shea Christopher M
Full Text Available Abstract Background Health information technology (HIT applications that incorporate point-of-care use of health-related quality of life (HRQL assessments are believed to promote patient-centered interactions between seriously ill patients and physicians. However, it is unclear how willing primary care providers are to use such HRQL HIT applications. The specific aim of this study was to explore factors that providers consider when assessing the value added of an HRQL application for their geriatric patients. Methods Three case studies were developed using the following data sources: baseline surveys with providers and staff, observations of staff and patients, audio recordings of patient-provider interactions, and semi-structured interviews with providers and staff. Results The primary factors providers considered when assessing value added were whether the HRQL information from the module was (1 duplicative of information gathered via other means during the encounter; (2 specific enough to be useful and/or acted upon, and; (3 useful for enough patients to warrant time spent reviewing it for all geriatric patients. Secondary considerations included level of integration of the HRQL and EHR, impact on nursing workflow, and patient reluctance to provide HRQL information. Conclusions Health-related quality of life modules within electronic health record systems offer the potential benefit of improving patient centeredness and quality of care. However, the modules must provide benefits that are substantial and prominent in order for physicians to decide that they are worthwhile and sustainable. Implications of this study for future research include the identification of perceived "costs" as well as a foundation for operationalizing the concept of "usefulness" in the context of such modules. Finally, developers of these modules may need to make their products customizable for practices to account for variation in EHR capabilities and practice
Lund, Henrik; Hvelplund, Frede Kloster; Sukkumnoed, Decharut
The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation.......The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation....
Neovascular age-related macular degeneration (AMD) is one of five retinal disorders studied in the Eye Disease Case-Control Study. Data were obtained from 421 patients with neovascular AMD and 615 controls on a broad array of possible risk factors through interviews, clinical examinations, and laboratory analyses of blood samples. Decreased risk of neovascular AMD was associated with higher levels of carotenoids in the serum samples, higher horizontal cup-to-disc ratios, and use of postmenopausal exogenous estrogens in women. Increased risk of neovascular AMD was associated with cigarette smoking, higher levels of serum cholesterol, and parity greater than zero. No support was found for sunlight exposure, serum zinc levels, or iris color as risk factors for this disease. Although no association was found with a history of cardiovascular disease itself, the associations with postmenopausal exogenous estrogen use, cigarette smoking, and serum cholesterol level are consistent with a hypothesis linking risk factors for cardiovascular disease with neovascular AMD. The association noted between serum carotenoid levels and neovascular AMD supports the hypothesis that higher levels of micronutrients with antioxidant capabilities may decrease the risk of AMD.
Li, Mei Ling; Lin, Ji; Hou, Jian Guo; Xu, Lei; Cui, Xin Gang; Xu, Xing Xing; Yu, Yong Wei; Han, Xue; Wang, Guo Min; Guo, Jian Ming; Xu, Dan Feng; Thompson, Timothy C; Cao, Guang Wen; Zhang, Hong Wei
To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population. 250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk. Green vegetables and green tea were associated with a decreased risk of PCa (OR=0.39, 95% CI: 0.28-0.53; OR=0.59, 95% CI: 0.40-0.87, respectively). Family history of PCa (OR=7.16, 95% CI: 2.01-25.49), history of prostate diseases (OR=2.28, 95% CI: 1.53-3.41), alcohol consumption (OR=1.97, 95% CI: 1.33-2.90), red meat consumption (OR=1.74, 95% CI: 1.20-2.52), barbecued (OR=2.29, 95% CI: 1.11-4.73) or fried (OR=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (OR=1.61, 95% CI: 1.00-2.59), marital separation (OR=1.94, 95% CI: 1.29-2.91), self-contained suffering (OR=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (OR=1.73, 95% CI: 1.18-2.54) were related to PCa. Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population. Copyright © 2014 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.
Paper 1, and 4103 epithelial ovarian cancer cases and 58,706 controls in Papers 2 and 3. We used the Danish Prescription Registry to assess use (≥2 prescriptions on separate dates) of paracetamol, non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, and statins. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for epithelial ovarian cancer associated with use of the study drugs, with adjustment for potential confounding factors selected a priori. We performed detailed analyses according to duration, intensity, and continuity of study drug use, and the analyses were stratified according to specific histologic types of epithelial ovarian cancer. In all studies, non-use (PhD thesis was a strong inverse association between prescription use of paracetamol and risk of epithelial ovarian cancer. The risk estimates decreased with increasing duration and intensity of paracetamol use, reaching a more than 50% reduction for the longest duration (>10 years) and the highest doses (OR: 0.45; 95% CI: 0.24-0.86). In contrast, we did not observe an inverse association between use of non-aspirin NSAIDs and risk of epithelial ovarian cancer. Moreover, this thesis provides further evidence that use of low-dose aspirin is associated with a reduced risk of epithelial ovarian cancer. In particular, long-term (≥5 years) continuous use of low-dose aspirin, defined as overlapping prescription coverage periods, was associated with a large reduction in risk (OR: 0.56; 95% CI: 0.32-0.97). Finally, we found no apparent association between statin use and epithelial ovarian cancer risk, although the analysis by histologic type suggested an inverse association with the risk of mucinous tumors. The results of this PhD thesis add important knowledge to the area of chemoprevention in relation to epithelial ovarian cancer. As for any observational study, we cannot exclude potential con-founding and exposure
This paper begins with a discussion of Canadian and international work that has identified a number of shortcomings with standardized assessments, which are framed within neoliberal ideology. It then explores the principles of good assessment and applies them to an analysis of British Columbia's standardized Social Studies 11 exam. It finds that…
Muhammad, Wazir; Ullah, Asad; Hussain, Amjad; Ali, Nawab; Alam, Khan; Khan, Gulzar; Matiullah; Maeng, Seongjin; Lee, Sang Hoon
A medical linear accelerator (LINAC) room must be properly shielded to limit the outside radiation exposure to an acceptable safe level defined by individual state and international regulations. However, along with this prime objective, some additional issues are also important. The current case-study was designed to unfold the issues related to over-shielded and unplanned treatment rooms for LINACs. In this connection, an apparently unplanned and over-shielded treatment room of 610 × 610 cm2 in size was compared with a properly designed treatment room of 762 × 762 cm2 in size ( i.e., by following the procedures and recommendations of the IAEA Safety Reports Series No. 47 and NCRP 151). Evaluation of the unplanned room indicated that it was over-shielded and that its size was not suitable for total body irradiation (TBI), although the license for such a treatment facility had been acquired for the installed machine. An overall 14.96% reduction in the total shielding volume ( i.e., concrete) for an optimally planned room as compared to a non-planned room was estimated. Furthermore, the inner room's dimensions were increased by 25%, in order to accommodate TBI patients. These results show that planning and design of the treatment rooms are imperative to avoid extra financial burden to the hospitals and to provide enough space for easy and safe handling of the patients. A spacious room is ideal for storing treatment accessories and facilitates TBI treatment.
Statistical post-processing techniques aim at generating plausible climate scenarios from climate simulations and observation-based reference products. These techniques are generally not physically-based, and consequently they remedy the problem of simulation biases at the risk of generating physical inconsistency (PI). Although this concern is often emphasized, it is rarely addressed quantitatively. Here, PI generated by quantile mapping (QM), a technique widely used in climatological and hydrological applications, is investigated using relative humidity (RH) and its parent variables, namely specific humidity (SH), temperature and pressure. PI is classified into two types: 1) inadequate value for an individual variable (e.g. RH > 100 %), and 2) breaking of an inter-variable relationship. Scenarios built for this study correspond to twelve sites representing a variety of climate types over North America. Data used are an ensemble of ten 3-hourly global (CMIP5) and regional (CORDEX-NAM) simulations, as well as the CFSR reanalysis. PI of type 1 is discussed in terms of frequency of occurrence and amplitude of unphysical cases for RH and SH variables. PI of type 2 is investigated with heuristic proxies designed to directly compare the physical inconsistency problem with the initial bias problem. Finally, recommendations are provided for an appropriate use of QM given the potential to generate physical inconsistency of types 1 and 2.
Full Text Available The study investigates different factors influencing people to have more stress in a hydropower unit located in city of Esfahan, Iran. Since there were only 81 people working for customer service section of this company and the proposed study tries to focus only on this part of the firm we have decided to distribute questionnaires among all of them. The questionnaire consists of two parts, in the first part, we gather all private information such as age, gender, education, job experience, etc. through seven important questions. In the second part of the survey, there are 66 questions, which include all the important factors influencing employees' stress. Cronbach alpha is calculated as 0.946, which is well above the minimum acceptable level. The results of our ANOVA tests shows that among different factors, difficulty of working condition as well as work pressure are two most important factors increasing stress among employees. The other findings indicate that there is not a significant difference on work stress among different groups of employees in terms of their job title, educational level, employment type and gender (P>0.05. The other finding indicates that there is a meaningful difference between different groups of people with various ages, marital status and job experience (P>0.05.
Hawton, Keith; Agerbo, Esben; Simkin, Sue; Platt, Belinda; Mellanby, Richard J
Suicide risk may be elevated in 'medical' occupational groups, although results of studies are inconsistent. National data are required to examine this issue. It is also important to investigate the possible contribution of psychiatric disorder and access to specific suicide methods. In a nested case-control design we used data from Danish national registers for 1981-2006 to examine risk of suicide in nurses, physicians, dentists, pharmacists and veterinary surgeons compared to teachers and the general population, and associations with psychiatric service contact and suicide methods. Crude age- and gender-adjusted rate ratios for suicide compared to teachers were significantly elevated in nurses (RR 1.90, 95% CI 1.63-2.21), physicians (RR 1.87, 95% CI 1.55-2.26), dentists (RR 2.10, 95% CI 1.58-2.79) and pharmacists (RR 1.91, 95% CI 1.26-2.87), but not veterinary surgeons. Risk was also elevated in nurses, physicians and dentists compared with the rest of the general population, the relative risk increasing following adjustments for psychiatric service contact, marital status, gross income and labour market status. Results were similar in both genders. The elevated risk in nurses and dentists decreased during the study period. Elevated risks were not associated with greater psychiatric service contact. Medicinal drugs were commonly used for suicide by nurses, physicians and pharmacists. The study was based in one country. Risk of suicide is increased in nurses, physicians, dentists and pharmacists in Denmark. This is not reflected in excess psychiatric service contact. Ready access to medicinal drugs may influence risk in nurses, physicians and pharmacists. Copyright © 2011 Elsevier B.V. All rights reserved.
Anna Dalla Marta
Full Text Available The contribution of agrobiomasses, as a source of energy, to the reduction of greenhouse gas emissions was confirmed by several studies. Biomass from agriculture represents one of the larger and more diverse sources to exploit and in particular ethanol and diesel have the potential to be a sustainable replacement for fossil fuels, mainly for transport purposes. However, the cultivation of energy crops dedicated to the production of biofuels presents some potential problems, e.g., competitiveness with food crops, water needs, use of fertilizers, etc., and the economic, energy, and environmental convenience of such activity depends on accurate evaluations about the global efficiency of the production system. In this study, the processes related to the cultivation of energy crops were analyzed from an energy and water cost perspective. The crops studied, maize (Zea mais and sunflower (Helianthus annuus, were identified for their different water requirements and cultivation management, which in turns induces different energy costs. A 50-year climatic series of meteorological data from 19 weather stations scattered in the Tuscany region was used to feed the crop model CropSyst for the simulation of crop production, water requirement, and cultivation techniques. Obtained results were analyzed to define the real costs of energy crop cultivation, depending on energy and water balances. In the energy crop cultivation, the only positive energy balance was obtained with the more efficient system of irrigation whereas all the other cases provided negative balances. Concerning water, the results demonstrated that more than 1.000 liters of water are required for producing 1 liter of bioethanol. As a consequence, the cultivation of energy crops in the reserved areas of the region will almost double the actual water requirement of the agricultural sector in Tuscany.
Pakpour, A.H.; Kumar, S.; Scheerman, J.F.M.; Lin, C.Y.; Fridlund, B.; Jansson, H.
Introduction: The study aimed to compare the oral health variables, general, and oral health-related quality of life (QoL), depression, and anxiety between spinal cord injury (SCI) patients and healthy controls and also to determine the key factors related to the oral health-related quality of life
Joseph, Dolly Rebecca Doran
The playing of computer games is one of the most popular non-school activities of children, particularly boys, and is often the entry point to greater facility with and use of other computer applications. Children are learning skills as they play, but what they learn often does not generalize beyond application to that and other similar games. Nevertheless, games have the potential to develop in students the knowledge and skills described by national and state educational standards. This study focuses upon middle-school aged children, and how they react to and respond to computer games designed for entertainment and educational purposes, within the context of science learning. Through qualitative, case study methodology, the game play, evaluation, and modification experiences of four diverse middle-school-aged students in summer camps are analyzed. The inquiry focused on determining the attributes of computer games that appeal to middle school students, the aspects of science that appeal to middle school children, and ultimately, how science games might be designed to appeal to middle school children. Qualitative data analysis led to the development of a method for describing players' activity modes during game play, rather than the conventional methods that describe game characteristics. These activity modes are used to describe the game design preferences of the participants. Recommendations are also made in the areas of functional, aesthetic, and character design and for the design of educational games. Middle school students may find the topical areas of forensics, medicine, and the environment to be of most interest; designing games in and across these topic areas has the potential for encouraging voluntary science-related play. Finally, when including children in game evaluation and game design activities, results suggest the value of providing multiple types of activities in order to encourage the full participation of all children.
Forman, Marianne; Hansen, Anne Grethe; Jørgensen, Michael Søgaard
indirect demand for greening activities. The analysis shows the co-construction of environmental concerns and demands, companies’ environmental practices and technological developments, and their stabilisation in the supply chain. The case studies also point to how the greening of frontrunners might make...... the way for further greening and for further company and product chain shaping of green demand. The case studies thus lead to suggest to continue the three types of governmental regulation to support the needs for greening: demands to the environmental impact, support to competence development......Companies and governments, particularly in the industrialised countries are increasingly aware of the environmental consequences of production, and ‘greening activities’ have increasingly played a role in company strategy and government policy. This has also been the case in Denmark, and the Danish...
Glowacki-Dudka, Michelle; Usman, Irianti; Treff, Marjorie
This study examines the breakdown of professional and personal communication and relationship through the lens of cultural differences. The case is based on the experience of two female adult educators--an American and a Saudi--working within continuing education at a private women's college in Jeddah, Saudi Arabia. Graduates of the same U.S.…
Sa, Creso M.
The emerging field of nanotechnology has created a new frontier for the convergence of university and industrial research. In the United States, major federal investments provided a massive boom for this field over the decade. This paper reports on a case study of how the University at Albany came to establish the first college of nanotechnology…
English, M.; Schexnayder, S.; Altman, J. [Tennessee Univ., Knoxville, TN (United States). Energy, Environment and Resources Center; Schweitzer, M. [Oak Ridge National Lab., TN (United States)
This report discusses the activities of organizations that seek to promote integrated resource planning and aggressive, cost-effective demand-side management by utilities. The activities of such groups -- here called energy efficiency advocacy groups (EEAGs) -- are examined in ten detailed am studies. Nine of the cases involve some form of interactive effort between investor-owned electric utilities and non-utility to develop policies, plans, or programs cooperatively. Many but not all of the interactive efforts examined are formal collaboratives. In addition, all ten cases include discussion of other EEAG activities, such as coalition-building, research, participation in statewide energy planning, and intervention in regulatory proceedings.
Taylor, Ruth; Thomas-Gregory, Annette
This article describes case study research for nursing and healthcare practice. Case study research offers the researcher an approach by which a phenomenon can be investigated from multiple perspectives within a bounded context, allowing the researcher to provide a 'thick' description of the phenomenon. Although case study research is a flexible approach for the investigation of complex nursing and healthcare issues, it has methodological challenges, often associated with the multiple methods used in individual studies. These are explored through examples of case study research carried out in practice and education settings. An overview of what constitutes 'good' case study research is proposed.
Whalon, Kelly J.; Conroy, Maureen A.; Martinez, Jose R.; Werch, Brittany L.
The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old…
Joshi, Ashwini; Jiang, Yang; Stemple, Joseph C; Archer, Sanford M; Andreatta, Richard D
Peripheral and behavioral effects of voice disorders are well documented in the literature; yet, there is little information regarding the central neural biomarkers and mechanisms underlying these disorders. Understanding the details of brain function changes in disordered voice production is a critical factor for developing better treatment strategies that result in more robust patient outcomes. To examine a model of induced unilateral vocal fold paralysis (iUVFP) to demonstrate and characterize the form of activity changes within central mappings of the larynx to the induced paralysis. The induced paralysis model allowed the participant to serve as his or her own control when comparing baseline results of normal voice with results during the paralysis and subsequent recovery. Prospective, case-study design. Functional magnetic resonance imaging was used to examine central laryngeal representations during three time points: pre-iUVFP, during iUVFP, and postrecovery from iUVFP. iUVFP was induced using a lidocaine with epinephrine nerve block unilaterally. Percent changes in blood oxygenation level-dependent (BOLD) activity served as the dependent variable. Results indicated an overall reduced activity level in sensorimotor, subcortical, and cerebellar regions during paralysis. Recovery from paralysis led to augmented responses, particularly in sensory, association, and cerebellar zones. The decrease in activity during iUVFP and the significantly increased activity during the recovery phase likely represent immediate neuroplastic events occurring within minutes of nerve blockade. Recovery-related changes in the BOLD response are hypothesized to be associated with a recalibration of the system after return of normal laryngeal function. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Madrigano, Jaime; Ito, Kazuhiko; Johnson, Sarah; Kinney, Patrick L; Matte, Thomas
As a result of climate change, the frequency of extreme temperature events is expected to increase, and such events are associated with increased morbidity and mortality. Vulnerability patterns, and corresponding adaptation strategies, are most usefully conceptualized at a local level. We used a case-only analysis to examine subject and neighborhood characteristics that modified the association between heat waves and mortality. All deaths of New York City residents from 2000 through 2011 were included in this analysis. Meteorological data were obtained from the National Climatic Data Center. Modifying characteristics were obtained from the death record and geographic data sets. A total of 234,042 adult deaths occurred during the warm season of our study period. Compared with other warm-season days, deaths during heat waves were more likely to occur in black (non-Hispanic) individuals than other race/ethnicities [odds ratio (OR) = 1.08; 95% CI: 1.03, 1.12], more likely to occur at home than in institutions and hospital settings (OR = 1.11; 95% CI: 1.06, 1.16), and more likely among those living in census tracts that received greater public assistance (OR = 1.05; 95% CI: 1.01, 1.09). Finally, deaths during heat waves were more likely among residents in areas of the city with higher relative daytime summer surface temperature and less likely among residents living in areas with more green space. Mortality during heat waves varies widely within a city. Understanding which individuals and neighborhoods are most vulnerable can help guide local preparedness efforts.
Wu, Rui; Dai, Hancheng; Geng, Yong; Xie, Yang; Masui, Toshihiko; Liu, Zhiqing; Qian, Yiying
PM 2.5 pollution-related diseases cause additional medical expenses and work time loss, leading to macroeconomic impact in high PM 2.5 concentration areas. Previous economic impact assessments of air pollution focused on benefits from environmental regulations while ignoring climate policies. In this study, we examine the health and economic impacts from PM 2.5 pollution under various air pollution control strategies and climate policies scenarios in the megacity of Shanghai. The estimation adopts an integrated model combining a Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, exposure-response functions (ERFs), and a computable general equilibrium (CGE) model. The results show that without control measures, Shanghai's mortality caused by PM 2.5 pollution are estimated to be 192 400 cases in 2030 and the work time loss to be 72.1 h/cap annually. The corresponding GDP values and welfare losses would be approximately 2.26% and 3.14%, respectively. With an estimated control cost of 0.76% of local GDP, Shanghai would gain approximately 1.01% of local GDP through local air pollution control measures and climate policies. Furthermore, the application of multiregional integrated control strategies in neighboring provinces would be the most effective in reducing PM 2.5 concentration in Shanghai, leading to only 0.34% of GDP loss. At the sectoral level, labor-intensive sectors suffer more output loss from PM 2.5 pollution. Sectors with the highest control costs include power generation, iron and steel, and transport. The results indicate that the combination of multiregional integrated air pollution control strategies and climate policies would be cost-beneficial for Shanghai.
Poorandokht Afshari; Shiva Yazdizadeh; Parvin Abedi; Homayra Rashidi
Background. Diabetic patients are at the greater risk of retinopathy, nephropathy, neuropathy, and sexual dysfunction compared to the general population. Objective. The aim of this study was to evaluate the sexual dysfunction in type 2 diabetes reproductive age women in Iran. Method. This was a case-control study carried out on 130 women with type 2 diabetes and 130 healthy women. The type 2 diabetes diagnosis was confirmed with abnormal fasting blood sugar, abnormal random blood sugar test, ...
Chui, Tina Tsz-Ting; Lee, Wen-Chung
Many diseases result from the interactions between genes and the environment. An efficient method has been proposed for a case-control study to estimate the genetic and environmental main effects and their interactions, which exploits the assumptions of gene-environment independence and Hardy-Weinberg equilibrium. To estimate the absolute and relative risks, one needs to resort to an alternative design: the case-base study. In this paper, the authors show how to analyze a case-base study under the above dual assumptions. This approach is based on a conditional logistic regression of case-counterfactual controls matched data. It can be easily fitted with readily available statistical packages. When the dual assumptions are met, the method is approximately unbiased and has adequate coverage probabilities for confidence intervals. It also results in smaller variances and shorter confidence intervals as compared with a previous method for a case-base study which imposes neither assumption. PMID:25137392
Petersen, Liselotte; Sørensen, Thorkild I A; Andersen, Per Kragh
probability weighting to account for the sampling in a conditional, shared frailty Poisson model and to use the robust variance estimator proposed by Moger et al. (Statist. Med. 2008; 27:1062-1074).To explore the performance of the estimation procedure, a simulation study was conducted. We studied situations...... of their biological and adoptive parents were collected with the purpose of studying the association of survival between the adoptee and his/her biological or adoptive parents. Motivated by this study, we explored how to make inference in a shared frailty model for case-cohort data. Our approach was to use inverse...
Some of the questions with respect to the trade of nitrogen oxides that businesses in the Netherlands have to deal with are dealt with: should a business buy or sell rights for NOx emission; which measures must be taken to reduce NOx emission; how much must be invested; and how to deal with uncertainties with regard to prices. Simulations were carried out with the MOSES model to find the answers to those questions. Results of some case studies are presented, focusing on the chemical sector in the Netherlands. Finally, the financial (dis)advantages of NOx trade and the related uncertainties for a single enterprise are discussed [nl
The reasons for wanting to document this case study and present the findings are simple. According to USDOE technical risk assessments (and our own initial work on the Hanford socioeconomic study), the likelihood of a major accident involving exposure to radioactive materials in the process of site characterization, construction, operation, and closure of a high-level waste repository is extremely remote. Most would agree, however, that there is a relatively high probability that a minor accident involving radiological contamination will occur sometime during the lifetime of the repository -- for example, during transport, at an MRS site or at the permanent site itself during repacking and deposition. Thus, one of the major concerns of the Yucca Mountain Socioeconomic Study is the potential impact of a relatively minor radiation-related accident. A large number of potential impact of a relatively minor radiation-related accident. A large number of potential accident scenarios have been under consideration (such as a transportation or other surface accident which results in a significant decline in tourism, the number of conventions, or the selection of Nevada as a retirement residence). The results of the work in Goiania make it clear, however, that such a significant shift in established social patterns and trends is not likely to occur as a direct outcome of a single nuclear-related accident (even, perhaps, a relatively major one), but rather, are likely to occur as a result of the enduring social interpretations of such an accident -- that is, as a result of the process of understanding, communicating, and socially sustaining a particular set of associations with respect to the initial incident
Rodrigues, João B; Araújo, Stéphane; Guedes-Pinto, Henrique; San Roman, Fidel; Viegas, Carlos; Bastos, Estela
Prognathism and brachygnathism are craniofacial deformities that severely affect the health of human and vertebrates, such as donkeys. The multifactorial etiology of this disease makes the genetic analysis a powerful tool for its understanding and prevention of spreading these deformities. This study aims to contribute to the characterization of the genetic basis of prognathism and brachygnathism in donkeys, using the Zamorano-Leonés donkey, an endangered Spanish breed, as a model. Matrilin-1 (MATN1) polymorphisms have been previously described as markers for mandibular prognathism in Korean and Japanese human populations. Genetic variations in MATN1 gene were sought, in order to verify its association in a case-control study, including 30 donkeys presenting brachygnathism, 30 donkeys presenting prognathism and 30 donkeys with normal occlusion phenotypes. One genetic variation (g503G > A) located in an intronic region of MATN1 gene was identified and characterized. Statistically significant differences were detected between the control group and prognathism cases, but no statistical significant results were found between the control group and the brachygnathism cases. These results support evidence for an important role of MATN1 on prognathism in the analyzed population with MATN1 genetic variation - 503G>A - having a protective effect. Further studies should be developed in order to understand the whole role of MATN1 and the mechanisms affected by its genetic variations. Copyright © 2013 Elsevier B.V. All rights reserved.
Ikard, Scott; Kress, Wade
Transmissivity is a bulk hydraulic property that can be correlated with bulk electrical properties of an aquifer. In aquifers that are electrically-resistive relative to adjacent layers in a horizontally stratified sequence, transmissivity has been shown to correlate with bulk transverse resistance. Conversely, in aquifers that are electrically-conductive relative to adjacent layers, transmissivity has been shown to correlate with bulk longitudinal conductance. In both cases, previous investigations have relied on small datasets (on average less than eight observations) that have yielded coefficients of determination (R2) that are typically in the range of 0.6 to 0.7 to substantiate these relations. Compared to previous investigations, this paper explores hydraulic-electrical relations using a much larger dataset. Geophysical data collected from 26 boreholes in Emirate Abu Dhabi, United Arab Emirates, are used to correlate transmissivity modeled from neutron porosity logs to the bulk electrical properties of the surficial aquifer that are computed from deep-induction logs. Transmissivity is found to be highly correlated with longitudinal conductance. An R2 value of 0.853 is obtained when electrical effects caused by variations in pore-fluid salinity are taken into consideration.
De Ambrosis, Anna; Levrini, Olivia
This paper concerns an empirical study carried out with a group of high school physics teachers engaged in the Module on relativity of a Master course on the teaching of modern physics. The study is framed within the general research issue of how to promote innovation in school via teachers' education and how to foster fruitful interactions…
Studies teacher-community relations in a community where teachers are becoming more involved in indigenous community issues. Argues that formal teacher education tends to emphasize modernity and consumer culture at the expense of distinct local customs. Draws connections between the case study and low-income minority communities in the United…
Grosen, Dorthe; Chevrier, Cécile; Skytthe, Axel
OBJECTIVES: To determine if the anatomical severity of oral clefting affects familial recurrence in a large population based sample. To provide reliable recurrence risk estimates for oral cleft for first, second, and third degree relatives. DESIGN: Population based cohort study. SETTING: Denmark....... PARTICIPANTS: 6776 individuals affected with an oral cleft born from 1952 to 2005 and 54 229 relatives. MAIN OUTCOME MEASURES: Recurrence risk estimates for oral cleft for first, second, and third degree relatives and stratification by severity, specificity, parent of origin effect, and family size for first...... degree relatives. RESULTS: For cleft lip and palate probands we observed recurrence risks for first, second, and third degree relatives of respectively 3.5% (95% CI 3.1% to 4.0%), 0.8% (95% CI 0.6% to 1.0%), and 0.6% (95% CI 0.4% to 0.8%). Individuals affected by the most severe oral cleft had...
Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University. The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion. The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group. It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products. Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’
Bratsas, Charalampos; Frantzidis, Christos A; Klados, Manousos; Papadelis, Christos; Pappas, Costas; Bamidis, Panagiotis D
The continuously increasing number of neuroscience studies and the difficulties associated with searching for related information and properly tracking neuroscience findings makes it imperative that one may be lead to isolated theories and findings which may be incompatible to each other or partially occluded. Semantically describing several aspects of studies in this field, such as, research groups attributes, aims of studies, experimental procedures followed, hardware and software tools utilised, acquisition systems used, as well as, the emerging neuro-physiological patterns found, may facilitate an integrative view of neuroscience theories. To this end, the current piece of work aims to provide a global theoretical framework using ontologies and semantic rules to describe neuroscience studies. Implementation details and applicability of the proof of concept are illustrated by means of an example targeting the semantic description of an emotion related study. The importance of the proposed framework in facilitating the envisaged personalised healthcare of the information society is discussed.
Full Text Available Abstract Background Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available. The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. Methods A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1 430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR with 95% confidence intervals (CI. Results Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14 or colleagues (OR 4.68; CI 1.43-15.29. Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70. Conclusions Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick.
Theunissen, M.J.; de Man, I.; Verdonk, P.; Bosma, H.; Feron, F.
Background: As school dropout is an important public health problem that needs to be addressed, we set out to examine whether and how, beyond the well-known effects of sex, gender beliefs and self-reported masculinity and femininity are related to school dropout. Methods: The study used a
Anna De Ambrosis
Full Text Available This paper concerns an empirical study carried out with a group of high school physics teachers engaged in the Module on relativity of a Master course on the teaching of modern physics. The study is framed within the general research issue of how to promote innovation in school via teachers’ education and how to foster fruitful interactions between research and school practice via the construction of networks of researchers and teachers. In the paper, the problems related to innovation are addressed by focusing on the phase during which teachers analyze an innovative teaching proposal in the perspective of designing their own paths for the class work. The proposal analyzed in this study is Taylor and Wheeler’s approach for teaching special relativity. The paper aims to show that the roots of problems known in the research literature about teachers’ difficulties in coping with innovative proposals, and usually related to the implementation process, can be found and addressed already when teachers approach the proposal and try to appropriate it. The study is heuristic and has been carried out in order to trace the “appropriation path,” followed by the group of teachers, in terms of the main steps and factors triggering the progressive evolution of teachers’ attitudes and competences.
Hijmans, Channa T.; Fijnvandraat, Karin; Oosterlaan, Jaap; Heijboer, Harriët; Peters, Marjolein; Grootenhuis, Martha A.
Low health-related quality of life (HRQoL) of children with sickle cell disease (SCD) may be associated with consequences of the disease, or with the low socio-economic status (SES) of this patient population. The aim of this study was to investigate the HRQoL of children with SCD, controlling for
Hijmans, C.T.; Fijnvandraat, K.; Oosterlaan, J.; Heijboer, H.; Peters, M.; Grootenhuis, M.A.
Background: Low health-related quality of life (HRQoL) of children with sickle cell disease (SCD) may be associated with consequences of the disease, or with the low socio-economic status (SES) of this patient population. The aim of this study was to investigate the HRQoL of children with SCD,
Gregoria Arum Yudarwati
Full Text Available Abstract: Studi kasus di industri pertambangan Indonesia dipilih sebagai jendela untuk memahami fungsi public relations (PR di era paska Suharto. Partisipan memandang era reformasi yang memungkinkan kebebasan berpendapat dan sistem desentralisasi sebagai pemicu untuk menyusun strategi public relations (PR yang baru dalam menjalin hubungan dengan publik. Personal relationship model of PR ditemukan sebagai model PR yang dominan di industri pertambangan Indonesia. Model ini dipilih sebagai strategi untuk membangun hubungan baik dengan orangorang kunci di komunitas yang dipahami sebagai masyarakat kolektif. Temuan ini mendukung proposisi yang menyatakan adanya pengaruh budaya setempat dan nilai-nilai lokal terhadap paktekPR.
Gomes, Raquel R; Habckost, Clarissa D; Junqueira, Larissa G; Leite, André F; Figueiredo, Paulo T; Paula, Lílian M; Acevedo, Ana C
An association between tooth agenesis and taurodontism has been suggested. To verify if tooth agenesis and taurodontism are associated within families and specific patterns of tooth agenesis, this study aims to compare the frequency of taurodontism in patients with nonsyndromic familial tooth agenesis, their first and second-degree relatives with complete permanent dentition and a control group of unrelated healthy individuals with complete permanent dentition. Panoramic radiographs of patients with nonsyndromic familial tooth agenesis, their first and second-degree relatives and a control group of individuals with complete permanent dentition were examined. Taurodontism was assessed on permanent mandibular first molars. The difference in the frequency of taurodontism among the studied groups was tested with Fisher's Exact Test. Seventeen families with nonsyndromic familial tooth agenesis were studied. The frequency of taurodontism was 29% in patients with tooth agenesis, 10.3% in their first and second degree relatives, and 6.6% in the control group. A significant statistical difference among the studied groups was observed (p=0.002). Taurodontism was proportionally more frequent in patients with a higher number of absent teeth. It was mainly observed in patients from families in which the proband was diagnosed with oligodontia. Taurodontism is more frequent in nonsyndromic familial tooth agenesis. Individuals in families with second premolar and molar oligodontia are more likely to have taurodontism, even the individuals with complete dentition. This association could define a subphenotype for future genetic studies of dental development. Copyright © 2012 Elsevier Ltd. All rights reserved.
Kontou, Niki; Psaltopoulou, Theodora; Soupos, Nick; Polychronopoulos, Evangelos; Xinopoulos, Dimitrios; Linos, Athena; Panagiotakos, Demosthenes B
The protective role of Mediterranean diet (MD) and the detrimental effect of smoking on colorectal cancer (CRC) have already been shown. The aim of this work was to evaluate the potential mediating effect of MD on the association between the aforementioned factor (smoking) and CRC. It is a case-control study. Two hundred fifty consecutive patients with CRC (63 ± 12 years, 59% males) and 250 age-sex group-matched controls, both from the area of Attica, were studied. Various socio-demographic, clinical, lifestyle (including detailed smoking habits) and dietary characteristics were measured. Adherence to the MD was evaluated using the MedDietScore (theoretical range 0-55). Each unit increase in the MedDietScore was associated with 13% lower likelihood of CRC (P dietary pattern with regards to CRC morbidity and mortality.
Werker, Claudia; Ooms, Ward; Caniëls, Marjolein C J
Previous studies investigating proximity and collaboration have not clarified personal elements, such as working or communication style. Here, we show that personal proximity-close similarity in terms of personal traits and behavioral patterns-substantially affects the whole life cycle of research collaborations. We conduct a multi-case study of Dutch nanotechnology researchers. We select our interviewees through a bibliometric analysis and focus on the most central Dutch nanotechnology researchers in the global network. Our results reveal that social proximity and temporary geographical proximity have indirect effects enabling potential partners to assess their personal proximity. Sufficient levels of personal proximity often make or break the deal, provided that partners' cognitive and organizational proximity-which are major drivers of research collaborations-suffice. Introducing personal proximity to analyze research collaborations puts previous findings on proximity dimensions' effect on collaboration in a new perspective.
Assessment of (dis)ability in a prospec tive commercial diver with a hand injury – a case study. A case study in disability. W A J (JAck) MeintJes, MB ChB, DOM, FCPHM (SA) Occ Med, MMed (Occ Med). Specialist, Occupational Medicine, Division of Community Health, Department of Interdisciplinary Health Sciences, ...
Guèze, Maximilien; Luz, Ana Catarina; Paneque-Gálvez, Jaime; Macía, Manuel J; Orta-Martínez, Martí; Pino, Joan; Reyes-García, Victoria
Understanding how indigenous peoples' management practices relate to biological diversity requires addressing contemporary changes in indigenous peoples' way of life. This study explores the association between cultural change among a Bolivian Amazonian indigenous group, the Tsimane', and tree diversity in forests surrounding their villages. We interviewed 86 informants in six villages about their level of attachment to traditional Tsimane' values, our proxy for cultural change. We estimated tree diversity (Fisher's Alpha index) by inventorying trees in 48 0.1-ha plots in old-growth forests distributed in the territory of the same villages. We used multivariate models to assess the relation between cultural change and alpha tree diversity. Cultural change was associated with alpha tree diversity and the relation showed an inverted U-shape, thus suggesting that tree alpha diversity peaked in villages undergoing intermediate cultural change. Although the results do not allow for testing the direction of the relation, we propose that cultural change relates to tree diversity through the changes in practices and behaviors that affect the traditional ecological knowledge of Tsimane' communities; further research is needed to determine the causality. Our results also find support in the intermediate disturbance hypothesis, and suggest that indigenous management can be seen as an intermediate form of anthropogenic disturbance affecting forest communities in a subtle, non-destructive way.
Guèze, Maximilien; Luz, Ana Catarina; Paneque-Gálvez, Jaime; Macía, Manuel J.; Orta-Martínez, Martí; Pino, Joan; Reyes-García, Victoria
Understanding how indigenous peoples’ management practices relate to biological diversity requires addressing contemporary changes in indigenous peoples’ way of life. This study explores the association between cultural change among a Bolivian Amazonian indigenous group, the Tsimane’, and tree diversity in forests surrounding their villages. We interviewed 86 informants in six villages about their level of attachment to traditional Tsimane’ values, our proxy for cultural change. We estimated tree diversity (Fisher’s Alpha index) by inventorying trees in 48 0.1-ha plots in old-growth forests distributed in the territory of the same villages. We used multivariate models to assess the relation between cultural change and alpha tree diversity. Cultural change was associated with alpha tree diversity and the relation showed an inverted U-shape, thus suggesting that tree alpha diversity peaked in villages undergoing intermediate cultural change. Although the results do not allow for testing the direction of the relation, we propose that cultural change relates to tree diversity through the changes in practices and behaviors that affect the traditional ecological knowledge of Tsimane’ communities; further research is needed to determine the causality. Our results also find support in the intermediate disturbance hypothesis, and suggest that indigenous management can be seen as an intermediate form of anthropogenic disturbance affecting forest communities in a subtle, non-destructive way. PMID:26097240
Full Text Available Background Previous studies have mostly focused on socio-demographic and health-related determinants of health-related behaviors. Although comprehensive health insurance coverage could discourage individual lifestyle improvement due to the ex-ante moral hazard problem, few studies have examined such effects. This study examines the association of a comprehensive set of factors including socio-demographic, health status, health insurance, and perceived change in health insurance coverage with health-related behaviors and their dynamics (ie, changes in behavior. Methods Using Survey of Health, Aging, and Retirement in Europe (SHARE data (a European aging survey among 50+ years old for the Netherlands in 2004 and 2007 (sample size: 1745, binary and multinomial logit models are employed to study health-related behaviors (daily smoking, excessive alcohol use, and physical inactivity in 2004 and their corresponding changes (stopping or starting unhealthy behavior between 2004 and 2007. Results Our findings show that being older, being female, having higher education and living with a partner increase the likelihood not to be a daily smoker or to stop daily smoking. At the same time, being older (OR = 3.02 [1.31, 6.95] and being female (OR = 1.77 [1.05, 2.96] increases the likelihood to be or to become physically inactive. We also find that worse perceived health insurance coverage in 2007 is associated with a lower likelihood (OR = 0.19 [0.06, 0.57] of stopping excessive alcohol use in that year. However, we do not find a strong association between the type of health insurance and health behavior. Conclusion Our findings show that all above mentioned factors (ie, socio-demographic and health status factors are associated with health-related behavior but not in a consistent way across all behaviors. Moreover, the dynamics of each behavior (positive or negative change is not necessarily determined by the same factors that determine the state of that
Full Text Available Background. Diabetic patients are at the greater risk of retinopathy, nephropathy, neuropathy, and sexual dysfunction compared to the general population. Objective. The aim of this study was to evaluate the sexual dysfunction in type 2 diabetes reproductive age women in Iran. Method. This was a case-control study carried out on 130 women with type 2 diabetes and 130 healthy women. The type 2 diabetes diagnosis was confirmed with abnormal fasting blood sugar, abnormal random blood sugar test, and abnormal level of HbA1C. Eligible women were requested to complete a demographic questionnaire and female sexual function index (FSFI. The chi-square test, independent t-test, and Multivariate Analysis of Covariance (MANCOVA were used for analyzing data. Results. Results of this study showed that diabetic women had significantly lower sexual desire, arousal, lubrication, and orgasm and more pain compared to the healthy women (p<0.05. Also diabetic women had lower sexual satisfaction compared to the healthy women (p=0.002. The total score of sexual function was significantly lower in the diabetic women compared to the healthy women (21.25±7.04 versus 22.43±7.6, p=0.004. Conclusion. Results of this study showed that the score of all dimensions of sexual function in diabetic patients was lower than that in healthy women. Education and counseling about controlling diabetes and sexual function among diabetic women in reproductive age are recommended.
Afshari, Poorandokht; Yazdizadeh, Shiva; Abedi, Parvin; Rashidi, Homayra
Background. Diabetic patients are at the greater risk of retinopathy, nephropathy, neuropathy, and sexual dysfunction compared to the general population. Objective. The aim of this study was to evaluate the sexual dysfunction in type 2 diabetes reproductive age women in Iran. Method. This was a case-control study carried out on 130 women with type 2 diabetes and 130 healthy women. The type 2 diabetes diagnosis was confirmed with abnormal fasting blood sugar, abnormal random blood sugar test, and abnormal level of HbA1C. Eligible women were requested to complete a demographic questionnaire and female sexual function index (FSFI). The chi-square test, independent t -test, and Multivariate Analysis of Covariance (MANCOVA) were used for analyzing data. Results. Results of this study showed that diabetic women had significantly lower sexual desire, arousal, lubrication, and orgasm and more pain compared to the healthy women ( p diabetic women had lower sexual satisfaction compared to the healthy women ( p = 0.002). The total score of sexual function was significantly lower in the diabetic women compared to the healthy women (21.25 ± 7.04 versus 22.43 ± 7.6, p = 0.004). Conclusion. Results of this study showed that the score of all dimensions of sexual function in diabetic patients was lower than that in healthy women. Education and counseling about controlling diabetes and sexual function among diabetic women in reproductive age are recommended.
Yang, Huaxia; Liu, Hui; Xu, Dong; Zhao, Lidan; Wang, Qian; Leng, Xiaomei; Zheng, Wenjie; Zhang, Fengchun; Tang, Fulin; Zhang, Xuan
To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL). Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. PRL cases were divided into active (a-PRL) (n = 82, 53.0%) and stable lupus (s-PRL) (n = 73, 47.0%). Compared with nonpregnant active female systemic lupus erythematosus (SLE) patients, a-PRL including new-onset lupus (n-PRL) and flare lupus (f-PRL) (n = 41 respectively), had a higher incidence of renal and hematological involvement but less mucocutaneous and musculoskeletal involvement (plupus flares and serological activity (hypocomplementemia and/or anti-dsDNA positivity) at the time of conception were associated with lupus flares in PRL mothers. SLE patients with a flare history and serological activity at the time of conception were at an increased risk of disease flares during pregnancy and puerperium. a-PRL patients were more prone to renal and hematological involvement, pregnancy complications, and a poorer prognosis despite more vigorous glucocorticoid treatment.
Britt, Sylvia E; Coles, Karen M; Polson, Shannon S
The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives. A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI). The largest of the 3 wounds was a Class III skin tear based on the Payne-Martin Classification System. It measured (L) 4.4 cm × (W) 1.8 cm × (D) 0.3 cm and required 3 months to heal. Experiences with this case revealed the need for evidence-based practice innovations to prevent physical, emotional, and economic cost resulting from MARSI. We recommend early identification and careful documentation of susceptibility to MARSI prior to surgery and implementation of consensus-based recommendations for prevention of MARSI as advocated by the MARSI consensus group when preparing patients for surgery and treating wounds.
Pakpour, Amir H; Kumar, Santhosh; Scheerman, Janneke F M; Lin, Chung-Ying; Fridlund, Bengt; Jansson, Henrik
The study aimed to compare the oral health variables, general, and oral health-related quality of life (QoL), depression, and anxiety between spinal cord injury (SCI) patients and healthy controls and also to determine the key factors related to the oral health-related quality of life (OHRQoL) in the SCI patients. A total of 203 SCI patients and 203 healthy controls were enrolled. Patients and healthy adults were invited to attend a dental clinic to complete the study measures and undergo oral clinical examinations. OHRQoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14), and the general health-related quality of life (GHRQoL) was evaluated by SF-36. In SCI patients, depression and anxiety were recorded using the Hospital Anxiety and Depression Scale (HADS), while Functional Assessment Measure (FAM) was used to assess dependence and disability. All the subjects were examined for caries which was quantified using the decayed, missing, and filled Teeth (DMFT) index, gingival bleeding index (GI), plaque index, and periodontal status by community periodontal index (CPI). The analysis of covariance (ANCOVA) revealed significant differences between the two groups in terms of oral health expressed in DMFT, oral hygiene, and periodontal status, controlled for age, gender, family income, and occupational status (poral hygiene practices, greater levels of plaque, gingival bleeding, and caries experience than the healthy controls. In addition, more number of SCI patients had periodontal pockets and dry mouth than the comparative group. SCI patients experienced more depression and anxiety, poor GHRQoL, and OHRQoL than the healthy control group. The factors that influenced OHRQoL in SCI patients were age, toothbrushing frequency, smoking, oral clinical status, depression, physical component of GHRQoL, and level of lesion. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background We investigated the role of infection with genital and cutaneous human papillomavirus types (HPV in the aetiology of ocular surface squamous neoplasia (which includes both conjunctival intraepithelial neoplasia (CIN and carcinoma using data and biological material collected as part of a case-control study in Uganda. Results Among 81 cases, the prevalence of genital and cutaneous HPV types in tumour tissue did not differ significantly by histological grade of the lesion. The prevalence of genital HPV types did not differ significantly between cases and controls (both 38%; Odds ratio [OR] 1.0, 95% confidence interval [CI] 0.4–2.7, p = 1.0. The prevalence of cutaneous HPV types was 22% (18/81 among cases and 3% (1/29 among controls (OR 8.0, 95% CI 1.0–169, p = 0.04. Conclusion We find no evidence of an association between genital HPV types and ocular surface squamous neoplasia. The prevalence of cutaneous HPV was significantly higher among cases as compared to controls. Although consistent with results from two other case-control studies, the relatively low prevalence of cutaneous HPV types among cases (which does not differ by histological grade of tumour indicates that there remains considerable uncertainty about a role for cutaneous HPV in the aetiology of this tumour.
Spörri, Jörg; Kröll, Josef; Schwameder, Hermann; Schiefermüller, Christian; Müller, Erich
Course setting has often been discussed as a potential preventative measure in the World Cup ski-racing community. However, there is limited understanding of how it is related to injury risk. This study was undertaken to investigate the effect of increased horizontal gate distance on energy-related and injury mechanism-related variables. During a video-based three-dimensional (3D)-kinematic field measurement, a top world-class racer performed giant slalom runs at two course settings with different horizontal gate distances. A full-body segment model was reconstructed in 3D and selected biomechanical parameters were calculated. For the analysed turn, no significant differences were found in turn speed for increased horizontal gate distance. However, a large effect size was observed for speed reduction towards the end of the turn. Turn forces were by tendency higher at the beginning and significantly higher towards the end of the turn. Additionally, significant differences were found in higher inward leaning, and large effect sizes were observed for a decreased fore/aft position after gate passage. On the basis of the data of this study, no final conclusion can be made about whether, for a section of consecutive turns, increasing horizontal gate distance is an effective tool for speed reduction. However, this study pointed out two major drawbacks of this course setting modification: (1) it may increase fatigue as a consequence of loading forces acting over a longer duration; (2) it may increase the risk of out-of-balance situations by forcing the athlete to exhaust his backward and inward leaning spectrum.
Saxena, V.P.; Verma, S.C.
Exploration and exploitation of uranium involves drilling, mining, milling and extraction processes including heap leaching in some cases. At the exploration stage, the country's laws related to statutory environmental clearance covering forest and sanctuaries or Coastal Regulatory Zones (CRZ) are equally applicable for atomic minerals. At the developmental mining or commercial exploitation stage in addition to the environmental impact assessment, the provisions of Atomic Energy (working of Mines, Minerals and handling of Prescribed Substances) Rules 1984 are also to be followed which covers radiation monitoring, pollution control and other safety measures which are enforced by licensing authorities and the Atomic Energy Regulatory Board (AERB) of India. In India, Jaduguda, Bhatin, Narwapahar in Singhbhum Thrust Belt (STB), Asthota and Khiya in Siwaliks, Domiasiat in Cretaceous sandstones, Bodal and Jajawal in Precambrian crystallines, are some of the centres where mining has been carried out up to various underground levels. Substantial amount of dust and radon gas are generated during mining and milling operations. Though uranium mining is considered as hazardous for contamination by radionuclides, it is observed that many non-uranium mines have registered up to 100 mWL radon concentration, e.g. copper mines in STB area show up to 900 mewl in a few cases. Compared to this the Uranium mines in India have not shown any increase over the limits prescribed by AERB. Specific problems associated with mining include release of radon and other radioactive pollutants like Th-230, Ra-226, Pb-210 and Po-210, substantial dust generation, ground water contamination, proximity of population to working mines and environmental surveillance. These problems are adequately handled by periodical monitoring of various radiological parameters such as radon daughter working level, long lived alpha activity and concentration of radionuclides in gaseous, liquid and solid medium. Pre
Smebye, Kari Lislerud; Kirkevold, Marit; Engedal, Knut
Many countries have passed laws giving patients the right to participate in decisions about health care. People with dementia cannot be assumed to be incapable of making decisions on their diagnosis alone as they may have retained cognitive abilities.The purpose of this study was to gain a better understanding of how persons with dementia participated in making decisions about health care and how their family carers and professional caregivers influenced decision making. This Norwegian study had a qualitative multi-case design. The triad in each of the ten cases consisted of the person with dementia, the family carer and the professional caregiver, in all 30 participants. Inclusion criteria for the persons with dementia were: (1) 67 years or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2, moderate dementia; (3) able to communicate verbally. The family carers and professional caregivers were then asked to participate.A semi-structured interview guide was used in interviews with family carers and professional caregivers. Field notes were written after participant observation of interactions between persons with dementia and professional caregivers during morning care or activities at a day centre. How the professional caregivers facilitated decision making was the focus of the observations that varied in length from 30 to 90 minutes. The data were analyzed using framework analysis combined with a hermeneutical interpretive approach. Professional caregivers based their assessment of mental competence on experience and not on standardized tests. Persons with dementia demonstrated variability in how they participated in decision making. Pseudo-autonomous decision making and delegating decision making were new categories that emerged. Autonomous decision making did occur but shared decision making was the most typical pattern. Reduced mental capacity, lack of available choices or not being given the opportunity to participate led to non
Full Text Available Abstract Background Low health-related quality of life (HRQoL of children with sickle cell disease (SCD may be associated with consequences of the disease, or with the low socio-economic status (SES of this patient population. The aim of this study was to investigate the HRQoL of children with SCD, controlling for SES by comparing them to healthy siblings (matched for age and gender, and to a Dutch norm population. Methods The HRQoL of 40 children with homozygous SCD and 36 healthy siblings was evaluated by the KIDSCREEN-52. This self-report questionnaire assesses ten domains of HRQoL. Differences between children with SCD and healthy siblings were analyzed using linear mixed models. One-sample t-tests were used to analyze differences with the Dutch norm population. Furthermore, the proportion of children with SCD with impaired HRQoL was evaluated. Results In general, the HRQoL of children with SCD appeared comparable to the HRQoL of healthy siblings, while children with SCD had worse HRQoL than the Dutch norm population on five domains (Physical Well-being, Moods & Emotions, Autonomy, Parent Relation, and Financial Resources. Healthy siblings had worse HRQoL than the Dutch norm population on three domains (Moods & Emotions, Parent Relation, and Financial Resources. More than one in three children with SCD and healthy siblings had impaired HRQoL on several domains. Conclusion These findings imply that reduced HRQoL in children with SCD is mainly related to the low SES of this patient population, with the exception of disease specific effects on the physical and autonomy domain. We conclude that children with SCD are especially vulnerable compared to other patient populations, and have special health care needs.
Full Text Available In Denpasar the capital of Bali Province, motorcycle accident contributes to about 80% of total road accidents. Out of those motorcycle accidents, 32% are fatal accidents. This study investigates the influence of accident related factors on motorcycle fatal accidents in the city of Denpasar during period 2006-2008 using a logistic regression model. The study found that the fatality of collision with pedestrians and right angle accidents were respectively about 0.44 and 0.40 times lower than collision with other vehicles and accidents due to other factors. In contrast, the odds that a motorcycle accident will be fatal due to collision with heavy and light vehicles were 1.67 times more likely than with other motorcycles. Collision with pedestrians, right angle accidents, and heavy and light vehicles were respectively accounted for 31%, 29%, and 63% of motorcycle fatal accidents.
Tarazona, Guillermo; Benedit, Gonzalo; Fernández, Rogelio; Pérez, Marta; Rodríguez, Jaime; Jiménez, Carlos; Cuevas, Carmen
QM/NMR-DFT (quantum mechanics combined with nuclear magnetic resonance parameters calculated by density functional theory approximations) studies allowed us to link two stereoclusters separated by two methylene groups present in the new meroditerpenes halioxepine B (2) and halioxepine C (3) and the known halioxepine (1), isolated from two Indonesian sponges of the genus Haliclona (Reniera). DP4 and DP4+ probabilities were used to discriminate the two diastereotopic arrangements of the two stereoclusters, whose unconnected relative configurations were determined by ROESY and J-based configurational analysis. To confirm the DFT studies, the full relative configuration of 1 was deduced using a mixture of benzene-d 6 and pyridine-d 5 as the NMR solvent. ROESY measurements connected the two stereoclusters and demonstrated that DFT calculations accurately predict the configuration when two methylenes separate the two stereoclusters. The different arrangements of the distant stereoclusters C-1/C-2/C-7 and C-10/C-15 for compounds 2 and 3 were deduced by DFT calculations and explained the opposite optical rotations observed for the two compounds. Halioxepines B (2) and C (3) display moderate cytotoxicity against different human cancer cell lines.
.... This report evaluates the dynamics of heliport development and operation in order to achieve greater success rate in the future through the case study investigation of six heliports that have both succeeded and failed...
Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...
As with any other hydroelectric installation project around the world, the construction of large dams in Africa such as the Kariba in Zambia, the Aswan High Dam in Egypt, the Akossombo in Ghana, and the Kossou in Ivory Coast have caused massive displacements of populations. Parallel to the attendant positive effects, negative effects have been observed following the relocation of those populations. These negative effects are social, cultural, political, economic, sanitary, demographic, psychological, and ecological. A comparative study is conducted of the four cases of dam construction cited above in order to demonstrate that errors committed by planners were at the source of those negative effects of population displacement. The knowledge of those errors committed in the past should serve as lessons for future instances of population relocation. Such lessons are outlined in the areas of relocation planning, principles of indemnization, re-housing of populations on new sites, and adaptation of the populations to new agricultural techniques. 116 refs., 14 figs., 5 tabs
Ridder, Hanne Mette Ochsner; Fachner, Jörg
be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....
Kandul Nikolai P
Full Text Available Abstract Background Alternative splicing (AS of maturing mRNA can generate structurally and functionally distinct transcripts from the same gene. Recent bioinformatic analyses of available genome databases inferred a positive correlation between intron length and AS. To study the interplay between intron length and AS empirically and in more detail, we analyzed the diversity of alternatively spliced transcripts (ASTs in the Drosophila RNA-binding Bruno-3 (Bru-3 gene. This gene was known to encode thirteen exons separated by introns of diverse sizes, ranging from 71 to 41,973 nucleotides in D. melanogaster. Although Bru-3's structure is expected to be conducive to AS, only two ASTs of this gene were previously described. Results Cloning of RT-PCR products of the entire ORF from four species representing three diverged Drosophila lineages provided an evolutionary perspective, high sensitivity, and long-range contiguity of splice choices currently unattainable by high-throughput methods. Consequently, we identified three new exons, a new exon fragment and thirty-three previously unknown ASTs of Bru-3. All exon-skipping events in the gene were mapped to the exons surrounded by introns of at least 800 nucleotides, whereas exons split by introns of less than 250 nucleotides were always spliced contiguously in mRNA. Cases of exon loss and creation during Bru-3 evolution in Drosophila were also localized within large introns. Notably, we identified a true de novo exon gain: exon 8 was created along the lineage of the obscura group from intronic sequence between cryptic splice sites conserved among all Drosophila species surveyed. Exon 8 was included in mature mRNA by the species representing all the major branches of the obscura group. To our knowledge, the origin of exon 8 is the first documented case of exonization of intronic sequence outside vertebrates. Conclusion We found that large introns can promote AS via exon-skipping and exon turnover during
BACKGROUND: Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. METHODS\\/DESIGN: Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK) and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. DISCUSSION: The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in
Full Text Available Abstract Background Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP, remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain. Methods/Design Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds. Discussion The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying
Benisi-Kohansal, Sanaz; Shayanfar, Mehdi; Mohammad-Shirazi, Minoo; Tabibi, Hadi; Sharifi, Giuve; Saneei, Parvane; Esmaillzadeh, Ahmad
Data on the association of adherence to the Dietary Approaches to Stop Hypertension (DASH)-style and glioma are scarce. We aimed to examine the association between adherence to the DASH-style diet and glioma in Iranian adults. In this study, 128 pathologically confirmed cases of glioma were recruited from hospitals and 256 age- and sex-matched controls were enrolled from other wards of the hospital. Dietary intakes were assessed using a 126-item validated FFQ. Adherence to the DASH-style diet was followed considering the healthy and non-healthy foods emphasised in the DASH dietary pattern. After controlling for potential confounders, individuals with the greatest adherence to the DASH diet were 72 % less likely to have glioma compared with those with the lowest adherence (OR 0·28; 95 % CI 0·13, 0·57). Individuals with the highest consumption of fruits had lower odds for having glioma compared with those with the lowest intake (OR 0·31; 95 % CI 0·14, 0·68). A protective association was also observed between consumption of legumes and nuts and risk of glioma (OR 0·23; 95 % CI 0·10, 0·53). We found a significant positive association between red and processed meat (OR 2·60; 95 % CI 1·16, 5·81) and salt intakes (OR 2·87; 95 % CI 1·30, 6·34) and risk of glioma, after taking all potential confounders into account. Adherence to the DASH-style dietary pattern was inversely associated with glioma. In addition, some components of the DASH diet, including red meats and salt intakes, were positively associated with glioma. Consumption of nuts and legumes as well as fruits was inversely associated with glioma. Prospective cohort studies are required to confirm our findings.
Natalia V. Zaytseva
Full Text Available His article deals with political dialogue as the basis of the progressive development of interstate cooperation and one of the few ways to diminish interstate tensions without use of military force. With the growing list of new threats and challenges it is very important to work out an effective mechanism of interstate cooperation and to use it in foreign policy. Political dialogue helps to form the basis for cooperation between states to ensure the security, political and socio-economic stability of countries. Moreover, the political dialogue in its various forms is no longer a seldom-used private practice. It is the "all-encompassing reality" now the study of which is necessary for understanding of the social, economic, and humanitarian phenomena in the international relations. The author analyzes principles, functions, rules of constructive interstate dialogue, reflects the conditions of the development of a true political dialogue and reveals the situation of its "stylization" The provisions presented in this article are presented from the viewpoint of practical use in the development of a constructive foreign policy. At the same time the author points to their philosophical basis, identifies regularities and characteristics from the standpoint of philosophical knowledge. As a practical demonstration of carrying on the political dialogue the article presents a brief description of Russian-German political relations at the present stage. Bilateral relations between these two countries, based on the rich history, consilience of main positions in resolving of international problems, largely reflect the basic terms and principles of a competent political dialogue.
Natalia V. Zaytseva
Full Text Available His article deals with political dialogue as the basis of the progressive development of interstate cooperation and one of the few ways to diminish interstate tensions without use of military force. With the growing list of new threats and challenges it is very important to work out an effective mechanism of interstate cooperation and to use it in foreign policy. Political dialogue helps to form the basis for cooperation between states to ensure the security, political and socio-economic stability of countries. Moreover, the political dialogue in its various forms is no longer a seldom-used private practice. It is the "all-encompassing reality" now the study of which is necessary for understanding of the social, economic, and humanitarian phenomena in the international relations. The author analyzes principles, functions, rules of constructive interstate dialogue, reflects the conditions of the development of a true political dialogue and reveals the situation of its "stylization" The provisions presented in this article are presented from the viewpoint of practical use in the development of a constructive foreign policy. At the same time the author points to their philosophical basis, identifies regularities and characteristics from the standpoint of philosophical knowledge. As a practical demonstration of carrying on the political dialogue the article presents a brief description of Russian-German political relations at the present stage. Bilateral relations between these two countries, based on the rich history, consilience of main positions in resolving of international problems, largely reflect the basic terms and principles of a competent political dialogue.
Cochran, Kimberly; Townsend, Timothy; Reinhart, Debra; Heck, Howell
Methodology for the accounting, generation, and composition of building-related construction and demolition (C&D) at a regional level was explored. Six specific categories of debris were examined: residential construction, nonresidential construction, residential demolition, nonresidential demolition, residential renovation, and nonresidential renovation. Debris produced from each activity was calculated as the product of the total area of activity and waste generated per unit area of activity. Similarly, composition was estimated as the product of the total area of activity and the amount of each waste component generated per unit area. The area of activity was calculated using statistical data, and individual site studies were used to assess the average amount of waste generated per unit area. The application of the methodology was illustrated using Florida, US approximately 3,750,000 metric tons of building-related C&D debris were estimated as generated in Florida in 2000. Of that amount, concrete represented 56%, wood 13%, drywall 11%, miscellaneous debris 8%, asphalt roofing materials 7%, metal 3%, cardboard 1%, and plastic 1%. This model differs from others because it accommodates regional construction styles and available data. The resulting generation amount per capita is less than the US estimate - attributable to the high construction, low demolition activity seen in Florida.
Li, Xianbo; Zuo, Rui; Teng, Yanguo; Wang, Jinsheng; Wang, Bin
Increasing pressure on water supply worldwide, especially in arid areas, has resulted in groundwater overexploitation and contamination, and subsequent deterioration of the groundwater quality and threats to public health. Environmental risk assessment of regional groundwater is an important tool for groundwater protection. This study presents a new approach for assessing the environmental risk assessment of regional groundwater. It was carried out with a relative risk model (RRM) coupled with a series of indices, such as a groundwater vulnerability index, which includes receptor analysis, risk source analysis, risk exposure and hazard analysis, risk characterization, and management of groundwater. The risk map is a product of the probability of environmental contamination and impact. The reliability of the RRM was verified using Monte Carlo analysis. This approach was applied to the lower Liaohe River Plain (LLRP), northeastern China, which covers 23604 km2. A spatial analysis tool within GIS which was used to interpolate and manipulate the data to develop environmental risk maps of regional groundwater, divided the level of risk from high to low into five ranks (V, IV, III, II, I). The results indicate that areas of relative risk rank (RRR) V cover 2324 km2, covering 9.8% of the area; RRR IV covers 3986 km2, accounting for 16.9% of the area. It is a new and appropriate method for regional groundwater resource management and land use planning, and is a rapid and effective tool for improving strategic decision making to protect groundwater and reduce environmental risk.
Mokhtar, Intan Azura; Majid, Shaheen; Foo, Schubert; Zhang, Xue; Theng, Yin-Leng; Chang, Yun-Ke; Luyt, Brendan
Increased demand for medical or healthcare services has meant that nurses are to take on a more proactive and independent role intending to patients, providing basic treatment and deciding relevant clinical practice. This, in turn, translates into the need for nurses to be able to translate research and evidence into their practice more efficiently and effectively. Hence, competencies in looking for, evaluating, synthesizing and applying documented information or evidence-based practice becomes crucial. This article presents a quantitative study that involved more than 300 nurses from a large government hospital in Singapore. A self-reporting questionnaire was developed to collect data pertaining to evidence-based practice and activities, including those that demonstrate information literacy competencies. Results seem to suggest that the nurses preferred to use print and human information sources compared to electronic information sources; were not proactive in looking up research or evidence-based information and, instead, preferred such information to be fed to them; and that they perceived they lacked the ability to evaluate research papers or effectively search electronic information related to nursing or evidence-based practice. It was also found that more than 80% of the nurses have not had any training related to evidence-based practice.
Natalya N. Korableva
Full Text Available Introduction: The sudden infant death syndrome (SIDS, accidental asphyxia and suffocation in bed are the most significant part of the conditions united by the term “sudden unexpected death in infants” (SUDI. A high level of SUDI and a significant proportion in infant mortality are typical for countries with low rates of infant and babies mortality. The aim of the research is to study the epidemiological characteristics and risk factors of the sudden infant death syndrome in the Komi Republic from 1997 to 2015, to assess the contribution of SIDS, occasional asphyxia and suffocation in bed to the mortality of infants to determine the optimization of approaches to the prevention of these conditions. Materials and Methods: The retrospective data analysis of the death of infants has been performed according to medical records, protocols of pathoanatomical studies, and the conclusions of the infant mortality commission of the Ministry of Health of the Komi Republic from 1997 to 2015. Risk factors were assessed retrospectively on the scale of life-threatening conditions (Tsinserling A.V. and co-authors, 1987. Results: The cumulative infant mortality rate from SIDS was 0.63 ± 0.33 ‰ (median – 0.55 ‰. Within the past 5 years, when the infant mortality rate in the region has not changed significantly, averaging 5.22 ± 0.73 ‰, the infant mortality rate from SIDS was 0.40 ± 0.25 ‰ (median 0.43. This compares with the level registered in the USA (0,4‰ in 2013 and in Western Europe with a similar level of infant mortality. In infant mortality of in the post-neonatal period, SIDS occurred in 13.8 ± 6.3 % (median – 12.2 %. Generally recognized data on the significant contribution of social and biological factors to decreasing the risk of sudden death syndrome were confirmed. The scale of life-threatening conditions showed the high sensitivity to death from SIDS. An examination of the place accident and assess of death circumstances is
Andersen, Vibeke; Egeberg, Rikke; Tjonneland, Anne
Background: More than 50% of the colorectal cancer (CRC) etiology has been attributed to diet. Established or suspected dietary factors modifying risk of CRC are red meat, cereals, fish, and fibre. Diet and lifestyle may be linked to cancer through inflammation. Interleukin-10 (IL-10) is an anti......-inflammatory cytokine. We wanted to test if dietary factors and IL10 polymorphisms interact in relation to colorectal carcinogenesis. Methods: The functional IL10 polymorphism C-592A (rs1800872) and the marker rs3024505 were assessed in relation to diet and lifestyle in a nested case-cohort study of 378 CRC cases...... and 775 randomly selected participants from a prospective study of 57,053 persons. Genotyping data on the IL10 polymorphism C-592A, smoking and nonsteroidal anti-inflammatory drugs (NSAID) was retrieved from Vogel et al. (Mutat Res, 2007; 624: 88). Incidence rate ratios (IRR) and 95% Confidence Interval...
P. J. Gallimore
Full Text Available Many important atmospheric aerosol processes depend on the chemical composition of the aerosol, e.g. water uptake and particle cloud interactions. Atmospheric ageing processes, such as oxidation reactions, significantly and continuously change the chemical composition of aerosol particles throughout their lifetime. These ageing processes are often poorly understood. In this study we utilize an aerosol flow tube set up and an ultra-high resolution mass spectrometer to explore the effect of relative humidity (RH in the range of <5–90% on the ozonolysis of maleic acid aerosol which is employed as model organic aerosol system. Due to the slow reaction kinetics relatively high ozone concentrations of 160–200 ppm were used to achieve an appreciable degree of oxidation of maleic acid. The effect of oxidative ageing on the hygroscopicity of maleic acid particles is also investigated using an electrodynamic balance and thermodynamic modelling. RH has a profound effect on the oxidation of maleic acid particles. Very little oxidation is observed at RH < 50% and the only observed reaction products are glyoxylic acid and formic acid. In comparison, when RH > 50% there are about 15 oxidation products identified. This increased oxidation was observed even when the particles were exposed to high humidities long after a low RH ozonolysis reaction. This result might have negative implications for the use of water as an extraction solvent for the analysis of oxidized organic aerosols. These humidity-dependent differences in the composition of the ozonolyzed aerosol demonstrate that water is both a key reactant in the oxidation scheme and a determinant of particle phase and hence diffusivity. The measured chemical composition of the processed aerosol is used to model the hygroscopic growth, which compares favourably with water uptake results from the electrodynamic balance measurements. A reaction mechanism is presented which takes into account the RH dependent
Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely
Keely, S P; Brinkman, N E; Zimmerman, B D; Wendell, D; Ekeren, K M; De Long, S K; Sharvelle, S; Garland, J L
Development of efficacious grey water (GW) treatment systems would benefit from detailed knowledge of the bacterial composition of GW. Thus, the aim of this study was to characterize the bacterial composition from (i) various points throughout a GW recycling system that collects shower and sink handwash (SH) water into an equalization tank (ET) prior to treatment and (ii) laundry (LA) water effluent of a commercial-scale washer. Bacterial composition was analysed by high-throughput pyrosequencing of the 16S rRNA gene. LA was dominated by skin-associated bacteria, with Corynebacterium, Staphylococcus, Micrococcus, Propionibacterium and Lactobacillus collectively accounting for nearly 50% of the total sequences. SH contained a more evenly distributed community than LA, with some overlap (e.g. Propionibacterium), but also contained distinct genera common to wastewater infrastructure (e.g. Zoogloea). The ET contained many of these same wastewater infrastructure-associated bacteria, but was dominated by genera adapted for anaerobic conditions. The data indicate that a relatively consistent set of skin-associated genera are the dominant human-associated bacteria in GW, but infrastructure-associated bacteria from the GW collection system and ET used for transient storage will be the most common bacteria entering GW treatment and reuse systems. This study is the first to use high-throughput sequencing to identify the bacterial composition of various GW sources. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
Perko, T.; Tomkiv, Y.; Oughton, D.H.; Cantone, M.C.; Gallego, E.; Prezelj, I.; Byrkina, E.
Using an analysis of the way European newspapers covered the Fukushima nuclear accident, this article explores how the mass media transmit information about radiation risks from experts to the general public. The study applied a media content analysis method on a total of 1340 articles from 12 leading newspapers in 6 countries: Belgium (N = 260), Italy (N = 270), Norway (N = 133), Russia (N = 172), Slovenia (N = 190) and Spain (N = 315). All articles analysed were selected as being directly or indirectly related to the Fukushima accident by containing the word 'nuclear' and/or 'Fukushima' and were published between the 11 March and the 11 May 2011. The data presented here focus specifically on a cross-cultural comparison of the way the media use quantitative units. Results suggest that although experts are accustomed to communicating about radiological risks in technical language, often using quantitative units to describe the risks, mass media do not tend to use these units in their reporting. Although the study found a large variation in the measurement units used in different countries, it appeared that journalists in all the analysed countries preferred to describe radioactivity by comparing different radiation exposures, rather than reporting the actual measured units. The paper concludes with some practical guidelines for sound public communication about radiation risks. (authors)
Ranđelović, Dragana; Cvetković, Vladica; Mihailović, Nevena; Jovanović, Slobodan
The relationship between edaphic characteristics and vegetation growing on mine wastes in the Bor region (East Serbia, SE Europe) was studied using multivariate statistical analysis. The influence of edaphic factors on the composition of plant life-forms was also investigated, since it could reflect strategies for the avoidance of or tolerance to disturbances of ecosystems. The goal was to provide potential models for the restoration and management of this and similar mine waste areas. The results of this study imply that soil textures, nitrogen contents, reclamation technology and the presence of hydrothermally altered andesite as the type of bedrock significantly influenced plant colonization and vegetation composition of the Bor mine wastes. These edaphic factors explained 30.3 % of the total variation in the vegetation data set. It was also revealed that the pattern of plant life-forms found on the considered site groups corresponded to the soil texture. Based on their relative abundance on the investigated sites and relationships with soil properties it is concluded that therophytes and geophytes are unsuccessful primary colonizers of the Bor mine wastes. Hemicryptophytes of psammophytic character were the most successful primary colonizers and therefore potential candidates for anthropogenically-assisted natural recovery. This study suggested that an assessment of edaphic factors should be widely used in the characterization of mine wastes prior to reclamation. Estimation of their role in the development of existing mine vegetation should predate reclamation procedures. Thus, approaches based on adequate plant life-forms should have a more prominent role in future mine reclamation schemes.
Bortoluzzi, Andressa; Blaya, Carolina; Salum, Giovanni A; Cappi, Carolina; Leistner-Segal, Sandra; Manfro, Gisele G
The role of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in anxiety disorder and anxiety-related traits is controversial. Besides this study, few studies have evaluated the triallelic genotype in adolescents. The aim of this study was to investigate whether anxiety disorders and anxiety-related traits are associated with 5-HTTLPR (biallelic and triallelic) in adolescents, integrating both case-control-based and family-based designs in a community sample. This is a cross-sectional community study of 504 individuals and their families: 225 adolescents (129 adolescents with anxiety disorder and 96 controls) and their biological families. We assessed psychiatric diagnosis using the Kiddie Schedule for Affective Disorders and Schizophrenia. The Temperament and Character Inventory and the Resnick Behavioral Inhibition Scale were used to evaluate harm avoidance and behavioral inhibition. DNA was extracted from saliva and genotyped, including biallelic and triallelic 5-HTTLPR classification, by PCR-RFLP followed by agarose gel electrophoresis. We were not able to find any associations between 5-HTTLPR and anxiety-related phenotypes in both case-control and trio analyses. Further investigation and meta-analytic studies are needed to better clarify the inconsistent results with regard to the association between 5-HTTLPR and anxiety-related phenotypes in adolescents.
Kikuchi, Ryunosuke; Ferreira, Carla Sofia; Dinis Ferreira, Antonio
A peri-urban area refers to a transition or interaction zone, where urban and rural activities are juxtaposed, and landscape features are subject to rapid modifications, mainly due to human activities. It is reported that peri-urban areas which might include valuable protected areas (e.g. forested hills, preserved woodlands, prime agricultural lands, etc.) can provide essential life support services for urban residents. A peri-urban area is not only a zone experiencing the immediate impacts of land demands from urban growth and pollution, but it is also a wider market-related zone of influence, recognized for the supply of agricultural and natural resource products. It is reported that China's environmental crisis is one of the most pressing challenges to emerge from the country's rapid industrialization; therefore a field study was carried out to investigate the qualitative relation of soil property with vegetable agricultural products in the Chinese peri-urban area located in Luoyang city (34°37'N and 112°27'E). Soil, water and plant (e.g. squash, Cucurbita maxima) samples were taken over the study site, and heavy metal concentrations were analyzed. All the soil samples showed Cd concentrations exceeded the permissible level established by Chinese guidelines for soil quality (0.3 mg/kg). The contents of Zn, Pb and Cu also surpassed the Chinese guideline levels (Zn = 250 mg/kg, Pb = 50 mg/kg and Cu = 100 mg/kg) in several soil samples. Although the sampled plants contained some degree of all the heavy metals, only the Al concentration was high in the Cucurbita maxima samples (317 mg/kg), which is a specie of cultivated squash. Considering the world market and the global trade of agricultural products, it can be said that the food risk associated with farm products containing Al is not local but global. It is concluded that an environmental contamination of the peri-urban areas may lead to the threat to food security.
Full Text Available Climate change is of major relevance to wine production as most of the wine-growing regions of the world, in particular the Douro region, are located within relatively narrow latitudinal bands with average growing season temperatures limited to 13–21°C. This study focuses on the incidence of climate variables and indices that are relevant both for climate change detection and for grape production with particular emphasis on extreme events (e.g. cold waves, storms, heat waves. Dynamical downscaling of MPI-ESM-LR global data forced with RCP8.5 climatic scenario is performed with the Weather Research and Forecast (WRF model to a regional scale including the Douro valley of Portugal for recent-past (1986–2005 and future periods (2046–2065; 2081–2100. The number, duration and intensity of events are superimposed over critical phenological phases of the vine (dormancy, bud burst, flowering, véraison, and maturity in order to assess their positive or negative implications on wine production in the region. An assessment on the statistical significance of climatic indices, their differences between the recent-past and the future scenarios and the potential impact on wine production is performed. Preliminary results indicate increased climatic stress on the Douro region wine production and increased vulnerability of its vine varieties. These results will provide evidence for future strategies aimed to preserve the high-quality wines in the region and their typicality in a sustainable way.
Full Text Available Background: Although intellectual disability (ID is a common disability in Iran, there is no investigation on the spatial distribution pattern of these patients in national level and the spatial maps for recognition the areas with higher prevalence of IDs and local neighborhoods of these regions or effect of socio-demographic factor on this scattering is not still available. This proposition motivated us to assess the population with ID in our country. Methods: In a cross-sectional study, we applied Moran′s Index (Moran′s I which includes information about the strength of the neighboring association between counties, as global univariate distribution assessment. A geographically weighted regression was used to explore relation between ID patient′s prevalence and some socio-demographic factors (migration and illiteracy rate, physician number (PN/10,000 people and health-care centers (HCCs/10,000 people. Results: We found that spatial clusters of ID patients exist among Iran counties (Moran′s I = 0.36, P 0.3. Conclusions: According to the results, our Initial hypothesis about the existence of spatial clusters in distribution of people with ID in Iran was proven. Spatial autocorrelation between migration and illiteracy rate and prevalence of patients with ID was shown and was in agreement with our hypothesis. However, our supposition that the prevalence should have inverse relationship with PN and HCC was rejected.
Full Text Available Abstract Background "Negative affect" is one of the major migraine triggers. The aim of the study was to assess attentional biases for negative affective stimuli that might be related to migraine triggers in migraine patients with either few or frequent migraine and healthy controls. Methods Thirty-three subjects with frequent migraine (FM or with less frequent episodic migraine, and 20 healthy controls conducted two emotional Stroop tasks in the interictal period. In task 1, general affective words and in task 2, pictures of affective faces (angry, neutral, happy were used. For each task we calculated two emotional Stroop indices. Groups were compared using one-way ANOVAs. Results The expected attentional bias in migraine patients was not found. However, in task 2 the controls showed a significant attentional bias to negative faces, whereas the FM group showed indices near zero. Thus, the FM group responded faster to negative than to positive stimuli. The difference between the groups was statistically significant. Conclusions The findings in the FM group may reflect a learned avoidance mechanism away from affective migraine triggers.
Launay, Gaetan; Sizaret, Stanislas; Guillou-Frottier, Laurent; Gloaguen, Eric; Melleton, Jérémie; Pichavant, Michel; Champallier, Rémi; Pinto, Filipe
The Panasqueira Sn-W deposit occurs as a dense network of flat wolframite and cassiterite-bearing quartz veins concentrated in the vicinity of a hidden greisen cupola, and to a lesser extent as disseminated cassiterites in the greisen. Previous studies (Thadeu 1951; 1979) have suggested that the Panasqueira deposit is genetically related to magmatic activity for which the most part is unexposed, and being only represented by the greisen cupola. Hydrothermal fluid circulation during the final stages of granite crystallisation has probably led to the greisenisation of the cupola followed by the deposition of the mineralization in the veins system. Mineral replacement reactions that occurred during the greisenisation could affect rock properties (porosity, density and permeability) which control fluid circulation in the granite. This study aims to investigate effects of greisenisation reactions on the dynamic (time varying) permeability that ultimately leads to fluid circulation in the greisen cupola. To do so, petrological study and experimental determinations of hydrodynamic features (porosity and permeability) for different granite alteration levels and petrographic types (unaltered granite to greisen) are combined and then integrated in coupled numerical models of fluid circulation around the granitic intrusion. Greisen occurs in the apical part of the granitic body and results in the pervasive alteration of the granite along the granite-schist contact. This greisen consists mainly of quartz and muscovite formed by the replacement of feldspars and bleaching of biotites of the initial granite. Otherwise, greisen is generally vuggy which suggests a porosity increase of the granite during hydrothermal alteration processes. This porosity increase has a positive effect on the permeability of the granitic system. Indeed, experimental measurements of permeability with the Paterson press indicate that the initial granite is impermeable (10-20 m2) whereas the greisen is
Nolte, Chester M., Ed.; Murrey, William A., Jr., Ed.
The failure of school district public relations has been the most common reason for the dismissal of otherwise competent school administrators. In an effort to counteract this weakness, a 2-week workshop was organized by the School of Education at the University of Denver in the summer of 1969 to provide training in public relations techniques.…
Moges, Awdenegest; Holden, Nicholas M
A study was conducted in southern Ethiopia to evaluate the nutrient status on smallholder farms with respect to land use class (garden, grassland, and outfield) and slope position (upper, middle, and lower). Soil physical and chemical properties were quantified using soil samples collected at two depths (0-15 and 15-30 cm). Available phosphorous was significantly different among the three land use classes. However, organic carbon and total nitrogen were lower in the outfield compared to the garden and grass land but not significantly different. The lower than expected nutrient status of the garden and grassland, which receive almost all available organic supplements, was attributed to the overall low availability of these inputs. Similarly, pH and cation exchange capacity were not significantly different among the different land use classes. However, the sum of the exchangeable cations was significantly higher in the garden compared to the outfields. Comparison at landscape level revealed that the sand fraction was significantly greater, whereas the silt fractions were significantly smaller, on the lower slopes relative to the middle slopes. Moreover, the organic carbon, total nitrogen, cation exchange capacity, Ca, and Mg values were significantly less on lower slopes than upper and middle slopes. Perhaps this is because of leaching and the effect of deposition of coarser sediments from the prevailing gully system. Overall, the fertility of the soil was adequate for supporting smallholder farming, but consideration must be given to reducing pressure on the land resources, addressing erosion problems, and providing a line of credit for purchasing inputs.
Dra. María Isabel Míguez González
Full Text Available With the aim of bring near to the spanish academic field the european approaches of Public Relations, this article makes a compared revision of the situation of this subject and profession in Germany and Spain. This revision shows important resemblances on the use of the term “public relations”, the confusion of this subject with other communicative activities, the professional development and the problems of the field in both countries. However, it also shows that Germany has more tradition on public relations research than Spain and, therefore, it has a more extensive corpus of theories about this subject. For this reason, since important resemblances exist in other aspects, german research on public relations could be interesting for the spanish academic field both to explain the situation of public relations in Spain and to motivate theoretical development in our country.
Houwen-van Opstal, S.L.; Jansen, M.; Alfen, N. van; Groot, I.J.M. de
The progression of Duchenne muscular dystrophy is expected to negatively influence the patients' health-related quality of life, but knowledge of the relationship with disease severity is limited. We investigated the relationship between health-related quality of life (KIDSCREEN-52 questionnaire)
M. B. Aryanezhad
Full Text Available Performance evaluation plays an important role in determining faults and difficulties of any organization as well as attempting to increase capabilities and improve activities. Data envelopment analysis (DEA, as a non-parametric method, has been one of the most important and significant management tools for measuring output or efficiency. In this paper, we propose a method to utilize balanced score card (BSC as a tool for designing performance evaluation indices of an organization. The integrated BSC-DEA has been applied as an empirical case for a major private bank organization and the results are analyzed.
Kenney M Cristina
Full Text Available Abstract Background Age-related macular degeneration (AMD is the leading cause of vision loss in elderly, Caucasian populations. There is strong evidence that mitochondrial dysfunction and oxidative stress play a role in the cell death found in AMD retinas. The purpose of this study was to examine the association of the Caucasian mitochondrial JTU haplogroup cluster with AMD. We also assessed for gender bias and additive risk with known high risk nuclear gene SNPs, ARMS2/LOC387715 (G > T; Ala69Ser, rs10490924 and CFH (T > C; Try402His, rs1061170. Methods Total DNA was isolated from 162 AMD subjects and 164 age-matched control subjects located in Los Angeles, California, USA. Polymerase chain reaction (PCR and restriction enzyme digestion were used to identify the J, U, T, and H mitochondrial haplogroups and the ARMS2-rs10490924 and CFH-rs1061170 SNPs. PCR amplified products were sequenced to verify the nucleotide substitutions for the haplogroups and ARMS2 gene. Results The JTU haplogroup cluster occurred in 34% (55/162 of AMD subjects versus 15% (24/164 of normal (OR = 2.99; p = 0.0001. This association was slightly greater in males (OR = 3.98, p = 0.005 than the female population (OR = 3.02, p = 0.001. Assuming a dominant effect, the risk alleles for the ARMS2 (rs10490924; p = 0.00001 and CFH (rs1061170; p = 0.027 SNPs were significantly associated with total AMD populations. We found there was no additive risk for the ARMS2 (rs10490924 or CFH (rs1061170 SNPs on the JTU haplogroup background. Conclusions There is a strong association of the JTU haplogroup cluster with AMD. In our Southern California population, the ARMS2 (rs10490924 and CFH (rs1061170 genes were significantly but independently associated with AMD. SNPs defining the JTU mitochondrial haplogroup cluster may change the retinal bioenergetics and play a significant role in the pathogenesis of AMD.
exposure at five years before the reference date were also done to allow for a possible longer latent period. Results: The odds ratio (OR) of acoustic neuroma with ever having been a regular mobile phone user was 0.85 (95% confidence interval 0.69-1.04). The OR for ≥10 years after first regular mobile.......88-1.97); there were, however, implausible values of reported use in those with ≥1640h of accumulated mobile phone use. With censoring at 5 years before the reference date the OR for ≥10 years after first regular mobile phone use was 0.83 (0.58-1.19) and for ≥1640h of cumulative call time it was 2.79 (1...... was conducted in 13 countries using a common protocol. Past mobile phone use was assessed by personal interview. In the primary analysis, exposure time was censored at one year before the reference date (date of diagnosis for cases and date of diagnosis of the matched case for controls); analyses censoring...
Home; Journals; Journal of Genetics; Volume 88; Issue 1. Utilizing linkage disequilibrium information from Indian Genome Variation Database for mapping mutations: SCA12 case study. Samira Bahl Ikhlak Ahmed The Indian Genome Variation Consortium Mitali Mukerji. Research Article Volume 88 Issue 1 April 2009 pp 55- ...
Wright, Phillip M.
This project, Retrospective Case Studies (RCS) operates directly under DGE's Resource Exploration and Assessment program. The overall objectives of this project are: (1) to improve the general and specific level of understanding of geothermal systems, and (2) to improve tools and technology for geothermal exploration and assessment.
sustainability, that began at our inception 12 years ago. This case study ... women. Over the years, we moved towards building a model of sustainable institutions .... poverty alleviation. However, over the last decade, a number of organizations had gained expertise in organizing and managing SHGs and as a result, very few.
Huggett, S.; Barber, J.
Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs
Aschemann-Witzel, Jessica; Hooge, De Ilona E.; Rohm, Harald; Normann, Anne; Bossle, Marilia Bonzanini; Grønhøj, Alice; Oostindjer, Marije
Food waste accounts for a considerable share of the environmental impact of the food sector. Therefore, strategies that aim to reduce food waste have great potential to improve sustainability of the agricultural and food supply chains. Consumer-related food waste is a complex issue that needs
Kockelkoren, Remko; De Vis, Jill B; Mali, Willem P Th M; Hendrikse, Jeroen; de Jong, Pim A; Rozemuller, Annemieke M; Koek, Huiberdina L
BACKGROUND: It was recently shown that calcification of the hippocampus can be detected on computed tomography (CT) images and these calcifications occur in up to 20% of people over 50 years of age. However, little is known about hippocampal calcification and its relation to cognition and cognitive
José Lourenço Kallás
Full Text Available OBJECTIVES: To make a retrospective analysis and evaluate a clinical response to the control of disc degeneration related pain of 396 patients submitted to percutaneous lumbar nucleoplasty; and to make a record of visual analogical scale (VAS up to a three-year follow-up after the surgical procedure. METHODS: Analysis of VAS score in 396 patients with lumbar disc degeneration related pain, according to anamnesis, clinical examination and magnetic resonance imaging (MRI, without improvement of previous clinical treatment, submitted to percutaneous nucleoplasty. RESULTS: A total of 26% of the patients presented 100% remission of pain or paresthesia, of whom 75% showed at least 50% of pain improvement. The median VAS pain improvement was about 67%. CONCLUSIONS: The median VAS improvement in inferior disc levels was higher than four points. The VAS showed improvement of the pain and paresthesia up to a three-year follow up after the surgical procedure.
This presentation discusses the public relations work through exhibitions and fairs. Fairs and exhibitions provide an ideal opportunity to contact the target groups directly: political and economic opinion-makers; media representatives; insiders; young people and schoolchildren; interested public. During exhibitions the interested visitors are also supplied with extensive information material, mostly free of charge. An example the photo atlas 'Nuclear Energy in Germany' which we offered in an English edition as well and is attached to this presentation
Washio, Masakazu; Kondo, Kyoko; Fujisawa, Nobumitsu; Harada, Eiji; Tashiro, Hideki; Mizokami, Tetsuya; Nogami, Hiroko; Iwanaga, Tomoaki; Nakanishi, Yoichi; Suzuki, Kanzo; Ohfuji, Satoko; Fukushima, Wakaba; Hirota, Yoshio
Pneumonia is the third largest cause of death in Japan. Pneumonia continues to be one of the most common causes of morbidity, hospitalization and mortality, especially in the elderly. The aim of the present study was to evaluate the factors related to the development of pneumonia acquired outside hospitals among the Japanese elderly. We carried out a hospital-based, case-control study. Cases were patients who had been newly diagnosed with pneumonia acquired outside hospitals. For each case, one to three controls were defined as outpatients with other diseases (not pneumonia) at the same hospitals. All participants (i.e. 50 cases and 110 controls) were aged 65 years and older. Compared with control participants, hypoalbuminemia (vaccination rate of seasonal influenza were lower in patients with pneumonia than control participants. Even after controlling for age, sex, hospital and aforementioned four factors, hypoalbuminemia (OR 9.19, 95% CI 3.70-22.81) increased the risk of pneumonia, whereas seasonal influenza vaccination (OR 0.37, 95% CI 0.16-0.85) reduced the risk. Even after excluding those who lived in a nursing home, hypoalbuminemina (OR 12.19, 95% CI 4.29-34.63) increased the risk of pneumonia. Hypoalbuminemia might be a risk factor for pneumonia among the elderly living in the community. © 2015 Japan Geriatrics Society.
Whalon, Kelly J; Conroy, Maureen A; Martinez, Jose R; Werch, Brittany L
The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old with an ASD, and took place in school settings. Articles were analyzed descriptively and using the evaluative method to determine study quality. Additionally, effect size estimates were calculated using nonoverlap of all pairs method and Tau-U. A total of 37 studies including 105 children were reviewed. Overall, ES estimates ranged from weak to strong, but on average, the reviewed interventions produced a moderate to strong effect, and quality ratings were generally in the acceptable to high range. Findings suggest that children with ASD can benefit from social skill interventions implemented with peers in school settings.
Houwen-van Opstal, S L S; Jansen, M; van Alfen, N; de Groot, I J M
The progression of Duchenne muscular dystrophy is expected to negatively influence the patients' health-related quality of life, but knowledge of the relationship with disease severity is limited. We investigated the relationship between health-related quality of life (KIDSCREEN-52 questionnaire) and disease severity (clinical assessments of body functions and activities) in 40 boys with Duchenne muscular dystrophy (19 ambulant, 21 wheelchair dependent) who were in different phases of the disease and underwent life-limiting events such as the loss of the ability to ambulate and the ability to lift the arms. In addition, we compared boys' health-related quality of life perceptions with that of their parents. The participants' health-related quality of life was similar to healthy peers' and not influenced by disease severity, except for the physical domain. Parents scored much lower than the boys on the KIDSCREEN-52 domains Self Perception, Moods and Emotions, and Bullying. The latter finding needs attention in the management of Duchenne muscular dystrophy. © The Author(s) 2013.
In the 1950s, fluoride emissions were determined to be a problem at US Steel's Geneva Steel Works in Utah. Neighboring farms were affected, in that fluorosis was found in cattle. The problem was settled in litigation, and US Steel installed state-of-the-art pollution control technology on the steel mill in order to eliminate recurrence. The investigations that led to the elucidation of fluorides as the problem, the installation of pollution control equipment, and the public relations efforts on the part of the company are described. 22 references.
Full Text Available In 2007, a series of landslides occurred at Tawangmangu, resulting in the collapse of several houses and the death of dozens of people. One essential pathway to reduce the vulnerability of communities goes through an increased preparedness. The present contribution aims to determine existing level of preparedness by analysing the people perception and knowledgeof landslides. Survey method with random sampling technique was applied to assess the level of people perception and to analysis local people knowledge regarding with landslide. The number of respondents was spread proportionally across five sub-villages; Plalar, Guyon, Sodong, Salere and Ngledoksari. The respondents were interviewed using questionnaires with open and closed questions. Statistical analysis with multiple linear regressions was applied to identify the influencing factors of local people perception related to landside. The result show that people in the area have good knowledge and perception about landslide. This condition is commonly influenced by age and education.
Ibe, Kalu K; Akaolisa, Casmir C Zanders
Water samples from rivers, streams, springs, and shallow wells in Alayi-Ovim area of southeast Nigeria have been analyzed for Pb, Ca, Mg, Fe, Mg, PO(4), NO(3), CO(3), SO(4), Cl, and pH. The analyses were carried out using atomic absorption spectrometer and Hach Direct Reading Equipment. Results of the analyses from the area conform to the WHO (1995) standards for drinking water. However, the results show relative enrichment of Ca, pH, Mg, CO(3), and Cl. Low values were obtained for Fe, SO(4), and NO(3). While the Cl and Pb enrichment in the area north of Alayi-Ovim axis is attributed to proximity to the lead-zinc and chloride-rich formations of the Turonian Eze-Aku and the Albian Asu River; the Ca, Mg, SO(4), and CO(3) enrichment in Southern part of Alayi-Ovim is due to the limestone-bearing Late Maastrichtian Nsukka Formation. Furthermore, the very low values of less than 5 ppm for these characters in water in the central region correlate well with the relatively clean Maastrichtian quartz arenite Ajali Sandstone Formation. The Pb-Zn and Cl incursions into the water system from the Older Albian Asu River/Turonian Eze-Aku Formations in the northern part of Alayi-Ovim area and the leaching of Mg, and Ca into the water system in the Maastrichtian limestone area in the south thus constitute geochemical indices for chemical pollution and mineral exploration for brine and dolomitic limestone in the area.
Kopp, Tine Iskov; Andersen, Vibeke; Tjoøneland, Anne
Maintenance of a balance between commensal bacteria and the mucosal immune system is crucial and intestinal dysbiosis may be a key event in the pathogenesis of colorectal cancer (CRC). The toll-like receptor 4 (TLR4) is an important pattern-recognition receptor that regulates inflammation...... and barrier function in the gut by a mechanism that involves activation of the nuclear factor-kappa B (NF-kappa B) transcription factor. Dietary and life style factors may impact these functions. We therefore used a Danish prospective case-cohort study of 1010 CRC cases and 1829 randomly selected participants...... from the Danish Diet, Cancer and Health cohort to investigate three polymorphisms in NFKB1 and TLR4 and their possible interactions with diet and life style factors in relation to risk of CRC. Homozygous carriage of the variant allele of the TLR4/rs5030728 polymorphism was associated with increased...
In the lecture Case Study - Czechoslovakia with the sub-title 'Unified System of Personnel Preparation for Nuclear Programme in Czechoslovakia' the actual status and the current experience of NPP personnel training and preparation in Czechoslovakia are introduced. The above mentioned training system is presented and demonstrated by the story of a proxy person who is going to become shift engineer in a nuclear power plant in Czechoslovakia. (orig./HP)
Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management. Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC). Date Released: 6/9/2010.
Yamamoto, Tsutomu; Shimizu, Yukiko.
A study was made of the relation to atomic bomb radiation of 535 cases of gastric carcinoma among 4,694 deaths occurring in a fixed population of Hiroshima and Nagasaki who were autopsied between 1961 and 1974. The proportion of all autopsies with gastric carcinoma as autopsy diagnosis tended to be high in the high dose group, but it could not be concluded with the present amount of information that there is a relation between gastric carcinoma and radiation in this autopsy study. Although no specific distribution of the histological types of gastric carcinoma was noted by radiation dose, the data indicated increases in the degree of extension of tumor cells in the gastric wall and the degree of metastasis to the lymph nodes seemed to be high in the high dose group. (author)
Dorard, Géraldine; Bungener, Catherine; Phan, Olivier; Edel, Yves; Corcos, Maurice; Berthoz, Sylvie
In recent decades, alexithymia has been considered a risk factor for multiple somatic and psychiatric conditions. Yet, whereas alexithymia has been extensively studied in adults with a substance misuse, only one study has reported data on cannabis abusers from the general population. Hence, our main objective was to explore alexithymia in a clinical sample of treatment-seeking young outpatients with a DSM-IV cannabis dependence or abuse diagnosis compared to controls. 120 young patients (95 males - mean age 17.9years (SD=2.8; 14 to 25)) with a cannabis dependence or abuse (DSM-IV-TR criteria evaluated with the MINI), seeking treatment in an addiction unit, and 110 healthy control subjects (77 males - mean age 18.2years (SD=3.4; 14 to 25)) participated in the study. They completed a battery of self-reports measuring alexithymia (TAS-20; BVAQ-B), depression (BDI-13) and state and trait anxiety (STAI). 35.3% of cannabis users were alexithymic, and logistic regression analysis showed that the alexithymic components of difficulties identifying and describing feelings combined with trait anxiety predicted group membership. This first study on young cannabis abusers and dependent subjects further emphasizes the importance of considering the affective style, and particularly the anxious temperament and alexithymia features, as factors associated with substance misuse during late adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available This paper presents an empirical study to investigate the relationship between organizational justice and professional commitment in Kermanshah official organizations. The study uses 20 questions to measure professional commitment from a questionnaire originally developed by Spell et al. (2007 [Spell, C. S., & Arnold, T. J. (2007. A multi-level analysis of organizational justice climate, structure, and employee mental health. Journal of Management, 33(5, 724-751.]. In addition, the study adopts 12 questions from another questionnaire developed by Vallas (1999 [Vallas, S. P. (1999. Rethinking post‐Fordism: The meaning of workplace flexibility. Sociological theory, 17(1, 68-101.] to measure organizational justice. Cronbach alpha for organizational justice questionnaire and professional commitment are 0.81 and 0.89, respectively, which are well above the minimum acceptable level. Based on the results of this survey, there is a positive and meaningful relationship between organizational justice and professional commitment. The implementation of the linear regression analysis also reveals that there is a positive and meaningful relationship between inter-organizational justice and professional commitment. The study performs Freedman test to rank three components of organizational justice and the results indicate that interactional justice maintains the highest level of importance while distributive justice comes last in terms of priority.
Werker, C.; Ooms, Ward; Caniëls, Marjolein C J
Previous studies investigating proximity and collaboration have not clarified personal elements, such as working or communication style. Here, we show that personal proximity—close similarity in terms of personal traits and behavioral patterns—substantially affects the whole life cycle of
Induced by Clostridium Difficile Enteritis as a Complication of Helicobacter Pylori Eradication Clinical Rheumatology 1999, 18:337-338. 34.Leirisalo...infection: a clinical and epidemiological nationwide study. Ann Rheum Dis 2005, 64:594-598. 5.Marks J, Holt J: The natural history of Reiter’s
Peek, Monica E; Ferguson, Molly J; Roberson, Tonya P; Chin, Marshall H
Diabetes self-management is central to diabetes care overall, and much of self-management entails individual behavior change, particularly around dietary patterns and physical activity. Yet individual-level behavior change remains a challenge for many persons with diabetes, particularly for racial/ethnic minorities who disproportionately face barriers to diabetes-related behavioral changes. Through the South Side Diabetes Project, officially known as "Improving Diabetes Care and Outcomes on the South Side of Chicago," our team sought to improve health outcomes and reduce disparities among residents in the largely working-class African American communities that comprise Chicago's South Side. In this article, we describe several aspects of the South Side Diabetes Project that are directly linked to patient behavioral change, and discuss the theoretical frameworks we used to design and implement our programs. We also briefly discuss more downstream program elements (e.g., health systems change) that provide additional support for patient-level behavioral change. © 2014 Society for Public Health Education.
Høyland, Anne Lise; Nærland, Terje; Engstrøm, Morten; Lydersen, Stian; Andreassen, Ole Andreas
An altered processing of emotions may contribute to a reduced ability for social interaction and communication in autism spectrum disorder, ASD. We investigated how face-emotion recognition in ASD is different from typically developing across adolescent age groups. Fifty adolescents diagnosed with ASD and 49 typically developing (age 12-21 years) were included. The ASD diagnosis was underpinned by parent-rated Social Communication Questionnaire. We used a cued GO/ NOGO task with pictures of facial expressions and recorded reaction time, intra-individual variability of reaction time and omissions/commissions. The Social Responsiveness Scale was used as a measure of social function. Analyses were conducted for the whole group and for young (emotion recognition and severity of social problems indicating a delayed development of emotional understanding in ASD. It also points towards alterations in top-down attention control in the ASD group. This suggests novel disease-related features that should be investigated in more details in experimental settings.
Shobirin, Abyzhar; Ramadhanty, Almira Husna; Hardiana, Ana
Surakarta is a rapidly urbanized city and it causes the limitation of the availability of land within its urban area. This entangled problem is resulting in the development of slum settlements that spread across the city. One of the slum concentration areas is located on Pepe riverbanks downstream area that belongs to Kampung Sangkrah administrative boundaries. Slum settlements are characterized as a densely-populated area lacking of, or absence of, open space. This condition forces slum inhabitants to effectively use their available spaces, even multi-functionally. This research aims to observe how slum inhabitants multi-functionally use the spaces around their houses and determine the typology of multifunctional space and also the factors that influence it. To understand this phenomenon, this research used activity pattern perspectives. The scope of observation covers in-house (internal) space utilizations and neighborhood-level (external) space utilization. The data used for this research were collected primarily through site observations and interviews, using sampling to conduct data collection for in-house activities and space utilization. The analysis was conducted using descriptive method qualitatively. The research concluded that there are three types of multifunctional space utilization within slum settlements, and the utilization of spaces, whether internal or external utilization also varies depending on the inhabitants' economic-related activities.
Núñez-García, Edgar; Valencia-García, Luis César; Sordo-Mejía, Ricardo; Kajomovitz-Bialostozky, Daniel; Chousleb-Kalach, Alberto
Acute pseudo-obstruction of the colon is a disorder characterised by an increase in intra-luminal pressure that leads to ischaemia and necrosis of the intestinal wall. The mechanism that produces the lesion is unknown, although it has been associated with: trauma, anaesthesia, or drugs that alter the autonomic nervous system. The pathophysiology of medication induced colon toxicity can progress to a perforated colon and potentially death. Present a case of a colonic pseudo-obstruction in a patient with polypharmacy as the only risk factor and to review the medical literature related to the treatment of this pathology. The case is presented of a 67 year old woman with colonic pseudo-obstruction who presented with diffuse abdominal pain and distension. The pain progressed and reached an intensity of 8/10, and was accompanied by fever and tachycardia. There was evidence of free intraperitoneal air in the radiological studies. The only risk factor was the use of multiple drugs. The colonic pseudo-obstruction progressed to intestinal perforation, requiring surgical treatment, which resolved the problem successfully. It is important to consider drug interaction in patients with multiple diseases, as it may develop complications that can be avoided if detected on time. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
Feng, Chenchen; Chen, Lina; Li, Wan; Wang, Hong; Zhang, Liangcai; Jia, Xu; Miao, Zhengqiang; Qu, Xiaoli; Li, Weiguo; He, Weiming
The histological grade/stage of tumor is widely acknowledged as an important clinical prognostic factor for cancer progression. Recent experimental studies have explored the following two topics at the molecular level: (1) whether or not gene expression levels vary by different degrees among different tumor grades/stages, and (2) whether some well-defined modules could distinguish one grade/stage from another. In this article, using breast cancer as an example, we investigated this topic and ...
Astrid V Stronen
Full Text Available Genetic rescue, outcrossing with individuals from a related population, is used to augment genetic diversity in populations threatened by severe inbreeding and extinction. The endangered Norwegian Lundehund dog underwent at least two severe bottlenecks in the 1940s and 1960s that each left only five inbred dogs, and the approximately 1500 dogs remaining world-wide today appear to descend from only two individuals. The Lundehund has a high prevalence of a gastrointestinal disease, to which all remaining dogs may be predisposed. Outcrossing is currently performed with three Nordic Spitz breeds: Norwegian Buhund, Icelandic Sheepdog, and Norrbottenspets. Examination of single nucleotide polymorphism (SNP genotypes based on 165K loci in 48 dogs from the four breeds revealed substantially lower genetic diversity for the Lundehund (HE 0.035 than for other breeds (HE 0.209-0.284. Analyses of genetic structure with > 15K linkage disequilibrium-pruned SNPs showed four distinct genetic clusters. Pairwise FST values between Lundehund and the candidate breeds were highest for Icelandic Sheepdog, followed by Buhund and Norrbottenspets. We assessed the presence of outlier loci among candidate breeds and examined flanking genome regions (1 megabase for genes under possible selection to identify potential adaptive differences among breeds; outliers were observed in flanking regions of genes associated with key functions including the immune system, metabolism, cognition and physical development. We suggest crossbreeding with multiple breeds as the best strategy to increase genetic diversity for the Lundehund and to reduce the incidence of health problems. For this project, the three candidate breeds were first selected based on phenotypes and then subjected to genetic investigation. Because phenotypes are often paramount for domestic breed owners, such a strategy could provide a helpful approach for genetic rescue and restoration of other domestic populations at
Anne Lise Høyland
Full Text Available An altered processing of emotions may contribute to a reduced ability for social interaction and communication in autism spectrum disorder, ASD. We investigated how face-emotion recognition in ASD is different from typically developing across adolescent age groups. Fifty adolescents diagnosed with ASD and 49 typically developing (age 12-21 years were included. The ASD diagnosis was underpinned by parent-rated Social Communication Questionnaire. We used a cued GO/ NOGO task with pictures of facial expressions and recorded reaction time, intra-individual variability of reaction time and omissions/commissions. The Social Responsiveness Scale was used as a measure of social function. Analyses were conducted for the whole group and for young (< 16 years and old (≥ 16 years age groups. We found no significant differences in any task measures between the whole group of typically developing and ASD and no significant correlations with the Social Responsiveness Scale. However, there was a non-significant tendency for longer reaction time in the young group with ASD (p = 0.099. The Social Responsiveness Scale correlated positively with reaction time (r = 0.30, p = 0.032 and intra-individual variability in reaction time (r = 0.29, p = 0.037 in the young group and in contrast, negatively in the old group (r = -0.23, p = 0.13; r = -0.38, p = 0.011, respectively giving significant age group interactions for both reaction time (p = 0.008 and intra-individual variability in reaction time (p = 0.001. Our findings suggest an age-dependent association between emotion recognition and severity of social problems indicating a delayed development of emotional understanding in ASD. It also points towards alterations in top-down attention control in the ASD group. This suggests novel disease-related features that should be investigated in more details in experimental settings.
Full Text Available The paper examines the relationships between the species composition of flower visitors and plants in the semi-natural xerothermic grasslands in southern and central Poland. Thirty 10 × 10 m permanent plots were laid out in total, mainly in nature reserves. The vegetation units studied were classified according to the Braun-Blanquet system; these were phytocoenoses of the Festuco-Brometea classes Inuletum ensifoliae, Adonido-Brachypodietum pinnati and the transitional plant community. Entomological research was performed using the Pollard method within the same plots. A particular site was visited only once and different sites were studied between April and August 2008. We applied, among others, co-correspondence-analysis Co-CA, detrended correspondence analysis (DCA and redundancy analysis (RDA to investigate the co-occurrence patterns of plants and flower visitors and their biotopic requirements. We found that the species composition of flower visitors cannot be predicted by floristic composition when the duration of the study is restricted to one day (but under similar weather conditions; however, there is a positive relationship between the species richness of insects and plants and a positive relationship between the number of plant species and the abundance of flower visitors. The Ellenberg moisture index and the cover of meadow species significantly explained the species composition of insects. The three various vegetation units and five dominant xerothermic species, i.e. Adonis vernalis, Anemone sylvestris, Inula ensifolia, Linum hirsutum and Carlina onopordifolia that were studied across time differed in the species richness of insects. Our results demonstrate that possible patterns in the species composition and the assembly rules of flower visitors are not apparent when the Pollard method is applied. Based on the data obtained using this method, the flower visiting assemblages seem not to be driven by competition and they primarily
Full Text Available Predicting species range shifts in response to climatic change is a central aspect of global change studies. An ever growing number of species have been modeled using a variety of species distribution models (SDMs. However, quantitative studies of the characteristics of range shifts are rare, predictions of range changes are hard to interpret, analyze and summarize, and comparisons between the various models are difficult to make when the number of species modeled is large. Maxent was used to model the distribution of 12 Abies spp. in China under current and possible future climate conditions. Two fuzzy set defined indices, range increment index (I and range overlapping index (O, were used to quantify range shifts of the chosen species. Correlation analyses were used to test the relationships between these indices and species distribution characteristics. Our results show that Abies spp. range increments (I were highly correlated with longitude, latitude, and mean roughness of their current distributions. Species overlapping (O was moderately, or not, correlated with these parameters. Neither range increments nor overlapping showed any correlation with species prevalence. These fuzzy sets defined indices provide ideal measures of species range shifts because they are stable and threshold-free. They are reliable indices that allow large numbers of species to be described, modeled, and compared on a variety of taxonomic levels.
Full Text Available In this research the relationship between teachers’ perception of organizational justice and their organizational commitment levels was investigated. The scope of research is comprised of teachers serving in public and foundation schools affiliated with Ministry of National Education in Turkey. A sample was taken due to the difficulty in reaching study group. The teachers in study group were enrolled from Marmara, Central Anatolia, Aegean, Black Sea, Mediterranean Sea, Eastern Anatolia and Southeastern Anatolia regions. A simple coincidental sampling formula was utilized while determining the number of sample. In this research the relationship between perception of organizational justice and organizational commitment applied to 679 teachers serving in public and foundatin schools ffiliated with Ministry of National Education was analyzed through using data obtained from answers given to survey questions. As a result of research it was established that there was a significant relationship between teachers’ perception of organizational justice and organizational commitment levels, the strongest relationship was present between interactional justice and organizational commitment levels; however, there were significant relationships between perception of organizational justice and their organizational commitment levels in terms of certain demographic variables.
Bottini, Gabriella; Brugger, Peter; Sedda, Anna
Body integrity identity disorder (BIID) is characterized by the overwhelming desire to amputate one or more healthy limbs or to be paraplegic. Recently, a neurological explanation of this condition has been proposed, in part on the basis of findings that the insular cortex might present structural anomalies in these individuals. While these studies focused on body representation, much less is known about emotional processing. Importantly, emotional impairments have been found in psychiatric disorders, and a psychiatric etiology is still a valid alternative to purely neurological accounts of BIID. In this study, we explored, by means of a computerized experiment, facial emotion recognition and emotional responses to disgusting images in seven individuals with BIID, taking into account their clinical features and investigating in detail disgust processing, strongly linked to insular functioning. We demonstrate that BIID is not characterized by a general emotional impairment; rather, there is a selectively reduced disgust response to violations of the body envelope. Taken together, our results support the need to explore this condition under an interdisciplinary perspective, taking into account also emotional connotations and the social modulation of body representation.
Sue K Park
Full Text Available OBJECTIVE: Genetic variants regulating the host immune system may contribute to the susceptibility for the development of gastric cancer. Little is known about the role of the innate immunity- and non-Hodgkin's lymphoma (NHL-related genes for gastric cancer risk. This nested case-control study was conducted to identify candidate genes for gastric cancer risk for future studies. METHODS: In the Discovery phase, 3,072 SNPs in 203 innate immunity- and 264 NHL-related genes using the Illumine GoldenGateTM OPA Panel were analyzed in 42 matched case-control sets selected from the Korean Multi-center Cancer Cohort (KMCC. Six significant SNPs in four innate immunity (DEFA6, DEFB1, JAK3, and ACAA1 and 11 SNPs in nine NHL-related genes (INSL3, CHMP7, BCL2L11, TNFRSF8, RAD50, CASP7, CHUK, CD79B, and CLDN9 with a permutated p-value <0.01 were re-genotyped in the Replication phase among 386 cases and 348 controls. Odds ratios (ORs for gastric cancer risk were estimated adjusting for age, smoking status, and H. pylori and CagA sero-positivity. Summarized ORs in the total study population (428 cases and 390 controls are presented using pooled- and meta-analyses. RESULTS: Four SNPS had no heterogeneity across the phases: in the meta-analysis, DEFA6 rs13275170 and DEFB1 rs2738169 had both a 1.3-fold increased odds ratio (OR for gastric cancer (95% CIs = 1.1-1.6; and 1.1-1.5, respectively. INSL3 rs10421916 and rs11088680 had both a 0.8-fold decreased OR for gastric cancer (95% CIs = 0.7-0.97; and 0.7-0.9, respectively. CONCLUSIONS: Our findings suggest that certain variants in the innate immunity and NHL-related genes affect the gastric cancer risk, perhaps by modulating infection-inflammation-immunity mechanisms that remain to be defined.
Alaoui Youssef Lamrani
Full Text Available Managing operational risk efficiently is a critical factor of microfinance institutions (MFIs to get a financial and social return. The purpose of this paper is to identify, assess and prioritize the root causes of failure within the microfinance lending process (MLP especially in Moroccan microfinance institutions. Considering the limitation of traditional failure mode and effect analysis (FMEA method in assessing and classifying risks, the methodology adopted in this study focuses on developing a fuzzy logic inference system (FLIS based on (FMEA. This approach can take into account the subjectivity of risk indicators and the insufficiency of statistical data. The results show that the Moroccan MFIs need to focus more on customer relationship management and give more importance to their staff training, to clients screening as well as to their business analysis.
Sanket, Shah; Madireddi, Jagadesh; Stanley, Weena; Sura, Pradeep; Prabhu, Mukhyaprana
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder characterized by irreversible and progressive limitation of expiratory airflow. COPD is now considered as a systemic disease with several extra-pulmonary manifestations which include osteoporosis, muscle weakness, arrhythmia, stroke, cancer etc. The role of vitamin D in skeletal integrity is well established. Role of it in several other diseases like autoimmune, infectious, respiratory and cardiovascular diseases has been increasingly recognised. Data on vitamin D status in COPD in Indian population was limited while those comparing vitamin D with stage, pack year and body mass index were lacking. To assess Vitamin D in subjects with COPD and matched controls and also to study the variability in serum vitamin D levels with COPD disease characteristics. A total of 162 patients aged 18-65 years from south India presenting to kasturba hospital were included in the study. Serum 25- hydroxy-vitamin D were measured in 81 COPD patients (combined COPD stage A-D) and compared with 81 age and gender matched controls. Level Vitamin D was assessed using logistic regression analysis. COPD patients had an increased risk for vitamin D deficiency compared to controls after adjustment for age and gender(OR =2.687 (1.40,5.13)). Variables associated with lower 25(OH) D levels in COPD patients were higher pack year (p=0.001), current smoking status (p=0.026), Low BMI (p=0.02), and GOLD stage III- IV (p=0.001). COPD was associated with an increased risk of vitamin D deficiency, and there was a significant association between vitamin D levels and Combined COPD stage severity. Also, a higher pack year and a low BMI are associated with lower levels of vitamin D.
Full Text Available The aim of the article is to provide a critical perspective of the public policy measures to tackle the illegal employment of foreigners in the Czech Republic taken by the Czech government in the wake of the global financial crisis. In the introductory part of the article, the problem of illegal employment of migrants in the Czech Republic is delimitated and put into a theoretical context. Based on the study of official documents as well as on expert interviews, the analysis of the changes in the public policy dealing with the problem of illegal employment is conducted. While the crisis triggered a more open public debate and brought the problem on the agenda of some core public policy actors and while new measures were taken to address the issue, some of the main underlying problems remain unaddressed. In the final part, a possible future development in the area of illegal employment of migrants is outlined, drawing on the global labor migration trends as well as on the current public policy practice in the Czech Republic.
Cojoc Gianina Maria
Full Text Available The increase in most components of the climate over the past 50 years, including air and water temperature, is a real phenomenon, as attested by the numerous specialized researches according to IPCC (2013. The water temperature is one of the most important climatic components in analyzing the hydrological regime of the Bistrita River (Romania. The thermal regime of the Bistrita River basin and the frost phenomena associated with the risk factor are particularly important and frequently appear in this area. In recent years, under the Siret Water Basin Administration, this parameter was permanently monitored, so we could do an analysis, which shows that the water temperature fluctuations, influenced by air temperature, lead to the emergence of the ice jam phenomenon. The present study aims to analyze the water temperature, as compared to the air temperature, and the effect of these components on the liquid flow regime (the values were recorded at the hydrological stations on the main course of the Bistrita River. The negative effects resulted from the ice jam phenomenon require developing methods of damage prevention and defense. The frost phenomena recorded after the construction of the Bicaz dam are analyzed in this article
Giovani Glaucio de Oliveira Costa
Full Text Available This article aims to present the application of Homogeneity analysis as an alternative to the analysis of qualitative data. Homogeneity analysis is a multivariate technique that has two basic purposes: dimensionality reduction and structural analysis. The work examined actual values of average rents for residential sites in 24 districts of the city of Rio de Janeiro in December 2010 for living room and bedroom, living room and two bedrooms and living room and three bedrooms. The study aimed at the grouping of localities due to similarity in their average rents. As the result of the analysis, we identified 3 homogeneous groups, coexisting in the same space. Profile 1 is formed by neighborhoods with rents in lower ranges. Most of the neighborhoods in this profile are on the westside and northside. Profile 2 is formedby neighborhoods with rents in the intermediate ranges. They include the south zone and Barra. Profile 3 is formedby neighborhoods with rents in higher ranges. They include only neighborhoods in the South side. These results are important to highlight the importance of Homogeneity analysis as to decisions by real estate administrators.
Rudel Ruthann A
Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.
Cassagnole, Manon; Ramos, Maria-Helena; Thirel, Guillaume; Gailhard, Joël; Garçon, Rémy
The improvement of a forecasting system and the evaluation of the quality of its forecasts are recurrent steps in operational practice. However, the evaluation of forecast value or forecast usefulness for better decision-making is, to our knowledge, less frequent, even if it might be essential in many sectors such as hydropower and flood warning. In the hydropower sector, forecast value can be quantified by the economic gain obtained with the optimization of operations or reservoir management rules. Several hydropower operational systems use medium-range forecasts (up to 7-10 days ahead) and energy price predictions to optimize hydropower production. Hence, the operation of hydropower systems, including the management of water in reservoirs, is impacted by weather, climate and hydrologic variability as well as extreme events. In order to assess how the quality of hydrometeorological forecasts impact operations, it is essential to first understand if and how operations and management rules are sensitive to input predictions of different quality. This study investigates how 7-day ahead deterministic and ensemble streamflow forecasts of different quality might impact the economic gains of energy production. It is based on a research model developed by Irstea and EDF to investigate issues relevant to the links between quality and value of forecasts in the optimisation of energy production at the short range. Based on streamflow forecasts and pre-defined management constraints, the model defines the best hours (i.e., the hours with high energy prices) to produce electricity. To highlight the link between forecasts quality and their economic value, we built several synthetic ensemble forecasts based on observed streamflow time series. These inputs are generated in a controlled environment in order to obtain forecasts of different quality in terms of accuracy and reliability. These forecasts are used to assess the sensitivity of the decision model to forecast quality
Hertler, Christine; Wolf, Dominik; Bruch, Angela; Märker, Michael
Pleistocene specialized herbivore communities permits to infer habitat features. The hominin locality Makuyuni permits to study two successive fossil communities and changes occurring. Both fossil horizons are associated with either hominin specimens and/or artifacts. Therefore, hominins persist in the habitats in view of a changing environment.
Antecedents and experience of nuclear activities in Argentina; the Atomic Energy Commission (CNEA). First development and research activities. Research reactors and radioisotopes plants. Health physics and safety regulations. - Feasibility studies for the first nuclear power plant. Awarding the first plant CNA I (Atucha I). Relevant data related to the different project stages. Plant performance. - Feasibility study for the second nuclear power plant. Awarding the second plant CNE (Central Nuclear Embalse). Relevant data related to established targets. Differences compared with the first station targets. Local participation. Plant performance. (orig./GL)
Energy is an important factor in international relations and recently the global energy paradigm has been seen to be shifting towards the East. In light of such change, a comparative assessment of the role of energy in Qatar' East Asian foreign relations will be conducted by taking China, Japan and South Korea as case studies. The research aimed to assess each of the bilateral relationship in terms of their origin and development in the energy sector generating an interpretation of their growing interdependence, taking into consideration the various domestic, regional and international influencing factors. At this level, LNG development and trade was adopted to see the extent of energy cooperation. In general, energy cooperation played the leading role in the three relationships, but to different degrees. Furthermore, all three bilateral relationship pertain to the 'complex interdependence approach' that is supported by the use of institutionalism and soft power.
Tvaryanas, Anthony P; Maupin, Genny M; Fouts, Brittany L
The purpose of this study was to determine the association between deployment-related occupational/environmental exposures and incident postdeployment mental health (PDMH) conditions in a defined population of military health care professionals working in the deployed critical care environment. A nested case-control study compared cohort members with a PDMH condition (cases, N = 146) with those without a PDMH condition (controls, N = 800) in terms of deployment-related exposures as ascertained using Postdeployment Health Assessment DD 2796 questionnaire data. Multivariable logistic regression models were used to compute odds ratios. Nonphysician career fields (i.e., nurses and medical technicians), exposure to dead bodies or people killed/wounded, history of a vehicular accident/crash, exposure to sand/dust, exposure to lasers, and use of mission-oriented protective posture (MOPP) overgarments were associated with increased likelihood for a PDMH condition. The infrequent exposures (i.e., vehicular accident/crash, lasers, and MOPP overgarments) were the exposures most strongly associated with subsequent PDHM conditions. For military health care providers returning from the deployed environment, several exposures are useful for predicting those at increased risk for a PDMH condition. However, there are likely many other important risk factors beyond those captured on the DD 2796 questionnaire. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
Benavides Molineros, Julia; Aguirre Ramirez, Nestor
In Colombia, decisions related to genetically modified organisms (GMOs) must be supported by assessment of the risk to biodiversity, human health and agricultural production. Based on this assessment, authorities can make decisions involving authorization or denial of the requested activities. The rationality of the decision-making process is very well established with respect to human health, particularly toxicity and allergenicity, but that is not the case for biodiversity issues. One of the biggest problems in this area is the lack of definition of a decision-making methodology, which leads to decisions made in an intuitive and non-systematic manner. Authorities in the field have recognized the need for a decision-making information system to help solve this situation. A proposal for the basic structure of a decision-making information system oriented to authorities involved in the process is presented. The proposal was developed based on a review of the main existing methodologies for GMO risk assessment and on a case study of the gene flow from GMOs to wild relatives. The structure is presented as a broad entity-relationship model from which the detailed design of the system can be developed. The proposal emphasizes the documentation of the decision protocols and the rationality of use of the information inputs.
Høyland, Anne L; Øgrim, Geir; Lydersen, Stian; Hope, Sigrun; Engstrøm, Morten; Torske, Tonje; Nærland, Terje; Andreassen, Ole A
Executive functions are often affected in autism spectrum disorders (ASD). The underlying biology is however not well known. In the DSM-5, ASD is characterized by difficulties in two domains: Social Interaction and Repetitive and Restricted Behavior, RRB. Insistence of Sameness is part of RRB and has been reported related to executive functions. We aimed to identify differences between ASD and typically developing (TD) adolescents in Event Related Potentials (ERPs) associated with response preparation, conflict monitoring and response inhibition using a cued Go-NoGo paradigm. We also studied the effect of age and emotional content of paradigm related to these ERPs. We investigated 49 individuals with ASD and 49 TD aged 12-21 years, split into two groups below (young) and above (old) 16 years of age. ASD characteristics were quantified by the Social Communication Questionnaire (SCQ) and executive functions were assessed with the Behavior Rating Inventory of Executive Function (BRIEF), both parent-rated. Behavioral performance and ERPs were recorded during a cued visual Go-NoGo task which included neutral pictures (VCPT) and pictures of emotional faces (ECPT). The amplitudes of ERPs associated with response preparation, conflict monitoring, and response inhibition were analyzed. The ASD group showed markedly higher scores than TD in both SCQ and BRIEF. Behavioral data showed no case-control differences in either the VCPT or ECPT in the whole group. While there were no significant case-control differences in ERPs from the combined VCPT and ECPT in the whole sample, the Contingent Negative Variation (CNV) was significantly enhanced in the old ASD group ( p = 0.017). When excluding ASD with comorbid ADHD we found a significantly increased N2 NoGo ( p = 0.016) and N2-effect ( p = 0.023) for the whole group. We found no case-control differences in the P3-components. Our findings suggest increased response preparation in adolescents with ASD older than 16 years and
Anne L. Høyland
Full Text Available Executive functions are often affected in autism spectrum disorders (ASD. The underlying biology is however not well known. In the DSM-5, ASD is characterized by difficulties in two domains: Social Interaction and Repetitive and Restricted Behavior, RRB. Insistence of Sameness is part of RRB and has been reported related to executive functions. We aimed to identify differences between ASD and typically developing (TD adolescents in Event Related Potentials (ERPs associated with response preparation, conflict monitoring and response inhibition using a cued Go-NoGo paradigm. We also studied the effect of age and emotional content of paradigm related to these ERPs. We investigated 49 individuals with ASD and 49 TD aged 12–21 years, split into two groups below (young and above (old 16 years of age. ASD characteristics were quantified by the Social Communication Questionnaire (SCQ and executive functions were assessed with the Behavior Rating Inventory of Executive Function (BRIEF, both parent-rated. Behavioral performance and ERPs were recorded during a cued visual Go-NoGo task which included neutral pictures (VCPT and pictures of emotional faces (ECPT. The amplitudes of ERPs associated with response preparation, conflict monitoring, and response inhibition were analyzed. The ASD group showed markedly higher scores than TD in both SCQ and BRIEF. Behavioral data showed no case-control differences in either the VCPT or ECPT in the whole group. While there were no significant case-control differences in ERPs from the combined VCPT and ECPT in the whole sample, the Contingent Negative Variation (CNV was significantly enhanced in the old ASD group (p = 0.017. When excluding ASD with comorbid ADHD we found a significantly increased N2 NoGo (p = 0.016 and N2-effect (p = 0.023 for the whole group. We found no case-control differences in the P3-components. Our findings suggest increased response preparation in adolescents with ASD older than 16 years and
Vallance, S A; Entwistle, R C; Hitchens, P L; Gardner, I A; Stover, S M
Identification of exercise history patterns that are related to catastrophic scapular fracture will facilitate prevention of racehorse fatalities. To determine if exercise patterns are associated with scapular fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete scapular fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and scapular fracture were investigated using conditional logistic regression. Thoroughbreds with a scapular fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a scapular fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of scapular fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03-177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54-0.94). Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk. © 2012 EVJ Ltd.
Liao, Kuo-Jen; Hou, Xiangting; Strickland, Matthew J
An important issue of regional air quality management is to allocate air quality management funds to maximize environmental and human health benefits. In this study, we use an innovative approach to tackle this air quality management issue. We develop an innovative resource allocation model that allows identification of air pollutant emission control strategies that maximize mortality avoidances subject to a resource constraint. We first present the development of the resource allocation model and then a case study to show how the model can be used to identify resource allocation strategies that maximize mortality avoidances for top five Metropolitan Statistical Areas (MSAs) (i.e., New York, Los Angeles, Chicago, Dallas-Fort Worth, and Philadelphia) in the continental United States collectively. Given budget constraints in the U.S. Environmental Protection Agency's (EPA) Clean Air Act assessment, the results of the case study suggest that controls of sulfur dioxide (SO2) and primary carbon (PC) emissions from EPA Regions 2, 3, 5, 6, and 9 would have significant health benefits for the five selected cities collectively. Around 30,800 air pollution-related mortalities could be avoided during the selected 2-week summertime episode for the five cities collectively if the budget could be allocated based on the results of the resource allocation model. Although only five U.S. cities during a 2-week episode are considered in the case study, the resource allocation model can be used by decision-makers to plan air pollution mitigation strategies to achieve the most significant health benefits for other seasons and more cities over a region or the continental U.S. Effective allocations of air quality management resources are challenging and complicated, and it is desired to have a tool that can help decision-makers better allocate the funds to maximize health benefits of air pollution mitigation. An innovative resource allocation model developed in this study can help
Jedrychowski, Wieslaw; Maugeri, Umberto; Popiela, Tadeusz; Kulig, Jan; Sochacka-Tatara, Elzbieta; Pac, Agnieszka; Sowa, Agata; Musial, Agnieszka
Laboratory in-vitro studies and animal experiments showing the potential health benefits from apples raises the question to what extent the regular consumption of apples in humans may have a beneficial effect on colorectal cancer risk. A total of 592 incident cases of colorectal cancer have been enrolled in a hospital-based case-control study. The comparison group included 765 controls chosen from the patients of the same hospital without history of cancer and admitted for treatment of nonneoplastic conditions. Interviews of both cases and controls were conducted in the hospital setting by trained interviewers. The median intake of fruits among cases was lower than in controls (9.5 vs. 11 servings/week) and the difference was statistically significant. Apples were the most frequent fruit consumed by the study participants and about 80% of variability in the total fruit consumption resulted from the intake of apples. We did not observe any significant statistical differences in consumption of berries, citrus, or stone fruits and other kinds of fruits across cases and controls. The adjusted estimates of colorectal cancer risk related to the daily consumption of apples (in quintiles) were based on the unconditional multivariate logistic model, which considered the set of potential confounding variables such as demographic characteristics of participants (age, gender, place of residency, marital status, tobacco smoking), total energy intake, intake of vegetables and fruits without apples. The results of the logistic analysis showed that the adjusted risk of colorectal cancer inversely correlated with daily number of apple servings. The reduced risk of colorectal cancer of border significance level was already observed at the consumption of at least one apple a day (odds ratio=0.65, 95% CI: 0.39-1.09), but at the intake of more than one apple a day the risk was reduced by about 50% (odds ratio=0.53, 95% CI: 0.35-0.79). Neither the consumption of vegetables nor other
Ben Meir, Zehava; Garber, Anna; Rassin, Michal; Silner, Dina
This article presents a case study of a patient who was treated for 5 years from the time of diagnosis until his death. The patient was diagnosed with familial polyposis at the age of 35 due to a family history of the same. He suffered from low body image and showed a poor response to treatment, especially regarding nutrition. The period of time related to the presentation of symptoms and the patient's subsequent deterioration was characterized by attempts on the part of nursing staff to improve the patient's quality of life. Treatment of multiple fistulae was employed, while keeping the skin intact, along with the creative development of a unique bandaging method. This article describes the course of the patient's disease and specifies his problems and their solutions. It is hoped that presentation of this case will benefit caregiving staff in dealing with similar cases.
Yu, Zhi-gang; Jia, Cun-xian; Geng, Cui-zhi; Tang, Jin-hai; Zhang, Jin; Liu, Li-yuan
There has been an increase in the incidence of breast cancer in China, but no definite risk and protective factors for breast cancer have been identified in Chinese females. This study was designed to identify the risk factors for female breast cancer in North and East China. A 1:3 matched, case-control study was conducted. All of the subjects in the case and control groups were selected from a previous epidemiological survey of 122 058 females aged 25 to 70 years. Single and multiple Logistic regression analyses were used to study potential factors in the development of breast cancer. Significant differences at the level of α=0.20 between case and control groups were observed for the following factors: economic status, social status, family annual income, bean product consumption, body mass index (BMI), family history of breast cancer in the first or second degree, number of miscarriages, menstrual pattern, benign breast disease history, nipple leakage, inverted nipple, history of diabetes mellitus, history of hypertension, history of ovarian cyst, physical exercise, current and global quality of life satisfaction, healthy behavior and prevention, and scores of breast cancer-related knowledge. After Cox-regression model analysis (α=0.10), six factors were found to be significantly related to breast cancer, of which the ORs and 95%CIs were: BMI, 1.696 (1.169-2.460, P=0.005); benign breast disease history, 2.672 (0.848-8.416, P=0.093); family history of breast cancer, 7.080 (1.758-28.551, P=0.006); number of miscarriages, 1.738 (1.014-2.978, P=0.044); global quality of life satisfaction, 3.044 (1.804-5.136, P=0.000); healthy behavior and prevention, 3.294 (1.692-6.412, P=0.000). A comprehensive range of factors related to breast cancer was identified. Women should be educated about a healthy lifestyle, especially those with a family history of breast cancer or a personal history of benign breast disease.
Conan, Anne; O'Reilly, Ciara E; Ogola, Eric; Ochieng, J Benjamin; Blackstock, Anna J; Omore, Richard; Ochieng, Linus; Moke, Fenny; Parsons, Michele B; Xiao, Lihua; Roellig, Dawn; Farag, Tamer H; Nataro, James P; Kotloff, Karen L; Levine, Myron M; Mintz, Eric D; Breiman, Robert F; Cleaveland, Sarah; Knobel, Darryn L
Diarrheal disease remains among the leading causes of global mortality in children younger than 5 years. Exposure to domestic animals may be a risk factor for diarrheal disease. The objectives of this study were to identify animal-related exposures associated with cases of moderate-to-severe diarrhea (MSD) in children in rural western Kenya, and to identify the major zoonotic enteric pathogens present in domestic animals residing in the homesteads of case and control children. We characterized animal-related exposures in a subset of case and control children (n = 73 pairs matched on age, sex and location) with reported animal presence at home enrolled in the Global Enteric Multicenter Study in western Kenya, and analysed these for an association with MSD. We identified potentially zoonotic enteric pathogens in pooled fecal specimens collected from domestic animals resident at children's homesteads. Variables that were associated with decreased risk of MSD were washing hands after animal contact (matched odds ratio [MOR] = 0.2; 95% CI 0.08-0.7), and presence of adult sheep that were not confined in a pen overnight (MOR = 0.1; 0.02-0.5). Variables that were associated with increased risk of MSD were increasing number of sheep owned (MOR = 1.2; 1.0-1.5), frequent observation of fresh rodent excreta (feces/urine) outside the house (MOR = 7.5; 1.5-37.2), and participation of the child in providing water to chickens (MOR = 3.8; 1.2-12.2). Of 691 pooled specimens collected from 2,174 domestic animals, 159 pools (23%) tested positive for one or more potentially zoonotic enteric pathogens (Campylobacter jejuni, C. coli, non-typhoidal Salmonella, diarrheagenic E. coli, Giardia, Cryptosporidium, or rotavirus). We did not find any association between the presence of particular pathogens in household animals, and MSD in children. Public health agencies should continue to promote frequent hand washing, including after animal contact, to reduce the risk of MSD. Future studies
Frisell, Thomas; Hellgren, Karin; Alfredsson, Lars; Raychaudhuri, Soumya; Klareskog, Lars; Askling, Johan
Our objective was to estimate the risk of developing rheumatoid arthritis (RA) associated with a family history of non-RA arthritis-related diseases. This familial co-aggregation is of clinical interest since it is often encountered when assessing family history of RA specifically, but also informative on the genetic overlap between these diseases. Since anticitrullinated peptide antibodies/rheumatoid factor (RF)-positive and RF-negative RA have both specific and shared genetic factors, the familial co-aggregation was assessed separately for seropositive and seronegative disease. Nested case-control study in prospectively recorded Swedish total population data. The Multi-Generation Register identified first-degree relatives. RA and arthritis-related diseases were ascertained through the nationwide patient register. RA serology was based on International Classification of Diseases tenth revision coded diagnoses, mainly reflecting RF. Familial risks were calculated using conditional logistic regression. Results were replicated using the Swedish rheumatology register. Familial co-aggregation was found between RA and every studied arthritis-related disease, but the magnitude varied widely, from juvenile idiopathic arthritis (JIA) (seropositive RA OR=3.98 (3.01 to 5.26); seronegative RA OR=5.70 (3.47 to 9.36)) to osteoarthritis (seropositive RA OR=1.03 (1.00 to 1.06); seronegative RA OR=1.05 (1.00 to 1.09)). The familial co-aggregation pattern of non-RA arthritis-related diseases was overall similar for seropositive and seronegative RA. Among those with family history of RA, relatives' other arthritis-related diseases conferred little or no additional risk. Although family history of several arthritis-related diseases may be useful to predict RA (eg, lupus and JIA), others (eg, osteoarthritis and arthralgia) are less useful. Seropositive and seronegative RA had rather similar familial co-aggregation patterns with arthritis-related diseases, suggesting that the two RA
Barasa, Edwine W; Cleary, Susan; English, Mike; Molyneux, Sassy
Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. We used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. We collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. We applied a combination of two frameworks, Norman Long's actor interface analysis and VeneKlasen and Miller's expressions of power framework to examine and interpret our findings RESULTS: The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. Designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could
Seyedeh Fatemeh Miri
Full Text Available Background: Identifying and investigating the factors influencing self-efficacy and eventually health related quality of life (HRQoL can be an important step toward the prevention and treatment of the obesity. The aim of the study was to compare weight self-efficacy and HRQoL among normal-weight, overweight and obese Iranian adolescents. Materials and Methods In this case-control study, 118 obese and overweight adolescents (case group and 118 adolescents with normal weight (control group were recruited. Adolescent's anthropometric characteristics were measured. The Weight Efficacy Lifestyle Questionnaire (WEL, pediatric quality of life inventory (PedsQLTM 4.0 and self-reported physical activity were completed by the adolescents. Results: Multivariate logistic regression adjusting for various confounders indicated that overweight and obese adolescents were less likely to be physically active (adjusted odds ratio, AOR= 0.66; 95% confidence interval [CI], 0.48 to 0.911, had lower ability to cope with social pressure (AOR= 0.54; 95% CI, 0.32 to 0.93, involved in less positive activities (AOR= 0.53; 95% CI, 0.37 to 0.75, and felt more negative emotions (AOR= 0.23; 95% CI, 0.14 to 0.36 than their normal-weight counterparts. Moreover, obese and overweight adolescents were more likely to report deteriorated quality of life in all PedsQL subscales than those with normal weight P
Hansen, Bo T; Campbell, Suzanne; Nygård, Mari
Examine long-term incidence trends of human papillomavirus (HPV)-related cancer in Norway, and estimate the number of cancer cases preventable by vaccines against HPV 16/18 or HPV 16/18/31/33/45/52/58. Observational registry-based study. We extracted incident cases of HPV-related cancer during 1953-2015 from the Cancer Registry of Norway. Tumour HPV prevalence estimates from large international meta-analyses or from Norway were used to estimate the protective potential of HPV vaccines. The Norwegian population. Incidence trend analyses during 1953-2015 for squamous cell carcinoma (SCC) of the cervix, vulva, vagina, oropharynx, anus and penis, and adenocarcinoma of the cervix. Additionally, the number of cancer cases preventable by HPV vaccination. Among women, incidences of SCC of the anus, oropharynx, vulva and cervical adenocarcinoma increased, while vaginal SCC showed no trend. For these cancers combined, the average annual percentage change (AAPC) during 1953-2015 was 1.2 (95% CI 0.7 to 1.6). The incidence of cervical SCC generally decreased during 1976-2004 and remained stable thereafter. Among men, incidences of SCC of the anus, oropharynx and penis increased. The AAPC during 1953-2015 combined for all male HPV-related cancer was 1.9 (95% CI 1.3 to 2.5). A vaccine against HPV 16/18 might yearly prevent 402 (95% CI 382 to 420) cancers. A vaccine against HPV 16/18/31/33/45/52/58 might yearly prevent 478 (95% CI 464 to 490) cancers, of which 206 (95% CI 202 to 209) occur in non-cervical organs, and 113 (95% CI 110 to 115) occur among men. The incidences of HPV-related cancers that are not effectively prevented by screening have generally increased during 1953-2015. HPV vaccination can prevent a substantial number of cancers in Norway, in cervical and non-cervical organs, among women and men. © 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
Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff
To estimate the risk of surgery for subacromial impingement syndrome (SIS) in relation to occupational exposures, lifestyle factors and diabetes mellitus. We conducted a case-control study nested in a register-based cohort study of the Danish working population. For each of 3000 first-time cases of surgery for SIS, two age-matched and sex-matched controls were drawn. Cases and controls received a questionnaire on job history and other factors. Job histories were combined with a psychosocial job exposure matrix (JEM) and the updated Shoulder JEM, which provided exposure intensities on measurement scales. Ten-year cumulative exposures to upper arm elevation >90°, repetitive shoulder movements, forceful shoulder exertions and hand-arm vibrations (HAVs) were estimated. We used conditional logistic regression. There were 5396 persons (60%) who answered the questionnaire. For occupational mechanical exposures, the adjusted OR (OR adj ) ranged from 1.9 (95% CI 1.5 to 2.5 for HAVs) to 2.5 (95% CI 1.9 to 3.5 for force) among men and 1.7 (95% CI 1.2 to 2.5 for HAVs) to 2.0 (95% CI 1.3 to 2.9 for force) among women. No statistically significant associations were found for occupational psychosocial factors. Body mass index (BMI) and pack-years of smoking showed OR adj up to 2.0. Diabetes mellitus showed OR adj of 1.5 (95% CI 1.1 to 2.2) for men and 2.2 (95% CI 1.4 to 3.4) for women. Our findings add to the evidence of an increased risk of surgery for SIS in relation to occupational cumulative mechanical exposures, even when an increased risk in relation to BMI, smoking and diabetes mellitus is taken into account. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Improving knowledge and behaviours related to the cause, transmission and prevention of Tuberculosis and early case detection: a descriptive study of community led Tuberculosis program in Flores, Indonesia
Full Text Available Abstract Background The community’s awareness of Tuberculosis (TB and delays in health care seeking remain important issues in Indonesia despite the extensive efforts of community-based TB programs delivered by a non-government organisation (NGO. This study explored the knowledge and behaviours in relation to TB and early diagnosis before and after an asset-based intervention designed to improve these issues. Methods Six villages in Flores, Indonesia were purposively selected to participate in this study. Three villages served as intervention villages and the other three villages provided a comparison group. Data collection included interviews, group discussions, observations, field notes and audit of records. Results In total, 50 participants across six villages were interviewed and three group discussions were conducted in the intervention villages supplemented by 1 – 5 h of observation during monthly visits. Overall, participants in all villages had limited knowledge regarding the cause and transmission of TB before the intervention. The delay in health seeking behaviour was mainly influenced by ignorance of TB symptoms. Health care providers also contributed to delayed diagnosis by ignoring the symptoms of TB suspects at the first visit and failing to examine TB suspects with sputum tests. Stigmatisation of TB patients by the community was reported, although this did not seem to be common. Early case detection was less than 50 % in four of the six villages before the asset-based intervention. Knowledge of TB improved after the intervention in the intervention villages alongside improved education activities. Early case detection also increased in the intervention villages following this intervention. The behaviour changes related to prevention of TB were also obvious in the intervention villages but not the comparison group. Conclusion This small project demonstrated that an asset-based intervention can result in positive changes in
Paulo Fagundes Visentini
Full Text Available Analysis of the impact of revolutions in the International Relations and the World System as constitutive and renewed elements. Criticizes the stance of theories that consider it a domestic phenomenon that causes a systemic disturbance, focusing in the case of the African Revolutions in the 1970s. Explores the international dimension they possess, considering their impact regarding the end of the Cold War, even though it happened in the periphery of the world.
Full Text Available Bisphosphonates (BPs are the most widely used and effective antiresorptive agents for the treatment of diseases in which there is an increase in osteoclastic resorption, including post-menopausal osteoporosis, Paget’s disease, and tumor-associated osteolysis. Oral and maxillofacial surgeons are well aware of the side effects of bisphosphonates and mainly with bisphosphonate-related osteonecrosis of the jaws (BRONJ. Less known are the mucosal lesions associated with the use of these agents. In the scientific literature, there are only few reports of mucosal lesions due to the direct contact of the oral form of BPs with the mucosa (bisphosphonate-related mucositis. They are mostly related to improper use of bisphosphonate tablets that are chewed, sucked or allowed to melt in the mouth before swallowing. Lesions are atypical and need to be differentiated from other mucosal erosions. We present a case of bisphosphonate-related mucositis due to the improper use of alendronate.
Watanabe, Masaki; Takahashi, Akira (Nagoya Univ. (Japan). Faculty of Medicine); Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro
A total of 254 patients who were proved to have pontine high intensity areas on T[sub 2]-weighted magnetic resonance imaging (MRI) were analyzed in relation to brain stem semiology. A comparative study on MRI and MR angiography was made between 254 patients with pontine high signals and 276 control cases showing no abnormality either on T[sub 1] or T[sub 2]-weighted images. Of the 254 patients, 62 had transient subjective complaints such as vertigo-dizziness. Supratentorial high signals, basilar artery tortuousness and vertebral artery asymmetry on MR angiography were seen more frequently in patients with pontine high signals than in the controls. In conclusion, pontine high signals may result from diffuse arteriosclerosis and MR angiography is considered to be a useful screening method. (author).
In this session, Session JA1, the discussion focuses on the following topics: The Staged Decompression to the Hypobaric Atmosphere as a Prophylactic Measure Against Decompression Sickness During Repetitive EVA; A New Preoxygenation Procedure for Extravehicular Activity (EVA); Metabolic Assessments During Extra-Vehicular Activity; Evaluation of Safety of Hypobaric Decompressions and EVA From Positions of Probabilistic Theory; Fatty Acid Composition of Plasma Lipids and Erythrocyte Membranes During Simulation of Extravehicular Activity; Biomedical Studies Relating to Decompression Stress with Simulated EVA, Overview; The Joint Angle and Muscle Signature (JAMS) System - Current Uses and Future Applications; and Experimental Investigation of Cooperative Human-Robotic Roles in an EVA Work Site.
Full Text Available Abstract Background Substance use disorders have repeatedly been found to lead to premature death, i.e. drug-related death by disease, fatal intoxications, or trauma (accidents, suicide, undetermined suicide, and homicide. The present study examined the relationship between multi-drug substance use and natural and unnatural death. Methods All consecutive, autopsied patients who had been in contact with the Addiction Centre in Malmö University Hospital from 1993 to 1997 inclusive were investigated. Drug abuse was investigated blindly in the case records and related to the cause of death in 387 subjects. Results Every substance apart from alcohol used previously in life added to the risk of unnatural death in a linear way. There were independent increased risks of fatal heroin overdoses or undetermined suicide. Death by suicide and violent death were unrelated to additional abuse. Conclusion The number of drugs used was related to an increased risk of unnatural death by undetermined suicide (mainly fatal intoxications and heroin overdose.
Kim, Jayeon; Mersereau, Jennifer E.; Khankari, Nikhil; Bradshaw, Patrick T.; McCullough, Lauren E.; Cleveland, Rebecca; Shantakumar, Sumitra; Teitelbuam, Susan L.; Neugut, Alfred I.; Senie, Ruby T.; Gammon, Marilie D.
Purpose Despite the overlap between the clinical symptoms/sequelae of polycystic ovarian syndrome (PCOS) and many known reproductive risk factors for breast cancer, the relationship between PCOS and breast cancer remains unclear, possibly because of the complex heterogeneity and challenges in diagnosing PCOS over time. We hypothesized that PCOS, specific PCOS-related symptoms/sequelae, or clusters of PCOS-related symptoms/sequelae, may be differentially associated with pre- vs. postmenopausal breast cancer risk. Materials and Methods Cases were 1,508 women newly diagnosed with a first primary in situ or invasive breast, and the 1,556 population-based controls were frequency-matched by age. Results History of physician-diagnosed PCOS was reported by 2.2% (n=67), among whom oral contraceptive (OC) use, irregular menstruation, and infertility due to ovulatory dysfunction were common. Using unconditional logistic regression, adjusted odds ratios (95% confidence intervals) for PCOS were increased for premenopausal [2.74 (1.13, 6.63)], but not post-menopausal breast cancer [0.87 (0.44, 1.71)]. We used cluster analysis to investigate whether risk among all women varied by PCOS-related symptoms/sequelae, such as reproductive irregularities, OC use, and components of insulin resistance. In the cluster analysis, odds ratios were elevated among premenopausal women who had a history of OC use and no ovulatory dysfunction [1.39 (1.03, 1.88)], compared to those with fewer number of PCOS-related symptoms/sequelae. Conclusion PCOS, and associated PCOS-related symptoms/sequelae including OC use, may play a role in the development of premenopausal breast cancer. Our findings require confirmation in studies with a larger number of premenopausal women with systematically applied diagnostic criteria for PCOS. PMID:26797454
Finnbjornsdottir, Ragnhildur Gudrun; Elvarsson, Bjarki Thor; Gislason, Thorarinn; Rafnsson, Vilhjalmur
Objectives To study the association between daily mortality and short-term increases in air pollutants, both traffic-related and the geothermal source-specific hydrogen sulfide (H2S). Design Population-based, time stratified case-crossover. A lag time to 4 days was considered. Seasonal, gender and age stratification were calculated. Also, the best-fit lag when introducing H2S >7 µg/m3 was selected by the Akaike Information Criterion (AIC). Setting The population of the greater Reykjavik area (n=181 558) during 2003–2009. Participants Cases were defined as individuals living in the Reykjavik capital area, 18 years or older (N=138 657), who died due to all natural causes (ICD-10 codes A00-R99) other than injury, poisoning and certain other consequences of external causes, or cardiovascular disease (ICD-10 codes I00-I99) during the study period. Main outcome measure Percentage increases in risk of death (IR%) following an interquartile range increase in pollutants. Results The total number of deaths due to all natural causes was 7679 and due to cardiovascular diseases was 3033. The interquartile range increased concentrations of H2S (2.6 µg/m3) were associated with daily all natural cause mortality in the Reykjavik capital area. The IR% was statistically significant during the summer season (lag 1: IR%=5.05, 95% CI 0.61 to 9.68; lag 2: IR%=5.09, 95% CI 0.44 to 9.97), among males (lag 0: IR%=2.26, 95% CI 0.23 to 4.44), and among the elderly (lag 0: IR%=1.94, 95% CI 0.12 to 1.04; lag 1: IR%=1.99, 95% CI 0.21 to 1.04), when adjusted for traffic-related pollutants and meteorological variables. The traffic-related pollutants were generally not associated with statistical significant IR%s. Conclusions The results suggest that ambient H2S air pollution may increase mortality in Reykjavik, Iceland. To the best of our knowledge, ambient H2S exposure has not previously been associated with increased mortality in population-based studies and therefore the results
Vijayaraghavan, Krish; Seigneur, Christian; Bronson, Rochelle; Chen, Shu-Yun; Karamchandani, Prakash; Walters, Justin T; Jansen, John J; Brandmeyer, Jo Ellen; Knipping, Eladio M
The contrasting effects of point source nitrogen oxides (NOx) and sulfur dioxide (SO2) air emission reductions on regional atmospheric nitrogen deposition are analyzed for the case study of a coal-fired power plant in the southeastern United States. The effect of potential emission reductions at the plant on nitrogen deposition to Escambia Bay and its watershed on the Florida-Alabama border is simulated using the three-dimensional Eulerian Community Multiscale Air Quality (CMAQ) model. A method to quantify the relative and individual effects of NOx versus SO2 controls on nitrogen deposition using air quality modeling results obtained from the simultaneous application of NOx and SO2 emission controls is presented and discussed using the results from CMAQ simulations conducted with NOx-only and SO2-only emission reductions; the method applies only to cases in which ambient inorganic nitrate is present mostly in the gas phase; that is, in the form of gaseous nitric acid (HNO3). In such instances, the individual effects of NOx and SO2 controls on nitrogen deposition can be approximated by the effects of combined NOx + SO2 controls on the deposition of NOy, (the sum of oxidized nitrogen species) and reduced nitrogen species (NHx), respectively. The benefit of controls at the plant in terms of the decrease in nitrogen deposition to Escambia Bay and watershed is less than 6% of the overall benefit due to regional Clean Air Interstate Rule (CAIR) controls.
Full Text Available It is assumed that obesity adversely affects the health related quality of life (HRQOL of women with polycystic ovary syndrome (PCOS, not only due to the excess weight, but also due to several other obesity induced metabolic and reproductive consequences. We aimed to compare the effects of excess body weight on the HRQOL between women with PCOS and controls.This is a case control study of 142 women with PCOS and 140 age- and BMI- matched controls. The Iranian version of short form health survey 36 (SF 36 was used to assess HRQOL. Domains of SF 36 were compared in women with PCOS and controls using multivariate analysis of covariance. The Pearson correlation was used to assess the correlation between body mass index (BMI and domain scores of SF 36, and the differences between two correlations in cases and controls, using Fisher's Z test.Women with PCOS had significantly lower scores for both, the physical and the mental component summary scales, compared to controls. In the cases, a significant negative correlations were observed for BMI with physical function (r = - 0.301, P<0.001, bodily pain (r = - 0.23, P = 0.006, and physical summary score (r = -0.3, P = 0.007. In controls, significant correlation was seen for BMI with bodily pain (r = - 0.3, P<0.001 and physical summary score (r = - 0.27, P = 0.001. The differences between correlations of physical function with BMI in PCOS and controls were statistically significant (Z = -2.41, P = 0.008.Although the physical aspects of HRQOL are adversely affected by overweight in both PCOS and controls, these impaired effects are greater in women with PCOS.
Kopp, Tine Iskov; Andersen, Vibeke; Tjonneland, Anne; Vogel, Ulla
Maintenance of a balance between commensal bacteria and the mucosal immune system is crucial and intestinal dysbiosis may be a key event in the pathogenesis of colorectal cancer (CRC). The toll-like receptor 4 (TLR4) is an important pattern-recognition receptor that regulates inflammation and barrier function in the gut by a mechanism that involves activation of the nuclear factor-κB (NF-κB) transcription factor. Dietary and life style factors may impact these functions. We therefore used a Danish prospective case-cohort study of 1010 CRC cases and 1829 randomly selected participants from the Danish Diet, Cancer and Health cohort to investigate three polymorphisms in NFKB1 and TLR4 and their possible interactions with diet and life style factors in relation to risk of CRC. Homozygous carriage of the variant allele of the TLR4/rs5030728 polymorphism was associated with increased risk of CRC (incidence rate ratio (IRR) = 1.30; 95% confidence interval (CI): 1.05-1.60; P = 0.02 (gene-dose model); IRR = 1.24; 95%CI: 1.01-1.51; P = 0.04 (recessive model)). Del-carriers of the NFKB1/rs28362491 polymorphism had a 17% (95%CI: 1.03-1.34; P = 0.02) increased risk of CRC compared to homozygous carriers of the ins-allele. However, none of these risk estimates withstood adjustment for multiple comparisons. We found no strong gene-environment interactions between the examined polymorphism and diet and life style factors in relation to CRC risk.
Tine Iskov Kopp
Full Text Available Maintenance of a balance between commensal bacteria and the mucosal immune system is crucial and intestinal dysbiosis may be a key event in the pathogenesis of colorectal cancer (CRC. The toll-like receptor 4 (TLR4 is an important pattern-recognition receptor that regulates inflammation and barrier function in the gut by a mechanism that involves activation of the nuclear factor-κB (NF-κB transcription factor. Dietary and life style factors may impact these functions. We therefore used a Danish prospective case-cohort study of 1010 CRC cases and 1829 randomly selected participants from the Danish Diet, Cancer and Health cohort to investigate three polymorphisms in NFKB1 and TLR4 and their possible interactions with diet and life style factors in relation to risk of CRC. Homozygous carriage of the variant allele of the TLR4/rs5030728 polymorphism was associated with increased risk of CRC (incidence rate ratio (IRR = 1.30; 95% confidence interval (CI: 1.05-1.60; P = 0.02 (gene-dose model; IRR = 1.24; 95%CI: 1.01-1.51; P = 0.04 (recessive model. Del-carriers of the NFKB1/rs28362491 polymorphism had a 17% (95%CI: 1.03-1.34; P = 0.02 increased risk of CRC compared to homozygous carriers of the ins-allele. However, none of these risk estimates withstood adjustment for multiple comparisons. We found no strong gene-environment interactions between the examined polymorphism and diet and life style factors in relation to CRC risk.
Lawler, Robert W.
Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…
Schmidt-Pokrzywniak, Andrea; Jöckel, Karl-Heinz; Bornfeld, Norbert; Sauerwein, Wolfgang; Stang, Andreas
To examine the association among phenotypic characteristics, chronic and intermittent ultraviolet (UV) radiation, and the risk of uveal melanoma. Case-control study. Overall, between September of 2002 and March of 2005, 1677 eligible subjects (age range: 20-74 years, living in Germany) participated. Interviews were conducted with 459 incident uveal melanoma cases (response proportion 94%), 827 population controls (55%), 180 ophthalmologist controls (52%), and 187 sibling controls (57%). Data on phenotypic characteristics and chronic and intermittent UV radiation exposure were obtained from a self-administered postal questionnaire and computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Furthermore, we studied the presence of synergy (super additive of risk or relative excess risk due to interaction) between light iris color and several UV radiation exposures. Hair color at age 20 years, eye color, untanned skin color, ability to tan, propensity to burn on exposure, freckling, occupational sun exposure, artificial UV radiation, burns to the eyes. In all 3 control groups, fair skin color, freckling as a child, nevi on the upper arms, burns to the eyes, use of sunlamps, and ever worked outside for 4 or more hours per day were positively associated with uveal melanoma. The association with eye color was apparent only in population controls (odds ratio = 1.9; 95% confidence interval [CI], 1.4-5.2), resulting in a relative excess risk due to interaction of 0.9 (95% CI, -0.6-2.3) for light iris color and more than 5 eye burns (UV-related keratitis) and 0.6 (95% CI, -0.3 to 1.5) for light iris color and eye protection. Our interaction analyses suggest that there is an etiologic synergism between light iris color and the exposure of UV radiation. People with light iris color may have an especially increased risk for uveal melanoma if they are exposed to UV radiation. The author(s) have no
Full Text Available The Energy Performance of Buildings Directive (EPBD 2010 calls for the Nearly Zero Energy Building (nZEB Standard for new buildings from 2021 onwards: Buildings using “almost no energy” are powered by renewable sources or by the energy produced by the building itself. For residential buildings, this ambitious new standard has already been reached. But for other building types, this goal is still far away. The potential of these buildings to meet a nZEB Standard was investigated by analyzing ten case studies, representing non-residential buildings with different uses. The analysis shows that the primary characteristics common to critical building types are a dense building context with a very high degree of technical installation (such as hospital, research, and laboratory buildings. The large primary energy demand of these types of buildings cannot be compensated by building- and property-related energy generation, including off-site renewables. If the future nZEB Standard were to be defined with lower requirements because of this, the state-related properties of Bavaria suggest that the real potential energy savings available in at least 85% of all new buildings would be insufficiently exploited. Therefore, it would be more useful to individualize the legal energy verification process for new buildings, to distinguish critical building types such as laboratories and hospitals from the other building types.
Güneş, Serkan; Ekinci, Özalp; Teke, Halenur; Yıldırım, Veli
Raynaud's phenomenon is a recurrent vasospastic condition with reducing in peripheral blood flow due to cold, or emotional stress. White, blue and red discolorations occur during the attacks. Serotonin reuptake inhibitors, psychostimulants, and aripiprazole are reported to be related with Raynaud's phenomenon. Risperidone is an atypical antipsychotic drug with dopaminergic and serotonergic effects. In children and adolescents, risperidone is used for bipolar disorder, tic disorders, conduct disorder, schizophrenia, symptoms of irritability and self-mutilation. Here we report a case of Raynaud's phenomenon associated with risperidone in a 12-year-old boy. Raynaud's phenomenon occurred two weeks after starting risperidone and disappeared after stopping risperidone.
Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene, intakes of folate and related B vitamins and colorectal cancer: a case-control study in a population with relatively low folate intake.
Sharp, Linda; Little, Julian; Brockton, Nigel T; Cotton, Seonaidh C; Masson, Lindsey F; Haites, Neva E; Cassidy, Jim
Folate is key in one-carbon metabolism, disruption of which can interfere with DNA synthesis, repair, and methylation. Efficient one-carbon metabolism requires other B vitamins and the optimal activity of enzymes including 5,10-methylenetetrahydrofolate reductase (MTHFR). We report a population-based case-control study of folate intake, related dietary factors and MTHFR polymorphisms (C677T, A1298C) and colorectal cancer in a population with relatively high colorectal cancer incidence and relatively low folate intake. A total of 264 cases with histologically confirmed incident colorectal cancer and 408 controls participated. There was no clear trend in risk with reported intakes of total, or dietary, folate, riboflavin, vitamin B12 or vitamin B6, nor were there interactions between folate intake and the other B vitamins or alcohol. For C677T, risk decreased with increasing variant alleles (multivariate OR for CT v. CC = 0.77 (95 % CI 0.52, 1.16); OR for TT v. CC = 0.62 (95 % CI 0.31, 1.24)), which, although not statistically significant, was consistent with previous studies. For A1298C, compared with AA subjects, CC subjects had modest, non-significant, reduced risk (multivariate OR = 0.81 (95 % CI 0.45, 1.49)). There were significant interactions between total folate and C677T (P = 0.029) and A1298C (P = 0.025), and total vitamin B6 and both polymorphisms (C677T, P = 0.016; A1298C, P = 0.033), although the patterns observed differed from previous studies. Seen against the setting of low folate intake, the results suggest that the role of folate metabolism in colorectal cancer aetiology may be more complex than previously thought. Investigation of particular folate vitamers (for example, tetrahydrofolate, 5,10-methylenetetrahydrofolate) may help clarify carcinogenesis pathways.
Moncayo, Roy; Rudisch, Ansgar; Diemling, Markus; Kremser, Christian
The concept of acupuncture point localisation in Traditional Chinese Medicine (TCM) is based on millenary practical experience. Modern imaging methods such as PET, MRI and SPECT have been used primary for the investigation of the mechanisms of action of acupuncture. In this pilot single-case study we have evaluated the technical possibilities for in-vivo imaging of the anatomical relations of acupuncture points using state of the art MRI. Preliminary experiments relating to the quality of acupuncture needles under the setting of MRI were done both with stainless steel and gold needles. In a second step, in-vivo imaging was carried out. A licensed acupuncture practitioner (RM) chose two points belonging to the so-called extraordinary vessels. In 2 sequential, separate procedures, he inserted himself gold acupuncture needles using a neutral technique (known as Ping Bu Ping Xie) into the Dai mai and Shen mai points, i.e. gall bladder 26 and bladder 62. Imaging was done on a Siemens Magnetom Avanto MR scanner using a head array and body coil. Mainly T1-weighted imaging sequences, as routinely used for patient exams, were used to obtain multi-slice images. In the preliminary experiments only acupuncture needles made of gold showed enough stability in order to be used for further imaging procedures. Using an onion and a banana as an object, further studies showed that the gold needles produced a void defect that corresponds to the tip of the inserted needle, while at the same time an artefactually increased diameter was observed. The in-vivo experiments showed that the Dai mai point was in relation to the abdominal internal oblique muscle. The Shen mai point artefact showed up close to the longus and brevis peroneal tendons at the fibular malleolus. Side effects related to heating or burning were not observed. Improved anatomical recognition was obtained using 3D-volume rendering techniques. Through an adequate choice of acupuncture material (gold needles) as well as of
Shimada, Yuichi J; Tsugawa, Yusuke; Iso, Hiroyasu; Brown, David F M; Hasegawa, Kohei
Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension. We performed a self-controlled case series study of obese patients with hypertension who underwent bariatric surgery using population-based ED and inpatient databases that recorded every bariatric surgery, ED visit, and hospitalization in three states (California, Florida, and Nebraska) from 2005 to 2011. The primary outcome was acute care use for hypertension-related disease. We used conditional logistic regression to compare each patient's risk of the outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. We identified 980 obese patients with hypertension who underwent bariatric surgery. The median age was 48 years (interquartile range, 40-56 years), 74% were female, and 55% were non-Hispanic white. During the reference period, 17.8% (95% confidence interval [CI], 15.4-20.2%) had a primary outcome event. The risk remained unchanged in the subsequent 12-month pre-surgery period (18.2% [95% CI, 15.7-20.6%]; adjusted odds ratio [aOR] 1.02 [95% CI, 0.83-1.27]; P = 0.83). In the first 12-month period after bariatric surgery, the risk significantly decreased (10.5% [8.6-12.4%]; aOR 0.58 [95% CI, 0.45-0.74]; P bariatric surgery (12.9% [95% CI, 10.8-15.0%]; aOR 0.71 [95% CI, 0.57-0.90]; P = 0.005). By contrast, there was no significant reduction in the risk among obese patients who underwent non-bariatric surgery (i.e., cholecystectomy, hysterectomy, spinal fusion, or mastectomy). In this population-based study of
Full Text Available When determining risk related to natural hazard processes, many studies neglect the investigations of the damage potential or are limited to the assessment of immobile values like buildings. However, persons as well as mobile values form an essential part of the damage potential. Knowledge of the maximum number of exposed persons in an endangered area is of great importance for elaborating evacuation plans and immediate measures in case of catastrophes. In addition, motor vehicles can also be highly damaged, as was shown by the analysis of avalanche events. With the removal of mobile values in time as a preventive measure this kind of damage can be minimised. This study presents a method for recording the maximum number of exposed persons and monetarily assessing motor vehicles in the municipality of Galtür (Tyrol, Austria. Moreover, general developments of the damage potential due to significant socio-economic changes since the mid-twentieth century are pointed out in the study area. The present situation of the maximum number of persons and mobile values in the official avalanche hazard zones of the municipality is described in detail. Information on the number of persons is derived of census data, tourism and employment statistics. During the winter months, a significant increase overlaid by strong short-term fluctuation in the number of persons can be noted. These changes result from a higher demand of tourism related manpower as well as from varying occupancy rates. The number of motor vehicles in endangered areas is closely associated to the number of exposed persons. The potential number of motor vehicles is investigated by means of mapping, statistics on the stock of motor vehicles and the density distribution. Diurnal and seasonal fluctuations of the investigated damage potential are pointed out. The recording of the number of persons and mobile values in endangered areas is vital for any disaster management.
Keiler, M.; Zischg, A.; Fuchs, S.; Hama, M.; Stötter, J.
When determining risk related to natural hazard processes, many studies neglect the investigations of the damage potential or are limited to the assessment of immobile values like buildings. However, persons as well as mobile values form an essential part of the damage potential. Knowledge of the maximum number of exposed persons in an endangered area is of great importance for elaborating evacuation plans and immediate measures in case of catastrophes. In addition, motor vehicles can also be highly damaged, as was shown by the analysis of avalanche events. With the removal of mobile values in time as a preventive measure this kind of damage can be minimised. This study presents a method for recording the maximum number of exposed persons and monetarily assessing motor vehicles in the municipality of Galtür (Tyrol, Austria). Moreover, general developments of the damage potential due to significant socio-economic changes since the mid-twentieth century are pointed out in the study area. The present situation of the maximum number of persons and mobile values in the official avalanche hazard zones of the municipality is described in detail. Information on the number of persons is derived of census data, tourism and employment statistics. During the winter months, a significant increase overlaid by strong short-term fluctuation in the number of persons can be noted. These changes result from a higher demand of tourism related manpower as well as from varying occupancy rates. The number of motor vehicles in endangered areas is closely associated to the number of exposed persons. The potential number of motor vehicles is investigated by means of mapping, statistics on the stock of motor vehicles and the density distribution. Diurnal and seasonal fluctuations of the investigated damage potential are pointed out. The recording of the number of persons and mobile values in endangered areas is vital for any disaster management.
Hvejsel, Marie Frier
and furnishing articulation hereof. In the second volume of the thesis; ‘INTERIORITY: a prefab case study’ this theory of interiority has been endeavored applied in a specific prefab project concerning the development of a novel prefab building system and housing series in collaboration with the Danish prefab......, tectonically. Hence, it has been a particular idea of the study to explore the relation between furniture, the spatial envelope itself, and its construct by using furniture as an architectural concept. Consequently, the thesis has specifically investigated whether this notion of interiority, describing...
Adam W Kiefer
Full Text Available Children and adolescent athletes are at a higher risk for concussion than adults, and also experience longer recovery times and increased associated symptoms. It has also recently been demonstrated that multiple, seemingly mild concussions may result in exacerbated and prolonged neurologic deficits. Objective assessments and return to play criteria are needed to reduce risk and morbidity associated with concussive events in these populations. Recent research has pushed to study the use of electroencephalography as an objective measure of brain injury. In the present case study, we present a novel approach that examines event related potentials via a brain network activation (BNA analysis as a biomarker of concussion and recovery. Specifically, changes in BNA scores as indexed through this approach, offer a potential indicator of neurological health as the BNA assessment qualitatively and quantitatively indexes the network dynamics associated with brain injury. Objective tools such as these support accurate and efficient assessment of brain injury and may offer a useful step in categorizing the temporal and spatial changes in brain activity following concussive blows, as well as the functional connectivity of brain networks, associated with concussion.
Full Text Available Background: Psoriasis is a chronic inflammatory disease of the skin and joints with an increased cardiovascular risk. Previous studies have shown a higher prevalence of metabolic syndrome (MS in psoriatic patients. Objective: To investigate the prevalence of MS in patients with psoriasis and healthy controls, and to determine the relation between disease severity and the presence of MS. Materials and Methods: We performed a hospital-based case-control study on 118 adult patients with psoriasis vulgaris and 120 controls matched for age, sex and body mass index. MS was diagnosed by the presence of three or more of the South Asian Modified National Cholesterol Education Program′s Adult Panel III criteria. Results: MS was significantly more common in psoriatic patients than in controls (44.1% vs. 30%, P value = 0.025. Psoriatic patients also had a higher prevalence of triglyceridemia (33.9% vs. 20.8%, P value = 0.011, abdominal obesity (34.7% vs. 32.5%, P value = 0.035 and elevated blood sugar. There was no difference in the high density lipoprotein (HDL levels and presence of hypertension among patients with psoriasis and normal controls. There was no correlation between the severity and duration of psoriasis with MS. Conclusion: MS is frequent in patients with psoriasis. We have found no relationship between disease severity and presence of MS. Hence, we suggest that all patients must be evaluated for the MS, irrespective of the disease severity.
Beatriz Helena Tess
Full Text Available This article analyzes intersectorial health-related policies (IHRP based on a case study performed in 2008-2009 that mapped the social policies of the city of Piracicaba, State of Sao Paulo, Brazil. The research strategy comprised quantitative and qualitative methodologies and converging information sources. Legal and theoretical conceptual frameworks were applied to the Piracicaba study results and served as the basis for proposing a typology of IHRP. Three types of IHRP were identified: health policies where the health sector is coordinator but needs non-health sectors to succeed; policies with a sector other than health as coordinator, but which needs health sector collaboration to succeed; and thirdly, genuine intersectorial policies, not led by any one sector but by a specifically-appointed intersectorial coordinator. The authors contend that political commitment of local authorities alone may not be enough to promote efficient intersectorial social policies. Comprehension of different types of IHRP and their interface mechanisms may contribute to greater efficiency and coverage of social policies that affect health equity and its social determinants positively. In the final analysis,, this will lead to more equitable health outcomes.
May 22, 2009 ... No other complications except hypersensitivity to hypnotic agents were observed. Case 2: The patient was a 10-year-old boy with Cornelia de Lange syndrome who underwent dental treatment under general anaesthesia. He had a history and symptoms of obstructive airway disorders in addition to showing ...
The report contains abstracts of 132 case studies of bioremediation technology applied to hazardous waste clean-up. It was prepared to compile bioremediation studies in a variety of locations and treating diverse contaminants, most of which were previously undocumented. All data are based on vendor-supplied information and there was no opportunity to independently confirm its accuracy. These 132 case studies, from 10 different biotechnology companies, provide users with reference information about on-going and/or completed field applications and studies. About two-thirds of the cases were at full-scale clean-up level with the remainder at pilot or laboratory scale. In 74 percent of the cases, soil was at least one of the media treated. Soil alone accounts for 46 percent of the cases. Petroleum-related wastes account for the largest contaminant with 82 cases. Thirty-one states are represented in the case studies
Full Text Available IntroductionAs physical performance may be more difficult for overweight children than for their non-overweight peers, understanding how weight impacts student performance in the physical education (P.E. classroom could inform school-based obesity prevention programming.Materials and methodsThis qualitative case study examined one elementary physical educator’s perspectives of overweight students’ weight-related experiences in her classroom. Narratives were elicited during an in-depth interview and analyzed using structural and thematic analyses. We utilized the social cognitive theory to inform our exploration of the narratives.FindingsThe thematic analysis illuminated a behavioral pattern of student refusal to participate in the P.E. classroom while the structural analysis emphasized the teacher’s constructive, individualized responses to participation refusals. Combined, the two analytic techniques provided a more holistic snapshot of the experiences of overweight students in this elementary school. In addition, a preliminary model explaining the behavioral pattern among overweight students in this particular P.E. classroom was created.DiscussionStudents who were overweight were more likely to initially refuse to attempt physical tasks in the classroom because they feared peer ridicule, and the teacher played a critical role in whether these students chose to participate in subsequent classes. As agents of change, P.E. educators should be included in formative stages of comprehensive, systemic changes to combat childhood obesity.
Odum, Mary; Outley, Corliss W; McKyer, E Lisako J; Tisone, Christine A; McWhinney, Sharon L
As physical performance may be more difficult for overweight children than for their non-overweight peers, understanding how weight impacts student performance in the physical education (P.E.) classroom could inform school-based obesity prevention programming. This qualitative case study examined one elementary physical educator's perspectives of overweight students' weight-related experiences in her classroom. Narratives were elicited during an in-depth interview and analyzed using structural and thematic analyses. We utilized the social cognitive theory to inform our exploration of the narratives. The thematic analysis illuminated a behavioral pattern of student refusal to participate in the P.E. classroom while the structural analysis emphasized the teacher's constructive, individualized responses to participation refusals. Combined, the two analytic techniques provided a more holistic snapshot of the experiences of overweight students in this elementary school. In addition, a preliminary model explaining the behavioral pattern among overweight students in this particular P.E. classroom was created. Students who were overweight were more likely to initially refuse to attempt physical tasks in the classroom because they feared peer ridicule, and the teacher played a critical role in whether these students chose to participate in subsequent classes. As agents of change, P.E. educators should be included in formative stages of comprehensive, systemic changes to combat childhood obesity.
Yalçınsoy, Murat; Salturk, Cuneyt; Takır, Hurıye Berk; Kutlu, Semra Batı; Oguz, Ayşegul; Aksoy, Emine; Balcı, Merih; Kargın, Feyza; Mocin, Ozlem Yazıcıoglu; Adıguzel, Nalan; Gungor, Gokay; Karakurt, Zuhal
Nosocomial pneumonia (NP) and ventilator associated pneumonia (VAP) have been associated with financially significant economic burden and increased case fatality rate in adult intensive care units (ICUs). This study was designed to evaluate case fatality rate among patients with NP and VAP in a respiratory ICU. In 2008-2013, VAP and NP in the ICUs were included in this retrospective single-centre cohort study. Data on demographics, co-morbidities, severity of illness, mechanical ventilation, empirical treatment, length of hospital stay and laboratory findings were recorded in each group, as were case fatality rate during ICU admission and after discharge including short-term (28-day) and long-term (a year) case fatality rate. A total of 108 patients with VAP (n = 64, median (IQR) age: 70 (61-75) years, 67.2% were men) or NP (n = 44, median (IQR) age: 68 (62-74) years, 68.2% were men) were found. Appropriate empirical antibiotic therapy was identified only in 45.2 and 42.9% of patients with VAP and NP, respectively. Overall case fatality rate in VAP and NP (81.3 vs 84.1), ICU case fatality rate (42.2 vs 45.5%), short-term case fatality rate (15.6 vs 27.3%) and long-term case fatality rate (23.4 vs 11.4%) were similar between VAP and NP groups along with occurrence 50% of case fatality rate cases in the first 2 months and 90% within the first year of discharge. Multivariate analysis showed that chronic obstructive pulmonary disease (COPD) (HR: 3.15, 95% CI: 1.06-9.38; p = 0.039) and presence of septic shock (HR: 3.83, 95% CI: 1.26-11.60; p = 0.018) were independently associated with lower survival. In conclusion, our findings in a retrospective cohort of respiratory ICU patients with VAP or NP revealed high ICU, short- and long-term case fatality rates within 1 year of diagnosis, regardless of the diagnosis of NP after 48 h of initial admission or after induction of ventilator support. COPD and presence of septic shock are associated with high
Mikhaylova, Anna; Popova, Liudmila
The research consists in studying the level of population's trust in nasleg administration (in the administrative-territorial unit) of MS "Khatyryksky nasleg" of Namsky ulus using the case study. The leading research methods for the problem are empirical methods that allow revealing the level of population's trust in administration. The…
Golui, Debasis; Guha Mazumder, D N; Sanyal, S K; Datta, S P; Ray, P; Patra, P K; Sarkar, S; Bhattacharya, K
Safe limit of arsenic in soil in relation to dietary exposure of arsenicosis patients was established in Malda district of West Bengal. Out of 182 participants examined, 80 (43.9%) participants showed clinical features of arsenicosis, characterized by arsenical skin lesion (pigmentation and keratosis), while 102 participants did not have any such lesion (control). Experimental results of the twenty eight soils (own field) of the participants showed the mean Olsen extractable and total arsenic concentration of 0.206 and 6.70mgkg -1 , respectively. Arsenic concentration in rice grain ranged from 2.00 to 1260μgkg -1 with the mean value of 146μgkg -1 . The hazard quotient (HQ) for intake of As by human through consumption of rice varied from 0.03 to 3.52. HQ exceeds 1.0 for drinking water and rice grain grown in the study area in many cases. As high as 77.6% variation in As content in rice grain could be explained by the solubility-free ion activity model. Toxic limit of extractable As in soil for rice in relation to soil properties and human health hazard, associated with consumption of rice grain by human, was established. For example, the permissible limit of Olsen extractable As in soil would be 0.43mgkg -1 for rice cultivation, if soil pH and organic carbon content were 7.5% and 0.50%, respectively. However, the critical limit of Olsen extractable As in soil would be 0.54mgkg -1 , if soil pH and organic carbon were 8.5% and 0.75%, respectively. The conceptual framework of fixing the toxic limit of arsenic in soils with respect to soil properties and human health under modeling-framework was established. Copyright © 2017 Elsevier Inc. All rights reserved.
Augusto César Ferreira de Moraes
Full Text Available Este estudo de caso teve como objetivo verificar a relação do treinamento de tênis de campo com o ciclo menstrual em uma atleta com 17 anos de idade. O período de treinamento foi de 16 semanas. As avaliações motoras foram realizadas em dois momentos, no período de ovulação do ciclo menstrual da atleta investigada. Foram analisadas ascapacidades motoras específicas ao tênis de campo: velocidade, potência muscular de membros superiores, potência muscular de membros inferiores e agilidade. Os resultados encontrados demonstram que houve melhora considerável em todas as variáveis. Sendo assim, sugere-se que um planejamento orientado, baseado no princípio da individualidade, poderá orientar cargas de treinos, buscando melhores resultados, entretanto são necessárias monitorações, em diferentes períodos do ciclo menstrual com uma população maior, na busca de respostas por demais fatores relacionados com a menstruação e exercício.This case study had as objective to verify the relation between tennis training and the menstrual cycle of a 17-year-old athlete. The training period lasted 16 weeks. Performance tests were carried out in two instances during the ovulation period of the menstrual cycle of the investigated athlete. Motor skills specific to tennis were analyzed: speed, arm muscle strength, leg muscle strength and agility. The results demonstrated a considerable improvement in allvariables. Therefore, it is suggested that a guided plan, based of the principle of individuality, will be able to guide training loads and seek better results. However, monitoring is necessary in thedifferent periods of the menstrual cycle, using a larger population sample, in the search for answers to other factors related to menstruation and exercise.
Rodrigo Chaves Ribeiro
Full Text Available CONTEXT AND OBJECTIVE: Long-term totally implantable catheters (e.g. Port-a-Cath® are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred. DESIGN AND SETTING: Case series study at Hospital do Servidor Público Estadual, São Paulo. METHODS: Retrospective review of catheter embolism in oncological pediatric patients with long-term totally implantable catheters. RESULTS: The first patient was a 3-year-old girl diagnosed with stage IV Wilms' tumor. Treatment was started with the introduction of a totally implantable catheter through the subclavian vein. At the time of removal, it was realized that the catheter had fractured inside the heart. An endovascular procedure was necessary to remove the fragment. The second case was a boy diagnosed with stage II Wilms' tumor at the age of two years. At the time of removal, it was noticed that the catheter had disconnected from the reservoir and an endovascular procedure was also necessary to remove the embolized catheter. CONCLUSION: Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.
Kleyman, Inna; Weimer, Louis H
Syncope, or the sudden loss of consciousness, is a common presenting symptom for evaluation by neurologists. It is not a unique diagnosis but rather a common manifestation of disorders with diverse mechanisms. Loss of consciousness is typically preceded by a prodrome of symptoms and sometimes there is a clear trigger. This article discusses several cases that illustrate the various causes of syncope. Reflex syncope is the most common type and includes neurally mediated, vasovagal, situational, carotid sinus hypersensitivity, and atypical forms. Acute and chronic autonomic neuropathies and neurodegenerative disorders can also present with syncope. Copyright © 2016 Elsevier Inc. All rights reserved.
Brunetti, Marie; Rajasekharan, Sathyanath; Ustero, Piluca; Ngo, Katherine; Sikhondze, Welile; Mzileni, Buli; Mandalakas, Anna; Kay, Alexander W
In Swaziland, as in many high HIV/TB burden settings, there is not information available regarding the household location of TB cases for identifying areas of increased TB incidence, limiting the development of targeted interventions. Data from "Butimba", a TB REACH active case finding project, was re-analyzed to provide insight into the location of TB cases surrounding Mbabane, Swaziland. The project aimed to identify geographical areas with high TB burdens to inform active case finding efforts. Butimba implemented household contact tracing; obtaining landmark based, informal directions, to index case homes, defined here as relative locations. The relative locations were matched to census enumeration areas (known location reference areas) using the Microsoft Excel Fuzzy Lookup function. Of 403 relative locations, an enumeration area reference was detected in 388 (96%). TB cases in each census enumeration area and the active case finders in each Tinkhundla, a local governmental region, were mapped using the geographic information system, QGIS 2.16. Urban Tinkhundla predictably accounted for most cases; however, after adjusting for population, the highest density of cases was found in rural Tinkhundla. There was no correlation between the number of active case finders currently assigned to the 7 Tinkhundla surrounding Mbabane and the total number of TB cases (Spearman rho = -0.57, p = 0.17) or the population adjusted TB cases (Spearman rho = 0.14, p = 0.75) per Tinkhundla. Reducing TB incidence in high-burden settings demands novel analytic approaches to study TB case locations. We demonstrated the feasibility of linking relative locations to more precise geographical areas, enabling data-driven guidance for National Tuberculosis Programs' resource allocation. In collaboration with the Swazi National Tuberculosis Control Program, this analysis highlighted opportunities to better align the active case finding national strategy with the TB disease
Harrington, J. M.; Carter, J. T.; Birrell, L.; Gompertz, D.
OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...
Rozendaal, Anna M.; Essen, Anthonie J. van; Meerman, Gerard J. te; Bakker, Marian K.; Biezen, Jan J. van der; Goorhuis-Brouwer, Sieneke M.; Vermeij-Keers, Christl; Walle, Hermien E. K. de
Periconceptional folic acid has been associated with a reduced risk of neural tube defects, but findings on its effect in oral clefts are largely inconclusive. This case-control study assesses the effects of periconceptional folic acid on cleft risk, using complementary data from the Dutch Oral Cleft Registry and a population-based birth defects registry (Eurocat) of children and foetuses born in the Northern Netherlands between 1997 and 2009. Cases were live-born infants with non-syndromic clefts (n = 367) and controls were infants or foetuses with chromosomal/syndromal (n = 924) or non-folate related anomalies (n = 2,021). We analyzed type/timing/duration of supplement use related to traditional cleft categories as well as to their timing (early/late embryonic periods) and underlying embryological processes (fusion/differentiation defects). Consistent supplement use during the aetiologically relevant period (weeks 0–12 postconception) was associated with an increased risk of clefts (adjusted odds ratio 1.72, 95 % confidence interval 1.19–2.49), especially of cleft lip/alveolus (3.16, 1.69–5.91). Further analysis systematically showed twofold to threefold increased risks for late differentiation defects—mainly clefts of the lip/alveolus—with no significant associations for early/late fusion defects. Effects were attributable to folic acid and not to other multivitamin components, and inclusion of partial use (not covering the complete aetiologically relevant period) generally weakened associations. In conclusion, this study presents several lines of evidence indicating that periconceptional folic acid in the Northern Netherlands is associated with an increased risk of clefts, in particular of cleft lip/alveolus. This association is strengthened by the specificity, consistency, systematic pattern, and duration of exposure-response relationship of our findings, underlining the need to evaluate public health strategies regarding folic acid and to
Xu, Cai-Gang; Zheng, Su-Ping; Huang, Jie; Wu, Jin-Xu
To evaluate the relationships of malignant lymphoma (ML) and exposure factors, including environmental, drug using, socioeconomic level and life style etc. (1) Hospital-based case-control study with 1:2 matching was used; (2) 150 cases of ML and 300 controls were resulted; (3) logistic regression was used. (1) Adjust odds ratios (aOR) regarding contact to organic solvents were: benzene aOR = 2.78, P = 0.001;banana oil aOR = 2.28, P = 0.043; paint aOR = 1.96, P = 0.023; (2) aOR on pesticides contact: organic phosphorus aOR = 1.98, P = 0.034; chrysanthester aOR = 2.57, P = 0.013; organic nitride aOR = 2.55, P = 0.003; (3) aOR of using aspirin was 2.36, P = 0.005; (4) dog-raising: aOR = 1.76, P = 0.034; (5) the aORs of interval-term exposure to small dosage X-ray was 0.49, P = 0.015, and frequently catching cold was 0.67, P = 0.024; (6) the P-value of different occupations was more than 0.05; cigarette smoking OR = 1.01, P = 0.897; giving up smoking OR = 1.17, P = 0.073; alcohol-drinking aOR = 1.01, P = 0.414; hair-dyes OR = 1.06, P = 0.850; hair-perms OR = 1.26, P = 0.438; socioeconomic level OR = 1.00, P = 1.000 and with introversive character OR = 1.26, P = 0.266. (1) Factors that might increase the risk of suffering from malignant lymphomas would include direct contact to organic solvents and some pesticides (organic phosphorus, chrysanthester and organic nitride), intake of aspirin, as well as dog-raising. (2) Regular exposure to small dosage X-ray and frequently catching cold seemed to decrease the risk of suffering from ML. (3) Occupation, smoking, giving up smoking, alcohol-drinking, hair-dyes, hair-perms, socioeconomic level and introversive character showed no significant relations to the risk of suffering from ML in this study.
Terry, C; Rasoulpour, R J; Knowles, S; Billington, R
There is currently no standard paradigm for hazard and human risk assessment of environmental metabolites for agrochemicals. Using an actual case study, solutions to challenges faced are described and used to propose a generic concept to address risk posed by metabolites to human safety. A novel approach - built on the foundation of predicted human exposures to metabolites in various compartments (such as food and water), the threshold of toxicological concern (TTC) and the concept of comparative toxicity - was developed for environmental metabolites of a new chemical, sulfoxaflor (X11422208). The ultimate aim was to address the human safety of the metabolites with the minimum number of in vivo studies, while at the same time, ensuring that human safety would be considered addressed on a global regulatory scale. The third component, comparative toxicity, was primarily designed to determine whether the metabolites had the same or similar toxicity profiles to their parent molecule, and also to one another. The ultimate goal was to establish whether the metabolites had the potential to cause key effects - such as cancer and developmental toxicity, based on mode-of-action (MoA) studies - and to develop a relative potency factor (RPF) compared to the parent molecule. Collectively, the work presented here describes the toxicology programme developed for sulfoxaflor and its metabolites, and how it might be used to address similar future challenges aimed at determining the relevance of the metabolites from a human hazard and risk perspective. Sulfoxaflor produced eight environmental metabolites at varying concentrations in various compartments - soil, water, crops and livestock. The MoA for the primary effects of the parent molecule were elucidated in detail and a series of in silico, in vitro, and/or in vivo experiments were conducted on the environmental metabolites to assess relative potency of their toxicity profiles when compared to the parent. The primary metabolite
Steenhuis, H.J.; de Bruijn, E.J.
Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior
Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille
The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...
Ingole, Vijendra; Kovats, Sari; Schumann, Barbara; Hajat, Shakoor; Rocklöv, Joacim; Juvekar, Sanjay; Armstrong, Ben
Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 °C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 °C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 °C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate.
Ingole, Vijendra; Kovats, Sari; Schumann, Barbara; Hajat, Shakoor; Rocklöv, Joacim; Juvekar, Sanjay; Armstrong, Ben
Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 °C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 °C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 °C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate.
Ismail, Noor Hasnani; Manaf, Zahara Abdul; Azizan, Noor Zalmy
The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults. A case-control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30 years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent's family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist. Cases had a significantly higher dietary glycemic load (175 ± 35) compared to controls (122 ± 28) (p consumptions was significantly higher in cases compared to controls. Females in the case group had a higher daily energy intake compared to their counterparts in the control group, 1812 ± 331 and 1590 ± 148 kcal respectively (p Body Mass Index, and body fat percentage between case and control groups (p > 0.05). Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris.
Neff, Bonita Dostal; And Others
A case study analyzed a special event, AmeriFlora '92, held from April 1992 to October 1992 in Columbus, Ohio. AmeriFlora '92 was established as a temporary organization covering nearly 8 years of planning, operations, and dismantling. The lack of attendance and the resulting financial impact inspired a major effort to examine the role of public…
Magnarella, Paul J., Ed.
Six articles in this volume focus on anthropological diplomacy--the study of the theory and practice of peace and conflict resolution among societies, based on knowledge of a society's fundamental cultural premises. The first article, by Ronald Cohen, considers questions pertinent to anthropological diplomacy, including the impact of diverse…
Mohammad Abbaszadeh; Faranak Aghdasi Elmi; Mosa Saadati; Morteza Mobaraki
In the last decade, especial attention is given to medical issues in medical sociology. One of the important issues is beauty as it is pursued by plastic surgery. Since in modern society appearance has become very important and some beauty standards are given extraordinary importance (whether right or wrong), a lot of people undergo many problems and difficulties to achieve beauty by plastic surgery. The present study provides a sociological analysis of tendency towards beauty as it is follow...
Mikkelsen, Kim Sass
Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…
Willumsen, Ea Christina; Byg-Fabritius, Edith Ursula Tvede
This paper is an investigation of the online crowdfunding platform Kickstarter, and discusses what makes a Kickstarter campaign successful. Two previous Kickstarter campaigns have been debated in focus groups interviews, as the basis of the study is a reception analysis of two focus group interviews. Ee apply theories from Schrøder (2000) and Batey (2008) to our analysis to study how the campaigns appeal to their backers. By drawing on ideas from Rogers (2003) and Pine & Gilmore (1998), w...
Work related musculoskeletal disorders among farm workers: A case study of an agricultural college in Zimbabwe. ... hazards, therefore a need for intervention to protect them from musculoskeletal complaints. Improvement in farm work practices through ergonomic training might help reduce musculoskeletal complaints.
Banu Aktaş Yılmaz
Full Text Available The incidence of cystic fibrosis-related diabetes (CFRD has increased, since the life expectancy of cystic fibrosis (CF patients continues to improve. CFRD increases the mortality in patients, because of the negative impacts of CFRD on pulmonary functions. Knowledge of the pathogenesis and course of the disease is essential to administer the appropriate therapy. A thirty-one-year-old CFRD patient, who had hypoglycemia and weight loss under the calorie restriction diet and basal insulin therapy, was admitted to the Endocrinology Department for revision of her therapy. A high-calorie diet considering increased energy demand and multiple insulin injections according the carbohydrate counting were administered to the patient. She gained weight and target blood glucose levels were achieved as a result of this therapy. We present the first case with CFRD followed in our clinic with the review of the literature about the pathogenesis, course and therapy of this disease to draw attention to a special kind of diabetes, which we will encounter more frequently. Turk Jem 2012; 16: 74-8
Lazerova, S.S.; Goede, de R.G.M.; Peneva, V.K.; Bongers, A.M.T.
Variability in the spatial distribution of nematode communities in relation to the structural heterogeneity of the environment was studied in nine different microhabitats within a relatively small area of a natural oak forest in Bulgaria. Maturity and diversity indices, trophic structure and the
Lacks of investment make it difficult for women to earn a living from agriculture. Financially independence of ... 2 Associate Professor; St. Mary's University College; School of Graduate. Studies;Eylachewz@yahoo.com .... lies within 0.5 degree north latitude and 39 degree longitude along the Addis. Ababa Gojjam road.
but, due to the impact of this, the social world. The study ..... This academic dissertation, by Ndoro (2014), was undertaken in partial fulfilment of the requirements for a Master of Business. Administration (MBA) at a South African university business school ..... era) may thus have precipitated Jobs's marijuana use. (Schlender ...
Aben, F. M.; Bakker, R. R.; Dekkers, M. J.; Van Hinsbergen, D. J.; Harris, R. A.; Zachariasse, J.; Duffy, B. G.
, therefore deemed to carry a reliable nearly syn-depositional signal. The third suite, residing in a few clay levels, consists of late diagenetic greigite intergrown between sheet silicates, resulting in anomalously high magnetizations. A revised magnetostratigraphy of the Viqueque Type section is obtained by using reliable sample levels containing early diagenetic greigite only. This magnetostratigraphy shows a polarity pattern consistent with biostratigraphy and is correlated unequivocally to the GPTS. This case study shows that a well-designed rock magnetic research combined with microscopy can unravel complex and seemingly inconsistent polarity patterns related to greigite. End-member modelling of IRM-acquisition curves by itself cannot distinguish the subtle differences between the various greigite populations but is nonetheless crucial to the integrated approach because it enables to categorize samples for dedicated microscopy study. We recommend this approach to assess the veracity of the polarity of greigite-bearing strata.
Ozawa, Makiko; Fujinaga, Yasunari; Asano, Junpei; Nakamura, Akira; Watanabe, Takayuki; Ito, Tetsuya; Muraki, Takashi; Hamano, Hideaki; Kawa, Shigeyuki
Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic condition characterized by high serum immunoglobulin G4 (IgG4) concentration and IgG4-bearing plasma cell infiltration in affected organs. Although it has become evident that IgG4-RD also involves the systemic aortic/arterial system, the precise details of this condition remain unclear. The present study sought to clarify the clinical features of IgG4-related periaortitis/periarteritis. Among 223 patients with IgG4-RD, 179 (131 male, median onset age 67 years) were recruited for this study. Periaortitis/periarteritis was defined as vessel wall thickness with circumferential enhancement on contrast-enhanced computed tomography. Periaortitis/periarteritis was identified in 65 (36.3%; 53 male) of 179 IgG-RD patients. The distribution of IgG4-related periaortitis/periarteritis could be broadly classified into five types, with the most prevalent Type 2 (44.6%) being localized at the infra-renal artery portion of the abdominal aorta and continuing to the iliac arteries. The infra-renal artery region of the abdominal aorta was most frequently involved (>80%) among IgG4-related periaortitis/periarteritis cases. Comparisons of clinical parameters between IgG4-RD patients with and without periaortitis/periarteritis revealed significantly higher propensities for older IgG4-RD onset age and highly active disease state featuring elevated serum IgG, IgG4, circulating immune complex, and soluble interleukin-2 receptor. All patients showed improvement of wall thickening after steroid therapy, although nine patients (20.9%) exhibited worsening of luminal dilatation. The main risk factor for this manifestation was prior luminal dilatation according to multivariate analysis. IgG4-related periaortitis/periarteritis predominantly occurred at the infra-renal artery portion of the abdominal aorta, affected older IgG4-RD onset patients, and was prevalent in highly active disease states. As reported previously, the
Full Text Available This study investigated the relationship between lifestyle which seems as a scale of globalization process with body image. Required data was collected by systematic random sampling among 508 women in Shiraz. Based on existing theories and studies theoretical framework has constituted based on Giddens theory. Six hypotheses have been established. For collecting information, survey method and self reported questionnaire were used. In data analysis and explanation, multiple regression and unilateral dispersion analyses were used. The result showed that among effective factors on body image, modern musical lifestyle, religious' lifestyle, leisure lifestyle and participative lifestyle explained 23 percent of variations of body image. Among these variables, only religious lifestyle had negative relationship with body image and other variables had positive relationship with dependant variable.
Tourism can be a challenging subject for students because it is both dynamic and susceptible to economic turbulence and shifts in trends. Tourism: A Modern Synthesis is an essential textbook for tourism students looking for a clear and comprehensive introduction to their studies which helps overcome these challenges. The authors apply a strong business approach to the subject reflecting developments in the teaching and content of modern courses and the text covers both key principles and cont...
The perception of interpersonal relations between instructors and students as experienced within classroom and online communication: a mixed method case study of undergraduate women in a Saudi institution
Alamri, Jamilah Mohammed
This thesis contributes to the understanding of the instructor-student relationship construct, and social media adoption in higher education systems that are generally characterised by a formal quality, and that of Saudi Arabia in particular. The potential impact of social media, as it leaks into higher education practice globally, is of great concern and cannot be overlooked by research. A formal education system, such as that of Saudi, is a convenient case study for examining two overarchin...
A rapid and precise tsunami forecast based on offshore monitoring is getting attention to reduce human losses due to devastating tsunami inundation. We developed a forecast method based on the combination of hierarchical Bayesian inversion with pre-computed database and rapid post-computing of tsunami inundation. The method was applied to Tokyo bay to evaluate the efficiency of observation arrays against three tsunamigenic earthquakes. One is a scenario earthquake at Nankai trough and the other two are historic ones of Genroku in 1703 and Enpo in 1677. In general, rich observation array near the tsunami source has an advantage in both accuracy and rapidness of tsunami forecast. To examine the effect of observation time length we used four types of data with the lengths of 5, 10, 20 and 45 minutes after the earthquake occurrences. Prediction accuracy of tsunami inundation was evaluated by the simulated tsunami inundation areas around Tokyo bay due to target earthquakes. The shortest time length of accurate prediction varied with target earthquakes. Here, accurate prediction means the simulated values fall within the 95% credible intervals of prediction. In Enpo earthquake case, 5-minutes observation is enough for accurate prediction for Tokyo bay, but 10-minutes and 45-minutes are needed in the case of Nankai trough and Genroku, respectively. The difference of the shortest time length for accurate prediction shows the strong relationship with the relative distance from the tsunami source and observation arrays. In the Enpo case, offshore tsunami observation points are densely distributed even in the source region. So, accurate prediction can be rapidly achieved within 5 minutes. This precise prediction is useful for early warnings. Even in the worst case of Genroku, where less observation points are available near the source, accurate prediction can be obtained within 45 minutes. This information can be useful to figure out the outline of the hazard in an early
Won, Seong Jun; Lee, Eunkyu; Kim, Hee Jung; Oh, Hyun-Kyung; Jeong, Han-Sin
Poor oral hygiene is one of the risk factors for sialolithiasis particularly in adults; however the etiology of sialolithiasis in pediatric patients remains largely unknown. The purpose of this study is to identify the association between sialolithiasis and the oral/oropharyngeal infections in the pediatric population, as surrogate indicators for oral hygiene and retrograde infections to the affected salivary gland. This was a population based case-control study using the Korean National Health Insurance Database. We identified 10,095 pediatric patients, diagnosed with sialolithiasis, as cases (study period 2011-2015) and 50,475 age/gender/residence matched subjects without sialolithiasis, but with unrelated diseases (e.g., simple trauma in extremities) were set as controls. Logistic regression analyses were conducted to evaluate the association of sialolithiasis with oral or oropharyngeal infections. The morbidity rate of sialadenitis was much higher in the cases than the controls (32.92% vs 0.72%, p oral or oropharyngeal infections (stomatitis, gingivitis, periodontitis, and pharyngo-tonsillitis) was significantly lower in pediatric sialolithiasis patients in all age (0-18) groups. The adjusted odds ratios of the multivariate analyses also confirmed significantly less prevalence of the oral and oropharyngeal infections in pediatric sialolithiasis patients. Oral or oropharyngeal infections were inversely associated with pediatric sialolithiasis, suggesting that pediatric sialolithiasis may result from the intrinsic factors of the salivary gland itself, not from oral or oropharyngeal infections. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Derechos Digitales is a Latin American advocacy and research network focussed on freedom on the internet, privacy and copyright reform. For the pilot project a specific IDRC funded project was the notional focus of study. However in practice the effort for considering data sharing was aimed at being organisation wide. The organisation already shares reports and other resources (particularly images and infographics by default. While open data was described as being “in the DNA of the organisation” there was little practice across the network of sharing preliminary and in-process materials. Some aspects of data collection on research projects, particularly to do with copyright and legal issues, have significant privacy issues and as the organisation focuses on privacy as one of its advocacy areas this is taken very seriously. Many materials from research projects are not placed online at all. Derechos Digitales run distributed projects and this creates challenges for consistent management. Alongside this the main contact at DD changed during the course of the pilot. This exchange exemplified the challenges of maintaining organisational systems and awareness through a personnel change.
Vahid Riahi Riahi
Full Text Available Environmental sustainability of rural settlements based on a systematic viewpoint may be defined as a realization of sustainable development in different social, economic and environmental aspects of rural areas. Achieving this goal requires that we pay more attention to effective elements and factors through a set of sustainability indices. This research was meant to analyze sustainable factors of rural settlement in three dimensions: environmental, social and economic context using multi-criteria decision analysis and explanation of the relationships between its active and effective factors in the rural area of the Khorramdarreh County in the province of Zanjan. The research method used is the descriptive analytic approach. Data from 287 households were sampled randomly from a total of 1143 households in the four villages including: Rahmat Abad, Alvand, Baghdareh and, Sukhariz (out of 15 villages in the Khorramdarreh County. In the process of doing this research and after calculating the weights, the difference in the sustainability of environmental, social, economic and physical aspects in rural areas of this county have been determined. Data was collected using library and field research through questionnaires. Data analysis was performed by the One-Sample t Test and the Vikur and path analysis techniques, using statistical software SPSS. The findings show that environmental sustainability in the study area is half desirable. Among the different aspects of environmental sustainability, the most effective factors are physical, economic, social and environmental aspects, respectively. Little attention of policy-making –system to socio-cultural and environmental aspects, especially in practice, and rapid and unplanned utilization of production resources are the most important factors affecting this situation in two given dimensions. Although, in programmed documents the planning system agents emphasize on the socio-cultural sustainability
Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann
Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, ca...
Goede, de J.; Verschuren, W.M.M.; Boer, J.M.A.; Verberne, L.D.M.; Kromhout, D.; Geleijnse, J.M.
Background: Dietary polyunsaturated fatty acids (PUFA) are inversely related to coronary heart disease (CHD) in epidemiological studies. We examined the associations of plasma n-6 and n-3 PUFA in cholesteryl esters with fatal CHD in a nested case-control study. Additionally, we performed a
Ravindran, Rekha M; Kutty, V Raman
This study intended to identify the risk factors for injurious falls that led to hospitalization of older persons living in the community. A hospital-based unmatched incident case-control study was done among 251 cases and 250 controls admitted at a tertiary care centre in Kerala. Mean age of cases was 71.6 ± 9.13 years and that of controls was 67.02 ± 6.17 years. Hip fractures were the predominant injury following falls. Falls were mostly a result of intrinsic causes. After adjusting for other variabes, the risk factors for all injuries were age above 70 years (odds ratio [OR] = 2.25; 95% confidence interval [CI] = 1.46-3.46), previous fall history (OR = 2.76; 95% CI = 1.08-7.08), impaired vision (OR = 4.49; 95% CI = 2.77-7.30), not living with spouse (OR = 1.97; 95% CI = 1.31-2.97), door thresholds (OR = 1.52; 95% CI = 1.01-2.29), and slippery floor (OR = 2.37; 95% CI = 1.31-4.32). The risk factors for hip fractures and other injuries were identified separately. Fall prevention strategies among older persons are warranted in Kerala. © 2015 APJPH.
Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...
Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...
Md Ahsan Habib
Cyber crime is a threat to our E- commerce . A hacker group named "Lazarus" hacked $951 million from Bangladesh Bank's account. This is the short case study of this incident with professional ethical view.
Ardestani, Mohammad Emami; Onvani, Shokouh; Esmailzadeh, Ahmad; Feizi, Awat; Azadbakht, Leila
This case-control study was designed to investigate the association between adherences to the Dietary Approaches to Stop Hypertension (DASH) diet in patients with chronic obstructive pulmonary disease (COPD) in comparison to subjects without COPD. This is a case-control study. Usual dietary intake was assessed using a validated food frequency questionnaire. Lung function was evaluated with spirometry testing, and one of the researchers inquired about other respiratory symptoms, including chronic cough, sputum, and breathlessness. Adherence to the DASH dietary pattern was assessed according to the Fung method. This study was conducted at Alzahra University Hospital of Isfahan, Iran, in 2015. Eight-four patients with COPD and 80 subjects without a history of COPD participated in study. The mean age of participants was 57 years. Average smoking in the case group was about 27.5 pack-years. Spirometry tests including forced expiratory volume in 1 second (FEV 1 ), forced vital capacity (FVC), and FEV 1 /FVC were significantly lower in patients with COPD (p = 0.0001). Among COPD symptoms, cough was significantly decreased across tertiles of DASH score (p = 0.03). Significant differences were found for DASH score between patients with COPD and control subjects (19.82 + 3.63 vs 21.13 + 3.82, p = 0.02). Vitamin C, vitamin E, and dietary fiber intake were lower in patients with COPD (144.32 + 70.51 vs 166.97 + 71.88, p = 0.04, 7.49 + 3.91 vs 8.72 + 3.21, p = 0.02 and 19.34 + 7.05 vs 22.19 + 7.87, p = 0.01, respectively). We observed that adherence to a DASH dietary pattern among patients with COPD was significantly lower compared to the control group. Cough was significantly decreased by increments in adherence to a DASH dietary pattern.
van de Werve, Charlotte; Perignon, Alice; Jauréguiberry, Stéphane; Bricaire, François; Bourhy, Pascal; Caumes, Eric
Leptospirosis belongs to the spectrum of travel-related infections. We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100. Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered. Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis. © 2013 International Society of Travel Medicine.
The energy revolution leads not only to build more wind turbines and the much-discussed circuit line from northern to southern Germany. Instead, the now old energy form of nuclear power needs to be handled. The disposal is one of the biggest unsolved issues of our time. In the conflict between energy and environment policies, the radioactive contamination of nuclear energy must be disposed of. The book is a highly topical compendium of legal and political aspects, which are not sufficiently taken into account because of their specialty in the public discourse. Based on the case study Konrad almost all legal and political priorities are treated very understandable.
The Perceptions of the Automotive Supply Industry Related to Information Technology Utilization and Creating Barriers to Competitive Market Entry: A Case Study of the Implications for Strategic Planning
Cargal, Joseph L.
The purpose of this study was to examine information technology/systems strategy related factors in the automotive supply industry based on responses to the Strategic Planning and Business Performance Survey provided to automotive suppliers. This population produces supplies to the automotive industry with products valued at hundreds of billions…
Full Text Available The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or ‘Classical psychoanalysis’ dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.
Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.
The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725
Roy, Cynthia; Tremblay, Pierre-Yves; Anassour-Laouan-Sidi, Elhadji; Lucas, Michel; Forest, Jean-Claude; Giguère, Yves; Ayotte, Pierre
Gestational diabetes mellitus (GDM) affects between 5 and 10% of all pregnancies in Canada and can lead to adverse health outcomes in both the mother and fetus. Amino acids (AA) and acylcarnitines (AC) have been identified as early biomarkers of type 2 diabetes but their usefulness in screening for GDM has yet to be demonstrated. We conducted a nested case-control study involving 50 controls and 50 GDM cases diagnosed between the 24th and 28th week of gestation. Heparinized plasma samples were obtained during the first and early second trimester of pregnancy. Case and controls were matched according to date of recruitment, maternal age, gestational age at blood sampling as well as pre-pregnancy body mass index. Eight AA and eight AC were quantified using an ultra-high pressure liquid-chromatography quadrupole time-of-flight mass spectrometry platform. Conditional regression analyses adjusted for matching factors and smoking habits during pregnancy were performed to identify plasma metabolites associated with GDM risk. Odds ratio (OR) and 95% confidence interval (CI) for the prediction of GDM per one standard deviation increase of AA or AC in plasma levels were 0.25 (0.08-0.79) for butyrylcarnitine, 0.31 (0.12-0.79) for glutamic acid, 2.5 (1.2-5.3) for acetylcarnitine, 2.9 (1.3-6.8) for isobutyrylcarnitine and 5.3 (1.7-17.0) for leucine. These five metabolites were selected by stepwise conditional logistic regression to create a predictive model with an OR of 2.7 (1.5-4.9). Whether the identified metabolites can predict the risk of developing GDM requires additional studies in a larger sample of pregnant women. Copyright © 2018 Elsevier B.V. All rights reserved.
Greenop, Kathryn R; Blair, Eve M; Bower, Carol; Armstrong, Bruce K; Milne, Elizabeth
Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their causes are largely known. This study investigated the association between maternal and birth characteristics and risk of CBT. Cases families were recruited from all 10 Australian pediatric oncology centers between 2005 and 2010. Control families were recruited via random-digit dialing, frequency matched to cases on the basis of child's age, sex, and State of residence. Maternal and birth characteristics of children were ascertained by questionnaires. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for relevant confounders. For this analysis, data on 319 case children and 1,079 control children were available. No association was found between risk of CBT and birth weight, fetal growth, birth order, gestational age, or maternal body mass index. The ORs for inadequate and excessive maternal gestational weight gain (GWG) (Institute of Medicine 2009 guidelines) were 1.8 (95% CI 1.2-2.6) and 1.4 (95% CI 1.0-2.1), respectively; similar findings for GWG were seen across categories of child's age, fetal growth, maternal body mass index and height, maternal smoking, and parental education. Risk of low grade glioma appeared increased with preterm birth (OR 1.6 (95% CI 0.8-3.1) and admission to neonatal intensive care (NICU) for >2 days (OR 1.7, 95% CI 0.9-3.6). We found little evidence of associations between risk of CBT and most birth characteristics. The associations we observed with GWG, prematurity and NICU admission require corroboration in other studies. © 2013 Wiley Periodicals, Inc.
Mangopa Malik, Andy Anton
Urban green open space is one of the assets that provide substantial benefits to the urban community. One important function of urban green open space is a function of ecology. This study will provide initial explanation on the various studies related to the ecological function of urban green open space. The study of urban space management approach related to ecological function will explain the extent of the role of stakeholders in the urban areas that will further strengthen the importance of the existence of green open space, especially in city of Depok. With so many problems related to the supply and use of green open space in the city of Depok. This approach was originally applied by the private sector and many applications made a great contribution, so it began to be used by the government in managing public assets there. This study will use descriptive method, at the beginning of the study will explain the existence of the reality of urban green open space as part of the urban space by viewing it from theoretical overview of space, function and role of the various problems that occur in it. The results of this study indicate there are six problems in the management of green open spaces in city of Depok. Using the stages in asset management will provide space for participation of existing stakeholders in the management of green open spaces in city of Depok.
Full Text Available Abstract Background The relative scale has been used for decades in analysing binary data in epidemiology. In contrast, there has been a long tradition of carrying out meta-analyses of continuous outcomes on the absolute, original measurement, scale. The biological rationale for using the relative scale in the analysis of binary outcomes is that it adjusts for baseline variations; however, similar baseline variations can occur in continuous outcomes and relative effect scale may therefore be often useful also for continuous outcomes. The aim of this study was to determine whether the relative scale is more consistent with empirical data on treating the common cold than the absolute scale. Methods Individual patient data was available for 2 randomized trials on zinc lozenges for the treatment of the common cold. Mossad (Ann Intern Med 125:81–8, 1996 found 4.0 days and 43% reduction, and Petrus (Curr Ther Res 59:595–607, 1998 found 1.77 days and 25% reduction, in the duration of colds. In both trials, variance in the placebo group was significantly greater than in the zinc lozenge group. The effect estimates were applied to the common cold distributions of the placebo groups, and the resulting distributions were compared with the actual zinc lozenge group distributions. Results When the absolute effect estimates, 4.0 and 1.77 days, were applied to the placebo group common cold distributions, negative and zero (i.e., impossible cold durations were predicted, and the high level variance remained. In contrast, when the relative effect estimates, 43 and 25%, were applied, impossible common cold durations were not predicted in the placebo groups, and the cold distributions became similar to those of the zinc lozenge groups. Conclusions For some continuous outcomes, such as the duration of illness and the duration of hospital stay, the relative scale leads to a more informative statistical analysis and more effective communication of the study
Green, Ohad; Ayalon, Liat
Migrant home care workers constitute an "invisible" and vulnerable group in society, as they work in isolation in the homes of frail older adults. Past research has shown that this population is particularly vulnerable to work-related abuse. The aim of the present study was to explore the help-seeking behaviors of migrant home care workers who were exposed to work-related abuse. Overall, 187 Filipino home care workers completed a self-report questionnaire regarding four types of work-related abuse (sexual, physical, emotional, and exploitation), help-seeking strategies (i.e., formal and informal reporting), and reasons for not disclosing abusive incidents. A total of 56.7% reported some type of abuse. Of these, less than half reported the abuse, mostly informally to family and friends. None reported the abuse to the police. Main reasons for not disclosing the abuse were fears that things would get worse and the belief that it will take too much time and effort. The findings demonstrate that migrant home care workers are highly vulnerable to work-related abuse but are not likely to report work-related abuse and put an end to the cycle of abuse and violence. This calls for the development of further policy and interventions to protect this already vulnerable population. © The Author(s) 2015.
Vin-Raviv, Neomi; Dekel, Rachel; Barchana, Micha; Linn, Shai; Keinan-Boker, Lital
Several studies have suggested that post-traumatic stress disorder (PTSD) is related to adverse health outcomes. There are limited data on PTSD and cancer, which has a long latency period. We investigated the association between World War II (WWII)-related PTSD and subsequent breast cancer (BC) risk among Jewish WWII survivors and examined whether this association was modified by exposure to hunger during WWII. We compared 65 BC patients diagnosed in 2005 through 2010 to 200 population-based controls who were members of various organizations for Jewish WWII survivors in Israel. All participants were born in Europe, lived at least six months under Nazi rule during WWII, and immigrated to Israel after the war. We estimated PTSD using the PTSD Inventory and applied logistic regression models to estimate the association between WWII-related PTSD and BC, adjusting for potential confounders. We observed a linear association between WWII-related PTSD and BC risk. This association remained significant following adjustment for potential confounders, including obesity, alcohol consumption, smoking, age during WWII, hunger exposure during WWII, and total number of traumatic life events (OR = 2.89, 95% CI = 1.14-7.31). However, the level of hunger exposure during WWII modified this effect significantly. These findings suggest an independent association between WWII-related PTSD and subsequent BC risk in Jewish WWII survivors that is modified by hunger, a novel finding. Future research is needed to further explore these findings.
Amal Ramadan Abd Elhalim
Full Text Available University works to provide all the material educational and psychological needs of the university students in order to achieve the social of the university. it affects the quality of the output descriptive survey method was used to identify the academic and social problems of the female students at the Faculty of Applied medical Science and correlate problems to the level of their performance. there was a questionnaire consists of 64 phrases which were distributed into 8 axes and applied to a random sample of 210 at different levels in the first semester of the academic year 2014-2015 Departments of MLT PHT CLN DRD. The study showed the problem of University environment ranked the first place University library in the Scand placebut the problems related to Curriculum the in third place the problems related to the field training in fourth placeFollowed by problems related to psychological and social problems in fifth place problems related to academic guidance in sixth place the problems related to the time table in seventh place finally came problems on the faculty staff in the eighth and last place and that the most important variables affecting the academic performance of the students There are significant correlation relationship between each of the University environment academic guidanceUniversity library and field training on the one hand and the cumulative average of the other hand no significant correlation relationships between the academic performance of students in the study and curriculum faculty staff where it appeared that the correlation coefficients were not significant at the 5 level Recommendations to the college administration to conceived proposal for mechanisms to confirm how to deal with the academic problems in the college through comprehensive strategy to solve and prevent academic problems faced the studentssolve the problem of Library And reconsider some courses need to Attention to academic guidance processes And of
Jensen, Camilla B.; Lundqvist, Marika; Sørensen, Thorkild I.A.
Background: Vitamin D level in pregnancy may be associated with risk of overweight in the offspring later in life.Methods: In a case-cohort study based on Danish biobanks and registers we examined the association between 25-hydroxy-vitamin D (25(OH)D) level at birth and overweight at 7 years. Cases...... of overweight (n = 871) were randomly selected among 7-year-old children from the Copenhagen School Health Records Register (CSHRR) with a BMI above the 90th percentile. The cohort (n = 1,311) was a random sample selected among all Danish children born during the same period. Neonatal 25(OH)D was measured...... in dried blood spots. Results: 25(OH)D3 exhibited the expected seasonal variation. Median level of 25(OH)D3 was 20.6 (11.9-33.3) nmol/l in the overweight group and 23.4 (13.5-34.3) nmol/l in the cohort. We found no association between neonatal 25(OH)D3 level and risk of overweight at age 7 years, neither...
Gaussoin, Sarah A; Espeland, Mark A; Absher, John; Howard, Barbara V; Jones, Beverley M; Rapp, Stephen R
The aim of the study was to compare a two-staged clinic-based standardized protocol with a supplemental proxy-based protocol. The Women's Health Initiative Memory Study enrolled 7479 women, aged 65-79 years and free of dementia, in a clinical trial of postmenopausal hormone therapy who were followed for up to 13 years with annual two-staged clinic-based standardized protocols to identify incidence of probable dementia. A supplemental proxy-based protocol, involving telephone administration of the dementia questionnaire, was designed to assess the cognitive status of women who could no longer attend clinic visits because they died (n = 1058) or became dependent (n = 228). Chi-squared tests were used to compare characteristics of women eligible for proxy-based versus clinic-based assessment. Risk factor relationships were described using proportional hazards regression. Women who were eligible for proxy-based assessments tended to have worse cognitive impairment risk factor profiles and had higher rates of probable dementia (15.2% vs 3.5%) than clinic-assessed participants. Augmenting the clinic-based cases with those identified from proxy interviews reduced undercounting and materially altered observed relationships that years since menopause, smoking status, diabetes, and prior use of hormone therapy had with incidence of probable dementia. Although proxy interviews were successful in reducing biases in estimated incidence rates and risk factor relationships, it is unlikely that they will fully eliminate many biases. Proxy-based assessments are necessary in longer term studies to reduce undercounting of dementia cases and to characterize risk factor relationships. Copyright © 2011 John Wiley & Sons, Ltd.
Gaussoin, Sarah A.; Espeland, Mark A.; Absher, John; Howard, Barbara V.; Jones, Beverley M.; Rapp, Stephen R.
Objective The aim of the study was to compare a two-staged clinic-based standardized protocol with a supplemental proxy-based protocol. Methods The Women’s Health Initiative Memory Study enrolled 7479 women, aged 65–79 years and free of dementia, in a clinical trial of postmenopausal hormone therapy who were followed for up to 13 years with annual two-staged clinic-based standardized protocols to identify incidence of probable dementia. A supplemental proxy-based protocol, involving telephone administration of the dementia questionnaire, was designed to assess the cognitive status of women who could no longer attend clinic visits because they died (n = 1058) or became dependent (n = 228). Chi-squared tests were used to compare characteristics of women eligible for proxy-based versus clinic-based assessment. Risk factor relationships were described using proportional hazards regression. Results Women who were eligible for proxy-based assessments tended to have worse cognitive impairment risk factor profiles and had higher rates of probable dementia (15.2% vs 3.5%) than clinic-assessed participants. Augmenting the clinic-based cases with those identified from proxy interviews reduced undercounting and materially altered observed relationships that years since menopause, smoking status, diabetes, and prior use of hormone therapy had with incidence of probable dementia. Conclusions Although proxy interviews were successful in reducing biases in estimated incidence rates and risk factor relationships, it is unlikely that they will fully eliminate many biases. Proxy-based assessments are necessary in longer term studies to reduce undercounting of dementia cases and to characterize risk factor relationships. PMID:21416508
Sørensen, Pernille Dissing; Løkke, Ann-Kristina
design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...
Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy
A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…
Korver, Sjaak; Walton, Martin N.; van Loenen, Guus
The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the
Mohammed, Shan; Peter, Elizabeth; Gastaldo, Denise; Howell, Doris
Little consideration has been given to how case study might be used in poststructural research to explore power relations that constitute a phenomenon. Many case study scholars, most notably Robert Yin, adopt a postpositivist perspective that assumes the "truth" can be accessed through applying prescriptive and rigid research techniques. Using a discussion of Michel Foucault's key theoretical ideas and the insights gained through a Foucauldian case study of people with advanced cancer who continue to receive curative treatment, the authors argue for the expansion of case study in poststructural inquiry. They propose that the use of poststructuralist case study is valuable because of the flexibility and comprehensiveness of the methodology, which allows for the exploration of a deeper understanding of the broader discourses that shape a phenomenon, as well as how power/knowledge relations shape the behaviours and perceptions of people. They also introduce the reflexive implications of poststructural case study research. Copyright© by Ingram School of Nursing, McGill University.
Jensen, Camilla B.; Lundqvist, Marika; Sørensen, Thorkild I. A.
Background: Vitamin D level in pregnancy may be associated with risk of overweight in the offspring later in life. Methods: In a case-cohort study based on Danish biobanks and registers we examined the association between 25-hydroxy-vitamin D (25(OH)D) level at birth and overweight at 7 years......, neither in the crude model (OR (CI) 1.00 (0.99; 1.00)) nor in a model adjusted for maternal ethnicity, educational level, civil status, parity, season and year of birth, and offspring ponderal index (OR (CI) 1.00 (0.99; 1.01)). Conclusion: Risk of overweight at 7 years of age was not associated...
Herrero, Miguel; Mendiola, J. A.; Cifuentes, Alejandro; Ibáñez, Elena
In this chapter, a broad description of several case studies related to common antioxidants found in food-related products is presented. In this regard, special attention is put on the novel advanced environmentally-friendly extraction methods nowadays employed to extract and purify those potent antioxidants from natural matrices. A brief description of these extraction processes is provided together with some of the instrumentation needed. Besides, the studies carried out so f...
Hroncová, Emília; Ladomerský, Juraj; Musil, Juraj
Currently, it is necessary to deal with issues related to the emissions as there is a constantly increasing interest in combusting sludge from sewage treatment plants in the boilers for wood. An analysis of the energetic importance of the combustion of sewage sludge has already been carried out, but the effects of various treatments of the sludge are not always clear, e.g. composting and subsequent combustion to the air pollution. Investments in other thermal processes of energetic utilisation of sewage sludge and organic waste are not always successfully implemented. The objective of this paper is to point out some problematic cases for acceptance of thermal processes related to energetic use of waste in terms of the air protection. The other aim is to mention the experience with solutions of such issues in Slovakia. There are mentioned first results of the operational validation experiments during the energy generation in circulating fluidized bed boiler in peaking power plant (Power 110MW) with the addition of the so-called alternative fuel based on wood and sewage sludge to the main fuel - black coal (anthracite). And there has already been achieved the highest share of 12.4%w. (dry matter) of sewage sludge in form of compost in blend with black coal, which is technologically viable. Moreover analyzed the problems of the authorization and operation of the co-combustion of sewage sludge and of combustion of products of various kinds of pyrolysis waste - pyrolysis gas and pyrolysis oil are analyzed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Rajoo, Sangeetha Govinda; Gandhewar, Jaishree
To describe a case of recurrent episcleritis associated with a patient's menstrual cycle. A retrospective case review of a 39-year-old woman who presented with a 12-year history of recurrent episcleritis in relation to her menstruation. She was seen during an acute attack and started on a reducing regime of topical steroids for 5 weeks. She was then advised to use it a week before and after menstruation. Examination and investigations revealed episcleritis with a negative systems review. After starting the treatment, she was symptom free when reviewed at 4, 8, 14, and 33 weeks. Now, the patient uses topical steroids only 1 week before menstruation. Literature review revealed no recent case reports and provided insufficient evidence to understand this relationship. We recommend increased awareness and reporting because there is a need for more studies to understand this relationship and to provide evidence for management.
Liu, Huiyu; Zhang, Mingyang; Lin, Zhenshan
Climate changes are considered to significantly impact net primary productivity (NPP). However, there are few studies on how climate changes at multiple time scales impact NPP. With MODIS NPP product and station-based observations of sunshine duration, annual average temperature and annual precipitation, impacts of climate changes at different time scales on annual NPP, have been studied with EEMD (ensemble empirical mode decomposition) method in the Karst area of northwest Guangxi, China, during 2000-2013. Moreover, with partial least squares regression (PLSR) model, the relative importance of climatic variables for annual NPP has been explored. The results show that (1) only at quasi 3-year time scale do sunshine duration and temperature have significantly positive relations with NPP. (2) Annual precipitation has no significant relation to NPP by direct comparison, but significantly positive relation at 5-year time scale, which is because 5-year time scale is not the dominant scale of precipitation; (3) the changes of NPP may be dominated by inter-annual variabilities. (4) Multiple time scales analysis will greatly improve the performance of PLSR model for estimating NPP. The variable importance in projection (VIP) scores of sunshine duration and temperature at quasi 3-year time scale, and precipitation at quasi 5-year time scale are greater than 0.8, indicating important for NPP during 2000-2013. However, sunshine duration and temperature at quasi 3-year time scale are much more important. Our results underscore the importance of multiple time scales analysis for revealing the relations of NPP to changing climate.
Vos, M.; Toekesi, K.; Benkoe, I.
Complete text of publication follows. Electron Rutherford backscattering (ERBS) has a number of distinct advantages for semi-quantitative analysis of samples. These are for example: a) Its high energy makes it rather insensitive to surface effects. b) The peaks appear well approximated by Gaussian with no obvious problems due to background subtraction. c) All the electrons involved have very similar kinetic energy, and hence one does not need to consider changes of the mean-free path or the analyzer transmission function. d) There are no intrinsic satellites to complicate the quantitative interpretation. On the other hand ERBS has a weak point, peaks tend to overlap. Peak separation is proportional to the incoming energy E0, but the intrinsic peak width increases proportional to the square root of E 0 . In practice one has to live with overlapping peaks. In the present work we mainly focus on the measurement and analysis procedure, and compare our best estimate of the concentration of the various elements in mouse bone with that obtained in a recent paper. The promise of ERBS as an analytical technique is clear from the successful analysis of the simple case of calcium carbonate and the somewhat more complicated case of hydroxyapatite. Here agreement between the measured and actual composition are on a very respectable 10% level. The actual bone sample showed more variation in outcome and a somewhat less satisfactory agreement between experiment and theory (see Fig. 1). The variation in outcome between the different measurements can be due to the fact that we average over very few grains, and that the grain composition will vary somewhat with its original position in the bone. In summary, ERBS can become a useful tool to study bone mineralization. As our knowledge of bone mineralization is incomplete this is currently an active topic of multidisciplinary research involving people working in physics, chemistry and biological/medical sciences. One of the important
Lai, Shih-Wei; Liao, Kuan-Fu; Lin, Cheng-Li; Lin, Hsien-Feng
Background and Objectives: Limited research focuses on the risk of ischemic cerebrovascular disease associated with use of dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) in patients with type 2 diabetes mellitus in Taiwan. This study aimed to investigate the association between DPP-4 inhibitors use and the first episode of ischemic cerebrovascular disease. Methods: We designed a case-control study using the database of the Taiwan National Health Insurance Program. There were 1999 type 2 diabetic subjects aged 20-84 years with the first episode of ischemic cerebrovascular disease from 2000 to 2013 as the cases, and 7996 sex- and age-matched, randomly selected type 2 diabetic subjects aged 20-84 years without any type of cerebrovascular diseases as the matched controls. We estimated the odds ratio (OR) and 95% confidence interval (CI) of ischemic cerebrovascular disease associated with cumulative duration of DPP-4 inhibitors use by the multivariable logistic regression model. Results: After adjustment for confounding variables, the adjusted OR of ischemic cerebrovascular disease was 0.96 (95% CI 0.95, 0.97) in subjects with ever use of DPP-4 inhibitors as increase in use duration for every 1 month, compared with never use. The sub-analysis disclosed that the adjusted ORs of ischemic cerebrovascular disease were 1.57 (95% CI 1.36, 1.80) for subjects with cumulative duration of DPP-4 inhibitors use cerebrovascular disease in type 2 diabetic patients in a duration-dependent response. The beneficial effect will be marked when DPP-4 inhibitors use is ≥1 year.
Discovery of discriminatory quality control markers for Chinese herbal medicines and related processed products by combination of chromatographic analysis and chemometrics methods: Radix Scutellariae as a case study.
Wang, Fei; Wang, Bo; Wang, Long; Xiong, Zi-Yue; Gao, Wen; Li, Ping; Li, Hui-Jun
The processing procedure of traditional Chinese herbal medicines (CHMs) plays an essential role in clinical applications. However, little progress has been made on the quality control of crude and processed products. The present work, taking Radix Scutellariae (RS), wine-processed RS and carbonized RS as a typical case, developed a comprehensive strategy integrating chromatographic analysis and chemometric methods for quality evaluation and discrimination of crude RS and its processed products. Chemical fingerprints were established by high-performance liquid chromatography coupled with photodiode array detector and quadrupole time-of-flight mass spectrometry, and similarity analyses were calculated based on eleven common characteristic peaks. Subsequently, four chemical markers were discovered by back propagation-artificial neural network (BP-ANN) modeling. The selected markers were quantified by the 'single standard to determine multi-components' (SSDMC) method, and then the quantitative data were subjected to principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA). Furthermore, support vector machine (SVM) was employed to predict the different processed products of RS. Finally, a hotmap visualization was conducted for clarifying the distribution of major flavonoids among different drugs. Collectively, the proposed strategy might be well-acceptable for quality control of CHMs and their related processed products from the processing mechanism-based perspective. Copyright © 2017 Elsevier B.V. All rights reserved.
Xu, Linyu; Song, Huimin; Wang, Yan; Yin, Hao
Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP) from industrial effluent and gaseous emissions, and established a multi-pathway exposure model based on a Level IV multimedia fugacity model to analyze the human health risks in a city that has undergone rapid industrialization. In this study, GIS tools combined with land-use data was introduced to analyze smaller spatial scales so as to enhance the spatial resolution of the results. An uncertainty analysis using a Monte Carlo simulation was also conducted to illustrate the rationale of the probabilistic assessment mode rather than deterministic assessment. Finally, the results of the case study in Nanjing, China indicated the annual average human cancer risk induced by local industrial emissions during 2002-2008 (lowest at 1.99x10(-6) in 2008 and highest at 3.34x10(-6) in 2004), which was lower than the USEPA prescriptive level (1x10(-6)-1x10(-4)) but cannot be neglected in the long term. The study results could not only instruct the BaP health risk management but also help future health risk prediction and control.
Full Text Available Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP from industrial effluent and gaseous emissions, and established a multi-pathway exposure model based on a Level IV multimedia fugacity model to analyze the human health risks in a city that has undergone rapid industrialization. In this study, GIS tools combined with land-use data was introduced to analyze smaller spatial scales so as to enhance the spatial resolution of the results. An uncertainty analysis using a Monte Carlo simulation was also conducted to illustrate the rationale of the probabilistic assessment mode rather than deterministic assessment. Finally, the results of the case study in Nanjing, China indicated the annual average human cancer risk induced by local industrial emissions during 2002–2008 (lowest at 1.99´10–6 in 2008 and highest at 3.34´10–6 in 2004, which was lower than the USEPA prescriptive level (1´10–6–1´10–4 but cannot be neglected in the long term. The study results could not only instruct the BaP health risk management but also help future health risk prediction and control.
Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.
These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not
Miki, Kozo; Matsumura, Tomohiro; Morishita, Masaharu; Namba, Kazuyuki; Kinoshita, Fumio
A case of marked eosinophilia following radiotherapy for a malignant tumor of the lower jaw was reported. The patient (62 years old, male) was diagnosed as having squamous cell carcinoma, and the received external irradiation of 60 Co (the total dose of 2600 rad/13 f) and the administration of bleomycin (BLM) of 90 mg/6 f. However, the tumor did not disappear completely, and it was extracted. A marked increase of eosinophils was recognized 30 days after the finish of irradiation, and the percentage of eosinophils reached 46%. Moreover, it reached 52% 6 days after that time, but it decreased rapidly by blood transfusion during and after the operation. The percentage of eosinophils after the operation showed a mild or moderate increase. 5 months after the first irradiation, external irradiation of 60 Co with the total dose of 3000 rad/15 f was performed together with the administration of 5-Fu and BudR because of the recurrence. One month after irradiation started again, the percentage of eosinophils increased again to 23%, and after that, a rapid increase was still recognized. The percentage of eosinophils decreased to a normal range after blood transfusion. Eosinophilia in this case was suggested to be caused by radiatiotherapy, because an increase of eosinophils was recognized a certain period after irradiation, allergic reactions by drugs were not recognized on the skin except oral mucosa, and there was no past history of allergic diseases. (Ueda, J.)
Full Text Available Many young people experiment with cannabis, yet only a subgroup progress to dependence suggesting individual differences that could relate to factors such as genetics and behavioral traits. Dopamine receptor D2 (DRD2 and proenkephalin (PENK genes have been implicated in animal studies with cannabis exposure. Whether polymorphisms of these genes are associated with cannabis dependence and related behavioral traits is unknown.Healthy young adults (18-27 years with cannabis dependence and without a dependence diagnosis were studied (N = 50/group in relation to a priori-determined single nucleotide polymorphisms (SNPs of the DRD2 and PENK genes. Negative affect, Impulsive Risk Taking and Neuroticism-Anxiety temperamental traits, positive and negative reward-learning performance and stop-signal reaction times were examined. The findings replicated the known association between the rs6277 DRD2 SNP and decisions associated with negative reinforcement outcomes. Moreover, PENK variants (rs2576573 and rs2609997 significantly related to Neuroticism and cannabis dependence. Cigarette smoking is common in cannabis users, but it was not associated to PENK SNPs as also validated in another cohort (N = 247 smokers, N = 312 non-smokers. Neuroticism mediated (15.3%-19.5% the genetic risk to cannabis dependence and interacted with risk SNPs, resulting in a 9-fold increase risk for cannabis dependence. Molecular characterization of the postmortem human brain in a different population revealed an association between PENK SNPs and PENK mRNA expression in the central amygdala nucleus emphasizing the functional relevance of the SNPs in a brain region strongly linked to negative affect.Overall, the findings suggest an important role for Neuroticism as an endophenotype linking PENK polymorphisms to cannabis-dependence vulnerability synergistically amplifying the apparent genetic risk.
Gourzoulidis, George; Kontodimopoulos, Nick; Kastanioti, Catherine; Bellali, Thaleia; Goumas, Konstantinos; Voudigaris, Dikaios; Polyzos, Nikolaos
The aim of this study was to examine HRQoL outcome and EI of managers of Health Organizations. We collected data from 120 general managers of Greek public hospitals who completed the Assessing Emotions Scale (AES) and the SF-36 Health Survey. The results showed that male managers generally exhibited better HRQoL and slightly worse EI than females, although differences were not significant throughout. The three EI factors of the AES addressing appraisal, optimism/regulation and utilization of emotions correlated from 0.18 to 0.39 with sub-dimensions of HRQoL mostly related to mental -rather than physical- aspects of health, and were also significant predictors of HRQoL. There was a noteworthy gender difference in the manner in which EI predicted HRQoL and this suggests more testing. Overall, this study might enrich the potential for EI studies in Greece as well as to contribute to the international literature.
N. V. Kuzmina
Full Text Available The authors present a case study of scrofuloderma in a female patient aged 55; the patient’s condition was of interest due to the prevalence of the pathology and long-term (25 years undiagnosed skin tuberculosis as a result of problems with the diagnostics of this localization of tuberculosis.
This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)
Jensen, Helle Bækkelund
In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....
This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...
Matic, Marija; Pekmezovic, Tatjana; Djukic, Tatjana; Mimic-Oka, Jasmina; Dragicevic, Dejan; Krivic, Biljana; Suvakov, Sonja; Savic-Radojevic, Ana; Pljesa-Ercegovac, Marija; Tulic, Cane; Coric, Vesna; Simic, Tatjana
Glutathione S-transferases (GSTs) are a family of enzymes involved in detoxification. Genes encoding for GSTA1, GSTM1, GSTP1, and GSTT1 proteins are polymorphic, which can result in complete or partial loss of enzyme activity. Previous studies have associated polymorphisms of GSTA1, GSTM1, and GSTP1 genes with a higher risk of bladder cancer, but this is still controversial. Potential role of GSTA1 polymorphism in susceptibility to bladder cancer in Whites is lacking. We examined association between GSTA1, GSTM1, GSTP1, and GSTT1 gene variants and bladder cancer risk and evaluated whether they were modified by smoking. A hospital-based case-control study recruited 201 incidence cases and 122 age-matched controls. Deletion polymorphism of GSTM1 and GSTT1 was identified by polymerase chain reaction method. Single nucleotide polymorphism of GSTA1 and GSTP1 was identified by restriction fragment length polymorphism method. Uniconditional multivariate logistic regression was applied to model association between genetic polymorphisms and bladder cancer risk, as well as effect modification by smoking. No significant difference was observed in the distributions of GSTM1, GSTT1, GSTA1, and GSTP1 gene variants between patients and controls. None of the examined polymorphisms was significantly associated with bladder cancer risk independently. The results of gene-smoking interaction analyses indicated a significant combined effect of smoking and all common GST polymorphisms tested (P for trend = 0.001). However, the most significant effect on bladder cancer risk was observed in smokers carrying lower activity GSTA1-AB/BB and GSTM-null genotype (OR = 3.5, P risk observed did not significantly differ with respect to quantity of cigarettes smoked. However, heavy smokers with GSTM1-null genotype had 2 times higher risk of bladder cancer than GSTM1-null light smokers (OR = 4.8 vs. OR = 2.0) when GSTM1-active non-smokers served as reference group. Smokers carrying both GSTM1-null
Lancman, S; Barros, J O; Silva, M D; Pereira, A R; Jardim, T A
Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.
Full Text Available The chronic exposure of airport related noise can lead to decreased quality of health and is a risk faktor of disease. Noise can stimulate physiological response to cardiovascular parameters such as blood pressure. The increase in blood pressure can be used as indicator of disturbance of the cardiovascular system. Ahmad Yani Airport is an international airport with a high mobility, thus people living near, are susceptible and have a risk for decreased quality health. Thus, the purposes of this study was to determine the effects of chronic noise exposure of airport related noise on the blood pressure. The study was an observational analytic cross-sectional study. This research was conducted in the area near Ahmad Yani Airport in Semarang, which is located on Perumahan Cakarawala (Â± 1000m and Perumahan Semarang Indah (Â± 5000m. Total of 60 respondents were randomly included in the study. Noise is measured with a Sound Level Meter (SLM Extech Type 70 335 with Leq measurement method (Equivalent Continous Noise Level for 24 hours (Lsm. The preliminary questionnaire was distributed to fulfill the criteria of inclusion and exclusion. The blood pressures were evaluated using the mercury Spygmomanometer, before and after exposure (flight activity. Data were analyzed with dependent t test. Noise measurements indicated that the Perumahan Cakrawala II had ahigh noise exposure above the noise level standards (NAB of 69 dBA (Lsm > NAB 55dBA, while the Perumahan Semarang Indah has noise exposure at 51 dBA below the NAB. The results indicated that the chronic noise exposure of flight activity had significant effect on blood pressure (p = 0.00. The increase in blood pressure among Perumahan Cakrawala II respondents was higher (systolic: by 83.3%, diastolic: by 59.9% compared to Perumahan Semarang Indah (systolic: by 69.9%, diastolic : by 49,9%. In conclusion, exposure to chronic noise due to flight activity significantly affected blood pressure.
Hypertension is a serious stress related disorder, typically requiring pharmacology in combination with various methods of health promotion including diet, specific lifestyle and psychophysiological techniques. This case study describes the effective treatment of a hypertensive crisis in a 63 year old woman with special ...
Chocholáč, Jan; Průša, Petr
The bullwhip effect generally refers to the phenomenon where order variability increases as the orders move upstream in the supply chain. It is serious problem for every member of the supply chain. This effect begins at customers and passes through the chain to producers, which are at the end of the logistic chain. Especially food supply chains are affected by this issue. These chains are unique for problems of expiration of goods (particularly perishable goods), variable demand, orders with quantity discounts and effort to maximize the customer satisfaction. This paper will present the problem of the bullwhip effect in the real supply chain in the food industry. This supply chain consists of approximately 350 stores, four central warehouses and more than 1000 suppliers, but the case study will examine 87 stores, one central warehouse and one supplier in 2015. The aim of this paper is the analysis of the order variability between the various links in this chain and confirmation of the bullwhip effect in this chain. The subject of the analysis will be perishable goods.
Fu, Ting; Cao, Haixia; Yin, Rulan; Zhang, Lijuan; Zhang, Qiuxiang; Li, Liren; Gu, Zhifeng
Gout is a painful, inflammatory disease that may cause decreased function and health-related quality of life (HRQoL). Limited study did not take the influence of gout characteristics and anxiety on HRQoL into consideration and there are no studies associated with functional disability in individuals with gout from China. This study aims to investigate the related factors of functional disability and HRQoL in gout patients recruited from China. A total of 226 consecutive gout patients and 232 age- and gender-matched healthy individuals were involved in the study. A series of questionnaires (the Short Form 36 health survey, the Patient Health Questionnaire, the Generalized Anxiety Disorder questionnaire, the 10 cm Visual Analog Scale, and the Health Assessment Questionnaire-Disability Index) were applied. Blood samples were taken to examine the level of serum uric acid. Independent samples t-tests, Chi square tests, U test, Spearman rank correlation, logistic regression modeling, and linear regression were used to analyze the data. After adjusted demographic variables, individuals with gout have poorer HRQoL compared to healthy controls. Univariate tests presented that patients with functional disability had longer disease duration, more frequent flares/last year, more severe total pain, more number of tophi, higher degree of depression and anxiety, with a trend toward diabetes, the treatment of colchicine and corticosteroids use, compared to patients without functional disability. Meanwhile, place of residence, hypertension, DM, disease duration, cardiovascular disease, number of flares/last year, total pain, more number of tophi, presence of tender joints, depression, anxiety, currently using colchicine and corticosteroids were correlated significantly with HRQoL. Additionally, multiple regression analysis identified severe pain, depression, and colchicine use as predictors of functional disability. Cardiovascular disease, total pain, number of flares/last year
Tariq, Saadia R; Shaheen, N; Khalique, A; Shah, Munir H
In order to study the distribution, correlation, and apportionment of selected metals, the tannery effluent, related soil, and groundwater samples were collected from Multan, Pakistan, and analyzed on flame atomic absorption spectrophotometer. Among the selected metals, Na, Ca, K, Cr, and Mg revealed dominant concentrations with average values of 5,499, 945, 565, 209, and 107 mg/L and 2,634, 330, 484, 14.1, and 60.5 mg/L in the effluents and groundwater, respectively, whereas the mean metal levels in soil samples were 10,026, 6,726, 9,242, 476, and 9,857 mg/kg. Overall, the mean metal concentrations in the tannery effluents, groundwater, and related soils reveal following order, respectively: Na > Ca > K > Cr > Mg > Ni > Fe > Zn > Co > Pb > Mn > Cd; Na > K > Ca > Mg > Cr > Zn > Ni > Pb > Fe > Co > Mn > Cd; Na > Mg > K > Ca > Cr > Co > Ni > Fe > Pb > Mn > Zn > Cd. Generally, the metal distribution in tannery effluents, soils, and groundwater was found to be random as evidenced by large differences between mean and median values as well as considerably higher standard deviation and skewness values. The selected metal data were also subjected to correlation study to investigate the covariation of metal levels in the three media. The source apportionment of the metal data in the effluents, soils, and groundwater was carried out using principal component analysis in addition to basic statistical and correlation analyses. The source apportionment studies evidenced the gross contamination of groundwater and soils in the vicinity of tanning industrial units in Multan. The current mean metal levels in the soil and groundwater were found to be considerably higher compared with the background concentration levels and WHO guideline values.
Determinant Variables, Enteric Pathogen Burden, Gut Function and Immune-related Inflammatory Biomarkers Associated With Childhood Malnutrition: A Prospective Case-Control Study in Northeastern Brazil.
Lima, Aldo A M; Leite, Álvaro M; Di Moura, Alessandra; Lima, Noélia L; Soares, Alberto M; Abreu, Cláudia B; Filho, José Quirino; Mota, Rosa M S; Lima, Ila F N; Havt, Alexandre; Medeiros, Pedro H Q S; Prata, Mara M G; Guedes, Marjorie M; Cavalcante, Paloma A; Veras, Herlice N; Santos, Ana K S; Moore, Sean R; Pinkerton, Relana C; Houpt, Eric R; Guerrant, Richard L
Malnutrition results in serious consequences for growth and cognitive development in children. We studied select child and maternal biologic factors, socioeconomic factors, enteric pathogenic burden and gut function biomarkers in 402 children 6-24 months of age in Northeastern Brazil. In this prospective case-control study, not being fed colostrum [odds ratio (OR): 3.29, 95% confidence interval (CI): 1.73-6.26], maternal age ≥18 years (OR: 1.88, 95% CI: 1.10-3.22) and no electric fan (OR: 2.46, 95% CI: 1.22-4.96) or bicycle (OR: 1.80, 95% CI: 1.10-2.95) in the household were positively associated, and higher birth weight (OR: 0.27, 95% CI: 0.19-0.38), larger head circumference (OR: 0.74, 95% CI: 0.66-0.82) and shortness of breath in the last 2 weeks (OR: 0.49, 95% CI: 0.27-0.90) were negatively associated with malnutrition. Subclinical enteric pathogen infections were common, and enteroaggregative Escherichia coli infections were more prevalent in malnourished children (P = 0.045). Biomarkers such as the lactulose-mannitol test, myeloperoxidase, neopterin and calprotectin were highly elevated in both malnourished and nourished children. Nourished children had a better systemic immune response than the malnourished children, as detected by elevated serum amyloid A-1 and soluble cluster of differentiation protein 14 biomarkers (P malnutrition in children. There was a substantial subclinical enteric pathogen burden, particularly with enteroaggregative E. coli, in malnourished children.
Chingarande, George Rugare; Moodley, Keymanthri
Compensation for research related injuries is a subject that is increasingly gaining traction in developing countries which are burgeoning destinations of multi center research. However, the existence of disparate compensation rules violates the ethical principle of fairness. The current paper presents a comparison of the policies of Brazil, Russia, India, China and South Africa (BRICS). A systematic search of good clinical practice guidelines was conducted employing search strategies modeled in line with the recommendations of ADPTE Collaboration (2007). The search focused on three main areas namely bibliographic data bases, clinical practice guidelines data bases and a restricted internet search. A manual search of references cited in relevant guideline documents was also conducted. The search terms, Medical Subject Headings (MeSH) and key words were developed for a PubMed platform and then adapted for all other data bases. The search terms were kept constant for each country with the only difference being the country name. The documents so obtained were subjected to systematic content analysis. The study revealed that there is vast panoply of regulations which exist on a continuum. On one extreme is India with comprehensive regulations that are codified into law, and on the other end there is China which does not have specific laws regulating research related injuries. There are a number of differences and similarities such as mandatory insurance requirements, existence of no fault compensation, compensable injuries and the role of research ethics committees. It is imperative to enact legislations that protect participants without stifling the research enterprise. There is need for consistency and ideally harmonization of such regulations at a global level. A model policy on compensation for research related injuries should borrow from the best aspects of the different country policies and should be informed by the cardinal ethics principles of autonomy, justice
Bulduk, Sıdıka; Bulduk, Emre Özgür; Güler, Alpaslan
Work-related musculoskeletal disorders (WMSDs) cause pain and economic loss. Risk of WMSDs is affected by job satisfaction as a psychosocial factor. The aim of this study was to investigate job satisfaction among aircraft baggage handlers and their exposure to work-related musculoskeletal disorder risk factors. Two data collection tools addressing risk levels (Quick Exposure Check) and psychosocial factors (Job Satisfaction Survey) were answered by 399 male baggage handlers employed in Esenboga International Airport in Ankara, Turkey. Risk exposure scores for WMSDs among baggage handlers were 27±3.4 (high) for the back (static), 42±7.2 (very high) for the back (moving), 42±6.1 (very high) for the shoulder/arm, 44±1.9 (very high) for the wrist/hand, and 13±5.1(high) for the neck. The average job satisfaction levels of the majority was either low (4.2250±1.10184) or moderate (3.1019±0.93352). In addition, low and moderate job satisfaction was significantly associated with higher WMSD risk levels among baggage handlers. Increased WMSD risk levels among baggage handlers are associated with low and moderate job satisfaction, suggesting that it is mandatory to perform intervention methods in this occupation.
Full Text Available Hygiene disregarding and usage of contaminated tools leads to viral infections, fungal, bacterial and skin diseases, eczema, warts, tetanus and so on. Thus assessment of knowledge, attitudes and performance of barbers in order to ensure the security and public health is really necessary. This study is aimed at determining the knowledge, attitude and performance of female barbers in relation to job's environmental health in Malayer city. In present descriptive- analytical study, 75 female barbers sampling of Malayer city were selected by clusters – systematic method. The data were obtained through questionnaires for completion and checklist. Data analysis was performed using SPSS 21 statistical software. The result showed, 86.66% of people have attained correct awareness of regulations and 92.28% had positive attitude toward regulations and 86.38% of people in this study showed appropriate health practice. In order to, compare the average knowledge level in regard to parameters such as age, work experiences and income situation showed a statistically significant difference. In attitude and performance section, the difference between age and mentioned parameters was not statistically significant (P≥ 0.05. Despite the desirable level of knowledge, attitude and practice of barbers female in Malayer city, in order to improve the situation, to be better the presence of barbers in special guilds courses to train seriously.
Antonio Ángel Rodríguez Serrano
Full Text Available While there exists an international trend to develop zero or near zero emissions building solutions by 2020, and European governments continuously update their building regulations to optimize the building envelope and energy systems to achieve this during the building use stage, at least in Spain the building regulations do not take into account the impact of emissions resulting from urbanization and construction activities prior to building use. This research studies in detail the entire emissions balance (and how it may be related to energy efficiency in a newly built residential cluster project in Mancha Real (Jaén, Spain, and influences due to the choice of different urban typologies. For comparison, terraced housing and low-density, four-floor, multi-family housing alternatives have been studied. The present work assessed the life cycle of the building with the help of commercial software (CYPE, and the energy efficiency and emissions according to the legal regulations in Spain with the official software LIDER and CALENER VYP. After a careful choice of building and systems alternatives and their comparison, the study concludes that the major emissions impact and energy costs of urbanization and building activity occurs during construction, while later savings due to reductions in building use emissions are very modest in comparison. Therefore, deeper analysis is suggested to improve the efficiency of the construction process for a significantly reduced emission footprint on the urban environment.
Full Text Available Financial performance, as a multi-criteria economic category, constitutes a current topic broadly investigated by authors and experts in finance, financial management, accounting, evaluation and general management. In this ever more competitive capital market, because investors are increasingly better informed, it becomes essential for a company to know and periodically evaluate its stock performance in order to compare it at economic branch level. This present research study analyses six companies that activate in the energy and related utilities sector, listed at the Bucharest Stock Exchange, between 2004 and 2015, with the aim of identifying branch similarities regarding the evolution of the key stock growth ratios and indicators used in stock performance analysis. Furthermore, the authors deemed appropriate to correlate their results with the evolution of the main rates of return of the same companies
Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul
Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure
Proesmans, Karel; Broeck, Christian Van den
Stochastic efficiency is evaluated in five case studies: driven Brownian motion, effusion with a thermo-chemical and thermo-velocity gradient, a quantum dot and a model for information to work conversion. The salient features of stochastic efficiency, including the maximum of the large deviation function at the reversible efficiency, are reproduced. The approach to and extrapolation into the asymptotic time regime are documented. (paper)
José Rato Nunes
Full Text Available The characterization of the content of trace metals in soils is an instrument in many programs of environmental protection, including the establishment of regional-level standards to detect sites affected by contamination. The objectives of the present study were to study the available levels of Cd, Cr, Cu, Ni, Pb, and Zn in surface horizons of agricultural soils in a typical European Mediterranean region, to establish the geochemical baseline concentration (GBC, background level (BL, and reference value (RV of each of these available metals, and to investigate their possible correlations with soil properties. To establish the GBC and RV values, we used the “standard threshold method”. Topsoil samples (0–20 cm were collected from 630 sites, and extracted with Diethylene Triamine Pentaacetic Acid (DTPA to determine their available heavy metal concentrations. The GBC values established were: 0.04 to 0.90 mg kg−1, 0.70 to 2.50 mg kg−1, 0.10 to 6.30 mg kg−1, 0.30 to 7.90 mg kg−1, 0.29 to 4.50 mg kg−1, and 0.18 to 2.50 mg kg−1 for Cd, Cr, Cu, Ni, Pb, and Zn, respectively. Soil properties were found to be correlated with the available heavy metal content, suggesting that the enhanced mobility of heavy metals are related to anthropic activities.
Kim, Eung Seok; Choi, Hyun Il
An increase in the occurrence of sudden local flooding of great volume and short duration has caused significant danger and loss of life and property in Korea as well as many other parts of the World. Since such floods usually accompanied by rapid runoff and debris flow rise quite quickly with little or no advance warning to prevent flood damage, this study presents a new flash flood indexing methodology to promptly provide preliminary observations regarding emergency preparedness and response to flash flood disasters in small ungauged catchments. Flood runoff hydrographs are generated from a rainfall-runoff model for the annual maximum rainfall series of long-term observed data in the two selected small ungauged catchments. The relative flood severity factors quantifying characteristics of flood runoff hydrographs are standardized by the highest recorded maximum value, and then averaged to obtain the flash flood index only for flash flood events in each study catchment. It is expected that the regression equations between the proposed flash flood index and rainfall characteristics can provide the basis database of the preliminary information for forecasting the local flood severity in order to facilitate flash flood preparedness in small ungauged catchments. PMID:22690208
Zhang, Yan-Hua; Li, Yan; Chen, Chuang; Peng, Chun-Wei
The present study aim is to study the significance of serum tumor markers in predicting tumor progression and clinical outcomes in gastric cancer (GC). Preoperative serum tumor markers were determined in 166 GC patients, who were followed after curative gastrectomy. The associations between tumor marker status and tumor invasion depth, clinical stage, lymph node metastasis, and survival were analyzed. Carcinoembryonic antigen (CEA) was significantly correlated with serosal invasion of the stomach and clinical stage, and carbohydrate antigen 19-9 (CA19-9) related to the clinical stage (p markers positive had a shorter survival, 19.0, 11.0 and 3.0 months median survival time for one, two and three markers positive, respectively (p cancer antigen 125 (CA125) were more sensitive and specific in predicting worse prognosis than diagnosis. Multivariate analysis showed that CA19-9 and clinical stage were independent prognostic factors (p tumor invasion into the serosa of the stomach, which may call for new therapies. CA19-9 is an independent negative prognostic factor.
IMPlementation of A Relatives' Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol.
Lobban, Fiona; Appleton, Victoria; Appelbe, Duncan; Barraclough, Johanna; Bowland, Julie; Fisher, Naomi R; Foster, Sheena; Johnson, Sonia; Lewis, Elizabeth; Mateus, Céu; Mezes, Barbara; Murray, Elizabeth; O'Hanlon, Puffin; Pinfold, Vanessa; Rycroft-Malone, Jo; Siddle, Ron; Smith, Jo; Sutton, Chris J; Walker, Andrew; Jones, Steven H
Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives' Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives' distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process under observation. We outline our
Predictive modeling of groundwater nitrate pollution using Random Forest and multisource variables related to intrinsic and specific vulnerability: a case study in an agricultural setting (Southern Spain).
Rodriguez-Galiano, Victor; Mendes, Maria Paula; Garcia-Soldado, Maria Jose; Chica-Olmo, Mario; Ribeiro, Luis
Watershed management decisions need robust methods, which allow an accurate predictive modeling of pollutant occurrences. Random Forest (RF) is a powerful machine learning data driven method that is rarely used in water resources studies, and thus has not been evaluated thoroughly in this field, when compared to more conventional pattern recognition techniques key advantages of RF include: its non-parametric nature; high predictive accuracy; and capability to determine variable importance. This last characteristic can be used to better understand the individual role and the combined effect of explanatory variables in both protecting and exposing groundwater from and to a pollutant. In this paper, the performance of the RF regression for predictive modeling of nitrate pollution is explored, based on intrinsic and specific vulnerability assessment of the Vega de Granada aquifer. The applicability of this new machine learning technique is demonstrated in an agriculture-dominated area where nitrate concentrations in groundwater can exceed the trigger value of 50 mg/L, at many locations. A comprehensive GIS database of twenty-four parameters related to intrinsic hydrogeologic proprieties, driving forces, remotely sensed variables and physical-chemical variables measured in "situ", were used as inputs to build different predictive models of nitrate pollution. RF measures of importance were also used to define the most significant predictors of nitrate pollution in groundwater, allowing the establishment of the pollution sources (pressures). The potential of RF for generating a vulnerability map to nitrate pollution is assessed considering multiple criteria related to variations in the algorithm parameters and the accuracy of the maps. The performance of the RF is also evaluated in comparison to the logistic regression (LR) method using different efficiency measures to ensure their generalization ability. Prediction results show the ability of RF to build accurate models
Hoang Van Minh
Full Text Available Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results: 1 Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2 Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3 Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4 Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5 Information and research: Data that can be used for planning and management (including population and epidemiological
Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars
Background As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely
Shi V. Liu
Full Text Available An important factor in evaluating health risk of near-road air pollution is to accurately estimate the traffic-related vehicle emission of air pollutants. Inclusion of traffic parameters such as road length/area, distance to roads, and traffic volume/intensity into models such as land use regression (LUR models has improved exposure estimation. To better understand the relationship between vehicle emissions and near-road air pollution, we evaluated three traffic density-based indices: Major-Road Density (MRD, All-Traffic Density (ATD and Heavy-Traffic Density (HTD which represent the proportions of major roads, major road with annual average daily traffic (AADT, and major road with commercial annual average daily traffic (CAADT in a buffered area, respectively. We evaluated the potential of these indices as vehicle emission-specific near-road air pollutant indicators by analyzing their correlation with black carbon (BC, a marker for mobile source air pollutants, using measurement data obtained from the Near-road Exposures and Effects of Urban Air Pollutants Study (NEXUS. The average BC concentrations during a day showed variations consistent with changes in traffic volume which were classified into high, medium, and low for the morning rush hours, the evening rush hours, and the rest of the day, respectively. The average correlation coefficients between BC concentrations and MRD, ATD, and HTD, were 0.26, 0.18, and 0.48, respectively, as compared with −0.31 and 0.25 for two commonly used traffic indicators: nearest distance to a major road and total length of the major road. HTD, which includes only heavy-duty diesel vehicles in its traffic count, gives statistically significant correlation coefficients for all near-road distances (50, 100, 150, 200, 250, and 300 m that were analyzed. Generalized linear model (GLM analyses show that season, traffic volume, HTD, and distance from major roads are highly related to BC measurements. Our analyses
Liu, Shi V; Chen, Fu-Lin; Xue, Jianping
An important factor in evaluating health risk of near-road air pollution is to accurately estimate the traffic-related vehicle emission of air pollutants. Inclusion of traffic parameters such as road length/area, distance to roads, and traffic volume/intensity into models such as land use regression (LUR) models has improved exposure estimation. To better understand the relationship between vehicle emissions and near-road air pollution, we evaluated three traffic density-based indices: Major-Road Density (MRD), All-Traffic Density (ATD) and Heavy-Traffic Density (HTD) which represent the proportions of major roads, major road with annual average daily traffic (AADT), and major road with commercial annual average daily traffic (CAADT) in a buffered area, respectively. We evaluated the potential of these indices as vehicle emission-specific near-road air pollutant indicators by analyzing their correlation with black carbon (BC), a marker for mobile source air pollutants, using measurement data obtained from the Near-road Exposures and Effects of Urban Air Pollutants Study (NEXUS). The average BC concentrations during a day showed variations consistent with changes in traffic volume which were classified into high, medium, and low for the morning rush hours, the evening rush hours, and the rest of the day, respectively. The average correlation coefficients between BC concentrations and MRD, ATD, and HTD, were 0.26, 0.18, and 0.48, respectively, as compared with -0.31 and 0.25 for two commonly used traffic indicators: nearest distance to a major road and total length of the major road. HTD, which includes only heavy-duty diesel vehicles in its traffic count, gives statistically significant correlation coefficients for all near-road distances (50, 100, 150, 200, 250, and 300 m) that were analyzed. Generalized linear model (GLM) analyses show that season, traffic volume, HTD, and distance from major roads are highly related to BC measurements. Our analyses indicate that
Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars
As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease
Lawrence Renée H
Full Text Available Abstract Background Incorporating shared medical appointments (SMAs or group visits into clinical practice to improve care and increase efficiency has become a popular intervention, but the processes to implement and sustain them have not been well described. The purpose of this study was to describe the process of implementation of SMAs in the local context of a primary care clinic over time. Methods The setting was a primary care clinic of an urban academic medical center of the Veterans Health Administration. We performed an in-depth case analysis utilizing both an innovations framework and a nested systems framework approach. This analysis helped organize and summarize implementation and sustainability issues, specifically: the pre-SMA local context; the processes of tailoring and implementation of the intervention; and the evolution and sustainability of the intervention and its context. Results Both the improvement intervention and the local context co-adapted and evolved during implementation, ensuring sustainability. The most important promoting factors were the formation of a core team committed to quality and improvement, and the clinic leadership that was supported strongly by the team members. Tailoring had to also take into account key innovation-hindering factors, including limited resources (such as space, potential to alter longstanding patient-provider relationships, and organizational silos (disconnected groups with core team members reporting to different supervisors. Conclusion Although interventions must be designed to meet the needs of the sites in which they are implemented, specific guidance tailored to the practice environment was lacking. SMAs require complex changes that impact on care routines, collaborations, and various organizational levels. Although the SMA was not envisioned originally as a form of system redesign that would alter the context in which it was implemented, it became clear that tailoring the
Erlendsson, Egill; Gísladóttir, Guðrún
Around AD 870 the virgin environment of Iceland became populated by humans and mammal land herbivores. Since then, the island has lost nearly all of its native birch woodland, resulting in dramatic degradation of landscapes and ecosystems, attributed mainly to over-exploitation of woodlands and late-medieval climate deterioration. As part of policy making in agriculture, a heated debate is ongoing over limitations to sheep grazing in pastures suffering from long-term degradation. In this context the history of climate and land use is of great importance. Those who consider grazing a minimal attribute to land degradation argue that the harsh climate conditions of the little ice age are the primary mechanism behind the current degraded landscape. Others err on the side of caution and propose a careful approach to grazing. This study forms a contribution to the historical context of the impact of grazing upon the Icelandic terrestrial ecosystem. Using the analyses of pollen and spores from coprophilous fungi as principal methods, we present data about historical environmental change from within two different land holdings in Kjarardalur Valley, West Iceland. One dataset comes from within a landholding governed by the chieftain farm Reykholt, the other comes from within the land of the indipendent farm, Norðtunga. In the past the valley was used primarily as a pasture, associated with shielings (organised seasonal grazing). Pollen data from the pasture in Kjarardalur Valley, West Iceland, demonstrate a rapid loss of birch (Betula pubescens) woodland from grazing areas owned by the major farm and institution, Reykholt. The suppressive nature of grazing is demonstrated by the expansion of woodland as soon when animal stocks are reduced, probably as a consequence of the bubonic plague after AD 1402. Resumed exploitation of resources eventually depleted all birch woodland from the Reykholt landholding and precipitated soil erosion. The trajectory of environmental change
Okamoto, K.; Ando, Y.; Sano, Y.
In order to know the fate of an organic carbon in deep subduction zone, we have observed the Sanbagawa eclogite (Tonaru eclogite) accompanying cupper-iron sulfides (so called Besshi mine type Cu-Fe sulfides). The sulfides are considered as precipitates related to the Jurassic ridge-hydrothermal alteration. In the eclogite, Cu-Fe sulfides contain silicate with graphite along cracks. The rims of the sulfides are replaces as Fe-Cu oxides. It is considered that the graphites were on the sulfide and along the interstitial domain such as cracks then rim of the oxides were overgrown. The graphite crystallization temperature calibrated using laser Raman peak shift, is estimated lower than 300 oC. It is obviously lower than that of the metamorphic temperature of the eclogite 550-600 oC. It clearly suggests that graphite was probably from the micro-bacteria with Cu-Fe sulfides in the hydrothermal zone in the Mid-oceanic ridge system. It is well known that the Cu-Fe oxides were formed in high P/T Sanbagawa metamorphism. Therefore overgrowth of the oxides on the studied sulfide-graphite association were in deep subduction zone. In summary, the Jurassic ridge-hydrothermal alteration provides bacteria cluster, and subsequently the organic carbon would be recycled down deep in the mantle via subduction zone.
Mu, Li; Geng, Li-Cheng; Xu, Hui; Luo, Man; Geng, Jing-Miao; Li, Li
Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.
Full Text Available Algal bloom in a freshwater lake is a rapid increase of aquatic plants, which disrupts the ecological balance and its potential for beneficial uses. This problem has been managed by relating the trophic levels of a lake with nutrient loading. This traditional management approach is less than satisfactory as it neglects considering the intricate relationship between nutrient loading and the algal community. As a result, it often fails to detect an imminent algal bloom and fails to formulate and implement timely remedial measures. The advancement of modern molecular biosciences has provided an opportunity to improve this traditional approach. In this study, field and laboratory experiments on lake bioproductivity and biodiversity were conducted in Lake Wilson on central Oahu, Hawaii. Bioproductivity or algal productivity was evaluated in terms of the rate of chlorophyll growth in the lake water, and the biodiversity or genetic biodiversity was evaluated by using the method of denaturing gradient gel electrophoresis of the algae species and the Shannon index. Research results indicated that eukaryote communities in Lake Wilson were more diverse under the mesotrophic state of algal productivity than those under the oligotrophic and eutrophic states. Therefore, the reduction of the biodiversity of a mesotrophic lake can be used in water quality management as a warning sign of an imminent algal bloom.
Kulinkina, Alexandra V; Kosinski, Karen C; Liss, Alexander; Adjei, Michael N; Ayamgah, Gilbert A; Webb, Patrick; Gute, David M; Plummer, Jeanine D; Naumova, Elena N
Continuous access to adequate quantities of safe water is essential for human health and socioeconomic development. Piped water systems (PWSs) are an increasingly common type of water supply in rural African small towns. We assessed temporal and spatial patterns in water consumption from public standpipes of four PWSs in Ghana in order to assess clean water demand relative to other available water sources. Low water consumption was evident in all study towns, which manifested temporally and spatially. Temporal variability in water consumption that is negatively correlated with rainfall is an indicator of rainwater preference when it is available. Furthermore, our findings show that standpipes in close proximity to alternative water sources such as streams and hand-dug wells suffer further reductions in water consumption. Qualitative data suggest that consumer demand in the study towns appears to be driven more by water quantity, accessibility, and perceived aesthetic water quality, as compared to microbiological water quality or price. In settings with chronic under-utilization of improved water sources, increasing water demand through household connections, improving water quality with respect to taste and appropriateness for laundry, and educating residents about health benefits of using piped water should be prioritized. Continued consumer demand and sufficient revenue generation are important attributes of a water service that ensure its function over time. Our findings suggest that analyzing water consumption of existing metered PWSs in combination with qualitative approaches may enable more efficient planning of community-based water supplies and support sustainable development. Copyright © 2016 Elsevier B.V. All rights reserved.
Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin
Ransom, Khadijah S.; Johnson, Grace K.
As a continuation from summer 2012, the Shuttle Case Study Collection has been developed using lessons learned documented by NASA engineers, analysts, and contractors. Decades of information related to processing and launching the Space Shuttle is gathered into a single database to provide educators with an alternative means to teach real-world engineering processes. The goal is to provide additional engineering materials that enhance critical thinking, decision making, and problem solving skills. During this second phase of the project, the Shuttle Case Study Collection website was developed. Extensive HTML coding to link downloadable documents, videos, and images was required, as was training to learn NASA's Content Management System (CMS) for website design. As the final stage of the collection development, the website is designed to allow for distribution of information to the public as well as for case study report submissions from other educators online.
Cleary, Jessica E
.... This thesis examines the relationship between the tendency of state policies regarding Palestinian refugees in Lebanon, Egypt, and Syria to create isolation or integration, and the relative extent...
Full Text Available Abstract Background Current conceptual frameworks on the interrelationship between armed conflict and poverty are based primarily on aggregated macro-level data and/or qualitative evidence and usually focus on adherents of warring factions. In contrast, there is a paucity of quantitative studies about the socioeconomic consequences of armed conflict at the micro-level, i.e., noncommitted local households and civilians. Methods We conducted a secondary analysis of data pertaining to risk factors for malaria and neglected tropical diseases. Standardized questionnaires were administered to 182 households in a rural part of western Côte d'Ivoire in August 2002 and again in early 2004. Between the two surveys, the area was subject to intensive fighting in the Ivorian civil war. Principal component analysis was applied at the two time points for constructing an asset-based wealth-index and categorizing the households in wealth quintiles. Based on quintile changes, the households were labeled as 'worse-off', 'even' or 'better-off'. Statistical analysis tested for significant associations between the socioeconomic fates of households and head of household characteristics, household composition, village characteristics and self-reported events associated with the armed conflict. Most-poor/least-poor ratios and concentration indices were calculated to assess equity changes in households' asset possession. Results Of 203 households initially included in the first survey, 21 were lost to follow-up. The population in the remaining 182 households shrunk from 1,749 to 1,625 persons due to migration and natural population changes. However, only weak socioeconomic dynamics were observed; every seventh household was defined as 'worse-off' or 'better-off' despite the war-time circumstances. Analysis of other reported demographic and economic characteristics did not clearly identify more or less resilient households, and only subtle equity shifts were noted
Fürst, Thomas; Tschannen, Andres B; Raso, Giovanna; Acka, Cinthia A; de Savigny, Don; Girardin, Olivier; N'Goran, Eliézer K; Utzinger, Jürg
Current conceptual frameworks on the interrelationship between armed conflict and poverty are based primarily on aggregated macro-level data and/or qualitative evidence and usually focus on adherents of warring factions. In contrast, there is a paucity of quantitative studies about the socioeconomic consequences of armed conflict at the micro-level, i.e., noncommitted local households and civilians. We conducted a secondary analysis of data pertaining to risk factors for malaria and neglected tropical diseases. Standardized questionnaires were administered to 182 households in a rural part of western Côte d'Ivoire in August 2002 and again in early 2004. Between the two surveys, the area was subject to intensive fighting in the Ivorian civil war. Principal component analysis was applied at the two time points for constructing an asset-based wealth-index and categorizing the households in wealth quintiles. Based on quintile changes, the households were labeled as 'worse-off', 'even' or 'better-off'. Statistical analysis tested for significant associations between the socioeconomic fates of households and head of household characteristics, household composition, village characteristics and self-reported events associated with the armed conflict. Most-poor/least-poor ratios and concentration indices were calculated to assess equity changes in households' asset possession. Of 203 households initially included in the first survey, 21 were lost to follow-up. The population in the remaining 182 households shrunk from 1,749 to 1,625 persons due to migration and natural population changes. However, only weak socioeconomic dynamics were observed; every seventh household was defined as 'worse-off' or 'better-off' despite the war-time circumstances. Analysis of other reported demographic and economic characteristics did not clearly identify more or less resilient households, and only subtle equity shifts were noted.However, the results indicate significant changes in
Full Text Available The need to improve the accuracy of carbon emission measurements is a major issue which the tourism industry must resolve in order to reduce adverse impacts on climate change and the environment. This study established a detailed consumption list based on household survey data and calculated the carbon emissions of accommodation and services of the rural tourism industry of Mount Qingcheng using the input–output and lifecycle methods. Further, it analysed the key factors affecting carbon emissions. The results indicate that within the surveyed area, carbon emissions from accommodation and services amounted to 30.27 kg CO2/per person per day; these emissions were primarily from indirect sources, which accounted for 74.99% of the total emissions. Emissions from construction and production of durable goods accounted for 13.08% and 21.58% of the total emissions. The omission of these sources of carbon emissions was the primary reason for the carbon emission levels of the tourism industry being underestimated previously. For each additional 10,000 yuan in revenue, accommodation and related services of the rural tourism industry emit an additional 1412.08 kg of CO2. This is higher than the level of carbon emissions of the agriculture industry, but lower than those of the processing and manufacturing industries. Tourist consumption behaviours and types of tourism operations are important factors affecting carbon emissions. Effective emission reduction strategies include guiding tourist consumption behavioural changes, optimizing tourism operation portfolios, and extending the service life of constructions and durable goods.
Yamada, Kazunori; Yamamoto, Motohisa; Saeki, Takako; Mizushima, Ichiro; Matsui, Shoko; Fujisawa, Yuhei; Hara, Satoshi; Takahashi, Hiroki; Nomura, Hideki; Kawa, Shigeyuki; Kawano, Mitsuhiro
The aim was to further characterize immunoglobulin G4-related disease (IgG4-RD) by a large-scale multicenter study of its clinical and laboratory features conducted by multidisciplinary physicians of IgG4-RD in Japan. Various specialists retrospectively evaluated IgG4-RD patients diagnosed between 1996 and 2015 in five hospitals by analyzing their baseline clinical features, laboratory, imaging, and pathological test findings, and treatment. Of the 334 patients listed, 205 were male and median age at diagnosis was 65 years. The mean number of organs involved was 3.2 at diagnosis. The most frequently affected organs were the salivary glands, followed by the lacrimal glands, lymph nodes, pancreas, retroperitoneum/periaorta, kidneys, and lungs. The mean serum level of IgG4 was 755 mg/dl, and more than 95% of patients had elevated serum IgG4 levels. The median serum level of C-reactive protein (CRP) was 0.1 mg/dl and the level was less than 1 mg/dl in 90% of patients. A total of 34.7% of patients had low serum levels of C3. Serum levels of C3 and non-IgG4 IgG, calculated as the total IgG minus IgG4, showed an inverse correlation in patients with kidney lesions, while serum IgG4 levels were not correlated with serum C3 levels. Corticosteroid was administered in 78.0% of patients, and was effective in all. The serum CRP level is generally low and the serum IgG4 level is elevated in most Japanese IgG4-RD patients, in contrast to western patients. These original findings suggest that these two parameters in IgG4-RD differ in some interesting ways from those hitherto reported in western populations. Additional studies, especially international comparative ones, are needed to elucidate the extent and significance of these differences between populations. Attention will also have to be paid to whether the existence of such differences requires consideration when devising international classification criteria.
For the past three decades, the U.S. Department of Transportations John A. Volpe National : Transportation Systems Center Acoustics Facility (Volpe Center) has been providing noise-related technical support to various government organizations at t...
Carl, Marla L
... research and analysis of the issues facing our government and our world They have the luxury of exploring a variety of options related to an issue and the resources to dig deeply and vertically...
Stich, Amy E.; Colyar, Julia E.
In this paper, the authors argue that despite a resurgence of elite studies, the majority of existing scholarship works to reify and legitimize social inequality through its language and method. In particular, the authors utilize Pierre Bourdieu's concept of relational thinking to review and critique contemporary research on elite education and…
Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.
Ellinger, Andrea D.; McWhorter, Rochell
This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…
Pinto, I. R.
The study of the impact of global warming on lightning activity is a key point to understand the impact of global warming on climate changes. However, no specific reference to future changes in lightning activity exists in the last 2007 Intergovernmental Panel on Climate Change (IPCC) report. Since the majority of global lightning activity occurs in the tropics, changes in future global lightning activity will depend on changes in the tropical climate. Nevertheless, the projections given by the contemporary General Circulation Models (GCMs) for the tropical climate have large uncertainties since the simulation of convection is heavily parameterised. This is because the typical scale of this process is smaller than the model resolution. Depending on the convection parameterization adopted it is possible to obtain an increase or, even, a decrease in the global lightning activity. Also a wide range in the spatial variability of the simulated lightning activity is found, attributed to the different parameterizations. Another approach to investigate the lightning-climate relationship is based on data for short periods in a given region, even considering that it may be influenced by factors such as topography, local atmospheric circulation patterns and ocean currents, among others, while not being related to surface temperature or moisture. This approach is used in this article, applied to the city of São Paulo. Thunderstorm, precipitation, temperature and moisture data for this city for the period from 1950 to 2000 obtained by two meteorological stations and lightning data for this city for the period from 1999 to 2007 obtained by the Brazilian Lightning Detection network (BrasilDat) were used in the analysis. In order to gain some insights into possible future changes in global lightning activity data in the city of São Paulo are analyzed and discussed in the context of two specific points: the hypothesis that a hotter and drier global climate predicted by most GCMs
Zsögön, Agustin; Cermak, Tomas; Voytas, Dan; Peres, Lázaro Eustáquio Pereira
The ideotype is a theoretical model of an archetypal cultivated plant. Recent progress in genome editing is aiding the pursuit of this ideal in crop breeding. Breeding is relatively straightforward when the traits in question are monogenic in nature and show Mendelian inheritance. Conversely, traits with a diffuse, polygenic basis such as abiotic stress resistance are more difficult to harness. In recent years, many genes have been identified that are important for plant domestication and act by increasing yield, grain or fruit size or altering plant architecture. Here, we propose that (a) key monogenic traits whose physiology has been unveiled can be molecularly tailored to achieve the ideotype; and (b) wild relatives of crops harboring polygenic stress resistance genes or other traits of interest could be de novo domesticated by manipulating monogenic yield-related traits through state-of-the-art gene editing techniques. An overview of the genomic and physiological challenges in the world's main staple crops is provided. We focus on tomato and its wild Solanum (section Lycopersicon) relatives as a suitable model for molecular design in the pursuit of the ideotype for elite cultivars and to test de novo domestication of wild relatives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Risk patterns in drug safety study using relative times by accelerated failure time models when proportional hazards assumption is questionable: an illustrative case study of cancer risk of patients on glucose-lowering therapies.
Ng, Edmond S-W; Klungel, Olaf H; Groenwold, Rolf H H; van Staa, Tjeerd-Pieter
Observational drug safety studies may be susceptible to confounding or protopathic bias. This bias may cause a spurious relationship between drug exposure and adverse side effect when none exists and may lead to unwarranted safety alerts. The spurious relationship may manifest itself through substantially different risk levels between exposure groups at the start of follow-up when exposure is deemed too short to have any plausible biological effect of the drug. The restrictive proportional hazards assumption with its arbitrary choice of baseline hazard function renders the commonly used Cox proportional hazards model of limited use for revealing such potential bias. We demonstrate a fully parametric approach using accelerated failure time models with an illustrative safety study of glucose-lowering therapies and show that its results are comparable against other methods that allow time-varying exposure effects. Our approach includes a wide variety of models that are based on the flexible generalized gamma distribution and allows direct comparisons of estimated hazard functions following different exposure-specific distributions of survival times. This approach lends itself to two alternative metrics, namely relative times and difference in times to event, allowing physicians more ways to communicate patient's prognosis without invoking the concept of risks, which some may find hard to grasp. In our illustrative case study, substantial differences in cancer risks at drug initiation followed by a gradual reduction towards null were found. This evidence is compatible with the presence of protopathic bias, in which undiagnosed symptoms of cancer lead to switches in diabetes medication. Copyright © 2015 John Wiley & Sons, Ltd.
Prentice, Andrew M
Africa is the final continent to be affected by the nutrition transition and, as elsewhere, is characterized by the paradoxical coexistence of malnutrition and obesity. Several features of the obesity epidemic in Africa mirror those in other emerging nations: it penetrates the richer nations and urban areas first with a strong urban- rural gradient; initially it affects the wealthy, but later there is a demographic switch as obesity becomes a condition more associated with poverty, and it shares many of the same drivers related to the increasing affordability of highly refined oils and carbohydrates, and a move away from subsistence farm work and towards sedentary lifestyles. Africa also has some characteristics of the obesity epidemic that stand out from other regions such as: (1) excepting some areas of the Pacific, Africa is probably the only region in which obesity (especially among women) is viewed culturally as a positive and desirable trait, leading to major gender differences in obesity rates in many countries; (2) most of Africa has very low rates of obesity in children, and to date African obesity is mostly an adult syndrome; (3) Africans seem genetically prone to higher rates of diabetes and hypertension in association with obesity than Caucasians, but seem to be relatively protected from dislipidemias; (4) the case-specific deaths and disabilities from diabetes and hypertension in Africa are very high due to the paucity of health services and the strain that the 'double burden' of disease places on health systems. Copyright (c) 2009 S. Karger AG, Basel.
Beuth, Thomas; Buhmann, Dieter; Fischer-Appelt, Klaus; Moenig, Joerg; Ruebel, Andre; Wolf, Jens [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS), Koeln (Germany); Bollingerfehr, Wilhelm; Filbert, Wolfgang [DBE Technology GmbH, Peine (Germany); Charlier, Frank [international nuclear safety engineering gmbh (nse), Aachen (Germany); Baltes, Bruno
The question of the long-term safety of a repository system is inseparably linked with the intensive technical examination of the possible future evolution of the site and the repository system e. g. as a result of climatic, geologic, waste-related and repository-related processes. Here, the possible evolutions to be considered are those that have the potential to have a negative impact on the intended, furthest-possible, immediate, and lasting isolation of the radioactive waste in a defined area around the underground workings of the repository mine in salt rock, which is referred to as the containment-providing rock zone (CPRZ).
Heaven, D; Henein, M; Sutton, R
Only four cases of tricuspid stenosis related to endocardial pacemaker leads have been reported. Two further cases associated with perforation of a tricuspid valve leaflet by a pacemaker lead are presented: a 46 year old woman and a 60 year old man. It is possible that tricuspid valve disease related to endocardial pacemaker and non-thoracotomy defibrillator leads is underrecognised. Diagnosis requires clinical suspicion and the use of Doppler echocardiography. Recent evidence of fibrosis aff...
Arch, B N; Thurston, M N
Deaths and injuries related to fires are largely preventable events. In the UK, a plethora of community-based fire safety initiatives have been introduced over the last 25 years, often led by fire and rescue services, to address this issue. This paper focuses on one such initiative--home safety assessments (HSAs). Cheshire Fire and Rescue Service (in England) implemented a uniquely large-scale HSA intervention. This paper assesses its effectiveness. The impact of HSAs was assessed in relation to three outcomes: accidental dwelling fires (ADFs), ADFs contained and injuries arising from ADFs. A two-period comparison in fire-related rates of incidences in Cheshire between 2002 and 2011 was implemented, using Poisson regression and adjusting for the national temporal trend using a control group comprising the 37 other English non-metropolitan fire-services. Significant reductions were observed in rates of ADFs [incidence rate ratios (IRR): 0.79, 95% confidence interval (CI): 0.74-0.83, P < 0.001, 2002/03-2007/08 versus 2008/09-2010/11] and associated injuries (IRR: 0.49, 95% CI: 0.39-0.60, P < 0.001, 2002/03-2006/07 versus 2007/08-2010/11), but not in the proportion of fires contained to room of origin. There is strong evidence to suggest that the intervention was successful in reducing domestic fires and related injuries.
Willems, C.J.L.; Goense, T.; Maghami Nick, Hamidreza M.; Bruhn, D.F.
This paper analyzes the relation between well spacing and Net Present Value of a Hot Sedimentary Aquifer geothermal doublet. First, a sensitivity analysis is carried out to evaluate the effect of uncertainty of geological and production parameters on the Net present Value. Second a finite-element
Full Text Available This paper proposes a discussion concerning the use of social media-related geographic information in the context of the strategic environmental assessment (SEA of Sardinian Municipal masterplans (MMPs. We show that this kind of information improves, substantially, the SEA process since it provides planners, evaluators, and the local communities with information retrieved from social media that would have not been available otherwise. This information integrates authoritative data collection, which comes from official sources, and enlightens tastes and preferences of the users of services and infrastructure, and their expectations concerning their spatial organization. A methodological approach related to the collection of social media-related geographic information is implemented and discussed with reference to the urban context of the city of Cagliari (Sardinia, Italy. The results are very effective in terms of provision of information, which may possibly increase the spatial knowledge available for planning policy definition and implementation. In this perspective, this kind of information discloses opportunities for building analytical scenarios related to urban and regional planning and it offers useful suggestions for sustainable development based on tourism strategies.
An important factor in evaluating health risk of near-road air pollution is to accurately estimate the traffic-related vehicle emission of air pollutants. Inclusion of traffic parameters such as road length/area, distance to roads, and traffic volume/intensity into models such as...
Berghout, Niels; Cabal, Helena; Gouveia, João Pedro; van den Broek, Machteld; Faaij, André
This paper provides a method to identify drivers, barriers and synergies (DBS) related to the deployment of a CO
Singh, Amardeep; Subhi, Yousif; Nielsen, Marie Krogh
Age-related macular degeneration (AMD) is a degenerative disease of the retina and a leading cause of irreversible vision loss. We investigated the systemic differences in the frequency of T helper (Th) 1 and Th17 cells in patients with non-exudative and exudative AMD and compared to age...
Full Text Available The National Ambulatory Medical Care Survey collects data on office-based physician care from a nationally representative, multistage sampling scheme where the ultimate unit of analysis is a patient-doctor encounter. Patient race, a commonly analyzed demographic, has been subject to a steadily increasing item nonresponse rate. In 1999, race was missing for 17 percent of cases; by 2008, that figure had risen to 33 percent. Over this entire period, single imputation has been the compensation method employed. Recent research at the National Center for Health Statistics evaluated multiply imputing race to better represent the missing-data uncertainty. Given item nonresponse rates of 30 percent or greater, we were surprised to find many estimates’ ratios of multiple-imputation to single-imputation estimated standard errors close to 1. A likely explanation is that the design effects attributable to the complex sample design largely outweigh any increase in variance attributable to missing-data uncertainty.
Full Text Available This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and shocks.
Philippe Deprez; Mario V. Wüthrich
This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and sho...
Dinan, Frank J.; Szczepankiewicz, Steven H.; Carnaham, Melinda; Colvin, Michael T.
The analysis of a Murder case study can be used in general chemistry or nonscience major chemistry courses to teach data handling and analysis in a non-laboratory context. This case study will help students to respond more enthusiastically and with more interest to a set of material placed before them related to a real case rather than…
Kienstra, Natascha; van der Heijden, Peter G.M.
In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study
Doble, Martin J.; Skourup, Henriette; Wadhams, Peter
Data are presented from a survey by airborne scanning laser profilometer and an AUV-mounted, upward looking swath sonar in the spring Beaufort Sea. The air-snow (surface elevation) and water-ice (draft) surfaces were mapped at 1 x 1 m resolution over a 300 x 300 m area. Data were separated...... into level and deformed ice fractions using the surface roughness of the sonar data. The relation (R = d/f) between draft, d, and surface elevation, f, was then examined. Correlation between top and bottom surfaces was essentially zero at full resolution, requiring averaging over patches of at least 11 m...... diameter to constrain the relation largely because of the significant error (similar to 15 cm) of the laser instrument. Level ice points were concentrated in two core regions, corresponding to level FY ice and refrozen leads, with variations in R attributed primarily to positive snow thickness variability...
A case-study collection was developed for NASA's Space Shuttle Program. Using lessons learned and documented by NASA KSC engineers, analysts, and contractors, decades of information related to processing and launching the Space Shuttle was gathered into a single database. The goal was to provide educators with an alternative means to teach real-world engineering processes and to enhance critical thinking, decision making, and problem solving skills. Suggested formats were created to assist both external educators and internal NASA employees to develop and contribute their own case-study reports to share with other educators and students. Via group project, class discussion, or open-ended research format, students will be introduced to the unique decision making process related to Shuttle missions and development. Teaching notes, images, and related documents will be made accessible to the public for presentation of Space Shuttle reports. Lessons investigated included the engine cutoff (ECO) sensor anomaly which occurred during mission STS-114. Students will be presented with general mission infom1ation as well as an explanation of ECO sensors. The project will conclude with the design of a website that allows for distribution of information to the public as well as case-study report submissions from other educators online.
Full Text Available Susceptibility to ankylosing spondylitis (AS is largely genetically determined. JARID1A, JMY and PTGER4 have recently been found to be associated with AS in patients of western European descent. We aim to examine the influence of JARID1A, JMY, and PTGER4 polymorphisms on the susceptibility to and the severity of ankylosing spondylitis in Chinese ethnic majority Han population. This work can lead the clinical doctors to intervene earlier. Blood samples were drawn from 396 AS patients and 404 unrelated healthy controls. Both the AS patients and the controls are Han Chinese. The AS patients are classified based on the severity of the disease. Thirteen tag single nucleotide polymorphisms (tagSNPs in JARID1A, JMY and PTGER4 are selected and genotyped. Frequencies of different genotypes and alleles are analyzed among the different severity AS patients and the controls. The rs2284336 SNP in JARID1A, the rs16876619 and rs16876657 SNPs in JMY are associated with susceptibility of AS. The rs11062357 SNP in JARID1A, the rs2607142 SNP in JMY and rs10440635 in PTGER4 are related to severity of AS. Haplotype analyses indicate PTGER4 is related to susceptibility to AS; JARID1A and JMY are related to severity of AS.
Huang, W Q; Li, L H; Li, Z; Hong, S J
To perform retrospective analysis on 20 dead cases related to heroin abuse, and to provide references for the forensic assessment of correlative cases. Among 20 dead cases related to heroin abuse, general situation, using method of drug, cause of death and result of forensic examination were analyzed by statistical analysis for summarizing the cause of death and pathologic changes. The dead were mostly young adults, with more male than female. The results of histopathological examinations showed non-specific pathological changes. There were four leading causes of death, including acute poisoning of heroin abuse or leakage （13 cases, 65%）, concurrent diseases caused by heroin abuse （3 cases, 15%）, inspiratory asphyxia caused by taking heroin （2 cases, 10%）, and heroin withdrawal syndrome （2 cases, 10%）. The forensic identification on dead related to heroin abuse must base on the comprehensive autopsy, and combine with the qualitative and quantitative analysis of heroin and its metabolites in death and the case information, as well as the scene investigation. Copyright© by the Editorial Department of Journal of Forensic Medicine
The aim here was to use total-reflection X-ray fluorescence (TXRF) to determine the elemental composition (besides Na), and the relative contribution of each element in leaf secretion of the mangrove species Avicennia germinans, grown under contrasting salinities (0-865 mol m(-3) NaCl). Na was determined by conventional atomic absorption spectrometry (AAS). Total secretion was 2.00+/-0.28 mmol m(-2) per day in control plants (at 0 NaCl) and increased progressively up to 46.87+/-7.14 mmol m(-2) per day at 865 mol m(-3) NaCl. Na and Cl accounted for 85.91+/-1.81% of the total secretion in control plants and about 96.32+/-0.30% in salt-treated plants. The excretion of Na exceeded that of Cl when salinity increased and this led to a progressive increase in Na/Cl ratios from 0.46+/-0.02 in control plants up to 2.75+/-0.42 (at 865 mol m(-3) NaCl). Other elements were also secreted in sizeable amounts such as K, S, Ca, Br and Zn. However, the relative importance of these elements, in terms of total secretion, was considerable in control plants (15% of the total secretion) and declined significantly under salinity treatments (total secretion). In conclusion, TXRF has been shown to be a powerful tool allowing quantitative determination of Cl (1.2-13 mmol m(-2) per day), secreted in relatively large quantities, as well as other elements secreted in intermediate (S, Ca and K; 0.07-1.00 mmol m(-2) per day) and in trace quantities (Br and Zn; 0.6-4 µmol m(-2) per day).
Zhang, Yuqiu; Lin, Tong; Jiang, Alice; Zhao, Naiqing; Gong, Lan
Background Sjogren?s syndrome dry eye (SSDE) mainly affects middle-aged women and can negatively affect women?s psychological and social functioning. However, little is known about the correlation between vision-related quality of life (VR-QoL) and psychological status for women with SSDE. We therefore examined VR-QoL and psychological status in two groups of Chinese women: an SSDE group and a non-SSDE group. We also explored the associations between VR-QoL scores, sociodemographic measures, ...
A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…