WorldWideScience

Sample records for four-year efficacy cosmesis

  1. Four-Year Itch

    Science.gov (United States)

    Pierce, Dennis

    2017-01-01

    Ohio's decision to let community colleges award four-year degrees is part of a growing national trend. When this article went to press, more than 90 community colleges across 19 states offered active four-year degree programs. Counting New York's Fashion Institute of Technology, which technically is a community college, but offers degrees as high…

  2. Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Vicini, Frank; Beitsch, Peter; Quiet, Coral; Gittleman, Mark; Zannis, Vic; Fine, Ricky; Whitworth, Pat; Kuerer, Henry; Haffty, Bruce; Keisch, Martin; Lyden, Maureen

    2011-01-01

    Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.

  3. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  4. Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial

    DEFF Research Database (Denmark)

    Dillner, Joakim; Kjaer, Susanne K; Wheeler, Cosette M

    2010-01-01

    To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata).......To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata)....

  5. Evaluating the efficacy of different smoking policies in restaurants and bars in Beijing, China: a four-year follow-up study.

    Science.gov (United States)

    Liu, Ruiling; Jiang, Yuan; Travers, Mark J; Li, Qiang; Hammond, S Katharine

    2014-01-01

    In 2006, the World Health Organization Framework Convention on Tobacco Control became effective in mainland China. In 2007, advocacy on voluntary smoking bans in restaurants was initiated in Beijing, and in 2008 the Beijing government implemented a smoking regulation, requiring big restaurants to prohibit or restrict smoking. To evaluate the efficacy of different smoking policies adopted by Beijing restaurants and bars from 2006 to 2010. The study conducted field observations of patron smoking behavior and monitored fine particulate matter from secondhand smoke (SHS PM) from 91, 85, 94 and 79 Beijing restaurants and bars in 2006, 2007, 2008 and 2010, respectively, during peak-patronage times, with overlaps of venues during each two years. Area nicotine sampling during peak patronage times and servers' personal nicotine sampling during their working shifts were also conducted in 2010. Smoking was nominally prohibited or restricted in 18% of restaurants and bars monitored in 2006, in 11% of venues in 2007, in 83% of venues in 2008, and in 69% of venues in 2010. However, smoking was observed in more than 40% of the nominal nonsmoking venues/sections in 2008 and 2010. The median of observed patron active smoker density (ASD) was 0.24, 0.27, 0.00 and 0.10 active smokers per 100 m3 in 2006, 2007, 2008 and 2010, respectively. The median of SHS PM concentrations was 53, 83, 18 and 27 μg/m3, respectively. In 2010, both the median SHS PM and air nicotine concentrations in designated nonsmoking sections were about 40% of those in designated smoking sections, according to simultaneous sampling in both sections. Servers' personal exposure to air nicotine was quite similar in venues with different nominal smoking policies. In the 15 venues followed from 2006 to 2010, SHS PM concentrations changed randomly from 2006 to 2007, decreased in most venues in 2008, and then increased to some extent in 2010. Voluntary smoking policy is rarely adopted and cannot protect people from SHS

  6. Four years after the JCO criticality accident

    International Nuclear Information System (INIS)

    Sumita, Kenji

    2003-01-01

    It has been about four years since the first criticality accident in Japan. The JCO accident site was not so far from this auditorium. I have been asked to give a short review of important results from the various technical investigations on the accident that have been performed during the past four years. I will also give a short introduction to the changes that have been made in the nuclear safety regulation systems of the Japanese Government. (author)

  7. Cosmesis with bilateral mammoreduction for conservative breast cancer treatment.

    Science.gov (United States)

    Goffman, Thomas E; Schneider, Heather; Hay, Karen; Elkins, David E; Schnarrs, Robert A; Carman, Claire

    2005-01-01

    Over 7 years, 57 women with breast cancer underwent lumpectomy and bilateral mammoreduction. Physical complaints about large or lax breast shape were the predominate rationale. Two patients were immediately lost to follow-up, 55 patients remained and were followed every 3 months for an average of 1.6 years. This is the largest series traceable by computer and literature search. Chart review and patient examination in this retrospective review were utilized as the basis for data within the article. Collated notes from patients' doctors were assessed, as well as documented patient responses to the procedure. Pictures without head/face for identifiers were taken of the patients. Chart data were collected by clinicians, but were reviewed blindly by a statistician. The overall control and cosmesis rates as well as alleviation of heavy breast problems were noted. Only 6% of women had fair to poor cosmetic results; the majority (82%) had excellent to good results. Women with very large breasts or markedly relaxed breast tissue of concern to the patients proved optimal candidates for lumpectomy of cancer and bilateral mammoreduction in the conservative treatment of these cancers. There was a significant reduction in the physical complaints of the patients as well. For women with very pendulous or extremely large breasts, lumpectomy and bilateral mammoreduction may prove to be the optimal course of action.

  8. Four years in / four years out : two university buildings 2000-2008

    Energy Technology Data Exchange (ETDEWEB)

    Lovell, J. [Royal Inst. of British Architects, London (United Kingdom); Washington Univ., St. Louis, MO (United States). Graduate School of Architecture and Urban Design

    2009-07-01

    The University of Cambridge commissioned London-based Allies and Morrison to develop and design 2 new buildings for its Sidgwick campus, England. Two naturally ventilated buildings were completed and occupied in 2004. The Estate Management and Building Service at the University of Cambridge is now reviewing the actual energy performance of both buildings in terms of user comfort. The finding will be compared against original projections of the design team. The review will also compare actual running costs against projected costs and feedback from building users and facilities management. The approach taken by client and design team towards the life-time energy performance of the building was examined in terms of comfort and control and load management. A more complex system of sub-metering is now proposed for all new buildings. Post occupancy feedback data was used to evaluate the successes and failures of the project teams in terms of energy performance, thermal comfort and building management communication four years after completion. This paper noted that if viewed over 30 years, the initial construction budget of a building accounts for only a fraction of the true cost of a building. During its lifetime, primary expenditure will likely to be upon personnel costs; work performance and salaries, staff retention and absenteeism. Therefore, the success of a building must be seen in the context of its whole life and the comfort of its users. 14 refs., 9 figs.

  9. Access to Four-Year Public Colleges and Degree Completion

    OpenAIRE

    Joshua Goodman; Michael Hurwitz; Jonathan Smith

    2015-01-01

    Does access to four-year colleges affect degree completion for students who would otherwise attend two-year colleges? Admission to Georgia’s four-year public sector requires minimum SAT scores. Regression discontinuity estimates show that access to this sector increases four-year college enrollment and college quality, largely by diverting students from two-year colleges. Access substantially increases bachelor’s degree completion rates for these relatively low-skilled students. SAT retaking ...

  10. Scar Pain, Cosmesis and Patient Satisfaction in Laparoscopic and Open Cholecystectomy.

    Science.gov (United States)

    Rafiq, Muhammad Salman; Khan, Mah Muneer

    2016-03-01

    To compare patient-satisfaction, scar-pain and cosmesis between laparoscopic and open-cholecystectomy. Cross-sectional survey. Khyber Teaching Hospital, Peshawar, from August 2012 to May 2014. A total of 400 patients, who had undergone open or laparoscopic cholecystectomy in all units of the Surgical Department, were included. Data was collected on questionnaires given and read to the patients along with counselling and information regarding scar-pain using visual analog score, and satisfaction and cosmesis on a 0 - 10 scale, by a medical professional in the patients' native language. This was done postoperatively on patients' follow-up visits at 1 and 4 weeks. Mean scar pain score at 1 and 4 weeks postoperatively was higher for open-cholecystectomy; 4.96 ±1 and 0.96 ±1, compared to 2.24 ±0.6 and 0, respectively for laparoscopic-cholecystectomy (p < 0.001 and < 0.001). Cosmesis was higher for laparoscopic-group; 8.6 ±1.2 vs. 6.2 ±1.46 for open-cholecystectomy (p < 0.001). Patient-satisfaction was higher for laparoscopic-cholecystectomy; 9.28 ±1.5 vs. 8.32 ±2.3 for open-cholecystectomy (p < 0.001). Mean-cosmesis score was higher for laparoscopic-cholecystectomy for those younger than 40, females and unmarried. Mean patient-satisfaction score was higher for those older than 40 years who had undergone open-cholecystectomy, women who had undergone laparoscopic-cholecystectomy and for unmarried patients who had laparoscopic-cholecystectomy. Overall patient-satisfaction and cosmesis scoring was higher for laparoscopic-cholecystectomy especially among females, unmarried and younger than 40 years. Patients of 40 years and older had greater satisfaction scoring for open-cholecystectomy. Therefore, laparoscopic-cholecystectomy should be favoured in females and unmarried patients and those younger than 40 years.

  11. 2009-2012 State-ANDRA four-year contract

    International Nuclear Information System (INIS)

    2009-01-01

    Signed by State representatives and representatives of the French national Agency for radioactive waste management (ANDRA), this document defines for the four years to come several objectives for the action and the activities of the ANDRA considered as an industrial operator, as an innovating actor possessing a high level research capacity, as a public expert guaranteeing the radioactive waste management solutions, as an information and valorization centre for France and foreign countries. All these objectives are further detailed in appendix

  12. Nuclear Electric - four years on and right on course

    International Nuclear Information System (INIS)

    Hawley, R.

    1994-01-01

    Since the Government's decision, four years ago, to withdraw the nuclear stations from the electricity supply industry privatisation, and place a moratorium on the construction of further nuclear plant, the newly formed nuclear generators, Nuclear Electric and Scottish Nuclear, have risen to the challenge of proving that nuclear power can be as competitive in the United Kingdom as it is elsewhere in the world. The Chief Executive of Nuclear Electric documents changes which have taken place within the organisation since privatisation, presenting data on output and market share and productivity to back his argument. (UK)

  13. Video-EEG recording: a four-year clinical audit.

    LENUS (Irish Health Repository)

    O'Rourke, K

    2012-02-03

    In the setting of a regional neurological unit without an epilepsy surgery service as in our case, video-EEG telemetry is undertaken for three main reasons; to investigate whether frequent paroxysmal events represent seizures when there is clinical doubt, to attempt anatomical localization of partial seizures when standard EEG is unhelpful, and to attempt to confirm that seizures are non-epileptic when this is suspected. A clinical audit of all telemetry performed over a four-year period was carried out, in order to determine the clinical utility of this aspect of the service and to determine means of improving effectiveness in the unit. Analysis of the data showed a high rate of negative studies with no attacks recorded. Of the positive studies approximately 50% showed non-epileptic attacks. Strategies for improving the rate of positive investigations are discussed.

  14. Analyzing the Bitcoin Network: The First Four Years

    Directory of Open Access Journals (Sweden)

    Matthias Lischke

    2016-03-01

    Full Text Available In this explorative study, we examine the economy and transaction network of the decentralized digital currency Bitcoin during the first four years of its existence. The objective is to develop insights into the evolution of the Bitcoin economy during this period. For this, we establish and analyze a novel integrated dataset that enriches data from the Bitcoin blockchain with off-network data such as business categories and geo-locations. Our analyses reveal the major Bitcoin businesses and markets. Our results also give insights on the business distribution by countries and how businesses evolve over time. We also show that there is a gambling network that features many very small transactions. Furthermore, regional differences in the adoption and business distribution could be found. In the network analysis, the small world phenomenon is investigated and confirmed for several subgraphs of the Bitcoin network.

  15. Thirty-four years' experience with biliary atresia in Denmark

    DEFF Research Database (Denmark)

    Kvist, N; Davenport, M

    2011-01-01

    Biliary atresia (BA) is a rare disease in Denmark (population ∼ 5.5 million) and there has been some controversy on how smaller countries should manage such conditions to obtain the best possible outcomes. The aim of this study was to evaluate the efficacy of primary surgery (i. e., Kasai portoen...

  16. Suicide in India: a four year retrospective study.

    Science.gov (United States)

    Mohanty, Sachidananda; Sahu, Geeta; Mohanty, Manoj Kumar; Patnaik, Manju

    2007-05-01

    Suicide is one of the ten leading causes of death in the world, accounting for more than a million deaths annually. The purpose of the study was to identify the risk groups. In the four-year period from January 2000 to December 2003, 588 suicide victims were autopsied. Information was obtained by interviewing the acquaintances of the victim, perusal of hospital records and the autopsy findings. All the cases were analyzed as to sex, age, and methods of suicide, seasonal variation, diurnal variation and other sociological aspects. The present study depicts a suicidal rate of 11.76 per 100,000 population. Males and females were almost equally the sufferers. The largest number of victims were found in the age group of 21-30 years. Hanging and poisoning constituted the two major modes of suicides (63%). Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Indoor incidence was almost double of the outdoor incidence, mostly seen in rainy season (43%) and occurred almost equally during day and night. Financial burden (37%) and marital disharmony (35%) were the principal reasons for the suicide.

  17. FACT. More than four years of blazar monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Dorner, Daniela [Universitaet Wuerzburg (Germany); Collaboration: FACT-Collaboration

    2016-07-01

    Since October 2011, the First G-APD Cherenkov Telescope (FACT) has been collecting more than 5500 hours of physics data. Thanks to the silicon based photosensors (SiPMs, aka G-APDs), observations during bright ambient light like full moon can be carried out without degradation of the sensors. Keeping the gain of the SiPMs stable using an online feedback system, a stable and homogeneous detector performance is achieved. Based on this and an automatic data taking procedure, an unbiased longterm data sample is collected. An automatic quick look analysis provides results shortly after the data are taken allowing to send flare alerts within the same night. The main targets for FACT are the bright TeV blazars Mrk 421 and Mrk 501 which are monitored since January 2012. In addition, several other sources like for example the Crab Nebula, 1ES 1959+650, 1ES 2344+54.1 are observed. In this presentation, the results from more than four years of monitoring are summarized. Several flares from Mrk 501 and Mrk 421 are discussed in the multi-wavelength (MWL) context. Mrk 501 underwent major outbursts in June 2012 and June 2014 during the yearly MWL campaigns. Mrk 421 showed a bright flare in April 2013 where also MWL observations are available. 1ES 1959+650 showed enhanced flux in autumn 2015. Results from these observations are discussed.

  18. Postural changes in dental hygienists. Four-year longitudinal study.

    Science.gov (United States)

    Barry, R M; Woodall, W R; Mahan, J M

    1992-01-01

    Numerous surveys identify the occurrence of musculoskeletal complaints as a concern in dentistry. However, no longitudinal data exist to indicate whether postural changes occur as a result of practicing dental hygiene. The purpose of this preliminary, four-year longitudinal study was to investigate whether any postural changes developed during the hygienists' clinical education and/or during subsequent dental hygiene practice after one and/or two years. It was anticipated that the awkward positions and intense physical demands placed on hygienists might initiate musculoskeletal problems, but that no postural changes would occur over this short period of time. Nine of 10 dental hygienists in the graduating class of 1987 were surveyed for existing musculoskeletal complaints, and the subjects were photographed for a measurement of postural change. Responses from participants indicated an increase in musculoskeletal-related complaints in each of the six areas investigated. The photographic findings indicated that one of the nine hygienists showed an increase in forward head posture, a postural change.

  19. Cognitive Effects of Technology Over Four Years of College

    Directory of Open Access Journals (Sweden)

    Chad N. Loes

    2016-05-01

    Full Text Available Technology permeates higher education, yet less is known about the use of established technologies, such as email and other electronic communication mediums (e.g., discussion boards, listservs for instructional purposes on important student outcomes such as cognitive development. In this study, we use data from the Wabash National Study to estimate the effects of email and other electronic medium use for academic purposes on three measures of cognitive development over four years of college. To investigate this, we regress each measure of cognitive development on email and electronic medium use, while simultaneously controlling for a wide array of potential confounding influences. Net of these influences, we find that email and electronic medium use are positively associated with gains in students’ Need for Cognition. These same technologies fail to have more than a chance influence on students’ critical thinking skills, however. Lastly, email use is associated with gains in the Positive Attitudes Toward Literacy measure for Whites and females, whereas electronic medium use leads to gains in the same outcome for racial and ethnic minorities. While institutions consider newer technologies for instructional purposes, our findings suggest established technologies can play a powerful role in the development of students’ cognitive skills.

  20. Four Years on Orbit at the Moon with LOLA

    Science.gov (United States)

    Smith, D. E.; Zuber, M. T.; Neumann, G. A.; Mazarico, E.; Torrence, M. H.; Lemoine, F. G.

    2013-12-01

    After four years of near-continuous operation at the Moon, the Lunar Orbiter Laser Altimeter (LOLA) continues to collect altimetry, surface roughness, slope and normal reflectance data. Although the instrument is beginning to show the effects of tens of thousands of thermal cycles and the natural process of the aging of the laser transmitters, LOLA continues to acquire data on the sunlit portion of every orbit on all 5 laser beams when below 100-km altitude. LOLA has acquired over 6x10^9 altimeter measurements, all geodetically controlled to the center-of-mass of the Moon with a radial precision of around 10 cm and an accuracy of about 1 meter. The position of the measurements on the lunar surface is primarily limited by the knowledge of the position of the spacecraft in orbit; in the last year the LRO orbit accuracy has improved significantly as a result of the availability of an accurate gravity model of the Moon from the GRAIL Discovery mission. Our present estimate of positional accuracy is less than 10 m rms but is only achievable with a GRAIL gravity model to at least degree and order 600 because of the perturbing gravitational effect of the Moon's surface features. Significant improvements in the global shape and topography have assisted the Lunar Reconnaissance Orbiter Camera (LROC) stereo mapping program, and the identification of potential lunar landing sites for ESA and Russia, particularly in the high-latitude polar regions where 5- and 10-meter average horizontal resolution has been obtained. LOLA's detailed mapping of the polar regions has improved the delineation of permanently-shadowed areas and assisted in the understanding of the LEND neutron data and its relationship to surface slopes. Recently, a global, calibrated LOLA normal albedo dataset at 1064 nm has been developed and is being combined with analysis and modeling by the Diviner team for the identification of the coldest locations in the polar regions.

  1. Five-Year Outcomes, Cosmesis, and Toxicity With 3-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Rodríguez, Núria; Sanz, Xavier; Dengra, Josefa; Foro, Palmira; Membrive, Ismael; Reig, Anna; Quera, Jaume; Fernández-Velilla, Enric; Pera, Óscar; Lio, Jackson; Lozano, Joan; Algara, Manuel

    2013-01-01

    Purpose: To report the interim results from a study comparing the efficacy, toxicity, and cosmesis of breast-conserving treatment with accelerated partial breast irradiation (APBI) or whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy (3D-CRT). Methods and Materials: 102 patients with early-stage breast cancer who underwent breast-conserving surgery were randomized to receive either WBI (n=51) or APBI (n=51). In the WBI arm, 48 Gy was delivered to the whole breast in daily fractions of 2 Gy, with or without additional 10 Gy to the tumor bed. In the APBI arm, patients received 37.5 Gy in 3.75 Gy per fraction delivered twice daily. Toxicity results were scored according to the Radiation Therapy Oncology Group Common Toxicity Criteria. Skin elasticity was measured using a dedicated device (Multi-Skin-Test-Center MC-750-B2, CKelectronic-GmbH). Cosmetic results were assessed by the physician and the patients as good/excellent, regular, or poor. Results: The median follow-up time was 5 years. No local recurrences were observed. No significant differences in survival rates were found. APBI reduced acute side effects and radiation doses to healthy tissues compared with WBI (P 75% of patients in the APBI arm had excellent or good cosmesis, and these outcomes appear to be stable over time. The percentage of patients with excellent/good cosmetic results was similar in both groups. Conclusions: APBI delivered by 3D-CRT to the tumor bed for a selected group of early-stage breast cancer patients produces 5-year results similar to those achieved with conventional WBI

  2. Cerebral vein thrombosis in a four year old with Behçet's disease.

    Science.gov (United States)

    Hacihamdioglu, Duygu Ovunc; Demiriz, Murat; Sobaci, Gungor; Kocaoglu, Murat; Demirkaya, Erkan; Gok, Faysal

    2014-01-01

    Behçet's disease (BD) is a multisystem disorder. The main pathology in BD is vasculitis that involves arteries and veins of all calibers. Central nervous system involvement occurs in 5-10% of patients. Increased morbidity and mortality is rarely observed in children. The mean age at onset in pediatric BD is approximately 7 years. Neurologic involvement in BD is usually observed after 3-6 years. We report the case of a four-year-old Turkish boy with BD with sagittal sinus thrombosis treated with infliximab. The patient presented papilledema without neurologic signs. Although long-term efficacy evaluations are needed in this case, infliximab therapy may be a good option in childhood BD with refractory sinus thrombosis. This is the youngest case of BD with sagittal sinus thrombosis reported so far. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Strategic laparoscopic surgery for improved cosmesis in general and bariatric surgery: analysis of initial 127 cases.

    Science.gov (United States)

    Nguyen, Ninh T; Smith, Brian R; Reavis, Kevin M; Nguyen, Xuan-Mai T; Nguyen, Brian; Stamos, Michael J

    2012-05-01

    Strategic laparoscopic surgery for improved cosmesis (SLIC) is a less invasive surgical approach than conventional laparoscopic surgery. The aim of this study was to examine the feasibility and safety of SLIC for general and bariatric surgical operations. Additionally, we compared the outcomes of laparoscopic sleeve gastrectomy with those performed by the SLIC technique. In an academic medical center, from April 2008 to December 2010, 127 patients underwent SLIC procedures: 38 SLIC cholecystectomy, 56 SLIC gastric banding, 26 SLIC sleeve gastrectomy, 1 SLIC gastrojejunostomy, and 6 SLIC appendectomy. SLIC sleeve gastrectomy was initially performed through a single 4.0-cm supraumbilical incision with extraction of the gastric specimen through the same incision. The technique evolved to laparoscopic incisions that were all placed within the umbilicus and suprapubic region. There were no 30-day or in-hospital mortalities or 30-day re-admissions or re-operations. For SLIC cholecystectomy, gastric banding, appendectomy, and gastrojejunostomy, conversion to conventional laparoscopy occurred in 5.3%, 5.4%, 0%, and 0%, respectively; there were no major or minor postoperative complications. For SLIC sleeve gastrectomy, there were no significant differences in mean operative time and length of hospital stay compared with laparoscopic sleeve gastrectomy; 1 (3.8%) of 26 SLIC patients required conversion to five-port laparoscopy. There were no major complications. Minor complications occurred in 7.7% in the SLIC sleeve group versus 8.3% in the laparoscopic sleeve group. SLIC in general and bariatric operations is technically feasible, safe, and associated with a low rate of conversion to conventional laparoscopy. Compared with laparoscopic sleeve gastrectomy, SLIC sleeve gastrectomy can be performed without a prolonged operative time with comparable perioperative outcomes.

  4. A spike at benefit exhaustion: Still possible after four years of unemployment

    DEFF Research Database (Denmark)

    Lyk-Jensen, Stéphanie; Weatherall, Cecilie Dohlmann

    European policymakers wonder whether the long-term unemployed can still find jobs if the benefit period is shortened. We investigate this question by analysing how long-term unemployed react to the threat of running out of unemployment insurance (UI) after receiving it for almost four years....... The empirical analysis is based on very precise administrative records of men’s unemployment spells. To identify the effect of UI exhaustion, we exploit a legislative change in the duration of benefits that progressively reduced UI entitlement from five to four years. Our results show a spike 3-6 months before...

  5. The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conservation therapy

    International Nuclear Information System (INIS)

    Markiewicz, Deborah A.; Schultz, Delray J.; Haas, Jonathan A.; Harris, Eleanor E. R.; Fox, Kevin R.; Glick, John H.; Solin, Lawrence J.

    1996-01-01

    Purpose: Chemotherapy plays an increasingly important role in the treatment of both node-negative and node-positive breast cancer patients, but the optimal sequencing of chemotherapy and radiation therapy is not well established. The purpose of this study is to evaluate the interaction of sequence and type of chemotherapy and hormonal therapy given with radiation therapy on the cosmetic outcome and the incidence of complications of Stage I and II breast cancer patients treated with breast-conserving therapy. Methods and Materials: The records of 1053 Stage I and II breast cancer patients treated with curative intent with breast-conserving surgery, axillary dissection, and radiation therapy between 1977-1991 were reviewed. Median follow-up after treatment was 6.7 years. Two hundred fourteen patients received chemotherapy alone, 141 patients received hormonal therapy alone, 86 patients received both, and 612 patients received no adjuvant therapy. Patients who received chemotherapy ± hormonal therapy were grouped according to sequence of chemotherapy: (a) concurrent = concurrent chemotherapy with radiation therapy followed by chemotherapy; (b) sequential = radiation followed by chemotherapy or chemotherapy followed by radiation; and (c) sandwich = chemotherapy followed by concurrent chemotherapy and radiation followed by chemotherapy. Compared to node negative patients, node-positive patients more commonly received chemotherapy (77 vs. 9%, p < 0.0001) and/or hormonal therapy (40 vs. 14%, p < 0.0001). Among patients who received chemotherapy, the majority (243 patients) received concurrent chemotherapy and radiation therapy with two cycles of cytoxan and 5-fluorouracil (5-FU) administered during radiation followed by six cycles of chemotherapy with cytoxan, 5-fluorouracil and either methotrexate(CMF) or doxorubicin(CAF). For analysis of cosmesis, patients included were relapse free with 3 years minimum follow-up. Results: The use of chemotherapy had an adverse effect

  6. Four years experience with filtration systems in commercial nurseries for eliminating Phytophthora species from recirculation water

    Science.gov (United States)

    T. Ufer; M. Posner; H.-P. Wessels; S. Wagner; K. Kaminski; T. Brand; Werres S.

    2008-01-01

    In a four year project, three different filtration systems were tested under commercial nursery conditions to eliminate Phytophthora spp. from irrigation water. Five nurseries were involved in the project. Slow sand filtration systems were tested in three nurseries. In the fourth nursery, a filtration system with lava grains (Shieer® Bio filtration)...

  7. A Critical Reflection: Foster Care Youth Experiences at a Four Year Postsecondary Institution

    Science.gov (United States)

    Greer, Renada D.

    2016-01-01

    Foster care youth face significant challenges to postsecondary educational success, especially while enrolled at four-year institutions. Foster care youth are absent of family support that their non-foster peers receive throughout the college experience. Without family support, foster care youth encounter greater challenges to persevere through…

  8. Building a four year post-secondary curriculum in educational science and technology

    NARCIS (Netherlands)

    Plomp, T.; Verhagen, Pleunes Willem

    1982-01-01

    This report begins by providing background information on educational technology in the Netherlands, differences between a four-year program in the Netherlands and undergraduate programs in the United States, and the structure of Dutch university programs. The need for a Department of Educational

  9. Four Years of Reports of Alcohol-Related Harm to Pediatricians in the Netherlands

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van Zanten, Eva; van der Lely, Nicolaas

    2015-01-01

    Over the four years of the study, the number of adolescents treated with alcohol-related harm increased significantly (from 297 in 2007 to 684 in 2010), up to a total of 1,616. The dominant reason for hospitalization was “alcohol intoxication” (in total 1,350; 88% of all cases). The gender ratio did

  10. Four-Year Results of a Youth Smoking Prevention Program Using Assertiveness Training.

    Science.gov (United States)

    Del Greco, Linda; And Others

    1986-01-01

    Seventh graders (N=161) participated in health education classes consisting of either an innovative smoking education program, the program plus assertiveness training, or a traditional smoking education program. Data collected four years later revealed no significant differences in smoking behavior, changes in assertion, or sex differences among…

  11. Enhancing Software Engineering Education through Open Source Projects: Four Years of Students' Perspectives

    NARCIS (Netherlands)

    Papadopoulos, P.M.; Stamelos, I.G.; Meiszner, A.

    2015-01-01

    This paper presents the results after four years of running of an instructional method that utilizes free/libre open source software (FLOSS) projects as tools for teaching software engineering in formal education. In the last four academic years, a total of 408 juniors majoring in Informatics (in a

  12. Development of health over four years among middle-aged and older Europeans

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen

    2013-01-01

    Older adults in Eastern and Central European countries have a higher risk of developing poor self-rated health over four years. The same geographical pattern is seen for a higher risk of developing hypertension and diabetes. Low educational level significantly increases the risk of developing poor...... self-perceived health....

  13. Positive Youth Development through an Outdoor Physical Activity Programme: Evidence from a Four-Year Evaluation

    Science.gov (United States)

    Armour, Kathleen; Sandford, Rachel

    2013-01-01

    In 2006, Sandford, Armour and Warmington undertook a comprehensive review of the literature on the role of physical activity/sport and physical education in promoting positive development for disaffected youth. This paper revisits the findings of the literature review in light of data from a four-year evaluation of one corporate-sponsored physical…

  14. Analyzing Four-Year Public University and Two-Year College Graduation Rates

    Science.gov (United States)

    Ober, David R.; Beekman, John A.; Pierce, Rebecca L.

    2018-01-01

    This paper examines the graduation rates between 2000 and 2015 of United States colleges and universities at the national, state, and institutional levels. This research focuses on two-year and four-year programs. Rates are investigated longitudinally along with variables that distinguish between public/private institutions, percentages of…

  15. The Pros and Cons of Two-Year Versus Four-Year Degrees.

    Science.gov (United States)

    Urbaniak, Anthony

    1985-01-01

    Reports results of a research survey conducted to determine what differences (job titles, income, relevance of courses, satisfaction, suitability) exist between two-year (Associate of Science) graduates and four-year (Bachelor of Science) graduates in business. Statistical tables are included. (CT)

  16. The differential prevalence of obesity and related behaviors in two vs. four-year colleges.

    Science.gov (United States)

    Laska, Melissa Nelson; Pasch, Keryn E.; Lust, Katherine; Story, Mary; Ehlinger, Ed

    2012-01-01

    The objective of this study was to determine whether obesity prevalence and weight-related behaviors (e.g., diet, physical activity) differ among students enrolled in two-year community/technical colleges and those attending four-year colleges/universities. This information could inform the development of intervention strategies. Through an existing surveillance system of Minnesota post-secondary education institutions, survey data were collected from 16,539 students from 27 campuses (14 two-year college campuses, 13 four-year college/university campuses; 2007-2008), including self-reported physical activity, media use, dietary patterns, weight control behaviors, height and weight. Unadjusted analyses indicated that students enrolled in two-year colleges, particularly females, had a higher prevalence of overweight/obesity, lower levels of physical activity, more television viewing, higher intakes of soda, fast food, and diet pills compared to students attending four-year colleges (pstudents there were fewer differences between two-year and four-year colleges. Controlling for sociodemographic factors (e.g., race/ethnicity, age), most disparities in prevalence estimates remained, though many were attenuated. Overall, few young adults engage in weight-related behaviors consistent with national recommendations. Two-year college students may represent a particularly at-risk group. Disparities between two- and four-year college students exist beyond the sociodemographic differences in these populations. Effective weight-related interventions are needed for young adults, particularly females attending two-year colleges and all males attending post-secondary institutions. PMID:20966910

  17. The Influence of Wealth and Race in Four-Year College Attendance

    OpenAIRE

    Su Jin Jez

    2008-01-01

    College is increasingly essential for economic and social mobility. Current research devotes significant attention to race and socioeconomic factors in college access. Yet wealth’s role, as differentiated from income, is largely unexplored. Utilizing a nationally representative dataset, this study analyzes the role of wealth among students who attend four-year colleges. The hypothesis that wealth matters through the provision of differential habitus, social capital, and cultural capital tha...

  18. Four-year-BS-position-paper.pdf | misc docs | academy | Indian ...

    Indian Academy of Sciences (India)

    Home; academy; misc docs; Four-year-BS-position-paper.pdf. 404! error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year meeting of ...

  19. Post-fire hydrologic response in Central Portugal. A four years study at microplot scale.

    Science.gov (United States)

    Vieira, Diana; Malvar, Maruxa; Martins, Martinho; Machado, Ana; Nunes, João; Keizer, Jacob

    2014-05-01

    Wildfires are a natural phenomenon in regions with a Mediterranean-type climate. However, their present-day widespread occurrence in southern Europe is unprecedented and strongly reflects human activity such as ignition, land-use changes, land abandonment and introduction of highly flammable plantations. Besides wildfires, post-fire management practices such as plowing, terracing, clearcutting and logging should also be considered, since their occurrence is getting increasingly common. And, in a long-term period these practices seem to be executed intercalated with repeated fire occurrences in the same site, sharing the impacts together with fire in an escalated degradational effect. In this sense, the work presented here concerns four years of runoff and erosion data at microplot scale after the wildfire, comparing different land management practices that occurred before the fire. Preliminary results indicate that in four years of monitoring, runoff is constantly higher in plowed sites than in the unplowed ones, with the exception of the first year. Regarding soil losses the plowed plots present always higher sediment rates than the unplowed ones. The comparison between two unplowed sites with different land uses, indicate higher runoff and erosion risk for pine comparatively to the eucalypt ones, however the reduced soil depth in the first can have an important role in these differences. Following these facts, the aim of the present work is to answer the following research questions: i) Do these four years of observations fit with the window of disturbance model presented by Prosser and Williams (1998). or the alternative version by Wittenberg and Inbar (2009)?; ii) Does pre-fire disturbances (wildfire, land use changes and land management practices) still have repercussions after wildfire?; In what sense does four years of intensive monitoring provides that one year couldn't provide?

  20. Habitual active transport, TV viewing and weight gain: a four year follow-up study.

    Science.gov (United States)

    Ding, Ding; Sugiyama, Takemi; Owen, Neville

    2012-01-01

    To examine the associations of TV viewing time and domain-specific physical activity with weight change; to determine whether domain-specific physical activity moderates the potential association of TV viewing time with weight change. We used four-year longitudinal data (baseline: 2003-2004, follow-up: 2007-2008) on 969 adults from selected neighborhoods in Adelaide, Australia (Age: 48.6 ± 10.6 years, 61% females). Mixed models examined four-year weight change as the dependent variable, with TV viewing time, habitual transport and past week domain-specific physical activity at baseline as independent variables. On average, participants gained 1.6 kg over four years. TV viewing time at baseline was positively associated with weight gain at follow-up. Each additional hour of TV viewing was associated with 0.24-0.27 kg of extra weight gain. This relationship was not moderated by recent recall of transport, leisure-time, and occupational physical activity, but was moderated by habitual transport: an additional hour of TV viewing time at baseline was significantly associated with an extra weight gain of 0.65 kg at follow-up among those who were inactive in everyday transport; TV time was not significantly associated with weight change among those who were regularly active in transport. Habitual active transport may protect adults against risk of weight gain associated with prolonged TV viewing time. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. LOCAL INTERSTELLAR HYDROGEN'S DISAPPEARANCE AT 1 AU: FOUR YEARS OF IBEX IN THE RISING SOLAR CYCLE

    International Nuclear Information System (INIS)

    Saul, Lukas; Rodríguez, Diego; Scheer, Juergen; Wurz, Peter; Bzowski, Maciej; Kubiak, Marzena; Sokół, Justina; Fuselier, Stephen; McComas, Dave; Möbius, Eberhard

    2013-01-01

    NASA's Interstellar Boundary Explorer (IBEX) mission has recently opened a new window on the interstellar medium (ISM) by imaging neutral atoms. One ''bright'' feature in the sky is the interstellar wind flowing into the solar system. Composed of remnants of stellar explosions as well as primordial gas and plasma, the ISM is by no means uniform. The interaction of the local ISM with the solar wind shapes our heliospheric environment with hydrogen being the dominant component of the very local ISM. In this paper, we report on direct sampling of the neutral hydrogen of the local ISM over four years of IBEX observations. The hydrogen wind observed at 1 AU has decreased and nearly disappeared as the solar activity has increased over the last four years; the signal at 1 AU has dropped off in 2012 by a factor of ∼8 to near background levels. The longitudinal offset has also increased with time presumably due to greater radiation pressure deflecting the interstellar wind. We present longitudinal and latitudinal arrival direction measurements of the bulk flow as measured over four years beginning at near solar minimum conditions. The H distribution we observe at 1 AU is expected to be different from that outside the heliopause due to ionization, photon pressure, gravity, and filtration by interactions with heliospheric plasma populations. These observations provide an important benchmark for modeling of the global heliospheric interaction. Based on these observations we suggest a further course of scientific action to observe neutral hydrogen over a full solar cycle with IBEX.

  2. Preservation of cosmesis with low complication risk after conservative surgery and radiotherapy for ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    Mills, Janete M.; Schultz, Delray J.; Solin, Lawrence J.

    1997-01-01

    Purpose: Although the clinical outcome after treatment of ductal carcinoma in situ (DCIS) using breast-conservation surgery and radiation therapy has been well documented, little data has been reported on cosmetic outcome or treatment complications. Therefore, the present study was performed to evaluate cosmesis and complications after breast-conservation treatment for DCIS and to analyze various factors that might affect cosmesis and predispose to complications. Methods and Materials: The records of 90 patients who were alive without evidence of disease with a 3-year minimum follow-up were evaluated for cosmetic results and treatment complications following breast-conservation surgery and radiation therapy for DCIS. Complete gross excision of the primary tumor had been performed in all patients. Additionally, 24 patients had undergone an axillary lymph node dissection in the earlier years of the study. The majority of the patients had received 50-50.4 Gy to the whole breast followed by an electron boost for a total dose of 60-66 Gy. Results: The cosmetic results of 90 evaluable patients at 3 years were: excellent in 69 (77%), good in 19 (21%), and fair in 2 (2%). The cosmetic results of 64 evaluable patients at 5 years were: excellent in 46 (72%), good in 16 (25%), and fair in 2 (3%). Factors associated with worse cosmetic results were an increased volume of tissue excised (>70 cm 3 ) and a negative ipsilateral breast biopsy after radiotherapy. Complications in the 24 patients with an axillary dissection were: arm edema (n = 6), cellulitis of the arm (n = 5), and axillary vein thrombosis (n = 1). Complications in the 66 patients without an axillary dissection were: cellulitis of the arm (n = 1) and cellulitis of the breast (n = 1). Discussion: Breast-conservation surgery followed by radiation therapy achieved excellent or good cosmetic results in 98 and 97% of patients at 3 years and 5 years, respectively. Complications were associated primarily with axillary

  3. Dermatitis and lymphadenitis resembling juvenile cellulitis in a four-year-old dog.

    Science.gov (United States)

    Neuber, A E; van den Broek, A H M; Brownstein, D; Thoday, K L; Hill, P B

    2004-05-01

    A four-year-old, entire male toy poodle was presented with a two-and-a-half-week history of ocular discharge progressing to periorbital alopecia, depigmentation, alopecia and ulceration around the muzzle. There was also a haemorrhagic discharge from the ears, pyrexia, lethargy and generalised lymphadenopathy. The clinical, cytological, bacteriological and histopathological findings were consistent with a diagnosis of dermatitis resembling juvenile cellulitis in an adult dog. Glucocorticoid therapy led to rapid resolution of the clinical signs and the dog has remained in remission for two years after cessation of treatment.

  4. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    Science.gov (United States)

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  5. Report on the green paper on energy. Four years of European initiatives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    In December 2000, the European Commission adopted a Green Paper on European Union energy policy. This brochure takes stock of the action undertaken in the following areas over the last four years:managing demand, diversifying internal energy sources,developing the internal energy market and the security of external supply. It presents: the Green Paper stakes, the progress made, the four political challenges, managing demand, diversifying European sources, the streamlined internal energy market, controlling external supply, future prospects for the Union, legislative developments and ten possibilities for economical energy use. (A.L.B.)

  6. A four-year surveillance program for detection of Plasmodium falciparum chloroquine resistance in Honduras

    Directory of Open Access Journals (Sweden)

    Gustavo A Fontecha

    2014-07-01

    Full Text Available Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt “CVMNK” genotype in codons 72-76.

  7. A four-year surveillance program for detection of Plasmodium falciparum chloroquine resistance in Honduras.

    Science.gov (United States)

    Fontecha, Gustavo A; Sanchez, Ana L; Mendoza, Meisy; Banegas, Engels; Mejía-Torres, Rosa E

    2014-07-01

    Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt "CVMNK" genotype in codons 72-76.

  8. Four Years of Real-Time GRB Followup by BOOTES-1B (2005–2008

    Directory of Open Access Journals (Sweden)

    Martin Jelínek

    2010-01-01

    Full Text Available Four years of BOOTES-1B GRB follow-up history are summarised for the first time in the form of a table. The successfully followed events are described case by case. Further, the data are used to show the GRB trigger rate in Spain on a per-year basis, resulting in an estimate of 18 triggers and about 51 hours of telescope time per year for real-time triggers. These numbers grow to about 22 triggers and 77 hours per year if we include also the GRBs observable within 2 hours after the trigger.

  9. Report on the green paper on energy. Four years of European initiatives

    International Nuclear Information System (INIS)

    2005-01-01

    In December 2000, the European Commission adopted a Green Paper on European Union energy policy. This brochure takes stock of the action undertaken in the following areas over the last four years:managing demand, diversifying internal energy sources,developing the internal energy market and the security of external supply. It presents: the Green Paper stakes, the progress made, the four political challenges, managing demand, diversifying European sources, the streamlined internal energy market, controlling external supply, future prospects for the Union, legislative developments and ten possibilities for economical energy use. (A.L.B.)

  10. A FOUR-YEAR CHRONOLOGY WITH NATIONAL TEAM BOXING IN CANADA

    Directory of Open Access Journals (Sweden)

    Robert J. Schinke

    2007-10-01

    Full Text Available Applied sport psychologists tend to begin their consulting relationships with national teams having formalized skills, and often, limited contextual and sport- specific understanding. The present report overviews the first four years of a long-term consulting relationship one practitioner developed with the Canadian National Boxing Team. From the vantage of an applied sport psychology consultant, I overview how a limited consulting role expanded into increased responsibilities and opportunities. Suggestions are provided for the aspiring sport psychology consultant interested in working with athletes and coaches within the combative sport of elite amateur boxing

  11. Describing medical student curiosity across a four year curriculum: An exploratory study.

    Science.gov (United States)

    Sternszus, Robert; Saroyan, Alenoush; Steinert, Yvonne

    2017-04-01

    Intellectual curiosity can be defined as a desire for knowledge that leads to exploratory behavior and consists of an inherent and stable trait (i.e. trait curiosity) and a variable context-dependent state (i.e. state curiosity). Although intellectual curiosity has been considered an important aspect of medical education and practice, its relationship to medical education has not been empirically investigated. The purpose of this exploratory study was to describe medical students' intellectual curiosity across a four-year undergraduate program. We employed a cross-sectional design in which medical students, across a four-year undergraduate program at McGill University, completed the Melbourne Curiosity Inventory as a measure of their state and trait intellectual curiosity. A Mixed Models ANOVA was used to compare students across year of training. Four hundred and two out of 751 students completed the inventory (53.5%). Trait curiosity was significantly higher than state curiosity (M = 64.5, SD = 8.5 versus M = 58.5, SD = 11.6) overall, and within each year of training. This study is the first to describe state and trait intellectual curiosity in undergraduate medical education. Findings suggest that medical students' state curiosity may not be optimally supported and highlight avenues for further research.

  12. Evolution of upper limb kinematics four years after subacute robot-assisted rehabilitation in stroke patients.

    Science.gov (United States)

    Pila, Ophélie; Duret, Christophe; Gracies, Jean-Michel; Francisco, Gerard E; Bayle, Nicolas; Hutin, Émilie

    2018-04-25

    To assess functional status and robot-based kinematic measures four years after subacute robot-assisted rehabilitation in hemiparesis. Twenty-two patients with stroke-induced hemiparesis underwent a ≥3-month upper limb combined program of robot-assisted and occupational therapy from two months post-stroke, and received community-based therapy after discharge. Four years later, 19 (86%) participated in this follow-up study. Assessments 2, 5 and 54 months post-stroke included Fugl-Meyer (FM), Modified Frenchay Scale (MFS, at Month 54) and robot-based kinematic measures of targeting tasks in three directions, north, paretic and non-paretic: distance covered, velocity, accuracy (root mean square (RMS) error from straight line) and smoothness (number of velocity peaks; upward changes in accuracy and smoothness represent worsening). Analysis was stratified by FM score at two months: ≥17 (Group 1) or Kinematic changes (three directions pooled) were: distance -1[-17;2]% (ns); velocity, -8[-32;28]% (ns); accuracy, +6[-13;98]% (ns); smoothness, +44[-6;126]% (p robot-assisted upper limb training during subacute post-stroke phase, movement kinematics deteriorated despite community-based therapy, especially in more severely impaired patients. EudraCT 2016-005121-36. Registration: 2016-12-20. Date of enrolment of the first participant to the trial: 2009-11-24.

  13. Dutch healthcare professionals inadequately perceived if three- and four-year-old preschool children were overweight.

    Science.gov (United States)

    Bocca, Gianni; Corpeleijn, Eva; Broens, Jasper; Stolk, Ronald P; Sauer, Pieter J

    2016-10-01

    We studied whether healthcare professionals adequately perceived if preschool children were overweight and whether this was influenced by their own body mass index (BMI). We sent 716 Dutch healthcare professionals questionnaires containing seven pictures and seven sketches of three- and four-year-old children showing body weights from underweight to morbidly obese. The professionals rated the pictures on a five-point scale from too heavy to too light and chose the sketch that they felt best depicted the child's body shape. They also reported their own height and weight and their BMI was calculated. Of the 716 questionnaires, 346 (48.3%) were returned with complete information and analysed. Healthcare professionals mostly chose sketches that showed children as being lighter than they really were. Depending on their own BMI group, the overweight child was perceived as having a normal weight by 74-79% of the healthcare professionals. The obese children were rated correctly by 44-52% of the professionals, but 14-15% said their weight was normal. The morbidly obese child was adequately assessed by 93-98% of the professionals. Healthcare professionals inadequately perceived whether three- and four-year-old children were overweight and this may have hindered early interventions, leading to overweight children becoming overweight adolescents. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens

    Directory of Open Access Journals (Sweden)

    Orhiosefe Omigie

    2009-08-01

    Full Text Available Orhiosefe Omigie, Lawrence Okoror, Patience Umolu, Gladys IkuuhDepartment of Microbiology, Ambrose Alli University, Ekpoma, NigeriaAbstract: A four-year prospective study was carried out to determine the incidence and rate of development of resistance by common urinary tract infection (UTI pathogens to quinolone antimicrobial agents. Results show that there is high intrinsic resistance to the quinolones among strains of Pseudomonas aeruginosa (43.4%, Escherichia coli (26.3%, and Proteus spp. (17.1%. Over four years, rising rates of resistance were observed in P. aeruginosa (14.6% increase, Staphylococcus aureus (9.8%, and E. coli (9.7%. The highest potency was exhibited by ciprofloxacin (91.2%, levofloxacin (89.2%, and moxifloxacin (85.1%, while there were high rates of resistance to nalidixic acid (51.7% and pefloxacin (29.0%. Coliforms, particularly E. coli (>45%, remain the most prevalent causative agents of UTI while females within the age range of 20–50 years were most vulnerable to UTI.Keywords: UTI, microorganisms, antibiotics, resistance

  15. IPS Empress inlays and onlays after four years--a clinical study.

    Science.gov (United States)

    Krämer, N; Frankenberger, R; Pelka, M; Petschelt, A

    1999-07-01

    Ceramic inlays are used as esthetic alternatives to amalgam and other metallic materials for the restoration of badly damaged teeth. However, only limited clinical data are available regarding adhesive inlays and onlays with proximal margins located in dentine. In a prospective, controlled clinical study, the performance of IPS Empress inlays and onlays with cuspal replacements and margins below the amelocemental junction was examined. Ninety-six IPS Empress fillings were placed in 34 patients by six clinicians. The restorations were luted with four different composite systems. The dentin bonding system Syntac Classic was used in addition to the acid-etch-technique. At baseline and after 6 months, one, two and four years after placement the restorations were assessed by two calibrated investigators using modified USPHS codes and criteria. A representative sample of the restorations was investigated by scanning electron microscopy to evaluate wear. Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier). Four inlays had suffered cohesive bulk fractures and three teeth required endodontic treatment. After four years in clinical service, significant deterioration (Friedman 2-way Anova; p Empress inlays and onlays bonded with the dentin bonding system Syntac Classic were found to have a 7% failure rate with 79% of the remaining restorations having marginal deficiencies.

  16. Overweight among Four-Year-Old Children in Relation to Early Growth Characteristics and Socioeconomic Factors

    Directory of Open Access Journals (Sweden)

    Jörgen Thorn

    2010-01-01

    Full Text Available Objectives. To assess early growth characteristics and socioeconomic factors of children in relation to body mass index (BMI and presence of overweight among four-year-old children. Methods. Two Child Health Centres (CHC participated in the study. They were selected to obtain two populations of children featuring divergent socio-economic characteristics. Growth data registered at the CHCs from birth to the 4-year check-up were recovered. Overweight was defined by the BMI cut-offs established by IOTF. BMI values expressed as BMI standard deviation score (BMISDS were used for analysis. Results. At the 4-year check-up, the BMISDS and the proportion of children with overweight (including the obese were significantly higher in the district with lower socio-economic status. High BMI at birth and low socio-economic status of the population in the CHC-district were shown to be independent determinants for overweight and BMISDS at four years of age. Conclusions. More research is needed to understand the mechanisms and how intervention programs should be designed in order to prevent the development of overweight and obesity in children.

  17. An evaluation of vocational high schools in Indonesia: A comparison between four-year and three-year programs

    Directory of Open Access Journals (Sweden)

    Soenarto Soenarto

    2017-12-01

    Full Text Available The research aimed to gain insights into the quality of four-year program vocational high school (VHS in Indonesia compared to four-year program VHS. This research was conducted based on the school graduate standard, business sector and industrial sector (or Dunia Usaha dan Dunia Industri (DUDI – or the performance of the graduates and alumni (the graduates’ satisfaction. The research was conducted using Discrepancy Evaluation Model using 16 VHSs (eight four-year program VHSs and eight three-year program VHSs. The result shows that from the standpoint of the school, the graduates of the four-year program VHS are higher in quality than those of the three-year program VHS. The four-year program VHS graduates are more qualified in seven aspects: teamwork, discipline, tenacity, theoretical knowledge, confidence, creativity, and leadership. Meanwhile, using DUDI standpoint, the four-year program VHS graduates are also higher in quality than the three-year program VHS graduates. In addition, the four-year program VHS graduates are better in the quality of their discipline, tenacity, theoretical knowledge, practical skills, confidence, carefulness, creativity, and leadership. The four-year program VHS graduates have a higher level of satisfaction in terms of income than the three-year program VHS graduates. The higher quality of the four-year program VHS graduates has resulted from longer duration of the internship program (PKL that provides them with reliable experience and skills concerning work-related problem-solving activities.

  18. EVOLUTION OF THE ROMANIAN CAPITAL MARKET IN THE LAST FOUR YEARS

    Directory of Open Access Journals (Sweden)

    SORIN CLAUDIU RADU

    2012-10-01

    Full Text Available The effects of the great recession have also been felt in Romania and the domestic capital market, component of the European financial market, has suffered from the negative evolutions of the world’s economy, fallowing the downward trend of the external markets since the crisis started. Considering the economic situation as of 2008, the Romanian capital market was faced with a small number of transactions, a decreased stock capitalization and low level of credibility, massive diminishment of liquidities, capital withdrawal on the financial market and significant depreciation of stock exchange indicators. This paper aims at presenting the evolution of the capital market in Romania for the last four years, pinpointing several strategic directions that are meant to support the domestic stock exchange and place them in the European stock exchanges top.

  19. Paediatric Stroke: A Rare Presentation of Iron Deficiency Anemia in a Four Year Old Child.

    Science.gov (United States)

    Subedi, K; Koirala, S; Basnet, R; Poudel, A

    Paediatric stroke is an uncommon syndrome with even lesser annual incidence rates of arterial ischemic stroke in infants and children. In children the diagnosis of stroke is frequently delayed or missed. This is due to subtle and nonspecific clinical presentations, a complicated differential diagnosis and a lack of awareness by physicians and also delay in the seeking of medical attention as in our case. We report you a rare case of a four year old child from remote Nepal who presented to our Out Patient Department after a long gap of around four months after the sudden onset of loss of consciousness and decreased movement of right limbs who after detailed history examination and lab investigations and imaging revealed ischemic stroke due to iron deficiency anemia.

  20. The Nuclear Organization and Management Analysis Concept methodology: Four years later

    International Nuclear Information System (INIS)

    Haber, S.B.; Shurberg, D.A.; Barriere, M.T.; Hall, R.E.

    1992-01-01

    The Nuclear Organization and Management Analysis Concept was first presented at the IEEE Human Factors meeting in Monterey in 1988. In the four years since that paper, the concept and its associated methodology has been demonstrated at two commercial nuclear power plants (NPP) and one fossil power plant. In addition, applications of some of the methods have been utilized in other types of organizations, and products are being developed from the insights obtained using the concept for various organization and management activities. This paper will focus on the insights and results obtained from the two demonstration studies at the commercial NPPs. The results emphasize the utility of the methodology and the comparability of the results from the two organizations

  1. Rotan manau intercropped with rubber: rate of root growth between three and four years after planting

    International Nuclear Information System (INIS)

    Wan Rashidah Kadir; Aminuddin Mohamad; Ahmad Sahali Mardi; Zaharah Abd Rahman

    1997-01-01

    Wan Rashidah, K., Aminuddin, M., Ahmad Sahali, M. & Zaharah, A.R. 1997. Rotan manau intercropped with rubber: rate of root growth between three and four years after planting. Efficient fertiliser management depends partly on understanding the active root distribution. In the present study, the active root distribution of 3- and 4-y-old plantation grown rotan manau (Calamus manan) was assessed using isotope tracer technique. For the 3-y-old rotan manau, three distances from the plant base (0.5, 1.0 and 1.5 m) at 5 and 30 cm depths were examined. For the 4-y-old plants, two distances, viz-a-viz at a centre between two rattan plants and another in the middle between two rattan plants and two rubber trees were studied. The isotope used was 32P, applied as a solution with KH2PO4. The rotan manau plants had been established under mature rubber plantation. High proportions of feeder roots were found at 0.5 and 1.0 m distances at the surface (5 cm depth) for the 3-y-old plants. Uptake of 32P was also observed for the application at 1.5 m distance for both depths but the counts were small. Statistical analysis gave a highly significant difference within the distances and within the different depths. For a better synchronisation between fertiliser application and plant uptake, it seems that application at approximately between 0.5 and 1.0 m distance around the plant is most appropriate at this age. At four years after planting, important uptake was obtained only for the two plants located near the application area. Anyhow, to some extent it reflected that roots had already extended for another 1 m compared to the 3-y-old plants

  2. A cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report.

    Science.gov (United States)

    Rao, Dinesh; Sood, Divya; Pathak, P; Dongre, Sudhir D

    2014-01-01

    Incidence of sudden cardiac death (SCD) has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127), followed closely by the age group 60-69 (28.43%; n-58). Male to female ratio was around 10:1. The maximum number of deaths (n=78) was within few hours (6 hours) after the onset of signs and symptoms. In 24 (11.8%) cases major narrowing was noted in both the main coronaries, in 87 (42.6%) cases in the left anterior descending coronary artery (LAD), and in 18 (51.5%) cases in the right coronary artery (RCA). The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86%) and myocardial infarction (n-104; 50.9%). most of the SCDs occurred in the place of residence (n-80; 39.2%) followed closely by death in hospital (n-49; 24.01%). Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1.

  3. Bobath or motor relearning programme? A follow-up one and four years post stroke.

    Science.gov (United States)

    Langhammer, Birgitta; Stanghelle, Johan K

    2003-11-01

    The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions. A randomized controlled trial of first time ever stroke patients. Group 1 (n = 33) and group 2 (n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively. The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community. The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major influence on the patients' ability to cope in the long-term. This follow-up at one and four years post stroke showed no major influence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.

  4. Head and neck cancer patient perspectives regarding pain, cosmesis, swallow function, voice quality and overall quality of life

    International Nuclear Information System (INIS)

    Bhatia, Vinona; Harari, Paul M.; Thompson, Sandra P.; Ford, Charles N.; Hartig, Gregory K.

    1996-01-01

    Purpose/Objective: Head and neck (H and N) cancer patients can experience unique and sometimes severe tumor-induced and treatment-precipitated alterations in physical appearance and function. This study was carried out to assist in defining H and N cancer patient perceptions regarding overall quality of life with particular attention to issues of pain, cosmesis, swallow function and voice quality. Materials and Methods: A series of 119 H and N cancer patients were studied over a 12-month period using a combination of personal interview and provision of selected questionnaires. The interview included administration of 2 assessment tools with each patient during the personal interview: the Performance Status Scale for H and N Cancer and the Karnofsky Performance Scale (KPS). Each patient then received a packet containing 4 additional tools with general instructions to complete and return the questionnaires via mail or at their next follow-up check. These tools included the Functional Assessment of Cancer Therapy for H and N Cancer (FACT-H and N), the Memorial Symptom Assessment Scale (MSAS), a Tumor Outcome Assessment Survey and a Visual Analog Scale (VAS) regarding life quality. All patients were interviewed twice (identical procedure) by the data manager at 3-5 month intervals. Seventy-six males and 43 females with a mean age of 63 years were studied. Forty-one patients had received treatment with radiation alone, 35 with surgery alone and 43 with combined surgery and postoperative radiation. Twenty-four percent of the patient cohort had Stage I/II tumors, whereas 76% had Stage III/IV tumors. Results: A primary categorization of patients was identified based upon cancer treatment date. New patients were considered those within 3 months of their cancer diagnosis (23 patients), intermediate patients were those between 3 months and 2 years from diagnosis (72 patients) and long-term patients were those greater than 2 years from cancer diagnosis (24 patients). The

  5. Exploring the experiences of female students in introductory project-based engineering courses at two- and four-year institutions

    Science.gov (United States)

    Swan, Amy K.

    2011-12-01

    This qualitative study explored the experiential and contextual factors that shaped female students' pathways into introductory project-based engineering classes at two community colleges and one four-year institution, as well as female students' experiences within and outside of these classes. The study was framed by Social Cognitive Career Theory (SCCT) (Lent, Brown & Hackett, 1996) and Bronfenbrenner's (1979) ecological systems theory. Findings were based on analyses of data gathered through multiple methods: observations; individual interviews with female students; focus group interviews with project teams; and document collection. The findings of this study revealed that while positive experiences with math or science were a likely pre-cursor to engineering interest, experiential learning appeared to be a more powerful force in fostering students' engineering interest. Specifically, participants developed an interest in engineering through academic, professional, and extracurricular engineering- and design-related activities that familiarized them with the tasks and skills involved in engineering work and helped them develop a sense of selfefficacy with regard to this work. Interest and self-efficacy, in turn, played a role in students' postsecondary educational decision-making processes, as did contextual factors including families and finances. This study's findings also showed that participants' project teams were a critically important microsystem within participants' ecological environments. Within this sometimes "chilly" microsystem, female students negotiated intrateam processes, which were in some cases affected by gender norms. Intrateam processes that influenced female students' project-based learning experiences included: interpersonal dynamics; leadership; and division of labor. This study also identified several ways in which the lived experiences of participants at the community colleges were different from, or similar to, those of participants

  6. Minilaparoscopic versus standard laparoscopic hysterectomy for uteri ≥ 16 weeks of gestation: surgical outcomes, postoperative quality of life, and cosmesis.

    Science.gov (United States)

    Uccella, Stefano; Cromi, Antonella; Casarin, Jvan; Bogani, Giorgio; Serati, Maurizio; Gisone, Baldo; Pinelli, Ciro; Fasola, Maddalena; Ghezzi, Fabio

    2015-05-01

    Hysterectomy for enlarged uteri is a surgical challenge. Our aim was to compare perioperative outcomes, cosmesis, and postoperative quality of life following laparoscopic hysterectomy for large uteri using minilaparoscopic 3-mm versus conventional laparoscopic 5-mm instruments. We prospectively enrolled women with a uterus between 16 and 20 weeks of gestation at the preoperative examination. These patients underwent laparoscopic procedures using either 3-mm (minilaparoscopy group) or 5-mm (standard laparoscopy group) instruments. Five months after surgery, patients were called back to fill out the validated Italian translation of the Short Form 12-item Health Survey. Data about the cosmetic outcome of the procedure were also collected, using a Numeric Rating Scale (NRS) from 0 to 10. Seventy-eight women were included (27 in the 3-mm and 51 in the 5-mm groups). Perioperative characteristics were comparable between groups. The median uterus weight was 575 (range, 440-1050) g and 550 (400-1000) g in the 3-mm and 5-mm groups, respectively. No minilaparoscopic procedure was converted to standard 5-mm or to an open approach. One (2%) conversion to open abdominal surgery was needed in the conventional laparoscopy group. A better subjective cosmetic outcome was found in the 3-mm (NRS, 9.7 ± 0.4) versus the 5-mm (NRS, 8.9 ± 1.2) group (P=.01). Postoperative quality of life was comparable between groups. Minilaparoscopic hysterectomy is feasible, even in the case of an enlarged-size uterus. Moreover, it is associated with a better cosmetic outcome, compared with conventional laparoscopy.

  7. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fowble, B; Fein, D A; Hanlon, A L; Eisenberg, B L; Hoffman, J P; Sigurdson, E R; Daly, M B; Goldstein, L J

    1995-07-01

    ) and positive axillary nodes (4% tam vs 21% no tam, p=.08). For patients with negative axillary nodes the 5 yr act breast recurrence rates were 6% tam vs 7% no tam (p=.29). Tamoxifen did not result in a decreased 5 year act. breast recurrence rate in patients who had a reexcision (5% tam vs 3% no tam, p=.91), or women {<=}50 years of age (17% tam vs 13% no tam, p=.59). The 5 year act. cause-specific survival was 89% with tam and 94% without tam for the axillary node negative patients (p=.29). For the axillary node positive patients, the 5 year act. cause-specific survival was 90% with tam compared to 70% without tam. Cosmesis (physician assessment) was good-excellent in 85% of the tam patients compared to 88% of the no tam patients. For patients receiving radiation to the breast only, cosmesis was good-excellent in 84% of the tam patients and 87% of the no tam patients. For patients receiving treatment to the breast and regional nodes, 86% of the tam patients had a good to excellent cosmetic result compared to 92% of the no tam patients. Breast edema was more common in the patients receiving tam (49% tam vs 31% no tam). There was a slight increase in the incidence of breast cellulitis in the patients receiving tam (3% tam vs 1% no tam). Tamoxifen did not increase the incidence of arm edema, rib fracture, or symptomatic pneumonitis. Conclusion: Overall, tamoxifen results in a decreased risk of breast recurrence at 5 and 8 years, however, the benefit was no longer observed at 9 years. This finding suggests that tam may delay rather than prevent a breast recurrence in patients undergoing conservative surgery and radiation. Patients who appeared to benefit most in terms of a diminished risk of breast recurrence at 5 yrs from the addition of tam were those with no reexcision, unknown or close margins and positive axillary nodes. There was no decrease in breast recurrence with tam for patients {<=}50 years of age or those who had a reexcision. There was an improvement in

  8. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, B.; Fein, D.A.; Hanlon, A.L.; Eisenberg, B.L.; Hoffman, J.P.; Sigurdson, E.R.; Daly, M.B.; Goldstein, L.J.

    1995-01-01

    ) and positive axillary nodes (4% tam vs 21% no tam, p=.08). For patients with negative axillary nodes the 5 yr act breast recurrence rates were 6% tam vs 7% no tam (p=.29). Tamoxifen did not result in a decreased 5 year act. breast recurrence rate in patients who had a reexcision (5% tam vs 3% no tam, p=.91), or women ≤50 years of age (17% tam vs 13% no tam, p=.59). The 5 year act. cause-specific survival was 89% with tam and 94% without tam for the axillary node negative patients (p=.29). For the axillary node positive patients, the 5 year act. cause-specific survival was 90% with tam compared to 70% without tam. Cosmesis (physician assessment) was good-excellent in 85% of the tam patients compared to 88% of the no tam patients. For patients receiving radiation to the breast only, cosmesis was good-excellent in 84% of the tam patients and 87% of the no tam patients. For patients receiving treatment to the breast and regional nodes, 86% of the tam patients had a good to excellent cosmetic result compared to 92% of the no tam patients. Breast edema was more common in the patients receiving tam (49% tam vs 31% no tam). There was a slight increase in the incidence of breast cellulitis in the patients receiving tam (3% tam vs 1% no tam). Tamoxifen did not increase the incidence of arm edema, rib fracture, or symptomatic pneumonitis. Conclusion: Overall, tamoxifen results in a decreased risk of breast recurrence at 5 and 8 years, however, the benefit was no longer observed at 9 years. This finding suggests that tam may delay rather than prevent a breast recurrence in patients undergoing conservative surgery and radiation. Patients who appeared to benefit most in terms of a diminished risk of breast recurrence at 5 yrs from the addition of tam were those with no reexcision, unknown or close margins and positive axillary nodes. There was no decrease in breast recurrence with tam for patients ≤50 years of age or those who had a reexcision. There was an improvement in cause

  9. Cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2014-03-01

    Full Text Available Introduction: Incidence of sudden cardiac death (SCD has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127, followed closely by the age group 60-69 (28.43%; n-58. Male to female ratio was around 10:1. The maximum number of deaths (n=78 was within few hours (6 hours after the onset of signs and symptoms. In 24 (11.8% cases major narrowing was noted in both the main coronaries, in 87 (42.6% cases in the left anterior descending coronary artery (LAD, and in 18 (51.5% cases in the right coronary artery (RCA. The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86% and myocardial infarction (n-104; 50.9%. most of the SCDs occurred in the place of residence (n-80; 39.2% followed closely by death in hospital (n-49; 24.01%. Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1. 

  10. THE INFORMATION-COMMUNICATION TECHNOLOGY IN THE HOME ENVIRONMENT OF FOUR-YEAR-OLD PRESCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Jurka Lepičnik Vodopivec

    2014-01-01

    Full Text Available Today, preschool children live in an era of information-communication technologies (ICT. There exist various definitions of ICT. For the purposes of our research we thus used a broader definition of ICT, which stretches beyond mobiles and computers, and includes a variety of everyday technologies. Children already encounter them in their family environment. We wanted to find out which ICT children use the most, how they access them and if ICT has any influence on their development. Our sample consisted of 130 parents of four-year-old children who visit kindergarten. We were interested in the adults' – parents' influence and in the influence of the children’s gender on the access to and usage of ICT. We similarly wanted to know if these are influenced by the toy industry market and family values. A part of the research is also dedicated to the ICT’s influence on the perception of childhood and a plausible occurrence of the digital divide.

  11. Who Benefits From Four-Year Higher Education in Turkey? A Case Study of Law School

    Directory of Open Access Journals (Sweden)

    Filiz GÖLPEK

    2013-01-01

    Full Text Available In many countries, a higher education system which is based on welfare state practices prevails. In this system, the services are substantially provided by the state free of charge or at quite low prices. Since the services are financed by taxes, additional sources cannot be provided; and because of the fact that it doesn't entail a real cost benefit comparison by the users, it leads to inefficiency. From the early 80s on, there has been a tendency towards the marketing mechanisms in the provision of many public services such as education due to both strong theoretical and empirical reason, and the restrictions in public financing. Together with this tendency, the question of who benefits from education services is tried to be answered in order to discuss the stimulation of activities and additional resources on a reasonable base. The aim of this study is to determine whether it is the individual or the society who benefits from this public service at the higher education level by calculating private and social return rates through internal return rate technique which is one of the cost benefit analysis method. Findings from calculations have shown that the individual gains more than the society after a four-year university education.

  12. FOUR-YEAR-OLD NAMSAN TUNNEL CONGESTION PRICING SCHEME IN SEOUL

    Directory of Open Access Journals (Sweden)

    Bongsoo SON, Ph. D.

    2002-01-01

    Full Text Available The purpose of this paper is to evaluate the effectiveness of the congestion pricing scheme at Namsan #1 and #3 tunnels in downtown Seoul four years after its implementation. The effectiveness of the scheme was measured by the changes of various traffic impacts. The traffic volume of the two tunnels was reduced by up to 25% for the first month. After that time, the traffic volume started to increase again and then exceeded the previous volume level. However, average travel speed of the two tunnel corridors improved by up to 74%. The overall traffic volume of the four alternative routes was increased; nevertheless, their average travel speed increased as well. The number of carpool vehicles occupied by 3 or more persons including the driver during the peak periods was remarkably increased. Before the congestion fee charging, toll-charged vehicles amounted to 68.5% of the total traffic volume of the two tunnels, and then the share dropped to 29% afterwards. The empirical analysis results for the effectiveness of the congestion pricing scheme are very promising.

  13. [Four year follow-up of a screening program for prostate cancer in workers].

    Science.gov (United States)

    Reinoso-Barbero, Luis; Díaz-Garrido, Ramón; Piñaga-Solé, Montserrat; Fernández-Fernández, Miguel; Belanger-Quintana, Diego; Gómez-Gallego, Félix

    2013-01-01

    To analyze our four-year follow-up experience (2008-2011) with a prostate cancer screening program offered to employees of a banking company. Data were obtained from the health examinations carried out by the bank's in-house occupational health service (with centers in Barcelona, Madrid and Valencia). PSA (prostate-specific antigen) blood levels were measured and cases with high levels (>4 ng/ml) were followed through diagnosis and treatment, including a telephone survey of confirmed cases. Personal and occupational characteristics of the participants were analyzed as well. 750 workers (99% with administrative and/or commercial jobs) met the inclusion criteria for the screening program. Of these, 110 had elevated PSA levels on at least one occasion. The diagnosis of prostate cancer was confirmed in 21 cases. There were no associations between a diagnosis of cancer and the remaining analyzed variables. Urology and pathology records were retrieved for 76% of the contacted cases. The most frequent histological type was adenocarcinoma (98%), the most common Gleason grade at diagnosis was 6-7% (88%), and the majority of cases were treated surgically (90%).With respect to adverse effects, 48% of cases described erectile dysfunction and 33% reported urinary incontinence. In our program the observed prevalence of prostate cancer was above that expected (respectively, 21 confirmed cases vs. 12 expected). The identified cases unanimously expressed their support for the screening program. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  14. Radioactive contamination status of an elementary school in southern Miyagi Prefecture, Japan, four years after decontamination

    International Nuclear Information System (INIS)

    Yamaguchi, Toshiro; Sato, Mitsuyoshi; Nagakubo, Kazuyoshi

    2017-01-01

    We investigated the radioactive contamination status of an elementary school in southern Miyagi Prefecture, Japan, four years after decontamination. The radioactive dose rate was measured in the playground (n = 36), back yard (n = 1), parking lot (n = 3), and gutters (n = 30) with a thallium-activated sodium iodide scintillation detector. In addition, topsoil from the playground and gutters sediment were measured with a high-purity germanium semiconductor detector, and sand from the parking lot and sediment from gutters was imaged following an autoradiography method. The mean radioactive dose rate in the playground was almost 0.08 μSv/h. The dose rate was higher at sites facing the mountains, near the main gate, and by the front entrance of the school building. Meanwhile, the radioactive cesium (Cs) concentration of sediment imaged using autoradiography was > 8,000 Bq/kg. These results indicated that the radioactive dose rates in the decontaminated school were below the threshold for being a health hazard. However, the topsoil in the playground had been re-contaminated with radioactive Cs, which had likely been transported via dirt attached to children's shoes and car tires. In addition, the radioactive sediment in the gutters had likely been contaminated by rainwater, suggesting that radioactive protection is necessary when handling gutter sediment. (author)

  15. Progressive Incrementalism: U.S Foreign Economic Policy Over the Next Four Years

    Directory of Open Access Journals (Sweden)

    John M. Curtis

    2013-01-01

    Full Text Available As we look ahead following last year’s U.S. presidential and congressional elections, Canadians — and Canadian business in particular — will want to have a better sense of the economic prospects, as well as the context, of U.S. foreign economic policy over the coming half-decade or so. For, notwithstanding all the talk, debates, op-ed articles, thinktank-pieces and even books in recent years suggesting or asserting the decline of American economic power, Canada’s ever-present integration and interdependence with our southern neighbour is both a reality and now, again, an important, medium-term asset. Over the coming four years and likely beyond, and once it has completed sorting out its “fiscal cliff” matter, the U.S. is positioned to be the source of increasing economic growth. The American economy has strengths: its high productivity and innovation compared to most other countries, massive piles of private sector cash leading to all sorts of investment potential, a devalued currency, and a relatively young workforce compared to the European Union, Japan, and even Canada. Therefore, although the U.S. economy continues to face large challenges related to fiscal imbalances, there are reasons to expect increasing economic growth over the medium term.

  16. The differential prevalence of obesity and related behaviors in two- vs. four-year colleges.

    Science.gov (United States)

    N Laska, Melissa; Pasch, Keryn E; Lust, Katherine; Story, Mary; Ehlinger, Ed

    2011-02-01

    The objective of this study was to determine whether obesity prevalence and weight-related behaviors (e.g., diet, physical activity) differ among students enrolled in 2-year community/technical colleges and those attending 4-year colleges/universities. This information could inform the development of intervention strategies. Through an existing surveillance system of Minnesota postsecondary education institutions, survey data were collected from 16,539 students from 27 campuses (14 two-year college campuses, 13 four-year college/university campuses; 2007-2008), including self-reported physical activity, media use, dietary patterns, weight control behaviors, height, and weight. Unadjusted analyses indicated that students enrolled in 2-year colleges, particularly females, had a higher prevalence of overweight/obesity, lower levels of physical activity, more television viewing, higher intakes of soda, fast food, and diet pills compared to students attending 4-year colleges (P students there were fewer differences between 2-year and 4-year colleges. Controlling for sociodemographic factors (e.g., race/ethnicity, age), most disparities in prevalence estimates remained, though many were attenuated. Overall, few young adults engage in weight-related behaviors consistent with national recommendations. Two-year college students may represent a particularly at-risk group. Disparities between 2- and 4-year college students exist beyond the sociodemographic differences in these populations. Effective weight-related interventions are needed for young adults, particularly females attending 2-year colleges and all males attending postsecondary institutions.

  17. Four-year evaluation of workers exposed to trimellitic anhydride. A brief report

    International Nuclear Information System (INIS)

    McGrath, K.G.; Roach, D.; Zeiss, C.R.; Patterson, R.

    1984-01-01

    In a four-year clinical, immunologic, and environmental study of trimellitic anhydride (TMA) exposure in a single plant, 20 workers exposed to TMA powder were evaluated in 1979 and a total of 32 workers were evaluated from 1979 to 1983. Two distinct groups emerged before and after workplace control improvements were made in 1979. Seventeen of the original 20 workers were available for longitudinal study through 1983. Annual clinical evaluations and serum radioimmunoassays for total antibody binding and specific IgE binding to 125I TM-HSA (human serum albumin) were performed on all 32 workers. In 1979, six workers had antibody against TM-HSA, three had the late respiratory systemic syndrome, and two had TMA-induced allergic rhinitis or allergic rhinitis and asthma. One worker had antibody against TM-HSA without illness. Fifteen additional workers were evaluated longitudinally after institution of several workplace control measures. Four of these 15 workers had TMA exposure prior to environmental improvement and joined the study in 1982. The remaining 11 workers joined the study in 1982 and had at least two years of TMA exposure in the modified workplace. None of these 11 workers developed a TMA-induced immunologic syndrome or significant total or specific IgE antibody binding to 125I TM-HSA

  18. The Effects of Inquiry-Based Integrated Information Literacy Instruction: Four-Year Trends

    Directory of Open Access Journals (Sweden)

    Lin Ching Chen

    2014-07-01

    Full Text Available The purpose of this study was to examine the effects of four-year integrated information literacy instruction via a framework of inquiry-based learning on elementary students’ memory and comprehension. Moderating factors of students’ academic achievement was another focus of this study. The subjects were 72 students who have participated in this study since they entered an elementary school in Chiayi district. This elementary school adopted the integrated information literacy instruction, designed by the researchers and elementary school teachers, and integrated it into various subject matters via a framework of inquiry-based learning, such as Super 3 and Big6 models. A series of inquiry-based integrated information literacy instruction has been implemented since the second semester of the subjects’ first grade. A total of seven inquiry learning projects has been implemented from grade one through grade four. Fourteen instruments were used as pretests and posttests to assess students’ factual recall and conceptual understanding of subject contents in different projects. The results showed that inquiry-based integrated information literacy instruction couldhelp students memorize facts and comprehend concepts of subject contents. Regardless ofacademic achievements, if students would like to devote their efforts to inquiry processes, their memory and comprehension of subject contents improvedeffectively. However, students of low-academic achievement might need more time to be familiar with the inquiry-based learning strategy.

  19. Psychological Processes and Repeat Suicidal Behavior: A Four-Year Prospective Study

    Science.gov (United States)

    2013-01-01

    Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt. PMID:23855989

  20. The Impact of Impulsivity on Weight Loss Four Years after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Kathrin Schag

    2016-11-01

    Full Text Available Bariatric surgery has serious implications on metabolic health. The reasons for a failure of bariatric surgery, i.e., limited weight loss, are multifactorial and include psychological factors. We established a theoretical model of how impulsivity is related to weight loss outcome. We propose that depressive symptoms act as a mediator between impulsivity and pathological eating behavior, and that pathological eating behavior has a direct impact on weight loss outcome. We calculated excessive weight loss (%EWL and assessed self-reported impulsivity (using the Baratt Impulsiveness Scale (BIS-15 total score, depressive symptoms (the Patient Health Questionnaire (PHQ-9 score, and pathological eating behavior (the Eating Disorder Inventory 2 (EDI-2 total score in 65 patients four years after laparoscopic sleeve gastrectomy. Regression and mediation analyses were computed to validate the theoretical model. The BIS-15, PHQ-9, and EDI-2 have medium to high correlations between each other, and EDI-2 correlated with %EWL. The mediation analysis yielded that the PHQ-9 represents a significant mediator between BIS-15 and EDI-2. The regression model between EDI-2 and %EWL was also significant. These results support our theoretical model, i.e., suggest that impulsivity has an indirect impact on weight loss outcome after bariatric surgery, mediated by depression and transferred through pathological eating behavior. Thus, the underlying psychological factors should be addressed in post-operative care to optimize weight loss outcome.

  1. Biochar in vineyards: impact on soil quality and crop yield four years after the application

    Science.gov (United States)

    Ferreira, Carla; Verheijen, Frank; Puga, João; Keizer, Jacob; Ferreira, António

    2017-04-01

    Biochar is a recalcitrant organic carbon compound, created by biomass heating at high temperatures (300-1000°C) under low oxygen concentrations. Biochar application to agricultural soils has received increasing attention over the last years, due to its climate change mitigation and adaptation potential and reported improved soil properties and functions relevant to agronomic and environmental performance. Reported impacts are linked with increased cation exchange capacity, enhanced nutrient and water retention, and positive influences on soil microbial communities, which influence crop yields. Nevertheless, few studies have focused on mid-to-long term impacts of biochar application. This study investigated the impact of biochar on soil quality and crop yield four years after biochar application in a vineyard in North-Central Portugal. The site has a Mediterranean climate with a strong Atlantic Ocean influence, with mean annual rainfall and temperature of 1100 mm and 15°C, respectively. The soil is a relatively deep ( 80cm) sandy loam Cambisol, with gentle slopes (3°). The experimental design included three treatments: (i) control, without biochar; (ii) high biochar application rate (40 ton/ha); and (iii) biochar compost (40 ton/ha, 10% biochar). Three plots per treatment (2m×3m) were installed in March 2012, using a mini-rotavator (0-15cm depth). In May 2016, soil quality was also assessed through soil surveys and sampling. Penetration resistance was performed at the soil surface with a pocket penetrometer, and soil surface sampling rings were used for bulk density analyses (100 cm3). Bulked soil samples (0-30 cm) were collected in each plot for aggregate stability, microbial biomass (by chloroform fumigation extraction) and net mineralization rate (through photometric determination of non-incubated and incubated samples). Decomposition rate and litter stabilisation was assessed over a 3-month period through the Tea Bag Index (Keuskamp et al., 2013). The number

  2. Stomatal response of Pinus sylvestriformis to elevated CO2 concentrations during the four years of exposure

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yu-mei; HAN Shi-jie; LIU Ying; JIA Xia

    2005-01-01

    Four-year-old Pinus sylvestriformis were exposed for four growing seasons in open top chambers to ambient CO2 concentration (approx. 350 μmol·mol-1) and high CO2 concentrations (500 and 700 μmol·mol-1) at Research Station of Changbai Mountain Forest Ecosystems, Chinese Academy of Sciences at Antu Town, Jilin Province, China (42oN, 128oE). Stomatal response to elevated CO2 concentrations was examined by stomatal conductance (gs), ratio of intercellular to ambient CO2 concentration (ci/ca) and stomatal number. Reciprocal transfer experiments of stomatal conductance showed that stomatal conductance in high-[CO2]-grown plants increased in comparison with ambient-[CO2]-grown plants when measured at their respective growth CO2 concentration and at the same measurement CO2 concentration (except a reduction in 700 μmol·mol-1 CO2 grown plants compared with plants on unchambered field when measured at growth CO2 concentration and 350 μmol·mol-1CO2). High-[CO2]-grown plants exhibited lower ci/ca ratios than ambient-[CO2]-grown plants when measured at their respective growth CO2 concentration. However, ci/ca ratios increased for plants grown in high CO2 concentrations compared with control plants when measured at the same CO2 concentration. There was no significant difference in stomatal number per unit long needle between elevated and ambient CO2. However, elevated CO2 concentrations reduced the total stomatal number of whole needle by the decline of stomatal line and changed the allocation pattern of stomata between upper and lower surface of needle.

  3. Injuries in Collegiate Women’s Volleyball: A Four-Year Retrospective Analysis

    Science.gov (United States)

    Sole, Christopher J.; Kavanaugh, Ashley A.; Stone, Michael H.

    2017-01-01

    A four-year retrospective analysis of injury data was conducted on a collegiate (NCAA Division I) women’s volleyball team. Twenty athletes (Year 1: age = 19.4 ± 0.9 y, height = 175.2 ± 5.1 cm, body mass = 70.5 ± 10.2 kg; Year 2: age = 20.1 ± 1.0 y, height = 175.7 ± 4.7 cm, body mass = 69.5 ± 10.1 kg; Year 3: age = 20.1 ± 1.4 y, height = 173.8 ± 6.3 cm, body mass = 69.9 ± 10.8 kg; Year 4: age = 19.5 ± 1.4 y, height = 174.4 ± 8.6 cm, body mass = 72.7 ± 10.8 kg) participated in this study, accounting for 1483 total training exposures. Injury was defined as any damage to a body part, incurred during volleyball or strength and conditioning-related activities, which interfered with training and/or competition. Injury rate was normalized to the number of athletes and exposure and expressed as injuries per 1000 exposures. A total of 133 injuries were recorded. The most common injury was to the knee (left = 7.5%, right = 12.0%). Injuries occurred most often in volleyball practice (75.2%), followed by competition (20.3%), and strength and conditioning-related activities (4.5%). Non-contact injuries (upper body = 26.3%, lower body = 53.4%) were more common than contact injuries (upper-body = 13.5%, lower-body = 6.8%). An examination of injury rates relative to the training year revealed patterns in injury occurrence. Specifically, spikes in injury rate were consistently observed during periods of increased training volume that were preceded by breaks in organized training, such as the early pre-season and off-season training periods.

  4. A four-year cardiovascular risk score for type 2 diabetic inpatients

    Directory of Open Access Journals (Sweden)

    Dolores Ramírez-Prado

    2015-06-01

    Full Text Available As cardiovascular risk tables currently in use were constructed using data from the general population, the cardiovascular risk of patients admitted via the hospital emergency department may be underestimated. Accordingly, we constructed a predictive model for the appearance of cardiovascular diseases in patients with type 2 diabetes admitted via the emergency department. We undertook a four-year follow-up of a cohort of 112 adult patients with type 2 diabetes admitted via the emergency department for any cause except patients admitted with acute myocardial infarction, stroke, cancer, or a palliative status. The sample was selected randomly between 2010 and 2012. The primary outcome was time to cardiovascular disease. Other variables (at baseline were gender, age, heart failure, renal failure, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidaemia, insulin, smoking, admission for cardiovascular causes, pills per day, walking habit, fasting blood glucose and creatinine. A cardiovascular risk table was constructed based on the score to estimate the likelihood of cardiovascular disease. Risk groups were established and the c-statistic was calculated. Over a mean follow-up of 2.31 years, 39 patients had cardiovascular disease (34.8%, 95% CI [26.0–43.6%]. Predictive factors were gender, age, hypertension, renal failure, insulin, admission due to cardiovascular reasons and walking habit. The c-statistic was 0.734 (standard error: 0.049. After validation, this study will provide a tool for the primary health care services to enable the short-term prediction of cardiovascular disease after hospital discharge in patients with type 2 diabetes admitted via the emergency department.

  5. Traumatic dental injuries in a university hospital: a four-year retrospective study.

    Science.gov (United States)

    Mahmoodi, Benjamin; Rahimi-Nedjat, Roman; Weusmann, Jens; Azaripour, Adriano; Walter, Christian; Willershausen, Brita

    2015-11-04

    Traumatic dental injuries present complex injuries of the dentoalveolar system. Aim of this study was to investigate the frequency and patterns of traumatic dental injuries in a University dental emergency service over four years. A retrospective investigation on all dental trauma patients presenting at the dental emergency service of the University Medical Center Mainz, Germany between 01/2010 and 12/2013 was conducted. Demographic data, the cause and type of trauma and the initial therapy were analyzed. Out of 16,301 patients, 1,305 patients (8 %; average age 14.7 years ±15.7; 60.1 % male, 39.9 % female) came due to trauma. 63.9 % of the traumas occurred on weekends. The most frequent reason for injuries was falls (54.6 %). No correlation could be found between the cause and the kind of trauma. In 48.6 % of the cases only one tooth was involved, in 33.5 % two. The permanent dentition was traumatized in 56.6 % of cases, the deciduous teeth in 41.1 %. The most frequently affected tooth was the central upper incisor (61.0 %). Hard-tissue injuries were significantly more frequent in the permanent dentition, while periodontal injuries were seen significantly more often in the deciduous dentition. Eight percent of all patients seeking help at the dental emergency service presented with trauma, meaning that dental traumatology is one of the major topics in emergencies. To improve the quality of care, further public education, expert knowledge among dental professionals and a well-structured emergency service are necessary.

  6. Four-year-old Children Align their Preferences with those of their Peers

    Directory of Open Access Journals (Sweden)

    Laura Hennefield

    2017-07-01

    Full Text Available Children express preferences for a wide range of options, such as objects, and frequently observe the preferences that others express towards these things. However, little is know about how these initial preferences develop. The present research investigated whether one particular type of social information – other children’s preferences – influences children’s own preferences. Four-year-old children observed, via video, two boys and two girls display the same preference for one of two stickers. Each child (peer expressed liking for one sticker and dislike for the other. Then children completed two rounds of the Dictator Game, a classic resource distribution task. In each round, children distributed either 10 'liked' stickers or 10 'disliked' stickers (counterbalanced between themselves and another child who was not present. If the preferences expressed by their peers influenced children’s own preferences, children should keep more of the 'liked' than 'disliked' stickers for themselves. In line with this prediction, more children kept more liked than disliked stickers, indicating their distribution patterns were influenced by their peers’ preferences. This finding suggests that children extracted informational content about the value of the stickers from their peers and used that information to guide their own preferences. Children might also have aligned their preferences with those of their peers to facilitate social bonding and group membership. This research demonstrates the strong influence of peers on children’s developing preferences, and reveals the effect of peer influence via video – a medium that young children are frequently exposed to but often struggle to learn from in other contexts.

  7. A four-year, systems-wide intervention promoting interprofessional collaboration

    Science.gov (United States)

    2012-01-01

    Background A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities. Methods We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved. Results Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved. Conclusions Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods. PMID:22520869

  8. McClellan Nuclear Radiation Center (MNRC) TRIGA reactor: Four years of operations

    International Nuclear Information System (INIS)

    Heidel, C.C.; Richards, W.J.

    1994-01-01

    McClellan Air Force Base, at Sacramento, California, is headquarters for the Sacramento Air Force Logistics Center (SM-ALC). McClellan Air Force Base provides extensive inspection and maintenance capabilities for the F-111, F-1 5, and other military aircraft. Criticality of the MNRC TRIGA reactor was obtained on January 20, 1990 with 63 standard TRIGA fuel elements, three fuel-followed control rods and one air-followed control rod. Presently there are 93 fuel elements in the reactor core. The reactor can be operated at 1 MW steady state power, producing pulses up to three dollars worth of reactivity addition, and can be square waved up to 1 MW. The reactor core contains a circular grid plate and a graphite reflector assembly surrounding the core. Four tangential beam ports installed in the reflector assembly provide a thermal neutron flux to four radiography bays. The reactor tank is twenty-four (24) feet deep, seven and one-half (7.5) feet in diameter, and has a protrusion in the upper portion of the reactor tank. This protrusion is scheduled for use as a neutron thermal collimator in the future. Besides the neutron radiography capabilities, the reactor contains a pneumatic rabbit system, a central thimble, an in-core irradiation facility, and three additional cutouts that provide locations for additional irradiation facilities. The central thimble can be removed along with the B-ring locations of the upper portion of the grid plate to provide an additional and larger in-core irradiation facility. A new upper grid plate has been manufactured to expand one triangular cutout so that larger experiments can be inserted directly into the reactor core. Some operational problems experienced during the first four years of operations are the timeout of the CSC and DAC watchdogs, deterioration of the heat exchanger gaskets, and loss of thermocouples in the instrumented fuel elements. (author)

  9. Four years of international counter proliferation training: The U.S. Department of Defense's experience

    International Nuclear Information System (INIS)

    Strauss, H.J.

    2001-01-01

    Full text: Over the last four years, the U.S. Department of Defense has engaged 17 countries in the former Soviet Union, Eastern/Central Europe, and the Baltic states in two counterproliferation initiatives, i.e., the DOD/FBI and the DOD/U.S. Customs Service Counterproliferation Programs. These activities are designed to train and equip border security and law enforcement personnel to prevent, deter, and investigate incidents related to weapons of mass destruction, as well as the trafficking in chemical, nuclear, and biological weapons materials and technologies. Though these programs have begun to produce tangible successes, some recipient countries have failed to demonstrate an earnest commitment to program goals. The U.S. DOD has fielded varied training courses in the region, together with associated WMD detection equipment. In spite of demands by the political leadership in many of the engaged countries, the most successful training has proven to be the more basic rather than the advanced training. Similarly, the real equipment needs prove to be for low rather than high technology. The presentation will explore the systemic, political/military, and geographic factors contributing to this result. The U.S. Department of Defense will continue to engage participating nations in these international counterproliferation programs, and will continue to respond positively to assistance requests based on recipient country needs and honest commitment. Still there remain numerous opportunities for other donor states and international agencies to make positive contributions in the counterproliferation arena. Only with increased donor state commitment - fiscal, programmatic, and personnel - together with full donor state coordination, can international proliferation and trafficking problems be effectively deterred and resolved. (author)

  10. Four years of UAS Imagery Reveals Vegetation Change Due to Permafrost Thaw

    Science.gov (United States)

    DelGreco, J. L.; Herrick, C.; Varner, R. K.; McArthur, K. J.; McCalley, C. K.; Garnello, A.; Finnell, D.; Anderson, S. M.; Crill, P. M.; Palace, M. W.

    2017-12-01

    Warming trends in sub-arctic regions have resulted in thawing of permafrost which in turn induces change in vegetation across peatlands. Collapse of palsas (i.e. permafrost plateaus) has also been correlated to increases in methane (CH4) emissions to the atmosphere. Vegetation change provides new microenvironments that promote CH4 production and emission, specifically through plant interactions and structure. By quantifying the changes in vegetation at the landscape scale, we will be able to understand the impact of thaw on CH4 emissions in these complex and climate sensitive northern ecosystems. We combine field-based measurements of vegetation composition and high resolution Unmanned Aerial Systems (UAS) imagery to characterize vegetation change in a sub-arctic mire. At Stordalen Mire (1 km x 0.5 km), Abisko, Sweden, we flew a fixed-wing UAS in July of each year between 2014 and 2017. High precision GPS ground control points were used to georeference the imagery. Seventy-five randomized square-meter plots were measured for vegetation composition and individually classified into one of five cover types, each representing a different stage of permafrost degradation. With this training data, each year of imagery was classified by cover type. The developed cover type maps were also used to estimate CH4 emissions across the mire based on average flux CH4 rates from each cover type obtained from flux chamber measurements collected at the mire. This four year comparison of vegetation cover and methane emissions has indicated a rapid response to permafrost thaw and changes in emissions. Estimation of vegetation cover types is vital in our understanding of the evolution of northern peatlands and its future role in the global carbon cycle.

  11. Pendimethalin and oxyfluorfen degradation under two irrigation conditions over four years application.

    Science.gov (United States)

    Alister, Claudio A; Gomez, Patricio A; Rojas, Sandra; Kogan, Marcelo

    2009-05-01

    A four-year field study was conducted to determine the effect of pluviometric conditions on pendimethalin and oxyfluorfen soil dynamics. Adsorption, dissipation and soil movement were studied in a sandy loam soil from 2003 to 2007. Pendimethalin and oxyfluorfen were applied every year on August at 1.33 and 0.75 kg ha(-1), respectively. Herbicide soil concentrations were determined at 0, 10, 20, 40, 90 and 340 days after application (DAA), under two pluviometric regimens, natural rainfall and irrigated (30 mm every 15 days during the first 90 DAA). More than 74% of the herbicide applied was detected at the top 2.5 cm layer for both herbicides, and none was detected at 10 cm or deeper. Pendimethalin soil half-life ranged from 10.5 to 31.5 days, and was affected mainly by the time interval between application and the first rain event. Pendimethalin soil residues at 90 DAA fluctuated from 2.5 to 13.8% of the initial amount applied, and it decreased to 2.4 and 8.6% at 340 DAA. Oxyfluorfen was more persistent than pendimethalin as indicated by its soil half-life which ranged from 34.3 to 52.3 days, affected primarily by the rain amount at the first rainfall after application. Oxyfluorfen soil residues at 90 DAA ranged from 16.7 to 34.8% and it decreased to 3.3 and 17.9% at 340 DAA. Based on half-life values, herbicide soil residues after one year, and soil depth reached by the herbicides, we conclude that both herbicides should be considered as low risk to contaminate groundwater. However, herbicide concentration at the top 2.5 cm layer should be considered in cases where runoff or soil erosion could occur, because of the potential for surface water contamination.

  12. The wind and fire disturbance in Central European mountain spruce forests: the regeneration after four years

    Directory of Open Access Journals (Sweden)

    Monika Budzáková

    2013-03-01

    Full Text Available A strong windstorm in November 2004 resulted in a huge blown-down spruce forest area in the southern part of the Tatra National Park in the Western Carpathians in Slovakia, Central Europe. The aim of this work is to study the vegetation composition of spruce forest at differently managed sites four years after this disturbance. Four study areas were selected for this purpose: (i an area where the fallen trees were extracted and new seedlings were planted; (ii an area, which was hit by a forest fire after the extraction; (iii an area where no active management was applied; (iv a reference forest unaffected by such disturbance. A total of 100 plots were selected, 25 of each area type. The result of DCA and CCA analyses consistently indicated that after this short period the non-extracted and extracted areas are currently most similar to the reference forest area, while the fire affected area differed. A one-way ANOVA comparing species cover for the different plot sizes indicated some significant differences between the extracted and non-extracted plots. The abundance of certain species commonly occurring in spruce forests, such as Dyopteris carthusiana agg., Vaccinium myrtillus and Avenella flexuosa, correlated weli with the non-extracted plots, compared to the extracted plots. Coverage of these species was lowest on burned plots. The lowest Shannon-Wiener’s diversity values were recorded in burned plots. This was most likely a consequence of mono-dominant competitive species spread, (mainly Chamerion angustifolium which profited from the altered ecological conditions following the fire. Although some differences were also registered in the Shannon-Wiener diversity index between the remaining research plots, however these were not statistically significant. The most important results of our investigations include the extensive influence of fire disturbance on vegetation. Study revealed that the wind-disturbed area is able to regenerate

  13. A prospective phase I comparison of toxicity and cosmesis outcomes of single-fraction IORT and hypofractionated radiotherapy with IORT boost in early-stage breast cancer.

    Science.gov (United States)

    Bhandari, Tanuja; Babaran, Wesley; Forouzannia, Afshin; Williams, Venita; Harness, Jay; Carpenter, Michele; Gobran, Maher; Khanijou, Rajesh; Wagman, Brittany; Ash, Robert; Wagman, Lawrence D

    Radiation therapy is proven to reduce local recurrence in patients with early-stage breast cancer. To reduce toxicity, treatment time, and improve accuracy, intraoperative radiation therapy was used as definitive treatment or as a boost. The study's objective was to compare the short-term toxicity and cosmesis of single-fraction (SF) IORT and hypofractionated radiotherapy with IORT boost (HfB) given as definitive treatment. Between March 2011 and December 2013, 57 patients aged 45-91 years and 24 patients aged 43-83 years (total n = 81) with Stage 0-II were treated with SF or HfB (Mobetron, IntraOp Medical, Sunnyvale, CA). For SF treatment, 21 Gy was delivered using 4.5-6 cm applicators with electron energies from 6 to 12 MeV. For HfB, an intraoperative boost of 10 Gy was delivered using 4-7 cm applicators with energies from 4 to 12 MeV followed by whole-breast radiation with 40.5 Gy over 15 fractions. Toxicity was assessed at 2 weeks, 6 months, and 12 months per Radiation Therapy Oncology Group acute skin toxicity criteria and cosmesis. At 12 months, SF and HfB were well tolerated by all patients with no Grade 3+ toxicity. At 1 year, Grade-2 toxicity was resolved. Ninety-eight percent of SF patients and ninety percent of HfB patients had 0-1 grade toxicity. In the SF and HfB groups, 100% of patients had excellent or good cosmesis at 12-month followup interval. The SF exhibited a more favorable cosmesis with a higher percentage of excellent scores compared with HfB (80.4% vs. 45%; p = 0.0033). After breast conservation surgery, SF or HfB may be an option for patients with early-stage breast cancer compared to conventional external beam radiotherapy. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  14. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

  15. The pediatric residency training on tobacco project: four-year parent outcome findings.

    Science.gov (United States)

    Hymowitz, Norman; Pyle, Sara A; Haddock, C Keith; Schwab, Joseph V

    2008-08-01

    To assess parent behavioral change and perception of resident intervention on tobacco. In a long-term study of the efficacy of training pediatric residents to address tobacco conducted at the New Jersey Medical School, sixteen pediatric training programs were assigned randomly to either special or standard training conditions. Parent surveys were administered in the fall of 2001 and 2005 in order to assess the effects of resident intervention on parent behavior, as well as parent perceptions of resident intervention. The percent of parents who smoke at sites associated with the special training condition, but not of those at sites associated with standard training, who reported that residents advised them to stop smoking, offered to help them quit, and provided quit smoking materials increased significantly from baseline to year 4. The percent of parents in the special training condition who reported quitting smoking in the past year also increased, although the increase was not statistically significant. A majority of the parents associated with each training condition reported receiving intervention for second hand smoke (SHS). For each training condition, the level of intervention to prevent exposure of infants and children to SHS exposure was similar at baseline and year 4, as was the percent of parents who reported having a smoke-free household. The results support the efficacy of the special training program and underscore the importance of preparing pediatric residents to address tobacco.

  16. Four-year follow-up study of pharmacological treatment in pathological gamblers.

    Science.gov (United States)

    Rosenberg, Oded; Dinur, Limor Klein; Dannon, Pinhas N

    2013-01-01

    In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before

  17. A Measurement of Electron Neutrino Appearance in the MINOS Experiment After Four Years of Data

    Energy Technology Data Exchange (ETDEWEB)

    Cavanaugh, Steven [Harvard Univ., Cambridge, MA (United States)

    2010-05-01

    experiment. After two years of running with 3.14 x 1020 protons-on-target (POT), a limit was set at δCP = 0 for the normal (inverted) hierarchy of sin2(2θ13) < 0.29 (0.42) at 90% C.L. This study finds after four years of data with an accumulated intensity of 7 x 1020 POT that sin2(2θ13) < 0.12 (0.20) with δCP = 0 at 90% C.L. for the normal (inverted) hierarchy.

  18. Weakness and numbness of extremities with bowel and bladder dysfunction for four years

    Directory of Open Access Journals (Sweden)

    Han-hui FU

    2017-03-01

    Full Text Available The patient was a 53-year-old female who was admitted for “numbness and weakness of lower extremities, urinary and defecation dysfunction for 4 years” in September 2016.  Four years ago, the patient felt numbness and weakness of lower extremities, with chest zonesthesia and back pain. The weakness of left lower extremity got severer next morning and she cannot feel her left foot on the pedal when riding bicycle. At night, she presented numbness under umbilicus level, feet scuff and urine retention. She was also unable to squat. No fever, headache, vomiting or visual defect was found. She was treated as stroke which showed no effect. Two days later, the numbness extended to thoracic level with no sweating below, dyspnea, deep voice, bucking, dysphagia and weakness of both upper and lower extremities. Spinal MRI showed a long T1 signal and long T2 signal extended cervical cord lesion from C4-T5 segments and spinal cord swelling. She was suspected to have multiple sclerosis (MS or neuromyelitis optica (NMO, thus prednisone was given that resulted in the improvement other than numbness of lower extremities, stagger and bladder dysfunction. In the following 4 years, alike symptoms relapsed every year. Though the glucocorticoid treatment was helpful for symptoms remission, sequelae including extremities numbness, weakness, stagger, urinary incontinence and intermittent constipation were left. The predisposing and relieving factors were unclear for relapse. Six months ago, the patient stopped the glucocorticoid treatment by herself, followed by the increase of attack frequencies. One month ago, she got diplopia in the right eye. The patient was admitted for further diagnosis and treatment. Since the onset of symptoms, the patient has been conscious. The appetite and defecation have been normal. No dryness of mouth and eye, shin rash, Reynolds Syndrome, photosensitization and joint pain was noticed. She has a weight loss of 5kg, during which time

  19. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    International Nuclear Information System (INIS)

    Khan, Atif J.; Vicini, Frank A.; Beitsch, Peter; Goyal, Sharad; Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard; Lyden, Maureen; Haffty, Bruce G.

    2012-01-01

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher’s exact test was performed to correlate age (≤70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors ≤2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  20. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Atif J., E-mail: atif_khan@rwjuh.edu [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Vicini, Frank A.; Beitsch, Peter [American Society of Breast Surgeons, Columbia, MD (United States); Goyal, Sharad [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard [American Society of Breast Surgeons, Columbia, MD (United States); Lyden, Maureen [BioStat International, Inc., Tampa, FL (United States); Haffty, Bruce G. [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); American Society of Breast Surgeons, Columbia, MD (United States)

    2012-10-01

    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  1. Evaluating Engagement Models for a Citizen Science Project: Lessons Learned From Four Years of Nature's Notebook

    Science.gov (United States)

    Crimmins, T. M.; Rosemartin, A.

    2012-12-01

    The success of citizen science programs hinges on their abilities to recruit and maintain active participants. The USA National Phenology Network's plant and animal phenology observation program, Nature's Notebook, has been active since 2009. This program engages thousands of citizen scientists in tracking plant and animal life cycle activity over the course of the year. We embarked on an evaluation of the various observer recruitment and retention tactics that we have employed over the ~4-year life of this program to better inform future outreach efforts specific to Nature's Notebook and for the broader citizen science community. Participants in Nature's Notebook may become engaged via one of three pathways: individuals may join Nature's Notebook directly, they may be invited to join through a USA-NPN partner organization, or they may engage through a group with local, site-based leadership. The level and type of recruitment tactics, training, and retention efforts that are employed varies markedly among these three models. In this evaluation, we compared the efficacy of these three engagement models using several metrics: number of individuals recruited, number of individuals that go on to submit at least one data point, retention rates over time, duration of activity, and quantity of data points submitted. We also qualitatively considered the differences in costs the three models require to support. In terms of recruitment, direct engagement yielded 20-100 times more registrants than other two models. In contrast, rates of participation were highest for site-based leadership (>35%, versus 20-30% for direct engagement; rates for partner organizations were highly variable due to small sample sizes). Individuals participating through partners with site-based leadership showed a much higher rate of retention (41% of participants remained active for two+ years) than those participating directly in Nature's Notebook (27% of participants remained active for two+ years

  2. A Survey of Marketing and Market Research Activities in Two and Four-Year Colleges and Universities.

    Science.gov (United States)

    Smith, Janet D.; And Others

    A survey of marketing and market research activities in large, urban, two- and four-year colleges was conducted to identify the nature of marketing problems faced by institutions; current and preferred emphasis placed on market research activities; modes of assessing the needs of target groups and developing appropriate programs; the location of…

  3. A comparison of four years of limnology in the Sawtooth Lakes with emphasis on fertilization in Redfish Lake

    International Nuclear Information System (INIS)

    Budy, P.; Luecke, C.; Wurtsbaugh, W.A.

    1996-01-01

    Included in this section of the report on limnology of Lakes in the Snake River Plain are descriptions of four years of limnological sampling to compare inter and intra annual variability in lake productivity to evaluate potential rearing conditions for juvenile sockeyed salmon. Data was used to evaluate the effects of nutrient enhancement, annual weather patterns, and planktivore consumption on lake productivity

  4. Surviving and Thriving: The Adaptive Responses of U.S. Four-Year Colleges and Universities during the Great Recession

    Science.gov (United States)

    Brint, Steven; Yoshikawa, Sarah R. K.; Rotondi, Matthew B.; Viggiano, Tiffany; Maldonado, John

    2016-01-01

    Press reports and industry statistics both give incomplete pictures of the outcomes of the Great Recession for U.S. four-year colleges and universities. To address these gaps, we conducted a statistical analysis of all articles that appeared in Lexis-Nexis on a sample of more than 300 U.S. colleges and universities during the Recession years. We…

  5. Three-to Four-Year-Olds' Recognition That Symbols Have a Stable Meaning: Pictures Are Understood Before Written Words

    Science.gov (United States)

    Apperly, Ian. A.; Williams, Emily; Williams, Joelle

    2004-01-01

    In 4 experiments 120 three-to four-year-old non readers were asked the identity of a symbolic representation as it appeared with different objects. Consistent with Bialystok (2000), many children judged the identity of written words to vary according to the object with which they appeared but few made such errors with recognizable pictures.…

  6. A Phenomenological Study: The Lived Experience of Former Foster Youth Attending a Four-Year College in Southern California

    Science.gov (United States)

    Lee, Dora Yiu Lam

    2010-01-01

    This qualitative study examined the lived experience of eight individuals attending a four-year college who were all part of a campus support program for former foster youth. The purpose of this phenomenological study was to understand and explore the lived experiences of these unique college students that have gone through the foster care system.…

  7. A comparison of four years of limnology in the Sawtooth Lakes with emphasis on fertilization in Redfish Lake

    Energy Technology Data Exchange (ETDEWEB)

    Budy, P.; Luecke, C.; Wurtsbaugh, W.A.

    1996-05-01

    Included in this section of the report on limnology of Lakes in the Snake River Plain are descriptions of four years of limnological sampling to compare inter and intra annual variability in lake productivity to evaluate potential rearing conditions for juvenile sockeyed salmon. Data was used to evaluate the effects of nutrient enhancement, annual weather patterns, and planktivore consumption on lake productivity.

  8. The Role of Addressee Backchannels and Conversational Grounding in Vicarious Word Learning in Four-Year-Olds

    Science.gov (United States)

    Tolins, Jackson; Namiranian, Neda; Akhtar, Nameera; Fox Tree, Jean E.

    2017-01-01

    Children successfully learn words through overhearing others engaged in verbal interactions. The current studies investigated the degree to which four-year-old overhearers are influenced by the response behaviors of addressees and by the interactional pattern of the speakers and addressees. It was found that while addressee responses on their own…

  9. Two-, Three-, and Four-Year Follow-Up on the Self-Regulatory Treatment of Chronic Headache.

    Science.gov (United States)

    Blanchard, Edward B.; And Others

    1987-01-01

    Chronic tension and vascular headache patients, initially treated with relaxation and biofeedback, were followed-up on an annual basis at two-, three-, and four-years posttreatment. Tension headache patients generally showed good maintenance of initial headache reduction at Year Four. Vascular patients showed a nonsignificant trend for gradual…

  10. Experiences of Female Faculty with Maternity Leave at Four-Year Universities in an Upper Midwest State

    Science.gov (United States)

    Myerchin, Audra Dawn

    2012-01-01

    The purpose of this mixed methods study was to explore female faculty members' experiences with maternity leave, while working as a career academic in higher education. Participants consisted of women currently employed in an upper Midwest state at six four-year institutions. An online survey was completed by 121 women, and 30 of these women also…

  11. Transitive Relational Mappings in Three- and Four-Year-Olds: The Analogy of Goldilocks and the Three Bears.

    Science.gov (United States)

    Goswami, Usha

    1995-01-01

    In three experiments, three- and four-year olds were asked to map relative size from one array of objects to another, map relative size to relative proportion, and map relative size to a variety of perceptual dimensions. Children were able to make relational mappings based on size when spatial positions and concrete representations of size of…

  12. Four-Year Cross-Lagged Associations between Physical and Mental Health in the Medical Outcomes Study.

    Science.gov (United States)

    Hays, Ron D.; And Others

    1994-01-01

    Applied structural equation modeling to evaluation of cross-lagged panel models. Self-reports of physical and mental health at three time points spanning four-year interval were analyzed to illustrate cross-lagged analysis methodology. Data were analyzed from 856 patients with hypertension, diabetes, heart disease, or depression. Cross-lagged…

  13. Cosmesis and Breast-Related Quality of Life Outcomes After Intraoperative Radiation Therapy for Early Breast Cancer: A Substudy of the TARGIT-A Trial

    Energy Technology Data Exchange (ETDEWEB)

    Corica, Tammy, E-mail: Tammy.Corica@health.wa.gov.au [Radiation Oncology Clinical Trials and Research Unit, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia (Australia); Nowak, Anna K. [School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia (Australia); Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); Saunders, Christobel M. [School of Surgery, University of Western Australia, Crawley, Western Australia (Australia); Department of Surgery Fiona Stanley Hospital, Western Australia (Australia); Bulsara, Max [Institute for Health Research, University of Notre Dame, Fremantle, Western Australia (Australia); Taylor, Mandy [Radiation Oncology, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital Nedlands, Western Australia (Australia); Vaidya, Jayant S. [Department of Surgery, Royal Free Hospital, London (United Kingdom); Clinical Trials Group, Division of Surgery and Interventional Science, University College, London, London (United Kingdom); Department of Surgery, Whittington Health, London (United Kingdom); Baum, Michael [Clinical Trials Group, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Joseph, David J. [School of Surgery, University of Western Australia, Western Australia (Australia); Genesis Cancer Care, Western Australia (Australia); Radiation Oncology, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital, Western Australia (Australia)

    2016-09-01

    Purpose: To report the first comprehensive investigation of patient-reported cosmesis and breast-related quality of life (QOL) outcomes comparing patients randomized to risk-adapted single-dose intraoperative radiation therapy (TARGIT-IORT) versus external beam radiation therapy (EBRT) on the TARGIT-A trial. Methods and Materials: Longitudinal cosmesis and QOL data were collected from a subset of TARGIT-A participants who received TARGIT-IORT as a separate procedure (postpathology). Patients completed a cosmetic assessment before radiation therapy and annually thereafter for at least 5 years. Patients also completed the combined European Organization for Research and Treatment of Cancer (EORTC) core questionnaire and Breast-Specific Module in addition to the Body Image after Breast Cancer Questionnaire at baseline and annually thereafter. The combined EORTC questionnaires were also collected 3, 6, and 9 months after wide local excision. Results: An Excellent–Good cosmetic result was scored more often than a Fair–Poor result for both treatment groups across all time points. The TARGIT-IORT patients reported better breast-related QOL than EBRT patients. Statistically and clinically significant differences were seen at month 6 and year 1, with EBRT patients having moderately worse breast symptoms (a statistically significant difference of more than 10 in a 100-point scale) than TARGIT-IORT patients at these time points. Conclusion: Patients treated with TARGIT-IORT on the TARGIT-A trial have similar self-reported cosmetic outcome but better breast-related QOL outcomes than patients treated with EBRT. This important evidence can facilitate the treatment decision-making process for patients who have early breast cancer suitable for breast-conserving surgery and inform their clinicians.

  14. Cosmesis and Breast-Related Quality of Life Outcomes After Intraoperative Radiation Therapy for Early Breast Cancer: A Substudy of the TARGIT-A Trial

    International Nuclear Information System (INIS)

    Corica, Tammy; Nowak, Anna K.; Saunders, Christobel M.; Bulsara, Max; Taylor, Mandy; Vaidya, Jayant S.; Baum, Michael; Joseph, David J.

    2016-01-01

    Purpose: To report the first comprehensive investigation of patient-reported cosmesis and breast-related quality of life (QOL) outcomes comparing patients randomized to risk-adapted single-dose intraoperative radiation therapy (TARGIT-IORT) versus external beam radiation therapy (EBRT) on the TARGIT-A trial. Methods and Materials: Longitudinal cosmesis and QOL data were collected from a subset of TARGIT-A participants who received TARGIT-IORT as a separate procedure (postpathology). Patients completed a cosmetic assessment before radiation therapy and annually thereafter for at least 5 years. Patients also completed the combined European Organization for Research and Treatment of Cancer (EORTC) core questionnaire and Breast-Specific Module in addition to the Body Image after Breast Cancer Questionnaire at baseline and annually thereafter. The combined EORTC questionnaires were also collected 3, 6, and 9 months after wide local excision. Results: An Excellent–Good cosmetic result was scored more often than a Fair–Poor result for both treatment groups across all time points. The TARGIT-IORT patients reported better breast-related QOL than EBRT patients. Statistically and clinically significant differences were seen at month 6 and year 1, with EBRT patients having moderately worse breast symptoms (a statistically significant difference of more than 10 in a 100-point scale) than TARGIT-IORT patients at these time points. Conclusion: Patients treated with TARGIT-IORT on the TARGIT-A trial have similar self-reported cosmetic outcome but better breast-related QOL outcomes than patients treated with EBRT. This important evidence can facilitate the treatment decision-making process for patients who have early breast cancer suitable for breast-conserving surgery and inform their clinicians.

  15. Species Diversity Effects on Productivity, Persistence and Quality of Multispecies Swards in a Four-Year Experiment

    DEFF Research Database (Denmark)

    Jing, Jingying; Søegaard, Karen; Cong, Wen-Feng

    2017-01-01

    ), neutral detergent fiber (NDF) and crude protein (CP), and a lower concentration of ash than the 10-mix and 12-mix. Slurry application increased annual yield production by 10% and changed the botanical composition, increasing the proportion of grass and decreasing the proportion of legumes. Compared......Plant species diversity may benefit natural grassland productivity, but its effect in managed grassland systems is not well understood. A four-year multispecies grassland experiment was conducted to investigate the effect of species diversity±legumes and non-leguminous forbs±on productivity...... increased sward production and yield persistence under cutting regime. The 12-mix had the highest yield from the second year onwards and no statistically significant yield reduction over four years, while annual yields in the 3-mix and 10-mix decreased significantly with increasing grassland age. The higher...

  16. Bacterial Pathogens and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Four-Year Surveillance Study (2009–2012)

    OpenAIRE

    Mirsoleymani, Seyed Reza; Salimi, Morteza; Shareghi Brojeni, Masoud; Ranjbar, Masoud; Mehtarpoor, Mojtaba

    2014-01-01

    The aims of this study were to assess the common bacterial microorganisms causing UTI and their antimicrobial resistance patterns in Bandar Abbas (Southern Iran) during a four-year period. In this retrospective study, samples with a colony count of ≥105 CFU/mL bacteria were considered positive; for these samples, the bacteria were identified, and the profile of antibiotic susceptibility was characterized. From the 19223 samples analyzed, 1513 (7.87%) were positive for bacterial infection. UTI...

  17. President Vladimir Putin’s Third Four-Year Term: Contradictory Outcomes – an Expec ted Result

    Directory of Open Access Journals (Sweden)

    Vladimir Aleksandrovich Ilyin

    2016-05-01

    Full Text Available In mid-March, Vladimir Putin’s third four-year presidency came to an end. If the term of office of the head of state were not prolonged in 2008, then the seventh presidential election would take place today, and therefore, a critical question arises: “What has been done and what needs to be done?... What does the President have in store for the people?”

  18. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach.

    Science.gov (United States)

    Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J

    2009-11-22

    Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  19. Foresight beyond the very next event: Four-year-olds can link past and deferred future episodes

    Directory of Open Access Journals (Sweden)

    Jonathan eRedshaw

    2013-07-01

    Full Text Available Previous experiments have demonstrated that by four years of age children can use information from a past episode to solve a problem for the very next future episode. However, it remained unclear whether four-year-olds can similarly use such information to solve a problem for a more removed future episode that is not of immediate concern. In the current study we introduced four-year-olds to problems in one room before taking them to another room and distracting them for 15 minutes. The children were then offered a choice of items to place into a bucket that was to be taken back to the first room when a five-minute sand-timer had completed a cycle. Across two conceptually distinct domains, the children placed the item that could solve the deferred future problem above chance level. This result demonstrates that by 48 months many children can recall a problem from the past and act in the present to solve that problem for a deferred future episode. We discuss implications for theories about the nature of episodic foresight.

  20. Differentiating maternal fatigue and depressive symptoms at six months and four years post partum: Considerations for assessment, diagnosis and intervention.

    Science.gov (United States)

    Giallo, Rebecca; Gartland, Deirdre; Woolhouse, Hannah; Brown, Stephanie

    2015-02-01

    fatigue and depressive symptoms are common among women in the postpartum period, and it has been proposed that fatigue is a risk factor for later depression. To progress this research, there is a need to clarify the conceptual and measurement issue of whether these two sets of symptoms are distinct constructs. There is also a need to determine whether they are distinct constructs beyond the postnatal period. The aim of the study was to assess the construct and discriminant validity of fatigue and depressive symptoms as measured by the SF-36 Vitality subscale (SF-36) and the Edinburgh Postnatal Depression Scale (EPDS) at six months and at four years post partum. data from over 1000 women participating in the Maternal Health Study, a longitudinal study of women׳s physical and psychological health and recovery after childbirth were used. confirmatory factor analysis revealed a two-factor model of fatigue and depressive symptoms represented as distinct but related constructs was a better fit to the data than a one-factor model of fatigue and depression sharing the same underlying construct at both six months and four years post partum. this study provides empirical evidence that maternal fatigue and depression in the first year after having a baby and at four years post partum are best understood as separate psychological constructs or experiences. The findings have important implications for clinical practice, in particular underlining the importance of differentiating tiredness from depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Reduction in transmission of Schistosoma mansoni by a four-year focal mollusciciding programme against Biomphalaria glabrata in Saint Lucia.

    Science.gov (United States)

    Prentice, M A; Jordan, P; Bartholomew, R K; Grist, E

    1981-01-01

    The effect of transmission of Schistosoma mansoni of a focal snail control programme was investigated over four years amongst approximately 1250 people living in five communities in the steep-sided Soufriere river valley, St. Lucia, West Indies. Bayer 6076 was applied from constant flow drip cans to 12 stream sections at a target dose of 8 mg/litre clonitralide every four weeks. Only proven and potential transmission sites were treated; marsh habitats, where Biomphalaria glabrata were widespread, were ignored. In the stream snail numbers were reduced by 94% in the first year and by 100% thereafter. Incidence of new S. mansoni infections amongst children fell from 18% in the last year before control to 6% and 9% after three and four years respectively. Amongst children and adults in the four years of control the conversion/reversion ratio declined leading to a lowering of the over-all prevalence from 40% to 22%. Parasitologically the results were similar to those of a previously evaluated area-wide mollusciciding programme. The mean annual cost per person protected was US $2.60. This figure is atypically high because the topography of the area severely limited the population size.

  2. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach

    Directory of Open Access Journals (Sweden)

    Christensen Helen

    2009-11-01

    Full Text Available Abstract Background Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. Methods The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. Results The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. Conclusion The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

  3. Accelerated partial breast irradiation using once-daily fractionation: analysis of 312 cases with four years median follow-up

    Directory of Open Access Journals (Sweden)

    Shaikh Arif Y

    2012-02-01

    Full Text Available Abstract Background There are limited data on accelerated partial breast irradiation (APBI using external beam techniques. Moreover, there are recent reports of increased fibrosis and unacceptable cosmesis with APBI using external beam with BID fractionation. We adopted a once daily regimen of APBI with fractionation similar to that shown to be effective in a Canadian randomized trial of whole breast irradiation. It is unclear whether patients with DCIS or invasive lobular carcinoma (ILC are suitable for APBI. Methods The retrospective cohort included 310 patients with 312 tumors of T1-T2N0-N1micM0 invasive ductal carcinoma (IDC, ILC, or Tis (DCIS treated with APBI via external beam. Most patients were treated using IMRT with 16 daily fractions of 270 cGy to a dose of 4320 cGy. The target volume included the lumpectomy cavity plus 1.0 cm to account for microscopic disease and an additional 0.5 to 1.0 cm for setup uncertainty and breathing motion. Ipsilateral breast failure (IBF was pathologically confirmed as a local failure (LF or an elsewhere failure (EF. Results Median follow-up was 49 months. Among the 312 cases, 213 were IDC, 31 ILC, and 68 DCIS. Median tumor size was 1.0 cm. There were 9 IBFs (2.9% including 5 LFs and 4 EFs. The IBF rates among patients with IDC, ILC, and DCIS were 2.4%, 3.2%, and 4.4%, respectively, with no significant difference between histologies. When patients were analyzed by the ASTRO APBI consensus statement risk groups, 32% of treated cases were considered suitable, 50% cautionary, and 18% unsuitable. The IBF rates among suitable, cautionary, and unsuitable patients were 4.0%, 2.6%, and 1.8%, respectively, with no significant difference between risk groups. Acute skin reactions were rare and long-term cosmetic outcome was very good to excellent. Conclusions External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not

  4. Four years of crusade!

    Directory of Open Access Journals (Sweden)

    Adilson Beatriz

    2012-04-01

    Full Text Available Orbital - The Electronic Journal of Chemistry is entering its 4th year of existence which is a reason to celebrate. A great work has been devoted to preserve a scientific journal of international reputation. This work was not always without mistakes or any trouble. However, these very adversities stimulate additional efforts in order to overcome our errors and, continuing with our serious proposal of editing a journal which scientists from all over the world can submit online their original works manuscripts to be published in peer review and open-access style. Beginning this year, Orbital was classified by the Chemistry Coordination Area on the B5 rank of CAPES Qualis (Brazil and, leveled as B4 by Coordination Areas of Materials and Engineering II. These important details demonstrate that Orbital is progressively attaining the acknowledgment of the Brazilian scientific community. The recognition by CAPES Qualis is crucial as the system evaluates the generation of knowledge in the Brazilian universities and the method by which this same knowledge disseminated to society. Not all these were possible without endeavoring of editors and volunteer assistance of advisors from several national and international institutions. Recently, the young Professors Kleber Thiago de Oliveira (UFSCAR, Grégoire Demetz (USP-RP and Amilcar Machulek Júnior (UFMS have joined us to share the idea and philosophy of Orbital by accepting our invitation to be associated editors. The tasks and challenges are enormous and, we are sure that new participants will support us on the way to achieve indexation in new Databases systems as SCOPUS, ISI and Scielo. Consequently, the international success of this electronic journal will be assured. We sincerely hope that in the academic Brazilian scenario, Orbital can figure as a solid bridge to interchange real creative science that is happening in various locations around the world.

  5. Four years of HELAS

    Science.gov (United States)

    Roth, M.; Lühe, O. v. d.; Aerts, C.; Christensen-Dalsgaard, J.; Corbard, T.; Daszyńska-Daszkiewicz, J.; Di Mauro, M. P.; Gizon, L.; Jiménez-Reyes, S.; Monteiro, M. J. P. F. G.; Pallé, P. L.; Thompson, M. J.

    2010-12-01

    The European Coordination Action on HELio- and ASteroseismology (HELAS) has completed its fourth and final year of initial funding by the European Commission. Set up as a network which combines solar and stellar physics communities in the important and vigorously evolving field of seismology, HELAS has been able to coordinate the efforts of European astronomers with remarkable success. Four large international conferences including the HELAS-IV conference on Lanzarote as well as many workshops were organized with a substantial contribution from HELAS. About a dozen workshops, addressing specialized questions in global and local helioseismology and asteroseismology were entirely organized by HELAS. Data analysis tools to prepare the European communities for the upcoming influx of data from new missions have been prepared, tested and demonstrated. Lecture notes and outreach material have been assembled and prepared for general access. As a result, HELAS has an important impact on the scientific output of the astrophysics seismology communities and significantly increased the visibility of European research in this field. This paper summarizes the activities and accomplishments of HELAS.

  6. [Visual outcomes four years after small incision lenticule extraction (SMILE) surgery on highly myopic eyes [French version

    Science.gov (United States)

    Burazovitch, J; Naguzeswski, D; Beuste, T; Guillard, M

    2017-09-01

    To determine whether the visual outcomes of the refractive surgery technique, small incision lenticule extraction (SMILE), are stable, effective, and predictable for high myopia over a four-year period. This is a retrospective study. The data were collected between March 2012 and July 2016. Two hundred and forty-eight patients participated in the study; that is, 496 eyes: 140 eyes of 70 patients (52 women/18 men) were classified in the highly myopic group (refraction measured in spherical equivalent [RMSE]>-6D), and 356 eyes of 178 patients (98 women/80 men) in the control group (RMSE≤-6D). Follow-up tests were conducted immediately post-operatively (D+1), after three months, after one year, and after four years. Refraction, uncorrected visual acuity (UCVA), and best visual corrected acuity (BCVA) were measured. The highly myopic group (HMG) contained more women, and astigmatism was higher for this group than for the control group (CG). These are BCVA, refractive stability, the index of safety (SI: BCVA preoperatively D+1/BCVA postoperatively), and predictability (the percentage of eyes within±0.5 D of the target). In both groups, UCVA was better after the fourth year than it was immediately after the procedure (HMG: P=0.001; CG: P=0.001). Although it differed at one year (P=0.01), the groups' refractive stability tended to converge over four years (P=0.138). Both groups' SI was identical in the four follow-up tests (P=0.734 at D+1; P=0.07 at M+1; P=0.160 at M3 and Y1; and P=0.274 at Y4). For the HMG, SI stability was attained after three months (1.00±0.1); whereas it was attained after one month (0.91±0.11) for the CG. Four years after the surgery, we observed that 87 % of the operated eyes in the HMG were within 0.5 D of the target. SMILE is a good refractive surgery technique for treating high myopia. It yields stable, safe, effective, and predictable results over four years. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor-positive early-stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, Barbara; Fein, Douglas A.; Hanlon, Alexandra L.; Eisenberg, Burton L.; Hoffman, John P.; Sigurdson, Elin R.; Daly, Mary B.; Goldstein, Lori J.

    1996-01-01

    Purpose: To evaluate the impact of tamoxifen on breast recurrence, cosmesis, complications, overall and cause-specific survival in women with Stage I-II breast cancer and estrogen receptor positive tumors undergoing conservative surgery and radiation. Methods and Materials: From 1982 to 1991, 491 women with estrogen receptor positive Stage I-II breast cancer underwent excisional biopsy, axillary dissection, and radiation. The median age of the patient population was 60 years with 21% < 50 years of age. The median follow-up was 5.3 years (range 0.1 to 12.8). Sixty-nine percent had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49% and the final margin of resection was negative in 64%. One hundred fifty-four patients received tamoxifen and 337 patients received no adjuvant therapy. None of the patients received adjuvant chemotherapy. Results: There were no significant differences between the two groups for age, race, clinical tumor size, histology, the use of reexcision, or median total dose to the primary. Patients who received tamoxifen were more often axillary node positive (44% tamoxifen vs. 5% no tamoxifen), and, therefore, a greater percentage received treatment to the breast and regional nodes. The tamoxifen patients less often had unknown margins of resection (9% tamoxifen vs. 22% no tamoxifen). The 5-year actuarial breast recurrence rate was 4% for the tamoxifen patients compared to 7% for patients not receiving tamoxifen (p 0.21). Tamoxifen resulted in a modest decrease in the 5-year actuarial risk of a breast recurrence in axillary node-negative patients, in those with unknown or close margins of resection, and in those who underwent a single excision. Axillary node-positive patients had a clinically significant decrease in the 5-year actuarial breast recurrence rate (21 vs. 4%; p 0.08). The 5-year actuarial rate of distant metastasis was not significantly decreased by the addition of adjuvant tamoxifen in all

  8. Association of Circulating 25(OHD and Lower Urinary Tract Symptoms: A Four-Year Prospective Study among Elderly Chinese Men

    Directory of Open Access Journals (Sweden)

    Zhao-Min Liu

    2016-05-01

    Full Text Available The role of vitamin D in relation to lower urinary tract symptoms (LUTS remains inconclusive. This four-year longitudinal study aims to explore the association of circulating 25(OHD and LUTS in elderly Chinese men. Two thousand Chinese men aged 65 and older were recruited from a local community, of which 1998 (99.9% at baseline and 1564 (78.2% at four-year follow-up reported data on LUTS, and 988 of the randomly chosen subpopulation were assayed for serum 25(OHD by radioimmunoassay at baseline. LUTS were evaluated by a validated International Prostate Symptoms Scale (IPSS. Data on demographic characteristics, lifestyle factors, health, and medications were collected. Serum parathyroid and sex steroid hormones and genotypes of vitamin D receptors were assayed. The association of serum 25(OHD and LUTS was examined by using multivariable regression models. Serum 25(OHD was not significantly associated with the changes of IPSS or the risk of LUTS in overall participants. However, among men with 25(OHD ≤ 60 nmol/L, each 10 nmol/L increase of 25(OHD over 0 nmol/L was significantly associated with 1.3 lower points of IPSS or a 51.6% decreased risk for moderate/severe LUTS four years later. Adjustment for serum androstenedione (p = 0.019 and dehydropiandrosterone (p = 0.037 attenuated the associations. Our study suggested that among individuals with low vitamin D status, the increase of the 25(OHD level may be associated with a lowered risk of LUTS.

  9. Young woman with a four-year history of epilepsy and progressive focal cortical atrophy — What is the diagnosis?

    Directory of Open Access Journals (Sweden)

    S. Pati

    2014-01-01

    Full Text Available The pathogenesis of disease progression in drug-refractory epilepsy is poorly understood. We report the case of a young woman with a four-year history of epilepsy that progressed rapidly as evidenced by the development of progressive focal cortical atrophy. She underwent biopsy that showed perinatal ischemia and a prominent inflammatory response, including T-cell infiltration and microglial activation. There was no consensus reached on the final diagnosis although the hypothesis of dual pathology (adult variant of Rasmussen's encephalitis and perinatal stroke was considered. The possible role of inflammation in the progression of epilepsy caused by a “static” lesion (perinatal stroke is discussed.

  10. Do postoperative radiographically verified technical success, improved cosmesis, and trunk shift corroborate with patient-reported outcomes in Lenke 1C adolescent idiopathic scoliosis?

    Science.gov (United States)

    Sharma, Shallu; Bünger, Cody Eric; Andersen, Thomas; Sun, Haolin; Wu, Chunsen; Hansen, Ebbe Stender

    2015-07-01

    To examine correlation between postoperative radiographic and cosmetic improvements in Lenke 1C adolescent idiopathic scoliosis (AIS) with patients' self-rated outcomes of health and disability at follow-up as determined by the Scoliosis Research Society questionnaire (SRS-30), Oswestry Disability Index score (ODI) and measure of overall health quality Euroqol-5d (EQ-5D). 24 Lenke 1C scoliosis patients, mean age 16.5 (12.8-38.1) years, treated with posterior pedicle screw-only construct, were included. The coronal profile indices (radiographic and cosmetic) regarding magnitude of spinal deformity and truncal balance were measured preoperatively, postoperatively and at final follow-up. A comprehensive index of overall back symmetry was also measured by means of the Posterior Trunk Symmetry Index (POTSI). Pearson's correlation analysis determined the association between the radiographic-cosmetic indices and patient-rated outcomes. Mean follow-up for the cohort was 4.4 (±1.86) years. The thoracic apical vertebra-first thoracic vertebra horizontal distance (AV-TI) correction had significant correlation with function, self-image, and mental health SRS-30 scores (0.55, 0.54, 0.66). Similarly, thoracic apical vertebra horizontal translation from central sacral vertical line (AV-CSVL) correction at follow-up had significant correlation with self-image and management domains (0.57, 0.50). Follow-up POTSI correlated well with SRS-30 and EQ-5D scores (r = -0.64, -0.54). Postoperative leftward trunk shift/spinal imbalance did not influence overall cosmesis and outcomes; significant spinal realignment was evident in follow-up resulting in physiological balance and acceptable cosmesis and outcomes. Significant, but less than "perfect" correlations were observed between the radiographic, cosmetic measures and patient-rated outcomes. Thoracic AV-CSVL, AV-T1 correction and POTSI associated significantly with SRS-30 scores. Whereas, thoracic Cobb angle, Cobb correction, and

  11. Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2017-07-01

    Full Text Available Objective. To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods. The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM. We used postestimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results. CFD prevalence is 2%,which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions. A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

  12. Extension of general practice training from three to four years: experiences of a vocational training programme in Southern Ireland.

    LENUS (Irish Health Repository)

    Dowling, Stephanie

    2009-05-01

    The aim of this study was to evaluate the experiences of trainees taking part in an extended (four-year) general practice training programme introduced in the South Eastern region of the Republic of Ireland to replace the previous traditional (three-year) programme. In a qualitative design, eight homogeneous focus groups were held to determine the value of the additional year of training. The first cohort of trainees was interviewed towards the start and at the end of their fourth year. Trainees finishing the following year were also interviewed, as were graduates from the final three-year programme. GP trainers and the four members of the programme directing team comprised two further independent focus groups. Trainees reported that the integration of hospital posts and general practice attachments over the four years was particularly beneficial. The exposure to a variety of different general practices and the opportunity to take part in specialty clinics were considered extremely useful. The fourth year of training was felt to be less pressurised than previous years. Professional and personal development was enhanced; improved readiness to practise and confidence were noted. Perceived disadvantages of extended training included a lack of acknowledgment for doctors in their fourth year and excessive emphasis placed on research during the final year of training. The addition of an extra year of vocational training improves professional and personal development and changes the learning experience for doctors. Doctors felt more confident and ready to enter independent practice at the end of the fourth year of training.

  13. Four-year-olds' strategic allocation of resources: attempts to elicit reciprocation correlate negatively with spontaneous helping.

    Science.gov (United States)

    Kenward, Ben; Hellmer, Kahl; Winter, Lina Söderström; Eriksson, Malin

    2015-03-01

    Behaviour benefitting others (prosocial behaviour) can be motivated by self-interested strategic concerns as well as by genuine concern for others. Even in very young children such behaviour can be motivated by concern for others, but whether it can be strategically motivated by self-interest is currently less clear. Here, children had to distribute resources in a game in which a rich but not a poor recipient could reciprocate. From four years of age participants strategically favoured the rich recipient, but only when recipients had stated an intention to reciprocate. Six- and eight-year-olds distributed more equally. Children allocating strategically to the rich recipient were less likely to help when an adult needed assistance but was not in a position to immediately reciprocate, demonstrating consistent cross-task individual differences in the extent to which social behaviour is self- versus other-oriented even in early childhood. By four years of age children are capable of strategically allocating resources to others as a tool to advance their own self-interest. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Where to find a trustworthy source of information? four years of risk communication about a nuclear waste disposal

    International Nuclear Information System (INIS)

    Findahl, O.

    1998-01-01

    Full text of publication follows: in September 1997 there was a referendum, in a small local district in the north of Sweden, on the disposal of the swedish high intensive nuclear waste. A small majority of the 2500 voters stopped the examination of the conditions for a storage. Four years earlier the opinion against a local storage of nuclear waste had been much stronger but during the years that followed more people came to think that an examination of the conditions for a storage was OK; that will create new jobs, and what will come later we will see. The closer to the referendum the stronger this positive opinion became. They did not have any information problems. There were experts and information sources they could believe in. But the majority was still negative and they were dissatisfied. They could not find any trustworthy information. And though they in the end had prevented the localization of the nuclear waste storage to their commune they still felt that the decision had been taken high above their heads. Why is it like that? And what happened during these four years of experimentation in democratic risk communication? (author)

  15. Clinical and immune characteristics of men, who worked within 30-km zone near Chernobyl four years after the accident

    International Nuclear Information System (INIS)

    Oradovskaya, I.V.; Ruzybakiev, R.M.; Prokopenko, V.D.

    1994-01-01

    Clinical examination with immune status assessment of more than 300 healthy persons, who worked in 30-km Chernobyl NPP zone four years after the accident was carried out. The clinical characters of immune deficiency were detected in 6.67 % of examined persons and appeared as repeated respiratory diseases. Significant increase in mean level of leukocytes and lymphocytes was revealed. Activation of T-helper link of cell immunity was determined by increase of CD 4 + cells in 35.2 % of examined persons, that were lower than in people who took part in Chernobyl accident amelioration in 1986. Decrease in content of T-cells and B-cells was observed in 1/4 and 3/4 of persons correspondingly by rosette assays. No changes in serum immunoglobulins level was observed

  16. Mammary tumors and serum hormones in the bitch treated with medroxyprogesterone acetate or progesterone for four years

    Energy Technology Data Exchange (ETDEWEB)

    Frank, D.W.; Kirton, K.T.; Murchison, T.E.; Quinlan, W.J.; Coleman, M.E.; Gilbertson, T.J.; Feenstra, E.S.; Kimball, F.A.

    1978-01-01

    After four years of a long term contraceptive steroid safety study, the incidence and the histologic type of mammary dysplasia produced is similar in beagles treated with medroxyprogesterone acetate (medroxyprogesterone) or progesterone. Serum insulin, thyroid stimulating hormone (TSH), triiodothyronine, growth hormone, prolactin, 17..beta..-estradiol, progesterone, and cortisol were determined by radioimmunoassay on samples collected after 45 months of treatment. Serum growth hormone and insulin concentrations were elevated in a dose related manner in both treatment groups. Triiodothyronine, cortisol, and estradiol-17..beta.. (medroxyprogesterone only) were lowered. TSH and prolactin concentrations were not changed. Pituitary--gonadal hormone interaction in the pathogenesis of mammary neoplasia of the dog is discussed. Prolonged treatment of the beagle with massive doses of progesterone or medroxyprogesterone results in a dose related incidence of mammary modules.

  17. The national neonatal screening programme for congenital toxoplasmosis in Denmark: results from the initial four years, 1999-2002

    DEFF Research Database (Denmark)

    Schmidt, Dorte Remmer; Høgh, Birthe; Andersen, O

    2006-01-01

    AIMS: To describe the outcome of four years' nationwide neonatal screening for congenital toxoplasmosis in liveborn newborns. METHODS: Congenital toxoplasmosis was diagnosed if specific Toxoplasma gondii IgM antibodies were detected in eluate from the PKU Guthrie filter paper card from a child....... Infants diagnosed with congenital toxoplasmosis were examined for intracranial and retinal lesions and treated for three months with sulphadiazine, pyrimethamine, and folinic acid continuously. RESULTS: Eluates from PKU-cards from 262 912 newborns were analysed. The birth prevalence of congenital...... toxoplasma infection was 2.1 per 10 000 liveborns. Congenital toxoplasmosis was suspected in 96 infants and confirmed in 55. Forty seven children were examined for intracranial and retinal lesions soon after birth; 12 had clinical signs at this first examination. Of these, 5 had intracranial calcifications...

  18. Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children.

    Science.gov (United States)

    van Sluijs, Esther M F; McMinn, Alison M; Inskip, Hazel M; Ekelund, Ulf; Godfrey, Keith M; Harvey, Nicholas C; Griffin, Simon J

    2013-01-01

    Correlates of physical activity (PA) are hypothesized to be context and behaviour specific, but there is limited evidence of this in young children. The aim of the current study is to investigate associations between personal, social and environmental factors and objectively measured light and moderate-to-vigorous PA (LPA and MVPA, respectively) in four-year-old children. Cross-sectional data were used from the Southampton Women's Survey, a UK population-based longitudinal study. Four-year old children (n = 487, 47.0% male) had valid PA data assessed using accelerometry (Actiheart) and exposure data collected with a validated maternal questionnaire (including data on child personality, family demographics, maternal behaviour, rules and restrictions, and perceived local environment). Linear regression modelling was used to analyse associations with LPA and MVPA separately, interactions with sex were explored. LPA minutes were greater in children whose mothers reported more PA (vs. inactive: regression coefficient±standard error: 6.70±2.94 minutes), and without other children in the neighbourhood to play with (-6.33±2.44). MVPA minutes were greater in children with older siblings (vs. none: 5.81±2.80) and those whose mothers used active transport for short trips (vs. inactive: 6.24±2.95). Children accumulated more MVPA in spring (vs. winter: 9.50±4.03) and, in boys only, less MVPA with availability of other children in the neighbourhood (-3.98±1.70). Young children's LPA and MVPA have differing associations with a number of social and environmental variables. Interventions targeting PA promotion in young children outside of formal care settings should consider including intensity specific factors.

  19. Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children.

    Directory of Open Access Journals (Sweden)

    Esther M F van Sluijs

    Full Text Available BACKGROUND: Correlates of physical activity (PA are hypothesized to be context and behaviour specific, but there is limited evidence of this in young children. The aim of the current study is to investigate associations between personal, social and environmental factors and objectively measured light and moderate-to-vigorous PA (LPA and MVPA, respectively in four-year-old children. METHODS: Cross-sectional data were used from the Southampton Women's Survey, a UK population-based longitudinal study. Four-year old children (n = 487, 47.0% male had valid PA data assessed using accelerometry (Actiheart and exposure data collected with a validated maternal questionnaire (including data on child personality, family demographics, maternal behaviour, rules and restrictions, and perceived local environment. Linear regression modelling was used to analyse associations with LPA and MVPA separately, interactions with sex were explored. RESULTS: LPA minutes were greater in children whose mothers reported more PA (vs. inactive: regression coefficient±standard error: 6.70±2.94 minutes, and without other children in the neighbourhood to play with (-6.33±2.44. MVPA minutes were greater in children with older siblings (vs. none: 5.81±2.80 and those whose mothers used active transport for short trips (vs. inactive: 6.24±2.95. Children accumulated more MVPA in spring (vs. winter: 9.50±4.03 and, in boys only, less MVPA with availability of other children in the neighbourhood (-3.98±1.70. DISCUSSION: Young children's LPA and MVPA have differing associations with a number of social and environmental variables. Interventions targeting PA promotion in young children outside of formal care settings should consider including intensity specific factors.

  20. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications

    Directory of Open Access Journals (Sweden)

    Wadasadawala Tabassum

    2009-01-01

    Full Text Available Context: Accelerated partial-breast irradiation (APBI using various approaches is being increasingly employed for selected women with early breast cancer (EBC. Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT. Settings and Design: Women with EBC fulfilling the American Brachytherapy Society (ABS criteria were selected as ′cases′ if treated with APBI or as ′controls′ if offered WBRT during the period from May 2000 to December 2004. Materials and Methods: APBI patients were treated with high-dose-rate brachytherapy (HDR to a dose of 34 Gy/10#/6-8 days. WBRT was delivered to the whole breast to a dose of 45 Gy/25# followed by tumor bed boost, either with electrons (15 Gy/6# or interstitial brachytherapy (HDR 10 Gy/1#. Results: At the median follow-up of 43.05 months in APBI and 51.08 months in WBRT there was no difference in overall survival (OS, disease-free survival (DFS, late arm edema, and symptomatic fat necrosis between the two groups. However, APBI resulted in increase in mild breast fibrosis at the tumor bed. Telangiectasias were observed in three patients of the APBI group. The cosmetic outcome was significantly better in the APBI group as compared to the WBRT group (P = 0.003. Conclusions: This study revealed equivalent locoregional and distant disease control in the two groups. APBI offered better overall cosmetic outcome, though at the cost of a slight increase in mild breast fibrosis and telangiectasias.

  1. Training Intensity Distribution Over a Four-Year Cycle in Olympic Champion Rowers: Different Roads Lead to Rio.

    Science.gov (United States)

    Plews, Daniel J; Laursen, Paul B

    2017-09-27

    The purpose of this study was to compare the training intensity distribution (TID) of the undefeated world champion male rowing New Zealand (kiwi) pair over a four-year Olympic cycle, across training phases, training years, and between individuals. Training data, including heart rate and boat speed, were recorded in the athletes rowing in the same boat between March 2013 and August 2016, ending with the Rio Olympics final. Progressive exercise tests assessed first (LT 1 ) and second (LT 2 ) lactate thresholds and associated heart rates, to determine the percentage of training performed below, between and above these demarcation points. Training an average of only 12-15 h/wk throughout the Olympic cycle, the mean percent distribution of time (±SD) at each training intensity was 80.4 ± 5.5% LT 2 for Rower A and 67.3 ± 9.0% LT 2 for Rower B. Across the years 2014-2016, Rower A performed most likely more training training between LT 1 -LT 2 . Training appeared to become more polarised, with greater amounts of time spent training duration (R=0.38-0.43). Two of the world's best rowers, rowing together in the same boat with an undefeated record across an Olympic cycle, travelled markedly different "roads to Rio" within the context of their TID, with one rower displaying a polarised model of TID, and the other pyramidal. However, TID trended towards becoming more polarised in both rowers with increased training duration.

  2. New CLGF Four-Year Grant to Help Local Government Service Delivery and Boost CLGF’s Research Capacity

    Directory of Open Access Journals (Sweden)

    Lucy Slack

    2012-12-01

    Full Text Available The UK Department for International Development (UK AID has agreed £4.5 million funding for a four-year CLGF programme to improve governance and service delivery at local level in several areas of the Commonwealth including Africa and Asia from 2012-16. It will also help to support national policy frameworks for local government service delivery, and increase engagement of local government in regional policy planning and implementation. CLGF will continue to work with its members, UN partners and others to mobilise more resources towards the support of local government in the Commonwealth. The new programme will focus on local government pilot projects in LED, supporting ministries and local government associations in strengthening their national policy making for local government, and establish regional forums to enable local government to engage in and influence regional policy making to reflect the needs and priorities of local government. It will also boost CLGF’s research capacity with targeted research to strengthen CLGF’s policy making and advocacy, including more sustained engagement in international policy debates on key issues affecting local government, such as climate change.

  3. Integrating critical thinking and evidence-based dentistry across a four-year dental curriculum: a model for independent learning.

    Science.gov (United States)

    Marshall, Teresa A; Straub-Morarend, Cheryl L; Handoo, Nidhi; Solow, Catherine M; Cunningham-Ford, Marsha A; Finkelstein, Michael W

    2014-03-01

    Introducing critical thinking and evidence-based dentistry (EBD) content into an established dental curriculum can be a difficult and challenging process. Over the past three years, the University of Iowa College of Dentistry has developed and implemented a progressive four-year integrated critical thinking and EBD curriculum. The objective of this article is to describe the development and implementation process to make it available as a model for other dental schools contemplating introduction of critical thinking and EBD into their curricula. The newly designed curriculum built upon an existing problem-based learning foundation, which introduces critical thinking and the scientific literature in the D1 year, in order to expose students to the rationale and resources for practicing EBD in the D2 and D3 years and provide opportunities to practice critical thinking and apply the EBD five-step process in the D2, D3, and D4 years. All curricular content is online, and D3 and D4 EBD activities are integrated within existing clinical responsibilities. The curricular content, student resources, and student activities are described.

  4. Four years of experience with the use of calculated isotopic correlations in establishing input balances at the La Hague plant

    International Nuclear Information System (INIS)

    Aries, M.; Patigny, P.; Bouchard, J.; Giacometti, A.; Girieud, R.

    1983-01-01

    For more than four years the La Hague reprocessing plant has been using calculated isotopic correlations to establish and check its input balances. The masses of uranium and plutonium entering the plant are determined by the gravimetric balance method, which utilizes the burnup obtained by calculated isotopic correlation as well as the Pu/U ratio measured at the dissolver after cross-checking with the values obtained by correlation. Further, a verification of all the parameters needed to establish these balances - whether physical or chemical in origin - is carried out systematically by means of internal coherence constants which make it possible to detect any anomalies in the dissolution data. The calculated isotopic correlations were evaluated when the analyses of numerous representative samples of irradiated fuel and experimental results of separated isotopic irradiation in water reactor spectra had been interpreted. The accuracy achieved was improved by allowing in the neutron calculations for effects inherent in the first reactor core and by selecting a set of calculation functions which attenuates (by compensation effects) the various perturbations in the irradiation history. The results obtained at La Hague with calculated isotopic correlations on nearly 600 t of reprocessed UO 2 , because of their large number and above all their high quality, suggest that it be proposed extending the method to other reprocessing plants. This could be done by the operator himself or by national or international control bodies within the framework of a safeguards arrangement. (author)

  5. [Intravenous thrombolysis for acute ischemic stroke. A four years’ experience in a Chilean public hospital].

    Science.gov (United States)

    Soto V, Álvaro; Morales I, Gladys; Grandjean B, Marcela; Pollak W, Débora; Del Castillo C, Carolina; García F, Pía; Von Johnn A, Alexis; Riquelme G, Alfonso

    2017-04-01

    Intravenous thrombolysis (IVT) with alteplase (tissue plasminogen activator) is the standard pharmacological treatment in acute ischemic stroke (AIS), reducing disability in patients. To report the results a thrombolysis protocol during four years in a regional public hospital. Data from 106 consecutive patients aged 68 ± 13 years (57% men) who were treated with IVT, from May 2012 until April 2016, was analyzed. The median door-to-needle time was 80 minutes (interquartile range = 57-113). The median National Institute of Health Stroke Scale (NIHSS) scores on admission and at discharge were was 11.5 and 5 points respectively. At discharge, 27% of hospitalized patients had a favorable outcome (n = 99), defined as having 0 to 1 points in the modified Rankin scale. Symptomatic intracerebral hemorrhage and mortality rates were 5.7 and 13.1%, respectively. The thrombolysis rate rose from 0.7% in 2012 to 6% in 2016. The implementation of 24/7 neurology shifts in the Emergency Department allowed us to increase the amount and quality of IVT in our hospital, as measured by the rate of thrombolysis and by process indicators such as door-to-needle time.

  6. Bacterial Pathogens and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Four-Year Surveillance Study (2009–2012

    Directory of Open Access Journals (Sweden)

    Seyed Reza Mirsoleymani

    2014-01-01

    Full Text Available The aims of this study were to assess the common bacterial microorganisms causing UTI and their antimicrobial resistance patterns in Bandar Abbas (Southern Iran during a four-year period. In this retrospective study, samples with a colony count of ≥105 CFU/mL bacteria were considered positive; for these samples, the bacteria were identified, and the profile of antibiotic susceptibility was characterized. From the 19223 samples analyzed, 1513 (7.87% were positive for bacterial infection. UTI was more frequent in male (54.9%. E. coli was reported the most common etiological agent of UTI (65.2%, followed by Klebsiella spp. (26%, Pseudomonas aeruginosa (3.6%, and Staphylococcus coagulase positive (3.7%. Results of antimicrobial susceptibility analysis for E. coli to commonly used antibiotics are as follows: Amikacin (79.7%, Ofloxacin (78.3%, Gentamicin (71.6%, Ceftriaxone (41.8, Cefotaxime (41.4%, and Cefixime (27.8%. Empirical antibiotic selection should be based on awareness of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal or even national guidelines. In this study, Amikacin and Gentamicin were shown to be the most appropriate antibiotics for empiric therapy of pyelonephritis, but empirical therapy should only be done by specialist physicians in cases where it is necessary while considering sex and age of children.

  7. Four year experience of sarcoma of soft tissues and bones in a tertiary care hospital and review of literature

    Directory of Open Access Journals (Sweden)

    Ansari Tayyaba Z

    2011-05-01

    Full Text Available Abstract Background Sarcoma encompasses an uncommon group of cancer and the data is insufficient from Pakistan. We report our four years experience of Sarcoma of soft tissues and bones. Methods This cross sectional study was carried out at Aga Khan University Hospital from 2004 to 2008. The patients were divided into two groups from the outset i.e. initially diagnosed and relapsed group and separate sub group analysis was conducted. Results Out of 93 newly diagnosed patients, 58 belonged to bone sarcoma and 35 to soft tissue sarcoma group. While for relapsed patients, 5 had soft tissue sarcoma and 9 had bone sarcoma. Mean age was 32.5 years. At presentation, approximately two third patients had localised disease while remaining one third had metastatic disease. The Kaplan Meier estimate of median recurrence free survival was 25 months, 35 months, and 44 months for Osteogenic sarcoma, Ewing's sarcoma and Chondrosarcoma respectively. For Leiomyosarcoma and Synovial sarcoma, it was 20 and 19 months respectively. The grade of the tumour (p = 0.02 and surgical margin status (p = 0.001 were statistically significant for determination of relapse of disease. Conclusion The median recurrence free survival of patients in our study was comparable to the reported literature but with significant lost to follow rate. Further large-scale, multi centre studies are needed to have a more comprehensive understanding of this heterogeneous disease in our population.

  8. Cross-sectional associations between maternal self-efficacy and dietary intake and physical activity in four-year-old children of first-time Swedish mothers

    DEFF Research Database (Denmark)

    Rohde, Jeanett Friis; Bohman, Benjamin; Berglind, Daniel

    2018-01-01

    .03). Mothers' belief in their ability to limit unhealthy dietary and physical activity behaviours was inversely associated with children's intake of unhealthy snacks (β: -0.06 [95%CI: -0.10; -0.02] P 

  9. [Preference Changes Regarding Future Work Area and Intended Position Among German Residents after Four Years of Residency].

    Science.gov (United States)

    Ziegler, Stine; van den Bussche, Hendrik; Römer, Farina; Krause-Solberg, Lea; Scherer, Martin

    2017-06-01

    Introduction  We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Methods  Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training. The return rate at baseline was 48 % and the four surveys after reached rates from 85 % up. In all samples about two thirds were women, which corresponds to the actual gender differentiation in under- and postgraduate training. Descriptive statistics and regression analyses were performed. Results  Compared to private practice the hospital is clearly preferred, although the attraction of hospital jobs decreased over the years. The decision for or against the hospital is connected to the discipline. Working in private practice is seen as possibility for part time work. Men prefer self-employment whereas women prefer to work under an employment contract. In the hospital, male doctors prefer to work in leading positions. Those positions are associated with full-time work. Leadership training especially takes place in university hospitals. Discussion  Three trends are recognized: Reluctance against leading positions, growing interest for part time work and rising popularity of work as an employee in private practice. Those trends can be understood as a rejection of traditional professional role models. The realization of these preferences is easily feasible because of the current labour market situation. Therefore, emerging problems have to be faced in another way. A change of gender-typical role models was rarely detected. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Experiences of internet-delivered cognitive behavior therapy for social anxiety disorder four years later: A qualitative study

    Directory of Open Access Journals (Sweden)

    Camilla Olsson Halmetoja

    2014-07-01

    Full Text Available The current study is a qualitative follow-up of a study on guided internet-delivered cognitive behavior therapy (ICBT for social anxiety disorder (SAD, conducted four years after treatment completion. The main aim was to capture participants' description of their experiences of the treatment, their view on treatment effects, memories of the treatment, and whether they continued using the gained knowledge after treatment. Sixty participants were selected from the original study's treatment group. A criterion based sampling approach was used based on the obtained treatment effect, and with a minimum of five completed treatment modules. E-mail invitations were sent, with information about the follow-up and the instruction to respond if interested in participating. Twelve semi-structured interviews were made and the material was analyzed using an approach based on grounded theory. The results showed that all participants found the treatment to have some effect, but they also found it to be demanding, difficult, and hard. Many appreciated to hear of the experiences of other participants in the online forum. Under the theme of memory, most could describe the setup of the treatment in general terms. The exposure module was mentioned by all, cognitive restructuring by most, and some also reported memories of the psychoeducation. A core process was identified which involved how the attained treatment effect was viewed over the time, and how this view changed from treatment completion to current time. The findings outlined in this study describe how treatment effects can be sustained via an active approach to the treatment and the symptoms of SAD.

  11. Shift work schedule and night work load: Effects on body mass index - a four-year longitudinal study.

    Science.gov (United States)

    Buchvold, Hogne Vikanes; Pallesen, Ståle; Waage, Siri; Bjorvatn, Bjørn

    2018-05-01

    Objectives The aim of this study was to investigate changes in body mass index (BMI) between different work schedules and different average number of yearly night shifts over a four-year follow-up period. Methods A prospective study of Norwegian nurses (N=2965) with different work schedules was conducted: day only, two-shift rotation (day and evening shifts), three-shift rotation (day, evening and night shifts), night only, those who changed towards night shifts, and those who changed away from schedules containing night shifts. Paired student's t-tests were used to evaluate within subgroup changes in BMI. Multiple linear regression analysis was used to evaluate between groups effects on BMI when adjusting for BMI at baseline, sex, age, marital status, children living at home, and years since graduation. The same regression model was used to evaluate the effect of average number of yearly night shifts on BMI change. Results We found that night workers [mean difference (MD) 1.30 (95% CI 0.70-1.90)], two shift workers [MD 0.48 (95% CI 0.20-0.75)], three shift workers [MD 0.46 (95% CI 0.30-0.62)], and those who changed work schedule away from [MD 0.57 (95% CI 0.17-0.84)] or towards night work [MD 0.63 (95% CI 0.20-1.05)] all had significant BMI gain (Pnight workers had significantly larger BMI gain compared to day workers [B=0.89 (95% CI 0.06-1.72), Pnight shifts and BMI change using our multiple linear regression model. Conclusions After adjusting for possible confounders, we found that BMI increased significantly more among night workers compared to day workers.

  12. Four-year follow-up study in a NF1 boy with a focal pontine hamartoma.

    Science.gov (United States)

    Parisi, Pasquale; Persechino, Severino; Paolino, Maria Chiara; Nicita, Francesco; Torrente, Isabella; Bozzao, Alessandro; Villa, Maria Pia

    2013-02-11

    Neurofibromatosis is a collective name for a group of genetic conditions in which benign tumours affect the nervous system. Type 1 is caused by a genetic mutation in the NF1 gene (OMIM 613113) and symptoms can vary dramatically between individuals, even within the same family. Some people have very mild skin changes, whereas others suffer severe medical complications. The condition usually appears in childhood and is diagnosed if two of the following are present: six or more café-au-lait patches larger than 1.5 cm in diameter, axillary or groin freckling, 2 or more Lisch nodules (small pigmented areas in the iris of the eye), 2 or more neurofibromas, optic pathway gliomas, bone dysplasia, and a first-degree family relative with Neurofibromatosis type 1. The pattern of inheritance is autosomal dominant, however, half of all NF1 cases are 'sporadic' and there is no family history. Neurofibromatosis type 1 is an extremely variable condition whose morbidity and mortality is largely dictated by the occurrence of the many complications that may involve any of the body systems. We describe a family affected by NF1 in whom genetic molecular analysis identified the same mutation in the son and father. Routine MRI showed pontine focal lesions in the eight-year-old son, though not in the father. We performed a four years follow-up study and at follow-up pontine hamartoma size remained unchanged in the son, and the father showed still no brain lesions, confirming thus an intra-familial phenotype variability.

  13. Four-year follow-up study in a NF1 Boy with a focal pontine hamartoma

    Directory of Open Access Journals (Sweden)

    Parisi Pasquale

    2013-02-01

    Full Text Available Abstract Neurofibromatosis is a collective name for a group of genetic conditions in which benign tumours affect the nervous system. Type 1 is caused by a genetic mutation in the NF1 gene (OMIM 613113 and symptoms can vary dramatically between individuals, even within the same family. Some people have very mild skin changes, whereas others suffer severe medical complications. The condition usually appears in childhood and is diagnosed if two of the following are present: six or more café-au-lait patches larger than 1.5 cm in diameter, axillary or groin freckling, 2 or more Lisch nodules (small pigmented areas in the iris of the eye, 2 or more neurofibromas, optic pathway gliomas, bone dysplasia, and a first-degree family relative with Neurofibromatosis type 1. The pattern of inheritance is autosomal dominant, however, half of all NF1 cases are ‘sporadic’ and there is no family history. Neurofibromatosis type 1 is an extremely variable condition whose morbidity and mortality is largely dictated by the occurrence of the many complications that may involve any of the body systems. We describe a family affected by NF1 in whom genetic molecular analysis identified the same mutation in the son and father. Routine MRI showed pontine focal lesions in the eight-year-old son, though not in the father. We performed a four years follow-up study and at follow-up pontine hamartoma size remained unchanged in the son, and the father showed still no brain lesions, confirming thus an intra-familial phenotype variability.

  14. Clinical and Hematological Evaluation of Patients with Sickle Cell Anemia Before and After Four Years of Using Hydroxyurea

    Directory of Open Access Journals (Sweden)

    Ieda Maria Gonçalves Pacce Bispo

    2017-06-01

    Full Text Available Objective: Evaluating clinical and hematological-clinical parameters of patients with sickle cell anemia (SCA before and after four years of using hydroxyurea (HU.  Method: A retrospective cohort study implementing a quantitative, descriptive and analytical approach developed in two public teaching hospitals located in the Central-West region of Brazil, from November 2010 to October 2011. Data collection was performed through medical records of 32 patients with SCA to assess clinical and hematological parameters before and after HU treatment. The study was approved by the UFMS Ethics Committee under protocol number 1890/2010. Results: All of the 32 patients were homozygous with a mean age in the prescription of hydroxyurea of 19.72±7.58 years, an initial dose of 15.59±4.27 mg/kg/day, and 22.48±5.35 mg/kg/day in the fourth year of treatment. Regarding the use of HU, average values of some hematological parameters presented a significant difference in the fourth year compared to the mean values prior to HU use, such as fetal hemoglobin (14.49±7.52%, red blood cells (2.54±0.38x1012/L, hematocrit (25.30±4.03% and hemoglobin (9.22±3.34g/dL.  Conclusion: Treatment with hydroxyurea showed a significant increase in fetal hemoglobin levels, increased hemoglobin, hematocrit and average corpuscular hemoglobin concentration, with reduced episodes of pain, infection and acute chest syndrome in such a way as to reaffirm its efficiency in treating these patients. Keywords: Hemoglobin; Sickle Cell Anemia; Hydroxyurea.

  15. Drought, Frost, Rain and Sunshine. Four Years of Sap Flow Measurements for One of the World's Largest Conifers

    Science.gov (United States)

    Macinnis-Ng, C.; Taylor, D. T.; Kaplick, J.; Clearwater, M.

    2015-12-01

    Amongst the largest and longest lived conifers in the world, the endemic New Zealand kauri, Agathis australis, provides a proxy-climate record dating back 4000 y. Tree-ring widths provide a strong indicator of the occurrence of El Niño Southern Oscillation (ENSO) events. We are measuring physiological processes, including carbon uptake and loss, leaf-scale gas exchange and sap flow together with meteorological data to explore the mechanisms of the climate response of this iconic and culturally significant species. In this continuous 15 min time interval sap flow dataset spanning four years, we have captured very wet and very dry summer periods. Winter flow rates peaked lower than summer flow rates and winter flow also started later and finished earlier in the day, resulting in less water use. Larger, canopy dominant trees (DBH up to 176 cm) had large sapwood area (sapwood depth up to 18 cm) and faster flow rates and therefore dominated stand water use. During dry periods, smaller trees (DBH 20-80 cm) were more responsive to dry soils than larger trees, suggesting access to deeper soil water stores. Leaf-scale gas exchange rates were low with very low stomatal conductance values reflecting known vulnerability to xylem embolism. Night-time refilling of sapwood was particularly evident during the summer drought with evidence that refilling was incomplete as the drought progressed. Photosynthetically active radiation and vapour pressure deficit are strongly correlated with sap flow across all seasons, a promising indicator for future modelling work on this dataset. Water saving strategies and stand-scale water budgets are discussed.

  16. Carriage of Staphylococcus aureus among Portuguese nursing students: A longitudinal cohort study over four years of education.

    Directory of Open Access Journals (Sweden)

    Teresa Conceição

    Full Text Available Staphylococcus aureus is a major human pathogen that can colonize healthy people mainly in the anterior nares. The aim of the present study was to evaluate S. aureus nasal colonization over time among Portuguese nursing students, including methicillin-resistant S. aureus (MRSA.In this longitudinal cohort study, we collected 280 nasal swabs from nursing students at 14 time points over four years of schooling (2012-2016. The isolates were characterized by pulsed-field gel electrophoresis (PFGE, spa typing, multilocus sequence typing (MLST, and SCCmec typing for MRSA. Among 47 students, 20 (43% carried methicillin-susceptible S. aureus (MSSA at admission, but none was colonized with MRSA. A total of 19 students (40% became colonized after exposure during the nursing training, out of which five carried MRSA. Overall, 39 students (83% had S. aureus detected at least once during the study period. Among the 97 MSSA isolates, most (65% belonged to four clones: PFGE A-ST30 (21%, B-ST72 (20%, C-ST508 (13%, and D-ST398 (11%. Three of the five MRSA carriers were colonized with the predominant clone circulating in Portuguese hospitals (ST22-IVh and two with ST3162-II. Colonization of nursing students was highly dynamic with continuous appearance of strains with distinct PFGE types in the same individual.A considerable proportion of students became colonized by S. aureus, including MRSA, during the nursing education, evidencing this population represents an important reservoir of S. aureus. Therefore, education on infection control measures in nursing schools is of major importance.

  17. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil.

    Directory of Open Access Journals (Sweden)

    José E Hagan

    2016-01-01

    Full Text Available Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent.We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007 and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86% individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6 per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16, contact with mud (OR 1.57, 95% CI 1.17-2.17 and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04. The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years.The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings

  18. PKS 2005-489 at VHE: four years of monitoring with HESS and simultaneous multi-wavelength observations

    Science.gov (United States)

    H.E.S.S. Collaboration; Acero, F.; Aharonian, F.; Akhperjanian, A. G.; Anton, G.; Barres de Almeida, U.; Bazer-Bachi, A. R.; Becherini, Y.; Behera, B.; Benbow, W.; Bernlöhr, K.; Bochow, A.; Boisson, C.; Bolmont, J.; Borrel, V.; Brucker, J.; Brun, F.; Brun, P.; Bühler, R.; Bulik, T.; Büsching, I.; Boutelier, T.; Chadwick, P. M.; Charbonnier, A.; Chaves, R. C. G.; Cheesebrough, A.; Chounet, L.-M.; Clapson, A. C.; Coignet, G.; Costamante, L.; Dalton, M.; Daniel, M. K.; Davids, I. D.; Degrange, B.; Deil, C.; Dickinson, H. J.; Djannati-Ataï, A.; Domainko, W.; O'C. Drury, L.; Dubois, F.; Dubus, G.; Dyks, J.; Dyrda, M.; Egberts, K.; Eger, P.; Espigat, P.; Fallon, L.; Farnier, C.; Fegan, S.; Feinstein, F.; Fiasson, A.; Förster, A.; Fontaine, G.; Füßling, M.; Gabici, S.; Gallant, Y. A.; Gérard, L.; Gerbig, D.; Giebels, B.; Glicenstein, J. F.; Glück, B.; Goret, P.; Göring, D.; Hauser, M.; Heinz, S.; Heinzelmann, G.; Henri, G.; Hermann, G.; Hinton, J. A.; Hoffmann, A.; Hofmann, W.; Hofverberg, P.; Holleran, M.; Hoppe, S.; Horns, D.; Jacholkowska, A.; de Jager, O. C.; Jahn, C.; Jung, I.; Katarzyński, K.; Katz, U.; Kaufmann, S.; Kerschhaggl, M.; Khangulyan, D.; Khélifi, B.; Keogh, D.; Klochkov, D.; Kluźniak, W.; Kneiske, T.; Komin, Nu.; Kosack, K.; Kossakowski, R.; Lamanna, G.; Lenain, J.-P.; Lohse, T.; Marandon, V.; Martineau-Huynh, O.; Marcowith, A.; Masbou, J.; Maurin, D.; McComb, T. J. L.; Medina, M. C.; Méhault, J.; Moderski, R.; Moulin, E.; Naumann-Godo, M.; de Naurois, M.; Nedbal, D.; Nekrassov, D.; Nicholas, B.; Niemiec, J.; Nolan, S. J.; Ohm, S.; Olive, J.-F.; de Oña Wilhelmi, E.; Orford, K. J.; Ostrowski, M.; Panter, M.; Paz Arribas, M.; Pedaletti, G.; Pelletier, G.; Petrucci, P.-O.; Pita, S.; Pühlhofer, G.; Punch, M.; Quirrenbach, A.; Raubenheimer, B. C.; Raue, M.; Rayner, S. M.; Renaud, M.; Rieger, F.; Ripken, J.; Rob, L.; Rosier-Lees, S.; Rowell, G.; Rudak, B.; Rulten, C. B.; Ruppel, J.; Sahakian, V.; Santangelo, A.; Schlickeiser, R.; Schöck, F. M.; Schwanke, U.; Schwarzburg, S.; Schwemmer, S.; Shalchi, A.; Sikora, M.; Skilton, J. L.; Sol, H.; Stawarz, Ł.; Steenkamp, R.; Stegmann, C.; Stinzing, F.; Superina, G.; Szostek, A.; Tam, P. H.; Tavernet, J.-P.; Terrier, R.; Tibolla, O.; Tluczykont, M.; van Eldik, C.; Vasileiadis, G.; Venter, C.; Venter, L.; Vialle, J. P.; Vincent, P.; Vivier, M.; Völk, H. J.; Volpe, F.; Wagner, S. J.; Ward, M.; Zdziarski, A. A.; Zech, A.

    2010-02-01

    Aims: Our aim is to study the very high energy (VHE; E>100 GeV) γ-ray emission from BL Lac objects and the evolution in time of their broad-band spectral energy distribution (SED). Methods: VHE observations of the high-frequency peaked BL Lac object PKS 2005-489 were made with the High Energy Stereoscopic System (HESS) from 2004 through 2007. Three simultaneous multi-wavelength campaigns at lower energies were performed during the HESS data taking, consisting of several individual pointings with the XMM-Newton and RXTE satellites. Results: A strong VHE signal, ~17σ total, from PKS 2005-489 was detected during the four years of HESS observations (90.3 h live time). The integral flux above the average analysis threshold of 400 GeV is ~3% of the flux observed from the Crab Nebula and varies weakly on time scales from days to years. The average VHE spectrum measured from ~300 GeV to ~5 TeV is characterized by a power law with a photon index, Γ = 3.20± 0.16_stat± 0.10_syst. At X-ray energies the flux is observed to vary by more than an order of magnitude between 2004 and 2005. Strong changes in the X-ray spectrum (ΔΓX ≈ 0.7) are also observed, which appear to be mirrored in the VHE band. Conclusions: The SED of PKS 2005-489, constructed for the first time with contemporaneous data on both humps, shows significant evolution. The large flux variations in the X-ray band, coupled with weak or no variations in the VHE band and a similar spectral behavior, suggest the emergence of a new, separate, harder emission component in September 2005. Supported by CAPES Foundation, Ministry of Education of Brazil.Now at Harvard-Smithsonian Center for Astrophysics, Cambridge, USA.Now at W.W. Hansen Experimental Physics Laboratory & Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, USA.

  19. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil.

    Science.gov (United States)

    Hagan, José E; Moraga, Paula; Costa, Federico; Capian, Nicolas; Ribeiro, Guilherme S; Wunder, Elsio A; Felzemburgh, Ridalva D M; Reis, Renato B; Nery, Nivison; Santana, Francisco S; Fraga, Deborah; Dos Santos, Balbino L; Santos, Andréia C; Queiroz, Adriano; Tassinari, Wagner; Carvalho, Marilia S; Reis, Mitermayer G; Diggle, Peter J; Ko, Albert I

    2016-01-01

    Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent. We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007) and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86%) individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6) per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16), contact with mud (OR 1.57, 95% CI 1.17-2.17) and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04). The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hot-spots" consistently had higher transmission risk during study years. The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings indicate that

  20. GeoFORCE Alaska: Four-Year Field Program Brings Rural Alaskan High School Students into the STEM Pipeline

    Science.gov (United States)

    Fowell, S. J.; Rittgers, A.; Stephens, L.; Hutchinson, S.; Peters, H.; Snow, E.; Wartes, D.

    2016-12-01

    GeoFORCE Alaska is a four-year, field-based, summer geoscience program designed to raise graduation rates in rural Alaskan high schools, encourage participants to pursue college degrees, and increase the diversity of Alaska's technical workforce. Residents of predominantly Alaska Native villages holding degrees in science, technology, engineering, or math (STEM) bring valuable perspectives to decisions regarding management of cultural and natural resources. However, between 2010 and 2015 the average dropout rate for students in grades 7-12 was 8.5% per year in the North Slope School District and 7% per year in the Northwest Arctic School District. 2015 graduation rates were 70% and 75%, respectively. Statewide statistics highlight the challenge for Alaska Native students. During the 2014-2015 school year alone 37.6% of Alaska Native students dropped out of Alaskan public schools. At the college level, Alaska Native students are underrepresented in University of Alaska Fairbanks (UAF) science departments. Launched in 2012 by UAF in partnership with the longstanding University of Texas at Austin program, GeoFORCE applies the cohort model, leading the same group of high school students on geological field academies during four consecutive summers. Through a combination of active learning, teamwork, and hands-on projects at spectacular geological locations, students gain academic skills and confidence that facilitate high school and college success. To date, GeoFORCE Alaska has recruited two cohorts. 78% of these students identify as Alaska Native, reflecting community demographics. The inaugural cohort of 18 students from the North Slope Borough completed the Fourth-Year Academy in summer 2015. 94% of these students graduated from high school, at least 72% plan to attend college, and 33% will major in geoscience. A second cohort of 34 rising 9th and 10th graders entered the program in 2016. At the request of corporate sponsors, this cohort was recruited from both the

  1. Overview of the SEU project for extended burnup at the Atucha-I NPP. Four years of operating experience

    International Nuclear Information System (INIS)

    Fink, J.M.; Higa, M.; Perez, R.; Pineyro, J.; Sidelnik, J.; Casario, J.A.; Alvarez, L.

    2002-01-01

    Atucha I is a 357 MWe nuclear station moderated and cooled with heavy water, of German design located in Argentina. Fuelling is on-power and the plant was originally fuelled with natural uranium. To reduce fuel costs a program was initiated in August 1993 to introduce gradually slightly enriched uranium (SEU) fuel (0.85 w% U-235) with an associated burnup increase from 5900 MWd/tU to 11300 MWd/tU. The introduction of SEU fuel started in January 1995 and the program was divided in three Phases with an upper limit of SEU FA in the core: 12, 60 and 252 (full core) and licensing documentation was prepared for each Phase. This paper describes the most important aspects of the operating and project experience, and some factors limiting the burnup extension from an operation point of view. After four years of the program and with 181 SEU FA (71%) of the core, the operating experience has been good and without unfavourable effects due to the use of SEU fuel with the only exception of a small increase of the time to reach full power in plant startups or power cycling. In particular, the new criteria to prevent PCI failures in power ramps for higher burnup SEU fuel in refueling operations, plant startups or power cycling has been effective. The average discharge burnup of the SEU fuel taken out of the reactor in 1998 was 11263 MWd/tU. The average discharge burnup of the natural fuel in the same year was 6640 MWd/tU, with an increase of about 12% of the original value for a natural fuel core. The average number of fresh fuel assemblies per full power day was being reduced from 1.31 to 0.92 in 1998 and 0.83 in 1999. The fuel costs dropped gradually during the program from 9.38 (with natural uranium fuel) to 6.57 $/MWh in the first four months of 1999 (taking as reference the NU and SEU FA costs for 1999). Because of this the SEU program has been an important contribution to the reduction of Atucha I operating costs and to the competitiveness of nuclear power generation against

  2. Distant Galaxies, Black Holes and Other Celestial Phenomena: NASA's Chandra X-ray Observatory Marks Four Years of Discovery Firsts

    Science.gov (United States)

    2003-09-01

    . Building on previous achievements, including catching a supermassive black hole devouring material in our own Milky Way galaxy, Chandra accomplished even more during its fourth year. The observatory revealed new details about X-ray jets produced by black holes and discovered two black holes flourishing in a single galaxy 400 million light years from Earth. By tracking, for the first time, the life cycle of large-scale X-ray jets produced by a black hole, Chandra revealed that as the jets evolved, the material in them traveled near the speed of light for several years before slowing and fading. These jets - from a stellar-sized black hole about 10 or so times the mass of the Sun - were the first ones caught in the act of slowing down. This enabled astronomers, in just four years, to observe a process that could take a million years to unfold. By revealing two active black holes in the nucleus of the extraordinarily bright galaxy NGC 6240, another Chandra image proved for the first time that two supermassive black holes can co-exist in the same galaxy. Currently orbiting each other, in several hundred million years these black holes will merge to create an even larger black hole, resulting in a catastrophic event that will unleash intense radiation and gravitational waves. Also in Chandra's fourth year, the observatory offered new insights into pulsars - small and extremely dense stars. Generated by a series of Chandra observations, an X-ray movie of the Vela pulsar. revealed a spectacularly erratic jet that varied in a way never before seen. Whipping about like an untended firehose at about half the speed of light, the jet of high-energy particles offered new insight into the nature of jets from pulsars and black holes. Previous Chandra highlights include revealing the most distant X-ray cluster of galaxies, identifying a pulsating hot spot of X-rays in Jupiter's upper atmosphere, uncovering a ''cool'' black hole at the heart of the Andromeda Galaxy, and finding an X

  3. Improved parenting maintained four years following a brief parent training intervention in a non-clinical sample.

    Science.gov (United States)

    Reedtz, Charlotte; Klest, Sihu

    2016-08-24

    The aim of the present study is to evaluate whether the effects of a short, six session version of an evidence-based parent training programme (The Incredible Years), delivered in a non-clinical community sample in the northern Norway, are maintained 4 years following the initial intervention. Data were collected primarily from mothers in a randomized controlled trial (N = 117). Children's mean age at 4 year follow-up was 7.5 years. A mixed model analyses of linear change with a time by condition interaction revealed that statistically significant differences were maintained between the parent training and control groups for several outcomes. The parent training group showed a reduction in harsh disciple and an increase of both self-reported positive parenting and parental efficacy when compared to the control group who received services as usual. No significant differences between the two groups were found for child behaviour problems as measured by the ECBI Intensity scale. In addition, mixed model analyses of quadratic change were conducted to test the differences in the trajectory of change over four time points. There were significant differences in the trajectory of change for (1) the ECBI with the parent training group showing an immediate drop in the intensity of problem behaviour and (2) the positive parenting scale showing an immediate steep increase; no other significant differences in trajectory were detected. Families from a non-clinical sample who participated in a brief version of the Incredible Years Basic parent training programme maintained changes in positive parenting, harsh discipline, and parental efficacy 4 years after completion of the intervention. ClinicalTrials. gov NCT02850510 . Retrospectively registered 29 July 2016.

  4. Four-year measurement of methane flux over a temperate forest with a relaxed eddy accumulation method

    Science.gov (United States)

    Sakabe, A.; Kosugi, Y.; Ueyama, M.; Hamotani, K.; Takahashi, K.; Iwata, H.; Itoh, M.

    2013-12-01

    Forests are generally assumed to be an atmospheric methane (CH4) sink (Le Mer and Roger, 2001). However, under Asian monsoon climate, forests are subject to wide spatiotemporal range in soil water status, where forest soils often became water-saturated condition heterogeneously. In such warm and humid conditions, forests may act as a CH4 source and/or sink with considerable spatiotemporal variations. Micrometeorological methods such as eddy covariance (EC) method continuously measure spatially-representative flux at a canopy scale without artificial disturbance. In this study, we measured CH4 fluxes over a temperate forest during four-year period using a CH4 analyzer based on tunable diode laser spectroscopy detection with a relaxed eddy accumulation (REA) method (Hamotani et al., 1996, 2001). We revealed the amplitude and seasonal variations of canopy-scale CH4 fluxes. The REA method is the attractive alternative to the EC method to measure trace-gas flux because it allows the use of analyzers with an optimal integration time. We also conducted continuous chamber measurements on forest floor to reveal spatial variations in soil CH4 fluxes and its controlling processes. The observations were made in an evergreen coniferous forest in central Japan. The site has a warm temperate monsoon climate with wet summer. Some wetlands were located in riparian zones along streams within the flux footprint area. For the REA method, the sonic anemometer (SAT-550, Kaijo) was mounted on top of the 29-m-tall tower and air was sampled from just below the sonic anemometer to reservoirs according to the direction of vertical wind velocity (w). After accumulating air for 30 minutes, the air in the reservoirs was pulled into a CO2/H2O gas analyzer (LI-840, Li-Cor) and a CH4 analyzer (FMA-200, Los Gatos Research). Before entering the analyzers, the sampled air was dried using a gas dryer (PD-50 T-48; Perma Pure Inc.). The REA flux is obtained from the difference in the mean concentrations

  5. A four-year experience with a Web-based self-help intervention for depressive symptoms in Mexico

    Directory of Open Access Journals (Sweden)

    María Asunción Lara

    2014-06-01

    Full Text Available OBJECTIVE: To describe a four-year descriptive, naturalistic study monitoring the use of HDep (Help for Depression or Ayuda para depression (ADepin Spanish, an open-access/free Web-based, psycho-education, cognitive-behavioral intervention program produced in Mexico consisting of seven self-help modules that include feedback-generating assessments of depressive symptoms, vignettes, recorded messages, a relaxation exercise, a personal workbook, blogs, and user discussion forums. METHODS: Data were collected on all individuals who entered the HDep site since the program's launching in 2009. Those who entered the site two or more times and also registered as "users" or "participants." The user data consisted of 1 user profiles; 2 scores for the CES-D (Center for Epidemiological Studies Depression Scale, for users who completed the feedback-generating assessments of depressive symptoms; 3 user evaluations of the usefulness of HDep; and 4 transcripts of HDep discussion forum posts. The raw user data were obtained through Moodle (Modular Object-Oriented Dynamic Learning Environment, a free software e-learning platform and analyzed quantitatively (using SPSS and qualitatively (using ATLAS.ti. RESULTS: A total of 28 078 individuals accessed HDep and 17 318 of those (61.6% qualified as users. Of all users, 84.4% were women, 64.6% used the workbook, and 60.9% entered the discussion forums (of whom 16.3% added a post. Depressive symptoms (CES-D score ≥ 16 were observed in 97.1% of the users who completed the feedback-generating assessment (n = 16 564. User retention dropped across the seven modules (from 12 366 users for Module 1 to 626 for Module 7. However, all seven modules were rated very high for "helpfulness/usefulness," with mean scores all above 4 on a 1 - 5 scale. The HDep discussion forums showed a rich social interaction. Predictors of entering at least one module (based on stepwise logistic regression analysis included being a woman, being

  6. Auditory-Visual Speech Perception in Three- and Four-Year-Olds and Its Relationship to Perceptual Attunement and Receptive Vocabulary

    Science.gov (United States)

    Erdener, Dogu; Burnham, Denis

    2018-01-01

    Despite the body of research on auditory-visual speech perception in infants and schoolchildren, development in the early childhood period remains relatively uncharted. In this study, English-speaking children between three and four years of age were investigated for: (i) the development of visual speech perception--lip-reading and visual…

  7. Sustaining the Support in Four-Year-Olds in Childcare Services with the Goal of Promoting Their Cognitive and Language Development

    Science.gov (United States)

    Bigras, Nathalie; Lemay, Lise; Bouchard, Caroline; Eryasa, Joell

    2017-01-01

    This paper aims to describe the quality of play as offered by early childhood educators working with four-year-olds within an educational childcare service. It also aims to identify the correlation between the quality of play support and a child's cognitive, language and socio-emotional development. Finally, it focuses on the factors associated…

  8. Designing for Diverse Classrooms: Using iPpads and Digital Cameras to Compose eBooks with Emergent Bilingual/Biliterate Four-Year-Olds

    Science.gov (United States)

    Rowe, Deborah Wells; Miller, Mary E.

    2016-01-01

    This paper reports the findings of a two-year design study exploring instructional conditions supporting emerging, bilingual/biliterate, four-year-olds' digital composing. With adult support, children used child-friendly, digital cameras and iPads equipped with writing, drawing and bookmaking apps to compose multimodal, multilingual eBooks…

  9. Simultaneous vs. Successive Bilingualism among Preschool-Aged Children: A Study of Four-Year-Old Korean-English Bilinguals in the USA

    Science.gov (United States)

    Kim, Ah-Young; Park, Anne; Lust, Barbara

    2018-01-01

    The current study compares simultaneous vs. successive bilingualism through a mixed-method research design with four four-year-old Korean-English bilingual children who were born and raised in the USA. Two simultaneous bilinguals were exposed to Korean and English from birth, whereas two successive bilinguals were exposed to Korean from birth, but…

  10. A Longitudinal Study on Substance Use and Related Problems in Women in Opioid Maintenance Treatment from Pregnancy to Four Years after Giving Birth

    Directory of Open Access Journals (Sweden)

    Ingunn O. Lund

    2014-01-01

    Full Text Available Background Women in opioid maintenance treatment (OMT have a past characterized by drug abuse, which is a challenging start for parenthood. Studies of mothers in OMT are typically limited to pregnancy and early infancy. Knowledge about how they cope with substance use and related problems in the years following birth is therefore important. The aims of the study were to examine changes in mothers’ substance use, psychological problems, and other challenges; from one to four years after their children were born, and describe kindergarten attendance and prevalence and type of child protective services involvement when the children were four years old. Method A four-year prospective cohort study of mothers in OMT. The European severity index was used to map substance use and related problems during the third trimester of pregnancy, one and four years after birth. Results At the four-year follow-up, use of illegal substances remained low (4% and use of legal substances (39% was similar to the one-year follow-up. The proportion of women with psychological problems was significantly higher than at one-year follow-up (69 vs. 39%, P = .009. At age four, most children (89% attended kindergarten, and the child protective services were following 73% of the families, mostly with voluntary measures. Conclusion Mothers in OMT cope well with substance use over time, given access to sufficient support. The findings imply that a preventive governmental strategy with close support of mother and child, have a positive impact contributing to making OMT and motherhood more compatible.

  11. Prognosis and continuity of child mental health problems from preschool to primary school: results of a four-year longitudinal study.

    Science.gov (United States)

    Beyer, Thomas; Postert, Christian; Müller, Jörg M; Furniss, Tilman

    2012-08-01

    In a four-year longitudinal study, changes in and continuity of behavioral and emotional problems were examined in 814 subjects from kindergarten to primary school. Mental health problems were assessed by means of the Child Behavior Checklist (CBCL). The distribution of the CBCL broadband groups revealed a high level of continuity of internalizing symptoms over the four-year period and a shift from externalizing symptoms at baseline towards a combination of internalizing and externalizing symptoms at follow-up. The presence of mental health problems at follow-up was correlated with gender (higher amongst boys), pre-existing mental health problems at baseline, and separation or divorce of the parents, but not with single-family status or the age and educational level of the mother. The increasing number of children with a combination of internalizing and externalizing symptoms demonstrates the increasing complexity of child mental health problems in the developmental span from preschool age to school age.

  12. The effect of nurse education on the self-esteem and assertiveness of nursing students: A four-year longitudinal study.

    Science.gov (United States)

    İlhan, Nesrin; Sukut, Özge; Akhan, Latife Utaş; Batmaz, Makbule

    2016-04-01

    The nurse education program affects many aspects of personal development. Nursing students gain skills in critical thinking and analysis and also develop communication and management skills. The four-year program may also have an effect on students' assertiveness and self-esteem. This study was conducted to determine the impact of the four-year higher nursing school educational program on students' self-esteem and assertiveness. Descriptive longitudinal design. The study took place at a Foundation University in Istanbul, Turkey over the period 2006-2010. The students' levels of self-esteem and assertiveness were assessed at the beginning and end of the first, second, third and fourth years of the program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The Socio-Cultural and Leadership Experiences of Latina Four-Year College and University Presidents: A Traves de sus Voces (Through Their Voices)

    Science.gov (United States)

    Maes, Johanna B.

    2012-01-01

    The Latina population in the United States is one of the largest of all racial and ethnic groups, and it is expected to grow exponentially within the next forty years. Despite these large numbers of Latinas in the U.S., there is a disparity with this population who are leading our nation's four-year colleges and universities. A reason for…

  14. A four-year follow-up controlled study of stress response and symptom persistence in Brazilian children and adolescents with attention deficit disorder and hyperactivity (ADHD).

    Science.gov (United States)

    Palma, Sonia Maria Motta; Natale, Ana Carolina Motta Palma; Calil, Helena Maria

    2015-12-15

    This study evaluated children and adolescents with Attention Deficit Disorder andHyperactivity Disorder (ADHD), reassessing them at a four-year follow-up. Their cortisol response to a stress stimulus was measured twice. ADHD symptom persistence, development of comorbidities, and psychostimulant usage were also reassessed. The initial sample consisted of 38 ADHD patients and 38 healthy controls, age ranging 6-14. At the follow-up, there were 37 ADHD patients and 22 healthy controls, age ranging 10-18. ADHD was classified as persistent if the patients fulfilled all DSM IV criteria for syndromic or subthreshold or had functional impairment. Salivary cortisol samples were collected prior to the application of a cognitive stressor (Continuous Performance Test - CPT), and at three time intervals afterwards at baseline and at the follow-up. Their reassessment showed that 75% had persistent symptoms, psychiatric comorbidities (oppositional defiant and behavioral disorders), functional and academic impairement. Only seven patients were on medication. The ADHD group's cortisol levels were lower than those measured four years earlier, but cortisol concentrations were similar for both ADHD and control groups at the four-year follow-up. The cortisol results suggest that HPA axis reactivity could be a marker differentiating ADHD from ADHD with comorbidities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study.

    Science.gov (United States)

    Mamoto, Kenji; Inui, Kentaro; Okano, Tadashi; Sugioka, Yuko; Tada, Masahiro; Koike, Tatsuya; Nakamura, Hiroaki

    2017-01-01

    Patients with rheumatoid arthritis (RA) have been recognized to experience falls frequently due to functional disabilities. The aim of this study was to prospectively investigate factors influencing falls in patients with RA compared to controls. We compared the frequency of falls in 208 RA patients and 205 age- and sex-matched volunteers for four years and analyzed risk factors for falls in RA patients using multivariate regression analysis. No significant difference in the incidence rate of falls (/person-year) between patients with RA (median [interquartile range]: 0 [0, 0.5]) and controls (0 [0, 0.5]) was evident during four years. Logistic regression analysis identified age, sex, body mass index, history of falls, and lower limb implant at baseline as significant risk factors for falls. The highest quartile of anti-CCP antibody level (>300.6 U/ml) was the strongest predictor for multiple falls (odds ratio, 2.97; 95% confidence interval, 1.12-7.91, p = 0.029) among RA patients. During four years we could not observe the higher incidence rate of falls in RA patients compared to controls in our cohort. Subjects with a higher titer of anti-CCP antibody might be at higher risk of frequent falls among RA patients.

  16. Bullying and victimisation are common in four-year-old children and are associated with somatic symptoms and conduct and peer problems.

    Science.gov (United States)

    Ilola, Anna-Marja; Lempinen, Lotta; Huttunen, Jukka; Ristkari, Terja; Sourander, Andre

    2016-05-01

    There are few population-based studies on bullying behaviour among preschool children. The aims of the study were to investigate the prevalence of bullying behaviour among four-year-old children, as reported by their parents, the prevalence of types of bullying behaviour and the associations between bullying behaviour and psychosocial factors. This study was based on a population-based study sample of 931 children who attended their check-up at a child health clinic at four years of age. Parents completed the questionnaire about their child's bullying behaviour and risk factors during the check-up. Bullying behaviour, especially being both a bully and a victim, was a common phenomenon among four-year-old children. Being a bully or both a bully and victim were most strongly associated with conduct problems, while being a victim was associated with somatic symptoms and peer problems. Bullying behaviour was frequently found in preschool children and associated with a wide range of other problems, which indicate that routine checking of bullying behaviour should be included in child health clinic check-ups. Bullying prevention programmes are usually targeted at school-aged children, but this study highlights the importance of focusing already on preschool children. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample.

    Science.gov (United States)

    Tibi, L; van Oppen, P; van Balkom, A J L M; Eikelenboom, M; Rickelt, J; Schruers, K R J; Anholt, G E

    2017-07-01

    Depression is the most common comorbidity in obsessive-compulsive disorder (OCD). However, the mechanisms of depressive comorbidity in OCD are poorly understood. We assessed the directionality and moderators of the OCD-depression association over time in a large, prospective clinical sample of OCD patients. Data were drawn from 382 OCD patients participating at the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study. Cross-lagged, structural equation modeling analyses were used to assess the temporal association between OCD and depressive symptoms. Assessments were conducted at baseline, two-year and four-year follow up. Cognitive and interpersonal moderators of the prospective association between OCD and depressive symptoms were tested. Cross-lagged analyses demonstrated that OCD predicts depressive symptoms at two-year follow up and not vice a versa. This relationship disappeared at four-year follow up. Secure attachment style moderated the prospective association between OCD and depression. Depressive comorbidity in OCD might constitute a functional consequence of the incapacitating OCD symptoms. Both OCD and depression symptoms demonstrated strong stability effects between two-year and four-year follow up, which may explain the lack of association between them in that period. Among OCD patients, secure attachment represents a buffer against future depressive symptoms. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the Yushu earthquake: a cross-sectional survey in China.

    Science.gov (United States)

    Dongling, Liu; Hui, Chen; Ling, Ma; Wenqian, Bie; Zailiang, Liu; Changying, Chen

    2017-04-01

    To examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake. On 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China. This was a cross-sectional descriptive study. This study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles. The results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms. The presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder. The findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for

  19. Impact factor (if) of hospitality, leisure, sports & tourism journals: current trends, overall ranking and temporal stability over a four year period

    OpenAIRE

    Sans-Rosell, Nuria; Reverter Masià, Joaquín; Hernández González, Vicenç

    2013-01-01

    A journal’s “impact factor” (IF) is the bibliometric index that reflects the frequency with which an ‘‘average article’’ from a scientific journal has been cited in subsequent publications.The purpose of the present study is to examine the current impact factor of Hospitality, Leisure, Sports & Tourism journals, their overall ranking and temporal stability over a four year period. For this reason, we have included the impact factor of the scientific journals classifiedin the “Hospitality,...

  20. [The LORAS Project and quality assurance. In four years from input- to outcome-oriented financing in public health. 1: The LORAS Project].

    Science.gov (United States)

    Lenz, M J; Hochreutener, M A

    2001-02-01

    This series of three articles is a summary of the operations, findings and results of the hospital reform projects in the Canton of Zurich, termed LORAS. With the aid of the LORAS project within four years Zurich hospitals have been transformed. Whereas they used to adhere to input-oriented covering of deficits they now operate with outcome-oriented prospective financing of output. Part 1 describes the whole Project. Part 2 focuses on the development of outcome-measurement. Part 3 finally describes the implementation of the outcome-measurement in the canton of Zurich.

  1. [The LORAS project and quality assurance. In four years from input- to outcome-oriented financing in public health. 2: LORAS project outcome parts 1 & 98].

    Science.gov (United States)

    Lenz, M J; Hochreutener, M A

    2001-04-01

    This series of three articles is a summary of the operations, findings and results of the hospital reform projects in the Canton of Zurich, termed LORAS. With the aid of the LORAS project within four years Zurich hospitals have been transformed. Whereas they used to adhere to input-oriented covering of deficits they now operate with outcome-oriented prospective financing of output. Part 1 describes the whole project. Part 2 focuses on the development of outcome-measurement. Part 3 finally describes the implementation of the outcome-measurement in the canton of Zurich.

  2. [REPORTING CRITICAL LAB RESULTS, A CHALLENGE FOR THE LAB AND THE PHYSICIAN - A SUMMARY OF FOUR YEARS OF EXPERIENCE IN MEIR MEDICAL CENTER LABORATORIES].

    Science.gov (United States)

    Rashid, Gloria; Goldman, Jacob; Weinstein, Doron; Tohami, Tali; Neumark, Eran; Weiss, Eli

    2015-08-01

    Critical laboratory results require prompt reporting to the attending physician, as they may indicate that a patient is in a life-threatening condition. Although this important subject has been covered in many publications, it needs more attention from our healthcare organizations, which have no official policy on the subject. Matching expectations between the doctor and the laboratory needs to be better defined. The aim of this work was to inform the community of doctors and laboratories about the multiple problems concerning the reporting of critical laboratory results, to create a platform for exchanging views and ideas, and to build an extensive infrastructure for developing a unified plan to address this important issue. We present the results of four years of experience of reporting critical laboratory values at the Meir Medical Center Laboratories. The idea leading this work was to present the relatively low rate of critical results reported by the laboratories in 2010, sharing the problems discovered while investigating the situation in depth, and presenting the solutions that enabled us to obtain the desired results within four years. Gradual implementation of these improvements resulted in critical value reporting increasing from 55% in 2010 to 95% currently. We suggest a model for improving critical laboratory values reporting based on our 4-year experience, which emphasizes: (1) The importance of selecting proper tests and values for critical results; (2) The significance of using technology and computerized measures to support the process; and (3) Developing quick procedures for monitoring and controlling the process.

  3. Impact of routine rotavirus vaccination on all-cause and rotavirus hospitalizations during the first four years following vaccine introduction in Rwanda.

    Science.gov (United States)

    Sibomana, Hassan; Rugambwa, Celse; Mwenda, Jason M; Sayinzoga, Felix; Iraguha, Gisele; Uwimana, Jeanine; Parashar, Umesh D; Tate, Jacqueline E

    2018-05-10

    Rwanda introduced pentavalent rotavirus vaccine into its national immunization program in 2012. To determine the long-term impact of rotavirus vaccine on disease burden in a high burden setting, we examined trends in rotavirus and all-cause diarrhea hospitalizations in the first four years following rotavirus vaccine introduction. We used data from an active surveillance system, from a review of pediatric ward registries, and from the Health Management Information System to describe trends in rotavirus and all-cause diarrhea hospitalizations from January 2009 through December 2016. Percent reductions were calculated to compare the number of all-cause and rotavirus diarrhea hospitalizations pre- and post-rotavirus vaccine introduction. The proportion of diarrhea hospitalizations due to rotavirus declined by 25-44% among all children introduction to 12-13% post-vaccine introduction. In the national hospital discharge data, substantial decreases were observed in all-cause diarrhea hospitalizations among children introduction era. Published by Elsevier Ltd.

  4. Central odontogenic fibroma (simple type) in a four year old boy: Atypical cone-beam computed tomographic appearance with periosteal reaction

    Energy Technology Data Exchange (ETDEWEB)

    Anbiaee, Najme; Ebrahimnejad, Hamed; Sanaei, Alireza [Dept. of , Oral and Maxillofacial Radiology, Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad (Iran, Islamic Republic of)

    2015-06-15

    Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

  5. Comprehensive Survey Results of Childhood Thyroid Ultrasound Examinations in Fukushima in the First Four Years After the Fukushima Daiichi Nuclear Power Plant Accident.

    Science.gov (United States)

    Suzuki, Shinichi; Suzuki, Satoru; Fukushima, Toshihiko; Midorikawa, Sanae; Shimura, Hiroki; Matsuzuka, Takashi; Ishikawa, Tetsuo; Takahashi, Hideto; Ohtsuru, Akira; Sakai, Akira; Hosoya, Mitsuaki; Yasumura, Seiji; Nollet, Kenneth E; Ohira, Tetsuya; Ohto, Hitoshi; Abe, Masafumi; Kamiya, Kenji; Yamashita, Shunichi

    2016-06-01

    Thyroid nodules and cancers are rare in children compared with adults. However, after the 1986 Chernobyl Nuclear Power Plant accident, a rapid increase in childhood thyroid cancer was observed. To avoid any confusion and misunderstanding of data obtained in Fukushima after the 2011 nuclear accident, baseline prevalence of thyroid nodules and cancers should be carefully assessed with standardized criteria systematically, and comprehensively applied to the population perceived to be at risk. Under the official framework of the Fukushima Health Management Survey, the thyroids of children in Fukushima were examined using ultrasound, and the results collected in the first four years after the nuclear accident were analyzed in order to establish a baseline prevalence of childhood thyroid abnormalities, especially cancer. Of 367,685 people aged 18 years or younger as of April 1, 2011, who were living in Fukushima Prefecture at the time of the accident, 300,476 underwent thyroid ultrasound screening. Of those, 2108 subjects with thyroid nodules were further examined using an advanced ultrasound instrument, with standardized criteria applied to determine the need for fine-needle aspiration cytology (FNAC). FNAC results determined the need for surgery and histological confirmation of the cytological diagnosis. Of the 2108 rescreened subjects, 543 underwent FNAC, of whom 113 were diagnosed with malignancy or suspected malignancy. Subsequently, 99 patients underwent surgical resection, revealing 95 cases of papillary thyroid cancer, three poorly differentiated cancers, and one benign nodule. The overall prevalence of childhood thyroid cancer in Fukushima was determined to be 37.3 per 100,000 with no significant differences between evacuated and non-evacuated areas. Thyroid cancer patients had external exposure estimates of detected in this four-year study in Fukushima can be attributed to mass screening. It clearly exceeds what is found incidentally anywhere else. Direct

  6. Behaviour of oceanic 137Cs following the Fukushima Daiichi Nuclear Power Plant accident for four years simulated numerically by a regional ocean model

    Science.gov (United States)

    Tsumune, D.; Tsubono, T.; Aoyama, M.; Misumi, K.; Tateda, Y.

    2015-12-01

    A series of accidents at the Fukushima Dai-ichi Nuclear Power Plant (1F NPP) following the earthquake and tsunami of 11 March 2011 resulted in the release of radioactive materials to the ocean by two major pathways, direct release from the accident site and atmospheric deposition.We reconstructed spatiotemporal variability of 137Cs activity in the regional ocean for four years by numerical model, such as a regional scale and the North Pacific scale oceanic dispersion models, an atmospheric transport model, a sediment transport model, a dynamic biological compartment model for marine biota and river runoff model. Direct release rate of 137Cs were estimated for four years after the accident by comparing simulated results and observed activities very close to the site. The estimated total amounts of directly release was 3.6±0.7 PBq. Directly release rate of 137Cs decreased exponentially with time by the end of December 2012 and then, was almost constant. Decrease rate were quite small after 2013. The daily release rate of 137Cs was estimated to be the order of magnitude of 1010 Bq/day by the end of March 2015. The activity of directly released 137Cs was detectable only in the coastal zone after December 2012. Simulated 137Cs activities attributable to direct release were in good agreement with observed activities, a result that implies the estimated direct release rate was reasonable. There is no observed data of 137Cs activity in the ocean from 11 to 21 March 2011. Observed data of marine biota should reflect the history of 137Cs activity in this early period. We reconstructed the history of 137Cs activity in this early period by considering atmospheric deposition, river input, rain water runoff from the 1F NPP site. The comparisons between simulated 137Cs activity of marine biota by a dynamic biological compartment and observed data also suggest that simulated 137Cs activity attributable to atmospheric deposition was underestimated in this early period. The

  7. Assessing the fate of antibiotic contaminants in metal contaminated soils four years after cessation of long-term waste water irrigation

    International Nuclear Information System (INIS)

    Tamtam, Fatima; Oort, Folkert van; Le Bot, Barbara; Dinh, Tuc; Mompelat, Sophie; Chevreuil, Marc; Lamy, Isabelle; Thiry, Medard

    2011-01-01

    Spreading of urban wastewater on agricultural land may lead to concomitant input of organic and inorganic pollutants. Such multiple pollution sites offer unique opportunities to study the fate of both heavy metals and pharmaceuticals. We examined the occurrence and fate of selected antibiotics in sandy-textured soils, sampled four years after cessation of 100 years irrigation with urban wastewater from the Paris agglomeration. Previous studies on heavy metal contamination of these soils guided our sampling strategy. Six antibiotics were studied, including quinolones, with a strong affinity for organic and mineral soil components, and sulfonamides, a group of more mobile molecules. Bulk samples were collected from surface horizons in different irrigation fields, but also in subsurface horizons in two selected profiles. In surface horizons, three quinolones (oxolinic acid, nalidixic acid, and flumequine) were present in eight samples out of nine. Their contents varied spatially, but were well-correlated one to another. Their distributions showed great similarities regarding spatial distribution of total organic carbon and heavy metal contents, consistent with a common origin by wastewater irrigation. Highest concentrations were observed for sampling sites close to irrigation water outlets, reaching 22 μg kg -1 for nalidixic acid. Within soil profiles, the two antibiotic groups demonstrated an opposite behavior: quinolones, found only in surface horizons; sulfamethoxazole, detected in clay-rich subsurface horizons, concomitant with Zn accumulation. Such distribution patterns are consistent with chemical adsorption properties of the two antibiotic groups: immobilization of quinolones in the surface horizons ascribed to strong affinity for organic matter (OM), migration of sulfamethoxazole due to a lower affinity for OM and its interception and retention in electronegative charged clay-rich horizons. Our work suggests that antibiotics may represent a durable

  8. The prevalence of Giardia intestinalis and Entamoeba histolytica/dispar in Van Regional Training and Research Hospital: A four-year monitoring

    Directory of Open Access Journals (Sweden)

    Yasemin Bayram

    2013-03-01

    Full Text Available Objective: The aim of this retrospective study was to determinethe frequency rates of Giardia and E.histolytica/E.dispar and their distribution by years as well as agegroups and gender distribution during a four-year period.Materials and methods: A total of 9911 stool samplessent to our laboratory between January 2008 and December2011 were tested for parasites. Native-Lugol and formolethyl acetate sedimentation methods were utilized formicroscopic identification of Entamoeba sp. and Giardiatrophozoites and cysts in fresh stool samples. Additionally,trichrome staining was performed in stool sampleswhere the distinctive diagnosis could not be confirmed.Results: From a total of 9911 stool samples analyzedduring the study, 4.7% were positive for Giardia and 6.2%were positive for Entemoeba histolytica/ Entemoeba dispar.Of Giardia-positive patients 57% were male and 43%female. Similarly, 56% of Entemoeba histolytica/ Entemoebadispar positive patients were male and 44% werefemale. Both parasites’ higher frequency rates seen inmale groups were found statistically significant (p<0.01.Conclusion: It is seen that intestinal protozoon infectionsare still present as an important public health problemin our region. In order to prevent this problem, personalhygiene and sanitation rules education for community aswell as infrastructure improvements are necessary.Key words: Giardia, Entemoeba histolytica/ Entemoeba dispar, prevalence

  9. Bone Marrow Examination in Cases of New-onset Pancytopenia: A Four-year Study from a Medical College in the Rural Hilly Setting of Western Himalayas, India

    Directory of Open Access Journals (Sweden)

    Rashmi Kaul Raina

    2016-05-01

    Full Text Available New-onset pancytopenia is a common diagnostic challenge. Pancytopenia is an indication for bone marrow examination. The present study has been carried out to determine the frequencies of various etiologies of pancytopenia based on bone marrow morphology in a defined geographical location. All cases of new-onset pancytopenia, diagnosed on peripheral smear and seen over a four-year period from January 2012 to December 2015 in the department of pathology, were analysed. Patients lacking representative bone marrow in the aspirate or receiving chemotherapy were excluded. Out of 69 cases, 29 were males and 40 were females. Most of the patients were in the age group of 19-60 years (52.2%. Nineteen (26.1% of them were less than 18 years old. The three major causes of pancytopenia were: megaloblastic anemia (hypercellular marrow with megaloblastic erythropoiesis in 25 (36.2% cases, hypercellular marrow with dimorphic erythropoiesis in 13 (18.8% cases, and haematological malignancies in 12 (17.4% cases of the study. Bone marrow examination along with laboratory evaluation helps to establish specific diagnosis in cases of new-onset pancytopenia.

  10. The diet, physical activity and accommodation of patients with quiescent pulmonary tuberculosis in a poor South Indian community. A four-year follow-up study.

    Science.gov (United States)

    Ramakrishnan, C V; Rajendran, K; Mohan, K; Fox, W; Radhakrishna, S

    1966-01-01

    A previous report from the Tuberculosis Chemotherapy Centre, Madras, has shown that, if standard chemotherapy is given for one year, the response of patients treated at home in very poor environmental circumstances is nearly as good as that of those treated in sanatorium under much more favourable conditions. This paper reports on a four-year follow-up of all the patients whose disease was bacteriologically quiescent at the end of the year's treatment. During this period, all the patients were managed on a domiciliary basis; about a quarter of them received chemotherapy with isoniazid alone for two years, another quarter received the drug for one year and the rest received no specific chemotherapy. Despite adverse environmental factors (poor diet; long hours of work often involving strenuous physical activity; overcrowded living conditions; and, for the sanatorium patients, the stresses of returning suddenly to the unfavourable home environment), the great majority of patients in both series maintained quiescent disease throughout the follow-up period. Furthermore, the few patients whose disease relapsed bacteriologically were at no special dietary disadvantage in comparison with those who maintained quiescent disease throughout, nor did they show any appreciable differences in occupation, physical activity or living accommodation. These findings, together with the earlier ones, indicate that, despite adverse environmental circumstances, standard chemotherapy for an adequate period of time is sufficient in the great majority of patients for the attainment of bacteriological quiescence and its maintenance thereafter.

  11. Development of four-year fuel cycle based on the advanced fuel assembly with uranium-gadolinium fuel and its implementation to the operating WWER-440 units

    International Nuclear Information System (INIS)

    Lunin, G.; Novikov, A.; Pavlov, V.; Pavlovichev, P.; Filimonov, P.

    2000-01-01

    Over the past few years in Russia the investigations aimed at the increase of the reliability, safety and efficiency of operation of the WWER-1000 reactors as well as of its competitiveness in the world market were carried out. In the frame of these investigations the four-year fuel cycle, based on advanced fuel assemblies with zirconium alloy spacer grids and guide tubes and with fuel pellet having a reduced diameter of the central hole (1,5 mm), has been developed. For the compensation of a part of excess reactivity, Gd 2 O 3 integrated burnable absorbers are used. CPS absorbing rods contain a combine absorber (B 4 C + Dy 2 O 3 *TiO 2 ). A part of depleted fuel is located on the core periphery. The algorithms controlling the reactor power and power distribution have been updated. For checking of the solutions adopted and for verification of code package developed at the RRC 'Kurchatov Institute' the wide-scale experimental operation of advanced FA and its individual components is carried out. (Authors)

  12. Enhancing psychosocial and spiritual palliative care: Four-year results of the program of comprehensive care for people with advanced illnesses and their families in Spain.

    Science.gov (United States)

    Gómez-Batiste, Xavier; Mateo-Ortega, Dolors; Lasmarías, Cristina; Novellas, Anna; Espinosa, Jose; Beas, Elba; Ela, Sara; Barbero, Javier

    2017-02-01

    We aimed to describe the overall quantitative and qualitative results of a "La Caixa" Foundation and World Health Organization Collaborating Center Program entitled "Comprehensive Care for Patients with Advanced Illnesses and their Families" after four years of experience. Qualitative and quantitative methods were employed to assess the program. Quasiexperimental, prospective, multicenter, single-group, and pretest/posttest methods were utilized to assess the quantitative data. The effectiveness of psychosocial interventions was assessed at baseline (visit 1) and after four follow-up visits. The following dimensions were assessed: mood state, discomfort, anxiety, degree of adjustment or adaptation to disease, and suffering. We also assessed the four dimensions of the spiritual pain scale: faith or spiritual beliefs, valuable faith or spiritual beliefs, meaning in life, and peace of mind/forgiveness. Qualitative analyses were performed via surveys to evaluate stakeholder satisfaction. We built 29 psychosocial support teams involving 133 professionals-mainly psychologists and social workers. During the study period, 8,964 patients and 11,810 family members attended. Significant improvements were observed in the psychosocial and spiritual dimensions assessed. Patients, family members, and stakeholders all showed high levels of satisfaction. This model of psychosocial care could serve as an example for other countries that wish to improve psychosocial and spiritual support. Our results confirm that specific psychosocial interventions delivered by well-trained experts can help to ease suffering and discomfort in end-of-life and palliative care patients, particularly those with high levels of pain or emotional distress.

  13. Long-term leaching behavior of simulated Savannah River Plant waste glass: Part 1, MCC-1 leachability results, four-year leaching data

    International Nuclear Information System (INIS)

    Wicks, G.G.; Stone, J.A.; Chandler, G.T.; Williams, S.

    1986-08-01

    Long-term leaching data were obtained on SRP 131/TDS waste glass using MCC-1 or slightly modified MCC-1 standard leaching tests. Experiments were conducted out to four years at 40 0 C and 3-1/2 years at 90 0 C. These experiments have produced the longest standardized leaching data currently available in the waste management community. Long-term leaching data provide important input to modeling of waste glass behavior and ultimate prediction of waste glass performance. In this study, the leaching behavior of SRP waste glass was found to be excellent; leachates based on a variety of elements were not only very low, but also improved with increasing time. In addition to these data, results are also reported from another independent Savannah River study. Leaching behavior at 40 0 C and 90 0 C was assessed not only for a similar SRP 131 waste glass composition, but also for extreme waste glass compositions involving high-iron and high-aluminum waste. In addition, these experiments were performed using not only a standard deionized water leachant, but also simplified brine and silicate groundwater simulations. These two large data bases will be summarized and correlated along with some of the more interesting results recently reported in another study, a two-year leaching program performed on a similar SRP waste glass composition at Battelle Pacific Northwest Laboratories

  14. Impact on practice of a British Association for Sexual Health and HIV Sexually Transmitted Infections Foundation (STIF) course: an audit of the first four years in Ireland.

    Science.gov (United States)

    Calamai, A; Howard, R; Kelly, R; Lambert, J

    2013-02-01

    In order to investigate the overall impact of the British Association for Sexual Health and HIV (BASHH) Sexually Transmitted Infections Foundation (STIF) course taught in Ireland since 2007, attendees were sent two questionnaires to investigate the overall impact of the course, its effect on clinical practice and the need for further education. Response rate was 19.4%. The majority found the course beneficial and that it did cover their practice needs (96.4%), with 83.6% saying that their confidence and technique in sexual history taking had improved. There was a 3.7% increase in the provision of HIV testing from precourse levels, although only 80% did so routinely; a 12.7% increase in syphilis testing; a 5.4% increase in testing for Chlamydia and a 12.7% increase for gonorrhoea. Some confusion seems to persist in relation to sexually transmitted infection (STI) risk factors. The second questionnaire tested STI knowledge. Most respondents scored well (average 81% correct answers); however, respondents who attended four years previously scored, on average, 7% worse than the others, suggesting the need for a periodic update in the area of STI education.

  15. Seasonal variations and sources of atmospheric polycyclic aromatic hydrocarbons and organochlorine compounds in a high-altitude city: Evidence from four-year observations

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ping; Wang, Xiaoping; Sheng, Jiujiang; Wang, Hailong; Yuan, Xiaohua; He, Yuanqing; Qian, Yun; Yao, Tandong

    2018-02-01

    Lijiang is a high-altitude city located on the eastern fringe of the Tibetan Plateau, with complex seasonal atmospheric circulations (i.e. westerly wind, Indian Monsoon, and East Asia Monsoon). Very few previous studies have focused on seasonal variations and sources of organic pollutants in Lijiang. In this study, a four-year air campaign from June 2009 to July 2013 was conducted to investigate the temporal trends and the sources of polycyclic aromatic hydrocarbons (PAHs) and organochlorine compounds [including organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs)]. The atmospheric PAH concentrations in winter are 2-3 times of those in summer, probably because of the combined result of enhanced local emission and long-range atmospheric transport (LRAT) during winter. Traffic pollution was the primary local source of PAHs, while biomass burning is the dominant LRAT source. Different from PAHs, OCPs and PCBs mainly underwent LRAT to reach Lijiang. The peak concentrations of most of OCPs occurred in pre-monsoon season and winter, which are carried by air masses from Myanmar and India through westerly winds. As compared with other sites of the Tibetan Plateau, without the direct barrier of the Himalaya, Lijiang is easily contaminated by the incursion of polluted air masses.

  16. In-situ infiltration performance of different permeable pavements in a employee used parking lot--A four-year study.

    Science.gov (United States)

    Kumar, Kuldip; Kozak, Joseph; Hundal, Lakhwinder; Cox, Albert; Zhang, Heng; Granato, Thomas

    2016-02-01

    Permeable pavements are being adopted as a green solution in many parts of the world to manage urban stormwater quantity and quality. This paper reports on the measured in-situ infiltration performance over a four-year period since construction and use of three permeable parking sections (permeable pavers, permeable concrete and permeable asphalt) of an employee car parking lot. There was only a marginal decline in infiltration rates of all three pavements after one year of use. However, between years two to four, the infiltration rates declined significantly due to clogging of pores either by dry deposition of particles and/or shear stress of vehicles driving and degrading the permeable surfaces; during the last two years, a greater decline was also observed in driving areas of the parking lots compared to parking slots, where minimal wear and tear are expected. Maintenance strategies were employed to reclaim some of the lost infiltration rate of the permeable pavements to limited success. Despite this decline, the infiltration rates were still four to five times higher than average rainstorm intensity in the region. Thus, these permeable pavement parking lots may have significant ecological importance due to their ability to infiltrate rainwater quickly, reduce the runoff in the catchment area, and also dampen runoff peak flows that could otherwise enter the collection system for treatment in a combined sewer area. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. A hacker's guide to catching a debris flow: Lessons learned from four years of chasing mud in Colorado and southern California

    Science.gov (United States)

    Kean, J. W.; McCoy, S. W.; Staley, D. M.; Coe, J.; Leeper, R.; Tucker, G. E.

    2012-12-01

    Direct measurements of natural debris flows provide valuable insights into debris-flow processes and hazards. Yet debris flows are difficult to "catch" because they live in rugged terrain, appear infrequently, and have an appetite for destroying monitoring equipment. We present an overview of some successful (and failed) techniques we have used over the past four years to obtain direct measurements of 40+ debris flows in Colorado and southern California. Following the "MacGyver" theme of the session, we focus on the improvised equipment and methods we use in our hunt for quality data. These include an inexpensive erosion sensor to measure rates of debris-flow entrainment, a custom load cell enclosure for measuring debris-flow normal force, tracer rocks implanted with passive integrated transponders, basic pressure transducers to measure debris-flow timing, and standard digital cameras adapted to obtain high-resolution (1936 x 1288 pixels) video footage of debris flows. These techniques are also suitable for catching data on elusive flash floods. In addition, we also share some practical solutions to the logistical problems associated with installing monitoring equipment in rugged debris-flow terrain, such as suspension of non-contact stage gages high above channels.

  18. Radiotherapy Breast Boost With Reduced Whole-Breast Dose Is Associated With Improved Cosmesis: The Results of a Comprehensive Assessment From the St. George and Wollongong Randomized Breast Boost Trial

    International Nuclear Information System (INIS)

    Hau, Eric; Browne, Lois H.; Khanna, Sam; Cail, Stacy; Cert, Grad; Chin, Yaw; Clark, Catherine; Inder, Stephanie; Szwajcer, Alison; Graham, Peter H.

    2012-01-01

    Purpose: To evaluate comprehensively the effect of a radiotherapy boost on breast cosmetic outcomes after 5 years in patients treated with breast-conserving surgery. Methods: The St. George and Wollongong trial (NCT00138814) randomized 688 patients with histologically proven Tis-2, N 0–1, M0 carcinoma to the control arm of 50 Gy in 25 fractions (342 patients) and the boost arm of 45 Gy in 25 fractions to the whole breast followed by a 16 Gy in 8 fraction electron boost (346 patients). Five-year cosmetic outcomes were assessed by a panel subjectively in 385 patients and objectively using pBRA (relative breast retraction assessment). A subset of patients also had absolute BRA measurements. Clinician assessment and patient self-assessment of overall cosmetic and specific items as well as computer BCCT.core analysis were also performed. Results: The boost arm had improved cosmetic overall outcomes as scored by the panel and BCCT.core software with 79% (p = 0.016) and 81% (p = 0.004) excellent/good cosmesis respectively compared with 68% in no-boost arm. The boost arm also had lower pBRA and BRA values with a mean difference of 0.60 and 1.82 mm, respectively, but was not statistically significant. There was a very high proportion of overall excellent/good cosmetic outcome in 95% and 93% in the boost and no–boost arms using patient self-assessment. However, no difference in overall and specific items scored by clinician assessment and patient self-assessment was found. Conclusion: The results show the negative cosmetic effect of a 16-Gy boost is offset by a lower whole-breast dose of 45 Gy.

  19. Pediatric Epidemic of Salmonella enterica Serovar Typhimurium in the Area of L’Aquila, Italy, Four Years after a Catastrophic Earthquake

    Directory of Open Access Journals (Sweden)

    Giovanni Nigro

    2016-05-01

    Full Text Available Background: A Salmonella enterica epidemic occurred in children of the area of L’Aquila (Central Italy, Abruzzo region between June 2013 and October 2014, four years after the catastrophic earthquake of 6 April 2009. Methods: Clinical and laboratory data were collected from hospitalized and ambulatory children. Routine investigations for Salmonella infection were carried out on numerous alimentary matrices of animal origin and sampling sources for drinking water of the L’Aquila district, including pickup points of the two main aqueducts. Results: Salmonella infection occurred in 155 children (83 females: 53%, aged 1 to 15 years (mean 2.10. Of these, 44 children (28.4% were hospitalized because of severe dehydration, electrolyte abnormalities, and fever resistant to oral antipyretic and antibiotic drugs. Three children (1.9% were reinfected within four months after primary infection by the same Salmonella strain. Four children (2.6%, aged one to two years, were coinfected by rotavirus. A seven-year old child had a concomitant right hip joint arthritis. The isolated strains, as confirmed in about the half of cases or probable/possible in the remaining ones, were identified as S. enterica serovar Typhimurium [4,5:i:-], monophasic variant. Aterno river, bordering the L’Aquila district, was recognized as the main responsible source for the contamination of local crops and vegetables derived from polluted crops. Conclusions: The high rate of hospitalized children underlines the emergence of a highly pathogenic S. enterica strain probably subsequent to the contamination of the spring water sources after geological changes occurred during the catastrophic earthquake.

  20. Pediatric Epidemic of Salmonella enterica Serovar Typhimurium in the Area of L'Aquila, Italy, Four Years after a Catastrophic Earthquake.

    Science.gov (United States)

    Nigro, Giovanni; Bottone, Gabriella; Maiorani, Daniela; Trombatore, Fabiana; Falasca, Silvana; Bruno, Gianfranco

    2016-05-06

    A Salmonella enterica epidemic occurred in children of the area of L'Aquila (Central Italy, Abruzzo region) between June 2013 and October 2014, four years after the catastrophic earthquake of 6 April 2009. Clinical and laboratory data were collected from hospitalized and ambulatory children. Routine investigations for Salmonella infection were carried out on numerous alimentary matrices of animal origin and sampling sources for drinking water of the L'Aquila district, including pickup points of the two main aqueducts. Salmonella infection occurred in 155 children (83 females: 53%), aged 1 to 15 years (mean 2.10). Of these, 44 children (28.4%) were hospitalized because of severe dehydration, electrolyte abnormalities, and fever resistant to oral antipyretic and antibiotic drugs. Three children (1.9%) were reinfected within four months after primary infection by the same Salmonella strain. Four children (2.6%), aged one to two years, were coinfected by rotavirus. A seven-year old child had a concomitant right hip joint arthritis. The isolated strains, as confirmed in about the half of cases or probable/possible in the remaining ones, were identified as S. enterica serovar Typhimurium [4,5:i:-], monophasic variant. Aterno river, bordering the L'Aquila district, was recognized as the main responsible source for the contamination of local crops and vegetables derived from polluted crops. The high rate of hospitalized children underlines the emergence of a highly pathogenic S. enterica strain probably subsequent to the contamination of the spring water sources after geological changes occurred during the catastrophic earthquake.

  1. Vitamin D and Calcium Addition during Denosumab Therapy over a Period of Four Years Significantly Improves Lumbar Bone Mineral Density in Japanese Osteoporosis Patients

    Directory of Open Access Journals (Sweden)

    Takako Suzuki

    2018-02-01

    Full Text Available This study investigated whether or not vitamin D and calcium supplementation affected bone metabolism and bone mineral density (BMD over a period of four years of denosumab therapy in patients with primary osteoporosis. Patients were divided into a denosumab monotherapy group (22 cases or a denosumab plus vitamin D and calcium supplementation group (combination group, 21 cases. We measured serum bone alkaline phosphatase (BAP, tartrate-resistant acid phosphatase (TRACP-5b, urinary N-terminal telopeptide of type-I collagen (NTX, and BMD of the lumbar 1–4 vertebrae (L-BMD and bilateral hips (H-BMD at baseline and at 12, 24, 36, and 48 months of treatment. There were no significant differences in patient background. Serum BAP, TRACP-5b, and urinary NTX were significantly and comparably inhibited in both groups from 12 to 48 months versus baseline values. L-BMD was significantly increased at every time point in both groups, while H-BMD was significantly increased at every time point in the combination group only. There were significant differences between the groups for L-BMD at 24, 36, and 48 months (P < 0.05 and for H-BMD at 12 months (P < 0.05. Compared with denosumab monotherapy, combination therapy of denosumab plus vitamin D and calcium significantly increased H-BMD at 12 months and L-BMD from 24 to 48 months. These findings indicate that continuous vitamin D and calcium supplementation is important, especially for 12 months to improve H-BMD and from 24 to 48 months to improve L-BMD.

  2. Walk for life - the National Clubfoot Project of Bangladesh: the four-year outcomes of 150 congenital clubfoot cases following Ponseti method

    Directory of Open Access Journals (Sweden)

    Angela Margaret Evans

    2016-11-01

    Full Text Available Abstract Background Congenital clubfoot deformity can cause significant disability, and if left untreated, may further impoverish those in developing countries, like Bangladesh. The Ponseti method has been strategically introduced in Bangladesh by a non-government organisation, Walk For Life (WFL. WFL has provided free treatment for over 17,500 Bangladeshi children with clubfeet since 2009, sustained by local ownership, and international support. This study assesses the 4-year results in children for whom treatment began before the age of 3 years. Methods A centrally located WFL clinic at Mymensingh Medical College Hospital (MMCH, representative of the larger WFL clinics, which treats >100 cases annually, was reviewed. In 2015, 99 of the 147 eligible subjects who had begun treatment in 2011 were available for follow up. Specific assessment tools enabled evaluation of parent satisfaction, gait function, and relapse cases. Results Results for 99/147 cases were returned after four years: 72 males, 27 females. Typical clubfeet comprised 98/99 of cases, and 55/99 were bilateral. The tenotomy rate was 80 %. Brace use after 3 months was 90 %, at 12 months was 65 %, and at 4 years post treatment was 40 %. Functionally, 98/99 of children could walk and run (99 %. Relapsing deformity was found in 13 %. Relapse severity varied: eight were flexible and partial, five were rigid. Half of the children lost to follow were due to changed phone numbers. While parents were very happy with their child’s feet (97 %, a materials cost of 3000 Taka ($US40 was deemed unaffordable by 60 %. Conclusions The 4-year outcomes after Ponseti treatment for clubfoot deformity, showed that 99 % of children available for follow up, were walking independently. The relapse rate was low. Parent satisfaction was high, but those whose children required further treatment were less satisfied.

  3. Lower Protein-to-Carbohydrate Ratio in Maternal Diet is Associated with Higher Childhood Systolic Blood Pressure up to Age Four Years

    Directory of Open Access Journals (Sweden)

    Michelle L. Blumfield

    2015-04-01

    Full Text Available The prenatal environment can influence development of offspring blood pressure (BP, which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Children’s Health study. Maternal diet was assessed using a validated 74-item food frequency questionnaire at 18 to 24 weeks and 36 to 40 weeks, with a reference period of the previous three months. Child systolic and diastolic BP were measured at 3, 6, 9, 12, 24, 36 and 48 months, using an automated BP monitor. Using mixed-model regression analyses adjusted for childhood growth indices, pregnancy intakes of percentage of energy (E% polyunsaturated fat (β coefficient 0.73; 95% CI 0.003, 1.45; p = 0.045, E% omega-6 fatty acids (β coefficient 0.89; 95% CI 0.09, 1.69; p = 0.03 and protein-to-carbohydrate (P:C ratio (β coefficient −14.14; 95% CI −27.68, −0.60; p = 0.04 were associated with child systolic BP trajectory up to 4 years. Child systolic BP was greatest at low proportions of dietary protein (<16% of energy and high carbohydrate (>40% of energy intakes. There may be an ideal maternal macronutrient ratio associated with optimal infant BP. Maternal diet, which is potentially modifiable, may play an important role in influencing offspring risk of future hypertension.

  4. Inflammation and renal function after a four-year follow-up in subjects with unimpaired glomerular filtration rate: results from the observational, population-based CARLA cohort.

    Directory of Open Access Journals (Sweden)

    Daniel Medenwald

    Full Text Available There is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; however, relations in subjects with preserved renal function remain insufficiently understood.To examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.After excluding subjects with reduced estimated glomerular filtration rate (eGFR<60 mL/min/1.73 m2 and missing data, the cohort incorporated 785 men and 659 women (aged 45-83 years. Follow-up was performed four years after baseline. Covariate adjusted linear and logistic regression models were used to assess the association of plasma/serum concentrations of soluble tumour necrosis factor receptor 1 (sTNF-R1, C-reactive protein (CRP, and interleukin 6 (IL-6 with change in eGFR/creatinine. The areas under the curve (AUCs from receiver operating characteristics (ROCs were estimated.In adjusted models sTNF-R1 was distinctively associated with a decline in eGFR in men (0.6 mL/min/1.73 m2 per 100 pg/mL sTNF-R1; 95% CI: 0.4-0.8, but not in women. A similar association could not be found for CRP or IL-6. Estimates of sTNF-R1 in the cross-sectional analyses were similar between sexes, while CRP and IL-6 were not relevantly associated with eGFR/creatinine.In the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.

  5. Pre- and postnatal exposure of children to tobacco smoke during the first four years of life – observations of the authors

    Directory of Open Access Journals (Sweden)

    Barbara Kamer

    2014-11-01

    Full Text Available [b]Introduction[/b]. Environmental exposure to tobacco smoke is a significant threat for human health, where the higher is its degree, the more immature the human organism is. Therefore, the exposure to Tobacco smoke in foetal life exerts unfavourable effects on developing foetus and may cause early and distant results in children. [b]Material and methods.[/b] The study comprised 318 children in their first four years of life, treated for various medical conditions. The examined children were divided into two groups, Group 1 – children exposed to Tobacco smoke – and Group 2 – a control group with children from non-smoking families. History data were obtained on the basis of a specially designed questionnaire, used by the doctor in an individual conversation with parent. In each third child from the group 1 cotinine concentration in urine was assayed by the method of high performance liquid chromatography-UV-VIS and the cotinine/creatinine ratio was calculated. [b]Results of stud[/b][b]y[/b]. Results demonstrated environmental exposure to tobacco smoke in 173 children (Group 1. Out of them 31.2% were the children whose mothers had smoked also during pregnancy (Subgroup A. The other 119 children from Group 1 were accounted to Subgroup B, i.e., children, where other household members had been smoking cigarettes. A comparative group comprised 143 children from non-smoking families. The results demonstrated then that 17% of all the examined children were those, exposed to tobacco smoke effects already in their foetal life, predisposing them to prematurity and low birth weight. Moreover, it was observed that the young age and lower education level of their parents, together with worse housing conditions, may suggest a predisposing character and role of the mentioned factors.

  6. Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain).

    Science.gov (United States)

    Poveda, Rafael; Jiménez, Yolanda; Gavaldá, Carmen; Sanchís, José María; Carbonell, Enrique; Margaix, María; Sarrión, Gracia

    2008-05-01

    A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total of 5784 fillings were carried out (93.3% with silver amalgam, 5.6% with composites and the rest as provisional fillings). The permanent first molars were the teeth with the largest number of fillings (70.2% of the total). These were followed in order of frequency by the second molars (19.1%). As regards composite resin fillings, most involved the upper central incisors, followed by the upper lateral incisors. A total of 644 extractions were performed, corresponding to 110 permanent teeth and 534 temporary teeth. In the case of the permanent dentition, the first molars were the most commonly removed teeth. In the temporary dentition, the most frequently removed teeth were the second molars. The response of the population to this program has been very good, and reinforces the preventive measures already in place, with the provision of restorative treatments to improve the oral and dental health of the pediatric population, and yielding good results in terms of the program quality indicators. The Service of Stomatology (Valencia University General Hospital) is able to address the demand and offers the public health network integrated and continuous patient care.

  7. The Effects of "Handwriting without Tears®" on the Handwriting Skills of Appropriate Size, Form, and Tool for a Four Year-Old Boy with a Developmental Delay

    Science.gov (United States)

    Meyers, Colleen; McLaughlin, T. F.; Derby, Mark; Weber, Kimberly P.; Robison, Milena

    2015-01-01

    The ability to write one's own name legibly is a critical lifelong skill for academic success. The purpose of the present study was to evaluate the effects of the Handwriting Without Tears® program on teaching a four year-old how to write his first name using proper size, form, and tool. The participant was a four year-old boy in a self-contained…

  8. A four-year field program investigating long-term effects of repeated exposure of honey bee colonies to flowering crops treated with thiamethoxam.

    Directory of Open Access Journals (Sweden)

    Edward Pilling

    Full Text Available Neonicotinoid residues in nectar and pollen from crop plants have been implicated as one of the potential factors causing the declines of honey bee populations. Median residues of thiamethoxam in pollen collected from honey bees after foraging on flowering seed treated maize were found to be between 1 and 7 µg/kg, median residues of the metabolite CGA322704 (clothianidin in the pollen were between 1 and 4 µg/kg. In oilseed rape, median residues of thiamethoxam found in pollen collected from bees were between <1 and 3.5 µg/kg and in nectar from foraging bees were between 0.65 and 2.4 µg/kg. Median residues of CGA322704 in pollen and nectar in the oilseed rape trials were all below the limit of quantification (1 µg/kg. Residues in the hive were even lower in both the maize and oilseed rape trials, being at or below the level of detection of 1 µg/kg for bee bread in the hive and at or below the level of detection of 0.5 µg/kg for hive nectar, honey and royal jelly samples. The long-term risk to honey bee colonies in the field was also investigated, including the sensitive overwintering stage, from four years consecutive single treatment crop exposures to flowering maize and oilseed rape grown from thiamethoxam treated seeds at rates recommended for insect control. Throughout the study, mortality, foraging behavior, colony strength, colony weight, brood development and food storage levels were similar between treatment and control colonies. Detailed examination of brood development throughout the year demonstrated that colonies exposed to the treated crop were able to successfully overwinter and had a similar health status to the control colonies in the following spring. We conclude that these data demonstrate there is a low risk to honey bees from systemic residues in nectar and pollen following the use of thiamethoxam as a seed treatment on oilseed rape and maize.

  9. A Four-Year Field Program Investigating Long-Term Effects of Repeated Exposure of Honey Bee Colonies to Flowering Crops Treated with Thiamethoxam

    Science.gov (United States)

    Pilling, Edward; Campbell, Peter; Coulson, Mike; Ruddle, Natalie; Tornier, Ingo

    2013-01-01

    Neonicotinoid residues in nectar and pollen from crop plants have been implicated as one of the potential factors causing the declines of honey bee populations. Median residues of thiamethoxam in pollen collected from honey bees after foraging on flowering seed treated maize were found to be between 1 and 7 µg/kg, median residues of the metabolite CGA322704 (clothianidin) in the pollen were between 1 and 4 µg/kg. In oilseed rape, median residues of thiamethoxam found in pollen collected from bees were between <1 and 3.5 µg/kg and in nectar from foraging bees were between 0.65 and 2.4 µg/kg. Median residues of CGA322704 in pollen and nectar in the oilseed rape trials were all below the limit of quantification (1 µg/kg). Residues in the hive were even lower in both the maize and oilseed rape trials, being at or below the level of detection of 1 µg/kg for bee bread in the hive and at or below the level of detection of 0.5 µg/kg for hive nectar, honey and royal jelly samples. The long-term risk to honey bee colonies in the field was also investigated, including the sensitive overwintering stage, from four years consecutive single treatment crop exposures to flowering maize and oilseed rape grown from thiamethoxam treated seeds at rates recommended for insect control. Throughout the study, mortality, foraging behavior, colony strength, colony weight, brood development and food storage levels were similar between treatment and control colonies. Detailed examination of brood development throughout the year demonstrated that colonies exposed to the treated crop were able to successfully overwinter and had a similar health status to the control colonies in the following spring. We conclude that these data demonstrate there is a low risk to honey bees from systemic residues in nectar and pollen following the use of thiamethoxam as a seed treatment on oilseed rape and maize. PMID:24194871

  10. Four-years experience with monitoring of persons at the treatment of children patients with neuroblastoma by 131I-MIBG combination with hyperbaric oxygen therapy

    International Nuclear Information System (INIS)

    Hermanska, J.; Zimak, J.; Paskova, Z.; Dosel, P.

    2001-01-01

    Treatment of children patients with neuroblastoma by 131 I-MIBG in combination with hyperbaric oxygen therapy (HBO) started in the Czech Republic in 1997. Estimation of radiation load from extemal irradiation plays very important role in the treatment scheme elaborated at the Department of Nuclear Medicine. According to this scheme, activities of 5.5 GBq and 3.7 GBq are administered at the first and repeated therapies,respectively. 3 rd , 4 th , 5 th and 6 th day after the administration patients undergo HBO in the Institute of Aviation Medicine Prague. Activity administration and following care are realised at the bed station of the Department of Nuclear Medicine, which is the workplace of III. category with unsealed radionuclide sources. Real dose equivalents were checked during the reported four-year period. Members of both groups were equipped by personal digital dosemeters STEPHEN 6000 for inspection. From the presented results, the following conclusions can be drawn: (1) Monitoring of family members has to be performed in spite of the fact that exceeding of equivalent dose of 5 mSv is non-realistic. Unexpected situation concerning behaviour of both parents and children cannot be excluded. Moreover, records of H-values have to be stored and analysed in the case of possible pregnancy. (2) A question arises in connection with the special limit 5 mSv: What is the whole time of the treatment? Is it possible to understand it, similarly as in the case of iodine therapy, as 5 mSv per year or is it necessary to take into account really the whole, often very long, time of the treatment? (3) Monitoring of the staff maintaining the hyperbaric chamber and ambulance drivers seems to be unnecessary. Under normal condition, the staff is outside the chamber and its contact with a patient is minimal. In unusual situation, the instructed nurse from the Department of Nuclear Medicine equipped by STEPHEN 6000 will estimate dose equivalent and contact responsible medical

  11. The Nord-Trøndelag Health Study shows increased prevalence of primary recurrent headaches among adolescents over a four-year period.

    Science.gov (United States)

    Jacobsena, Brit A; Dyb, Grete; Hagen, Knut; Stovner, Lars J; Holmen, Turid L; Zwart, John-Anker

    2017-12-29

    change significantly (79.4% versus 77.5%; OR: 0.89, 95%CI: 0.79-1.02, p = 0.09), whereas the prevalence of recurrent headaches increased from 30.3% in Young-HUNT 1 to 35.4% in Young-HUNT 2 (OR: 1.26, 95%CI: 1.09-1.46, p = 0.002). The prevalence of tension-type headache changed significantly from 19.0% to 21.9% (OR: 1.20, 95%CI: 1.02-1.42, p = 0.03). Also the prevalence of migraine tended to increase (7.5% versus 8.7%, OR: 1.18, 95%CI: 0.92-1.52, p = 0.18). The overall frequency of recurrent headache changed towards more monthly and less weekly headache. Conclusions This is the first large-scale population-based study among adolescents in Norway assessing changes in the prevalence of primary headaches over a four-year period of time. The overall prevalence of recurrent headaches increased significantly from Young-HUNT 1 to Young-HUNT 2. An increase was seen in all types of recurrent headaches and was significant for tension-type headache. Implications Earlier follow-up studies have examined changes in prevalence of recurrent headaches in young age, but the results are diverging. Our findings support the impression that the prevalence of recurrent headache among adolescents is increasing, and underlines the need for prospective designed studies with emphasis on prognosis and etiological factors.

  12. Four-Year Durability of Initial Combination Therapy with Sitagliptin and Metformin in Patients with Type 2 Diabetes in Clinical Practice; COSMIC Study.

    Directory of Open Access Journals (Sweden)

    Eu Jeong Ku

    Full Text Available We investigated the efficacy of initial combination therapy with sitagliptin and metformin in patients with type 2 diabetes for 4 years in clinical practice.Between 2009 and 2010, we reviewed 1,178 patients with type 2 diabetes (HbA1c ≥7.5% or 58 mmol/mol prescribed initial combination therapy with sitagliptin and metformin. After excluding 288 patients without a second follow-up, 890 individuals (age, 58.0 ± 12.5 years; BMI, 25.4 ± 3.5 kg/m2; HbA1c, 8.6 ± 1.1% were followed up with every 3-6 months for 4 years. Homeostasis model assessments for insulin resistance and β-cell function (HOMA-β were recorded at baseline. The response criterion was HbA1c reduction by ≥0.8% from baseline or attainment of the target HbA1c (≤7.0% or 53 mmol/mol. At the end of every year of treatment, changes in HbA1c from the baseline were assessed.After 1 year, 72.2% of patients with initial combination therapy had responded, defined as HbA1c reduction ≥0.8% or attainment of the target HbA1c ≤7.0%. After 4 years, 35.4% of the patients still showed a response, with an HbA1c level of 7.0 ± 0.9%. A high HbA1c level at baseline was the most significant independent predictor of the long-term response (P<0.001. In addition, low HOMA-β was a significant predictor of a greater reduction in HbA1c. This treatment was generally well tolerated over the 4-year follow-up period, without any serious adverse events.This real-world follow-up study shows a persistent glucose-reducing effect of initial combination therapy with sitagliptin and metformin for up to 4 years.

  13. Public High School Four-Year On-Time Graduation Rates and Event Dropout Rates: School Years 2010-11 and 2011-12. First Look. NCES 2014-391

    Science.gov (United States)

    Stetser, Marie C.; Stillwell, Robert

    2014-01-01

    This National Center for Education Statistics (NCES) First Look report introduces new data for two separate measures of 4-year on-time graduation rates as well as event dropout rates for school year (SY) 2010-11 and SY 2011-12. Specifically this report provides the following: (1) Four-year adjusted cohort graduation rate (ACGR) data reported by…

  14. Developmental Mathematics Students: Who are They and What is Their Mathematics Self-Efficacy?

    OpenAIRE

    Baxter, Ryan; Bates, Alan; Al-Bataineh, Adel Tawfig

    2017-01-01

    The purpose of this quantitative study was to determine differences indevelopmental mathematics students’ self-efficacy within the demographic datafrom the survey. Data from a sample of 240 Intermediate Algebra students at asingle four-year university using the Mathematics Self-Efficacy Resultsindicate that males possess higher levels of mathematics self-efficacy andconfidence with their mathematical abilities than females. Students whocompleted a lower developmental mathematics course prior ...

  15. Developmental Mathematics Students: Who are They and What is Their Mathematics Self-Efficacy?

    OpenAIRE

    Ryan Baxter; Alan Bates; Adel Tawfig Al-Bataineh

    2016-01-01

    The purpose of this quantitative study was to determine differences in developmental mathematics students’ self-efficacy within the demographic data from the survey. Data from a sample of 240 Intermediate Algebra students at a single four-year university using the Mathematics Self-Efficacy Results indicate that males possess higher levels of mathematics self-efficacy and confidence with their mathematical abilities than females. Students who completed a lower developmental mathematics course ...

  16. Collective Efficacy

    DEFF Research Database (Denmark)

    Chen, Ying; Zhou, Xiaohu; Klyver, Kim

    2018-01-01

    at manufacturing companies show that benevolent leadership and moral leadership, both components of paternalistic leadership, are positively related to organizational commitment and further that collective efficacy mediates the moral leadership–organizational commitment relationship. We did not find a relationship...... between authoritarian leadership and organizational commitment. Besides, it was found that team cohesion negatively moderates the relationship between moral leadership and collective efficacy and positively moderates the relationship between collective efficacy and organizational commitment. Explanations......Based on social cognitive theory, we theorize that collective efficacy plays a mediating role in the relationship between paternalistic leadership and organizational commitment and that this mediating role depends on team cohesion. The empirical results from a study of 238 employees from 52 teams...

  17. Four years after Chernobyl: the medical repercussions

    International Nuclear Information System (INIS)

    Hubert, D.

    1990-01-01

    The nuclear accident at Chernobyl accounted for an acute radiation syndrome in 237 persons on the site. Triage was the initial problem and was carried out according to clinical and biological criteria; evaluating the doses received was based on these criteria. Thirty one persons died and only 1 survived a dose higher than 6 Gy. Skin radiation burns which were due to inadequate decontamination, greatly worsened prognosis. The results of 13 bone marrow transplantations were disappointing, with only 2 survivors. Some time after the accident, these severely irradiated patients are mainly suffering from psychosomatic disorders, in the USSR, some areas have been significantly contaminated and several measures were taken to mitigate the impact on population: evacuating 135 000 persons, distributing prophylactic iodine, establishing standards and controls on foodstuff. Radiation phobia syndrome which developed in many persons, is the only sanitary effect noticed up to now. Finally, in Europe, there was only an increase in induced abortions and this was totally unwarranted. If we consider the risk of radiation induced cancer, an effect might not be demonstrated [fr

  18. Programmable gaming environments for four year olds

    Directory of Open Access Journals (Sweden)

    Edith K. Ackermann

    2002-01-01

    Full Text Available Apprendere a programmare alla scuola dell'infanzia? Perche'? Che cosa ci puo' essere di interessante in questo per un bambino? Che cosa si puo' imparare? Questo articolo e' rivolto ai ricercatori, ai progettisti, agli educatori e ai genitori; tutti questi hanno buone ragioni per interrogarsi.

  19. Programmable gaming environments for four year olds

    OpenAIRE

    Edith K. Ackermann

    2002-01-01

    Apprendere a programmare alla scuola dell'infanzia? Perche'? Che cosa ci puo' essere di interessante in questo per un bambino? Che cosa si puo' imparare? Questo articolo e' rivolto ai ricercatori, ai progettisti, agli educatori e ai genitori; tutti questi hanno buone ragioni per interrogarsi.

  20. The state repatriation programme: four years later

    Directory of Open Access Journals (Sweden)

    Kirillova Yelena

    2010-12-01

    Full Text Available This article analyses the problems of the state voluntary repatriation programme and describes its key functions and implementation mechanisms. The author identifies the causes of deceleration in the repatriation process as well as the weak points of the Programme and the ways to improve it. The article offers data on the resettlement of compatriots over the three years of the Programme implementation, its demographic structure, and the regions of resettlement.

  1. A Natural Playscape: Four Years Later

    Science.gov (United States)

    Keeler, Rusty

    2008-01-01

    In 2004, the author had the pleasure of joining the staff of New Day Children's Center in Watertown, New York, and a huge group of community volunteers in building the center's playscape. This past summer, she was able to visit Watertown again so she went to check on the progress of the center's playscape. In this article, she shares several…

  2. Neonatal Intestinal Obstruction-Four Year Experience

    Directory of Open Access Journals (Sweden)

    D. Rathore

    2015-06-01

    Full Text Available Aim of study: To study the aetiology and frequency, sex incidence, age of presentation, management and outcome of neonatal intestinal obstruction. Material and Methods: This prospective study of 316 neonates with intestinal obstruction was conducted over a period of 4 years from November 2009 to October 2013 at single institute. These cases were managed by various surgical procedures. Their epidemiology, day of presentation, associated anomalies and outcomes were studied. Results: A total of 316 neonates (277 males and 39 females were operated for intestinal obstruction. 268(84.81% neonates presented in the 1st week of life. Imperforate anus occurred in 206 (65.19%.Small bowel atresia accounted for23 (7.27% cases while duodenal atresia was seen in19 (6.01% patients. Infantile hypertrophic pyloric stenosis and Malrotation each occurred in 14 (4.43% patients; Hirschsprung’s disease in 18(5.69%, Necrotising Enterocolitis in 12(3.79%, Meconium disease of newborn in 9(2.85% while colonic atresia was seen in one (0.3% patient. Colostomy was performed in 145(45.88%, Pouchostomy in 15(4.74% and Cutback anoplasty in 56(17.72% patients. Ramsted’s Pyloromyotomy in 13(4.11%% neonates, Laparoscopic Pyloromyotomy in 1(0.3%,Kimura’s Duodenoduodenostomy in 19(6.01% ,End to Back anastomosis in 24(7.59% , End to End anastomosis in 7(2.21% , Multiple anastomosis in 2(0.6% , Enterotomy with irrigation in 7(2.21% , Ladd’s procedure in 14(4.43% , ,Single stage transanal pull through in 8(2.53% , Ileostomy in 2(0.6% , Single stage Abdominoperineal pull through in 2(0.6%, Levelling colostomy in 6(1.89% ,Peritoneal drain insertion under Local anaesthesia in 5(1.58% . Overall mortality was 13.60%. Conclusion: Intestinal Obstruction is the most common surgical emergency in neonatal period. Early and accurate diagnosis is paramount for proper patient management. The etiology, mode of presentation, morbidity and outcome of surgery of intestinal obstruction in neonates in our study were not significantly different from other studies.

  3. Four-year experience with methotrexate exposures.

    Science.gov (United States)

    LoVecchio, Frank; Katz, Kenneth; Watts, David; Wood, Ian

    2008-09-01

    Unintentional methotrexate (MTX) acute oral overdose is rarely reported. We conducted a retrospective chart review of all human exposure calls (>150,000 charts) for MTX ingestions reported to our Poison Center during 2000-2003. Thirteen patients met the criteria. The average amount of MTX ingested was 13.03 mg (data from 7 cases), and the average patient age was 43 years (20 months to 80 years). No significant toxicities occurred. Although intravenous MTX toxicity can be severe, this does not appear to be a phenomenon associated with either acute unintentional or suicidal oral ingestion.

  4. Philadelphia's Renaissance Schools Initiative after Four Years

    Science.gov (United States)

    Stratos, Kati; Wolford, Tonya; Reitano, Adrienne

    2015-01-01

    In 2010-2011, the School District of Philadelphia (the District) launched its Renaissance Schools Initiative, a program designed to dramatically improve student achievement in the District's lowest performing schools. Some schools became Promise Academies, based on the federal turnaround model, and remained District-operated neighborhood schools.…

  5. Lifestyle and health status in a sample of Swedish women four years after pregnancy: a comparison of women with a history of normal pregnancy and women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Persson, Margareta; Winkvist, Anna; Mogren, Ingrid

    2015-03-13

    Despite the recommendations to continue the regime of healthy food and physical activity (PA) postpartum for women with previous gestational diabetes mellitus (GDM), the scientific evidence reveals that these recommendations may not be complied to. This study compared lifestyle and health status in women whose pregnancy was complicated by GDM with women who had a normal pregnancy and delivery. The inclusion criteria were women with GDM (ICD-10: O24.4 A and O24.4B) and women with uncomplicated pregnancy and delivery in 2005 (ICD-10: O80.0). A random sample of women fulfilling the criteria (n = 882) were identified from the Swedish Medical Birth Register. A questionnaire was sent by mail to eligible women approximately four years after the pregnancy. A total of 444 women (50.8%) agreed to participate, 111 diagnosed with GDM in their pregnancy and 333 with normal pregnancy/delivery. Women with previous GDM were significantly older, reported higher body weight and less PA before the index pregnancy. No major differences between the groups were noticed regarding lifestyle at the follow-up. Overall, few participants fulfilled the national recommendations of PA and diet. At the follow-up, 19 participants had developed diabetes, all with previous GDM. Women with previous GDM reported significantly poorer self-rated health (SRH), higher level of sick-leave and more often using medication on regular basis. However, a history of GDM or having overt diabetes mellitus showed no association with poorer SRH in the multivariate analysis. Irregular eating habits, no regular PA, overweight/obesity, and regular use of medication were associated with poorer SRH in all participants. Suboptimal levels of PA, and fruit and vegetable consumption were found in a sample of women with a history of GDM as well as for women with normal pregnancy approximately four years after index pregnancy. Women with previous GDM seem to increase their PA after childbirth, but still they perform their PA at

  6. Effectiveness of Eye Movement Desensitization and Reprocessing(EMDR to Reduce the Severity of Symptoms of Post-Traumatic Stress Disorder and Stuttering With Psychological Origin(Case Study in Child with Four Years Old

    Directory of Open Access Journals (Sweden)

    Azam Hashemian Moghadam

    2017-02-01

    Full Text Available Abstract Background: The present research aimed to measure the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR on reducing the severity of symptoms of post-traumatic Stress Disorder (PTSD and Stuttering in a four-year-old child post-traumatic stress disorder in children is one of the disorders relating to trauma and stressful factors, also, stutterring or word fluency disorder is a nerve growth disorder. Materials and Methods: This research design was conducted as a case study with a multiple baseline design. Participant in this research was a four-year- old child with Diagnostic Posttraumatic Stress Disorder and Psychogenic Stuttering. He had been placed under the intervention with EMDR at Shahid Birjand Counseling Center. The instruments used for this research included demographic researcher-made questionnaire, the third edition of stuttering severity test, the scale of parents’ report of post-traumatic Symptoms and child’s report of posttraumatic Symptoms. Data analysis was done through graphic and descriptive analysis. The data was collected as base line and during the treatment as well as after the treatment and follow-up (in terms of 3 and 24 months. Results: Means percentage improvement (MPI to reducing the severity of post-traumatic symptoms was achieved as %74.66 and it was %56.06 for reduction of the severity of stuttering and they continued to maintain in the follow-up period. Conclusion: Results showed that EMDR method had affected on reduction of the severity of post-traumatic stress disorder symptoms and stuttering intensity.

  7. Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens.

    Directory of Open Access Journals (Sweden)

    Urban Alehagen

    Full Text Available Selenium and coenzyme Q10 are important antioxidants in the body. As the intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases, an intervention trial using selenium and coenzyme Q10 for four years was performed. As previously reported, the intervention was accompanied by reduced cardiovascular mortality. The objective of the present study was to analyze cardiovascular mortality for up to 10 years after intervention, to evaluate if mortality differed in subgroups differentiated by gender, diabetes, ischemic heart disease (IHD, and functional class.Four-hundred forty-three healthy elderly individuals were included from a rural municipality in Sweden. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results mortality was registered.Significantly reduced cardiovascular mortality could be seen in those on selenium and coenzyme Q10 intervention. A multivariate Cox regression analysis demonstrated a reduced cardiovascular mortality risk in the active treatment group (HR: 0.51; 95%CI 0.36-0.74; P = 0.0003. The reduced mortality could be seen to persist during the 10-year period. Subgroup analysis showed positive effects in both genders. An equally positive risk reduction could be seen in those with ischemic heart disease (HR: 0.51; 95%CI 0.27-0.97; P = 0.04, but also in the different functional classes.In a 10-year follow-up of a group of healthy elderly participants given four years of intervention with selenium and coenzyme Q10, significantly reduced cardiovascular mortality was observed. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanism explaining the persistency remains to be elucidated. Since this was a small study, the observations should be regarded as hypothesis-generating.

  8. Accelerated increase and decrease in subjective age as a function of changes in loneliness and objective social indicators over a four-year period: results from the health and retirement study.

    Science.gov (United States)

    Ayalon, Liat; Palgi, Yuval; Avidor, Sharon; Bodner, Ehud

    2016-07-01

    The study examined the role of changes in loneliness and objective social indicators in the formation of changes in subjective age over a four-year period. The Health and Retirement Study is a US nationally representative study of older adults over 50 and their spouse of any age. We restricted the sample to individuals, 65 years of age and older (n = 2591). An accelerated increase in subjective age was defined as an increase in subjective age over the two waves greater than five years. An accelerated decrease in subjective age was defined as a difference that was lower than three years. These were examined against a change in subjective age in the range of three to five years (i.e., change consistent with the passage of time). For 23.4% of the sample, changes in subjective age were consistent with the passage of time. A total of 38.3% had an accelerated decrease in subjective age, whereas 38.3% had an accelerated increase. A decrease in loneliness over the two waves resulted in an accelerated decrease in subjective age, whereas an increase in depressive symptoms resulted in an accelerated increase in subjective age. Changes in objective social indicators, physical difficulties or medical comorbidity did not predict changes in subjective age. This is one of very few studies that examined changes in subjective age over time. Changes in subjective age represent an important construct that corresponding to other changes in subjective experiences.

  9. Barriers to a healthy lifestyle for three- to four-year-old children of Australian-born and overseas-born mothers with post-gestational diabetes: An Australian qualitative study.

    Science.gov (United States)

    Zulfiqar, Tehzeeb; Nolan, Christopher J; Banwell, Cathy; Young, Rosemary; Boisseau, Lynelle; Ingle, Martha; Lithander, Fiona E

    2018-01-01

    Children of mothers affected by gestational diabetes mellitus (GDM) are at higher risk of long-term cardio-metabolic diseases. We explore the diet and physical activity knowledge and practices of Australian-born and overseas-born mothers with GDM history, for their three- to four-year-old children following antenatal health promotion education at a tertiary hospital. We conducted face-to-face, semi-structured interviews with 8 Australian-born and 15 overseas-born mothers with a history of GDM. Findings indicated that mothers of both groups were unaware of the increased health risks of their GDM for their children and could not recall receiving specific dietary or physical activity advice aimed at future child health. Their understanding of the diet and physical activity recommendations was inconsistent. Mothers of both groups expressed concern about the lack of reiteration of child health promotion messages following childbirth, particularly at postnatal follow-up visits. Diet and physical activity of the children of overseas-born mothers were adversely affected by inadequate maternal understanding of the recommendations due to language barriers, and child weight, healthy eating, and physical activity patterns derived from their home countries. We recommend enhanced health education for women with GDM on the future child health risks and their reduction by healthy lifestyle choices. This needs to be culturally relevant and reiterated after pregnancy.

  10. Presence of the relative age effect and its effect on playing time among under-20 players in the Norwegian premier league Tippeligaen – a four-year follow up

    Directory of Open Access Journals (Sweden)

    Stig Arve Sæther

    2016-03-01

    Full Text Available European top-level soccer clubs are continually looking for talented players. Few clubs, however, are willing to let youth players play at the highest senior level. Perhaps as a consequence, the search for talented players has resulted in an imbalance in the characteristics of these players, towards an overrepresentation of players born early in the selection year, an effect called the relative age effect (RAE. The RAE has been documented to be present among senior top-level players. Even so, few studies have investigated the effect among youth players at the senior level. The aim of this study is to examine RAE among U17-U20 players in the Norwegian premier league Tippeligaen in the 2009-2012 seasons. Participants were 315 male players born in 1990-1996. The results showed that 68% of the players were born in the two first quartiles of the year. The effect was even increasing in the four-year period. As we could expect based on the literature, the oldest players are given more playing time. However, the connection between playing time and RAE was inconsistent. Norwegian top-level soccer seems to be affected by the RAE when selecting their players. These players are not however guaranteed playing time because of the RAE.

  11. MUD and Self Efficacy.

    Science.gov (United States)

    Lee, Kwan Min

    2000-01-01

    Proposes a theoretical framework for analyzing the effect of MUD (Multi-User Dungeons) playing on users' self-efficacy by applying Bandura's social learning theory, and introduces three types of self-efficacy: computer self-efficacy; social self-efficacy; and generalized self-efficacy. Considers successful performance, vicarious experience,…

  12. Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs?

    Science.gov (United States)

    Maschmann, J; Holderried, M; Blumenstock, G; Bamberg, M; Rieger, M A; Wallwiener, D; Brucker, S

    2013-07-01

    Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p < 0.001), and between 2010 and 2011 (p = 0.02). Discussion: AWTL and 10 h-dwt could be continuously respected quite well after implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02).

  13. A Longitudinal Investigation of the Science Teaching Efficacy Beliefs and Science Experiences of a Cohort of Preservice Elementary Teachers

    Science.gov (United States)

    Deehan, James; Danaia, Lena; McKinnon, David H.

    2017-01-01

    This paper assesses the relationship between participation in two tertiary science courses and the science teaching efficacy beliefs (STEBs) of one cohort of preservice elementary teachers over a four-year period. Two Type II case studies were conducted within the courses. Data were collected through 26 administrations of the Science Teaching…

  14. Tertiary Students' ICT Self-Efficacy Beliefs and the Factors Affecting Their ICT-Use

    Science.gov (United States)

    Turel, Vehbi; Calik, Sinan; Doganer, Adem

    2015-01-01

    This study looked at tertiary (i.e. undergraduate /a four-year degree) students' information and communication technology (ICT) self-efficacy beliefs and their level in use of certain common programmes at a newly established (i.e. 2007) university in Turkey in the spring of 2012. The study examined the tertiary students' (a) demographic…

  15. Using nitrogen stable isotope ratios (δ15N) of macroalgae to determine the effectiveness of sewage upgrades: changes in the extent of sewage plumes over four years in Moreton Bay, Australia

    International Nuclear Information System (INIS)

    Costanzo, Simon D.; Udy, James; Longstaff, Ben; Jones, Adrian

    2005-01-01

    Nitrogen loading to aquatic ecosystems from sewage is recognised worldwide as a growing problem. The use of nitrogen stable isotopes as a means of discerning sewage nitrogen in the environment has been used annually by the Ecosystem Health Monitoring Program in Moreton Bay (Australia) since 1997 when the technique was first developed. This ('sewage plume mapping') technique, which measures the δ 15 N isotopic signature of the red macroalga Catenella nipae after incubation in situ, has demonstrated a large reduction in the magnitude and spatial extent of sewage nitrogen within Moreton Bay over the past 5 years. This observed reduction coincides with considerable upgrades to the nitrogen removal efficacy at several sewage treatment plants within the region. This paper describes the observed changes and evaluates whether they can be attributed to the treatment upgrades

  16. Using nitrogen stable isotope ratios ({delta}{sup 15}N) of macroalgae to determine the effectiveness of sewage upgrades: changes in the extent of sewage plumes over four years in Moreton Bay, Australia

    Energy Technology Data Exchange (ETDEWEB)

    Costanzo, Simon D. [National Research Centre for Environmental Toxicology, University of Queensland, 39 Kessels Road, Coopers Plains, QLD 4108 (Australia)]. E-mail: s.costanzo@uq.edu.au; Udy, James [Marine Botany, Centre for Marine Studies, University of Queensland, 4072 (Australia); Longstaff, Ben [Environmental Protection Agency, 80 Meiers Road, Indooroopilly, QLD 4058 (Australia); Jones, Adrian [University of Maryland Center for Environmental Science, P.O. Box 775, Cambridge, MD 21613, USA (United States)

    2005-07-01

    Nitrogen loading to aquatic ecosystems from sewage is recognised worldwide as a growing problem. The use of nitrogen stable isotopes as a means of discerning sewage nitrogen in the environment has been used annually by the Ecosystem Health Monitoring Program in Moreton Bay (Australia) since 1997 when the technique was first developed. This ('sewage plume mapping') technique, which measures the {delta}{sup 15}N isotopic signature of the red macroalga Catenella nipae after incubation in situ, has demonstrated a large reduction in the magnitude and spatial extent of sewage nitrogen within Moreton Bay over the past 5 years. This observed reduction coincides with considerable upgrades to the nitrogen removal efficacy at several sewage treatment plants within the region. This paper describes the observed changes and evaluates whether they can be attributed to the treatment upgrades.

  17. Evolução clínica e capacidade funcional de pacientes com cardiomiopatia dilatada após quatro anos do transplante Clinical and functional capacity of patients with dilated cardiomyopathy after four years of transplantation

    Directory of Open Access Journals (Sweden)

    Daniela Gardano Bucharles Mont'Alverne

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a evolução do paciente miocardiopata após transplante (Tx cardíaco, analisando sua sobrevida, complicações trans e pós-operatórias e respostas cardiovasculares após cerca de quatro anos do procedimento cirúrgico. MÉTODOS: A pesquisa foi realizada no período de fevereiro a maio de 2011, com pacientes submetidos a Tx cardíaco no Hospital Dr. Carlos Alberto Studart Gomes - Hospital de Messejana (HDM. A amostra foi composta de todos os pacientes transplantados no ano de 2007 no referido hospital. Inicialmente, foi aplicada uma ficha de avaliação, coletando dados dos prontuários, sobre a evolução do paciente no período trans e pós-operatório até a alta hospitalar. Após a coleta dessas informações, os pacientes foram submetidos ao teste da caminhada dos seis minutos (TC6. Os valores encontrados na distância percorrida foram comparados aos valores de referência esperados para a população utilizando a equação de Enright e Sherrill. RESULTADOS: Do total de 24 pacientes que realizaram Tx cardíaco no HDM no ano de 2007, 14 foram avaliados e 10 excluídos do estudo. Com relação às complicações, no período transoperatório, a mais evidenciada foi a disfunção do ventrículo direito (64,3% e, no pós-operatório, quadro de taquicardia (64,3%. Analisando o TC6 observou-se diminuição de 11,6% na distância percorrida quando comparada à distância estimada (486 ± 55 m, 550 ± 59 m, respectivamente. CONCLUSÃO: Os resultados obtidos neste estudo perante o TC6 evidenciam que as respostas cardiovasculares dos pacientes avaliados estão abaixo do estimado, contudo dentro da faixa de normalidade estabelecida.OBJECTIVE: To evaluate patient with cardiomyopathy's progress after cardiac transplant, by analyzing his survival, complications and cardiovascular responses after nearly four years of surgery. METHODS: The survey was conducted from February to May 2011, with patients undergoing cardiac transplantation

  18. An Exploratory Study into the Efficacy of Learning Objects

    Directory of Open Access Journals (Sweden)

    Nicholas W. Farha, Ph.D.

    2009-07-01

    Full Text Available Learning objects have quickly become a widely accepted approach to instructional technology, particularly in on-line and computer-based learning environments. While there is a substantial body of literature concerning learning objects, very little of it verifies their efficacy. This research investigated the effectiveness of learning objects by comparing learning outcomes using a learning object with outcomes using a traditional textbook-based method of instruction. Participants were 327 undergraduate college students at a traditional public four-year coed institution, a private four-year women’s college, a private four-year engineering institution, and a public two-year community college. Through a series of independent samples t-tests and Analyses of Variance, results revealed mean scores for the learning object group that were nearly three times higher than the mean scores for the textbook-taught group. Gaming experience, age, gender, and learner preference were evaluated for their potential influence on the results; no statistically significant differences were found, implying that the learning object itself was central to the outcomes achieved. The future of learning objects is bright, and more empirical research is called for in the area of learning object effectiveness.

  19. Strobe Light Deterrent Efficacy Test and Fish Behavior Determination at Grand Coulee Dam Third Powerplant Forebay

    International Nuclear Information System (INIS)

    Simmons, Mary Ann; Johnson, Robert L.; McKinstry, Craig A.; Simmons, Carver S.; Cook, Chris B.; Brown, Richard S.; Tano, Daniel K.; Thorsten, Susan L.; Faber, Derrek M.; Lecaire, Richard; Francis, Stephen

    2004-01-01

    This report documents the third year of a four-year study to assess the efficacy of a prototype strobe light system to elicit a negative phototactic response in kokanee salmon (Oncorhynchus nerka) and rainbow trout (O. mykiss) in the forebay to the third powerplant at Grand Coulee Dam. This work was conducted for the Bonneville Power Administration, U.S. Department of Energy, by Pacific Northwest National Laboratory (PNNL) in conjunction with the Confederated Tribes of the Colville Reservation (Colville Confederated Tribes)

  20. Strobe Light Deterrent Efficacy Test and Fish Behavior Determination at Grand Coulee Dam Third Powerplant Forebay

    Energy Technology Data Exchange (ETDEWEB)

    Simmons, Mary Ann; Johnson, Robert L.; McKinstry, Craig A.; Simmons, Carver S.; Cook, Chris B.; Brown, Richard S.; Tano, Daniel K.; Thorsten, Susan L.; Faber, Derrek M.; Lecaire, Richard; Francis, Stephen

    2004-01-01

    This report documents the third year of a four-year study to assess the efficacy of a prototype strobe light system to elicit a negative phototactic response in kokanee salmon (Oncorhynchus nerka) and rainbow trout (O. mykiss) in the forebay to the third powerplant at Grand Coulee Dam. This work was conducted for the Bonneville Power Administration, U.S. Department of Energy, by Pacific Northwest National Laboratory (PNNL) in conjunction with the Confederated Tribes of the Colville Reservation (Colville Confederated Tribes).

  1. Peritoneal dialysis and peritonitis rate: Kuwait, four years' experience.

    Science.gov (United States)

    Alyousef, Anas M; Abdou, Salah M; Mansour, Yasser S; Radi, Ahmad D

    2016-01-01

    Peritoneal dialysis (PD) program was established in Farwaniya Hospital Kidney Center, Kuwait, in February 2011. Patient recruitment for this modality of treatment was growing steadily. One of the major complications of PD is peritonitis. There is a belief that PD therapy is inferior and carries more complications than hemodialysis, we aimed to show that PD is a good and a non-inferior option for dialysis therapy with comparable outcome in both patient and technique survival. This was a retrospective analysis of all patients who were on PD from February 2011 to December 2014. Peritonitis rate, exit site infection rate, and all-cause mortality rate were all assessed for this period. Peritonitis rate during the 1 st year, 2011, was 0.92 incidents/year. This number had progressively declined in the following years; in 2012, it was 0.65 incidents/year; in 2013, it was 0.58 incidents/year; and in 2014, it was 0.38 incidents/year. This improvement in the rate of peritonitis incidence could be explained by better education of patients and meticulous supervision of the nursing staff. Farwaniya Hospital Kidney Center had an all-cause mortality rate of 9.3% among patients on renal replacement therapy in 2011. In 2012, all-cause mortality rate increased to 17.1%. The following year, 2013, it decreased to 14.3%, and in 2014, all-cause mortality rate dropped further to 7.6%. All-cause mortality rate among PD patients was zero in 2011. In 2012, the all-cause mortality rate in PD was 11.54%, and in 2013, it decreased to 10.52%. Then, again in 2014, the all-cause mortality rate among PD patients was zero. This improvement in all-cause mortality rate could be explained by the better medical care offered to the end-stage renal disease patients, in particular PD patients, in Farwaniya Hospital Kidney Center.

  2. Four years on: Are the gazelles still running?

    DEFF Research Database (Denmark)

    Senderovitz, Martin; Klyver, Kim; Steffens, Paul

    2016-01-01

    –profitability relationship and are tested using longitudinal data from a sample of 964 Danish gazelle firms. We find a positive relationship between growth and profitability among gazelle firms. This relationship is moderated, however, by market strategy; it is stronger for firms pursuing a broad market strategy rather than...

  3. FOUR YEARS OF OPERATIONS AND RESULTS WITH FORTE

    International Nuclear Information System (INIS)

    D. ROUSSEL-DUPRE; P. KLINGNER; L. CARLSON; ET AL

    2001-01-01

    The FORTE (Fast Onboard Recording of Transient Events) satellite was launched on 29 August 1997 and has been in continuous operation since that time. FORTE was placed in a nearly circular, 825-km-altitude, 70 degrees inclination orbit by a Pegasus rocket funded by Air Force Space Test Program. The Department of Energy funded the FORTE satellite, which was designed and built at Los Alamos. FORTE's successful launch and engineered robustness were a result of several years of dedicated work by the joint Los Alamos National Laboratory/Sandia National Laboratory project team, led through mission definition, payload and satellite development, and launch by Dr. Stephen Knox. The project is now led by Dr. Abram Jacobson. FORTE carries a suite of instruments, an optical system and a rf system, for the study of lightning and anthropogenic signals. As a result of this effort, new understandings of lightning events have emerged as well as a more complete understanding of the relationship between optical and rf lightning events. This paper will provide an overview of the FORTE satellite and will discuss the on orbit performance of the subsystems

  4. The Gulf Nuclear Energy Infrastructure Institute (GNEII) Four Years On

    International Nuclear Information System (INIS)

    Finch, Robert J.; Mohagheghi, Amir H.; Solodov, Alexander; Beeley, Philip A.; Boyle, David R.

    2014-01-01

    Introduction: What is GNEII? • Regionally based Institution → human resource capability → Future decision makers → managers & regulators. • Education & Development → Nuclear energy infrastructure → Integrated safeguards, safety, and security (3S) → Nuclear power fundamentals. • Strategic effort → Coordinated partnership → Responsible national nuclear energy program → Regional context. Why GNEII? • Build indigenous human resources → Education, Research, Technical capacity → Integrated 3S Systems Approach - coupled with - Nuclear Energy Infrastructure. • GNEII Addresses a Need → Increased nuclear power demand → Regional Nuclear Infrastructure → GNEII is a sustainable mechanism for developing a responsible nuclear energy program

  5. Four years of DNA barcoding: current advances and prospects.

    Science.gov (United States)

    Frézal, Lise; Leblois, Raphael

    2008-09-01

    Research using cytochrome c oxidase barcoding techniques on zoological specimens was initiated by Hebert et al. [Hebert, P.D.N., Ratnasingham, S., deWaard, J.R., 2003. Barcoding animal life: cytochrome c oxidase subunit 1 divergences among closely related species. Proc. R. Soc. Lond. B 270, S96-S99]. By March 2004, the Consortium for the Barcode of Life started to promote the use of a standardized DNA barcoding approach, consisting of identifying a specimen as belonging to a certain animal species based on a single universal marker: the DNA barcode sequence. Over the last 4 years, this approach has become increasingly popular and advances as well as limitations have clearly emerged as increasing amounts of organisms have been studied. Our purpose is to briefly expose DNA Barcode of Life principles, pros and cons, relevance and universality. The initially proposed Barcode of life framework has greatly evolved, giving rise to a flexible description of DNA barcoding and a larger range of applications.

  6. A survey of four years intrauterine insemination at Shariati Hospital

    Directory of Open Access Journals (Sweden)

    Aghahosseini M

    1998-08-01

    Full Text Available Intrauterine insemination (IUI has been practiced since the late 1800's primarily for idiopathic infertility, and in men with deficient semen parameters. The procedure is done by placing washed sperm in uterus a few hours before ovulation. The records of 427 couples receiving IUI for treatment of infertility at Shariati hospital in 1370-74 were reviewed retrospectively. These patients had IUI in 574 cycles. Eighty patients became pregnant and delivery rate was 14% per cycle. Pregnancy rate is impressive when ovulation induction is combined with insemination timed just before ovulation. The success rate in Shariati hospital is comparable to other infertility centers in the world and cost of a cycle of IUI with HMG superovulation is approximately one third the cost of IVF-ET or GIFT cycle and avoids invasive oocyte retrieval and extracorporeal fertilization. So we suggest that women with refractory infertility without anatomic distortion of pelvis can have at least 3-6 cycles of IUI before IVF or GIFT.

  7. Advanced Communications Technology Satellite (ACTS): Four-Year System Performance

    Science.gov (United States)

    Acosta, Roberto J.; Bauer, Robert; Krawczyk, Richard J.; Reinhart, Richard C.; Zernic, Michael J.; Gargione, Frank

    1999-01-01

    The Advanced Communications Technology Satellite (ACTS) was conceived at the National Aeronautics and Space Administration (NASA) in the late 1970's as a follow-on program to ATS and CTS to continue NASA's long history of satellite communications projects. The ACTS project set the stage for the C-band satellites that started the industry, and later the ACTS project established the use of Ku-band for video distribution and direct-to-home broadcasting. ACTS, launched in September 1993 from the space shuttle, created a revolution in satellite system architecture by using digital communications techniques employing key technologies such as a fast hopping multibeam antenna, an on-board baseband processor, a wide-band microwave switch matrix, adaptive rain fade compensation, and the use of 900 MHz transponders operating at Ka-band frequencies. This paper describes the lessons learned in each of the key ACTS technology areas, as well as in the propagation investigations.

  8. Four year-old girl with having bled intestinal sharp

    International Nuclear Information System (INIS)

    Rodriguez Toro, Gerzain

    2001-01-01

    Indigenous girl, natural of Vaupes, Colombia conduction to the Mitu Hospital to present depositions with bleed. Their father says that the girl is sick for two days; she presents anorexia, moderate abdominal pain and vomit scarce postprandial, followed by discreet diarrhea and of two depositions with blood and abundant clots, with posterior syncope. It confirms a bled digestive with sharp anemic syndrome. The possibilities of gastritis sharp erosive, gastric ulcer or duodenal and intestinal poliparasitism are suggested. It is diagnosed abdominal angioestrongilosis, illness produce by helminths that lives inside the blind and the distal ileum

  9. Four years of experience with temporamandibular joint (TMJ) arthrography

    International Nuclear Information System (INIS)

    Duarte Filho, D.L.; Wagner, R.

    1990-01-01

    The imaging investigation of the internal derangements of temporomandibular joint (TMJ) has been recently enriched with state of the art tools, such as CT and MRI. However these equipments are not widely available in our country. In addition, some lesions such as perforation of the MJ meniscus, are not demonstrated by either one of these methods, been fairly easily showed by arthorography. The purpose of this paper is to show our experience with 386 arthrograms performed in 193 patients. Our results are compatible with those of the literature. In the last group of 176 patients, we have abandonned the local anesthesia procedure, with good advantages. Arthrography is a very usefull method in the evaluation of TMJ and should be more used in our country. (author)

  10. Four-year clinical experience in photodynamic therapy

    Science.gov (United States)

    Stranadko, Eugeny P.; Skobelkin, Oleg K.; Vorozhtsov, Georgy N.; Mironov, Andrei F.; Markichev, Nikolai A.; Riabov, Michail V.

    1996-12-01

    The analysis of the results of photodynamic therapy (PDT) for treating malignant neoplasms of skin, breasts, tongue, oral mucose, lower lip, larynx, stomach, bladder, rectum and other locations has been made. During 1992 - 1996 867 tumoral foci in 222 patients have been treated with PDT. All patients were previously treated with conventional techniques or they were not treated due to contraindications either because of severe accompanying diseases or because of old age. A part of the patients had PDT because of recurrences or intradermal metastases in 1 - 2 years after surgical, radial or combined treatment. Up to now we have follow-up control data within 2 months and 4 years. Positive effect of PDT was seen in 93.7% of patients including complete regression of tumors in 64.9% and partial in 28.8%. Currently this new perspective technique of treating malignant neoplasms is successfully being used in Russia; new photosensitizers and light sources for PDT and fluorescent tumor diagnostics are being developed as well.

  11. A four-year retrospective review of postabortal surgical ...

    African Journals Online (AJOL)

    The issue of abortion is a delicate one in our country and most developing countries, presenting a complex moral and ethical dilemma. Most abortion laws in the developing countries, inherited from the former colonial powers, have remained stagnant for the past four decades, despite the fact that social values regarding sex ...

  12. Texas pavement preservation center four-year summary report.

    Science.gov (United States)

    2009-07-04

    The Texas Pavement Preservation Center (TPPC), in joint collaboration with the Center for Transportation Research (CTR) of the University of Texas at Austin and the Texas Transportation Institute (TTI) of Texas A&M University, promotes the use of pav...

  13. Chernobyl: four years later: attitudes, risk management and communication

    NARCIS (Netherlands)

    van der Pligt, J.; Midden, C.H.J.

    1990-01-01

    Discusses the impact that the nuclear reactor accident at Chernobyl has had on risk management and risk communication in relation to risk perception; decisions and coping with uncertainty; and public opinion, personal attitudes, and public policy.

  14. Actuarial Science at One Four-Year Comprehensive University

    Science.gov (United States)

    Charlwood, Kevin E.

    2014-01-01

    Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

  15. Four- year thyroidectomy procedures: Ligasure Vs. clamp & tie

    Directory of Open Access Journals (Sweden)

    Pazoki AR

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The electrothermal bipolar vessel sealing system is an adjunct to the hemostatic technique, which has been successfully used in many abdominal operation, recently made available to thyroid surgery. The purpose of this was compare the outcomes of new hemostatic technique with traditional method of clamp and tie."n"nMethods: In this retrospective cross-sectional study has been done in surgery's wards of Milad & Rasul- Akram hospitals in Tehran, Iran. During three- year period between 2005-2008 all patients with different kind of pathology that need operation were assessed. Time duration of surgery and hospital stay and post surgery complication in two group, ligasure (n=45 and clamp & tie (n=145 were compared with each others."n"nResults: No difference was seen between two groups in time duration of surgery. Significant difference was seen in hospital stay and complications of surgery. Time of operation in Ligasure group was 132/22 minute and in clamp and tie group was 130/10 minute. There was found significant difference in duration of hospital stay and postoperative complication. Hypocalcemia were seen in two and 24 cases in Ligasure and Clamp & Tie group, respectively (p<0.05. Hospital stay was 2.18 versus 2.65 day in ligasure and clamp & tie group, respectively (p=0.005."n"nConclusions: Although Ligasure is easier than clamp & tie for surgeons but no reduction in time duration of surgery was seen in ligasure group. The advantages of this method in this study was reduction of hospital stay and complication

  16. The African Institutions Initiative: Insights from the First Four Years

    Science.gov (United States)

    Cochrane, Gavin; Robin, Enora; Marjanovic, Sonja; Diepeveen, Stephanie; Hanlin, Rebecca; Kryl, David; Muchova, Lucia; Yaqub, Ohid; Chataway, Joanna

    2014-01-01

    In 2009, the Wellcome Trust launched a research capacity strengthening programme known as the "African Institutions Initiative" (AII). The AII is innovative in its methods and organization. The Initiative funded networked consortia (7 consortia involving 54 institutions in 18 African countries, and Northern partners). RAND Europe was…

  17. Fifty-four Years of Adventures in Infrared Astronomy

    Science.gov (United States)

    Becklin, Eric Eric

    2018-01-01

    My adventures in infrared astronomy started when I was a grad student in 1965 with the discovery of an infrared-bright object (now known as the Becklin-Neugebauer Object) in the Orion Nebula. In 1966, I made the first measurements of the infrared radiation from the center of the Milky Way Galaxy. I was fortunate enough to be able to take advantage of the 2.2 micron sky survey carried out by Neugebauer and Leighton (1969), which produced many remarkable discoveries, the most spectacular being the heavily dust-embedded carbon star IRC+10216, thebrightest object in the sky at 5 microns outside the solar system. In the 1970’s there was a growth in Infrared astronomy with the availability of many new facilities such as the Kuiper Airborne Observatory, (KAO) which I used extensively with Mike Werner and Ian Gatley for many unique observations. In 1977, I moved to Hawaii to work on the NASA IRTF 3- meter telescope. Many discoveries were made, including the first direct measurements of the rings of Jupiter at 2.2 microns (with Gareth Wynn-Williams) and the discovery of the first L dwarf star around a white dwarf (with Ben Zuckerman). In the 1980’s the introduction of large format arrays changed the way we did infrared astronomy. With Ian McLean, I moved to UCLA in 1990 to start the IR lab and get involved in Keck development and science. In 1995, Andrea, Ghez, Mark Morris and I started looking for evidence of a possible massive Black Hole in the Galactic Center. Spectacular observations using the Keck10 meter telescopes with large format near-infrared arrays and adaptive optics led to the confirmation of the presence of such a black hole and an estimate of its mass (4xE6 M (Sun)). In 1996, I began working on the Stratospheric Observatory For Infrared Astronomy (SOFIA) and I will finish my talk by discussing SOFIA observations of the ring of dust and gas orbiting the massive black hole in the center

  18. Spain doubles natural gas consumption in four years

    International Nuclear Information System (INIS)

    Van den Boom, H.

    1996-01-01

    Around the year 2000 3 million Spanish households and 3,000 industrial businesses must be connected to the Spanish natural gas distribution system, which is double the amount of the present connections. The Spanish government aims at a contribution of natural gas of 25% of the total household energy consumption within 10 years. figs., 11 ills

  19. A four-year comparison of two organic dairy systems

    OpenAIRE

    Weller, Mr Richard

    2006-01-01

    Two organic systems were studied, the first based on self-sufficiency (SS) and the feeding of high-forage diets, and the second on purchased concentrates (PC) and maximising milk output. The growing of both concentrate and forage feeds in the SS system reduced the stocking density. Feeding high-forage diets increased the proportion of milk produced from forage but decreased the energy concentration of the ration, leading to lower milk persistency, reduced milk protein in early lactation and r...

  20. Automating the AFROTC Four-Year Scholarship Program.

    Science.gov (United States)

    1986-04-01

    ATCH 2 b1 C -d C4 4" %C N 0" cl4 es C4 CN 1 onin %DG C1 06 0 -0 40 V 44-4 LIU-4- c4 A: U. -4 La 4 E vt a-’ iv El "l 04 0 0.I t b U El 4 V do v 0 CoU. -4...CEEB CLAS~S BOARD 1ST 2ND DCF QEP/ STRT,"’ HWFADC CfI3; PEL SCORES SCORE COMP SCOPE STAND RAMK".,H~DC ’ PREF PREF RACE PREY" rTL B1 = 46/1 C hiroms...A/N 88 Fencing 4 AIN 89 La Crosse 4 AIN 90 Rifle/Pistol 4 AIN 91 Rugby 4 AIN 92 Track 4 A/N 93 Wrestling 4 A/N 94 Others (Name and Codes) 15 A/N 95

  1. Four Years of Observations of GRB Localizations with TAROT

    International Nuclear Information System (INIS)

    Boeer, M.; Thiebaud, C.; Atteia, J.-L.; Malina, R.; Freitas Pacheco, J. de; Pedersen, H.; Klotz, A.

    2004-01-01

    We present a summary of the observations performed with the Telescope a Action Rapide pour les Objets Transitoires (TAROT - Rapid Action Telescope for Transient Objects) performed over the period 1999 - 2003. Seventeen GRB localization observations where performed shortly after the burst (10s - 90min.), and in at least one case, even while the source was still active in gamma-rays. During this period CGRO. HETE-2 and INTEGRAL were in operation. Though no alert was missed, no source was detected, to a magnitude limit between R = 15 and R = 20. Future plans are also presented, featuring the duplication of TAROT at ESO - La Silla

  2. Complications in paediatric craniofacial surgery: an initial four year experience.

    Science.gov (United States)

    Jones, B M; Jani, P; Bingham, R M; Mackersie, A M; Hayward, R

    1992-04-01

    107 children undergoing transcranial craniofacial surgery in a paediatric hospital have been reviewed to assess the incidence and type of complications which arose. This represents the first 4 years' experience of the craniofacial team. There were no deaths or permanent adverse sequelae of surgery. A total of 53 complications were seen in 42 patients. In 9.3% of patients they were potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The more serious complications were related either to haemorrhage and/or vasovagal shock at operation or to infection post-operatively. Infants undergoing monoblock frontofacial advancements and those with tracheostomies were at particular risk.

  3. Urgent tracheostomy: four-year experience in a tertiary hospital.

    Science.gov (United States)

    Costa, Liliana; Matos, Ricardo; Júlio, Sara; Vales, Fernando; Santos, Margarida

    2016-01-01

    Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely important. We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital. Indications, complications and clinical evolution of the patients were reviewed. The study included 56 patients (44 men and 12 women) with a median age of 55 years. The procedure was performed under local anesthesia in 21.4% of the patients. Two (3.6%) patients were subjected to conversion from cricothyrostomy to tracheostomy. Head and neck neoplasm was indicated in 44.6% of the patients, deep neck infection in 19.6%, and bilateral vocal fold paralysis in 10.7%. Stridor was the most frequent signal (51.8%). Of the 56 patients, 15 were transferred to another hospital. Among the other 41 patients, 21 were decannulated (average time: 4 months), and none of them were cancer patients. Complications occurred in 5 (12.2%) patients: hemorrhage in 3, surgical wound infection in 1, and cervico-thoracic subcutaneous emphysema in 1. No death was related to the procedure. Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with difficult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.

  4. The Course of Alcoholism: Four Years After Treatment

    National Research Council Canada - National Science Library

    Polich, J. M; Armor, David J; Braiker, Harriet B

    1980-01-01

    Alcoholism has traditionally been viewed as a persistent and chronic disorder. Recent years, however, have seen a growing belief that the disorder can be completely transformed into stable, long-term improvement after intervention...

  5. Gastric necrosis four years after fundoplication causing a dead foetus

    DEFF Research Database (Denmark)

    Thinggaard, Ebbe; Skovsen, Anders Peter; Kildsig, Jeppe

    2014-01-01

    A 31-year-old pregnant woman was admitted and treated for diabetic ketoacidosis. As the patient deteriorated and the viability of the foetus was uncertain a CT scan was done which showed free fluid and air intraabdominally. Surgery was performed. A dead foetus was delivered and a 2 × 5 cm necrotic...

  6. Effect of the dedicated education unit on nursing student self-efficacy: A quasi-experimental research study.

    Science.gov (United States)

    George, Lynn E; Locasto, Lisa W; Pyo, Katrina A; W Cline, Thomas

    2017-03-01

    Although the Dedicated Education Unit (DEU) has shown initial promise related to satisfaction with the teaching/learning environment, few studies have examined student outcomes related to the use of the DEU as a clinical education model beyond student satisfaction. The purpose of this quantitative, quasi-experimental study was to compare student outcomes from the traditional clinical education (TCE) model with those from the DEU model. Participants were students enrolled in a four-year baccalaureate program in nursing (n = 193) who had clinical education activities in one of three clinical agencies. Participants were assigned to either the DEU or a TCE model. Pre-clinical and post-clinical self-efficacy scores were measured for each group using an adapted Generalized Self-Efficacy Scale (Schwarzer and Jerusalem, 1995). Both groups experienced a significant increase in self-efficacy scores post clinical education. The increase in self-efficacy for the DEU students was significantly greater than the increase in self-efficacy for the traditional students. Self-efficacy is considered an important outcome of nursing education because high self-efficacy has been linked to making an easier transition from student to nursing professional. This study supports the quality of the DEU as a clinical education model by examining student self-efficacy outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The efficacy of pivmecillinam

    DEFF Research Database (Denmark)

    Jansåker, Filip; Frimodt-Møller, Niels; Bjerrum, Lars

    2016-01-01

    regimen is superior to a 3-day regimen. With this study we aim to identify and to compare the efficacy of pivmecillinam 400 mg t.i.d in a 3-day respectively 5-day regimen, against community acquired uncomplicated LUTI, i.e., in women at the age of 18-70 year old. METHOD/DESIGN: The general practitioner...... days). Pivmecillinam is also one of the first-line drugs recommended in the international guidelines for LUTIs (i.e., 400 mg b.i.d. for 5 days). The international recommended duration is based on evidence saying that a 7-day regimen is better than a 3-day regimen. However, no data says that a 5-day...

  8. Perceived parental efficacy: concept analysis.

    Science.gov (United States)

    Montigny, Francine; Lacharité, Carl

    2005-02-01

    This paper describes a concept analysis carried out to remove some of the ambiguity surrounding the conceptual meaning of perceived parental efficacy and to distinguish it from related concepts such as parental confidence and parental competence. Constructing parental efficacy is a crucial step for family members after the birth of their first child. For some authors, perceived parental efficacy is a motor for adequate parental practices. Confusion about the definition and measurement of this concept has hindered both psychology and nursing practice and research. Concept delineation and concept clarification are required in order to further the development of the concept of perceived parental efficacy. A literature search using a variety of online databases yielded 113 articles between the years 1980 and 2000. The final sample (n=60) consisted of 30 articles from two disciplines: nursing and psychology. A content analysis of the literature was done using Rodger's evolutionary concept analysis method. Content analysis of the literature yielded four contributors to perceived parental efficacy: positive enactive mastery experiences, vicarious experiences, verbal persuasion and an appropriate physiological and affective state. Perceived parental efficacy can thus be defined as 'beliefs or judgements a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child'. This conceptual analysis has allowed perceived parental efficacy to be distinguished from parental confidence and parental competence. Both nursing and psychology research, practice and education will benefit from a more precise and delineated concept.

  9. Enhancing Teacher Efficacy in Special Education.

    Science.gov (United States)

    McDaniel, Elizabeth A.; McCarthy, Holly DiBella

    1989-01-01

    A special education teacher's sense of teaching efficacy and personal teaching efficacy influences teacher motivation and effort, teacher-student interactions, and student achievement. Methods for enhancing teachers' sense of efficacy are suggested. (JDD)

  10. Obesity and hormonal contraceptive efficacy.

    Science.gov (United States)

    Robinson, Jennifer A; Burke, Anne E

    2013-09-01

    Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

  11. The Efficacy of Cognitive Shock

    Science.gov (United States)

    2015-05-21

    way, causing dissonance or cognitive conflict, so that the mental model has to be ‘accommodated’ to the new data. Categories and knowledge have to...The Efficacy of Cognitive Shock A Monograph by MAJ Anthony L. Marston United States Army School of Advanced Military Studies...DATES COVERED (From - To) JUN 2014 – MAY 2015 4. TITLE AND SUBTITLE The Efficacy of Cognitive Shock 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  12. Implementación de un laboratorio de habilidades clínicas centralizado en la Facultad de Medicina de la Universitat de Barcelona: Cuatro años de experiencia Implementation of a centralized clinical skills laboratory at the Medical School of the University of Barcelona: Four years of experience

    Directory of Open Access Journals (Sweden)

    A. Mazarro

    2009-12-01

    implement a centralized skills centre. Materials and methods: We describe the different steps of the process of implementation of this centre and the development of an elective course on clinical skills and procedures, in order to acquire experience in the management of this center and to show to the teachers the usefulness of these facilities. Finally, we investigated the level of acceptance of this tool by teachers and students by using different kinds of questionnaires. Results: In the last four years about 1000 medical students per year (undergraduate and postgraduate have been trained in the laboratory. Students consider that the center is an excellent tool to increase their individual competence in clinical skills and it is necessary to extend this tool to all students. For teachers, the center is a very useful tool to improve clinical training. Conclusions: Our experience has been positive and very useful in the curriculum change process carried out at present in our medical school. The experience could serve as a model for the implementation of skills centers in other Spanish Medical Schools. Medical School must increase the investment in order to improve the facilities and the accessibility of the center to all students and teachers.

  13. Ocorrência dos indicadores de risco para a deficiência auditiva infantil no decorrer de quatro anos em um programa de triagem auditiva neonatal de um hospital público Occurence of risk indicators for hearing loss over four years in a neonatal hearing screening program of a public hospital

    Directory of Open Access Journals (Sweden)

    Eliara Pinto Vieira

    2007-09-01

    Full Text Available OBJETIVO: Comparar a ocorrência dos indicadores de risco para a deficiência auditiva infantil ao longo de quatro anos, em um Programa de Triagem Auditiva Neonatal. MÉTODOS: Foram pesquisados os prontuários de 382 recém nascidos prematuros nascidos no Hospital São Paulo, de 2000 a 2004. RESULTADOS: Em 2000, encontramos 5,9% de casos de antecedentes familiares/consangüinidade, a qual aumentou de forma estatisticamente significante para 13,6% em 2003. A ventilação mecânica aumentou de forma estatisticamente significante de 24,6% casos em 2000, para 40,2% em 2004. O número de convulsões em RN foi de 4,2% em 2000 para 9,8% em 2004, aumento estatisticamente significante. Encontramos 11,0% de casos de infecção congênita em 2000, o que caiu para 4,3% em 2003. No ano de 2002, houve apenas um caso de sífilis, sendo que a ocorrência destas doenças diminuiu nos últimos anos. O HPIV foi de 15,3% no ano 2000 para 5% em 2003, com redução estatisticamente significante. Os casos de malformação caíram de 3,4% no ano 2000 para 0,7% em 2003. Os casos de ototoxicidade diminuíram de forma estatisticamente significante de 43,2% em 2000 para 30,0% em 2003. CONCLUSÃO: A análise estatística revelou aumento significante da ocorrência dos antecedentes familiares para a deficiência auditiva, do uso de ventilação mecânica e das convulsões neonatais. Os casos de infecção congênita e hemorragia periintraventricular diminuíram estatisticamente do ano 2000 para 2004. Os casos de malformação, baixo peso e ototoxicidade variaram de forma aleatória entre os anos estudados. E alguns indicadores de risco se mantiveram sem alterações estatisticamente significantes.PURPOSE: To compare the occurrence of risk indicators for hearing loss in children over a period of four years, in a Neonatal Hearing Screening Program. METHODS: Three hundred and eighty-two files of preterm infants born at Hospital São Paulo in the period from 2000 to 2004 were

  14. 學生選擇多元入學管道因素之探討:以四技為例 Factors Influencing Students’ Choices in the Multiple College Entrance Program: The Case of Four-Year Institutes of Technology

    Directory of Open Access Journals (Sweden)

    林大森 Da-Sen Lin

    2010-09-01

    Full Text Available 關於「大學多元入學方案」的相關討論,為近年來相當重要的研究議題。雖然累積了很多成果,但關注於技職體系的學術研究則相當罕見。本文以高等技職教育體系(四技)為研究對象,採用「臺灣高等教育資料庫」九十四學年度四技新生資料,分析家庭背景、高中職經歷如何影響個人選擇推薦甄選、登記分發、申請入學三大入學管道。研究發現:一、父母教育程度較高者,經由申請入學機會較大;二、相較於登記分發,推薦甄選以及申請入學者,較重視師長與親友之建議;三、人文學門中,推薦甄選途徑者較大機會錄取公立技職院校,而申請入學者則是在自然學門較容易考上公立技職院校。 One of the most widely investigated research topics in recent years concerns student participation in the Multiple College Entrance Program. Although many researchers have examined this topic, few studies have examined how this issue relates to students studying in the technological and vocational education system. The present study examined students studying in four-year institutes of technology. Utilizing a survey of freshmen conducted in 2005 as part of the Taiwan Higher Education Database, the present study analyzed how family background and high school experiences affected students’ choices for the three major channels of admission: recommendation and screening, registration and placement, and application. The main findings were: (1 Students whose parents have a higher than average level of education have more opportunities to apply for university by application. (2 Students who take advantage of the recommendation and screening or application admission channels are likely to rely on teachers’ and friends’ suggestions or opinions. (3 For departments in the fields of arts and humanities at public institutes of technology, more students entered via the

  15. The Power of Collective Efficacy

    Science.gov (United States)

    Donohoo, Jenni; Hattie, John; Eells, Rachel

    2018-01-01

    When the members of a team of educators are confident they have the ability to make a difference in a school, it can have a significant impact on school culture and achievement. In this article, the authors discuss the ways that collective efficacy (or its absence) manifests in a school and offer suggestions for leaders on how to develop it. Key…

  16. Teacher Efficacy in Rural Zimbabwe

    Science.gov (United States)

    Dunham, Judy K.; Song'ony, Daniel

    2008-01-01

    The need to address contextual variables, such as cultural bias and cultural norms, is a common challenge for researchers in international education. This article highlights societal conditions and cultural issues that could have impacted teacher efficacy data in Zimbabwe, a country known for its ongoing economic crisis, political repression, and…

  17. Recovering a "Disfigured"¹ Face: Cosmesis in the Everyday Use of Facial Prostheses

    NARCIS (Netherlands)

    Yaron, Gili; Widdershoven, G.A.M.; Slatman, Jenny

    2017-01-01

    Prosthetic devices that replace an absent body part are generally considered to be either cosmetic or functional. Functional prostheses aim to restore (some degree of) lost physical functioning. Cosmetic prostheses attempt to restore a “normal” appearance to bodies that lack (one or more) limbs by

  18. Perspectives of Cosmesis following Breast Conservation for Multifocal and Multicentric Breast Cancers

    Directory of Open Access Journals (Sweden)

    Mona P. Tan

    2015-01-01

    Full Text Available Background. Contemporary data suggest that breast conservation treatment (BCT for multifocal and multicentric breast cancer (MFMCBC may be appropriate with noninferior local control rates. However, there is a paucity of data to evaluate patient’s satisfaction with cosmetic outcomes after BCT for MFMCBC. This study was performed to bridge this information gap. Methods. All patients treated at the authors’ healthcare facility were included in the study. Patients with MFMCBC who were assessed to be eligible for BCT underwent tumour resection using standard surgical techniques with direct parenchymal closure through a single incision. After at least three years of follow-up, they were invited to participate in a survey regarding their cosmetic outcomes. Results. Of a total of 160 patients, 40 had MFMCBC, of whom 34 (85% underwent successful BCT. Five-year cancer-specific survival and disease-free survival were 95.7%. Twenty of the 34 patients responded to the survey. No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients’ self-assessment and clinician-directed evaluation of aesthetic results. Conclusion. BCT for MFMCBC is feasible with acceptable survival and cosmetic outcomes. However, there appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research.

  19. Radiotherapy and breast reconstruction: complications and cosmesis with TRAM versus tissue expander/implant

    International Nuclear Information System (INIS)

    Chawla, Ashish K.; Kachnic, Lisa A.; Taghian, Alphonse G.; Niemierko, Andrzej; Zapton, Daniel T.; Powell, Simon N.

    2002-01-01

    Purpose: Radiotherapy (RT) has an important role in breast cancer treatment after modified radical mastectomy. Many of these patients also undergo breast reconstruction. We reviewed our institutions' experience to determine the outcome of patients treated with breast reconstruction and RT. Methods and Materials: Between 1981 and 1999, 48 breast cancer patients underwent modified radical mastectomy, breast reconstruction, and ipsilateral breast RT during their treatment course. Reconstruction either preceded or followed RT. Autologous reconstruction with a transverse rectus abdominus myocutaneous (TRAM) flap was performed in 30 patients, and 18 underwent expander and implant (E/I) reconstruction. The primary endpoint was the quality of the reconstructed, irradiated breast, as measured by analyzing the actuarial incidence of complications. The cosmetic outcome was also assessed by multidisciplinary review of the follow-up visits. Results: The median follow-up from reconstruction was 32 months. The actuarial 2-year complication rate was 53% for patients receiving E/I vs. 12% for those receiving TRAM reconstruction (p<0.01). No other patient or treatment-related factors had a significant impact on complications. The cosmetic outcome was also significantly better in the TRAM subgroup than in the E/I subgroup. Conclusion: The tolerance and cosmetic outcome of breast reconstruction for breast cancer patients in irradiated sites depends significantly on the type of reconstruction used

  20. The Pinking Shears: A Novel Tool for Improving Skin Graft Cosmesis

    Directory of Open Access Journals (Sweden)

    Cormac W. Joyce, MB BCh

    2014-12-01

    Full Text Available Summary: A significant aesthetic disadvantage to split skin grafts is the obvious transition between the graft and the normal skin. We report on a novel method to interrupt this transition point by using pinking shears, which are dressmaking scissors with saw-toothed blades that create a chevron pattern instead of a straight edge. We describe a case where the pinking shears were utilized on a split skin graft and Integra for reconstruction of the skin on a volar forearm. This technique allows for breaking-up of the transition point between the skin graft and normal skin and gives rise to an improved aesthetic outcome as the boundary is significantly less well-defined. This novel method shows promise and further study is certainly warranted.

  1. Varicose vein surgery using a pneumatic tourniquet: reduced blood loss and improved cosmesis.

    OpenAIRE

    Thompson, J. F.; Royle, G. T.; Farrands, P. A.; Najmaldin, A.; Clifford, P. C.; Webster, J. H.

    1990-01-01

    A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The other group underwent identical surgery but with a 30 degree head down tilt only. Blood loss was significantly less (13.5 +/- 12 ml vs 133 +/- 78 ml; P less than 0.01) and postopera...

  2. A conceptual model of referee efficacy

    Directory of Open Access Journals (Sweden)

    Félix eGuillén

    2011-02-01

    Full Text Available This paper presents a conceptual model of referee efficacy, defines the concept, proposes sources of referee specific efficacy information, and suggests consequences of having high or low referee efficacy. Referee efficacy is defined as the extent to which referees believe they have the capacity to perform successfully in their job. Referee efficacy beliefs are hypothesized to be influenced by mastery experiences, referee knowledge/education, support from significant others, physical/mental preparedness, environmental comfort, and perceived anxiety. In turn, referee efficacy beliefs are hypothesized to influence referee performance, referee stress, athlete rule violations, athlete satisfaction, and co-referee satisfaction.

  3. Work Engagement, Organizational Commitment, Self Efficacy and ...

    African Journals Online (AJOL)

    Work engagement, organizational commitment and self-efficacy will create a positive attitude in records ... counseling, effective communication and leadership skills. This study therefore ...... self-efficacy and self-esteem: Toward theoretical and ...

  4. Self Efficacy among University Academic Staff

    African Journals Online (AJOL)

    Educator's Self Efficacy and Collective Educators' Self Efficacy among University Academic Staff: An Ethical Issue. ... staff on collective educators' self efficacy. The implication of the result in terms of collaborative work among academic staff was discussed in line with ethical principles and code of conduct of psychologists.

  5. Linking Preservice Teachers' Mathematics Self-Efficacy and Mathematics Teaching Efficacy to Their Mathematical Performance

    Science.gov (United States)

    Bates, Alan B.; Latham, Nancy; Kim, Jin-ah

    2011-01-01

    This study examined preservice teachers' mathematics self-efficacy and mathematics teaching efficacy and compared them to their mathematical performance. Participants included 89 early childhood preservice teachers at a Midwestern university. Instruments included the Mathematics Self-Efficacy Scale (MSES), Mathematics Teaching Efficacy Beliefs…

  6. Pre-Service Teachers' Mathematics Self-Efficacy and Mathematics Teaching Self-Efficacy

    Science.gov (United States)

    Zuya, Habila Elisha; Kwalat, Simon Kevin; Attah, Bala Galle

    2016-01-01

    Pre-service mathematics teachers' mathematics self-efficacy and mathematics teaching self-efficacy were investigated in this study. The purpose was to determine the confidence levels of their self-efficacy in mathematics and mathematics teaching. Also, the study was aimed at finding whether their mathematics self-efficacy and teaching…

  7. The effectiveness of a four-hour challenge course on leadership efficacy and work efficacy

    Science.gov (United States)

    Theresa Odello; Eddie Hill; Edwin Gomez

    2008-01-01

    This study examines the effects of participation in a 4-hour challenge course on leadership efficacy and work efficacy of college students. The findings of this research indicate that both leadership and work efficacy increased significantly after participation in a challenge course and that increased levels of the participants' self-efficacy remained 6 weeks...

  8. The Influence of Climate Change Efficacy Messages and Efficacy Beliefs on Intended Political Participation.

    Science.gov (United States)

    Hart, P Sol; Feldman, Lauren

    2016-01-01

    Using an online survey experiment with a national sample, this study examined how changing the type and valence of efficacy information in news stories discussing global climate change may impact intended political participation through the mediators of perceived internal, external, and response efficacy. Overall, the results revealed that after a single exposure to a news story, stories including positive internal efficacy content increased perceived internal efficacy, while stories including negative external efficacy content lowered perceived external efficacy. There were limited impacts of other types of efficacy content on perceived efficacy. Perceived internal, external, and response efficacy all offered unique, positive associations with intentions to engage in climate change-related political participation. The results suggest that news stories including positive internal efficacy information in particular have the potential to increase public engagement around climate change. The implications for science communication are discussed.

  9. Self-Efficacy: Conditioning the Entrepreneurial Mindset

    DEFF Research Database (Denmark)

    Neergaard, Helle; Mauer, René; Kirketerp Linstad, Anne

    2009-01-01

    Research that has sought to identify the underlying determinants of self-efficacy is sparse. This chapter seeks to identify antecedents of entrepreneurial self-efficacy and the processes that produce and reinforce self-efficacy. It seeks to broaden our understanding of the self-efficacy concept t...... through an exploration of its origins and via a journey to its impact in the field of entrepreneurship. Finally, it suggests pedagogical initiatives needed to promote entrepreneurial self-efficacy in the different social arenas of life....

  10. Work engagement, organizational commitment, self efficacy and ...

    African Journals Online (AJOL)

    Information Impact: Journal of Information and Knowledge Management ... Work engagement, organizational commitment and self-efficacy will create a positive ... effective training, counseling, effective communication and leadership skills.

  11. [Efficacy of balneotherapy in cholelithiasis].

    Science.gov (United States)

    Gorbunov, A Iu; Vakhrushev, Ia M

    2011-01-01

    To assess therapeutic efficacy of mineral water Uvinskaya at a prestone stage of cholelithiasis. A total of 135 cholelithiasis patients entered the trial. Of them 57 patients had a prestone stage and 78--stone stage of the disease. The stages were verified by clinical data, findings of dynamic hepatobiliscintigraphy, biochemical bile tests, anatomoemission spectroscopy with induction-bound plasma. 57 patients at prestone stage of cholelithiasis received balneotherapy with mineral water Uvinskaya. The treatment relieved pain syndrome, dyspeptic symptoms, enhanced absorption-excretion function of the liver, prolonged the time of maximal gall-bladder filling, shortened radiopharmaceutical half-life in the gall-bladder, raised the level of trace elements (magnesium, iron, potassium) in the bile, improved gall-bladder contraction, lithogenic bile characteristics. Mineral water Uvinskaya has a positive effect in a physical-chemical stage of cholelithiasis.

  12. Against Motivational Efficacy of Beliefs

    Directory of Open Access Journals (Sweden)

    Seungbae Park

    2015-07-01

    Full Text Available Danielle Bromwich (2010 argues that a belief is motivationally efficacious in that, other things being equal, it disposes an agent to answer a question in accordance with that belief. I reply that what we are disposed to do is largely determined by our genes, whereas what we believe is largely determined by stimuli from the environment. We have a standing and default disposition to answer questions honestly, ceteris paribus, even before we are exposed to environmental stimuli. Since this standing and default disposition is innate, and our beliefs have their source in environmental stimuli, our beliefs cannot be the source of the disposition. Moreover, a recent finding in neuroscience suggests that motivation is extrinsic to belief.

  13. The Relative Importance of Specific Self-Efficacy Sources in Pretraining Self-Efficacy Beliefs

    Science.gov (United States)

    Howardson, Garett N.; Behrend, Tara S.

    2015-01-01

    Self-efficacy is clearly important for learning. Research identifying the most important sources of self-efficacy beliefs, however, has been somewhat limited to date in that different disciplines focus largely on different sources of self-efficacy. Whereas education researchers focus on Bandura's original sources of "enactive mastery,"…

  14. Principal Self-Efficacy and Work Engagement: Assessing a Norwegian Principal Self-Efficacy Scale

    Science.gov (United States)

    Federici, Roger A.; Skaalvik, Einar M.

    2011-01-01

    One purpose of the present study was to develop and test the factor structure of a multidimensional and hierarchical Norwegian Principal Self-Efficacy Scale (NPSES). Another purpose of the study was to investigate the relationship between principal self-efficacy and work engagement. Principal self-efficacy was measured by the 22-item NPSES. Work…

  15. TESTING ANTIMICROBIAL EFFICACY ON POROUS MATERIALS

    Science.gov (United States)

    The efficacy of antimicrobial treatments to eliminate or control biological growth in the indoor environment can easily be tested on nonporous surfaces. However, the testing of antimicrobial efficacy on porous surfaces, such as those found in the indoor environment [i.e., gypsum ...

  16. Treatment Outcomes and Efficacy in the Schools.

    Science.gov (United States)

    Logemann, Jeri A.

    1998-01-01

    Introduces six articles which address treatment outcomes and efficacy in audiology and speech-language pathology in the schools. Stresses the importance of practitioners participating in studies of treatment outcomes and efficacy to demonstrate that their evaluations and treatments make a significant difference to individuals served. (DB)

  17. Measuring School Psychology Trainee Self-Efficacy

    Science.gov (United States)

    Lockwood, Adam B.; Mcclure, John; Sealander, Karen; Baker, Courtney N.

    2017-01-01

    There is an ever-increasing need for school psychology training programs to demonstrate their ability to produce competent practitioners. One method of addressing this need is through the assessment of self-efficacy. However, little research on self-efficacy in school psychology exists likely due to the lack of a psychometrically sound measure of…

  18. Four-year surveillance for ochratoxin a and fumonisins in retail foods in Japan.

    Science.gov (United States)

    Aoyama, Koji; Nakajima, Masahiro; Tabata, Setsuko; Ishikuro, Eiichi; Tanaka, Toshitsugu; Norizuki, Hiroko; Itoh, Yoshinori; Fujita, Kazuhiro; Kai, Shigemi; Tsutsumi, Toru; Takahashi, Masanori; Tanaka, Hiroki; Iizuka, Seiichiro; Ogiso, Motoki; Maeda, Mamoru; Yamaguchi, Shigeaki; Sugiyama, Kei-Ichi; Sugita-Konishi, Yoshiko; Kumagai, Susumu

    2010-02-01

    Between 2004 and 2007 we examined foods from Japanese retail shops for contamination with ochratoxin A (OTA) and fumonisins B(1), B(2), and B(3). A total of 1,358 samples of 27 different products were examined for OTA, and 831 samples of 16 different products were examined for fumonisins. The limits of quantification ranged from 0.01 to 0.5 microg/kg for OTA and 2 to 10 microg/kg for the fumonisins. OTA was detected in amounts higher than limits of quantification in wheat flour, pasta, oatmeal, rye, buckwheat flour and dried buckwheat noodles, raisins, wine, beer, coffee beans and coffee products, chocolate, cocoa, and coriander. OTA was found in more than 90% of the samples of instant coffee and cocoa, and the highest concentration of OTA, 12.5 microg/kg, was detected in raisins. The concentration of OTA in oatmeal, rye, raisins, wine, and roasted coffee beans varied remarkably from year to year. Fumonisins were detected in frozen and canned corn, popcorn grain, corn grits, cornflakes, corn soups, corn snacks, beer, soybeans, millet, and asparagus. The highest concentrations of fumonisins B(1), B(2), and B(3) were detected in corn grits (1,670, 597, and 281 microg/kg, respectively). All of the samples of corn grits were contaminated with fumonisins, and more than 80% of the samples of popcorn grain and corn snacks contained fumonisins. OTA and fumonisins were detected in several food products in Japan; however, although Japan has not set regulatory levels for these mycotoxins, their concentrations were relatively low.

  19. Aids-related kaposi's sarcoma in a four year old child: the challenge ...

    African Journals Online (AJOL)

    2017-04-01

    Apr 1, 2017 ... KS, endemic (African) KS and iatrogenic (transplanted- related) KS. ... mother so as to prevent mother to child transmission of. HIV. ... use, insect bite or allergy prior to onset of the rashes. ... but there was no history suggestive of sickle cell dis- ease. ... urine microscopy and renal function tests were within.

  20. [Comprehensive care program for the mentally ill in Spanish prisons (PAIEM): assessment after four years operation].

    Science.gov (United States)

    Sanz, J; Gómez-Pintado, P; Ruiz, A; Pozuelo, F; Arroyo, J M

    2014-01-01

    To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results. Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM. 91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load. The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison.

  1. Relative stability of core groups in pollination networks in a biodiversity hotspot over four years.

    Science.gov (United States)

    Fang, Qiang; Huang, Shuang-Quan

    2012-01-01

    Plants and their pollinators form pollination networks integral to the evolution and persistence of species in communities. Previous studies suggest that pollination network structure remains nested while network composition is highly dynamic. However, little is known about temporal variation in the structure and function of plant-pollinator networks, especially in species-rich communities where the strength of pollinator competition is predicted to be high. Here we quantify temporal variation of pollination networks over four consecutive years in an alpine meadow in the Hengduan Mountains biodiversity hotspot in China. We found that ranked positions and idiosyncratic temperatures of both plants and pollinators were more conservative between consecutive years than in non-consecutive years. Although network compositions exhibited high turnover, generalized core groups--decomposed by a k-core algorithm--were much more stable than peripheral groups. Given the high rate of turnover observed, we suggest that identical plants and pollinators that persist for at least two successive years sustain pollination services at the community level. Our data do not support theoretical predictions of a high proportion of specialized links within species-rich communities. Plants were relatively specialized, exhibiting less variability in pollinator composition at pollinator functional group level than at the species level. Both specialized and generalized plants experienced narrow variation in functional pollinator groups. The dynamic nature of pollination networks in the alpine meadow demonstrates the potential for networks to mitigate the effects of fluctuations in species composition in a high biodiversity area.

  2. IQ of four-year-olds who go on to develop dyslexia

    NARCIS (Netherlands)

    van Bergen, E.; de Jong, P.F.; Maassen, B.; Krikhaar, E.; Plakas, A.; van der Leij, A.

    2014-01-01

    Do children who go on to develop dyslexia show normal verbal and nonverbal development before reading onset? According to the aptitude-achievement discrepancy model, dyslexia is defined as a discrepancy between intelligence and reading achievement. One of the underlying assumptions is that the

  3. Four years of ozone measurements in the Central Amazon - Absorption mechanisms and reactions within the rainforest

    Science.gov (United States)

    Wolff, Stefan; Ganzeveld, Laurens; Tsokankunku, Anywhere; Saturno, Jorge; Souza, Rodrigo; Trebs, Ivonne; Sörgel, Matthias

    2017-04-01

    The ATTO (Amazon Tall Tower Observatory) site (02°08'38.8''S, 58°59'59.5''W) is located in the remote Amazon rainforest, allowing atmospheric and forest studies away from nearby anthropogenic emission sources. Starting with continuous measurements of vertical mixing ratio profiles of H2O, CO2 and O3 in April 2012 at 8 heights between 0.05 m and 80 m above ground, the longest continuous record of near surface O3 in the Amazon rainforest was established. Black carbon (BC), CO and micrometeorological measurements are available for the same period. During intensive campaigns, NOx was measured as well using the same profile system, and therefore several month of parallel NOx measurements are available. This data allows the analyses of diverse patterns regarding emission, deposition, turbulence and chemical reactions of trace gases within and above the rainforest for several rainy and dry seasons. The remote Amazon generally serves as a sink for O3 which is mainly deposited to the canopy. The deposition depends to a large extent on the aperture of the leaf stomata, which is correlated to temperature, humidity, solar radiation and water availability. Comparing these parameters with the in-canopy and above canopy gradients of O3, considering the turbulent conditions and further chemical reactions of O3 with NOx and VOC molecules, we estimated the role of the forest for the removal of ozone from the atmosphere under different meteorological conditions. We applied the Multi-Layer Canopy Chemical Exchange Model - MLC-CHEM to support the analysis of the observed profiles of NOx and O3. Under pristine conditions, the forest soil is the major source for NO emissions, which are directly reacting with O3 molecules, affecting the O3 gradient within the sub-canopy. We have analyzed differences between model and measurements in sub-canopy NO and O3 mixing ratios by the application of different NO soil emission scenarios and by the performance of several sensitivity analyses to investigate the deposition of O3 and NO2 in the canopy.

  4. Comparing Perceptions of Campus Crime Severity among Community College and Public Four-Year University Students

    Science.gov (United States)

    Lundstrom, Loren M.

    2010-01-01

    In recent years violent crimes on several university campuses have been highlighted by mass media, drawing national attention to the issue of campus crime. Not all college campuses, however, experience the same level of crime. While community colleges serve roughly half of all undergraduates in the U.S., statistically these public institutions…

  5. TECHNICAL CHARACTERIZATION OF ECO-COMPATIBLE PLASTIC FILMS FOR SOIL SOLARIZATION: FOUR YEARS OF EXPERIMENTS

    Directory of Open Access Journals (Sweden)

    Salvatore Margiotta

    2007-12-01

    Full Text Available Soil solarization relies on solar radiation being converted to heat for the killing of soilborne pathogens. On one hand, this technique can be considered as an environmentally-friendly way to manage soilborne pests, as an alternative of methyl bromide phased-out in 2005, than using chemicals. On the other hand, high employment of traditional plastic sheets in agriculture causes the production of enormous quantities of waste, whose inappropriate management might have negative effects on the environment. In order to determine a reduction of the charge of plastic waste and to facilitate the waste disposal, one of the most interesting approaches, from an environmental point of view, lies in the location of innovatory plastic films such as co-extruded ultrathin films, which are able to reduce the plastic quantity to be managed, and biodegradable laminates, which after a first usage, will spontaneously start up a degradation process that avoids their collection and their consequent disposal. Beside the ecological proprieties of these innovative films, it is necessary to study their technical and agronomical behavior in order to determine their efficiency and the possibility to be used in place of the traditional plastic films. This paper represents a review of the researches carrier out by the Technical Economics Department of the University of Basilicata (Italy in the last years (1999, 2000, 2002 and 2003 on the technical performances of some innovative plastic films used for soil solarization.

  6. Four-year treatment outcomes of adult patients enrolled in Mozambique's rapidly expanding antiretroviral therapy program.

    Directory of Open Access Journals (Sweden)

    Andrew F Auld

    Full Text Available BACKGROUND: In Mozambique during 2004-2007 numbers of adult patients (≥15 years old enrolled on antiretroviral therapy (ART increased about 16-fold, from 60 kg, WHO stage IV (AHR 1.7; 95% CI, 1.3-2.4, reference group WHO stage I/II, lack of co-trimoxazole prescription (AHR 1.4; 95% CI, 1.0-1.8, and later calendar year of ART initiation (AHR 1.5; 95% CI, 1.2-1.8. Rates of immunologic treatment failure and regimen-switch were 14.0 and 0.6 events per 100-patient years, respectively. CONCLUSIONS: ART initiation at earlier disease stages and scale-up of co-trimoxazole among ART patients could improve outcomes. Research to determine reasons for low regimen-switch rates and increasing rates of attrition during program expansion is needed.

  7. Pathways to a Four-Year Degree: Determinants of Degree Completion among Socioeconomically Disadvantaged Students.

    Science.gov (United States)

    Cabrera, Alberto F.; Burkum, Kurt R.; La Nasa, Steven M.

    The High School Sophomore Cohort of 1980 followed nine different pathways to a 4-year college degree. These paths were formed by a combination of different levels of academic preparation secured in high school and the first type of postsecondary institution attended. The pathway most likely to lead to a 4-year degree is one defined by acquiring…

  8. Determinants of mortality among one to four years old children in ...

    African Journals Online (AJOL)

    admin

    On the other hand sex of a child, family size, wealth index ..... mothers' educational level was elementary school and below ... maternal age, type of birth (single/multiple) and ... disadvantages of early marriage and giving birth at early ages ...

  9. Tweeting the meeting: A comparative analysis of an Australian emergency medicine conference over four years

    Directory of Open Access Journals (Sweden)

    Cristian Udovicich

    2016-01-01

    Full Text Available Objective: Social media allows user-generated content and dialog between users and has also entered into the domain of healthcare. The purpose of this study was to compare the use of Twitter at the Australasian College of Emergency Medicine Annual Scientific Meeting (ACEM ASM from 2011 to 2014 and analyze its ability to spread emergency medicine education. Materials and Methods: Retrospectively, TweetReach was utilized to analyze relevant tweets. Each Annual Scientific Meeting (ASM had an associated Twitter account/s from, which data were collected. Duplicate tweets were excluded from the analysis. Information on the number of total tweets (regular tweets, retweets, and replies and contributors was gathered. The potential audience, the reach, was calculated. Results: From 2011 to 2014 the number of tweets rose from 460 to 4694, a 920% increase. Only 54 Twitter users contributed to the 2011 ASM. This rose to 252 (2012, 291 (2013 and 572 (2014. The average number of tweets per contributor ranged from 8.2 to 10.9. The reach, the potential number of Twitter users exposed to posts, rose >30 times from 2011 (15,502 users to 2014 (471,166. Conclusion: The use of Twitter at the ACEM ASM rose significantly from 2011 to 2014. It is a highly useful tool for the dissemination of emergency medicine education. Twitter has been harnessed by the ASM to enhance the conference experience by further generating interaction between delegates as well as those worldwide.

  10. Tweeting the meeting: A comparative analysis of an Australian emergency medicine conference over four years.

    Science.gov (United States)

    Udovicich, Cristian; Barberi, Anthony; Perera, Kalpa

    2016-01-01

    Social media allows user-generated content and dialog between users and has also entered into the domain of healthcare. The purpose of this study was to compare the use of Twitter at the Australasian College of Emergency Medicine Annual Scientific Meeting (ACEM ASM) from 2011 to 2014 and analyze its ability to spread emergency medicine education. Retrospectively, TweetReach was utilized to analyze relevant tweets. Each Annual Scientific Meeting (ASM) had an associated Twitter account/s from, which data were collected. Duplicate tweets were excluded from the analysis. Information on the number of total tweets (regular tweets, retweets, and replies) and contributors was gathered. The potential audience, the reach, was calculated. From 2011 to 2014 the number of tweets rose from 460 to 4694, a 920% increase. Only 54 Twitter users contributed to the 2011 ASM. This rose to 252 (2012), 291 (2013) and 572 (2014). The average number of tweets per contributor ranged from 8.2 to 10.9. The reach, the potential number of Twitter users exposed to posts, rose >30 times from 2011 (15,502 users) to 2014 (471,166). The use of Twitter at the ACEM ASM rose significantly from 2011 to 2014. It is a highly useful tool for the dissemination of emergency medicine education. Twitter has been harnessed by the ASM to enhance the conference experience by further generating interaction between delegates as well as those worldwide.

  11. Can Australian radiographers assess screening mammograms accurately? First stage results from a four year prospective study

    International Nuclear Information System (INIS)

    Moran, S.; Warren-Forward, H.

    2016-01-01

    Introduction: Globally, the role of the radiographer is changing; some countries have developed advanced roles with specific scopes of practice. Other countries, like Australia, are in the process of this change. The aim of this research is to assess the diagnostic outcomes reported by the radiographers and compare them to those reported by current screen readers. Method: Six experienced radiographers were invited to participate in a prospective study conducted between 2010 and 2011. They were required to read 2000 mammograms each. Their results were compared with those of the radiologists. Statistical analysis of the results included overall cancer detection rates, recall rates, levels of agreement, kappa, sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results: A total of 9348 women were included in the study. The percentage of cancers detected by the radiographers ranged from 53% to 100% of the cancers detected by the radiologists. Radiologist recall rate ranged between 3.4% and 5.5% and the radiographers' range was 2.9%–9.8%. Level of agreement of the radiographers with the radiologists ranged from 90 to 96%. Conclusion: The potential for accuracy in screen reading by Australian radiographers is supported by the results of this study. Implementation of formal training is likely to result in an increase in the diagnostic accuracy of radiographers. - Highlights: • Radiographers prospectively read 2000 screening mammograms each. • These results support potential for accuracy in screen reading by radiographers. • Will advanced practice be introduced within BreastScreen Australia?.

  12. Four Year Old Children's Acquisition of Print Knowledge during Electronic Storybook Reading

    Science.gov (United States)

    Gong, Zhiyu; Levy, Betty Ann

    2009-01-01

    The experiment reported here explored the importance of engaging 4-year-old children's interest in the print itself during storybook reading. We explored the effect of computer animation of the print in order to draw the child's attention to each word as it was read. We also investigated the influence of illustrating that not all visual displays…

  13. Four-year changes in college athletes' ethical value choices in sports situations.

    Science.gov (United States)

    Priest, R F; Krause, J V; Beach, J

    1999-06-01

    Positive values for fairness in competition are supposed to undergird the behavior of athletes engaged in sport. Whether athletes' values actually develop over 4 years in a college that emphasizes character development is the focus of this study. Athletes' (N = 631) use of deontological ethics (Hahm, Beller & Stoll, 1989) in 21 sports value dilemmas were evaluated. At entrance, as well as near graduation, intercollegiate athletes' value scores were lower than intramural athletes' scores. Both groups' scores declined while they were in college. Individual-sport athletes had higher scores than team-sport athletes but manifested a greater decline over 4 years. The findings are consistent with other studies that show decreases in "sportsmanship orientation" and an increase in "professional" attitudes associated with participation in sport.

  14. A four-year investigation of Brayton cycle systems for future french space power applications

    International Nuclear Information System (INIS)

    Tilliette, Z.P.; Proust, E.; Carre, F.

    1988-01-01

    Within the framework of a joint program initiated in 1983 by the two French Government Agencies C.N.E.S. (Centre National d'Etudes Spatiales) and C.E.A. (Commissariat a l'Energie Atomique), in order to study space nuclear power systems for future ARIANE 5 applications, extensive investigations have dealt with the Brayton cycle which has been selected as the energy conversion system. Several aspects can be mentioned in this field: the matching of the power system to the available radiator dimensions up to 200 kWe, the direct or indirect waste heat transfer to the radiator, the use of a recuperator, the recent work on moderate (25 kWe) power levels, the simulation studies related to various operating conditions and the general system optimization. A limited experimental program is starting on some crucial technology areas including a first contract to the industry concerning the turbogenerator. Particular attention is being paid to the significance of the adoption of a Brayton cycle for space applications involving a nuclear heat source which can be either a liquid metal-cooled or a gas-cooled reactor. As far as a gas-cooled reactor, direct cycle system is concerned, the relevance to the reactor technology and the concept for moderator thermal conditioning, is particularly addressed

  15. Warming and nitrogen fertilization effects on winter wheat yields in northern China varied between four years

    DEFF Research Database (Denmark)

    Liu, Liting; Hu, Chunsheng; Olesen, Jørgen E

    2013-01-01

    per m2. This suggests that the wheat yield loss may be related to reduction of spike number, which was affected by decreased soil water content under warming. Warming tended to give larger yield reductions at higher nitrogen fertilizer rates, and this may be related to larger water consumption...... with both higher nitrogen and temperature leading to water shortages. These effects indicate that wheat yield loss from warming was primarily associated with more severe water shortage from greater evapotranspiration under warming. The large crop canopy in the fertilized plot may further have enhanced......). The volumetric water content decreased significantly before heading by 9.3, 3.9, 2.4 and 1.2 vol% in the soil depth of 0.10, 0.20, 0.40, 0.60 m in N2 and by 5.9, 1.4, 1.3 and 1.2 vol% in N1 from heating compared with no heating. The duration of the entire growth period was shortened by on average 7 days...

  16. The Second Fermi GBM Gamma-Ray Burst Catalog: The First Four Years

    NARCIS (Netherlands)

    von Kienlin, A.; Meegan, C.A.; Paciesas, W.S.; Bhat, P.N.; Bissaldi, E.; Briggs, M.S.; Burgess, J.M.; Byrne, D.; Chaplin, V.; Cleveland, W.; Connaughton, V.; Collazzi, A.C.; Fitzpatrick, G.; Foley, S.; Gibby, M.; Giles, M.; Goldstein, A.; Greiner, J.; Gruber, D.; Guiriec, S.; van der Horst, A.J.; Kouveliotou, C.; Layden, E.; McBreen, S.; McGlynn, S.; Pelassa, V.; Preece, R.D.; Rau, A.; Tierney, D.; Wilson-Hodge, C.A.; Xiong, S.; Younes, G.; Yu, H-F.

    2014-01-01

    This is the second of a series of catalogs of gamma-ray bursts (GRBs) observed with the Fermi Gamma-ray Burst Monitor (GBM). It extends the first two-year catalog by two more years, resulting in an overall list of 953 GBM triggered GRBs. The intention of the GBM GRB catalog is to provide information

  17. Outcomes of adult heroin users v. abstinent users four years after presenting for heroin detoxification treatment

    Directory of Open Access Journals (Sweden)

    Zureida Khan

    2014-08-01

    Full Text Available Background. There are no studies in South Africa (SA on the outcomes following detoxification and psychosocial rehabilitation of heroin-dependent patients. Objective. To compare the demographic, clinical, forensic and treatment data of active heroin users v. users who were abstinent at the time of interview 4 years after attending the Opioid Detoxification Unit at Stikland Hospital in the Western Cape Province, SA.  Method. Participants included patients above the age of 16 years who had been admitted to the Opioid Detoxification Unit at Stikland Hospital for heroin detoxification between July 2006 and June 2007. Participants were individually interviewed (either in person or tele­phonically using a structured self-report questionnaire to collect demographic, clinical, forensic and treatment data 4 years following heroin detoxification treatment at this unit.  Results. Of the participants, 60% were abstinent and a large portion (34% attributed this to social support. Furthermore, there was a significant (p=0.04 difference in the longest period of abstinence between the past user group and active users, with more participants in the past user group being abstinent for 18 months or longer (n=24, 57% than in the active users group (n=8, 29%. Active users (n=18, 64% had significantly (p=0.03 more legal problems than abstinent users (n=14, 33%. Most participants (n=38, 54% relapsed within 3 months after index detoxification and rehabilitation.  Conclusion. Active users had more legal problems than abstinent users, with social support structures playing a pivotal role in abstinence. Future research should assess the impact of interventions such as post-discharge social support programmes on criminality and heroin use in those that relapse following treatment.

  18. Outcomes of adult heroin users v. abstinent users four years after ...

    African Journals Online (AJOL)

    Background. There are no studies in South Africa (SA) on the outcomes following detoxification and psychosocial rehabilitation of heroindependent patients. Objective. To compare the demographic, clinical, forensic and treatment data of active heroin users v. users who were abstinent at the time of interview 4 years after ...

  19. Atmospheric Radionuclides from the FDNPP Accident-Four years' observations in Tsukuba, Japan and immediate resuspension

    Science.gov (United States)

    Igarashi, Yasuhito; Kajino, Mizuo; Zaizen, Yuji; Adachi, Kouji; Mikami, Masao

    2015-04-01

    The accident of Fukushima Dai-Ichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Corporation arisen by the hit of great earthquake and tsunami in March 11, 2011, emitted abundant fresh radioactive material to the atmospheric environment. With 4-years' observation for the Fukushima radioactivity at the Meteorological Research Institute, Japan (MRI) the persisting resuspension has been observed. The resuspension seems still in difficulty to give forecast by computer modeling; the observations are indispensable bodies of the research even in the future. As a primary approach, immediate re-suspension factors were roughly estimated with modeled deposition amounts by the first plume to the Kanto district and the observed minimum activity concentration between two plume events, i.e. Mar 17 09JST to Mar. 20 09JST, by assuming mass closure between re-suspension from the contaminated surface and outflow by horizontal advection and turbulence vertical mixing as follows: Diki ΔCi- Δ2Ci- Δz = U Δx + Kz Δz2 , where i indicates radionuclides namely 137Cs and 131I, Diindicates modeled total (gas+aerosol) cumulative deposition (Bq/m2) by Mar 17 09JST, ki is the re-suspension factor (/s), U and Kz are modeled space- and time- averaged horizontal wind speed (m/s) and vertical turbulent diffusivity (m2/s), respectively, Ci indicates time-averaged observed concentration of radionuclides (9.75×10-4 and 3.14×10-1 Bq/m3 for 137Cs and 131I, respectively), and Δx and Δz are horizontal and vertical length of space where the above mass closure is obtained. In order to obtain the horizontal and vertical gradient terms on the right hand of the equation, concentrations outside the space are assumed zero (no inflow to the space). The re-suspension factors for 137Cs and 131I are 7.0×10-6 and 5.3×10-4 (/s), respectively, for the smallest volume of space (Δx and Δz are 3 km and 100 m, respectively). Those for 137Cs and 131I varied 1.6×10-6-1.5×10-5 (6.1×10-6 on average) and 5.3×10-4-1.3×10-3 (4.6×10-4 on average), respectively, for the various spaces of horizontally plus-minus zero, one, or two grids from the grid center (i.e. Δx = 3, 9, or 15 km) and vertically plus zero, one, or two grids from the bottom (Δz = 100, 200 or 400 m). In summary, the immediate re-suspension factors for 137Cs and 131I are estimated in the order of 10-6-10-5 (/s) and 10-4-10-3 (/s) respectively and then that of 131I is approximately two orders of magnitude larger than that of 137Cs.

  20. College students' drinking patterns: trajectories of AUDIT scores during the first four years at university.

    Science.gov (United States)

    Johnsson, Kent O; Leifman, Anders; Berglund, Mats

    2008-01-01

    Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers. 359 students were selected for the present study, comprising all high-risk consumers (the 27% with highest scores, i.e. 11 for males and 7 for females) and a randomized sample of low-risk consumers (n = 177 and 182, respectively). The Alcohol Use Disorder Identification Test (AUDIT) was used as screening instrument. Trajectory analyses were made using a semiparametric group-based model. In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories. The pattern of changes in risk consumption is similar to that found in corresponding US studies. (c) 2008 S. Karger AG, Basel

  1. Formation and growth rates of atmospheric nanoparticles: four years of observations at two West Siberian stations

    Science.gov (United States)

    Arshinov, Mikhail Yu.; Belan, Boris D.; Davydov, Denis K.; Kozlov, Artem V.; Arshinova, Victoria

    2015-04-01

    In spite of fact that the first report on the new particle formation (NPF) itself was done by John Aitken more than one century ago (Aitken, 1898), a phenomenon of NPF bursts taken place in the atmosphere was discovered not very long ago. Nevertheless, to date it is known that they may occur quite often in a variety of environments (Kulmala et al., 2004; Hirsikko et al., 2011). Siberia occupies a vast area covered by forests, but the comprehensive data on burst frequency, as well as on formation and growth rates of freshly nucleated particles in this key region are still lacking. Continuous measurements of aerosol size distribution carried out in recent years at two West Siberian stations (TOR-station - 56o28'41"N, 85o03'15"E; Fonovaya Observatory - 56o25'07"N, 84o04'27"E) allowed this gap in data to be filled up. Analysis of the size spectra classified in accordance with criteria proposed by Dal Maso et al. (2005) and Hammed et al. (2007) enabled a conclusion to be drawn that NPF events in Wets Siberia are more often observed during spring (from March to May) and early autumn (secondary frequency peak in September). On average, particle formation bursts took place on 23-28 % of all days. Such a seasonal pattern of the NPF occurrence is very similar to one observed at SMEAR II Station (Hyytiälä, Finland; Dal Maso et al. 2005, 2007). Formation rates (FR) of particles with diameters below 25 nm varied in a wide range from 0.1 to 10 cm-3 s-1. Mean values of FR for the entire period of observations were 1.7 cm-3s-1 (median = 1.13 cm-3 s-1) at TOR-station and 0.88 cm-3 s-1 (median = 0.69 cm-3 s-1) at Fonovaya Observatory. Enhanced values of FR are usually observed from spring to autumn. Mean growth rates of observed at TOR-station and Fonovaya Observatory were 6.5 nm h-1 (median = 5.0 nm h-1) and 8.3 nm h-1 (median = 6.4 nm h-1), respectively. This work was supported by the Branch of Geology, Geophysics and Mining Sciences of RAS (Program No. 5); State contracts of the Ministry of Education and Science of Russia No. 14.604.21.0100, (RFMTFIBBB210290) and No. 14.613.21.0013 (RFMEFI61314X0013); and Russian Foundation for Basic Research (grant No. 14-05-00590). Dal Maso, M., Kulmala, M., Riipinen, I., Wagner, R., Hussein, T., Aalto, P. P., and Lehtinen, K. E. J. (2005). Formation and growth of fresh atmospheric aerosols: eight years of aerosol size distribution data from SMEAR II, Hyytiälä, Finland, Boreal Environ. Res. 10, 323-336. Dal Maso, M., Sogacheva, L., Aalto, P., Riipinen, I., Komppula, M., Tunved, P., Korhonen, L., Suur-uski, V., Hirsikko, A., Kurten, T., Kerminen, V., Lihavainen, H., Viisanen, Y., Hansson, H., and Kulmala, M. (2007). Aerosol size distribution measurements at four Nordic field stations: identification, analysis and trajectories analysis of new particle formation bursts, Tellus B 59, 350-361. Hamed, A., Joutsensaari, J., Mikkonen, S., Sogacheva, L., Dal Maso, M., Kulmala, M., Cavalli F., Fuzzi S., Facchini, M. C., Decesari, S., Mircea, M., Lehtinen, K. E. J., and Laaksonen, A. (2007). Nucleation and growth of new particles in Po Valley, Italy, Atmos. Chem. Phys. 7, 355-376. Hirsikko, A., Nieminen, T., Gagné, S., Lehtipalo, K., Manninen, H. E., Ehn, M., Hõrrak, U., Kerminen, V.-M., Laakso, L., McMurry, P. H., Mirme, A., Mirme, S., Petäjä, T., Tammet, H., Vakkari, V., Vana, M., and Kulmala, M. (2011). Atmospheric ions and nucleation: a review of observations, Atmos. Chem. Phys. 11, 767-798. Kulmala, M., Vehkamäki, H., Petäjä, T., Dal Maso, M., Lauri A., Kerminen, V.-M., Birmili, W., and McMurry, P. H. (2004a) Formation and growth rates of ultrafine atmospheric particles: a review of observations, J. Aerosol Science 35, 143-176.

  2. Four Year-Olds Use Norm-Based Coding for Face Identity

    Science.gov (United States)

    Jeffery, Linda; Read, Ainsley; Rhodes, Gillian

    2013-01-01

    Norm-based coding, in which faces are coded as deviations from an average face, is an efficient way of coding visual patterns that share a common structure and must be distinguished by subtle variations that define individuals. Adults and school-aged children use norm-based coding for face identity but it is not yet known if pre-school aged…

  3. IQ of Four-Year-Olds Who Go on to Develop Dyslexia

    Science.gov (United States)

    van Bergen, Elsje; de Jong, Peter F.; Maassen, Ben; Krikhaar, Evelien; Plakas, Anna; van der Leij, Aryan

    2014-01-01

    Do children who go on to develop dyslexia show normal verbal and nonverbal development before reading onset? According to the aptitude-achievement discrepancy model, dyslexia is defined as a discrepancy between intelligence and reading achievement. One of the underlying assumptions is that the general cognitive development of children who fail to…

  4. IQ of Four-Year-Olds Who Go On to Develop Dyslexia

    NARCIS (Netherlands)

    van Bergen, Elsje; de Jong, Peter F.; Maassen, Ben; Krikhaar, Evelien; Plakas, Anna; van der Leij, Aryan

    2014-01-01

    Do children who go on to develop dyslexia show normal verbal and nonverbal development before reading onset? According to the aptitude–achievement discrepancy model, dyslexia is defined as a discrepancy between intelligence and reading achievement. One of the underlying assumptions is that the

  5. Hip adductor pyomyositis from Streptococcus mitis in a four-year-old child.

    Science.gov (United States)

    Buldu, Metin Tolga; Raman, Raghu

    2016-01-01

    The unique aspect of this case study is the unusual history, presentation, ultrasonography, MRI and blood culture results, which lead to the diagnosis and treatment of adductor pyomyositis with a rare organism in a temperate country. The patient presented with a one-day history of malaise, fever, left groin pain and inability to weight bear on the left leg. There was no history of any trauma, predisposing infections or recent travel. Plain radiograph and ultrasound of the hip was normal with no effusion. Two consecutive blood cultures suggested Streptococcus mitis bacteraemia and MRI scan confirmed pyomyositis of the left hip adductors that was too small to drain. S. mitis is a normal commensal organism however it can lead to opportunistic infections particularly endocarditis. Echocardiogram revealed no cardiac complications, in particular no endocarditic vegetation. Patient was treated with intravenous benzylpenicillin for a week followed by oral phenoxymethylpenicillin for a week. Adductor pyomyositis must be considered as a differential diagnosis in a child with unusual presentation of hip pain. When an ultrasound is normal, MRI scan is warranted to confirm diagnosis. Septic screen should include blood cultures. The commonest causative organisms are the Staphylococcus family. However if S. mitis is isolated, cardiac sources of infection resulting in septic emboli must be investigated. Repeated MRI scans are required particularly if the patient does not respond to medical management. IV.

  6. Alcohol policies and practices among four-year colleges in the United States: prevalence and patterns.

    Science.gov (United States)

    Lenk, Kathleen M; Erickson, Darin J; Nelson, Toben F; Winters, Ken C; Toomey, Traci L

    2012-05-01

    The purpose of this study was to assess the prevalence of college alcohol policies and practices and to identify patterns of policies/practices across colleges. An online survey of administrators at a random sample of 351 4-year U.S. colleges was conducted in 2008. The prevalence of 31 alcohol policies and practices was assessed as well as differences across size and type of colleges. Latent class analyses identified classes of colleges based on their alcohol policies/practices. The majority of colleges prohibit alcohol use at sporting events, whereas less than half prohibit alcohol use at fraternity and sorority events. Less than half of the colleges also prohibit alcohol advertising in/on campus newspapers and radio stations. Small colleges are more likely than large colleges to prohibit alcohol use at tailgating events and to prohibit newspaper alcohol advertising. Public colleges are more likely than private colleges to prohibit alcohol use in dorms but less likely to prohibit alcohol advertising. We identified four classes of colleges-the largest class (38%) was characterized by having many alcohol policies/practices, the smallest class (13%) had none or few alcohol policies/practices, and the remainder fit into two middle classes that had certain policies/practices in place but lacked others. Most colleges report implementing some alcohol policies/ practices but are lacking others. Only two of every five colleges fit into a class that has many alcohol policies. More studies are needed to validate our findings and assess whether certain policies/practices and patterns of policies are associated with reducing student alcohol consumption and related problems.

  7. A Rare Eyeball Luxation After Cranioplasty and a Four-Year Follow-Up.

    Science.gov (United States)

    Yin, Lin; Zhang, Zhiyong; Liu, Wei; Tang, Xiaojun; Yin, Hongyu; Feng, Shi

    2017-09-01

    A rare patient of reducible eyeball luxation after cranioplasty in a child Crouzon syndrome was reported. To remedy the patient's chronic intracranial hypertension and brachycephaly, orbitofrontal advancement and cranial vault remodeling were carried out. About 25 days of postoperation, an acute eyeball luxation was observed, with the presence of a subcutaneous accumulation of liquid in the bilateral temporal regions. The dislocated eyeballs were brought back by applying gentle manual pressure. The patient received a conservative treatment without a tarsorrhaphy. The dislocation recurrence never occurred again. In a 4-year follow-up, it was shown that the child's vision was normal and proptosis was improved by series craniofacial reconstructions.

  8. [School performance of former premature infants in the first four years of school].

    Science.gov (United States)

    Frenzel, J; Paalhorn, U

    1992-12-01

    School achievement during the first four grades was analysed by means of subject marks in 203 prematurely born and in 140 maturely born children. In subjects referring to behaviour in the classroom, no statistically significant differences in average marks could be found between prematurely born children and the control group. The average marks in performance subjects were slightly higher in the subgroup of very prematurely born children. However, statistically significant lower marks were observed in the subject of sports only, and for formerly immature children also in the subject of manual training. The higher the educational level of the mothers, the better the average marks without sports. No relationships between school performance and manifestation of postnatal risk factor like Apgar score, blood gas values and duration of oxygen dependency could be seen. These results demonstrate that school performance of former premature infants lies within the normal variance of their grade.

  9. The Influence of the Pell Grant on Four Year Degree Production: A Panel Data Analysis

    Science.gov (United States)

    Williams, David S., II

    2014-01-01

    An increased amount of energy and effort has been focused on higher education and degree attainment in the United States. President Obama has recently tied the Pell grants into the discussion as a central point in his proposed system of higher education accountability. However, the influence of the Pell grant on degree production has not been…

  10. The Development of Compulsive Internet Use and Mental Health: A Four-Year Study of Adolescence

    Science.gov (United States)

    Ciarrochi, Joseph; Parker, Philip; Sahdra, Baljinder; Marshall, Sarah; Jackson, Chris; Gloster, Andrew T.; Heaven, Patrick

    2016-01-01

    Is compulsive Internet use (CIU) an antecedent to poor mental health, a consequence, or both? Study 1 used a longitudinal design to track the development of CIU and mental health in Grade 8 (N = 1,030 males, 1,038 females, M[subscript age] = 13.7), 9, 10, and 11. Study 2 extended Study 1 by examining the kinds of Internet behaviors most strongly…

  11. Student Loan Default: Do Characteristics of Four-Year Institutions Contribute to the Puzzle?

    Science.gov (United States)

    Webber, Karen L.; Rogers, Sharon L.

    2010-01-01

    College student debt and loan default are growing concerns in the United States. For each U.S. institution, the federal government is now reporting a cohort default rate, which is the percent of students who defaulted on their loan, averaged over a three-year period. Previous studies have amply shown that student characteristics are strongly…

  12. Performance of four-year-old Australian and Papua New Guinean ...

    African Journals Online (AJOL)

    This study to compare performance of three Australian–Papua New Guinean Acacia species/provenances (A. mangium, A. auriculiformis, A. crassicarpa) and A. julifera was conducted at Kongowe, Kibaha, Tanzania. Species/provenances were evaluated for survival, growth (diameter, height and volume), wood basic ...

  13. Test-Enhanced Learning in Competence-Based Predoctoral Orthodontics: A Four-Year Study.

    Science.gov (United States)

    Freda, Nicolas M; Lipp, Mitchell J

    2016-03-01

    Dental educators intend to promote integration of knowledge, skills, and values toward professional competence. Studies report that retrieval, in the form of testing, results in better learning with retention than traditional studying. The aim of this study was to evaluate test-enhanced experiences on demonstrations of competence in diagnosis and management of malocclusion and skeletal problems. The study participants were all third-year dental students (2011 N=88, 2012 N=74, 2013 N=91, 2014 N=85) at New York University College of Dentistry. The 2013 and 2014 groups received the test-enhanced method emphasizing formative assessments with written and dialogic delayed feedback, while the 2011 and 2012 groups received the traditional approach emphasizing lectures and classroom exercises. The students received six two-hour sessions, spaced one week apart. At the final session, a summative assessment consisting of the same four cases was administered. Students constructed a problem list, treatment objectives, and a treatment plan for each case, scored according to the same criteria. Grades were based on the number of cases without critical errors: A=0 critical errors on four cases, A-=0 critical errors on three cases, B+=0 critical errors on two cases, B=0 critical errors on one case, F=critical errors on four cases. Performance grades were categorized as high quality (B+, A-, A) and low quality (F, B). The results showed that the test-enhanced groups demonstrated statistically significant benefits at 95% confidence intervals compared to the traditional groups when comparing low- and high-quality grades. These performance trends support the continued use of the test-enhanced approach.

  14. Quantitative Reasoning: A Guided Pathway from Two- to Four-Year Colleges

    Directory of Open Access Journals (Sweden)

    Eric Gaze

    2018-01-01

    Full Text Available In this editorial, I place the Quantitative Reasoning (QR movement within the national context of math pathways and the broader Guided Pathways initiative. Community colleges in particular are experiencing a radical re-envisioning of their math requirements. Thoughtful reflection on the communication and computation needs of their students for the 21st century has led to state-wide adoption of QR curricula as an alternative pathway to the traditional College Algebra route. These Guided Pathways have shown great promise in boosting graduation rates and addressing equity and the achievement gap for our most vulnerable, first-generation, low-income students.

  15. Acute stroke unit improves stroke management-four years on from INASC.

    LENUS (Irish Health Repository)

    Shanahan, E

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = < 0.02) and SALT (74% vs 26%, p = < 0.02). Stroke management has significantly improved from 2008, however some deficiencies remain.

  16. Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Schwartz, Matthijs P.; Schreinemakers, J. Rieneke C.; Smout, André J. P. M.

    2013-01-01

    To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease (GERD). After unblinding and crossover, 50 patients (32 males, 18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized, placebo-controlled, single-center study,

  17. Evolution of Students' Varied Conceptualizations About Socially Responsible Engineering: A Four Year Longitudinal Study.

    Science.gov (United States)

    Rulifson, Greg; Bielefeldt, Angela R

    2018-03-20

    Engineers should learn how to act on their responsibility to society during their education. At present, however, it is unknown what students think about the meaning of socially responsible engineering. This paper synthesizes 4 years of longitudinal interviews with engineering students as they progressed through college. The interviews revolved broadly around how students saw the connections between engineering and social responsibility, and what influenced these ideas. Using the Weidman Input-Environment-Output model as a framework, this research found that influences included required classes such as engineering ethics, capstone design, and some technical courses, pre-college volunteering and familial values, co-curricular groups such as Engineers Without Borders and the Society of Women Engineers, as well as professional experiences through internships. Further, some experiences such as technical courses and engineering internships contributed to confine students' understanding of an engineer's social responsibility. Overall, students who stayed in engineering tended to converge on basic responsibilities such as safety and bettering society as a whole, but tended to become less concerned with improving the lives of the marginalized and disadvantaged. Company loyalty also became important for some students. These results have valuable, transferable contributions, providing guidance to foster students' ideas on socially responsible engineering.

  18. Intellectual Assessment of 111 Four-Year-Old Children with Phenylketonuria

    Science.gov (United States)

    Dobson, James C.; And Others

    1977-01-01

    Available from: Arthur Retlaw and Associates, Inc., Suite 2080, 1603 Orrington Avenue, Evanston, Illinois 60201. A sample of 4-year-old children (n=111) with PKU (phenylketonuria) who were placed on dietary therapy between 3 and 92 days of age were assigned to two treatment groups based on "moderate" and "low" serum…

  19. Late-onset superior mesenteric artery syndrome four years following scoliosis surgery – a case report

    Directory of Open Access Journals (Sweden)

    Abol Oyoun Nariman

    2015-01-01

    Full Text Available Background: Superior mesenteric artery (SMA syndrome has been reported as an uncommon condition of external vascular compression of the SMA particularly after rapid weight loss, body casts, or after corrective surgery for spinal deformities, usually within the first few weeks after surgery. Methods: This is a retrospective report of a case of a non-verbal autistic female patient who started to develop SMA syndrome at the age of 16, 4 years after posterior spinal fusion surgery for scoliosis. She was treated conservatively by increasing oral caloric intake, which resulted in increased body weight and relief of symptoms. Results: Seen at 10 years’ follow up, the patient is doing well, and is functional within the limits of her suboptimal cognitive and verbal conditions. She maintains good trunk balance with solid spinal fusion and intact instrumentation at latest follow up. Conclusion: Spinal surgeons should maintain a high index of suspicion for diagnosis of SMA syndrome even years after scoliosis surgery, especially for patients with communication problems, like the case we present here. Appropriate conservative measures can succeed in relieving the symptoms, increasing body weight, and preventing complications including the risk of death.

  20. Four years’ follow up at a smoking cessation clinic

    Directory of Open Access Journals (Sweden)

    M. Aguiar

    2009-03-01

    Full Text Available Smoking is an important cause of pulmonary pathology and this addiction can be regarded as a chronic, recurrent disease. The benefits of smoking cessation are unquestionable and all physicians should become more active and assertive in recommending it. Aim: To characterise the population seeking medical support for smoking cessation and understand why some successfully stop smoking and others do not. Material and methods: Retrospective analysis of medical records of outpatients in follow-up between January 2003 and June 2006. Age, gender, age at smokinginitiation, smoking burden (number of pack–years, associated diseases, degree of dependence (Fagerström test for nicotine addiction, prior attempts at and motivation for smoking cessation, need for cognitive/behavioural support and success and abandonment rates were evaluated. Results: Five hundred and twenty six patients were studied, 50% male with an average age of 45.5 ± 11.4 years. Almost half (43.1%; n = 227 of the patients started smoking before the age of 15. Average smoking burden was 35.8 ± 20 pack-years although 21.4% (n = 113 smoked more than 50 pack-years. Respiratory disease was present in 52.1% (COPD, 39.9% and others, 12.2% and cardiovascular disease in 14.6% of the patients. In 46% of patients (n = 242 a relevant psychiatric disorder was identified; depression (21.4%, anxiety disorder (19.4%, other dependencies (2.1% bipolar disorder (1.5% and schizophrenia (0.6%. The evaluation of degree of addiction revealed maximum level in 69.7% of the patients (n = 380. Many patients (72.2%; n = 380 reported prior attempts to quit smoking. The strongest reasons for giving up smoking were concern over health (83.5%, financial issues (8.2% and search for better quality of life (5.7%. Most patients (81.7%; n = 430 had undergone nicotine replacement therapy; skin patches (53.3%, chewing gum (1.1% or both (45.6%. Psychopharmacological treatment included administration of sedative-hypnotics (86.5%, bupropion hydrochloride (2.3% and antidepressants (0.6%. Seventy six patients (14% benefited from cognitive/ behavioural support. Two hundred and twenty three patients (42.4% were successful in giving up smoking while 219 (41.6% abandoned follow up, the majority after the first appointment. Most patients that abandoned follow up reported lack of motivation and the price of therapy. Conclusions: The population under study had a high rate of psychiatric disorders and a high level of dependence and lack of motivation that might justify the drop-out rate. Successful treatment was associated with close follow up, behavioural support and pharmacological therapy. Resumo: O tabagismo é uma importante causa de patologia pulmonar e a sua dependência poderá ser considerada uma doença crónica e recorrente. Os benefícios da cessação tabágica são inquestionáveis e todos os médicos têm responsabilidade na sua recomendação. Objectivo: Caracterização da população que recorre à consulta de apoio ao fumador (CAF do nosso hospital e procurar entender as razões do sucesso Materiais e métodos: Análise retrospectiva dos processos clínicos de todos os doentes que foram seguidos na CAF entre Janeiro de 2003 e Junho de 2006. Foram avaliados os seguintes parâmetros: idade, sexo, idade de início, carga tabágica (unidades maço ano--UMA, patologias associadas, grau de dependência (teste de Fargerström, tentativas prévias, motivações para cessação tabágica, necessidade de apoio cognitivo- comportamental e taxas de sucesso e abandono. Resultados: Foram avaliados 526 doentes, 50% (n = 263 do sexo masculino. A média de idades situava-se nos 45,5 ± 11,4 anos. Iniciaram o consumo antes dos 15 anos 43,1% (n = 227. A carga tabágica foi de 35,8 ± 20 UMA, observando-se em 21,4% (n = 113 dos doentes um consumo superior a 50 UMA. Patologia pulmonar esteve presente em 52,1% (DPOC – 39,9%; outras – 12,2% e a cardiovascular em 14,6% (n = 77 dos doentes. Em 46% (n = 242 foi identificada uma patologia psiquiátrica importante: perturbações depressivas (21,4%, transtorno de ansiedade (19,4%, outra toxicodependência (2,1%, doença bipolar (1,5% e esquizofrenia (0,6%. Trezentos e sessenta e sete doentes (69,7% obtiveram pontuação máxima no teste de Fagerström. Em 72,2% (n = 380 dos casos foram mencionadas tentativas prévias de abandono do tabagismo. Os motivos actuais evocados para a cessação tabágica relacionaram-se com: saúde (83,5%; factores económicos 8,2%; qualidade de vida (5,7%. Foram submetidos a terapêutica de substituição nicotínica 81,7% (n = 430 dos doentes, sendo a via de administração: sistema transdérmicos (53,3%, nicotina oral (1,1% ou ambos (45,6%. O suporte psicofarmacológico utilizado foi: ansiolítico (86,5%; cloridrato bupropiona (2,3%; antidepressivo (0,6%. Foi solicitado apoio cognitivo-comportamental a 14,4% (n = 76 dos doentes. A taxa de cessação tabágica foi de 42,4% (n = 223. A redução do consumo de tabaco superior a 50% foi de 1,9% (n = 10. A taxa de abandono da consulta, a maioria logo após a primeira consulta, foi de 41,6% (n = 219. A taxa de abandono da consulta relacionou-se com as características dos doentes, a falta de motivação, o preço da terapêutica e o meio ambiente desencorajador. Conclusão: Verificou-se nesta população elevada percentagem de indivíduos com patologia psiquiátrica e alto grau de dependência a nicotina, factores que, aliados ao stress como causa major de aumento de consumo de tabaco, implicaram uma especial atenção ao suporte cognitivo-comportamental no sentido de garantir melhores resultados. O sucesso terapêutico esteve sem dúvida relacionado com a aderência à consulta, a terapia comportamental e a terapêutica farmacológica. Key-words: Smoking cessation, outpatient smokers, Palavra-chave: Desabituação tabágica, fumador, consulta

  1. Tracking the Eye Movement of Four Years Old Children Learning Chinese Words

    Science.gov (United States)

    Lin, Dan; Chen, Guangyao; Liu, Yingyi; Liu, Jiaxin; Pan, Jue; Mo, Lei

    2018-01-01

    Storybook reading is the major source of literacy exposure for beginning readers. The present study tracked 4-year-old Chinese children's eye movements while they were reading simulated storybook pages. Their eye-movement patterns were examined in relation to their word learning gains. The same reading list, consisting of 20 two-character Chinese…

  2. Influenza infection in the intensive care unit: Four years after the 2009 pandemic.

    Science.gov (United States)

    Pérez-Carrasco, Marcos; Lagunes, Leonel; Antón, Andrés; Gattarello, Simone; Laborda, César; Pumarola, Tomás; Rello, Jordi

    2016-03-01

    The role of influenza viruses in severe acute respiratory infection (SARI) in Intensive Care Units (ICU) remains unknown. The post-pandemic influenza A(H1N1)pdm09 period, in particular, has been poorly studied. To identify influenza SARI patients in ICU, to assess the usefulness of the symptoms of influenza-like illness (ILI), and to compare the features of pandemic vs. post-pandemic influenza A(H1N1) pdm09 infection. A prospective observational study with SARI patients admitted to ICU during the first three post-pandemic seasons. Patient demographics, characteristics and outcomes were recorded. An influenza epidemic period (IEP) was defined as >100 cases/100,000 inhabitants per week. One hundred sixty-three patients were diagnosed with SARI. ILI was present in 65 (39.9%) patients. Influenza infection was documented in 41 patients, 27 (41.5%) ILI patients, and 14 (14.3%) non-ILI patients, 27 of them during an IEP. Influenza A viruses were mainly responsible. Only five patients had influenza B virus infection, which were non-ILI during an IEP. SARI overall mortality was 22.1%, and 15% in influenza infection patients. Pandemic and post-pandemic influenza infection patients shared similar clinical features. During influenza epidemic periods, influenza infection screening should be considered in all SARI patients. Influenza SARI was mainly caused by subtype A(H1N1)pdm09 and A(H3N2) in post-pandemic seasons, and no differences were observed in ILI and mortality rate compared with a pandemic season. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Eurythmy therapy in chronic disease: a four-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2007-04-01

    Full Text Available Abstract Background Many patients with chronic diseases use complementary therapies, often provided by their physicians. In Germany, several physician-provided complementary therapies have been reimbursed by health insurance companies as part of health benefit programs. In most of these therapies, the patient has a predominantly passive role. In eurythmy therapy, however, patients actively exercise specific movements with the hands, the feet or the whole body. The purpose of this study was to describe clinical outcomes in patients practising eurythmy therapy exercises for chronic diseases. Methods In conjunction with a health benefit program, 419 outpatients from 94 medical practices in Germany, referred to 118 eurythmy therapists, participated in a prospective cohort study. Main outcomes were disease severity (Disease and Symptom Scores, physicians' and patients' assessment on numerical rating scales 0–10 and quality of life (adults: SF-36, children aged 8–16: KINDL, children 1–7: KITA. Disease Score was documented after 0, 6 and 12 months, other outcomes after 0, 3, 6, 12, 18, 24, and (SF-36 and Symptom Score 48 months. Results Most common indications were mental disorders (31.7% of patients; primarily depression, fatigue, and childhood emotional disorder and musculoskeletal diseases (23.4%. Median disease duration at baseline was 3.0 years (interquartile range 1.0–8.5. Median number of eurythmy therapy sessions was 12 (interquartile range 10–19, median therapy duration was 119 days (84–188. All outcomes improved significantly between baseline and all subsequent follow-ups (exceptions: KITA Psychosoma in first three months and KINDL. Improvements from baseline to 12 months were: Disease Score from mean (standard deviation 6.65 (1.81 to 3.19 (2.27 (p Adverse reactions to eurythmy therapy occurred in 3.1% (13/419 of patients. No patient stopped eurythmy therapy due to adverse reactions. Conclusion Patients practising eurythmy therapy exercises had long-term improvement of chronic disease symptoms and quality of life. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that eurythmy therapy can be useful for patients motivated for this therapy.

  4. Epidemiology of chronic renal failure in Iran: A four year single center experience

    International Nuclear Information System (INIS)

    Afshar, R.; Sanavi, S.; Salimi, J.

    2007-01-01

    Chronic renal failure (CRF) is a major public health problem. Early diagnosis and proper management have important roles in prevention of CRF progression to end-stage renal disease (ESRD). For this purpose, determining the etiology of CRF may be helpful. This study was conducted in the nephrology department at the Mostafa Khomeini Hospital in Tehran, Iran from March 2001 to March 2005, to determine the etiology of CRF in adult Iranian patients. A total of 1200 patients with a diagnosis of CRF were involved in the study. Relevant data were collected using a reliable questionnaire. All data analyses were carried out using SPSS and the x2 test. Of the 1200 patients, 61% were males and 39% females. The most frequent age group was 61-75 years (38.3%) and the mean age of study patients was 51.6 +- 17 years. The etiology of CRF in our series included diabetes mellitus in 26.8%, hypertension in 13.5%, obstructive uropathy in 12%, cystic and congenital disorders in 10.3%, glomerulonephritis in 6.5%, urinary tract infections in 4%, vasculitis in 2%, tubulo-interstitial nephritis and pregnancy related in 0.8% each and unknown causes in 29.5% of the patients. Laboratory and ultrasonographic assessment at initiation of the study revealed blood urea nitrogen >100 mg/dl in 57.8% of the patients, serum creatinine >10mg/dl in 40.3%, glomerular filtration rate (GFR) < 10ml/min in 61.3%, hemoglobin < 10 g/dl in 65.8% and kidney size lesser than 8 cm in 46% of the cases. There was a significant statistical relationship between kidney size and duration of hypertension greater than five years (P=0.017). The high frequency of CRF of unknown etiology in this study may be attributed to diagnostic limitations prevailing in our country. A GFR of < 10 ml/min in 61.3% of these cases at presentation suggests late diagnosis/ and/or referral. Aggressive screening and treatment strategies to prevent ESRD are recommended. (author)

  5. Twenty four year time trends in fats and cholesterol intake by adolescents. Warsaw Adolescents Study

    Directory of Open Access Journals (Sweden)

    Charzewska Jadwiga

    2015-06-01

    Full Text Available The objective of this study was to determine time trends (1982–2006 in total fat intake and changes in fatty acid structure intake in adolescents from Warsaw in view of increasing prevalence of obesity. Data come from four successive surveys randomly selected samples of adolescents (aged 11–15 years old, from Warsaw region. In total 9747 pupils have been examined, with response rate varying from 55% to 87% depending on year. Surveys were done always in the spring season of the year. Food intake was assessed by using 24 hours recall method of consumption by the pupils all products, including enriched, dishes and beverages as well as diet supplements, in the last 24 hours preceding the examination. The content of energy and nutrients was calculated by means of own computer softwares (DIET 2 and 4, taking into account successive revisions of the tables of food composition and nutritional values, as well as current Polish DRI. A significant decreasing trend was found in intake of total fat, of saturated fatty acids (SFA and cholesterol. The percentage of energy from total fat, also decreased both in boys (to 35,1% and girls (to 33,7%, what failed to reach the desired level below 30% of energy from fat which is recommended. Also significant decrease of SFA consumption was not satisfactory enough to approach the values <10% of energy recommended as was from 13% to 15%. Decreasing trends in fat intake was not in accordance with the trend in obesity prevalence in the adolescents as average BMI is going up. To stabilize the health-oriented changes especially in the diets of adolescents, further activity is desired from professionals working with prevention of adolescents obesity.

  6. Lumbar endoscopic percutaneous discolisis, with Holmium YAG laser - four years of experience

    International Nuclear Information System (INIS)

    Ramirez L, Jorge Felipe; Rugeles O, Jose G

    2001-01-01

    we have designed a prospective study over 220 patients with lumbar hernia. our purpose is to show the results that we have obtained with endoscopic percutaneous holmium YAG laser lumbar disc decompression. In all cases, ambulatory surgery was performed using local anesthesia, follow up based on Mac Nab criteria was made with excellent and good results in 75% of patients this is a useful safety outpatient procedure with good results, fewer complications, reduced costs and with the same or better results than traditional procedures

  7. Variations of arsenic species content in edible Boletus badius growing at polluted sites over four years.

    Science.gov (United States)

    Mleczek, Mirosław; Niedzielski, Przemysław; Rzymski, Piotr; Siwulski, Marek; Gąsecka, Monika; Kozak, Lidia

    2016-07-02

    The content of arsenic (As) in mushrooms can vary depending on the concentration level of this metalloid in the soil/substrate. The present study evaluated the content of arsenic in Boletus badius fruiting bodies collected from polluted and non-polluted sites in relation to the content of this element in overgrown substrate. It was found that mushrooms from the arsenic-polluted sites contained mean concentrations from 49 to 450 mg As kg(-1) dry matter (d.m.), with the greatest content found for specimens growing in close proximity of sludge deposits (490±20 mg As kg(-1)d.m.). The mean content of total arsenic in mushrooms from clean sites ranged from 0.03 to 0.37 mg kg(-1) It was found that B. badius could tolerate arsenic in soil substrate at concentrations of up to 2500 mg kg(-1), at least. In different years of investigation, shifts in particular arsenic forms, as well as a general increase in the accumulation of organic arsenic content, were observed. The results of this study clearly indicate that B. badius should not be collected for culinary purposes from any sites that may be affected by pollution.

  8. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Prescott, E

    1993-01-01

    the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow......-up visit. 60 out of 83 reported increased pain, 8 reported improvement of pain. The 83 subjects showed no significant fall in muscle strength during the follow-up period. The majority reported severe fatigue but only one fifth fulfilled the proposed chronic fatigue syndrome criteria....

  9. Father Involvement with Three-to-Four-Year Olds at Home: Giving Fathers a Chance

    Science.gov (United States)

    Betawi, Iman Amy; Abdel Jabbar, Sinaria Kamil; AL Jabery, Mohammad. A.; Zaza, Haidar Ibrahim; Al-Shboul, Muhannad

    2014-01-01

    This study examined fathers' perceptions regarding their home-based activities (HBA) and the influence of fathers' demographic characteristics on their perceptions and practices at home. A total of 396 fathers completed a survey questionnaire describing their demographic information, perceptions and their practices regarding their involvement in…

  10. Effects of Diversity Experiences on Socially Responsible Leadership over Four Years of College

    Science.gov (United States)

    Parker, Eugene T., III; Pascarella, Ernest T.

    2013-01-01

    Regarding collegiate experiences, several studies have examined the effects of diversity experiences on educational, psychosocial, and other college outcomes (Pascarella & Terenzini, 2005). However, there exists a limited body of research, which has focused on the impact of those types of experiences on leadership development among students…

  11. Beta-lactam resistance among Enterobacteriaceae in Cambodia: The four-year itch

    Directory of Open Access Journals (Sweden)

    Yannick Caron

    2018-01-01

    Full Text Available Although antibiotics are too often used inappropriately in Cambodia, published data on antimicrobial resistance in this country are scarce. Epidemic dissemination and the transfer of resistance genes to other bacterial species put the population at risk. The aim of this study was to evaluate the frequency and characteristics of extended-spectrum beta-lactamase (ESBL-producing Enterobacteriaceae (ESBL-E isolated in consecutive samples tested at Institut Pasteur du Cambodge over a 4-year period (2012–2015. Antimicrobial susceptibility testing was performed by disk diffusion on agar technique and the results were read automatically using an OSIRIS system. The Etest was used to determine minimum inhibitory concentrations (MIC for some resistance phenotypes. The strain most commonly identified was Escherichia coli (63.9%. The proportion of ESBL-E increased gradually over the study period, from 23.8% to 38.4%. ESBL was detected in 42.7% of the E. coli strains and 33.7% of all Klebsiella pneumoniae isolated. The proportion of ESBL-producing E. coli increased significantly from 28.9% in 2012 to 48.2% in 2015, while the increase for K. pneumoniae remained non-significant. Multidrug resistance was high in this Cambodian series, with some strains displaying resistance to all antibiotics available in the country. There is currently no established system for the surveillance of antimicrobial resistance in Cambodia. Collecting samples from clinical settings throughout the country is critical to assess the impact of antimicrobial drug use in patients in Cambodia and in the Mekong Region.

  12. Fracture patterns in the maxillofacial region: a four-year retrospective study

    Science.gov (United States)

    2015-01-01

    Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557

  13. Electronic messaging between primary and secondary care: a four-year case report

    NARCIS (Netherlands)

    P.W. Moorman (Peter); P.J. Branger (Peter); W.J. van der Kam (Wouter); J. van der Lei (Johan)

    2001-01-01

    textabstractOBJECTIVE: To observe how electronic messaging between a hospital consultant and general practitioners (GPs) in 15 practices about patients suffering from diabetes evolved over a 3-year period after an initial 1-year study. DESIGN: Case report. Electronic

  14. Building theory-based concepts: four-year-olds preferentially seek explanations for features of kinds.

    Science.gov (United States)

    Cimpian, Andrei; Petro, Gina

    2014-05-01

    Is the structure of human concepts continuous across development, or does it undergo qualitative transformations? Extensive evidence with adults has demonstrated that they are motivated to understand why categories have the features they do. To investigate whether young children display a similar motivation-an issue that bears on the question of continuity vs. transformation in conceptual structure-we conducted three studies involving 4-year-olds (N=90) and adults (N=124). Experiments 1 and 2 suggested that 4-year-olds indeed display a strong motivation to explain why categories have the features they do. Specifically, when provided with the option of asking "why?" about features of novel categories vs. features of individuals from other novel categories, children preferred to ask "why?" about the category features. Moreover, children's explanatory preference was specific to facts about categories per se and did not extend to facts that were merely presented in the context of multiple category instances. Experiment 3 also ruled out the possibility that the category facts were preferred because these facts were more surprising. In sum, these three studies reveal an early-emerging motivation to make sense of the categories encountered in the world and, more generally, speak to the richness of children's conceptual representations. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Tip moth control and loblolly pine growth in intensive pine culture: four year results

    Science.gov (United States)

    David L. Kulhavy; Jimmie L. Yeiser; L. Allen Smith

    2006-01-01

    Twenty-two treatments replicated four times were applied to planted loblolly pine, Pinus taeda L., on bedded industrial forest land in east Texas for measurement of growth impact of Nantucket pine tip moth (NPTM), Rhyacionia frustrana Comstock, and effects on pine growth over 2 years. Treatments were combinations of Velpar®,...

  16. Four-year monitoring of foodborne pathogens in raw milk sold by vending machines in Italy.

    Science.gov (United States)

    Giacometti, Federica; Bonilauri, Paolo; Serraino, Andrea; Peli, Angelo; Amatiste, Simonetta; Arrigoni, Norma; Bianchi, Manila; Bilei, Stefano; Cascone, Giuseppe; Comin, Damiano; Daminelli, Paolo; Decastelli, Lucia; Fustini, Mattia; Mion, Renzo; Petruzzelli, Annalisa; Rosmini, Roberto; Rugna, Gianluca; Tamba, Marco; Tonucci, Franco; Bolzoni, Giuseppe

    2013-11-01

    Prevalence data were collected from official microbiological records monitoring four selected foodborne pathogens (Salmonella, Listeria monocytogenes, Escherichia coli O157:H7, and Campylobacter jejuni) in raw milk sold by self-service vending machines in seven Italian regions (60,907 samples from 1,239 vending machines) from 2008 to 2011. Data from samples analyzed by both culture-based and real-time PCR methods were collected in one region. One hundred raw milk consumers in four regions were interviewed while purchasing raw milk from vending machines. One hundred seventy-eight of 60,907 samples were positive for one of the four foodborne pathogens investigated: 18 samples were positive for Salmonella, 83 for L. monocytogenes, 24 for E. coli O157:H7, and 53 for C. jejuni in the seven regions investigated. No significant differences in prevalence were found among regions, but a significant increase in C. jejuni prevalence was observed over the years of the study. A comparison of the two analysis methods revealed that real-time PCR was 2.71 to 9.40 times more sensitive than the culture-based method. Data on consumer habits revealed that some behaviors may enhance the risk of infection linked to raw milk consumption: 37% of consumers did not boil milk before consumption, 93% never used an insulated bag to transport raw milk home, and raw milk was consumed by children younger than 5 years of age. These results emphasize that end-product controls alone are not sufficient to guarantee an adequate level of consumer protection. The beta distribution of positive samples in this study and the data on raw milk consumer habits will be useful for the development of a national quantitative risk assessment of Salmonella, L. monocytogenes, E. coli O157, and C. jejuni infection associated with raw milk consumption.

  17. LEP and results obtained by DELPHI after four years of operation

    International Nuclear Information System (INIS)

    Blocki, J.

    1993-10-01

    We characterize the most important problems of modern elementary particles physics, for the solution of which the LEP (Large Electron Positron) accelerator was built. We present the characteristics of this accelerator. The structure and properties of the DELPHI detector are described with special emphasis on the contribution of Polish groups. The most important results obtained so far in the LEP accelerator are discussed. (author). 12 refs, 17 figs, 1 tab

  18. Racially Minoritized Students at U.S. Four-Year Institutions

    Science.gov (United States)

    Stewart, Dafina-Lazarus

    2013-01-01

    Racially minoritized students attending U.S. colleges and universities are often compared to their White peers in research studies, generally emphasizing their cultural deficits, masking minority group achievement, and homogenizing within group variations. This article reports data for racially minoritized students who participated in the national…

  19. Scaling Student Success with Predictive Analytics: Reflections after Four Years in the Data Trenches

    Science.gov (United States)

    Wagner, Ellen; Longanecker, David

    2016-01-01

    The metrics used in the US to track students do not include adults and part-time students. This has led to the development of a massive data initiative--the Predictive Analytics Reporting (PAR) framework--that uses predictive analytics to trace the progress of all types of students in the system. This development has allowed actionable,…

  20. Four years with FALCON – An ESTRO educational project: Achievements and perspectives

    International Nuclear Information System (INIS)

    Eriksen, Jesper Grau; Salembier, Carl; Rivera, Sofia; De Bari, Berardino; Berger, Daniel; Mantello, Giovanna; Müller, Arndt-Christian; Martin, Arturo Navarro; Pasini, Danilo; Tanderup, Kari; Palmu, Miika; Verfaillie, Christine; Pötter, Richard; Valentini, Vincenzo

    2014-01-01

    Variability in anatomical contouring is one of the important uncertainties in radiotherapy. FALCON (Fellowship in Anatomic deLineation and CONtouring) is an educational ESTRO (European SocieTy for Radiation and Oncology) project devoted to improve interactive teaching, the homogeneity in contouring and to compare individual contours with endorsed guidelines or expert opinions. This report summarizes the experience from the first 4 years using FALCON for educational activities within ESTRO School and presents the perspectives for the future

  1. Four year-olds use norm-based coding for face identity.

    Science.gov (United States)

    Jeffery, Linda; Read, Ainsley; Rhodes, Gillian

    2013-05-01

    Norm-based coding, in which faces are coded as deviations from an average face, is an efficient way of coding visual patterns that share a common structure and must be distinguished by subtle variations that define individuals. Adults and school-aged children use norm-based coding for face identity but it is not yet known if pre-school aged children also use norm-based coding. We reasoned that the transition to school could be critical in developing a norm-based system because school places new demands on children's face identification skills and substantially increases experience with faces. Consistent with this view, face identification performance improves steeply between ages 4 and 7. We used face identity aftereffects to test whether norm-based coding emerges between these ages. We found that 4 year-old children, like adults, showed larger face identity aftereffects for adaptors far from the average than for adaptors closer to the average, consistent with use of norm-based coding. We conclude that experience prior to age 4 is sufficient to develop a norm-based face-space and that failure to use norm-based coding cannot explain 4 year-old children's poor face identification skills. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Intangible Capital: Four years of growth as an open-access scientific publication

    Directory of Open Access Journals (Sweden)

    Pep Simo

    2008-01-01

    Full Text Available This issue opens the fourth volume of the Intangible Capital journal, which makes its way towards the fifth year of publication. As usually, we start this volume by evaluating the previous one and tracing new directions. Among the main contributions during the year 2007, we consider important to highlight the following aspects: the renewal of the scientific indexation agreements, the platform change to OJS, the appointment of a new editor, new members included in the editorial board, the board of reviewers, the change towards a bilingual model, the new financing obtained and, the last but not the least, the work undertaken together with many scientific editors of open access Spanish journals for obtaining the positive evaluation of the CNEAI (National Commission for the Evaluation of the Research Activity and thus, being a proof of scientific excellence.

  3. Aids-related kaposi's sarcoma in a four year old child: the challenge ...

    African Journals Online (AJOL)

    Background: AIDSrelated Kaposi's sarcoma (KS) is an AIDS-defining illness and is now increasingly recognized in children infected with HIV. Many of these cases are missed due to low index of suspicion. Vertical transmission of HIV is the commonest route of transmission in children and this is preventable by early ...

  4. Acute stroke unit improves stroke management-four years on from INASC.

    Science.gov (United States)

    Shanahan, E; Keenan, R; Cunningham, N; O'Malley, G; O'Connor, M; Lyons, D; Peters, C

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = Stroke management has significantly improved from 2008, however some deficiencies remain.

  5. Transapical aortic valve implantation in Rouen: four years' experience with the Edwards transcatheter prosthesis.

    Science.gov (United States)

    Litzler, Pierre-Yves; Borz, Bogdan; Smail, Hassiba; Baste, Jean-Marc; Nafeh-Bizet, Catherine; Gay, Arnaud; Tron, Christophe; Godin, Matthieu; Caudron, Jerome; Hauville, Camille; Dacher, Jean-Nicolas; Cribier, Alain; Eltchaninoff, Hélène; Bessou, Jean-Paul

    2012-03-01

    The first French transapical transcatheter aortic valve implantation (TAVI) was performed in July 2007 in our department. To report 4-year outcomes of transapical implantation with the Edwards transcatheter bioprosthesis. We prospectively evaluated consecutive patients who underwent transapical implantation with an Edwards transcatheter bioprosthesis between July 2007 and October 2011. Patients were not suitable for conventional surgery (due to severe comorbidities) or transfemoral implantation (due to poor femoral access). Among 61 patients (59.0% men), mean logistic EuroSCORE was 27.5 ± 14.9% and mean age was 81.0 ± 6.8 years. Successful valve implantation was achieved in 59/61 patients (96.7%) of patients. The other two patients required conversion to conventional surgery due to prosthesis embolization and died. Six additional patients died in the postoperative period. Causes of perioperative death were two septic shocks (one of peritonitis), two multi-organ failure, one ventricular fibrillation and one respiratory insufficiency. Intraprocedural stroke was not observed in any patient. The actuarial survival rates at 1, 2 and 4 years were 73.8%, 67.2% and 41.0%. During this 4-year period, four patients died of cardiovascular events, but no impairment of transprosthesis gradient was observed. Our series of 61 patients who underwent transapical implantation of the Edwards transcatheter bioprosthesis shows satisfactory results, similar to other reports, considering the high level of severity of patients referred for this method. Transapical access is a reliable alternative method for patients that cannot benefit from a transfemoral approach. Copyright © 2012. Published by Elsevier Masson SAS.

  6. Four years of experience in our clinic regarding hysteroscopies for abnormal uterine hemorrhages

    Directory of Open Access Journals (Sweden)

    Tina Bobei

    2018-05-01

    Full Text Available Introduction. Abnormal uterine hemorrhages (AUH are the most common symptom for presentation to gynecologist. Any uterine bleeding other than menstrual bleeding, which concerns the duration, frequency, quality or quantity of the bleeding is considered abnormal. Material and Methods. We realized a retrospective study based on medical records of the patients admitted for abnormal uterine hemorrhage at “Saint John” Emergency Clinical Hospital, “Bucur” Maternity between 2013 and 2016. From the patients with AUH, we focused on those who underwent hysteroscopies. Results. Our study included 146 patients. The age of patients varied from 22 to 71 years. Abnormal uterine bleeding was most prevalent among women of 40-50 years (20%, and the mean age was 42.65%. 82.88% from our patients had obstetrical history and only 17.12% didn’t give birth either as an option, or from primary or secondary infertility. 7.53% of the patients were hypertensive and 5.48% had endocrine pathology. All patients underwent diagnostic hysteroscopy and 4.79% patients therapeutic hysteroscopy. The therapeutic measures that were made are: hysteroscopic resection of the endometrium (47.3%, excision of polyps (36.99%, sinechiolysis (8.22% and myomectomy (2.71%. The diagnoses were 46.48% endometrial polyp, 13.7% intramural leiomyoma, 13.7% IUD (intrauterine device and 9.59% intrauterine synechiae, while 15.06% cumulated for uterine septum, endometrial hyperplasia, cervical polyp, foreign intrauterine bodies, secondary infertility, dysfunctional metrorrhagia. Conclusion. In patients with abnormal uterine hemorrhages, hysteroscopy provides the most accurate diagnosis and can reduce the burden of hysterectomy in many cases.

  7. Dynamics of herbaceous vegetation during four years of experimental coppice introduction

    Czech Academy of Sciences Publication Activity Database

    Hédl, Radim; Šipoš, Jan; Chudomelová, Markéta; Utinek, D.

    2017-01-01

    Roč. 52, č. 1 (2017), s. 83-99 ISSN 1211-9520 R&D Projects: GA MŠk(CZ) EE2.3.20.0267 EU Projects: European Commission(XE) 278065 - LONGWOOD Institutional support: RVO:67985939 Keywords : biodiversity * ecological restoration * coppice-with-standards Subject RIV: EH - Ecology, Behaviour OBOR OECD: Plant sciences, botany Impact factor: 1.017, year: 2016

  8. Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience.

    Science.gov (United States)

    Gobin, Y Pierre; Dunkel, Ira J; Marr, Brian P; Brodie, Scott E; Abramson, David H

    2011-06-01

    To determine whether intra-arterial chemotherapy is safe and effective in advanced intraocular retinoblastoma. Retinoblastoma often presents with advanced intraocular disease and, despite conventional treatment with intravenous chemotherapy and external beam radiation therapy, may still require enucleation. Single-arm, prospective registry from May 30, 2006, to May 30, 2010, at an ophthalmic oncology referral center with ambulatory care. A total of 95 eyes of 78 patients with unilateral or bilateral retinoblastoma were treated. The intervention was selective catheterization of the ophthalmic artery and injection of chemotherapy, usually melphalan with or without topotecan. Drug dosage was determined by age and angioanatomy. The main outcome measures were procedural success, event-free (enucleation or radiotherapy) ocular survival, and ocular and extraocular complications. Catheterization succeeded in 98.5% of procedures. There were 289 chemotherapy injections (median, 3 per eye). The Kaplan-Meier estimates of ocular event-free survival rates at 2 years were 70.0% (95% confidence interval, 57.9%-82.2%) for all eyes, 81.7% (95% confidence interval, 66.8%-96.6%) for eyes that received intra-arterial chemotherapy as primary treatment, and 58.4% (95% confidence interval, 39.5%-77.2%) for eyes that had previous treatment failure with intravenous chemotherapy and/or external beam radiation therapy. There were no permanent extraocular complications. Our experience suggests that intra-arterial chemotherapy is safe and effective in the treatment of advanced intraocular retinoblastoma.

  9. Four-year follow-up of pregnancy-associated osteoporosis: a case report.

    Science.gov (United States)

    Takahashi, Naoto; Arai, Itaru; Kayama, Satoru; Ichiji, Kenji; Fukuda, Hironari; Handa, Jun-Ichi; Konno, Shin-Ichi

    2014-01-01

    A 22-year-old woman presented with complaints of severe pain in a wide region of the thoracolumbar spine. She developed severe pain in the thoracolumbar spine region 2 months after her first delivery and was referred 1 month later. A lateral thoracic X-ray showed depressed degenerative vertebrae (T7, T9). One month after the initial examination, thoracic sagittal magnetic resonance imaging showed low intensity areas on T1-weighted imaging and iso-high intensity areas on T2-weighted imaging at T5, 7, 8, 9 and 11. Bone mineral density measured by ultrasound was low (%YAM 76%). The bone metabolic markers were high, suggesting accelerated osteoclast activity. These findings prompted a diagnosis of pregnancy-associated osteoporosis. She was asked to stop breastfeeding and to wear a lumbar brace, and treatment with nutritional calcium, activated vitamin D3, and risedronate sodium was started. Her low back pain almost disappeared after treatment. Bone metabolic markers showed normalization 8 months after the initial examination. Risedronate sodium was stopped 2 years and 2 months after the initial examination. Teriparatide treatment was started because her bone mineral density remained low; however, the osteoblast marker P1NP was not increased 5 months after the start of teriparatide treatment.

  10. Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study.

    Science.gov (United States)

    Dinesh, H N; Kumar, Cd Jagadish; Sanjay, H M; Sachin, V; Basavaraju

    2015-07-01

    About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital.

  11. Emergent Literacy Performance across Two Languages: Assessing Four-Year-Old Bilingual Children

    Science.gov (United States)

    Westerveld, Marleen F.

    2014-01-01

    There are few emergent literacy assessments available for bilingual children. This study investigated the usefulness of a screening battery of oral language and print-related measures as an assessment tool for bilingual Samoan-English speaking children. A total of 18 children were recruited from three Samoan language immersion kindergartens (Aoga…

  12. The 150 Credit-Hour Requirement and CPA Examination Pass Rates--A Four Year Study

    Science.gov (United States)

    Briggs, Gary P.; He, Lerong

    2012-01-01

    Debate concerning the minimum educational requirements of certified public accountant (CPA) candidates in the USA has been taking place for decades. This paper compares the sectional pass rates of CPA candidates from jurisdictions requiring 150 credit hours of college study with the pass rates of candidates from jurisdictions not requiring 150…

  13. Impact of a four-year wellness programme on coronary artery ...

    African Journals Online (AJOL)

    During the last few decades employers have realised that the health of an employee can have a positive influence on productivity.Thus, some corporate employers started implementing wellness programmes as part of their employee assistance programmes. In order to evaluate the impact of such programmes, the present ...

  14. How Far from Income Equity Are Faculty in Four-Year, Non-Doctorial Universities?

    Science.gov (United States)

    Hensley, Brandon

    2014-01-01

    Increasingly, scholars in academia as well as journalists are noting vast pay discrepancies among professorial ranks. This study is an attempt to examine how gender, rank, and scholarly output influence faculty members' income from their institutions. Using equity theory as a conceptual framework, the 2004 National Study of Postsecondary Faculty…

  15. Four Years of Real-Time GRB Followup by BOOTES-1B (2005-2008)

    Czech Academy of Sciences Publication Activity Database

    Jelínek, M.; Castro-Tirado, A.J.; de Ugarte Postigo, A.; Kubánek, P.; Guziy, S.; Gorosabel, J.; Cunniffe, R.; Vítek, S.; Hudec, René; Reglero, V.; Sabau-Graziati, L.

    2010-01-01

    Roč. 2010, č. 1 (2010), 432172/1-432172/10 ISSN 1687-7969 R&D Projects: GA ČR GA205/08/1207 Grant - others:GA ČR(CZ) GA102/09/0997; ESA(XE) PECS project No. 98023 Institutional research plan: CEZ:AV0Z10030501 Keywords : observing * GRB * Spain Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics OBOR OECD: Astronomy (including astrophysics,space science)

  16. Association between subjective memory complaints and nursing home placement: a four-year follow-up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    nursing home placements were observed. Subjective memory complaints were associated with an adjusted Hazard Ratio (HR) of 2.59 for nursing home placement. Other statistical significant covariates were MMSE depression...... (HR = 4.74). The effect of subjective memory complaints is seen to moderate when subjects are older. CONCLUSION: The data of this study indicated that in an elderly primary care population the presence of subjective memory complaints was a significant independent predictor for nursing home placement......OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey...

  17. Interparental Conflict and Parental Divorce: The Individual, Relative, and Interactive Effects on Adolescents across Four Years.

    Science.gov (United States)

    Forehand, Rex; And Others

    1994-01-01

    Describes investigation examining individual, relative, and interactive influences of parental divorce and interparental conflict on adolescent functioning. Results demonstrate that multiple areas of functioning in multiple years were predicted by parental divorce, current interparental conflict, and interaction of both variables. (CRR)

  18. A Comparison of Four Year Health Outcomes following Combat Amputation and Limb Salvage

    Science.gov (United States)

    2017-01-25

    pathways that address the physical and psychological healthcare needs of such patients over time. Introduction Previous studies indicated that extremity...patients, there is a need to quan- tify and compare long-term health outcomes following amputation and limb salvage. A recent study followed the...and psychological complications. Wound complications. Wound complications selected for study were those that required prolonged surveillance

  19. TECHNICAL CHARACTERIZATION OF ECO-COMPATIBLE PLASTIC FILMS FOR SOIL SOLARIZATION: FOUR YEARS OF EXPERIMENTS

    OpenAIRE

    Salvatore Margiotta

    2007-01-01

    Soil solarization relies on solar radiation being converted to heat for the killing of soilborne pathogens. On one hand, this technique can be considered as an environmentally-friendly way to manage soilborne pests, as an alternative of methyl bromide phased-out in 2005, than using chemicals. On the other hand, high employment of traditional plastic sheets in agriculture causes the production of enormous quantities of waste, whose inappropriate management might have negative effects on the en...

  20. Four Years of Media Habits: Implications for U.S. Army Advertising to the Prime Market

    Science.gov (United States)

    1988-12-01

    X NBA Basketball NSA BASKETBALL X X College Basketball COLLEGE BASKETBALL X X College Basketball Playoffs COLLEGE PLAYOFFS NHL Hockey NHL HOCKEY x x...BASEBALLO 19.65 23.16 21.03 23.73 BASEBALL PLAYOFFS 29.28 32.54 28.79 31.53 WORLD SERIES 44.19 46.61 38.01 48.79 NBA BASKETBALL 20.26 27.41 20.67...SERIES 47.64 46.46 46.57 43.33 NBA BASKETBALL 34.60 39.40 45.32 63.33 COLLEGE BASKETBALL 31.50 35.63 41.09 53.33 COLLEGE PLAYOFFSO NHL HOCKEYb 12.07

  1. Four-year stability, change, and multidirectionality of well-being in very-old age.

    Science.gov (United States)

    Wettstein, Markus; Schilling, Oliver K; Reidick, Ortrun; Wahl, Hans-Werner

    2015-09-01

    We examined stability, change, and dedifferentiation of well-being in 124 participants with a baseline age between 87 and 97 years (M = 90.56, SD = 2.92) across 7 measurement occasions over 4 years. Measures of hedonic (life satisfaction, positive affect and negative affect) and eudaimonic well-being (autonomy, purpose in life, self-acceptance, environmental mastery), as well as indicators of mental distress (depressive symptoms, attitudes toward death and dying, disease phobia) were included. Average levels indicated high well-being at all measurement occasions in the majority of indicators analyzed. However, mean numbers of depressive symptoms were close to the cutoff point of clinical depression. Analyses of intra-individual correlations revealed high loadings of depressive symptoms, positive affect, and environmental mastery on a common factor. However, several well-being indicators were not substantially interrelated on the intra-individual level, suggesting their trajectories were rather independent of each other. Acceptance of death and dying was surprisingly high and even increased, whereas mean levels in fear of death were very low and declined over time. Overall, our findings do not suggest late-life dedifferentiation of well-being trajectories in very-old age. Our results rather support the need to consider indicators of hedonic and eudaimonic well-being, as well as mental distress, to understand the multifaceted and multidirectional dynamics of well-being in very-old age. (c) 2015 APA, all rights reserved).

  2. A quality-driven physician compensation model: four-year follow-up study.

    Science.gov (United States)

    Chung, Richard S; Chernicoff, Helen O; Nakao, Kimberly A; Nickel, Robert C; Legorreta, Antonio P

    2003-01-01

    This case report describes a qualitative and preliminary quantitative assessment of a quality-based physician compensation program. The Hawaii Medical Service Association's Physician Quality and Service Recognition program offers an innovative and effective approach for improving delivery of high-quality and cost-effective care to patients enrolled in preferred provider organizations. Support for the program is demonstrated through increasing numbers of voluntarily participating physicians. Preliminary assessment of population outcomes reveals sustained improvements in many clinical areas and mixed findings in others. This study contributes to the body of knowledge available to payers and policy makers considering alternative payment methods to reward improved performance.

  3. Cardiac Disease in Pregnancy - a four-year audit at Pretoria ...

    African Journals Online (AJOL)

    2002-2005). P Soma-Pillay, AP Macdonald, T Mathivha, J Bakker, M Mackintoch. Abstract. Background. Pre-existing medical disease constitutes one of the five major causes of maternal death in South Africa. Increasing numbers of women with ...

  4. Sexual Assault in Ballari, Karnataka, India: A Four Year Retrospective Review

    Directory of Open Access Journals (Sweden)

    Charan Kishor Shetty

    2017-12-01

    Full Text Available Sexual assault is both a common and a very serious crime which is investigated by the police with an intensity second only to that of murder. Despite India stiffening its laws on sexual crimes, nothing much has changed on the ground. This retrospective study was conducted on 86 cases of sexual assault received for examination at Vijayanagara Institute of medical sciences (VIMS, Ballari, Karnataka, during the year 2010 - 2013. This study revealed that most vulnerable age group were males aged 11-20 years, where most commonly sexual crimes were performed by the person familiar to the victim (33.72%.  The maximum numbers of victims were medico-legally examined on the second day (46.51% of the assault. Examinations as recent tear of hymen was noticed in 16.66% female victims, and restrain marks on the victims were present in 25 (29.06% cases. The study aims to enhance public awareness regarding sexual violence, as support the ground to the law enforcement authorities to implement strategies to prevent such cases in the future. Keywords: Forensic science; forensic pathology; sexual assault; hymen; anal intercourse.

  5. Beta-lactam resistance among Enterobacteriaceae in Cambodia: The four-year itch.

    Science.gov (United States)

    Caron, Yannick; Chheang, Rattanak; Puthea, Nop; Soda, Meng; Boyer, Sébastien; Tarantola, Arnaud; Kerléguer, Alexandra

    2018-01-01

    Although antibiotics are too often used inappropriately in Cambodia, published data on antimicrobial resistance in this country are scarce. Epidemic dissemination and the transfer of resistance genes to other bacterial species put the population at risk. The aim of this study was to evaluate the frequency and characteristics of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) isolated in consecutive samples tested at Institut Pasteur du Cambodge over a 4-year period (2012-2015). Antimicrobial susceptibility testing was performed by disk diffusion on agar technique and the results were read automatically using an OSIRIS system. The Etest was used to determine minimum inhibitory concentrations (MIC) for some resistance phenotypes. The strain most commonly identified was Escherichia coli (63.9%). The proportion of ESBL-E increased gradually over the study period, from 23.8% to 38.4%. ESBL was detected in 42.7% of the E. coli strains and 33.7% of all Klebsiella pneumoniae isolated. The proportion of ESBL-producing E. coli increased significantly from 28.9% in 2012 to 48.2% in 2015, while the increase for K. pneumoniae remained non-significant. Multidrug resistance was high in this Cambodian series, with some strains displaying resistance to all antibiotics available in the country. There is currently no established system for the surveillance of antimicrobial resistance in Cambodia. Collecting samples from clinical settings throughout the country is critical to assess the impact of antimicrobial drug use in patients in Cambodia and in the Mekong Region. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Online learning in dentistry: the changes in undergraduate perceptions and attitudes over a four year period.

    Science.gov (United States)

    Reynolds, P A; Rice, S; Uddin, M

    2007-10-13

    To assess the changing perceptions and attitudes of undergraduate dental students towards e-learning between 2001-2004. DESIGN, SAMPLE AND SETTING: This was a retrospective analysis of online questionnaire data, collected from four successive cohorts of final year students undertaking an online therapeutics course in a large teaching hospital. Students were required to complete a structured and open questionnaire relating to their perceived ICT skills, the course itself, and their perceptions of e-learning. Simple numeric qualitative and qualitative analyses were applied. Questionnaires were returned by 328 students (98% response rate). Students' perceptions of having advanced ICT skills increased from 5.5% to 14.5%, with home internet access rising from 62.3% to 89.1 % (2001-2004). There was an increase in: ease of access (25.3% to 47.3%), perception of time saving (17.9% to 37.4%), appreciation of combining traditional and e-learning methods (43.8% to 57.4%) and online tutor access (21.9% to 40.7%). Free comments supporting good e-learning experiences rose from 7.2% to 32.7% with poor remarks decreasing (3.1% to 1.9%). Students' perceptions of their ICT skills has increased, matched by better equipment and greater appreciation of e-learning. A shift towards preference of a blended approach of traditional and e-learning is evident.

  7. College and Changing Values: Two-Year and Four-Year Institutions.

    Science.gov (United States)

    Change, 1988

    1988-01-01

    Data from the "High School and Beyond" study sponsored by the Department of Education is examined, including student attitudes toward: career success, marriage, money, friendships, leadership, children, relocation, social inequalities, their professors, quality of instruction, work skills, intellectual development, counseling, college…

  8. Visual outcomes in treated bacterial keratitis: four years of prospective follow-up.

    Science.gov (United States)

    McClintic, Scott M; Prajna, Namperumalsamy V; Srinivasan, Muthiah; Mascarenhas, Jeena; Lalitha, Prajna; Rajaraman, Revathi; Oldenburg, Catherine E; O'Brien, Kieran S; Ray, Kathryn J; Acharya, Nisha R; Lietman, Thomas M; Keenan, Jeremy D

    2014-05-02

    We described the change in visual acuity experienced by eyes successfully treated for bacterial keratitis. This was a prospective cohort study of a subset of study participants who had previously enrolled in the Steroids for Corneal Ulcers Trial (SCUT). All study participants had been diagnosed with culture-proven bacterial keratitis before enrollment in SCUT and subsequently were randomized to adjunctive topical corticosteroids or placebo. During SCUT, we monitored study participants at enrollment, 3 weeks, 3 months, and 12 months. We invited a subset to complete a comprehensive eye examination approximately 4 years after enrollment in SCUT. Certified refractionists assessed best spectacle-corrected visual acuity (BSCVA) using the same protocol at each study visit. We examined 50 SCUT participants at 4 years after enrollment. Among those in this cohort, mean logMAR BSCVA at enrollment was 0.85 (Snellen equivalent, 20/160; 95% confidence interval [CI], 0.71-0.99). On average, visual acuity improved by 2.9 logMAR lines from enrollment to 3 weeks (P < 0.001), 1.2 lines from 3 weeks to 3 months (P = 0.002), and 0.8 lines from 3 to 12 months (P = 0.01). The BSCVA did not change significantly between 12 months and 4 years (0.04-line improvement, P = 0.88). After controlling for visual acuity at enrollment, BSCVA was not significantly different between the corticosteroid and placebo groups at 4 years (P = 0.53). Cases of bacterial keratitis may continue to demonstrate improvements in visual acuity up to 12 months following diagnosis, but further improvements are unlikely. These findings may guide the appropriate timing of surgical intervention in these patients. (ClinicalTrials.gov number, NCT00324168.).

  9. Different maturational changes of fast and slow sleep spindles in the first four years of life.

    Science.gov (United States)

    D'Atri, Aurora; Novelli, Luana; Ferrara, Michele; Bruni, Oliviero; De Gennaro, Luigi

    2018-02-01

    Massive changes in brain morphology and function in the first years of life reveal a postero-anterior trajectory of cortical maturation accompanied by regional modifications of NREM sleep. One of the most sensible marker of this maturation process is represented by electroencephalographic (EEG) activity within the frequency range of sleep spindles. However, direct evidence that these changes actually reflect maturational modifications of fast and slow spindles still lacks. Our study aimed at answering the following questions: 1. Do cortical changes at 11.50 Hz frequency correspond to slow spindles? 2. Do fast and slow spindles show different age trajectories and different topographical distributions? 3. Do changes in peak frequency explain age changes of slow and fast spindles? We measured the antero-posterior changes of slow and fast spindles in the first 60 min of nightly sleep of 39 infants and children (0-48 mo.). We found that (A) changes of slow spindles from birth to childhood mostly affect frontal areas (B) variations of fast and slow spindles across age groups go in opposite direction, the latter progressively increasing across ages; (C) this process is not merely reducible to changes of spindle frequency. As a main finding, our cross-sectional study shows that the first form of mature spindle (i.e., corresponding to the adult phasic event of NREM sleep) is marked by the emergence of slow spindles on anterior regions around the age of 12 months. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Phytomonitoring of chlorinated ethenes in trees: a four-year study of seasonal chemodynamics in planta.

    Science.gov (United States)

    Limmer, Matt A; Holmes, Amanda J; Burken, Joel G

    2014-09-16

    Long-term monitoring (LTM) of groundwater remedial projects is costly and time-consuming, particularly when using phytoremediation, a long-term remedial approach. The use of trees as sensors of groundwater contamination (i.e., phytoscreening) has been widely described, although the use of trees to provide long-term monitoring of such plumes (phytomonitoring) has been more limited due to unexplained variability of contaminant concentrations in trees. To assess this variability, we developed an in planta sampling method to obtain high-frequency measurements of chlorinated ethenes in oak (Quercus rubra) and baldcypress (Taxodium distichum) trees growing above a contaminated plume during a 4-year trial. The data set revealed that contaminant concentrations increased rapidly with transpiration in the spring and decreased in the fall, resulting in perchloroethene (PCE) and trichloroethene (TCE) sapwood concentrations an order of magnitude higher in late summer as compared to winter. Heartwood PCE and TCE concentrations were more buffered against seasonal effects. Rainfall events caused negligible dilution of contaminant concentrations in trees after precipitation events. Modeling evapotranspiration potential from meteorological data and comparing the modeled uptake and transport with the 4 years of high frequency data provides a foundation to advance the implementation of phytomonitoring and improved understanding of plant contaminant interactions.

  11. Driver hand-held cellular phone use: a four-year analysis.

    Science.gov (United States)

    Eby, David W; Vivoda, Jonathon M; St Louis, Renée M

    2006-01-01

    The use of hand-held cellular (mobile) phones while driving has stirred more debate, passion, and research than perhaps any other traffic safety issue in the past several years. There is ample research showing that the use of either hand-held or hands-free cellular phones can lead to unsafe driving patterns. Whether or not these performance deficits increase the risk of crash is difficult to establish, but recent studies are beginning to suggest that cellular phone use elevates crash risk. The purpose of this study was to assess changes in the rate of hand-held cellular phone use by motor-vehicle drivers on a statewide level in Michigan. This study presents the results of 13 statewide surveys of cellular phone use over a 4-year period. Hand-held cellular phone use data were collected through direct observation while vehicles were stopped at intersections and freeway exit ramps. Data were weighted to be representative of all drivers traveling during daylight hours in Michigan. The study found that driver hand-held cellular phone use has more than doubled between 2001 and 2005, from 2.7% to 5.8%. This change represents an average increase of 0.78 percentage points per year. The 5.8% use rate observed in 2005 means that at any given daylight hour, around 36,550 drivers were conversing on cellular phones while driving on Michigan roadways. The trend line fitted to these data predicts that by the year 2010, driver hand-held cellular phone use will be around 8.6%, or 55,000 drivers at any given daylight hour. These results make it clear that cellular phone use while driving will continue to be an important traffic safety issue, and highlight the importance of continued attempts to generate new ways of alleviating this potential hazard.

  12. A peer mentoring group for junior clinician educators: four years' experience.

    Science.gov (United States)

    Lord, Julie A; Mourtzanos, Emmanuel; McLaren, Kimberly; Murray, Suzanne B; Kimmel, Ryan J; Cowley, Deborah S

    2012-03-01

    To study the effect of a peer mentoring group (PMG). Six junior clinician educator faculty and one senior faculty at the University of Washington Medical Center's Department of Psychiatry formed a PMG in 2006. The PMG had 30 meetings during 2006-2010. Group format, goals, and meeting agendas were determined solely by participants. Feedback about positive and negative outcomes of participation in the PMG was determined by open-ended response to three sets of questions; qualitative analysis was performed by an outside research consultant. Program evaluation revealed benefits and undesirable or unintended outcomes. Reported benefits were increased workplace satisfaction; improved social connection; increased professional productivity and personal growth/development through accountability, collaboration, mutual learning, support, and information sharing; synergy, collaboration, and diversity of thought; increased involvement in professional activities; opportunity for peer discussions in a safe environment; and increased accountability and motivation. Undesirable or unintentional outcomes were exclusivity, lack of hierarchy, scheduling of meetings, absence of an intentional curriculum, diverse and competing interests, personal-professional enmeshment, and occasional loss of focus due to overemphasis on personal matters. Every member of the PMG was retained, and scholarly productivity increased, as did collaboration with other group members. Participants in this PMG experienced qualitative benefits and perceived advantages in career advancement and scholarly productivity. Negative consequences did not deter participation in the PMG or outweigh benefits. The self-sufficient and low-cost structure makes it particularly portable.

  13. Soil to plant transfer of 134Cs for olive and orange trees after four years' experimentation

    International Nuclear Information System (INIS)

    Skarlou, V.; Nobeli, C.; Anoussis, J.; Haidouti, C.

    1998-01-01

    The transfer parameters of 134 Cs from soil to tree crops (olive and orange trees) were calculated within a long-term glass-house pot experiment which was started in 1994. The effect of the soil characteristics on 134 Cs uptake was also studied using two soils with different physical and chemical properties. Both evergreen trees exhibited a similar behavior in the two soils, showing that a higher or lower uptake is not crop specific. The capacity of the trees for 134 Cs absorption through the roots seems to be significantly influenced by the soil type. The transfer factors were very low in the calcareous heavy soil and much higher in the acid light soil (up to 10 times for olives and 40 for the edible part of oranges). The difference in the TFs is higher between the two soils than between the two tree species. 134 Cs concentration kept increasing in the orange trees up to the 4th year of growth, while it seems to reach an equilibrium, with no further increase, in the olive trees. Although the behavior of the two tree species is similar, the difference in the final processed product is extreme. A significant amount of 134 Cs was observed in olives grown in the light-acid soil whereas no transfer to the olive oil was detected. On the other hand, the edible part of the oranges showed the highest 134 Cs of nearly all the plant parts

  14. From modernism to socialist realism in four years: Myaskovsky and Asafyev

    Directory of Open Access Journals (Sweden)

    Frolova-Walker Marina

    2003-01-01

    Full Text Available Two outstanding personalities of the Soviet musical life in the 1920's, the composer Nikolay Myaskovsky and the musicologist Boris Asafyev, both exponents of modernism, made volte-faces towards traditionalism at the beginning of the next decade. Myaskovsky's Symphony no. 12 (1931 and Asafyev's ballet The Flames of Paris (1932 became models for Socialist Realism in music. The letters exchanged between the two men testify to the formers uneasiness at the great success of those of his works he considered not valuable enough, whereas the latter was quite satisfied with his new career as composer. The examples of Myaskovsky and Asafyev show that early Soviet modernists made their move away from avant-garde creativity well before they faced any real danger from the bureaucracy.

  15. Twenty-four year record of Northern Hemisphere snow cover derived from passive microwave remote sensing

    Science.gov (United States)

    Armstrong, Richard L.; Brodzik, Mary Jo

    2003-04-01

    Snow cover is an important variable for climate and hydrologic models due to its effects on energy and moisture budgets. Seasonal snow can cover more than 50% of the Northern Hemisphere land surface during the winter resulting in snow cover being the land surface characteristic responsible for the largest annual and interannual differences in albedo. Passive microwave satellite remote sensing can augment measurements based on visible satellite data alone because of the ability to acquire data through most clouds or during darkness as well as to provide a measure of snow depth or water equivalent. It is now possible to monitor the global fluctuation of snow cover over a 24 year period using passive microwave data (Scanning Multichannel Microwave Radiometer (SMMR) 1978-1987 and Special Sensor Microwave/Imager (SSM/I), 1987-present). Evaluation of snow extent derived from passive microwave algorithms is presented through comparison with the NOAA Northern Hemisphere snow extent data. For the period 1978 to 2002, both passive microwave and visible data sets show a smiliar pattern of inter-annual variability, although the maximum snow extents derived from the microwave data are consistently less than those provided by the visible statellite data and the visible data typically show higher monthly variability. During shallow snow conditions of the early winter season microwave data consistently indicate less snow-covered area than the visible data. This underestimate of snow extent results from the fact that shallow snow cover (less than about 5.0 cm) does not provide a scattering signal of sufficient strength to be detected by the algorithms. As the snow cover continues to build during the months of January through March, as well as on into the melt season, agreement between the two data types continually improves. This occurs because as the snow becomes deeper and the layered structure more complex, the negative spectral gradient driving the passive microwave algorithm is enhanced. Trends in annual averages are similar, decreasing at rates of approximately 2% per decade. The only region where the passive microwave data consistently indicate snow and the visible data do not is over the Tibetan Plateau and surrounding mountain areas. In the effort to determine the accuracy of the microwave algorithm over this region we are acquiring surface snow observations through a collaborative study with CAREERI/Lanzhou. In order to provide an optimal snow cover product in the future, we are developing a procedure that blends snow extent maps derived from MODIS data with snow water equivalent maps derived from both SSM/I and AMSR.

  16. Integrating e-Learning and Classroom Learning; Four Years of Asynchronous Learning to Improve Academic Competences

    Directory of Open Access Journals (Sweden)

    Bart Rienties

    2008-06-01

    Full Text Available In an ever-changing world, competencies to process information efficiently are essential. However, several researchers indicate that graduates have limited abilities to solve complex problems in reality. In this paper, a possible solution to increase competences in effective searching, analysing and comparing information is provided. In a blended-learning environment, students had to share information before coming to class. The results of an analysis of four consecutive years of computersupported learning in a master-course indicate that students are willing to share information when conditions are favourable. In addition, a specific redesign of the task, control and social dimension let to increased knowledge sharing. Future research is necessary to assess whether this also has increased performance.

  17. Executive Functioning Predicts Academic Achievement in Middle School: A Four-Year Longitudinal Study

    Science.gov (United States)

    Samuels, William Ellery; Tournaki, Nelly; Blackman, Sheldon; Zilinski, Christopher

    2016-01-01

    Executive functioning (EF) is a strong predictor of children's and adolescents' academic performance. Although research indicates that EF can increase during childhood and adolescence, few studies have tracked the effect of EF on academic performance throughout the middle school grades. EF was measured at the end of Grades 6-9 through 21 teachers'…

  18. Four years prospective study of the maxillofacial trauma at a tertiary center in Western Nepal

    Directory of Open Access Journals (Sweden)

    Rajib Khadka

    2014-01-01

    Full Text Available Purpose: This study was conducted to find the epidemiological characteristics of maxillofacial trauma in the Western region of Nepal. Materials and Methods: All the trauma patients attending the Department of Oral and Maxillofacial surgery in 4 years period at a tertiary center in Western Nepal were included in the study. The incidence, prevalence, age and sex distribution, etiologies and types as well as seasonal and daily variation of maxillofacial trauma were studied. Results: Maxillofacial trauma with male (71.55% predominance was seen. Road traffic accidents (RTA, 46.5% were the most common cause, and 41.65% of fracture cases due to RTA were under the influence of alcohol. Accidents were more common on the rural roads (38.9%, and majorities (43.3% were due to motorcycle accidents. They were more common on Friday (36.7% and in winter seasons (51.2%. The mandible fractures (65.85% were more common than midface fractures (53.58% and 19.44% of the fractures were combined fractures. Parasymphysis in mandible (32.16% and zygoma (39.09% in midface were the most common type of fracture. Conclusion: The increased incidence of maxillofacial trauma following RTA under the influence of alcohol noted in this study reveals the need for formulating preventive measures in the Western region of Nepal. Need to aware people to avoid drink and drive proper traffic management, prevention of carrying excessive passengers, especially on the rooftop of vehicles on the highway and disposal of out of date vehicles and timely maintenance of faulty roads is a must.

  19. Flipping a Dental Anatomy Course: A Retrospective Study Over Four Years

    Directory of Open Access Journals (Sweden)

    Mahmoud M. Bakr

    2016-01-01

    Full Text Available Flipped classrooms have been successfully used to increase student engagement and support student learning in a range of educational fields, including health education. These advantages for student learning supported implementation of the flipped classroom in introductory sciences and preclinical courses in dental education. We report on a 4-year retrospective study which compared two methods of delivery of a first-year dental anatomy course. The first method used the traditional method, consisting of face to face contact teaching hours, which was compared to a partial flipped classroom, where lecture contact was maintained but practical classes were flipped. A series of online videos demonstrating different practical tasks such as wax carving and tooth identification. An online digital library and online quizzes for self-reflected learning were developed and trialled. Students’ Evaluations of Course (SEC and students’ overall performance in practical and theoretical assessments were used to evaluate the impact on student engagement and success, respectively, after implementation of the modified course offerings. This study evidences the success of the transition to a partially flipped course design. Careful design and consideration of implementation of the flipped classroom method in dental education are recommended to ensure that there is reliable availability of online resources and dedicated teaching staff for construction of resources and delivery of relevant in-class activities.

  20. Declining Academic Fields in U.S. Four-Year Colleges and Universities, 1970-2006

    Science.gov (United States)

    Brint, Steven; Proctor, Kristopher; Mulligan, Kerry; Rotondi, Matthew B.; Hanneman, Robert A.

    2012-01-01

    This research identifies 22 fields that declined in absolute numbers and/or prevalence over a 35-year period. Most were basic fields in the arts and sciences. Steep declines were evident only in a few fields, notably European languages and literatures. Larger, higher status, and historically liberal arts oriented institutions were less likely to…

  1. Risk of impaired glucose tolerance in normal weight hirsute women during four years observation

    DEFF Research Database (Denmark)

    Andries, Magdalene; Glintborg, Dorte; Andersen, Marianne

    2010-01-01

    Hirsutism is a common disorder affecting 5-20% of women in reproductive age. Only limited follow-up data exist regarding the prognosis for glucose tolerance and metabolic risk factors in hirsutism. Sixty-nine Caucasian hirsute women underwent a clinical examination and an oral glucose tolerance...... test (OGTT) during 1997-2002 (baseline) and during 2003-2004 (re-evaluation). The observation period was (median; range) 4 (2-7) years. During re-evaluation, body mass index (BMI) was 24.9 (22.4-29.0) kg/m(2) and total Ferriman-Gallwey score was 10 (7-15) (median; 25-75% quartile). The women had...... unchanged BMI compared to baseline but increased fasting and 2 hour glucose levels. Impaired OGTT outcome during follow-up was seen in 14/66 (21.2%) women, 5/66 (7.6%) developed diabetes. Women who took oral contraceptives had a significantly decreased area under the curve (AUC) for insulin during follow...

  2. A study on four-year college curriculum for the education of radiological technology in Korea

    International Nuclear Information System (INIS)

    Choi, Jong Hak; Lee, Sang Suk; Kim, Young Il; Kwon, Dal Gwan; Kim, Heung Tae; Lim, Han Young

    1995-01-01

    The education of radiologic technology began in the regular institute of higher education in Korea in 1963. Up to now from then, our education to bring up the radiologic technologists has developed greatly in quality and quantity, and now departments of radio-technology are founded in the 16 junior colleges in March, 1995. This study was done to verify the necessity and propriety to reform the education system of radiologic technology which was run as two or three year system of college curriculum for 32 years since 1963, and to search for the method to reform in the future. We got the following results from this research. 1. In the survey, on the desirable education year for radiologic technologists, 63.9 % of professors of department of radio-technology and 63.0 % of radiologic technologists chose the 4 year system, 27.9 % of professors and 34.6 % of radiologic technologists chose the 4 year system added to graduate school. 2. In the survey, on the future development of radiologic equipment and technique, 67.2 % of professors of department of radiologic technology and 86.4 % of radiologic technologists have a view of 'revolutional development'. Also, on the future tasks or roles

  3. Four years of training in family medicine: implications for residency redesign.

    Science.gov (United States)

    Sigmon, J Lewis; McPherson, Vanessa; Little, John M

    2012-09-01

    In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years. Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes. All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained. This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.

  4. Hypothyroid associated megaesophagus in dogs: four years (2009-2013 study in Hyderabad, India

    Directory of Open Access Journals (Sweden)

    Karlapudi Satish Kumar

    2015-06-01

    Full Text Available Megaoesophagus is uncommon but an important consideration for chronic regurgitation in dogs. Five dogs of various breeds were presented to the Teaching Veterinary Clinical Complex (TVCC at College of Veterinary Science, Hyderabad with signs of chronic regurgitation, loss of weight, lethargy, weakness, dehydration and abnormalities of skin, and hair coat were diagnosed for megaesophagus on barium meal contrast radiography. At the TVCC, radiography and gastroscopy were performed, and the condition was confirmed as megaesophagus. Ancillary hemato-biochemical evaluations revealed normocytic normochromic anemia and mild leukocytosis with normal enzymatic activity in liver and kidneys. The thyroid profile in 80% (n=4/5 dogs showed decreased T3 and T4, and elevated thyroid stimulating hormone (TSH levels confirming hypothyroidism. Ultrasonography of abdomen eliminated obstructions in the gastro-intestinal tract and other systemic conditions. Echocardiographic observations were normal in all the dogs. Treatment with metoclopramide (dosed at 5 mg/kg bwt and levothyroxine (dosed at 20 μg/kg bwt and modified management practices involving feeding and diets were successful in controlling the regurgitation in dogs and resulted in good clinical recovery within 20-30 days of post-treatment.

  5. Attempting to restore mountain big sagebrush (Artemisia tridentata ssp. vaseyana) four years after fire

    Science.gov (United States)

    Restoration of shrubs is increasingly needed throughout the world because of altered fire regimes, anthropogenic disturbance, and over-utilization. The native shrub mountain big sagebrush (Artemisia tridentata Nutt. ssp. vaseyana (Rydb.) Beetle) is a restoration priority in western North America be...

  6. Snowboarding injuries, a four-year study with comparison with alpine ski injuries.

    Science.gov (United States)

    Davidson, T M; Laliotis, A T

    1996-03-01

    Snowboarding is a rapidly growing winter sport. Its unorthodox maneuvers and young participants raise many safety concerns. We examined injury patterns in recreational snowboarders, comparing these patterns with those found in alpine skiers. Snowboarding and skiing injury patterns differed significantly (P knee (17% versus 39%) or thumb (2% versus 4%) injuries than skiers. For snowboarders, wrist injuries were most common in beginners (30%), knee injuries in low intermediates (28%), ankle injuries in intermediates (17%), and shoulder or clavicle injuries in advanced snowboarders (14%). Most snowboarders (90%) wore soft-shelled boots, 73% of lower extremity injuries occurred to the lead-foot side, and 73% of wrist injuries occurred during backward falls; 67% of knee injuries occurred during forward falls. Of all injuries, 8% occurred while loading onto or unloading from a ski lift. The sport of snowboarding brings with it a different set of injuries from those seen in alpine skiing. The data focus attention on improvements such as wrist guards or splints, releasable front-foot bindings, and better instruction for beginner snowboarders to improve the safety of this sport. Finally, the data confirm that snowboarders and skiers may be safely combined on the same slopes.

  7. Australian snowboard injury data base study. A four-year prospective study.

    Science.gov (United States)

    Bladin, C; Giddings, P; Robinson, M

    1993-01-01

    Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

  8. Pure Air`s Bailly scrubber: A four-year retrospective

    Energy Technology Data Exchange (ETDEWEB)

    Manavi, G.B.; Vymazal, D.C. [Pure Air, Allentown, PA (United States); Sarkus, T.A. [Dept. of Energy, Pittsburgh, PA (United States)

    1997-12-31

    Pure Air`s Advanced Flue Gas Desulfurization (AFGD) Clean Coal Project has completed four highly successful years of operation at NIPSCO`s Bailly Station. As part of their program, Pure Air has concluded a six-part study of system performance. This paper summarizes the results of the demonstration program, including AFGD performance on coals ranging from 2.0--2.4% sulfur. The paper highlights novel aspects of the Bailly facility, including pulverized limestone injection, air rotary sparger for oxidation, wastewater evaporation system and the production of PowerChip{reg_sign} gypsum. Operations and maintenance which have led to the facility`s notable 99.47% availability record are also discussed. A project company, Pure Air on the Lake Limited Partnership, owns the AFGD facility. Pure Air was the turn key contractor and Air Products and Chemicals, Inc. is the operator of the AFGD system.

  9. Enrollment Management Strategies at Four-Year Open Enrollment Institutions of Higher Education

    Science.gov (United States)

    Santoro, Dana S.

    2017-01-01

    Enrollment management plans have been researched and documented for the last fifty years and literature verifies that the use of these plans has only become more relevant in the 21st century. Strategies and activities for managing enrollment have been defined and shared for most types of institutions, however, there is limited research on the best…

  10. Premature Exfoliation of Deciduous Teeth in a Four-Year-Old Child with Hypophosphatemic Rickets

    OpenAIRE

    Chalbi M; Gharbi I; Jemmali B

    2017-01-01

    Background: Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Case Report: The following article presents a case report of a 4 year old Tunisian child, diagnosed with Hypophosphatemic rickets. Clinical features include growth ...

  11. Four-year prospective study of the respiratory effects of volcanic ash from Mt. St. Helens

    International Nuclear Information System (INIS)

    Buist, A.S.; Vollmer, W.M.; Johnson, L.R.; Bernstein, R.S.; McCamant, L.E.

    1986-01-01

    This report describes the 4-yr follow-up of 712 loggers exposed over an extended period to varying levels of fresh volcanic ash from the 1980 eruptions of Mt. St. Helens. Concerns related to the irritant effect the ash might have on the airways and also to its fibrogenic potential if exposures were intense and continued over many years. Our subjects were divided into 3 groups: high, low, and no exposure. Baseline testing was begun in June 1980, 1 month after the major eruption, and follow-up testing continued on an annual basis through 1984; 88% of the loggers have been tested at least 3 times. Analysis of lung function data showed that a significant, exposure-related decline in FEV1 occurred during the first year after the eruption. The decline was short-lived, however, and by 1984 the differences between exposure groups were no longer significant. Self-reported symptoms of cough, phlegm, and wheeze showed a similar pattern. No ash-related changes were seen in chest roentgenograms taken in 1980 and in 1984. Our findings are consistent with the hypothesis that the inhaled ash caused mucus hypersecretion and/or airway inflammation that reversed when the exposure levels decreased. The ash levels to which the loggers were exposed were low compared with permissible occupational levels for nuisance dusts, but generally higher than the total suspended particulate levels permissible in ambient air

  12. Radiation dose from food to man the first four years after Chernobyl

    International Nuclear Information System (INIS)

    Boee, E.; Strand, P.; Selnaes, T.D.

    1991-01-01

    In order to estimate the degree to which the Norwegian population was exposed to radiation as a consequence of the Chernobyl accident, four population groups were selected in 1987. Two groups encompassed individuals who were assumed to consume relatively large amounts of foods containing high levels of radionuclides. Two other groups included randomly selected people from two different districts. Two methods, dietary studies and whole-body measurements, were used to estimate the dose burden to which the participants had been exposed. The intake of radionuclides via food during the course of a year was estimated by dietary studies, while whole-body measurements were performed on people once a year to determine body reactivity levels. The annual dose was calculated on the basis of data gathered from the two types of study. The investigational period was March to May in 1987 to 1990. There was good correlation between doses estimated on the basis of dietary studies on the one hand and whole-body measurements on the other. Nevertheless, there was a two-fold difference in the size of the dose estimated by the two methods. The average annual radiocesium intake by the Norwegian population has been between 10000 and 25000 Bq, milk been the major source in the years following the accident. Dietary advice, together with agricultural decontamination measures, have resulted in considerable reduction in the level of exposure in the population. The study also demonstrated that changes in dietary habits have led to a dramatic dose reduction in the specially selected groups. 8 refs., 7 figs., 22 tabs

  13. Four years Follow-up of Patients with Irritable Bowel Syndrome.

    Science.gov (United States)

    Rusu, F; Dumitraşcu, D L

    2015-01-01

    There is little data on the long term evolution of patients with irritable bowel syndrome (IBS) and of associated conditions. We therefore studied the evolution of IBS patients in a single tertiary center during a long interval of time. We carried out a retrospective study based on the survey of patients records. We analyzed the records of symptoms, therapy, associated diseases, as consigned at follow-up visits for an interval of 4 years in average (2008-2011). A cohort of 114 patients with IBS diagnosed based on Rome III criteria were included (29 men and 85 women), age 19-85 years (mean age: 43.45 years). Urban patients were predominant. The main three symptoms were: abdominal pain, bowel disorders (constipation, diarrhea) and bloating. IBS--constipation (IBS--C) is associated with a favorable course of symptoms (increasing the number of stools, decrease intensity of abdominal pain and bloating) after treatment and IBS--diarrhea (IBS--D) is associated with variable symptoms after treatment (p = 0.031). Using trimebutin or mebeverin in association with other drugs for one month correlates with a favorable evolution of symptoms after treatment and monotherapy is associated with fluctuating symptoms ( pNSAI) or spasmolytics. The most common associated diseases observed in patients with IBS were: depression (27.19%), dyslipidemia (25.43%), hemorrhoidal disease (22.80%) and fibromyalgia (21%). The highest response rate was obtained with trimebutin or mebeverin + anxiolitics + probiotics. The most frequent disease associated with IBS was depression. Other diseases with a high incidence: dyslipidemia, hemorrhoidal disease and fibromyalgia. Further studies are needed to analyze the link between IBS and some associated diseases.

  14. Guiding Students from Matriculation to Graduation: Analysis of a Four Year Professional Development Program for Undergraduates

    Science.gov (United States)

    Maietta, Heather N.

    2009-01-01

    Career development is relevant for employees and employers, as well as a vital discipline for connecting school-to-work as educators struggle to facilitate the transition into employment for millions of students (Hoyt & Lester, 1995). The landscape of the world-of-work is ever changing, both in terms of economic stability and instability, and…

  15. Four Years of Farmer Experimentation on Soil Fertility in Tigray, Northern Ethiopia: Trends in Research Strategies

    Science.gov (United States)

    Kraaijvanger, Richard G.; Veldkamp, Tom

    2017-01-01

    Purpose: This paper analyses research strategies followed by farmer groups in Tigray, that were involved in participatory experimentation. Understanding choices made by farmers in such experimentation processes is important to understand reasons why farmers in Tigray often hesitated to adopt recommended practices. Design/Methodology/Approach: A…

  16. The Self-Efficacy Scale: A Construct Validity Study.

    Science.gov (United States)

    Sherer, Mark; Adams, Carol

    Self-efficacy is defined as the belief that one can successfully perform a behavior. Self-efficacy theory asserts that self-efficacy expectancies exert powerful influence on behavior and behavior change. The Self-efficacy Scale, which was developed to assess generalized self-efficacy expectations, consists of two subscales: general self-efficacy…

  17. Teachers’ work ability: a study of relationships between collective efficacy and self-efficacy beliefs

    Directory of Open Access Journals (Sweden)

    Guidetti G

    2018-05-01

    Full Text Available Gloria Guidetti,1 Sara Viotti,1 Andreina Bruno,2 Daniela Converso1 1Department of Psychology, University of Turin, Turin, Italy; 2Department of Education Science, University of Genoa, Genoa, Italy Introduction: Work ability constitutes one of the most studied well-being indicators related to work. Past research highlighted the relationship with work-related resources and demands, and personal resources. However, no studies highlight the role of collective and self-efficacy beliefs in sustaining work ability. Purpose: The purpose of this study was to examine whether and by which mechanism work ability is linked with individual and collective efficacies in a sample of primary and middle school teachers. Materials and methods: Using a dataset consisting of 415 primary and middle school Italian teachers, the analysis tested for the mediating role of self-efficacy between collective efficacy and work ability. Results: Mediational analysis highlights that teachers’ self-efficacy totally mediates the relationship between collective efficacy and perceived work ability. Conclusion: Results of this study enhance the theoretical knowledge and empirical evidence regarding the link between teachers’ collective efficacy and self-efficacy, giving further emphasis to the concept of collective efficacy in school contexts. Moreover, the results contribute to the study of well-being in the teaching profession, highlighting a process that sustains and promotes levels of work ability through both collective and personal resources. Keywords: collective efficacy, mediation, self-efficacy, teachers, work ability

  18. Prematurity and parental self-efficacy: the Preterm Parenting & Self-Efficacy Checklist.

    Science.gov (United States)

    Pennell, Claire; Whittingham, Koa; Boyd, Roslyn; Sanders, Matthew; Colditz, Paul

    2012-12-01

    There is a lack of research investigating parental self-efficacy in parents of infants born preterm as well as a paucity of parental self-efficacy measures that are domain-specific and theoretically grounded. This study aimed to compare parental self-efficacy in parents of infants born term, preterm and very preterm as well as to test whether parental self-efficacy mediates the relationship between psychological symptoms and parental competence. In order to achieve this, a new measure of parental self-efficacy and parental competence relevant for the preterm population and consistent with Bandura's (1977, 1986, 1989) conceptualisation of self-efficacy was developed. Participants included 155 parents, 83 of whom were parents of very preterm (GAparents of preterm (GAparents of term born infants. Parents completed the Preterm Parenting & Self-Efficacy Checklist (the new measure), Family Demographic Questionnaire, Depression Anxiety Stress Scale and Self-Efficacy Questionnaire. This initial study indicates that the Preterm Parenting & Self-Efficacy Checklist has adequate content validity, construct validity, internal consistency and split half reliability. Contrary to expectations, parents of very preterm infants did not report significantly lower overall levels of parental self-efficacy or significantly higher levels of psychological symptoms compared to parents of preterm and term infants. Parental self-efficacy about parenting tasks mediated the relationship between psychological symptoms and self perceived parental competence as predicted. Clinical implications of the results and suggestions for future research are discussed. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  19. At-Risk Boys' Social Self-Efficacy and Physical Activity Self-Efficacy in a Summer Sports Camp

    Science.gov (United States)

    Su, Xiaoxia; Xiang, Ping; McBride, Ron E.; Liu, Jiling; Thornton, Michael A.

    2016-01-01

    This study examined at-risk boys' social self-efficacy and physical activity self-efficacy within Bandura's self-efficacy framework. A total of 97 boys, aged between 10 and 13 years, attending a summer sports camp completed questionnaires assessing their social self-efficacy, physical activity self- efficacy, prosocial behaviors, and effort.…

  20. Political Efficacy and Participation of Nurse Practitioners.

    Science.gov (United States)

    O'Rourke, Nancy C; Crawford, Sybil L; Morris, Nancy S; Pulcini, Joyce

    2017-08-01

    Twenty-eight states have laws and regulations limiting the ability of nurse practitioners (NPs) to practice to the full extent of their education and training, thereby preventing patients from fully accessing NP services. Revisions to state laws and regulations require NPs to engage in the political process. Understanding the political engagement of NPs may facilitate the efforts of nurse leaders and nursing organizations to promote change in state rules and regulations. The purpose of this study was to describe the political efficacy and political participation of U.S. NPs and gain insight into factors associated with political interest and engagement. In the fall of 2015, we mailed a survey to 2,020 NPs randomly chosen from the American Academy of Nurse Practitioners' database and 632 responded (31% response rate). Participants completed the Trust in Government (external political efficacy) and the Political Efficacy (internal political efficacy) scales, and a demographic form. Overall, NPs have low political efficacy. Older age ( p≤.001), health policy mentoring ( p≤.001), and specific education on health policy ( p≤.001) were all positively associated with internal political efficacy and political participation. External political efficacy was not significantly associated with any of the study variables. Political activities of NPs are largely limited to voting and contacting legislators. Identifying factors that engage NPs in grassroots political activities and the broader political arena is warranted, particularly with current initiatives to make changes to state laws and regulations that limit their practice.

  1. An Analysis on the Effect of Computer Self-Efficacy over Scientific Research Self-Efficacy and Information Literacy Self-Efficacy

    Science.gov (United States)

    Tuncer, Murat

    2013-01-01

    Present research investigates reciprocal relations amidst computer self-efficacy, scientific research and information literacy self-efficacy. Research findings have demonstrated that according to standardized regression coefficients, computer self-efficacy has a positive effect on information literacy self-efficacy. Likewise it has been detected…

  2. Perceived Organisational Target Selling, Self- Efficacy, Sexual ...

    African Journals Online (AJOL)

    Open Access DOWNLOAD FULL TEXT ... Data were gathered using a self report questionnaire consisting of scales measuring variables in the study. Self efficacy, job insecurity, sexual harassment and target selling significantly jointly ...

  3. How specific is specific self-efficacy?

    DEFF Research Database (Denmark)

    Nielsen, Tine; Makransky, Guido; Vang, Maria Louison

    2017-01-01

    academic learning self-efficacy (SAL-SE) and specific academic exam self-efficacy (SAE-SE), each scale being measurement invariant relative to age, Gender, admission method and specific course targeted. Furthermore, significant and relevant differences between the SAL-SE and SAE-SE scores dependent......Self-efficacy is an important and much used construct in psychology and social science studies. The validity of the measurements used is not always sufficiently evaluated. The aim was to evaluate the psychometric properties of the Danish translation of the self-efficacy subscale of The Motivated...... Strategies for Learning Questionnaire (MSLQ-SE) within a higher education context. Rasch measurement models were employed focusing on measurement invariance and dimensionality. Results with one students sample showed the MSLQ-SE to be not one, but two separate unidimensional subscales, measuring specific...

  4. Concurrent Anticonvulsant/Ketogenic Diet Efficacy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-09-01

    Full Text Available Researchers at the Johns Hopkins Hospital, Baltimore, studied retrospectively the comparative efficacy of six most frequently used anticonvulsants when employed in combination with the ketogenic diet (KD for treatment of 115 children with epilepsy.

  5. Psychological Strategies in Managing Television Commercial Efficacy

    African Journals Online (AJOL)

    familiar versus novel), and information source (credible versus non-credible) as psychological strategies of managing television commercial efficacy. Subject's total score on recall of advert information, attitude to an advert, and intention to buy an ...

  6. Efficacy of long-term omalizumab therapy in patients with severe asthma.

    Science.gov (United States)

    Saji, Junko; Yamamoto, Takahito; Arai, Motonaka; Mineshita, Masamichi; Miyazawa, Teruomi

    2017-03-01

    The efficacy of omalizumab, an anti-immunoglobulin E (IgE) antibody, has been studied in patients with severe bronchial asthma. We conducted a study to evaluate, on the basis of both objective and subjective measures, the efficacy of omalizumab as a long-term therapy in patients with severe and persistent asthma. Omalizumab was administered subcutaneously every two or four weeks. The results of pulmonary function tests, Asthma Control Test (ACT) and Asthma Health Questionnaire (AHQ)-33 scores, the dosage of methylprednisolone during the 12-month treatment period, and the number of emergency visits prior to the start of treatment with omalizumab were compared in patients pre- and post-treatment with omalizumab. Fourteen patients were enrolled in the study between June 2010 and February 2012. Ten patients completed the study. With omalizumab treatment, there was no improvement in lung function; however, the number of emergency visits (19.3 before treatment vs. 1.2 after treatment, p=0.020) and the dosage of methylprednisolone (871.5mg before treatment vs. 119.0mg after treatment, p=0.046) decreased significantly. ACT and AHQ-33 scores at 16 weeks after treatment were significantly better than baseline scores. Four patients continued treatment with omalizumab for four years, and a reduction in their corticosteroid usage was noted. Long-term omalizumab therapy in our patients was found to significantly reduce corticosteroid usage and the number of emergency visits. Long-term omalizumab therapy was effective and might have potential to reduce the frequency of asthma exacerbations. The trial has not been registered because it is not an intervention study. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  7. Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Rhim, Hyun Chul; Kim, Eun Young; Kim, Young Sun; Choi, Dong Il; Lee, Won Jae; Lim, Hyo K.

    2009-01-01

    To assess the safety and therapeutic efficacy of a percutaneous radiofrequency (RF) ablation for the hepatocellular carcinoma (HCC) abutting the diaphragm. We retrospectively assessed 80 patients who underwent a percutaneous RF ablation for a single nodular (< 4 cm) HCC over the last four years. Each patient underwent an ultrasound-guided RF ablation using internally cooled electrodes for the first-line treatment. We divided patients into two subgroups based on whether the index tumor was abutting (less than 5 mm) the diaphragm or not: group A (abutting; n = 31) versus group B (non-abutting; n = 49). We compared the two subgroups for complications and therapeutic efficacy using image and the review of medical records. The statistical assessment included an independent t-test, Fisher's exact test, and chi-square test. The assessment of the diaphragmatic swelling at CT immediately following the procedure was more severe in group A than group B (mean thickness change:1.44 vs. 0.46 mm, p = 0.00). Further, right shoulder pain was more common in group A than B (p = 0.01). Although minor complications (hemothorax 1 case, pleural effusion 1 case) were noted only in group A, no major thoracic complication occurred in either group. The technical success rate was lower in group A than group B (84% vs. 98%, p = 0.03). As well, the primary and secondary technique effectiveness rates in group A and group B were 90% versus 98% (p = 0.29) and 79% versus 91% (p = 0.25), respectively. The local tumor progression rate was higher in group A than in group B (29% vs. 6%, p = 0.02). We found that the percutaneous RF ablation for the HCC abutting the diaphragm is a safe procedure without major complications. However, it is less effective with regard to technical success and local tumor control

  8. Multifaceted Impact of Self-Efficacy Beliefs on Academic Functioning.

    Science.gov (United States)

    Bandura, Albert; And Others

    1996-01-01

    Analyzed the psychosocial influences through which efficacy beliefs affect academic achievement. Found that parents' sense of academic efficacy and aspirations for their children, children's beliefs in their efficacy to regulate their own learning and academic attainments, children's perceived social efficacy and ability to manage peer pressure,…

  9. Development of a Physical Education Teaching Efficacy Scale

    Science.gov (United States)

    Humphries, Charlotte A.; Hebert, Edward; Daigle, Kay; Martin, Jeffrey

    2012-01-01

    Relationships have been found between teacher efficacy and many teaching and learning variables, but few researchers have examined teaching efficacy in physical education. The instrument reported here, the Physical Education Teaching Efficacy Scale, was developed based on the teaching efficacy literature, existing scales, and National Association…

  10. Examining Preservice Teachers' Culturally Responsive Teaching Self-Efficacy Doubts

    Science.gov (United States)

    Siwatu, Kamau Oginga; Chesnut, Steven Randall; Alejandro, Angela Ybarra; Young, Haeni Alecia

    2016-01-01

    This study was designed to add to the research on teachers' self-efficacy beliefs by examining preservice teachers' culturally responsive teaching self-efficacy doubts. We examined the tasks that preservice teachers felt least efficacious to successfully execute and explored the reasoning behind these self-efficacy doubts. Consequently, we were…

  11. THE CONCEPT OF LAW AND EFFICACY

    Directory of Open Access Journals (Sweden)

    Luka Burazin

    2017-12-01

    Full Text Available One of the senses of the term ‘efficacy’ refers to the fact that norm-addresses actually behave as is required of them by legal norms. This sense of the term is one which is generally used within the jurisprudential discussions about whether efficacy is the essential element of the concept of law. According to legal positivism, efficacy is in some cases and in certain ways the condition of legal validity of both legal norms and legal systems. On the other hand, legal realism tends to entirely identify legal validity or reduce it to efficacy. Thus, in both jurisprudential approaches, efficacy tends to play a role in shaping their respective concepts of law. However, while the legal positivistic view does not affect the most standard sense of legal validity of the legal norm (i.e. the legal norms’ membership in the legal system, and does not add much to the explanation of the concept of law by identifying efficacy as the criterion of legal systems’ existence, the legal realistic view is faced with some serious objections regarding its explanatory adequacy.

  12. Transformational School Leadership and Teacher Self-Efficacy as Predictors of Perceived Collective Teacher Efficacy

    Science.gov (United States)

    Ninkovic, Stefan R.; Kneževic Floric, Olivera C.

    2018-01-01

    Although scholars have acknowledged the role of collaborative relationships of teachers in improving the quality of instruction, teacher collective efficacy continues to be a neglected construct in educational research. The purpose of this paper is to explore the relations between transformational school leadership, teacher self-efficacy and…

  13. A Climate for Self-Efficacy: The Relationship between School Climate and Teacher Efficacy for Inclusion

    Science.gov (United States)

    Hosford, Susan; O'Sullivan, Siobhán

    2016-01-01

    Teacher efficacy represents a key construct in exploring successful implementation of inclusive policy. Teachers' impression of school climate is shown to relate to teacher efficacy; however, few studies pay due deference to its context/specific conceptualisation, with a particular lacuna in research noted in an Irish mainstream primary school…

  14. Measuring teachers’ interpersonal self-efficacy: relationship with realized interpersonal aspirations, classroom management efficacy and age

    NARCIS (Netherlands)

    Veldman, Ietje; Admiraal, Wilfried; Mainhard, Tim; Wubbels, Theo; Van Tartwijk, Jan

    2017-01-01

    In this study, we present the development and validation of an instrument for measuring teachers’ interpersonal self-efficacy: the Questionnaire on Teacher Interaction-Self-Efficacy (QTI-SE). We used the Questionnaire on Teacher Interaction as a basis to construct items. Current scales on teacher

  15. Field efficacy of acaricides against Varroa destructor.

    Directory of Open Access Journals (Sweden)

    María Jesús Gracia

    Full Text Available Field trials were conducted in Northeast Spain (Aragón to evaluate the effectiveness of two acaricides against Varroa destructor. These experiments took into account the season of the year, apiary, colony, and developmental state and strength of the colony. The acaricides used were a synthetic (amitraz, Apivar® and a natural (formulated from Api Life Var®, thymol oil and thymol alcohol product. The treatments used in the present study reduce high infestations of V. destructor, although they do not eliminate the infestation. Similar efficacies between treatments were found. Nevertheless, the efficacy of a treatment depends on the apiary where applied. Moreover, the detected variability in the apiary and hive poses a challenge to the identification of the significant factors. Therefore, more field studies to assess efficacies in several apiaries are needed to obtain a better understanding of the effects of the applied treatments.

  16. Women's perceptions of contraceptive efficacy and safety.

    Science.gov (United States)

    Kakaiya, Roshni; Lopez, Lia L; Nelson, Anita L

    2017-01-01

    Adoption of contraceptive implants and intrauterine devices has been less than might be expected given their superior efficacy and convenience. The purpose of this study was to assess knowledge and beliefs held by women, which may influence their contraceptive choices and theirongoing utilization of contraceptive methods. English speaking, nonpregnant, reproductive-age women, who were not surgically sterilized, were individually interviewed to obtain limited demographic characteristics and to assess their knowledge about the efficacy of various contraceptive methods in typical use and about the relative safety of oral contraceptives. A convenience sample of 500 women aged 18-45 years, with education levels that ranged from middle school to postdoctoral level was interviewed. The efficacy in typical use of both combined oral contraceptives and male condoms was correctly estimated by 2.2%; over two-thirds of women significantly over estimated the efficacy of each of those methods in typical use. Oral contraceptives were thought to be at least as hazardous to a woman's health as pregnancy by 56% of women. The majority of reproductive aged women surveyed substantially overestimated the efficacy of the two most popular contraceptive methods, often saying that they were 99% effective. Women with higher education levels were most likely to overestimate efficacy of oral contraceptives. Women of all ages and education levels significantly overestimated the health hazards of oral contraceptives compared to pregnancy. Overestimation of effectiveness of these methods of contraception, may contribute to lower adoption of implants and intrauterine devices. When individualizing patient counselling, misperceptions must be identified and addressed with women of all educational backgrounds. Not applicable.

  17. Efficacy of posaconazole in murine experimental sporotrichosis.

    Science.gov (United States)

    Fernández-Silva, Fabiola; Capilla, Javier; Mayayo, Emilio; Guarro, Josep

    2012-05-01

    We developed a murine model of systemic sporotrichosis by using three strains of each of the two commonest species causing sporotrichosis, i.e., Sporothrix schenckii sensu stricto and Sporothrix brasiliensis, in order to evaluate the efficacy of posaconazole (PSC). The drug was administered at a dose of 2.5 or 5 mg/kg of body weight twice a day by gavage, and one group was treated with amphotericin B (AMB) as a control treatment. Posaconazole, especially at 5 mg/kg, showed good efficacy against all the strains tested, regardless of their MICs, as measured by prolonged survival, tissue burden reduction, and histopathology.

  18. Self-Efficacy and green entrepreneurship

    International Nuclear Information System (INIS)

    Tan, K L; Suhaida, S; Leong, Y P

    2013-01-01

    The objective of this study is to investigate empirically the extent to which self-efficacy contributes to the development of green entrepreneurial intention. The measurement constructs of self-efficacy were classified into market opportunities, innovative environment, initiating relationships, defining purpose, coping with challenges, and developing human resources. The study comprises 252 usable convenient samples through structured questionnaires. The coefficient of determination R 2 shows that the variance of intention to entrepreneurship is explained by the variance of the independent variables. It was also found that the model is fit for prediction.

  19. Self-Efficacy and green entrepreneurship

    Science.gov (United States)

    Tan, K. L.; Suhaida, S.; Leong, Y. P.

    2013-06-01

    The objective of this study is to investigate empirically the extent to which self-efficacy contributes to the development of green entrepreneurial intention. The measurement constructs of self-efficacy were classified into market opportunities, innovative environment, initiating relationships, defining purpose, coping with challenges, and developing human resources. The study comprises 252 usable convenient samples through structured questionnaires. The coefficient of determination R2 shows that the variance of intention to entrepreneurship is explained by the variance of the independent variables. It was also found that the model is fit for prediction.

  20. Hidden consequences of political efficacy: Testing an efficacy-apathy model of political mobilization.

    Science.gov (United States)

    Osborne, Danny; Yogeeswaran, Kumar; Sibley, Chris G

    2015-10-01

    Political efficacy-the belief that one can influence politics-is a key predictor of people's involvement in social movements. Political institutions that are open to change should, however, be seen as just. Thus, political efficacy may ironically undermine minority group members' support for collective action by simultaneously increasing their belief in the fairness of the system. The current study aims to examine this possibility in a national sample of Māori-New Zealand's indigenous minority population. Participants (N = 399) were Māori (Mage = 44.22; SD = 13.30) women (n = 272) and men (n = 115; unreported = 12) who completed a survey assessing their levels of (a) political efficacy, (b) system justification, and (c) support for the political mobilization of their group, as well as relevant demographic covariates. Consistent with past research, political efficacy had a positive direct effect on participants' support for the political mobilization of Māori. Nevertheless, political efficacy also had a negative indirect effect on political mobilization support via increases in system justification. These results held after controlling for participants' ethnic identification, self-efficacy, and conservatism. Our findings uncover a hidden consequence of political efficacy and show that, while believing that the political system is receptive to change predicts political mobilization, it can also undermine minorities' support for the mobilization of their group. Thus, our results uncover a previously unknown process that maintains inequality between ethnic minority and majority group members. (c) 2015 APA, all rights reserved).

  1. 24-h Efficacy of Glaucoma Treatment Options.

    Science.gov (United States)

    Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

    2016-04-01

    Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

  2. Comparative Efficacy Of Topical Ciprofloxacin On Staphylococcus ...

    African Journals Online (AJOL)

    Ciprofloxacinis often considered drug of first choice in the treatment of bacterial keratitis.Most of the ocular infections are caused by Staphylococcus aureus and Pseudomonas aeruginosa. This study set to compare the efficacy of ciprofloxacin on these two microorganisms in vitro. The “agar well diffusion” and the 10-fold ...

  3. Efficacy of secondary isoniazid preventive therapy among ...

    African Journals Online (AJOL)

    Objective. To determine the efficacy of secondary preventive therapy against tuberculosis (TB) among goldminers working in South Africa. Design. An observational study. Methods. The incidence of recurrent TB was compared between two cohorts of HIV-infected miners: one cohort had received secondary preventive ...

  4. Leadership, Self-Efficacy, and Student Achievement

    Science.gov (United States)

    Grayson, Kristin

    2013-01-01

    This study examined the relationships between teacher leadership, science teacher self-efficacy, and fifth-grade science student achievement in diverse schools in a San Antonio, Texas, metropolitan school district. Teachers completed a modified version of the "Leadership Behavior Description Question" (LBDQ) Form XII by Stogdill (1969),…

  5. Comparative Efficacy of Albenzazole, Levamisole, Rafoxanide and ...

    African Journals Online (AJOL)

    A study of the efficacy of 4 antihelmintics was carried out using a faecal egg count reduction test (FECRT) in 105 goats on breeding farm at Ol'Magogo, Naivasha, Kenya. The goats were randomly assigned to 7 groups; received 5.0 mg kg body weight albendazole (ABZ), 15 mg kg levamisole (LEV) 15 mg kg rafoxanide ...

  6. Efficacy of Polytechnic Students' Interpersonal Communication Skills

    Science.gov (United States)

    Zainuddin, Zaharatul Akmar Ahmad; Selamat, Suzanah

    2012-01-01

    Every year polytechnics in Malaysia produce thousands of graduates in vocational areas, however, these graduates have to strive in a competitive job market against graduates from other tertiary institutions. This study aims to investigate polytechnic students efficacy on their communication skills. These skills are crucial in determining their…

  7. Evaluating Ritual Efficacy: Evidence from the Supernatural

    Science.gov (United States)

    Legare, Cristine H.; Souza, Andre L.

    2012-01-01

    Rituals pose a cognitive paradox: although widely used to treat problems, rituals are causally opaque (i.e., they lack a causal explanation for their effects). How is the efficacy of ritual action evaluated in the absence of causal information? To examine this question using ecologically valid content, three studies (N=162) were conducted in…

  8. COMPARATIVE EFFICACY OF Acorus calamus POWDER AND ...

    African Journals Online (AJOL)

    The efficacy of the powder of a natural plant product (Acorus calamus L.) and two synthetic insecticides (i.e. Pirimiphos methyl and Rotenone) was compared in the laboratory for the control Sitophilus oryzea (L), Rhizopertha dominica (F) and Tribolium castaneum (Herbst) in stored wheat grains. Seven concentrations of the ...

  9. Efficacy of Computer Games on Language Learning

    Science.gov (United States)

    Klimova, Blanka; Kacet, Jaroslav

    2017-01-01

    Information and communication technologies (ICT) have become an inseparable part of people's lives. For children the use of ICT is as natural as breathing and therefore they find the use of ICT in school education as normal as the use of textbooks. The purpose of this review study is to explore the efficacy of computer games on language learning…

  10. Promoting Efficacy Research on Functional Analytic Psychotherapy

    Science.gov (United States)

    Maitland, Daniel W. M.; Gaynor, Scott T.

    2012-01-01

    Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change,…

  11. Career Self Efficacy, Achievement Motivation and Organizational ...

    African Journals Online (AJOL)

    Career self efficacy, achievement motivation and organizational commitments are considered as predictors of lecturers‟ conflict preventive behaviours in tertiary institutions in Oyo town. 300 lecturers (149 male and 151 female) of the four tertiary institutions were randomly sampled. What is the relative contributions of each ...

  12. Self-Efficacy and Academic Listening

    Science.gov (United States)

    Graham, Suzanne

    2011-01-01

    This paper takes as its starting point the difficulties inherent in listening in a second language. It argues that self-efficacy, broadly defined as the belief in one's ability to carry out specific tasks successfully, is crucial to the development of effective listening skills, and that listening strategy instruction has the potential to boost…

  13. Mediated-Efficacy: Hope for "Helpless" Writers

    Science.gov (United States)

    Camfield, Eileen Kogl

    2016-01-01

    Building on previous studies of college students' writing self-efficacy beliefs, this article presents the empirical foundation for a reconceptualized understanding of this identity process. The study assessed 131 college freshmen enrolled in a developmental writing course who were evaluated holistically using grounded theory methodology. The…

  14. Estimating the efficacy of medical abortion.

    Science.gov (United States)

    Trussell, J; Ellertson, C

    1999-09-01

    Comparisons of the efficacy of different regimens of medical abortion are difficult because of the widely varying protocols (even for testing identical regimens), divergent definitions of success and failure, and lack of a standard method of analysis. In this article we review the current efficacy literature on medical abortion, highlighting some of the most important differences in the way that efficacy has been analyzed. We then propose a standard conceptual approach and the accompanying statistical methods for analyzing clinical trials of medical abortion and to explain how clinical investigators can implement this approach. Our review reveals that research on the efficacy of medical abortion has closely followed the conceptual model used for analysis of surgical abortion. The problem, however, is that, whereas surgical abortion is a discrete event occurring in the space of a few minutes or less, medical abortion is a process typically lasting from several days to several weeks. In this process, two events may occur that are not possible with surgical abortion. First, the woman can opt out of the process before a fair determination of efficacy can be made. Second, the process of medical abortion allows time for surgical interventions that may be convenient for the clinician but not strictly necessary from a medical perspective. Another difference from surgical abortions is that, for medical abortions, different medical abortion protocols specify different waiting periods, giving the drugs less time to work in some studies than in others before a determination of efficacy is made. We argue that, when analyzing efficacy of medical abortion, researchers should abandon their close reliance on the analogy to surgical abortion. In fact, medical abortion is more appropriately analyzed by life table procedures developed for the study of another fertility regulation technology; contraception. As with medical abortion, a woman initiating use of a contraceptive method can

  15. Proposed Sources of Coaching Efficacy: A Meta-Analysis.

    Science.gov (United States)

    Myers, Nicholas D; Park, Sung Eun; Ahn, Soyeon; Lee, Seungmin; Sullivan, Philip J; Feltz, Deborah L

    2017-08-01

    Coaching efficacy refers to the extent to which a coach believes that he or she has the capacity to affect the learning and performance of his or her athletes. The purpose of the current study was to empirically synthesize findings across the extant literature to estimate relationships between the proposed sources of coaching efficacy and each of the dimensions of coaching efficacy. A literature search yielded 20 studies and 278 effect size estimates that met the inclusion criteria. The overall relationship between the proposed sources of coaching efficacy and each dimension of coaching efficacy was positive and ranged from small to medium in size. Coach gender and level coached moderated the overall relationship between the proposed sources of coaching efficacy and each of the dimensions of coaching efficacy. Results from this meta-analysis provided some evidence for both the utility of, and possible revisions to, the conceptual model of coaching efficacy.

  16. relationship between self-efficacy and academic achievement

    African Journals Online (AJOL)

    Preferred Customer

    Many studies have been conducted on self-efficacy and academic achievement but ... efficacy beliefs affect how people approach new challenges and will contribute to ..... In addition, three psychology instructors critically assessed and ...

  17. Self-efficacy and parental motivation as correlates ofstudends ...

    African Journals Online (AJOL)

    Self-efficacy and parental motivation as correlates ofstudends' academic ... and academic performance of secondary school students in attaining academic ... and improve their self-efficacy and to motivate parents to provide more support, care ...

  18. Efficacy of Curcuma for Treatment of Osteoarthritis.

    Science.gov (United States)

    Perkins, Kimberly; Sahy, William; Beckett, Robert D

    2017-01-01

    The objective of this review is to identify, summarize, and evaluate clinical trials to determine the efficacy of curcuma in the treatment of osteoarthritis. A literature search for interventional studies assessing efficacy of curcuma was performed, resulting in 8 clinical trials. Studies have investigated the effect of curcuma on pain, stiffness, and functionality in patients with knee osteoarthritis. Curcuma-containing products consistently demonstrated statistically significant improvement in osteoarthritis-related endpoints compared with placebo, with one exception. When compared with active control, curcuma-containing products were similar to nonsteroidal anti-inflammatory drugs, and potentially to glucosamine. While statistical significant differences in outcomes were reported in a majority of studies, the small magnitude of effect and presence of major study limitations hinder application of these results. Further rigorous studies are needed prior to recommending curcuma as an effective alternative therapy for knee osteoarthritis. © The Author(s) 2016.

  19. White LEDs with limit luminous efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Lisitsyn, V. M.; Stepanov, S. A., E-mail: stepanovsa@tpu.ru; Yangyang, Ju [National Research Tomsk Polytechnic University, 30 Lenin Av., Tomsk, 634050 (Russian Federation); Lukash, V. S. [JSC Research Institute of Semiconductor Devices, 99a Krasnoarmeyskaja St., Tomsk, 634050 (Russian Federation)

    2016-01-15

    In most promising widespread gallium nitride based LEDs emission is generated in the blue spectral region with a maximum at about 450 nm which is converted to visible light with the desired spectrum by means of phosphor. The thermal energy in the conversion is determined by the difference in the energies of excitation and emission quanta and the phosphor quantum yield. Heat losses manifest themselves as decrease in the luminous efficacy. LED heating significantly reduces its efficiency and life. In addition, while heating, the emission generation output and the efficiency of the emission conversion decrease. Therefore, the reduction of the energy losses caused by heating is crucial for LED development. In this paper, heat losses in phosphor-converted LEDs (hereinafter chips) during spectrum conversion are estimated. The limit values of the luminous efficacy for white LEDs are evaluated.

  20. Efficacy of ALK5 inhibition in myelofibrosis

    OpenAIRE

    Yue, Lanzhu; Bartenstein, Matthias; Zhao, Wanke; Ho, Wanting Tina; Han, Ying; Murdun, Cem; Mailloux, Adam W.; Zhang, Ling; Wang, Xuefeng; Budhathoki, Anjali; Pradhan, Kith; Rapaport, Franck; Wang, Huaquan; Shao, Zonghong; Ren, Xiubao

    2017-01-01

    Myelofibrosis (MF) is a bone marrow disorder characterized by clonal myeloproliferation, aberrant cytokine production, extramedullary hematopoiesis, and bone marrow fibrosis. Although somatic mutations in JAK2, MPL, and CALR have been identified in the pathogenesis of these diseases, inhibitors of the Jak2 pathway have not demonstrated efficacy in ameliorating MF in patients. TGF-? family members are profibrotic cytokines and we observed significant TGF-?1 isoform overexpression in a large co...

  1. Perceived collective teacher efficacy in low performing schools

    African Journals Online (AJOL)

    Education Management and Leadership, School for Professional Studies in ... enhance collective teacher efficacy, the challenge of low-performing schools ... Collective teacher efficacy, therefore, involves the combined perceptions of ... because greater efficacy leads to greater effort and ... One of the strategies for sharing.

  2. Motivational Partnerships: Increasing ESL Student Self-Efficacy

    Science.gov (United States)

    Cave, Paul N.; Evans, Norman W.; Dewey, Dan P.; Hartshorn, K. James

    2018-01-01

    The present study investigated the relationship between student use of self-efficacy-building strategies through motivational partnerships and student levels of self-efficacy and motivation in an adult intensive English programme in the United States. The extent to which self-efficacy influenced motivation was also examined. After being organized…

  3. Using Video Feedback to Measure Self-Efficacy

    Science.gov (United States)

    Bobo, Linda; Andrews, Amanda

    2010-01-01

    When a student has a high sense of self-efficacy, foreseeing success and providing positive guides and supports for performing the skill will usually occur. A low self-efficacy tends to predict failure and anticipation of what could go wrong. Videotape feedback provided to students has reported favorable outcomes. Self-efficacy could alter…

  4. Examining Dimensions of Self-Efficacy for Writing

    Science.gov (United States)

    Bruning, Roger; Dempsey, Michael; Kauffman, Douglas F.; McKim, Courtney; Zumbrunn, Sharon

    2013-01-01

    A multifactor perspective on writing self-efficacy was examined in 2 studies. Three factors were proposed--self-efficacy for writing ideation, writing conventions, and writing self-regulation--and a scale constructed to reflect these factors. In Study 1, middle school students (N = 697) completed the Self-Efficacy for Writing Scale (SEWS), along…

  5. Teacher Self-Efficacy According to Turkish Cypriot Science Teachers

    Science.gov (United States)

    Olmez, Cemil; Ozbas, Serap

    2017-01-01

    This study examined the self-efficacy of Turkish Cypriot science teachers working at high schools in Northern Cyprus. The study sample was 200 science teachers who participated in the survey. The Teacher Self-Efficacy (TSE) Scale was used as a data source. It was observed that the science teachers' efficacy beliefs about student engagement in…

  6. Efficacy of aspiration in amebic liver abscess.

    Science.gov (United States)

    Ghosh, Jayant Kumar; Goyal, Sundeep Kumar; Behera, Manas Kumar; Tripathi, Manish Kumar; Dixit, Vinod Kumar; Jain, Ashok Kumar; Shukla, Ramchandra

    2015-01-01

    Amebic liver abscess (ALA) is a common and serious problem in our country. There are only a few controlled trials on the efficacy and advantages of combination therapy with percutaneous needle aspiration and pharmacotherapy, over pharmacotherapy alone for amebic liver abscess. This study was conducted to compare the efficacy of two different treatment modalities i.e. drug treatment alone vs. drug treatment and aspiration of abscess cavity in patients with small (up to 5 cm) and large (5 cm to 10 cm) size ALA. This is one of the largest single center, prospective, randomized studies comparing the efficacy of aspiration in ALA. (i) Mean body temperature, liver tenderness, total leukocyte count (TLC), serum alanine aminotransferase (ALT) and liver span were significantly decreased in the aspiration group on days 8 and 15 as compared to non-aspiration group especially in large abscess (5 cm to 10 cm). (ii) Abscess cavity maximum diameter decreased significantly in aspiration group on days 8 and 15, and 1 month & 3 months in large abscess (5cm to 10 cm). (i) Needle aspiration along with metronidazole hastens clinical improvement especially in large (5 cm up to 10 cm) cavities in patients with ALA. (ii) Aspiration is safe and no major complications occurred. (iii) Hence, combination therapy should be the first choice especially in large ALA (5 cm to 10 cm).

  7. Evaluating ritual efficacy: evidence from the supernatural.

    Science.gov (United States)

    Legare, Cristine H; Souza, André L

    2012-07-01

    Rituals pose a cognitive paradox: although widely used to treat problems, rituals are causally opaque (i.e., they lack a causal explanation for their effects). How is the efficacy of ritual action evaluated in the absence of causal information? To examine this question using ecologically valid content, three studies (N=162) were conducted in Brazil, a cultural context in which rituals called simpatias are used to treat a great variety of problems ranging from asthma to infidelity. Using content from existing simpatias, experimental simpatias were designed to manipulate the kinds of information that influences perceptions of efficacy. A fourth study (N=68) with identical stimuli was conducted with a US sample to assess the generalizability of the findings across two different cultural contexts. The results provide evidence that information reflecting intuitive causal principles (i.e., repetition of procedures, number of procedural steps) and transcendental influence (i.e., presence of religious icons) affects how people evaluate ritual efficacy. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Efficacy of REACH Forgiveness across cultures.

    Science.gov (United States)

    Lin, Yin; Worthington, Everett L; Griffin, Brandon J; Greer, Chelsea L; Opare-Henaku, Annabella; Lavelock, Caroline R; Hook, Joshua N; Ho, Man Yee; Muller, Holly

    2014-09-01

    This study investigates the efficacy of the 6-hour REACH Forgiveness intervention among culturally diverse undergraduates. Female undergraduates (N = 102) and foreign extraction (46.2%) and domestic (43.8%) students in the United States were randomly assigned to immediate treatment or waitlist conditions. Treatment efficacy and the effect of culture on treatment response were assessed using measures of emotional and decisional forgiveness across 3 time periods. Students in the treatment condition reported greater improvement in emotional forgiveness, but not decisional forgiveness, relative to those in the waitlist condition. Gains were maintained at a 1-week follow-up. Although culture did not moderate the effect of treatment, a main effect of culture on emotional forgiveness and marginally significant interaction effect of culture on decisional forgiveness were found. The REACH Forgiveness intervention was efficacious for college students from different cultural backgrounds when conducted in the United States. However, some evidence may warrant development of culturally adapted forgiveness interventions. © 2014 Wiley Periodicals, Inc.

  9. Leading by Example: A Case Study of the Influence of Principal Self-Efficacy on Collective Efficacy

    Science.gov (United States)

    Versland, Tena M.; Erickson, Joanne L.

    2017-01-01

    Self-efficacy is a perceived judgment that one has the ability to execute a course of action that brings about a desired result. Principal self-efficacy describes a set of beliefs that enable a principal to enact policies and procedures that promote the effectiveness of a school. Principal self-efficacy beliefs are also important because they…

  10. Prior Self-Efficacy Interacts with Experiential Valence to Influence Self-Efficacy among Engineering Students: An Experimental Study

    Science.gov (United States)

    Chang, Yevvon Yi-Chi; Chiou, Wen-Bin

    2017-01-01

    Self-efficacy toward science learning has been shown to play a crucial role in determining students' motivation and achievements. Social cognitive theory proposes that positive and negative task outcomes affect mastery experiences from which self-efficacy develops. The current research examined whether prior level of self-efficacy would serve as a…

  11. The knowledge, efficacy, and practices instrument for oral health providers: a validity study with dental students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Garvan, Cyndi W; Moore, Thomas E; Catalanotto, Frank A

    2013-08-01

    have reasonable internal consistency reliability to warrant its use for baseline and repeated measures in assessing changes in dental students' growth in cultural competence across four-year dental curricula.

  12. Information Updating in Working Memory: Its Effect on Teacher Efficacy

    Directory of Open Access Journals (Sweden)

    Jun Tao

    2012-01-01

    Full Text Available Teacher efficacy has a great impact on effective teaching and has been studied in various perspectives. The updating information ability in working memory is always related with many capabilities of cognition. An experiment of N-back task and a questionnaire of teacher efficacy were conducted in this study to test the effect of the ability of information updating in working memory on the teacher efficacy. A significant difference was found in the reaction time between high teacher efficacy group and low teacher efficacy group. The results showed that teachers who scored higher in the teacher efficacy scale tended to react faster than those who scored lower based on the same accuracy. And the updating information ability could serve as a predictor of teacher efficacy.

  13. Design and statistical considerations for studies evaluating the efficacy of a single dose of the human papillomavirus (HPV) vaccine.

    Science.gov (United States)

    Sampson, Joshua N; Hildesheim, Allan; Herrero, Rolando; Gonzalez, Paula; Kreimer, Aimee R; Gail, Mitchell H

    2018-05-01

    Cervical cancer is a leading cause of cancer mortality in women worldwide. Human papillomavirus (HPV) types 16 and 18 cause about 70% of all cervical cancers. Clinical trials have demonstrated that three doses of either commercially available HPV vaccine, Cervarix ® or Gardasil ®, prevent most new HPV 16/18 infections and associated precancerous lesions. Based on evidence of immunological non-inferiority, 2-dose regimens have been licensed for adolescents in the United States, European Union, and elsewhere. However, if a single dose were effective, vaccine costs would be reduced substantially and the logistics of vaccination would be greatly simplified, enabling vaccination programs in developing countries. The National Cancer Institute (NCI) and the Agencia Costarricense de Investigaciones Biomédicas (ACIB) are conducting, with support from the Bill & Melinda Gates Foundation and the International Agency for Research on Cancer (IARC), a large 24,000 girl study to evaluate the efficacy of a 1-dose regimen. The first component of the study is a four-year non-inferiority trial comparing 1- to 2-dose regimens of the two licensed vaccines. The second component is an observational study that estimates the vaccine efficacy (VE) of each regimen by comparing the HPV infection rates in the trial arms to those in a contemporaneous survey group of unvaccinated girls. In this paper, we describe the design and statistical analysis for this study. We explain the advantage of defining non-inferiority on the absolute risk scale when the expected event rate is near 0 and, given this definition, suggest an approach to account for missing clinic visits. We then describe the problem of estimating VE in the absence of a randomized placebo arm and offer our solution. Copyright © 2018. Published by Elsevier Inc.

  14. Engineering Professional Development: Elementary Teachers' Self-efficacy and Sources of Self-efficacy

    Science.gov (United States)

    Webb, Donna Louise

    Currently, STEM (science, technology, engineering, and mathematics) is a popular buzz word in P-12 education as it represents a means to advance American competitiveness in the global economy. Proponents of the engineering component of STEM advocate additional benefits in teaching engineering, such as its capacity to engage students in collaboration, and to apply critical thinking, systems thinking, negotiation, and communication skills to solve real-life contextual problems. Establishing a strong foundation of engineering knowledge at a young age will provide students with internal motivation as it taps into their curiosity toward how things work, and it also prepares them for secondary science courses. Successful STEM education is often constrained by elementary teachers' low perception of self-efficacy to teach science and engineering. Elementary teachers with low self-efficacy in science are more likely to spend less instructional time teaching science, which suggests that teachers with little to no training in engineering might avoid teaching this topic. Therefore, the purpose of this study was twofold: (a) to examine the effects of engineering professional development on elementary (K-6) teachers' content and pedagogical content knowledge (PCK) and perceptions of self-efficacy to teach engineering, and (b) to identify and explain sources influencing self-efficacy. Professional development was conducted in a metropolitan area in the Pacific Northwest. Results revealed that after the engineering professional development, teachers experienced statistically significant gains in content, PCK, and self-efficacy to teach engineering. Increases in self-efficacy were mainly attributed to mastery experiences and cultivation of a growth mindset by embracing the engineering design process.

  15. Chief Joseph Kokanee Enhancement Project; Strobe Light Deterrent Efficacy Test and Fish Behavior Determination at the Grand Coulee Dam Third Powerplant Forebay, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.; McKinstry, C.; Cook, C. [Pacific Northwest National Laboratory

    2005-02-01

    This report documents a four-year study(a) to assess the efficacy of a prototype strobe light system to elicit a negative phototactic response in kokanee (Oncorhynchus nerka kennerlyi) and rainbow trout (O. mykiss) at the entrance to the forebay of the third powerplant at Grand Coulee Dam. The work was conducted for the Bonneville Power Administration, U.S. Department of Energy, by Pacific Northwest National Laboratory (PNNL) in conjunction with the Confederated Tribes of the Colville Reservation (Colville Confederated Tribes). In this report, emphasis is placed on the methodology and results associated with the fourth project year and compared with findings from the previous years to provide an overall project summary. Since 1995, the Colville Confederated Tribes have managed the Chief Joseph Kokanee Enhancement Project as part of the Northwest Power and Conservation Council Fish and Wildlife Program. Project objectives have focused on understanding natural production of kokanee (a land-locked sockeye salmon) and other fish stocks in the area above Grand Coulee and Chief Joseph dams on the Columbia River (Figure S.1). A 42-month investigation from 1996 to 1999 determined that from 211,685 to 576,676 fish, including kokanee and rainbow trout, were entrained annually at Grand Coulee Dam. Analysis of the data found that 85% of the total entrainment occurred at the dam's third powerplant. Because these entrainment rates represent a significant loss to the tribal fisheries upstream of the dam, they have been judged unacceptable to fishery managers responsible for perpetuating the fishery in Lake Roosevelt. In an effort to reduce fish entrainment rates, the scope of work for the Chief Joseph Kokanee Enhancement Project was modified in 2001 to include a multiyear study of the efficacy of using strobe lights to deter fish from entering the third powerplant forebay. Pacific Northwest National Laboratory initiated the four-year study in collaboration with Colville

  16. Pharmacokinetics and efficacy of intraocular flurbiprofen.

    Science.gov (United States)

    Blazaki, S; Tsika, C; Tzatzarakis, M; Naoumidi, E; Tsatsakis, A; Tsatsanis, C; Tsilimbaris, Miltiadis K

    2017-12-01

    Intravitreal delivery of non-steroidal anti-inflammatory drugs could be an effective way to treat macular edema caused by posterior segment inflammation. In this study, we evaluated the intravitreal bioavailability and anti-inflammatory efficacy of flurbiprofen in rabbit eyes. For pharmacokinetics, 0.1 ml of 7.66 mg/ml flurbiprofen solution was injected intravitreally and vitreous drug levels were analyzed at specific time points using LC-MS technique. For efficacy, 100 ng lipopolysaccharide of E.coli was injected intravitreally in rabbits to induce inflammation. The animals were separated in three groups and received intraocular flurbiprofen, dexamethasone and PBS to serve as control. Complete ocular examination and total cell count in aqueous fluid were determined to evaluate the extent of inflammation. Eyes were then enucleated for histopathology analysis. The efficacy in the uveitis model was determined by clinical signs of inflammation, total leukocyte count and histology findings. No adverse events were observed during pharmacokinetic assessment. No signs of inflammation, hemorrhage or retina detachment were detected. The recovery of flurbiprofen from vitreous samples was 92.6%. The half-life of flurbiprofen was estimated to be 1.92 h with an elimination constant rate (K) of 0.36. Treatment with intraocular injections of flurbiprofen and dexamethasone significantly reduced total leukocyte count in a manner comparable to dexamethasone [reduction of 96.84% (p flurbiprofen injection compared to control eyes. Flurbiprofen is effective in suppressing inflammation in this experimental uveitis model. In our experimental setting, intravitreal flurbiprofen seem to have a therapeutic result comparable to dexamethasone. However, the half-life of the drug remains short, necessitating further research to prolong its presence in the vitreous cavity.

  17. Efficacy of oral moxifloxacin for aerobic vaginitis.

    Science.gov (United States)

    Wang, C; Han, C; Geng, N; Fan, A; Wang, Y; Yue, Y; Zhang, H; Xue, F

    2016-01-01

    The purpose of this study was to investigate the therapeutic efficacy of oral moxifloxacin for aerobic vaginitis (AV). We also identified factors that are associated with therapeutic efficacy. This prospective study enrolled general gynecological outpatients at Tianjin Medical University General Hospital between September 2012 and May 2014. Women diagnosed with AV (n = 102) were recruited. All enrolled women were treated with oral moxifloxacin, 400 mg once daily for 6 days (one course). Therapeutic efficacy was evaluated based on microscopic criteria, and cure rates were calculated. Women who were microscopically improved (but not cured) received a second course of therapy. Women classified with microscopic failure were treated using other strategies. Univariate and multivariate logistic regression analysis was used to identify factors that may be associated with a cure after one course of therapy. After one course of therapy, 65.7 % (67/102) of women were cured, 29.4 % (30/102) of women were improved (but not cured), 4.9 % (5/102) of women failed to respond to the therapy. After two courses of therapy, 85.3 % (87/102) of women were cured, 9.8 % (10/102) of women were improved, 4.9 % (5/102) of women failed to respond to the therapy, and clinical improvement was achieved in additional women. In the multivariate logistic regression analysis, women with a baseline vaginal pH value of vaginal pH value of ≥5.0 (OR, 3.503; 95 % CI, 1.278-9.601). Moxifloxacin is an effective therapeutic option for patients with AV. Most women with AV were cured with one course of moxifloxacin. For those with a higher vaginal pH value of ≥5.0 before treatment, two courses of therapy should be considered.

  18. Antibotulinal efficacy of sulfur dioxide in meat.

    Science.gov (United States)

    Tompkin, R B; Christiansen, L N; Shaparis, A B

    1980-01-01

    The addition of sodium metabisulfite as a source of sulfur dioxide delayed botulinal outgrowth in perishable canned comminuted pork when it was temperature abused at 27 degree C. The degree of inhibition was directly related to the level of sulfur dioxide. Levels greater than 100 microgram of sulfur dioxide per g were necessary to achieve significant inhibition when a target level of 100 botulinal spores per g was used. Sodium nitrite partially reduced the efficacy of the sulfur dioxide. Sulfur dioxide offers a new option for the control of botulinal outgrowth in cured or noncured meat and poultry products. PMID:6996613

  19. Validity and efficacy of the labor contract

    Directory of Open Access Journals (Sweden)

    Jorge Toyama

    2012-12-01

    Full Text Available The validity and efficacy of the labor contract as well as cases of nullity and defeasibility import an analysis of scopes of the supplementary application of Civil Code taking into account the peculiarities of Labor Law. Labor contract, while legal business has as regulatory framework to the regulations of Civil Code but it is necessary to determine, in each case, whether to apply fully this normative body, or modulate its supplemental application, or simply conclude that it doesn’t result compatible its regulation due to the special nature of labor relations. Specifically, this issue will be analyzed from cases of nullity and defeasibility of the labor contract.

  20. Sulfasalazine efficacy and tolerability in rheumatic diseases

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2005-01-01

    Full Text Available Sulfasalazine is one of the main disease modifying drugs for the treatment of chronic inflammatory joint and spine diseases. The article describes mechanism of action of sulfasalazine and its main metabolites. Detailed information about anti-inflammatory and immunosuppressive action of the drug is presented. Results of many studies of sulfasalazine efficacy in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis are discussed from the evidence based medicine point of view. Data on sulfasalazine tolerability and safety are presented with separate discussion of hypersensitivity and dose-dependent adverse reactions so as their treatment and prophylaxis.

  1. A structural Model of Self-efficacy in Handball Referees

    Science.gov (United States)

    Diotaiuti, Pierluigi; Falese, Lavinia; Mancone, Stefania; Purromuto, Francesco

    2017-01-01

    The study aimed to identify factors predicting self-efficacy in a sample of 248 Italian handball referees. The main hypothesis was that perception of teamwork efficacy would be a significant predictor of self-efficacy in handball referees. Participants completed an online questionnaire including Referee Self-Efficacy Scale (α = 0.85), Self-Determination Scale (α = 0.78), and an adaptation for Referees of the Sport Commitment Model (α = 0.80). Two hierarchical regression analyses have identified: (1) Enjoyment (β = 0.226), Couple Efficacy (β = 0.233), and Personal Awareness (β = 0.243), as predictors of Self-Efficacy; (2) Span of Co-Refereeing (β = 0.253), Perceived Quality of the Relationship (β = 0.239), and Mutual Agreement (β = 0.274), as predictors of Couple Self-Efficacy. A further SEM analysis confirmed the fit of a structural model of Self-efficacy considering the reciprocal influence of Couple Efficacy, Enjoyment and Awareness (χ2: 5.67; RMSEA: 0.000; SRMR: 0.019). The study underlines the importance of teamwork (or co-refereeing) as it relates to enjoyment and awareness in officiating and how it enhances the psychological well-being of handball referees. Future studies should investigate the relationship between factors influencing perceived teamwork efficacy and officiating performance outcome. PMID:28572783

  2. [Research and development on efficacy of Chinese herbal compound].

    Science.gov (United States)

    Liu, Jian-Xun; Ren, Jian-Xun; Lin, Cheng-Ren

    2016-03-01

    The efficacy not only is summarized by clinical effect of Chinese herbal compound on theory of traditional Chinese medicine, but also is manifested to clinical effect by interaction of many intricate chemical substances. The efficacy of Chinese herbal compound is current research focus in field of traditional Chinese medicine. By currently knowing in different aspects which included the progression in efficacy of Chinese herbal compound, symptomatic efficacy of Chinese herbal compound, the relationship between the efficacy and pharmacologic effect of Chinese herbal compound, the efficacy related pharmacodynamic substance and the evaluation of efficacy, it had been summarized mainly problems and methods in research and development process of the efficacy of Chinese herbal compound in this paper. Paper also elucidated problems that need to pay attention in research of efficacy in order to provide references for clinical and experimental studies of efficacy in Chinese herbal compound, boost research and development level of new traditional Chinese drug and facilitate modernization of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

  3. Adipocytes Impair Efficacy of Antiretroviral Therapy

    Science.gov (United States)

    Couturier, Jacob; Winchester, Lee C.; Suliburk, James W.; Wilkerson, Gregory K.; Podany, Anthony T.; Agarwal, Neeti; Chua, Corrine Ying Xuan; Nehete, Pramod N.; Nehete, Bharti P.; Grattoni, Alessandro; Sastry, K. Jagannadha; Fletcher, Courtney V.; Lake, Jordan E.; Balasubramanyan, Ashok; Lewis, Dorothy E.

    2018-01-01

    Adequate distribution of antiretroviral drugs to infected cells in HIV patients is critical for viral suppression. In humans and primates, HIV- and SIV-infected CD4 T cells in adipose tissues have recently been identified as reservoirs for infectious virus. To better characterize adipose tissue as a pharmacological sanctuary for HIV-infected cells, in vitro experiments were conducted to assess antiretroviral drug efficacy in the presence of adipocytes, and drug penetration in adipose tissue cells (stromal-vascular-fraction cells and mature adipocytes) was examined in treated humans and monkeys. Co-culture experiments between HIV-1-infected CD4 T cells and primary human adipocytes showed that adipocytes consistently reduced the antiviral efficacy of the nucleotide reverse transcriptase inhibitor tenofovir and its prodrug forms tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). In HIV-infected persons, LC-MS/MS analysis of intracellular lysates derived from adipose tissue stromal-vascular-fraction cells or mature adipocytes suggested that integrase inhibitors penetrate adipose tissue, whereas penetration of nucleoside/nucleotide reverse transcriptase inhibitors such as TDF, emtricitabine, abacavir, and lamivudine is restricted. The limited distribution and functions of key antiretroviral drugs within fat depots may contribute to viral persistence in adipose tissue. PMID:29630975

  4. The practical evaluation of DNA barcode efficacy.

    Science.gov (United States)

    Spouge, John L; Mariño-Ramírez, Leonardo

    2012-01-01

    This chapter describes a workflow for measuring the efficacy of a barcode in identifying species. First, assemble individual sequence databases corresponding to each barcode marker. A controlled collection of taxonomic data is preferable to GenBank data, because GenBank data can be problematic, particularly when comparing barcodes based on more than one marker. To ensure proper controls when evaluating species identification, specimens not having a sequence in every marker database should be discarded. Second, select a computer algorithm for assigning species to barcode sequences. No algorithm has yet improved notably on assigning a specimen to the species of its nearest neighbor within a barcode database. Because global sequence alignments (e.g., with the Needleman-Wunsch algorithm, or some related algorithm) examine entire barcode sequences, they generally produce better species assignments than local sequence alignments (e.g., with BLAST). No neighboring method (e.g., global sequence similarity, global sequence distance, or evolutionary distance based on a global alignment) has yet shown a notable superiority in identifying species. Finally, "the probability of correct identification" (PCI) provides an appropriate measurement of barcode efficacy. The overall PCI for a data set is the average of the species PCIs, taken over all species in the data set. This chapter states explicitly how to calculate PCI, how to estimate its statistical sampling error, and how to use data on PCR failure to set limits on how much improvements in PCR technology can improve species identification.

  5. Efficacy monitoring of in situ fuel bioremediation

    International Nuclear Information System (INIS)

    Mueller, J.; Borchert, S.; Heard, C.

    1996-01-01

    The wide-scale, multiple-purpose use of fossil fuels throughout the industrialized world has resulted in the inadvertent contamination of myriad environments. Given the scope and magnitude of these environmental contamination problems, bioremediation often represents the only practical and economically feasible solution. This is especially true when depth of contamination, magnitude of the problem, and nature of contaminated material preclude other remedial actions, short of the no-response alternative. From the perspective, the effective, safe and scientifically valid use of in situ bioremediation technologies requires cost-efficient and effective implementation strategies in combination with unequivocal approaches for monitoring efficacy of performance. Accordingly, with support from the SERDP program, the authors are field-testing advanced in situ bioremediation strategies and new approaches in efficacy monitoring that employ techniques instable carbon and nitrogen isotope biogeochemistry. One field demonstration has been initiated at the NEX site in Port Hueneme, CA (US Navy's National Test Site). The objectives are: (1) to use stable isotopes as a biogeochemical monitoring tool for in situ bioremediation of refined petroleum (i.e., BTEX), and (2) to use vertical groundwater circulation technology to effect in situ chemical containment and enhanced in situ bioremediation

  6. VIBE: Evaluation of Ibandronate Efficacy - Original Investigation

    Directory of Open Access Journals (Sweden)

    J-Y Reginster

    2008-12-01

    Full Text Available No prospective head-to-head trials comparing the fracture efficacy of the currently marketed weekly and monthly bisphosphonates have been conducted. Due to the large sample size such studies would require to reliably detect differences in fracture risk and the associated high costs, they are considered to be impractical. Whilst providing the highest level of evidence, clinical trials also have inherent limitations. Patients are selected by a number of criteria and therefore usually do not represent the normal patient population. Also due to a protocol, normal clinical practice is usually not reflected. In contrast, database studies allow the assessment of treatments in normal clinical practice. Whilst observational studies have limitations owing to more confounding variables, they do have an important place in evidence-based medicine (especially in the absence of prospective clinical trials, and if well-designed can give some indications regarding the comparative efficacy of osteoporosis therapies in real-world clinical practice. (From the World of Osteoporosis 2008;14: 62-5

  7. The efficacy of reflexology: systematic review.

    Science.gov (United States)

    Wang, Mei-Yeh; Tsai, Pei-Shan; Lee, Pi-Hsia; Chang, Wen-Yin; Yang, Che-Ming

    2008-06-01

    This paper is a report of a systematic review to evaluate the efficacy of reflexology in any condition. Anecdotal evidence has shown potential benefits of reflexology in a variety of health conditions. However, the efficacy of reflexology has yet to be determined. Cochrane library, PubMed, MEDLINE, EBM review, ProQuest Medical Bundle and SCOPUS databases were searched using the following medical subject headings or key words: reflexology, foot reflexotherapy, reflexological treatment, foot massage and zone therapy. Chinese articles were searched through the Chinese electronic periodical services and Wangfane database. The publication date was limited from 1996 to 2007. Studies were selected if they were written in English or Chinese, used a controlled clinical trial design, used reflexology as a stand-alone modality, and reported such outcomes as symptoms relief, quality of life and patients' perceptions of reflexology. Study quality was reviewed based on the evidence rating system of the United States Preventive Services Task Force, and studies with the evidence rating of II-2 fair or above were included in this review. Among the five studies suitable for review, there was only one report of a statistically significant treatment effect. Among the 12 outcome variables examined, the treatment effect size for urinary symptoms was large, whereas the effect size for other conditions was negligible. There is no evidence for any specific effect of reflexology in any conditions, with the exception of urinary symptoms associated with multiple sclerosis. Routine provision of reflexology is therefore not recommended.

  8. The Game Frame and Political Efficacy

    DEFF Research Database (Denmark)

    Pedersen, Rasmus Tue

    2012-01-01

    Several observational and experimental studies have confirmed the ‘spiral of cynicism’ hypothesis: the tendency of the news media to cover politics through a game frame, which focuses on political strategy instead of political issues, leads to cynicism about election campaigns and politicians amo...... on a survey among the electorate and a content analysis of political coverage in newspapers. The study shows that exposure to the game frame is indeed associated with lower levels of internal efficacy, even when controlling for potentially confounding variables.......Several observational and experimental studies have confirmed the ‘spiral of cynicism’ hypothesis: the tendency of the news media to cover politics through a game frame, which focuses on political strategy instead of political issues, leads to cynicism about election campaigns and politicians among...... the electorate. However, such cynicism may in itself be somewhat inconsequential, and so this article suggests that we move beyond cynicism regarding specific electoral campaigns or politicians, and that we turn our attention towards political efficacy. This is done in an empirical study, which is based...

  9. Adapting Computer Programming Self-Efficacy Scale and Engineering Students' Self-Efficacy Perceptions

    Science.gov (United States)

    Korkmaz, Özgen; Altun, Halis

    2014-01-01

    Students might have different type and different level of perceptions: Positive or negative perceptions on programming; a perception on benefit of programming, perceptions related to difficulties of programming process etc. The perception of student on their own competence is defined as self-efficacy. Based on the discussions reported in…

  10. Self-Efficacy as Predictor of Collective Self-Efficacy among Preschool Teachers in Turkey

    Science.gov (United States)

    Arslan, Emel

    2017-01-01

    This study investigates the effect of preschool teachers' collective self-efficacy. A study group consists of 172 preschool teachers who are working in public preschools affiliated with the Ministry of National Education in different cities of Turkey. In this study, teacher self-efficiency scale is employed to assess professional efficiency…

  11. A gender study investigating physics self-efficacy

    Science.gov (United States)

    Sawtelle, Vashti

    The underrepresentation of women in physics has been well documented and a source of concern for both policy makers and educators. My dissertation focuses on understanding the role self-efficacy plays in retaining students, particularly women, in introductory physics. I use an explanatory mixed methods approach to first investigate quantitatively the influence of self-efficacy in predicting success and then to qualitatively explore the development of self-efficacy. In the initial quantitative studies, I explore the utility of self-efficacy in predicting the success of introductory physics students, both women and men. Results indicate that self-efficacy is a significant predictor of success for all students. I then disaggregate the data to examine how self-efficacy develops differently for women and men in the introductory physics course. Results show women rely on different sources of self-efficacy than do men, and that a particular instructional environment, Modeling Instruction, has a positive impact on these sources of self-efficacy. In the qualitative phase of the project, this dissertation focuses on the development of self-efficacy. Using the qualitative tool of microanalysis, I introduce a methodology for understanding how self-efficacy develops moment-by-moment using the lens of self-efficacy opportunities. I then use the characterizations of self-efficacy opportunities to focus on a particular course environment and to identify and describe a mechanism by which Modeling Instruction impacts student self-efficacy. Results indicate that the emphasizing the development and deployment of models affords opportunities to impact self-efficacy. The findings of this dissertation indicate that introducing key elements into the classroom, such as cooperative group work, model development and deployment, and interaction with the instructor, create a mechanism by which instructors can impact the self-efficacy of their students. Results from this study indicate that

  12. Exploring self-efficacy as a predictor of disease management.

    Science.gov (United States)

    Clark, N M; Dodge, J A

    1999-02-01

    Self-efficacy is posited in social cognitive theory as fundamental to behavior change. Few health behavior studies have examined self-efficacy prospectively, viewed it as part of a reciprocal behavioral process, or compared self-efficacy beliefs in the same population across different behaviors. This article first discusses self-efficacy in its theoretical context and reviews the available prospective studies. Second, it explores self-efficacy as a predictor of disease management behaviors in 570 older women with heart disease. Although the R2 statistics in each case were modest, the construct is shown to be a statistically significant (pmanagement behaviors: using medicine as prescribed, getting adequate exercise, managing stress, and following a recommended diet. Building self-efficacy is likely a reasonable starting point for interventions aiming to enhance heart disease management behaviors of mature female patients.

  13. Teacher self-efficacy in instruction and in parent involvement

    Directory of Open Access Journals (Sweden)

    Peter Gavora

    2012-06-01

    Full Text Available The study investigated self-efficacy of a sample of Slovak primary schoolteachers in two areas: area of instruction and area of parent involvement. Twoinstruments were used: the 16-item Slovak version of Teacher Efficacy Scale ofGibson and Dembo, and ZdUR, a 24-item scale to measure self-efficacy of teacherin parents’ involvement, developed by authors of the present study. The correlation between scores of personal teaching efficacy dimension of TES and ZdUR was 0.58 and between general teaching efficacy of TES and ZdUR was only 0.01. Teachers inthis sample had better scores in all dimensions of ZdUR than those of TES, with theexception of engaging parents in school activities. Scores of four teachers in TES andZdUR were analysed to document the possibility of making the individual profiles ofteacher self-efficacy.

  14. Influence of Self-Efficacy on Compliance to Workplace Exercise

    DEFF Research Database (Denmark)

    Pedersen, Mette Merete; Zebis, Mette K; Jørgensen, Henning Langberg

    2013-01-01

    the influence of exercise-specific self-efficacy on compliance to workplace physical exercise. PURPOSE: To determine the influence of exercise-specific self-efficacy on compliance to specific strength exercises during working hours for laboratory technicians. METHODS: We performed a cluster...... of compliance to exercises during 20 weeks, but found self-efficacy to be a predictor of compliance in a private sector setting. Workplace-specific differences might be present and should be taken into account....

  15. Self-efficacy at work : Social, emotional, and cognitive dimensions

    OpenAIRE

    Loeb, Carina

    2016-01-01

    Research has shown that self-efficacy is one of the most important personal resources in the work context. However, research on working life has mainly focused on a cognitive and task-oriented dimension of self-efficacy representing employees’ perceptions of their capacity to successfully complete work tasks. Thus, little is known about the influence that believing in one’s social and emotional competence could have. This thesis aims to expand previous theory regarding self-efficacy in the wo...

  16. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin

    2010-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  17. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok

    2015-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  18. Reinforcement Magnitude: An Evaluation of Preference and Reinforcer Efficacy

    OpenAIRE

    Trosclair-Lasserre, Nicole M; Lerman, Dorothea C; Call, Nathan A; Addison, Laura R; Kodak, Tiffany

    2008-01-01

    Consideration of reinforcer magnitude may be important for maximizing the efficacy of treatment for problem behavior. Nonetheless, relatively little is known about children's preferences for different magnitudes of social reinforcement or the extent to which preference is related to differences in reinforcer efficacy. The purpose of the current study was to evaluate the relations among reinforcer magnitude, preference, and efficacy by drawing on the procedures and results of basic experimenta...

  19. The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

    Science.gov (United States)

    Tilden, Ellen L.; Caughey, Aaron B.; Lee, Christopher S.; Emeis, Cathy

    2016-01-01

    Objective To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Data Sources Eligible studies were identified through searching MEDLINE, CINAHL, Scopus, and Google Scholar databases. Study Selection Published research using a tool explicitly intended to measure childbirth self-efficacy and also examining outcomes within the perinatal period were included. All manuscripts were in English and published in peer-reviewed journals. Data Extraction First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasi-experimental studies), and perinatal outcomes were extracted and summarized. Data Synthesis Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. Conclusions There is overall consistency in how childbirth self-efficacy is defined and measured among studies, facilitating comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through: (a) utilization of experimental and quasi-experimental design; (b) recruitment and retention of more diverse samples; (c) explicit reporting of definitions of terms (e.g. ‘high risk’); (d) investigation of interventions that increase childbirth self-efficacy during pregnancy; and, (e) investigation regarding how childbirth self-efficacy enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should

  20. Exercise self-efficacy intervention in overweight and obese women.

    Science.gov (United States)

    Buckley, Jude

    2016-06-01

    This study investigated the effects of a brief tailored intervention on self-efficacy beliefs and exercise energy expenditure in active and inactive overweight and obese women. Participants were randomly assigned to either control (N = 50) or intervention (N = 47) conditions, and their exercise self-efficacy was assessed three times over a 12-week period. Results showed that the intervention increased schedule, physical, exercise-worries efficacy, and energy expenditure in the previously inactive group. The results suggest that self-efficacy interventions are effective at increasing exercise energy expenditure in inactive overweight and obese women. © The Author(s) 2014.