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Sample records for four-year prospective study

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

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    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

  2. Australian snowboard injury data base study. A four-year prospective study.

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    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.

  3. 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

  4. 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?.

  5. Eurythmy therapy in chronic disease: a four-year prospective cohort study

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    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

  6. Four years prospective study of the maxillofacial trauma at a tertiary center in Western Nepal

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    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.

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

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    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

  8. 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

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

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    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.

  10. Can Australian radiographers assess screening mammograms accurately? Biennial follow-up from a four year prospective study and lesion analysis

    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. This paper demonstrates the abilities of Australian radiographers in mammogram screen reading, highlighting some of their specific difficulties with different lesion types. Method: Six experienced radiographers participated in a prospective study, screen reading 2000 mammograms each between 2010 and 2011. This paper looks at the results of those same women at biennial re-screen. Analysis of the results included validation of normal results by negative follow-up screens and new cancers at biennial review; there is also analysis on the types of lesions detected and missed. Results: After biennial review, three cancers in 2013/2014 had been marked as abnormal by one radiographer two years prior, which increased her sensitivity from 64% to 85%. Sensitivity for the radiologists decreased from the assumed 100% to 95%. Radiographers appeared to be skilled in detection of calcifications and architectural distortions but had difficulty with non-specific densities. Conclusion: This study demonstrates the potential for Australian radiographers to enhance the accuracy of screen reading programs. - Highlights: • Radiographers have the potential to increase breast cancer detection rates. • Radiographers appear to be skilled at detecting calcifications. • Lesions commonly overlooked by radiographers could be targeted for training.

  11. A four year prospective study of injuries in elite Ontario youth provincial and national soccer players during training and matchplay

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    Mohib, Milad; Moser, Nicholas; Kim, Richard; Thillai, Maathavan; Gringmuth, Robert

    2014-01-01

    Introduction: With over 200 million amateur players worldwide, soccer is one of the most popular and internationally recognized sports today. By understanding how and why soccer injuries occur we hope to reduce prevalent injuries amongst elite soccer athletes. Methods: Via a prospective cohort, we examined both male and female soccer players eligible to train with the Ontario Soccer Association provincial program between the ages of 13 to 17 during the period of October 10, 2008 and April 20, 2012. Data collection occurred during all player exposures to potential injury. Exposures occurred at the Soccer Centre, Ontario Training grounds and various other venues on multiple playing surfaces. Results: A total number of 733 injuries were recorded. Muscle strain, pull or tightness was responsible for 45.6% of all injuries and ranked as the most prevalent injury. Discussion: As anticipated, the highest injury reported was muscular strain, which warrants more suitable preventive programs aimed at strengthening and properly warming up the players’ muscles. PMID:25550661

  12. Social support as a moderator of functional disability's effect on depressive feelings in early rheumatoid arthritis: a four-year prospective study.

    Science.gov (United States)

    Benka, Jozef; Nagyova, Iveta; Rosenberger, Jaroslav; Calfova, Anna; Macejova, Zelmira; Lazurova, Ivica; van Dijk, Jitse P; Groothoff, Johan W

    2014-02-01

    To examine associations of depressive feelings with disease-related variables and explore the moderating effect of social support on depressive feelings in individuals with early rheumatoid arthritis (RA) prospectively over 4 years. Data were collected annually over 4 years. The sample consisted of 124 individuals with diagnosed RA (85.5% women; mean age 47.9 years; mean disease duration 22.2 months). The strength of cross-sectional and prospective associations of sociodemographic, disease-related variables and the direct and moderating effects of social support on depression were tested using correlations, multilevel models, and hierarchical linear regressions. The study showed that emotional support moderated the influence of functional disability on depressive feelings in individuals with RA. This was not detected for instrumental support. Further prospective associations between functional status, marital status, and depressive feelings were also found. Overall, the strongest association was found between initial depressive feelings and depressive feelings over time. Initial depression seemed to be a risk factor in explaining later depressive feelings, but emotional support might be prospectively beneficial, especially for individuals with higher levels of disability. Early detection of individuals at risk for depression and providing interventions aimed at the specific functions of social support might help to decrease mental health problems. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Evaluating the Predictive Impact of an Emergent Literacy Model on Dyslexia in Italian Children: A Four-Year Prospective Cohort Study.

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    Bigozzi, Lucia; Tarchi, Christian; Pezzica, Sara; Pinto, Giuliana

    2016-01-01

    The strong differences in manifestation, prevalence, and incidence in dyslexia across languages invite studies in specific writing systems. In particular, the question of the role played by emergent literacy in opaque and transparent writing systems remains a fraught one. This research project tested, through a 4-year prospective cohort study, an emergent literacy model for the analysis of the characteristics of future dyslexic children and normally reading peers in Italian, a transparent writing system. A cohort of 450 children was followed from the last year of kindergarten to the third grade in their reading acquisition process. Dyslexic children were individuated (Grade 3), and their performances in kindergarten in textual competence, phonological awareness, and conceptual knowledge of the writing system were compared with a matched group of normally reading peers. Results showed the predictive relevance of the conceptual knowledge of the writing system. The study's implications are discussed. © Hammill Institute on Disabilities 2014.

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

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    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.

  15. Four-year prospective study of STAPH-IDENT system and conventional method for reference identification of Staphylococcus, Stomatococcus, and Micrococcus spp..

    Science.gov (United States)

    Rhoden, D L; Miller, J M

    1995-01-01

    A 4-year prospective study compared the accuracy of the STAPH-IDENT system (bioMérieux Vitek, Inc., Hazelwood, Mo.) with that of the reference procedure of the Centers for Disease Control and Prevention for the identification of Staphylococcus species, Stomatococcus mucilaginosus, and Micrococcus species. The study compared the results from 1,106 cultures (500 eye cultures, 217 strains submitted for reference identification, and 389 known stock strains) representing 21 species of the family Micrococcaceae. The overall agreement of genus and species identifications was 81.1%. The percent agreement for the five most common clinical isolates was as follows: Staphylococcus epidermidis, 97.1% (517 isolates); Staphylococcus hominis, 82.5% (57 isolates); Staphylococcus aureus, 77.2% (162 isolates); Staphylococcus haemolyticus, 75.8% (61 isolates); and Staphylococcus warneri, 64.1% (39 isolates). The lowest percent agreement was with Staphylococcus cohnii (11.1%; (9 isolates). Of the 217 isolates sent to the Centers for Disease Control and Prevention for identification, 60.4% (131) were correctly identified by the STAPH-IDENT system. Of these, S. epidermidis accounted for 23.9%, S. aureus accounted for 15.6%, S. warneri accounted for 6.9%, Staphylococcus lugdunensis accounted for 6.5%, S. haemolyticus accounted for 5.5%, and S. hominis accounted for 4.1%. The STAPH-IDENT system did not perform adequately when dealing with commonly encountered organisms and is unsuitable for identifying uncommon isolates. PMID:7699074

  16. Social Support as a Moderator of Functional Disability's Effect on Depressive Feelings in Early Rheumatoid Arthritis : A Four-Year Prospective Study

    NARCIS (Netherlands)

    Benka, Jozef; Nagyova, Iveta; Rosenberger, Jaroslav; Calfova, Anna; Macejova, Zelmira; Lazurova, Ivica; van Dijk, Jitse P.; Groothoff, Johan W.

    Objective: To examine associations of depressive feelings with disease-related variables and explore the moderating effect of social support on depressive feelings in individuals with early rheumatoid arthritis (RA) prospectively over 4 years. Method: Data were collected annually over 4 years. The

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

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    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.

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

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    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. 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.

  20. Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.

    Science.gov (United States)

    Kakkos, A; Bresson, L; Hudry, D; Cousin, S; Lervat, C; Bogart, E; Meurant, J P; El Bedoui, S; Decanter, G; Hannebicque, K; Regis, C; Hamdani, A; Penel, N; Tresch-Bruneel, E; Narducci, F

    2017-04-01

    Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal. Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study. The chemotherapy regimens were classified as having a low (20%) risk for inducing neutropenia. The overall removal rate due to complications was 7.2%. Among them, port-related infection (2.5%) and port expulsion (1%) were the most frequent. The interval between port insertion and its first use was shown to be a predictive factor for complication-related removal rates. A cut-off of 6 days was statistically significant (p = 0.008), as the removal rate for complications was 9.4% when this interval was 0-5 days and 5.7% when it was ≥6 days. Another factor associated with port complication rate was the neutropenia-inducing potential of the chemotherapy regimens used, with removal for complications involved in 5.5% of low-risk regimens versus 9.4% for the intermediate- and high-risk regimens (p = 0.003). An interval of 6 days between placement and first use of the port reduces the removal rate from complications. The intermediate- and high-risk for neutropenia chemotherapy regimens are related to higher port removal rates from complications than low-risk regimens. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  1. Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study.

    Science.gov (United States)

    Stone, Sheldon Paul; Fuller, Christopher; Savage, Joan; Cookson, Barry; Hayward, Andrew; Cooper, Ben; Duckworth, Georgia; Michie, Susan; Murray, Miranda; Jeanes, Annette; Roberts, J; Teare, Louise; Charlett, Andre

    2012-05-03

    To evaluate the impact of the Cleanyourhands campaign on rates of hospital procurement of alcohol hand rub and soap, report trends in selected healthcare associated infections, and investigate the association between infections and procurement. Prospective, ecological, interrupted time series study from 1 July 2004 to 30 June 2008. 187 acute trusts in England and Wales. Installation of bedside alcohol hand rub, materials promoting hand hygiene and institutional engagement, regular hand hygiene audits, rolled out nationally from 1 December 2004. Quarterly (that is, every three months) rates for each trust of hospital procurement of alcohol hand rub and liquid soap; Staphylococcus aureus bacteraemia (meticillin resistant (MRSA) and meticillin sensitive (MSSA)) and Clostridium difficile infection for each trust. Associations between procurement and infection rates assessed by mixed effect Poisson regression model (which also accounted for effect of bed occupancy, hospital type, and timing of other national interventions targeting these infections). Combined procurement of soap and alcohol hand rub tripled from 21.8 to 59.8 mL per patient bed day; procurement rose in association with each phase of the campaign. Rates fell for MRSA bacteraemia (1.88 to 0.91 cases per 10,000 bed days) and C difficile infection (16.75 to 9.49 cases). MSSA bacteraemia rates did not fall. Increased procurement of soap was independently associated with reduced C difficile infection throughout the study (adjusted incidence rate ratio for 1 mL increase per patient bed day 0.993, 95% confidence interval 0.990 to 0.996; P hospital procurement of alcohol rub and soap, which the results suggest has an important role in reducing rates of some healthcare associated infections. National interventions for infection control undertaken in the context of a high profile political drive can reduce selected healthcare associated infections.

  2. 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.).

  3. 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.

  4. 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.

  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. 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?

  7. 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.

  8. 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.

  9. 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.…

  10. 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.

  11. 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…

  12. 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.

  13. 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…

  14. 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...

  15. 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…

  16. 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'…

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  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. 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.

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

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    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.

  9. 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…

  10. 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.

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

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    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.

  12. 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

  13. 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…

  14. The Impact of Teachers and Their Science Teaching on Students' "Science Interest": A Four-Year Study

    Science.gov (United States)

    Logan, Marianne R.; Skamp, Keith R.

    2013-01-01

    There is a crisis in school science in Australia and this may be related to insufficient students developing an interest in science. This extended study looked at changes in 14 students' interest in science as they moved through junior secondary school into Year 10. Although the majority of these students still had an interest in science in Year…

  15. 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.

  16. Risk of stroke in patients hospitalized for isolated vertigo: a four-year follow-up study.

    Science.gov (United States)

    Lee, Ching-Chih; Su, Yu-Chieh; Ho, Hsu-Chieh; Hung, Shih-Kai; Lee, Moon-Sing; Chou, Pesus; Huang, Yung-Sung

    2011-01-01

    vertigo is a common presenting symptom in ambulatory care settings, and stroke is its leading and most challenging concern. This study aimed to determine the risk of stroke in vertigo patients in a 4-year follow-up after hospitalization for acute isolated vertigo. the study cohorts consisted of all patients hospitalized with a principal diagnosis of vertigo (n=3021), whereas patients hospitalized for an appendectomy in 2004 (n=3021) comprised the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the 4-year stroke-free survival rate between the 2 cohorts after adjusting for possible confounding and risk factors. Among vertigo patients, there was further stratification for risk factors to identify the group at high risk for stroke. of the 243 stroke patients, 185 (6.1%) were from the study cohort and 58 (1.9%) were from the control group. Comparing the 2 groups, patients with vertigo symptoms had a 3.01-times (95% CI, 2.20-4.11; Pstroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. Vertigo patients with ≥ 3 risk factors had a 5.51-fold higher risk for stroke (95% CI, 3.10-9.79; Pstroke than the general population. They should have a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years after hospital discharge after treatment of isolated vertigo.

  17. Effectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims database.

    Science.gov (United States)

    Shibata, Natsumi; Kimura, Shinya; Hoshino, Takahiro; Takeuchi, Masato; Urushihara, Hisashi

    2018-05-11

    To date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1-15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting. We conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies. The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination. Total study population throughout the four consecutive influenza seasons was over 116,000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons. We confirmed the clinical effectiveness of influenza vaccination in children aged 1-15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications

  18. Homotypic Cell Cannibalism and Cannibalism Index-A Four Year Study in Inltrating Ductal Carcinoma Breast

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    Alok Mohan

    2016-01-01

    Full Text Available Background: Homotypic cell cannibalism is a hallmark of malignant lesions. It serves as an emerging indicator of both the anaplastic grade and invasiveness. Aim and Objectives: The present study was conducted to correlate tumour cytological grade with the incidences of cell cannibalism. Material and Methods: Three stained smears per case were submitted for cytological grading. The smears were then submitted for visually counting the number of examples of cell cannibalism and the cannibalism index was calculated. Results: Seventy cytological diagnosed cases of breast malignancies were assessed for the presence of cell cannibalism. The results were correlated with the cytological grade of carcinoma. The study revealed that cell cannibalism was encountered in 68.57% cases of breast carcinoma. 44.4% of grade I, 71.4% of grade II and 100% of grade III tumours grade. It was observed that grade I tumours had mean cannibalism per smear of 1.62/1000 tumour cells smear, grade II mean cannibalism per smear of 2.50/ 1000 tumour cells and grade III mean cannibalism per smear 4.90/1000 tumour cells. Tumour diathesis and metastasis were also found more in cannibalism positive cases. Conclusion: The phenomenon of cell cannibalism was encountered more in high grade tumours. Thus it can be designated as an emerging marker of anaplasia and aggressive tumour behaviour

  19. A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

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    A. Guerrouani

    2013-01-01

    Full Text Available Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia. Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files. Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%. Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital. Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

  20. The Role of Conflict Identification and Management in Sustaining Community Collaboration: Report on a Four-Year Exploratory Study.

    Science.gov (United States)

    Blanch, Andrea K; Boustead, Robyn; Boothroyd, Roger A; Evans, Mary E; Chen, Huey-Jen

    2015-07-01

    Community collaboration has become increasingly common in behavioral health services. Conflict is likely to occur in any community coalition bringing together organizations with differing mandates, missions, and histories. However, research on how coalitions identify and handle conflict, and on the impact of conflict on sustainability is scarce. An exploratory study examined conflict in two federally funded children's "systems of care" using site visits and concept mapping to describe differences in how sites conceptualize and respond to conflict. Results suggest that unacknowledged and unaddressed conflict can negatively affect the development and sustainability of sites, and that focusing on cooperation may, paradoxically, make it more difficult to acknowledge conflict and to implement conflict transformation processes. Implications for behavioral health administrators are discussed, including potential interventions that could address these issues.

  1. Everolimus long-term use in patients with tuberous sclerosis complex: Four-year update of the EXIST-2 study.

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    John J Bissler

    Full Text Available We examined the long-term effects of everolimus in patients with renal angiomyolipoma associated with tuberous sclerosis complex or sporadic lymphangioleiomyomatosis.Following favorable results from the double-blind core phase of EXIST-2 (NCT00790400, patients were allowed to receive open-label everolimus (extension phase. Patients initially randomly assigned to everolimus continued on the same dose; those who were receiving placebo crossed over to everolimus 10 mg/day. Dose modifications were based on tolerability. The primary end point was angiomyolipoma response rate, defined as a ≥50% reduction from baseline in the sum volume of target renal angiomyolipomas in the absence of new target angiomyolipomas, kidney volume increase of >20% from nadir, and angiomyolipoma-related bleeding grade ≥2. The key secondary end point was safety.Of the 112 patients who received ≥1 dose of everolimus, 58% (95% CI, 48.3% to 67.3% achieved angiomyolipoma response. Almost all patients (97% experienced reduction in renal lesion volumes at some point during the study period. Median duration of everolimus exposure was 46.9 months. Sixteen (14.3% patients experienced angiomyolipoma progression at some point in the study. No angiomyolipoma-related bleeding or nephrectomies were reported. One patient on everolimus underwent embolization for worsening right flank pain. Subependymal giant cell astrocytoma lesion response was achieved in 48% of patients and skin lesion response in 68% of patients. The most common adverse events suspected to be treatment-related were stomatitis (42%, hypercholesterolemia (30.4%, acne (25.9%, aphthous stomatitis and nasopharyngitis (each 21.4%. Ten (8.9% patients withdrew because of an adverse event. Renal function remained stable, and the frequency of emergent adverse events generally decreased over time.Everolimus treatment remained safe and effective over approximately 4 years. The overall risk/benefit assessment supports the use

  2. High dengue case capture rate in four years of a cohort study in Nicaragua compared to national surveillance data.

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    Katherine Standish

    Full Text Available Dengue is a major public health problem in tropical and subtropical regions; however, under-reporting of cases to national surveillance systems hinders accurate knowledge of disease burden and costs. Laboratory-confirmed dengue cases identified through the Nicaraguan Pediatric Dengue Cohort Study (PDCS were compared to those reported from other health facilities in Managua to the National Epidemiologic Surveillance (NES program of the Nicaraguan Ministry of Health. Compared to reporting among similar pediatric populations in Managua, the PDCS identified 14 to 28 (average 21.3 times more dengue cases each year per 100,000 persons than were reported to the NES. Applying these annual expansion factors to national-level data, we estimate that the incidence of confirmed pediatric dengue throughout Nicaragua ranged from 300 to 1000 cases per 100,000 persons. We have estimated a much higher incidence of dengue than reported by the Ministry of Health. A country-specific expansion factor for dengue that allows for a more accurate estimate of incidence may aid governments and other institutions calculating disease burden, costs, resource needs for prevention and treatment, and the economic benefits of drug and vaccine development.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  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.

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    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. Waist-to-Height Gain and Triiodothyronine Concentrations in a Cohort of Socially Vulnerable Short-Stature Women: A Four-Year Follow-Up Study.

    Science.gov (United States)

    Florêncio, Telma M M T; Bueno, Nassib B; Britto, Revilane A P; Albuquerque, Fabiana C A; Lins, Isabela L L; Sawaya, Ana L

    2016-01-01

    Short stature that results from undernourishment during perinatal period is associated with an increased risk of diabetes and cardiovascular diseases in adulthood, particularly in poor populations. The present study investigated changes on anthropometric and metabolic parameters of socially vulnerable women with short stature. A prospective study with 48 women (19-45 years) who were mothers of undernourished children was conducted. Twenty-five of them were short (height ≤150 cm), and 23 were not short, to serve as a control (height >159 cm). Biochemical, anthropometric and dietary intake data were collected, before and after 4 years of follow-up. A mixed within-between analysis of covariance was used to assess the interaction between 'group' and 'time'. Waist-to-height ratio increased only in the short stature group, with significant interaction (+0.03 ± 0.03 in short group vs. +0.01 ± 0.03 in control; p for interaction = 0.04). The short stature group showed a significant decrease in the plasma triiodothyronine (T3) concentrations, without significant interaction (-0.16 ± 0.23 ng/ml in short group vs. -0.04 ± 0.29 ng/ml in control; p for interaction = 0.20). Women of short stature presented an increase in waist-to-height ratio, with a simultaneous decrease in total plasma T3. These alterations may lead them to increased risk of comorbidities. © 2016 S. Karger AG, Basel.

  9. Uterine packing versus Foley's catheter for the treatment of postpartum hemorrhage secondary to bleeding tendency in low-resource setting: A four-year observational study.

    Science.gov (United States)

    Rezk, Mohamed; Saleh, Said; Shaheen, Abdelhamid; Fakhry, Tamer

    2017-11-01

    To assess the effectiveness and safety of uterine packing versus Foley's catheter tamponade for controlling postpartum hemorrhage (PPH) secondary to bleeding tendency after vaginal delivery. This was a prospective observational study conducted on 92 patients with primary PPH due to bleeding tendency following vaginal delivery who were unresponsive to uterotonics and bimanual compression of the uterus. Patients were divided into two groups, Uterine packing group (n = 45) and Foley catheter group (n = 47). The primary outcome was the success rate of the procedure. Secondary outcome addressed the maternal complications. The use of uterine packing resulted in stoppage of active bleeding in 93.3% of cases compared to only 68.1% in the Foley's catheter group (p  0.05). Six cases who failed to Foley catheter tamponade underwent emergency hysterectomy with no cases in the uterine packing group. The use of uterine packing to arrest PPH is simple, quick and safe procedure to avoid further surgical interventions and to preserve the fertility in low-resource setting.

  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. 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.

  12. 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)

  13. Changes in prevalence of obesity and high waist circumference over four years across European regions: the European male ageing study (EMAS).

    Science.gov (United States)

    Han, Thang S; Correa, Elon; Lean, Michael E J; Lee, David M; O'Neill, Terrence W; Bartfai, György; Forti, Gianni; Giwercman, Aleksander; Kula, Krzysztof; Pendleton, Neil; Punab, Margus; Rutter, Martin K; Vanderschueren, Dirk; Huhtaniemi, Ilpo T; Wu, Frederick C W; Casanueva, Felipe F

    2017-02-01

    Diversity in lifestyles and socioeconomic status among European populations, and recent socio-political and economic changes in transitional countries, may affect changes in adiposity. We aimed to determine whether change in the prevalence of obesity varies between the socio-politically transitional North-East European (Łódź, Poland; Szeged, Hungary; Tartu, Estonia), and the non-transitional Mediterranean (Santiago de Compostela, Spain; Florence, Italy) and North-West European (Leuven, Belgium; Malmö, Sweden; Manchester, UK) cities. This prospective observational cohort survey was performed between 2003 and 2005 at baseline and followed up between 2008 and 2010 of 3369 community-dwelling men aged 40-79 years. Main outcome measures in the present paper included waist circumference, body mass index and mid-upper arm muscle area. Baseline prevalence of waist circumference ≥ 102 cm and body mass index ≥ 30 kg/m 2 , respectively, were 39.0, 29.5 % in North-East European cities, 32.4, 21.9 % in Mediterranean cities, and 30.0, 20.1 % in North-West European cities. After median 4.3 years, men living in cities from transitional countries had mean gains in waist circumference (1.1 cm) and body mass index (0.2 kg/m 2 ), which were greater than men in cities from non-transitional countries (P = 0.005). North-East European cities had greater gains in waist circumference (1.5 cm) than in Mediterranean cities (P developing waist circumference ≥ 102 cm, compared with men from Mediterranean cities, were 2.3 (1.5-3.5) in North-East European cities and 1.6 (1.1-2.4) in North-West European cities, and 1.6 (1.2-2.1) in men living in cities from transitional, compared with cities from non-transitional countries. These regional differences in increased prevalence of waist circumference ≥ 102 cm were more pronounced in men aged 60-79 years than in those aged 40-59 years. Overall there was an increase in the prevalence of obesity (body

  14. A four-year follow-up study of physical working conditions and perceived mental and physical strain among food industry workers.

    Science.gov (United States)

    Neupane, Subas; Virtanen, Pekka; Luukkaala, Tiina; Siukola, Anna; Nygård, Clas-Håkan

    2014-05-01

    This study hypothesized that in a longitudinal setting deteriorating physical working conditions increases the perceived physical and mental strain among food processing employees. The study was conducted in 2003 and 2007. It examined 248 blue-collar workers, all of whom were in the same occupation throughout the entire follow-up period. The data were obtained through a structural questionnaire distributed to the employees at the workplace. Mental strain had increased (7%) significantly among younger employees during the follow-up. The changes in mental strain for the younger employees were positively associated with the changes in physical strain. The changes in physical strain were also significantly associated with the changes in physical working conditions among both younger and the older workers. The results of this study partly support the study hypothesis, namely that deteriorating physical working condition increases physical strain and also increases mental strain, especially among younger employees. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  15. Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study

    DEFF Research Database (Denmark)

    Nielsen, Stine Elkjaer; Hansen, Henrik Post; Jensen, Berit Ruud

    2010-01-01

    Background: Neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular damage, predicts progression in non-diabetic chronic kidney. We evaluated urinary (u)-NGAL as a predictor of progression in diabetic nephropathy in type 1 diabetic (T1D) patients. Methods: As a substudy of a 4......-year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto). Outcome: Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death...

  16. Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study

    DEFF Research Database (Denmark)

    Nielsen, Stine Elkjaer; Hansen, Henrik Post; Jensen, Berit Ruud

    2010-01-01

    -year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto). Outcome: Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death....... Results: Mean age 40.7 (8.2) years and 50 men. 13 patients developed ESRD or died. Baseline GFR (mean, SD): 68 (31) ml/min/1.73 m(2). Baseline u-NGAL [geometric mean (95% CI)] and GFR were 15.6 ng/24 h (11.8-20.7) and 68 (31) ml/min/1.73 m(2). During follow-up, an increase in u-NGAL [geometric mean (95...

  17. A four year longitudinal sero-epidemiological study of bovine herpesvirus type-1 (BHV-1 in adult cattle in 107 unvaccinated herds in south west England

    Directory of Open Access Journals (Sweden)

    Ramirez-Villaescusa Ana M

    2009-01-01

    Full Text Available Abstract Background Bovine herpesvirus type-1 (BHV-1 is an important pathogen of cattle that presents with a variety of clinical signs, including the upper respiratory tract infection infectious bovine rhinotracheitis (IBR. A seroepidemiological study of BHV-1 antibodies was conducted in England from 2002 – 2004: 29,782 blood samples were taken from 15,736 cattle from 114 herds which were visited on up to three occasions. Antibody concentration was measured using a commercial ELISA. Farm management information was collected using an interview questionnaire, and herd size and cattle movements were obtained from the cattle tuberculosis testing database and the British Cattle Movement Service. Hierarchical statistical models were used to investigate associations between cattle and herd variables and the continuous outcome percentage positive (PP values from the ELISA test in unvaccinated herds. Results There were 7 vaccinated herds, all with at least one seropositive bovine. In unvaccinated herds 83.2% had at least one BHV-1 seropositive bovine, and the mean cattle and herd BHV-1 seroprevalence were 42.5% and 43.1% respectively. There were positive associations between PP value, age, herd size, presence of dairy cattle. Adult cattle in herds with grower cattle had lower PP values than those in herds without grower cattle. Purchased cattle had significantly lower PP values than homebred cattle, whereas cattle in herds that were totally restocked after the foot-and-mouth epidemic in 2001 had significantly higher PP values than those in continuously stocked herds. Samples taken in spring and summer had significantly lower PP values than those taken in winter, whereas those taken in autumn had significantly higher PP values than those taken in winter. The risks estimated from a logistic regression model with a binary outcome (seropositive yes/no were similar. Conclusion The prevalence of BHV-1 seropositivity in cattle and herds has increased since

  18. ARBRE monitoring - ecology of short rotation coppice. Four year study involving wildlife monitoring of commercial SCR plantations planted on arable land and arable control plots

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, M.D.; Bishop, J.D.; McKay, H.V.; Sage, R.B.

    2004-07-01

    This report summarises the findings of the UK Department of Trade and Industry (DTI) funded project monitoring wildlife within and around a number of commercially managed Short Rotation Coppice (SRC) plantations aimed at using the information gathered to assess the ecological impact of SRC plantations on the wildlife in the area. The background to the study is traced, and details are given of the monitoring programme examining the distribution of flora and fauna within the plantations, and the monitoring of birds, plants, insects and butterflies. The greater diversity of wildlife and plants in the SRC plots, the higher densities of birds, and the increasing number of butterfly species are discussed along with the increased mean number of invertebrate orders with subsequent growth of willow coppices, and the habitats at the edges of the plots and at headlands designed for access to machinery within the plots.

  19. Outcomes of a four-year specialist-taught physical education program on physical activity: a cluster randomized controlled trial, the LOOK study.

    Science.gov (United States)

    Telford, Rohan M; Olive, Lisa S; Cochrane, Thomas; Davey, Rachel; Telford, Richard D

    2016-06-08

    The objective of this study was to investigate the effect of a 4-year specialist-taught Physical Education (PE) program on physical activity (PA) among primary school children. A 4-year cluster randomised controlled trial was conducted in children (initially aged 8 years) from 29 primary schools (13 Intervention, 16 Control). Intervention students (N = 457) received 2 × 45 min PE lessons per week from specialist-trained PE teachers (68 lessons per year, 272 lessons over 4 years). Control group students (N = 396) received usual practice PE from generalist classroom teachers. PA during PE lessons was examined using the System for Observing Fitness Instruction Time (SOFIT). Pedometers (steps/day) were worn for 7 days each year, and accelerometers were worn concurrently in the final two years to assess moderate to vigorous (MVPA) and sedentary activity. Linear and generalized mixed models were used to determine differences in Intervention and Control student PA and the proportion of students meeting PA guidelines. The intervention increased SOFIT-observed student MVPA during PE lessons by 6.5 mins (16.7 v 10.2, p strategy. Our finding of a reduction in sedentary time among Intervention boys warrants further investigation into the potential role PE could play in influencing sedentary behaviour.

  20. Physical activity and experience of total knee replacement in patients one to four years postsurgery in the dominican republic: a qualitative study.

    Science.gov (United States)

    Stenquist, Derek S; Elman, Scott A; Davis, Aileen M; Bogart, Laura M; Brownlee, Sarah A; Sanchez, Edward S; Santiago, Adianez; Ghazinouri, Roya; Katz, Jeffrey N

    2015-01-01

    Musculoskeletal disorders are the second leading cause of years lived with disability globally. Total knee replacement (TKR) offers patients with advanced arthritis relief from pain and the opportunity to return to physical activity. We investigated the impact of TKR on physical activity for patients in a developing nation. As part of the Operation Walk Boston surgical mission program, we interviewed 18 Dominican patients (78% women) who received TKR about their level of physical activity after surgery. Qualitative interviews were conducted in Spanish, and English transcripts were analyzed using content analysis. Most patients found that TKR increased their participation in physical activities in several life domains, such as occupational or social pursuits. Some patients limited their own physical activities due to uncertainty about medically appropriate levels of joint use and postoperative physical activity. Many patients noted positive effects of TKR on mood and mental health. For most patients in the study, religion offered a framework for understanding their receipt of and experience with TKR. Our findings underscore the potential of TKR to permit patients in the developing world to return to physical activities. This research also demonstrates the influence of patients' education, culture, and religion on patients' return to physical activity. As the global burden of musculoskeletal disease increases, it is important to characterize the impact of activity limitation on patients' lives in diverse settings and the potential for surgical intervention to ease the burden of chronic arthritis. Copyright © 2015 by the American College of Rheumatology.

  1. Impact of parental emotional support and coercive control on adolescents' self-esteem and psychological distress: results of a four-year longitudinal study.

    Science.gov (United States)

    Boudreault-Bouchard, Anne-Marie; Dion, Jacinthe; Hains, Jennifer; Vandermeerschen, Jill; Laberge, Luc; Perron, Michel

    2013-08-01

    This study aims at investigating the impact of parental practices on youths' adjustment. In all, 605 adolescents completed questionnaires at ages 14, 16 and 18. Self-esteem, psychological distress as well as parental emotional support and coercive control were measured. Analyses based on individual growth models revealed that self-esteem increased with age, but psychological distress remained stable over time. Boys reported higher levels of self-esteem and lower levels of psychological distress than girls. Maternal and paternal emotional support reinforced self-esteem over time. Maternal coercive control undermined self-esteem, but only at ages 16 and 18. Psychological distress decreased with parental emotional support but increased with parental coercive control at ages 14, 16 and 18. Overall, these results indicate that positive parental practices are related to youths' well-being. These findings support the importance of establishing intervention strategies designed to promote best practices among parents of teenagers to help them develop into well-adjusted adults. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  2. High Proportions of Multidrug-Resistant Acinetobacter spp. Isolates in a District in Western India: A Four-Year Antibiotic Susceptibility Study of Clinical Isolates

    Directory of Open Access Journals (Sweden)

    Ingvild Odsbu

    2018-01-01

    Full Text Available The purpose of the study was to determine the proportions of multidrug-resistant (MDR Acinetobacter spp. isolates from the district of Nashik in Western India during the period from 2011–2014. Antibacterial susceptibility testing of isolates from inpatients and outpatients was performed using Kirby–Bauer disc diffusion method to determine inhibitory zone diameters. Proportions of non-susceptible isolates were calculated from the antibacterial susceptibility data. MDR was defined as an isolate being non-susceptible to at least one antibacterial agent in at least three antibacterial categories. The change in proportions of MDR isolates; extended-spectrum β-lactamase (ESBL-producing isolates; and non-susceptible isolates to specific antibacterial categories over calendar time was investigated by logistic regression. The proportions of MDR and ESBL-producing isolates ranged from 89.4% to 95.9% and from 87.9% to 94.0%; respectively. The proportions of non-susceptible isolates to aminoglycosides; carbapenems; antipseudomonal penicillins/β-lactamase inhibitors; cephalosporins; folate pathway inhibitors; or penicillins/β-lactamase inhibitors exceeded 77.5%. Proportions of fluoroquinolone and tetracycline non-susceptible isolates ranged from 65.3% to 83.3% and from 71.3% to 75.9%; respectively. No changes in trends were observed over time; except for a decreasing trend in fluoroquinolone non-susceptible isolates (OR = 0.75 (95% CI, 0.62–0.91. Significantly higher proportions of non-susceptible; MDR and ESBL-producing isolates were found among isolates from the respiratory system compared to isolates from all other specimen types (p < 0.05. High proportions of MDR Acinetobacter spp. isolates were observed in the period from 2011–2014. Antimicrobial stewardship programmes are needed to prevent the emergence and spread of antibiotic resistance.

  3. Four-year follow-up of transient ischemic attacks, strokes, and mimics: a retrospective transient ischemic attack clinic cohort study.

    Science.gov (United States)

    Dutta, Dipankar; Bowen, Emily; Foy, Chris

    2015-05-01

    There is limited information on outcomes from rapid access transient ischemic attack (TIA) clinics. We present 4-year outcomes of TIAs, strokes, and mimics from a UK TIA clinic database. All patients referred between April 2010 and May 2012 were retrospectively identified and outcomes determined. End points were stroke, myocardial infarction, any vascular event (TIA, stroke, or myocardial infarction), and all-cause death. Data were analyzed by survival analysis. Of 1067 patients, 31.6% were TIAs, 18% strokes, and 50.4% mimics. Median assessment time was 4.5 days from onset and follow-up was for 34.9 months. Subsequent strokes occurred in 7.1% of patients with TIA, 10.9% of patients with stroke, and 2.0% of mimics at the end of follow-up. Stroke risk at 90 days was 1.3% for patients diagnosed as TIA or stroke. Compared with mimics, hazard ratios for subsequent stroke were 3.88 (1.90-7.91) for TIA and 5.84 (2.81-12.11) for stroke. Hazard ratio for any subsequent vascular event was 2.91 (1.97-4.30) for TIA and 2.83 (1.81-4.41) for stroke. Hazard ratio for death was 1.68 (1.10-2.56) for TIA and 2.19 (1.38-3.46) for stroke. Our results show a lower 90-day stroke incidence after TIA or minor stroke than in earlier studies, suggesting that rapid access daily TIA clinics may be having a significant effect on reducing strokes. © 2015 American Heart Association, Inc.

  4. 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.

  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. Follow-up study of the WHO-Global Campaign Against Epilepsy Demonstration Project in rural China after four years of its terminati

    Directory of Open Access Journals (Sweden)

    YANG Hong-chao

    2012-10-01

    Full Text Available Objective To follow up the outcome of 2455 patients with epilepsy (the cohort treated by phenobarbital (PB during the WHO-Global Campaign Against Epilepsy Demonstration Project (GCAE/DP in rural China after 4 years of its termination, to provide practical evidence for community control of epilepsy in rural China. Methods In 2008, the trained local township physicians, using a well-designed questionnaire, by door-to-door interview, followed up the cohort residents in 8 counties of 6 provinces where the GCAE/DP was conducted and completed for 4 years. Results One thousand seven hundred and eighty of the 2455 patients were visited in the follow-up study. Nine hundred and thirty-nine (52.75% were still taking PB, the effectiveness rates (seizure free and seizure frequency reduced > 50% among them at 12, 24, 36, 48 months after the GCAE/DP were 66.77% (627/939, 68.37% (642/939, 71.35% (670/939, 73.06% (686/939, respectively. In 841 patients (47.25% who stopped taking PB, 244 cases (29.01% were seizure free, 320 (38.05% still had seizures but discontinued the treatment, 277 (32.94% were treated by other antiepileptic drugs (AEDs. Chi-square test was used to compare the therapeutic effectiveness in 939 patients continuing taking PB and 841 patients abandoning PB. Patients continuing taking PB had a better outcome than patients abandoning PB (χ2 = 12.423, P = 0.002. The main reasons of PB withdrawal were seizure free (29.01%, taking other AEDs (32.94%, no free drug or no money (11.06%, effect was not good or PB was not available (6.42% . Two hundred and six patients died between 2002 and 2008. The standardized mortality ratio (SMR for the cohort was 19.10. The three leading causes of death were: accidents (n = 59, 28.64% , cerebrovascular diseases (n = 30, 14.56% and status epilepticus (n = 28, 13.59%. Conclusion The GCAE/DP was successful and with long term good results, so it is worthy for further promotion. The mortality rate was very high in the

  7. A Prospective Observational Study

    African Journals Online (AJOL)

    Methods: This was a prospective, questionnaire-based observational study. Printed questionnaires were distributed to the visitors of medical, surgical and neurosurgical ICU patients to determine awareness of basic infection control practices among visitors to an ICU. All the ICU staff, including nurses, doctors, consultant ...

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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 ...

  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. 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.

  16. 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.

  17. Study on Transitions in Employment, Ability and Motivation (STREAM): The Design of a Four-year Longitudinal Cohort Study among 15,118 Persons Aged 45 to 64 Years

    NARCIS (Netherlands)

    Ybema, Jan F.; Geuskens, Goedele A.; van den Heuvel, Swenne G.; de Wind, Astrid; Leijten, Fenna R M; Joling, Catelijne I.; Blatter, Birgitte M.; Burdorf, Alex; van der Beek, Allard J.; Bongers, Paulien M.

    2014-01-01

    Aims: The objective of the Study on Transitions in Employment, Ability and Motivation (STREAM) is to acquire knowledge on determinants of transitions in employment and work productivity among persons aged 45-64 years. Research Framework: A research framework was developed, in which transitions in

  18. Study on transitions in employment, ability and motivation (STREAM): the design of a four-year longitudinal cohort study among 15,118 persons aged 45 to 64 years

    NARCIS (Netherlands)

    Ybema, J.F.; Geuskens, G.A.; Heuvel, S.G. van den; Wind, A. de; Leijten, F.R.M.; Jolings, C.; Blatter, B.M.; Burdorf, A.; Beek, A.J. van der; Bongers, P.M.

    2014-01-01

    The objective of the Study on Transitions in Employment, Ability and Motivation (STREAM) is to acquire knowledge on determinants of transitions in employment and work productivity among persons aged 45-64 years. Research Framework: A research framework was developed, in which transitions in

  19. A Prospective Study

    Directory of Open Access Journals (Sweden)

    Nandeesh BN

    2014-08-01

    Lattice and Avellino's dystrophies among dystrophies and Salzmann's nodular degeneration showed specific stromal deposits making them easily diagnosable at histopathology, whereas the rest showed non-specific stromal changes mandating correlation with clinical findings. Seven regraft corneas showed stromal fibrosis making identification of primary dystrophy impossible. However, transmural vascularization and lymphocytic stromal infiltrate were prominently noted in failed grafts though their numbers were few. Conclusion: This histopathologic study characterizes classic features of macular, Avellino's, lattice corneal dystrophies and Salzmann's degeneration for their microscopic diagnosis, while the rest showed non-specific changes. Stromal edema was prominently noted in degenerations than in dystrophies. Degree of stromal vascularization and type of cellular infiltrate need attention in regrafts. [J Interdiscipl Histopathol 2014; 2(4.000: 197-204

  20. 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.

  1. Students Who Become Nonpersisters: Who, When, Why, and To Do What? The Astin Index: One Approach to Predicting Persistence at UMCP Four Years after Initial Enrollment. Maryland Longitudinal Study Research Highlights. Research Reports 5 and 9.

    Science.gov (United States)

    Maryland Univ., College Park. Maryland Longitudinal Study Steering Committee.

    Two reports of student nonpersistence at the University of Maryland, College Park (UMCP), are provided, taken from the Maryland Longitudinal Study. The first study, which examined four questions regarding students who become nonpersisters, found the following: nonpersisters had poor high school and first-semester study habits, were apt to have…

  2. 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. 

  3. Scars remaining in atom bomb survivors: a four year follow-up study. The status of lenticular opacities caused by atomic radiation, Hiroshima and Nagasaki, Japan, 1951-1953

    Energy Technology Data Exchange (ETDEWEB)

    Wells, W; Tsukifuji, Neal; Sinskey, R M

    1959-01-01

    Two studies on injuries suffered by survivors of the atomic explosions on Hiroshima and Nagasaki are described. Separate abstracts have been prepared for each paper for inclusion in the Energy Database. (DMC)

  4. 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

  5. Mathematics Teachers' Views about Teaching as a Profession: Final Results of a Four-Year Longitudinal Study. A Report from the Urban Mathematics Collaborative Documentation Project. Program Report 91-4.

    Science.gov (United States)

    Middleton, James A.; And Others

    This paper reports the results of a 4-year longitudinal study of approximately 600 urban mathematics teachers who were surveyed to ascertain their attitudes regarding certain attributes of the profession of mathematics teaching, specifically: the use of the professional organization as a major referent, the belief in service to the public, the…

  6. Breaking the Glass Ceiling in Oklahoma Higher Education: A Case Study of Kate Galt Zaneis, the First Woman President of a Public Four-Year College or University in the United States

    Science.gov (United States)

    Smarr, Debbie L.

    2011-01-01

    Women's leadership within higher education continues to be the focus of research and essays. A look into the lives of past women leaders in higher education can provide a potential "road-map" for aspiring women to follow as they develop their leadership style to aid in their upward mobility. The study of the first woman to lead a public…

  7. Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia-spectrum and bipolar I disorders: Four-year follow-up of the ACCESS II study.

    Science.gov (United States)

    Schöttle, Daniel; Schimmelmann, Benno G; Ruppelt, Friederike; Bussopulos, Alexandra; Frieling, Marietta; Nika, Evangelia; Nawara, Luise Antonia; Golks, Dietmar; Kerstan, Andrea; Lange, Matthias; Schödlbauer, Michael; Daubmann, Anne; Wegscheider, Karl; Rohenkohl, Anja; Sarikaya, Gizem; Sengutta, Mary; Luedecke, Daniel; Wittmann, Linus; Ohm, Gunda; Meigel-Schleiff, Christina; Gallinat, Jürgen; Wiedemann, Klaus; Bock, Thomas; Karow, Anne; Lambert, Martin

    2018-01-01

    The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years. Over 4 years, only 10 patients disengaged from ACCESS. Another 23 left for practical reasons and were successfully transferred to other services. Hospitalization rates remained low (13.0% in year 3; 9.1% in year 4). Involuntary admissions decreased from 35% in the 2 years prior to ACCESS to 8% over 4 years in ACCESS. Outpatient contacts remained stably high at 2.0-2.4 per week. We detected significant improvements in psychopathology (effect size d = 0.79), illness severity (d = 1.29), level of functioning (d = 0.77), quality of life (d = 0.47) and stably high client satisfaction (d = 0.02) over 4 years. Most positive effects were observed within the first 2 years with the exception of illness severity, which further improved from year 2 to 4. Within continuous intensive 4-year ACCESS-care, sustained improvements in psychopathology, functioning, quality of life, low service disengagement and re-hospitalization rates, as well as low rates of involuntary treatment, were observed in contrast to other studies, which reported a decline in these parameters once a specific treatment model was stopped. Yet, stronger evidence to prove these results is required. Clinical Trial Registration Number: NCT01888627.

  8. The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study.

    Science.gov (United States)

    Huang, Dong-Ning; Yu, Miao; Xu, Nan-Fang; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Liu, Zhong-Jun

    2017-02-20

    Anterior cervical discectomy and fusion (ACDF) is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2-C7 angles (C2-C7), C0-C7 angles (C0-C7), external auditory meatus (EAM) tilt, sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), spinal sacral angles (SSA), Superior adjacent inter-vertebral angle (SAIV), inferior adjacent inter-vertebral angle (IAIV) and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Among the parameters, C2-C7 and C0-C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0-C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2-C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment modifications after ACDF. The compensatory alteration of spino-pelvic sagittal

  9. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China.

    Science.gov (United States)

    Qin, Xiaobo; Li, Yu'e; Wang, Hong; Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu; Fan, Fenliang; Liao, Yulin

    2016-11-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5tha(-1) biochar (BC1), application of 10tha(-1) biochar (BC2), application of 10tha(-1) biochar (BC3), rice straw return at 2400kgha(-1)(RS) and inoculated rice straw return at 2400kgha(-1)(RI). The results indicated that biochar amendment significantly decreased methane (CH4) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH4 flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p<0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20tha(-1)) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. The relationship between changes of cervical sagittal alignment after anterior cervical discectomy and fusion and spino-pelvic sagittal alignment under roussouly classification: a four-year follow-up study

    Directory of Open Access Journals (Sweden)

    Dong-Ning Huang

    2017-02-01

    Full Text Available Abstract Background Anterior cervical discectomy and fusion (ACDF is widely used in the treatment of cervical degenerative disease; however, the variation of cervical sagittal alignment changes after ACDF has been rarely explored. The purpose of this study is to determine the relationship between changes of cervical sagittal alignment after ACDF and spino-pelvic sagittal alignment under Roussouly classification. Methods A cohort of 133 Chinese cervical spondylotic patients who received ACDF from 2011 to 2012 was recruited. All patients were categorized with Roussouly Classification. Lateral X-ray images of global spine were obtained, and preoperative and postoperative parameters were measured and analyzed, including C2–C7 angles (C2–C7, C0–C7 angles (C0–C7, external auditory meatus (EAM tilt, sacral slope (SS, thoracic kyphosis (TK, lumbar lordosis (LL, spinal sacral angles (SSA, Superior adjacent inter-vertebral angle (SAIV, inferior adjacent inter-vertebral angle (IAIV and et al. The Wilcoxon signed-rank test was used for intragroup comparisons preoperatively and at postoperative 48 months. Results Among the parameters, C2–C7 and C0–C7 showed significant increase, while EAM TK, and IAIV decreased significantly. In type I, EAM and TK decreased significantly, however SS showed a significant increase; in type II, TK showed a significant decrease, but SSA showed a significant increase; in type III, a significant increase of C0–C7 was observed with a significant decrease in EAM, nevertheless, LL, SS and SSA showed significant decreases; and in type IV, C2–C7 showed a significant increase and EAM decreased significantly. The percentage of lordotic alignment in cervical spine increased, which was presenting in type I, III and IV. Nevertheless, the amount of patients with straight cervical alignment increased in type II. Conclusion The backward movement of head occurs is the compensatory mechanism in cervical sagittal alignment

  11. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Xiaobo [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Semiarid Prairie Agricultural Research Centre, Agriculture and Agri-Food Canada, P.O. Box 1030, Swift Current, Saskatchewan S9H 3X2 (Canada); Li, Yu' e, E-mail: liyue@caas.cn [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Wang, Hong [Semiarid Prairie Agricultural Research Centre, Agriculture and Agri-Food Canada, P.O. Box 1030, Swift Current, Saskatchewan S9H 3X2 (Canada); Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu [Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, The Key Laboratory for Agro-Environment, Ministry of Agriculture, No.12 Zhongguancun South Street, Haidian district, Beijing 100081 (China); Fan, Fenliang [Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081 (China); Liao, Yulin [Soils and Fertilizer Institute of Hunan Province, Changsha 410125 (China)

    2016-11-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5 t ha{sup −} {sup 1} biochar (BC1), application of 10 t ha{sup −} {sup 1} biochar (BC2), application of 10 t ha{sup −} {sup 1} biochar (BC3), rice straw return at 2400 kg ha{sup −} {sup 1}(RS) and inoculated rice straw return at 2400 kg ha{sup −} {sup 1}(RI). The results indicated that biochar amendment significantly decreased methane (CH{sub 4}) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH{sub 4} flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p < 0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20 t ha{sup −} {sup 1}) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. - Graphical abstract: Relative change ratio of different biochar amendments and rice straw residues to CK treatment during the

  12. Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China

    International Nuclear Information System (INIS)

    Qin, Xiaobo; Li, Yu'e; Wang, Hong; Liu, Chong; Li, Jianling; Wan, Yunfan; Gao, Qingzhu; Fan, Fenliang; Liao, Yulin

    2016-01-01

    To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5 t ha"− "1 biochar (BC1), application of 10 t ha"− "1 biochar (BC2), application of 10 t ha"− "1 biochar (BC3), rice straw return at 2400 kg ha"− "1(RS) and inoculated rice straw return at 2400 kg ha"− "1(RI). The results indicated that biochar amendment significantly decreased methane (CH_4) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH_4 flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p < 0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20 t ha"− "1) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system. - Graphical abstract: Relative change ratio of different biochar amendments and rice straw residues to CK treatment during the rice growing seasons from 2012 to 2015. * and *** stand for

  13. 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)

  14. Prospective outcomes of injury study.

    Science.gov (United States)

    Derrett, S; Langley, J; Hokowhitu, B; Ameratunga, S; Hansen, P; Davie, G; Wyeth, E; Lilley, R

    2009-10-01

    In New Zealand (NZ), 20% of adults report a disability, of which one-third is caused by injury. No prospective epidemiological studies of predictors of disability following all-cause injury among New Zealanders have been undertaken. Internationally, studies have focused on a limited range of predictors or specific injuries. Although these studies provide useful insights, applicability to NZ is limited given the importance of NZ's unique macro-social factors, such as NZ's no-fault accident compensation and rehabilitation scheme, the Accident Compensation Corporation (ACC). (1) To quantitatively determine the injury, rehabilitation, personal, social and economic factors leading to disability outcomes following injury in NZ. (2) To qualitatively explore experiences and perceptions of injury-related outcomes in face-to-face interviews with 15 Māori and 15 other New Zealanders, 6 and 12 months after injury. Four geographical regions within NZ. Prospective cohort study with telephone interviews 1, 4 and 12 months after injury. 2500 people (including 460 Māori), aged 18-64 years, randomly selected from ACC's entitlement claims register (people likely to be off work for at least 1 week or equivalent). Telephone interviews, electronic hospital and ACC injury data. Exposures include demographic, social, economic, work-related, health status, participation and/or environmental factors. Primary: disability (including WHODAS II) and health-related quality of life (including EQ-5D). Secondary: participation (paid and unpaid activities), life satisfaction and costs. Separate regression models will be developed for each of the outcomes. Repeated measures outcomes will be modelled using general estimating equation models and generalised linear mixed models.

  15. 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.)

  16. 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.)

  17. [Prospective study in 2 hospitals].

    Science.gov (United States)

    Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A

    2016-06-01

    The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  18. Randomized, interventional, prospective, comparative study to ...

    African Journals Online (AJOL)

    Randomized, interventional, prospective, comparative study to evaluate the antihypertensive efficacy and tolerability of ramipril versus telmisartan in stage 1 hypertensive patients with diabetes mellitus.

  19. 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.

  20. 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

  1. 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.

  2. Neurocutaneous syndrome: A prospective study

    Directory of Open Access Journals (Sweden)

    Radheshyam Purkait

    2011-01-01

    Full Text Available Background: Neurocutaneous syndromes (NCS are a group of genetic disorders that produce a variety of developmental abnormalities of the skin along with an increased risk of neurological complications. Cutaneous manifestations usually appear early in life and progress with time, but neurological features generally present at a later age. There is a paucity of data regarding the evolution of skin lesions and their correlation with the central nervous system involvement in children. Aim: The primary objective was to track the course of skin lesions in various forms of NCS in the pediatric age group. Our secondary aim was to assess whether there was any predictive value of the lesions in relation to the neurological manifestations. Materials and Methods: This prospective longitudinal study was conducted at a tertiary care pediatric dermatology referral clinic of the Institute of Child Health, Kolkata, West Bengal. Children between the age group 0 and 12 years were included in the study on the basis of standard diagnostic criteria for different NCS, during the period from March, 2000 to February, 2004, and each of the enrolled cases were followed up for a duration of six years. Results: The study population comprised of 67 children (35 boys, 32 girls.The mean age of presentation was 33.8±27.8 months (range 10 days to 111 months. The various forms of NCS observed was neurofibromatosis 1(NF1 (n=33, tuberous sclerosis complex (TSC (n=23, Sturge Weber syndrome (n=6, ataxia telangiectasia (n=2, PHACE syndrome (n=1, incontinentia pigmenti (n=1, and hypomelanosis of Ito (n=1. The presentations were varied, ranging from predominantly cutaneous to primarily neurological, depending on the disease entity and age group concerned. There was a significant increase in the number of café au lait macules (CALMs with time (P=0.0002 in NF1, unlike that of hypopigmented macules of TSC (P=0.15. Statistically, no relation was documented between the evolution of skin

  3. 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

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. 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

  9. 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

  10. Uranium project. Geochemistry prospection[Study of Uranium geochemical prospection in Uruguay]; Proyecto Uranio. Prospeccion geoquimica

    Energy Technology Data Exchange (ETDEWEB)

    Lambert, J

    1983-07-01

    Geochemistry studies the distribution of the chemicals elements in the terrestrial crust and its ways to migrate. The terminology used in this report is the following one: 1) Principles of the prospection geochemistry 2) Stages of the prospection geochemistry 3)utility of the prospection geochemistry 4) geochemistry of uranium 5) procedures used within the framework of uranium project 6) Average available 7) Selection of the zones of prospection geochemistry 8) Stages of the prospection, Sample preparation and analisis 9) Presentation of the results.

  11. A prospective study of gentamicin ototoxicity

    DEFF Research Database (Denmark)

    Winkel, O; Hansen, M M; Kaaber-Bühler, Søren

    2010-01-01

    of gentamicin did not rule out the possiblity of ototoxicity. These results urge the continuing of prospective studies and indicate that gentamicin should be used only as a link in the primary treatment of severe infection or in cases in which other, less toxic agents have failed....

  12. A prospective study of gentamicin ototoxicity

    DEFF Research Database (Denmark)

    Winkel, O; Hansen, M M; Kaaber-Bühler, Søren

    1978-01-01

    of gentamicin did not rule out the possiblity of ototoxicity. These results urge the continuing of prospective studies and indicate that gentamicin should be used only as a link in the primary treatment of severe infection or in cases in which other, less toxic agents have failed....

  13. 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.

  14. Complications of ERCP: a prospective study

    DEFF Research Database (Denmark)

    Christensen, Merete; Matzen, Peter; Schulze, Svend

    2004-01-01

    included in this prospective study. Complications were assessed at the time of ERCP and by postal/telephone contact at 30-days after the procedure. RESULTS: A total of 1177 ERCPs were included in the analysis, of which 56.2% were therapeutic. The 30-day complication rate was 15.9%; the procedure...... occurred in relation to 5% of the ERCP procedures (3 deaths). Cardiorespiratory complications occurred in 2.3% (2 deaths). Dilated bile duct ( p = 0.0001), placement of stent ( p = 0.001), and use of more than 40 mg of hyoscine-N-butyl bromide ( p ... analysis. Risk of pancreatitis was increased with age under 40 years ( p = 0.0078), placement of stent ( p = 0.031), and a dilated bile duct ( p = 0.036). CONCLUSIONS: This prospective study confirms that the complication rate of ERCP including therapeutic procedures is high. Cardiopulmonary complications...

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. Mathematical geology studies of deposit prospect types

    International Nuclear Information System (INIS)

    Liu Guangping

    1998-08-01

    Exact certainty prospect type of uranium deposit, not only can assure the quality of deposit prospects, but also increase economic benefits. Based on the standard of geological prospect of uranium deposit, the author introduces a method of Fuzzy Synthetical Comment for dividing prospect type of uranium deposit. The practical applications demonstrate that the regression accuracy, discriminated by Zadeh operator, of 15 known deposits is 100%

  20. 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

  1. 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.

  2. 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…

  3. 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…

  4. Prospective SAH Study in Japan, 2005(Prospective SAH Study)

    OpenAIRE

    塩川, 芳昭; 栗田, 浩樹; 藤井, 清孝; Yoshiaki, SHIOKAWA; Hiroki, KURITA; Kiyotaka, FUJII; 杏林大学脳神経外科; 杏林大学脳神経外科; 北里大学脳神経外科; Department of Neurosurgery, Kyorin University School of Medicine; Department of Neurosurgery, Kyorin University School of Medicine

    2009-01-01

    To clarify current treatment status of ruptured cerebral aneurysms in Japan, a prospective multicenter observational study on the treatment results for aneurysmal subarachnoid hemorrhage was conducted over calendar year 2005 and final 1-year outcomes were collected. Studied centers were selected from among institutes of committee member of Japanese stroke surgery organization or symposium of vasospasm in Japan. A total of 927 patients were enrolled in this study and treatment policies were le...

  5. Endodontic flare-ups: a prospective study.

    Science.gov (United States)

    Alves, Vanessa de Oliveira

    2010-11-01

    The objective of this prospective clinical study was to evaluate the incidence of flare-ups (pain and/or swelling requiring endodontic interappointment and emergency treatment) and identify the risk factors associated with their occurrence in patients who received endodontic treatment from June 2006 to June 2007 at the endodontics clinic of the São Paulo Dental Association (APCD), Jardim Paulista branch, São Paulo, Brazil. The incidence of flare-ups was 1.71% out of 408 teeth that had received endodontic therapy. Statistical analysis using the chi-squared test (P flare-up rate and the presence of a periradicular radiolucency. Copyright © 2010 Mosby, Inc. All rights reserved.

  6. 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

  7. 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.

  8. The BEST study - a prospective study to compare business class ...

    African Journals Online (AJOL)

    Background. As many as 10% of airline passengers travelling without prophylaxis for long distances may develop a venous thrombosis. There is, however, no evidence that economy class travellers are at increased risk of thrombosis. Objectives. A suitably powered prospective study, based on the incidence of deep-vein ...

  9. Bruxism in craniocervical dystonia: a prospective study.

    Science.gov (United States)

    Borie, Laetitia; Langbour, Nicolas; Guehl, Dominique; Burbaud, Pierre; Ella, Bruno

    2016-09-01

    Bruxism pathophysiology remains unclear, and its occurrence has been poorly investigated in movement disorders. The aim of this study was to compare the frequency of bruxism in patients with craniocervical dystonia vs. normal controls and to determine its associated clinical features. This is a prospective-control study. A total of 114 dystonic subjects (45 facial dystonia, 69 cervical dystonia) and 182 controls were included. Bruxism was diagnosed using a hetero-questionnaire and a clinical examination performed by trained dentists. Occurrence of bruxism was compared between the different study populations. A binomial logistic regression analysis was used to determine which clinical features influenced bruxism occurrence in each population. The frequency of bruxism was significantly higher in the dystonic group than in normal controls but there was no difference between facial and cervical dystonia. It was also higher in women than in men. Bruxism features were similar between normal controls and dystonic patients except for a higher score of temporomandibular jaw pain in the dystonic group. The higher frequency of bruxism in dystonic patients suggests that bruxism is increased in patients with basal ganglia dysfunction but that its nature does not differ from that seen in bruxers from the normal population.

  10. Ossiculoplasty: A Prospective Study of 80 Cases

    Directory of Open Access Journals (Sweden)

    Shrinivas Shripatrao Chavan

    2014-07-01

    Full Text Available Introduction: The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results hearing after tympanoplasty and tympanomastoid surgery for chronic otitis media. Today, otologists have a wide array of tools from which to choose, but may find it difficult to know which middle ear implant works best.   Materials and Methods: A prospective study of 80 patients who underwent ossiculoplasty was performed in the ear, nose, and throat (ENT department at a tertiary health care facility from 2011 to 2013. Patients with chronic suppurative otitis media with an air-bone gap (ABG of >25 dB with ossicular involvement were included in the study. Total ossicular replacement prosthesis (TORP, partial ossicular replacement prosthesis (PORP, and refashioned incus were used. Success was defined as ABG   Results: The majority patients were of middle age with moderate conductive hearing loss. Incus was the most susceptible ossicle. Overall success rate in this study was 80.0% with an average change of 15.76 dB in ABG.   Conclusion:  With continuing advances in our understanding of middle ear mechanics, the results of ossiculoplasty are improving and results can be very rewarding in experienced hands. Severity of preoperative ear discharge, preoperative mastoid cellularity, presence of disease, and surgical procedure proved to be significant prognostic factors. Autograft incus and PORP fared better when the malleus handle was present while TORP gave better results when the malleus handle was eroded.  

  11. 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.

  12. Injuries in competitive boxing. A prospective study.

    Science.gov (United States)

    Siewe, J; Rudat, J; Zarghooni, K; Sobottke, R; Eysel, P; Herren, C; Knöll, P; Illgner, U; Michael, J

    2015-03-01

    Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury. © Georg Thieme Verlag KG Stuttgart · New York.

  13. 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...

  14. 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.

  15. 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

  16. Depression after CABG: a prospective study

    Directory of Open Access Journals (Sweden)

    Joana Kátya Veras Rodrigues Sampaio Nunes

    2013-12-01

    Full Text Available INTRODUCTION: Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. OBJECTIVE: To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. METHODS: A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. RESULTS: The prevalence of patients aged 60-69 years was 22 patients (38.60%, 39 men (68.42%, 26 described themselves as mixed race (45.61%, 16 literate (28.07 % and 30 married (52.63%. The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32% at time zero to 17 (29.82% after. And with moderate, seven patients (12.28% before and 10 (17.54% after. In the categories of individuals with decreased minimum degree of 32 (56.14% to 28 (49.12%, and severe of three (5.26% for two (3.51% patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. CONCLUSION: There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory.

  17. 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.

  18. 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.

  19. Prospective study on quality of newborn care

    Directory of Open Access Journals (Sweden)

    N Khanam

    2013-12-01

    Full Text Available Background: Quality of services provided by health care provider, the closest health functionary to the community has impact on neonatal mortality. Aims: Study on quality of newborn care in rural areas.  Settings and Design: This is a prospective study in the field practice areas of J.N. Medical College and areas under primary health centre of public health care system in Wardha district.  Methods and Material: Modified quality check list on the basis of PHC MAP module guidelines for assessing the quality of service-module 6-user’s guide was prepared. Face to face interview with 205 (group-A/104 nos + group-B/101 nos mother of newborn was method to collected information in three postnatal visits.  Statistical analysis: Quality (verbal response of each service was quantified as acceptable, average and worst.  Quality of both the groups was compared by calculating P-value after utilizing Z-test.  Results: Over all acceptable quality of medical history was 30.03%, physical examination was 21.73%, preventive service was 91.17% and counseling was 24.83%. Significant difference between two groups were found on history taking for (cry, breathing and body movement of baby, recording weight and counseling regarding exclusive breast feeding for first 6 month of life. Worst quality in this study were observed in history for anything applying to eyes, umbilical cord stump and complication of baby for which appropriate management was taken. Except for weight recording and examination of head and fontanels all other variables under physical examination were not acceptable. Counseling regarding high risk condition of baby was only 13.66%. Conclusion: Existing newborn services except immunization is inadequate and needs to be strengthened especially physical examination and counseling services. 

  20. 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

  1. 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)...

  2. 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…

  3. 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

  4. 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…

  5. 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

  6. 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....

  7. 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…

  8. 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…

  9. 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)

  10. Prospects for future proton studies at HRIBF

    International Nuclear Information System (INIS)

    Bingham, C.R.; Batchelder, J. C.; Ginter, T.N.; Gross, C.J.; Grzywacz, R.; Janas, Z.; Karny, M.; McConnell, J.W.; Toth, K.S.; Rykaczewski, K.; Zganjar, E. F.

    2000-01-01

    Great progress has been made in the last 20 years in the study of proton emission from unstable nuclei, but the prospects for additional strides in the next several years are bright. The present main limitations on the study of proton radioactivity are related to the inability to produce copious quantities of nuclides beyond the proton drip line, and the difficulty of measuring proton radioactivity of a mass-separated nucleus in the first few microseconds of its existence. At the Holifield Facility we will attack the second of these limitations by using new signal processing CAMAC modules DGF-4C. Digitizing of the preamplifier signals should enable the analysis of a proton decay occurring at times even less than 1 microsecond after an implant in a strip detector. In the same process, the threshold energy at which we can make measurements will be lowered. These two things will hopefully enable the measurement of lower-energy, but faster decays of isotopes in the 100 Sn region and below. For the latter region, the proton decays crucial for a rp-process scenario are of particular interest (e.g. 69 Br decay). Secondly, for very short-lived species, we plan to make measurements (without residue separation) at points much closer to the target, thus reducing the flight time between the target and detector. As more intense radioactive beams become available, eg. 56 Ni, we will utilize these to produce more neutron-deficient nuclides by use of colder reactions than is possible with stable beams. In some cases where delayed proton emitters are present in the same isobaric chain, the use of the cold reactions with radioactive beams can provide purer samples of the isotope of interest, with a reduction in background from the delayed proton emitters in the same mass chain

  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. 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.

  13. A Study on Chocolate Consumption in Prospective Teachers

    Science.gov (United States)

    Ozgen, Leyla

    2016-01-01

    This study was planned and conducted to determine the chocolate consumption habits of prospective teachers. The study population was comprised of students attending the Faculty of Education at Gazi University in Ankara and the sample consisted of 251 prospective teachers selected with simple random sampling. 96.4% and 3.6% of the prospective…

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. [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.

  19. 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 ...

  20. 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.

  1. A PROSPECTIVE STUDY ON SPLENIC INJURY

    Directory of Open Access Journals (Sweden)

    Palanivel Rajagopal

    2017-04-01

    Full Text Available BACKGROUND An injured spleen is a well-known entity to those involved in trauma care. The majority of individual with a splenic injury now receive nonoperative intervention and therapy. This shift from operative to nonoperative treatment over the past several decades is a tremendous success story in which clinical judgment and reason triumphed over standard surgical dogma. In emergency room, restoration of airway, breathing and circulation should be focussed on. A careful history is the most important one. Nevertheless, the severity of the splenic injury plays a dominant part in determining whether nonoperative management is appropriate or-if-not-whether splenorrhaphy or splenectomy will be the more appropriate surgical option. As a general rule, younger, healthier patients with lower grade splenic injuries and fewer associated injuries and comorbidities are usually managed nonoperatively or with splenic repair, whether unstable, actively bleeding patients with more severe splenic trauma and/or multiple associated injuries require splenectomy. The aim of the study is to evaluate- 1. The impact of blunt or penetrating abdominal trauma on spleen. 2. Various modes of injury. 3. Various modes of clinical presentation of cases. 4. The value of various available investigations employed. 5. The various methods of treatment. 6. The morbidity and mortality. MATERIALS AND METHODS This study was a prospective study of 20 cases of splenic injury admitted in the triage ward of Mahatma Gandhi Memorial Government Medical College Hospital, Trichy, over a period of 2 years from December 2014 to December 2016. Once the patient is admitted, the name, age, sex and mode of injury are noted. The time interval between splenic injury and admission and time interval between admission to hospital and surgery are recorded. After resuscitating the patient, all patients were subjected to careful clinical examination. RESULTS The total number of patients who had sustained

  2. [Axial lumbar interbody fusion: prospective monocentric study].

    Science.gov (United States)

    Stulík, J; Adámek, S; Barna, M; Kaspříková, N; Polanecký, O; Kryl, J

    2014-01-01

    The aim of this prospective study was to evaluate clinical and radiographic results in the patients who underwent L5-S1 fixation using the technique of percutaneous lumbar interbody fusion (AxiaLIF). The study comprised 23 patients, 11 women and 12 men, who ranged from age of 21 to 63 years, with an average of 48.2 years. In all patients surgical posterior stabilisation involving the L5-S1 segment had previously been done. The initial indications for surgery were L5-S1 spondylolisthesis in 20 and L5-S1 spondylosis and stenosis in three patients. The AxiaLIF technique for L5-S1 fixation was indicated in overweight patients and in those after repeated abdominal or retroperitoneal surgery. A suitable position and shape of the sacrum or lumbosacral junction was another criterion. The patients were evaluated between 26 and 56 months (average, 40.4 months) after primary surgery and, on the basis of CT and radiographic findings, bone union and lumbosacral junction stability were assessed. The clinical outcome was investigated using the ODI and VAS systems and the results were statistically analysed by the Wilcoxon test for paired samples with statistical significance set at a level of 0.05. The average VAS value was 6.6 before surgery and, after surgery, 5.2 at three months, 4.2 at six months, 3.1 at one year, 2.9 at two years and 2.1 at three years (n=18). At two post-operative years, improvement in the VAS value by 56.1% was recorded. The average pre-operative ODI value was 25.1; the post-operative values were 17.0 at six months, 12.3 at one year, 10.6 at two years and 8.2 at three years (n=18). At two years after surgery the ODI value improved by 57.8%. To the question concerning their willingness to undergo, with acquired experience, surgery for the same diagnosis, 21 patients (91.3%) gave an affirmative answer. Neither screw breakage nor neurovascular damage or rectal injury was found. CT scans showed complete interbody bone fusion in 22 of the 23 patients (95

  3. 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...

  4. A prospective, controlled study of prophylactic drainage after colonic anastomoses

    DEFF Research Database (Denmark)

    Hoffmann, J.; Shokouh-Amiri, M H; Damm, P

    1987-01-01

    A prospective, randomized, controlled trial was designed to study the influence of a corrugated latex drain on anastomotic integrity, wound infection, and respiratory complications after elective colonic resections above the pelvic peritoneum. Sixty patients entered the trial; 28 were drained...

  5. A prospective descriptive study of the management of miscarriages ...

    African Journals Online (AJOL)

    Objective: To assess the current management of incomplete miscarriage at Harare and Parirenyatwa Hospitals and to determine the proportion of patients with incomplete miscarriage managed with Manual Vacuum Aspiration (MVA), sharp curettage or medical evacuation. Design: A prospective descriptive study.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. A prospective PET study of patients with glioblastoma multiforme

    DEFF Research Database (Denmark)

    Andersen, Preben B.; Blinkenberg, M; Lassen, U

    2006-01-01

    OBJECTIVE: To study the post-surgical metabolic and structural cerebral changes in patients with glioblastoma multiforme (GBM). MATERIALS AND METHODS: We examined ten patients prospectively with newly diagnosed GBM. All patients were primarily treated with surgery, followed by chemotherapy...... compared with structural imaging in the prospective evaluation of GBM. We found a difference in metabolic increase and tumor growth between the two treatment regimens, although this finding has limited relevance due to the design of the study....

  13. 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.

  14. Panorama de los estudios sobre aprendizaje de palabras en el habla de los niños de los doce meses a los cuatro años de edad Overview of the studies about word learning in the speech of children from two months to four years of age

    Directory of Open Access Journals (Sweden)

    Nicolás Arias

    2007-12-01

    Full Text Available Esta es una revisión de estudios empíricos sobre el aprendizaje de nuevas palabras en niños que comienzan a hablar. Se destacan tres grandes momentos en estos estudios. En el momento inicial, en la década de 1970, los estudios están sujetos al estudio del significado en distintos tipos de palabras. En el segundo momento (década de 1980 se estudia la relación entre el uso de nuevas palabras y expresiones verbales, y el desarrollo de conocimientos distintos al lenguaje. En el último momento (desde 1990 hasta la actualidad hay un despliegue de perspectivas conceptuales y de dispositivos experimentales en este campo de estudio. Es importante revisar en la investigación posterior algunos temas descuidados aún: el uso de palabras en oraciones, las definiciones precisas de las categorías gramaticales para clasificar palabras y las relaciones del aprendizaje de nuevas palabras con el resto del desarrollo del lenguaje en el niño.This is a review of empirical studies on word learning in children who are beginning to speak. The studies are distributed in three phases. The first phase, in the 1970’s, researchers studied the meaning in different kinds of words. In the second phase (1980’s the relationship between new words, verbal expressions and the development of distinct recognitions of language were studied. By the third phase (1990s to date there is a boom in new conceptual perspectives and experimental devices in this field of study. It is important to review in previous research some areas that were looked over such as: the use of words in sentences, more accurate definitions for grammatical categories used to classify words, and the relationship between new word learning and others aspects of a child’s language development.

  15. The Korea Nurses' Health Study: A Prospective Cohort Study.

    Science.gov (United States)

    Kim, Oksoo; Ahn, Younjhin; Lee, Hea-Young; Jang, Hee Jung; Kim, Sue; Lee, Jung Eun; Jung, Heeja; Cho, Eunyoung; Lim, Joong-Yeon; Kim, Min-Ju; Willett, Walter C; Chavarro, Jorge E; Park, Hyun-Young

    2017-08-01

    The Korea Nurses' Health Study (KNHS) is a prospective cohort study of female nurses, focusing on the effects of occupational, environmental, and lifestyle risk factors on the health of Korean women. Female registered nurses aged 20-45 years and living in the Republic of Korea were invited to join the study, which began in July 2013. They were asked to complete a web-based baseline survey. The study protocols and questionnaires related to the KNHS are based on the Nurses' Health Study 3 (NHS3) in the United States, although they were modified to reflect the Korean lifestyle. Participants were asked about demographic, lifestyle factors, disease history, occupational exposure, reproductive factors, and dietary habits during their adolescence: Follow-up questionnaires were/will be completed at 6-8 month intervals after the baseline survey. If a participant became pregnant, she answered additional questionnaires containing pregnancy-related information. Among 157,569 eligible female nurses, 20,613 (13.1%) completed the web-based baseline questionnaire. The mean age of the participants was 29.4 ± 5.9 years, and more than half of them were in their 20s. Eighty-eight percent of the participants had worked night shifts as a nurse (mean, 5.3 ± 4.3 nights per month). Approximately 80% of the participants had a body mass index below 23 kg/m 2 . Gastrointestinal diseases were the most prevalent health issues (25.9%). The findings from this prospective cohort study will help to identify the effects of lifestyle-related and occupational factors on reproductive health and development of chronic diseases in Korean women.

  16. 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.

  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. 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.

  19. ¿Qué Efecto Tiene Asistir a Sala Cuna y Jardín Infantil Desde los Tres Meses Hasta los Cuatro Años de Edad?: Estudio Longitudinal en la Junta Nacional de Jardines Infantiles What Is the Effect of Attending Nursery School Between Three Months and Four Years of Age?: A Longitudinal Study in the National Preschool Association

    Directory of Open Access Journals (Sweden)

    Ximena Seguel

    2012-11-01

    Full Text Available Este estudio longitudinal cuasi-experimental con grupo de comparación examinó el efecto de asistir desde 1 a 4 años de edad a jardines de la Junta Nacional de Jardines Infantiles (JUNJI de Chile sobre el desarrollo/aprendizaje de los párvulos y el efecto diferencial de asistir a partir de los 3 años. El muestreo fue bietápico (41 jardines y 427 niños al inicio y estratificado por región del país. El grupo de comparación, con características socioeconómicas similares (184 niños al inicio, no asistía a sala cuna. Los niños fueron evaluados anualmente con el Inventario de Desarrollo Battelle. También se recogieron variables familiares y educativas con entrevistas semi-estructuradas y pautas de observación. Comparaciones usando Propensity Score Matching y análisis de Mínimos Cuadrados Ordinarios arrojaron que alrededor del 80% de los niños cursa un desarrollo normal, independientemente de que asistan a los jardines infantiles JUNJI o permanezcan en sus casas. Asistir desde los 3 años tendría un efecto positivo en el desarrollo infantil. La calidad de las prácticas pedagógicas en lactantes y la actitud didáctica familiar explicarían mayormente el desarrollo de los párvulos.This quasi-experimental longitudinal study with comparison group examined the effect on the learning and developmental levels of infants attending the National Preschool Association (JUNJI nursery schools in Chile (between 3 months and 4 years of age and the differential effect of attending them from 3 years of age onward. A two-stage (41 nurseries and 427 children at the beginning and stratified sample by region was used. The comparison group, with similar socioeconomic characteristics (184 children at the beginning, did not attend a nursery school. Children were assessed yearly with the Battelle Developmental Inventory. Family and educational variables were collected using semi-structured interviews and an observational guideline. Comparisons using

  20. 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.

  1. 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.

  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. 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.

  4. 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....

  5. 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.

  6. 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.

  7. 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.

  8. [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.

  9. [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.

  10. Prospective Studies of Risk Factors Associated with Type 2 Diabetes, Cardiovascular Disease, and Mortality in Elderly Women

    DEFF Research Database (Denmark)

    Møller, Katrine Dragsbæk

    and novel risk factors and their relation to ageing, disease, and mortality in elderly Danish women. The studies are epidemiological in their character and based on data from the Prospective Epidemiological Risk Factor (PERF) study, a community-based cohort study on 5,855 elderly Danish women enrolled......The world’s population is ageing. With an increased life expectancy across the globe, more people will live into old age. Women outlive men averagely by four years, warranting an increased focus on healthy ageing in women. The demographic shift resulting in an increased fraction of elder...... individuals has given rise to concerns about whether the extra life years added are spent in good health or with disease conditions resulting in high impacts on health care systems, socioeconomic relations and on the individual level. The World Health Organization predicts the burden of non...

  11. Prospective study of caffeine consumption and risk of Parkinson's disease in men and women.

    Science.gov (United States)

    Ascherio, A; Zhang, S M; Hernán, M A; Kawachi, I; Colditz, G A; Speizer, F E; Willett, W C

    2001-07-01

    Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in two ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every two to four years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23-0.78; p for trend coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1-3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease.

  12. 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.

  13. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    Science.gov (United States)

    Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...

  14. A prospective study of Vitamin A Utilization in Lagos, Nigeria ...

    African Journals Online (AJOL)

    Also, drug utilization studies are primary in establishing mechanisms to promote the use of this vitamin. Hence, we investigated the use of Vitamin A in 4 referral paediatric units in Lagos, Nigeria. The study was prospective with the use of questionnaires administered to those patients placed on Vitamin A therapy among 380 ...

  15. Dropout from exercise programs for seniors: A prospective cohort study

    NARCIS (Netherlands)

    Stiggelbout, M.; Hopman-Rock, M.; Tak, E.; Lechner, L.; Mechelen, W. van

    2005-01-01

    This study examines dropout incidence, moment of dropout, and switching behavior in organized exercise programs for seniors in the Netherlands, as determined in a prospective cohort study (with baseline measurements at the start of the exercise program and follow-up after 6 months; N = 1,725,

  16. Weight at birth and subsequent fecundability: a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Cathrine Wildenschild; Hammerich Riis, Anders; Ehrenstein, Vera

    2014-01-01

    OBJECTIVE: To examine the association between a woman's birth weight and her subsequent fecundability. METHOD: In this prospective cohort study, we included 2,773 Danish pregnancy planners enrolled in the internet-based cohort study "Snart-Gravid", conducted during 2007-2012. Participants were 18...

  17. 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.

  18. Social Capital and Health: A Review of Prospective Multilevel Studies

    Science.gov (United States)

    Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

    2012-01-01

    Background This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health. PMID:22447212

  19. 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.

  20. 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.

  1. [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.

  2. 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)

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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…

  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. Backache amongst soldiers: a prospective analytical study

    International Nuclear Information System (INIS)

    Ilyas, S.; Rehman, A.U.; Janjua, S.H.; Tarrar, A.M.

    2012-01-01

    Objective: To investigate the occupational predispositions of low back pain in soldiers Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital, Bahawalpur, from June 2009 to Jan 2010. Patients and Methods: A questionnaire was developed to investigate the occupation-related issues in soldiers reporting with low backache in surgical OPD at CMH Bahawalpur. It included personal and occupational factors. The body mass index was also calculated. Of the 107 male soldiers assessed, 90 were enrolled into the study. The statistical analysis was performed by descriptive analysis of the data using SPSS 17.0. Results: Of all the soldiers evaluated (n=90), 32 (35.6%) were clerks/computer operators, 21 (23.1%) were drivers and 14(15.6%) were signal men. All were males (100%) and the average BMI was 24.8 kg/m2. The 69 (76.7%) patients who had backache had prolonged working hours (average 10.8 hours per day), 68 (75.6%) patients used to sleep over tape/nawar bed and only 12 (13.3%) had been sleeping on mattresses. The onset of pain was sudden in 58 (64.4%) patients. 27 (23.3%) had developed acute backache after prolonged sitting, 21 (30%) after lifting heavy objects. The pain was exaggerated by doing morning physical training 82 (91.1%), prolonged sitting 61 (67.8%) and standing with rifle 24 (26.7%). Conclusion: The prevalence of low back pain in sedentary occupation or soldiers on sitting jobs was higher 69 (76%). The number of working hours on these occupations was associated with occurrence as well as aggravation of low back pain. (author)

  10. Prospect of heavy ion studies in Japan

    International Nuclear Information System (INIS)

    Sakai, M.

    1976-01-01

    The status and future developments of heavy ion facilities in Japan are presented. New tandem, linear accelerator and Mumatron for studies of nuclear matter are under construction. Mumatron which provides 500 MeV/nucleon with rather small intensity consists of four parts, namely, Wideroe-type linear accelerator, Alvarez-type linear accelerator, Cockcroft-Walton accelerator and synchrotron. Mumatron is expected not only to open an entirely new field of nuclear physics but for application to the cancer therapy

  11. GLAUCOMA IN PSEUDOEXFOLIATION- CLINICAL PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Balasubramanian M. Manickavelu

    2018-01-01

    Full Text Available BACKGROUND Pseudoexfoliation is one of the common cause of secondary open-angle glaucoma worldwide with a mean progression rate higher than primary open-angle glaucoma. In India, prevalence rate of pseudoexfoliation is around 2% (Hiller et al. In South India, the prevalence rate is 6% in >40 years of age as per Krishnadas et al in 2003. The aim of the study is to study the demographic aspects of pseudoexfoliation, the frequency of glaucoma in patients with pseudoexfoliation syndrome and to assess the treatment response in pseudoexfoliation syndrome. MATERIALS AND METHODS The study was conducted among 96 patients with pseudoexfoliation who attended OP Department of Ophthalmology, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai, from January 2017 to June 2017. Complete ocular examination with visual acuity, anterior segment examination, intraocular pressure, gonioscopy, fundus examination, central corneal thickness, visual field, ultrasound B scan and ultrasound biomicroscopy was done. RESULTS Incidence of glaucoma is more common in pseudoexfoliation and most of them have open angles. All patients with pseudoexfoliation should undergo complete glaucoma evaluation for early detection. Further ophthalmologist should focus on detection of pseudoexfoliation, since it is related to high risk of operative complication. CONCLUSION Incidence of glaucoma is more in pseudoexfoliation with most common bilateral presentation with open angles with recalcitrant intraocular pressure. Severity of optic nerve damage and with progression of field defects appeared to be more compared to primary open-angle glaucoma. Better response to combination drug therapy and surgical therapy than primary open-angle glaucoma.

  12. Statistical principles for prospective study protocols:

    DEFF Research Database (Denmark)

    Christensen, Robin; Langberg, Henning

    2012-01-01

    In the design of scientific studies it is essential to decide on which scientific questions one aims to answer, just as it is important to decide on the correct statistical methods to use to answer these questions. The correct use of statistical methods is crucial in all aspects of research...... to quantify relationships in data. Despite an increased focus on statistical content and complexity of biomedical research these topics remain difficult for most researchers. Statistical methods enable researchers to condense large spreadsheets with data into means, proportions, and difference between means...... the statistical principles for trial protocols in terms of design, analysis, and reporting of findings....

  13. Criticality safety (prospect of study in NUCEF)

    International Nuclear Information System (INIS)

    Itagaki, Masafumi

    1996-01-01

    Experimental studies of criticality safety are under way using STACY and TRACY in NUCEF. Collection of fundamental data on criticality in a solution system is undergoing with STACY to confirm that the likelihood of criticality safety in the system constructed on the assumption of apparatuses in a reprocessing plant is enough large. Whereas some experiments simulating criticality accidents in a reprocessing plant using TRACY were designed to investigate the behaviors of fuel solution and radioactive matters in order to clarify whether it is possible to safely shut them in the facility even if a critical accident occurs. Both STACY and TRACY reached the criticality in 1995. Up to now a series of criticality experiments have been done using STACY with a core tank φ60 cm and the first periodical examination is now under way. On the other hand, we have a plan using TRACY to investigate the behaviors of nuclear heat solution at a criticality accident, and the releasing, transfer and deposition of radioactive materials. After reaching the criticality for the first, the performance verification test has been conducted. The full-scale study using TRACY is planned to begin in the second half of 1996. (M.N.)

  14. BENIGN PAROXYSMAL POSITIONAL VERTIGO- A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Herman Guild Manayil John

    2017-03-01

    Full Text Available BACKGROUND Benign Paroxysmal Positional Vertigo (BPPV is one of the most common disorders of the vestibular system, which maybe unilateral or involve both labyrinths. It can be effectively treated by Canalith Repositioning Manoeuvers (CRM, but lack of awareness leads to delay in effective treatment. MATERIALS AND METHODS Study was conducted in a tertiary care center where 184 patients with BPPV were subjected to positional test and CRM. RESULTS M:F ratio was 1:2.1. 85% of BPPV patients were relieved of symptoms with one sitting of CRM. CONCLUSION CRM is very effective in treatment of BPPV. General practitioners and specialists should be more educated about this condition, which will reduce the delay in correct diagnosis and proper treatment.

  15. Statistical principles for prospective study protocols:

    DEFF Research Database (Denmark)

    Christensen, Robin; Langberg, Henning

    2012-01-01

    In the design of scientific studies it is essential to decide on which scientific questions one aims to answer, just as it is important to decide on the correct statistical methods to use to answer these questions. The correct use of statistical methods is crucial in all aspects of research...... to quantify relationships in data. Despite an increased focus on statistical content and complexity of biomedical research these topics remain difficult for most researchers. Statistical methods enable researchers to condense large spreadsheets with data into means, proportions, and difference between means......, risk differences, and other quantities that convey information. One of the goals in biomedical research is to develop parsimonious models - meaning as simple as possible. This approach is valid if the subsequent research report (the article) is written independent of whether the results...

  16. A one season prospective cohort study of volleyball injuries

    NARCIS (Netherlands)

    Verhagen, E.A.L.M.; van der Beek, A.J.; Bouter, L.M.; Bahr, R.; van Mechelen, W.

    2004-01-01

    Objective: To estimate the overall incidence of acute and overuse volleyball injuries, and to describe factors associated with ankle sprains. Methods: 486 players from the second and third Dutch national volleyball divisions participated in the study and were followed prospectively during a whole

  17. Development in Children with Achondroplasia: A Prospective Clinical Cohort Study

    Science.gov (United States)

    Ireland, Penelope J.; Donaghey, Samantha; McGill, James; Zankl, Andreas; Ware, Robert S.; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M.

    2012-01-01

    Aim: Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. Method: This Australasian…

  18. The South African Surgical Outcomes Study: A 7-day prospective ...

    African Journals Online (AJOL)

    To investigate the perioperative mortality and need for critical care admission in patients undergoing inpatient non-cardiac surgery in SA. Methods. A 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient noncardiac surgery between 19 and 26 May 2014 at ...

  19. Unexpected allergic reactions to food, a prospective study

    NARCIS (Netherlands)

    Michelsen-Huisman, A.D.; Os-Medendorp, H. van; Versluis, A.; Kruizinga, A.G.; Castenmiller, J.J.M.; Noteborn, H.P.J.M.; Houben, G.F.; Knulst, A.C.

    2013-01-01

    Unexpected reactions occur in patients with food allergy, but frequency data are scare. This prospective study investigates the frequency, severity and causes of unexpected allergic reactions to food in adults with a doctor's diagnosed food allergy. Participants complete an online questionnaire

  20. Students' Perception on the Prospect of Economics Education Study Program

    Science.gov (United States)

    Meiriza, Mica Siar

    2015-01-01

    This study aims to determine the extent to which perceptions of students on the prospect of the Economics Education Program. The method used in this research is descriptive method in which the required data is obtained through questionnaire and technique of analyzing data used is percentages. Questionnaires were distributed through the Student…

  1. A prospective longitudinal study to estimate the prevalence of ...

    African Journals Online (AJOL)

    A prospective longitudinal study to estimate the prevalence of obesity in Egyptian children with nocturnal enuresis and the association between body mass index and ... Egyptian Journal of Medical Human Genetics ... Response to the treatment was evaluated statistically and correlated with body mass index percentile.

  2. Health effects of employment: a systematic review of prospective studies

    NARCIS (Netherlands)

    van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I.

    2014-01-01

    The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked.

  3. Status and prospects of nuclear arms control study

    International Nuclear Information System (INIS)

    Sun Xiangli; Wang Deli

    1995-01-01

    Some main issues and problems involved in nuclear arms control study, such as nuclear policy, NPT regime, verification technologies for a CTBT and disposal of military nuclear materials are introduced, in which both the current state and prospects of these issues are analyzed

  4. Moderate sedation helps improve future behavior in pediatric dental patients - a prospective study.

    Science.gov (United States)

    Antunes, Denise Espíndola; Viana, Karolline Alves; Costa, Paulo Sucasas; Costa, Luciane Rezende

    2016-10-24

    There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children's behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children's behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS); higher scores represented less cooperative behavior (range 5-20). Follow-up assessments were conducted on 50 children under four years old for up to 29 months. Data were analyzed by the Friedman/Wilcoxon tests and Cox regression model. OSUBRS mean (standard deviation) scores for the whole sample decreased from 11.9 (5.4) before treatment to 6.8 (3.2) at the final recall session (p dental treatment negatively affected the child's behavior in the dental chair, they became more cooperative over time. Moderately sedated children showed better prospective behavior than those in the non-sedation group.

  5. [Prenatal diagnosis. Review, personal and prospective studies].

    Science.gov (United States)

    Engel, E; Empson, J; DeLozier, D; McGee, B; da Costa Woodson, E; Engel-de Montmollin, M; Carter, T; Lorber, C; Cassidy, S B; Millis, J; Heller, R M; Boehm, F; Vanhooydonk, J

    1979-07-07

    instruments is particularly useful in cases where a severe fetal morphologic malformation cannot currently be identified by indirect visualization (ultrasound) or by analysis of cytogenetic or molecular markers. 6. Pathological accumulations of alpha-fetoprotein which are associated with diverse feto-placental abnormalities (particularly open malformations of the neural tube) can be detected in the amniotic fluid and/or maternal blood. In extension of this approach, it is foreseeable that conditions existing prenatally will be diagnosed in a growing number of cases from the study of fetal cells and molecules which can be isolated from the venous blood of pregnant women. This will become feasible as a result of some well-developed techniques which allow separation of fetal from maternal cells and metabolites, and also to some extremely fine analytic techniques, notably examination of the DNA itself by means of restriction enzymes.

  6. 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.

  7. 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.

  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. 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

  12. Behavioural Outcomes of Four-Year-Old Children Prenatally Exposed to Methadone or Buprenorphine: A Test of Three Risk Models

    Science.gov (United States)

    Konijnenberg, Carolien; Lund, Ingunn Olea; Melinder, Annika

    2015-01-01

    It is still under debate whether the reported effects of opioid maintenance therapy (OMT) on child behaviour are a direct effect of prenatal exposure, or whether other factors are involved. This prospective cohort study investigated three models: the teratogenic risk model, the maternal risk model, and a combined risk model in a group of 35…

  13. A Study on the Spatial Abilities of Prospective Social Studies Teachers: A Mixed Method Research

    Science.gov (United States)

    Yurt, Eyüp; Tünkler, Vural

    2016-01-01

    This study investigated prospective social studies teachers' spatial abilities. It was conducted with 234 prospective teachers attending Social Studies Teaching departments at Education Faculties of two universities in Central and Southern Anatolia. This study, designed according to the explanatory-sequential design, is a mixed research method,…

  14. 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

  15. Prospective

    International Nuclear Information System (INIS)

    Wagner, H.N. Jr.

    1984-01-01

    All living systems are characterized by an S-shaped growth curve, representing a lag phase, a phase of exponential growth and a plateau. Nuclear medicine is no exception. In one sense, medical imaging modalities, such as plain film and contrast studies, computerized tomography (CT), ultrasound, digital subtraction angiography, conventional nuclear imaging, and PET, are competitive. They compete for space, funds, people, enthusiasm, and interest. For example, in the 1970s the use of radionuclide brain scans dropped sharply in hospitals when CT became available; ultrasound and nuclear medicine studies of the biliary system led to a significant decrease in the use of oral cholecystograpy and intravenous cholangiography. Some predict that nuclear magnetic resonance (NMR) and digital radiography may have a significant impact on CT scanning by 1990, because current NMR images are comparable in anatomic resolution to CT without bone artifacts and, especially important in the 1980s, without ionizing radiation. In the face of all this competition, the continued growth and well-being of the field of nuclear medicine will depend on the degree to which the field can adapt itself to the changing circumstances of medical practice and research in the 1980s. The forces that will shape the future of nuclear medicine will continue to come from both within and outside the field

  16. Social determinants of tuberculosis in Europe: a prospective ecological study.

    Science.gov (United States)

    Ploubidis, George B; Palmer, Melissa J; Blackmore, Charlotte; Lim, Tek-Ang; Manissero, Davide; Sandgren, Andreas; Semenza, Jan C

    2012-10-01

    Tuberculosis (TB) is considered to be a disease of poverty, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices, and immigration from endemic countries. A prospective country level study, using a comprehensive dataset of TB incidence and prevalence taken from countries within the World Health Organization (WHO) European region, was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) and a nation's wealth, level of egalitarianism, migration rate, health-related lifestyle and social capital with TB incidence and prevalence over a 10-yr period (2000-2009). We found that ∼50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged gross domestic product and TB rates, and a positive prospective association between income inequality and TB. National income levels per capita and income inequality are important predictors for TB incidence and prevalence in the WHO European region. They account for 50% of country-level variation, indicating the importance of a combined absolute and relative socioeconomic disadvantage in the development of TB. These findings also provide a tool for forecasting potential fluctuations in the level of TB epidemics in the WHO European region, with respect to socioeconomic changes.

  17. A Study on Perception of Librarian's Job Prospects

    Directory of Open Access Journals (Sweden)

    Younghee Noh

    2017-03-01

    Full Text Available The purpose of this study is to investigate awareness of librarian’s job prospects, and to do this a survey was conducted with 502 college students in 14 Departments of Library and Information Science around Korea and 753 librarians in libraries and related agencies. The study results are as follows. First, satisfaction with educational curriculum was higher in students than librarians. Second, both students and librarians regarded workplace based practical training as employment requirements and also evaluated certifications and academic performance as important requirements. Third, both groups asked that information on employment rates be available in a timely manner, and perceived that the librarian’s job prospects were not bright. Therefore, in order to improve employment of librarians, it will be necessary to establish a job information system, reorganize the current educational curriculum into a practice-oriented curriculum, and introduce the national curriculum statements (NCS-based curriculum.

  18. 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.

  19. Prospective economical study of the nuclear power file; Etude economique prospective de la filiere electrique nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Charpin, J M [Commissariat General du Plan, 75 - Paris (France); Dessus, B [Ecodev-CNRS, 92 - Meudon (France); Pellat, R [CEA, 75 - Paris (France)

    2000-07-01

    On May 7, 1999 an economical study of the overall nuclear file, and in particular, of the back-end part of the fuel cycle and including the reprocessing, was requested by the French Prime Minister. This study includes the cost comparisons with the other means of power production and takes into consideration the environmental costs. The study is shared into five chapters dealing with: 1 - the legacy of the past: todays park of nuclear plants, economical and material status; 2 - the international evolution: the dynamics of nuclear policies worldwide (existing parks and R and D programs), the rise of environmental problems worldwide (CO{sub 2} and the climate convention, nuclear risks, attempts of including environment in the power costs), the choices made for the management of spent fuels in the main countries; 3 - the technological prospects for the power production and use: technologies for the mastery of power demand (residential, industrial and tertiary sectors, power transportation), technologies of power production (production from nuclear, fossil and renewable energies); 4 - prospective scenarios for France: two demand scenarios at the year 2050 vista (energy, electric power), power supply (supply structure with respect to scenarios, nuclear parks, power capacities), environmental aspects (CO{sub 2} emissions, plutonium and minor actinides production); 5 - the economical status of the different scenarios: data preparation, fossil fuel price scenarios, investment and operation costs of the different power production means (nuclear, fossil and renewable energies, natural gas and power distribution networks), comparison between fluxes and cumulated economic costs linked with the different scenarios (investments, exploitation, fuels, R and D, status for 2000 to 2050), time structure of expenditures with respect to the different scenarios (chronology, statuses, kWh costs, sensitivity with respect to the rate of discount, valorization of existing parks in 2050

  20. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    DEFF Research Database (Denmark)

    Madsen, M. B.; Skrede, S.; Bruun, T.

    2018-01-01

    these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses. Methods: The INFECT study is a multicentre, prospective observational cohort study. Patients with NSTIs are enrolled in five Scandinavian......Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating...

  1. 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.

  2. 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.

  3. Future prospects for studies in the VUV-SX region

    International Nuclear Information System (INIS)

    Tanaka, Kenichiro; Kitajima, Yoshinori

    1989-09-01

    This book carries papers presented at a workshop 'Future Prospects for Studies in the VUV-SX Region' held on March 22 and 23, 1989. The workshop focussed particularly on the promotion of research in the VUV and soft X-ray regions. Three sessions were held: Session 1 for studies in peripheral areas, Session 2 for theoretical studies, and Session 3 for recent developments. Session 1 covered five studies: 'Laser Spectroscopy: High-Resolution Observation of Highly Electronically Excited Gaseous Molecule', 'High-Resolution Electron Spectroscopy: Surface Phonon Spectroscopy', 'Experimental Study on Atoms and Molecules through Ion Trap', 'Basic Mechanism of Photo-Induced CVD', and 'Application of Circularly Polarized Light'. Session 2 covered five studies: 'Electronic State of High Tc Superconducting Oxide', 'Surface Condition and Electronic State', 'XES and XAS Study of Rare Earth Compound', 'Resonance Photoelectric Spectroscopy on Strongly Correlated Electronic System', and 'Circularly Polarized Light and Atomic Process in Soft X-Ray Region'. Session 3 covered six studies: 'Prospects of Application of Supercritical Liquid to Research on Physical Characteristics', 'Application of Orbit Radiation to Polarization Spectroscopy', 'XES Research for La Compounds', 'Characteristics of Ultra-Fine Particles', 'Surface Study by Angular-Resolution Photoelectric Spectroscopy', and 'EXAFS Study of Light Element'. (N.K.)

  4. Health services research in patients with breast cancer (CAMISS-prospective): study protocol for an observational prospective study

    OpenAIRE

    García-Gutierrez, Susana; Orive, Miren; Sarasqueta, Cristina; Legarreta, Maria Jose; Gonzalez, Nerea; Redondo, Maximino; Rivero, Amado; Serrano-Aguilar, Pedro; Castells, Xavier; Quintana, Jose Maria; Sala, Maria

    2018-01-01

    Background Though breast cancer remains a major health problem, there is a lack of information on health care provided to patients with this disease and associated costs. In addition, there is a need to update and validate risk stratification tools in Spain. Our purpose is to evaluate the health services provided for breast cancer in Spain, from screening and diagnosis to treatment and prognosis. Methods Prospective cohort study involving 13 hospitals in Spain with a follow-up period of up to...

  5. 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.

  6. 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.

  7. 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

  8. Differences in kinetic variables between injured and noninjured novice runners : A prospective cohort study

    NARCIS (Netherlands)

    Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida

    Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an

  9. Opium Use and Risk of Mortality from Digestive Diseases -- A Prospective Cohort Study

    Science.gov (United States)

    Malekzadeh, Masoud M.; Khademi, Hooman; Pourshams, Akram; Etemadi, Arash; Poustchi, Hossein; Bagheri, Mohammad; Khoshnia, Masoud; Sohrabpour, Amir Ali; Aliasgari, Ali; Jafari, Elham; Islami, Farhad; Semnani, Shahryar; Abnet, Christian C.; Pharoah, Paul DP.; Brennan, Paul; Boffetta, Paolo; Dawsey, Sanford M.; Malekzadeh, Reza; Kamangar, Farin

    2017-01-01

    Background Opium use, particularly in low doses, is a common practice among adults in northeastern Iran. We aimed to investigate the association between opium use and subsequent mortality from disorders of the digestive tract. Methods We used data from the Golestan Cohort Study (GCS), a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50,045 adults were enrolled during a four-year period (2004–2008) and followed annually until December 2012, with a follow-up success rate of 99%. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest. Results 8,487 (17%) participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 474 deaths from digestive diseases were reported (387 due to gastrointestinal cancers and 87 due to nonmalignant etiologies). Opium use was associated with an increased risk of death from any digestive disease (adjusted hazard ratio (HR) = 1.55, 95% CI 1.24 – 1.93). The association was dose-dependent, with a HR of 2.21 (1.57–3.31) for the highest quintile of cumulative opium use vs. no use (Ptrend = 0.037). The hazard ratios (95% CI) for the associations between opium use and malignant and nonmalignant causes of digestive mortality were 1.38 (1.07 – 1.76) and 2.60 (1.57 – 4.31), respectively. Increased risks were seen both for smoking opium and for ingestion of opium. Conclusion Long-term opium use, even in low doses, is associated with increased risk of death from both malignant and nonmalignant digestive diseases. PMID:24145676

  10. 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…

  11. 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

  12. 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…

  13. 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.…

  14. 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.

  15. 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…

  16. 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…

  17. Moderate sedation helps improve future behavior in pediatric dental patients – a prospective study

    Directory of Open Access Journals (Sweden)

    Denise Espíndola ANTUNES

    Full Text Available Abstract There is little evidence on the long-term effects of pharmacological management in children undergoing dental treatment. This study aimed to assess children’s behavior in consecutive dental sessions following oral rehabilitation using different pharmacological regimens for behavioral control. Participants were preschoolers who were previously treated for caries under one of the following: no sedative, oral sedation with midazolam, oral sedation with midazolam/ketamine, or general anesthesia. The children’s behavior in the follow-up sessions was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS; higher scores represented less cooperative behavior (range 5–20. Follow-up assessments were conducted on 50 children under four years old for up to 29 months. Data were analyzed by the Friedman/Wilcoxon tests and Cox regression model. OSUBRS mean (standard deviation scores for the whole sample decreased from 11.9 (5.4 before treatment to 6.8 (3.2 at the final recall session (p < 0.001. Moderate sedation with midazolam (OR 2.9, 95%CI 1.2–6.9 or midazolam/ketamine (OR 4.3, 95%CI 1.6–11.4 improved children’s future behavior. The general anesthesia group (n = 4 had a small sample size and the results should be considered with caution. Although invasive dental treatment negatively affected the child’s behavior in the dental chair, they became more cooperative over time. Moderately sedated children showed better prospective behavior than those in the non-sedation group.

  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. Anxiety and depression in patients receiving radiotherapy. Prospective study

    International Nuclear Information System (INIS)

    Chaturvedi, S.K.; Chandra, P.S.; Channabasavanna, S.M.; Anantha, N.; Reddy, B.K.M.; Sharma, S.

    1994-01-01

    The objective of this study was to detect the prevalence of anxiety and depressive disorders using the Hospital Anxiety and Depression Scale (HADS) prospectively in patients receiving Radiotherapy (RT) during and after treatment. 140 consecutive cancer patients referred for radiotherapy and their care givers were included. All patients were administered the Hospital Anxiety and Depression Scale (HADS) conducted at intake, just before starting RT, after finishing the course of RT, and at 3-4 months follow-up. Anxiety and depression are detected frequently in patients receiving RT both prior to treatment and later during follow-up

  20. A prospective study of urinary tract infection during pelvic radiotherapy

    International Nuclear Information System (INIS)

    Bialas, I.; Bessell, E.M.; Sokal, M.

    1989-01-01

    The frequency of urinary tract infection before and during pelvic radiotherapy was studied prospectively in 172 patients who were not catherised and had not had instrumentation for at least 4 weeks prior to radiotherapy. The incidence of urinary tract infection prior to radiotherapy was 17% and a further 17% of patients develped a urinary tract infection during radiotherapy. Mid-stream specimens of urine (MSU) should be examined for infection on a weekly basis during pelvic radiotherapy not only to identify this additional 17% of patients but also to detect those patients who have persistent urinary tract infection in spite of treatment with appropriate antibiotics. (author). 6 refs.; 1 fig.; 4 tabs

  1. Prospective study of aetiological factors in burning mouth syndrome

    Science.gov (United States)

    Lamey, P-J; Lamb, A B

    1988-01-01

    A prospective study of 150 consecutive patients with burning mouth syndrome and with a minimum follow up period of 18 months is reported. Factors related to dentures, to vitamin B complex deficiency, and to psychological abnormalities were found to be important, and undiagnosed diabetes mellitus, reduced salivary gland function, haematological deficiencies, candidal infection, parafunctional habits, and allergy might also play a part. Given a protocol for management which takes all these factors into account, some two thirds of patients can be cured or have their symptoms improved. PMID:3133028

  2. Male infertility after mesh hernia repair: A prospective study.

    Science.gov (United States)

    Hallén, Magnus; Sandblom, Gabriel; Nordin, Pär; Gunnarsson, Ulf; Kvist, Ulrik; Westerdahl, Johan

    2011-02-01

    Several animal studies have raised concern about the risk for obstructive azoospermia owing to vasal fibrosis caused by the use of alloplastic mesh prosthesis in inguinal hernia repair. The aim of this study was to determine the prevalence of male infertility after bilateral mesh repair. In a prospective study, a questionnaire inquiring about involuntary childlessness, investigation for infertility and number of children was sent by mail to a group of 376 men aged 18-55 years, who had undergone bilateral mesh repair, identified in the Swedish Hernia Register (SHR). Questionnaires were also sent to 2 control groups, 1 consisting of 186 men from the SHR who had undergone bilateral repair without mesh, and 1 consisting of 383 men identified in the general population. The control group from the SHR was matched 2:1 for age and years elapsed since operation. The control group from the general population was matched 1:1 for age and marital status. The overall response rate was 525 of 945 (56%). Method of approach (anterior or posterior), type of mesh, and testicular status at the time of the repair had no significant impact on the answers to the questions. Nor did subgroup analysis of the men ≤40 years old reveal any significant differences. The results of this prospective study in men do not support the hypothesis that bilateral inguinal hernia repair with alloplastic mesh prosthesis causes male infertility at a significantly greater rate than those operated without mesh. Copyright © 2011 Mosby, Inc. All rights reserved.

  3. 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.

  4. 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…

  5. Prospective study of blood metabolites associated with colorectal cancer risk.

    Science.gov (United States)

    Shu, Xiang; Xiang, Yong-Bing; Rothman, Nathaniel; Yu, Danxia; Li, Hong-Lan; Yang, Gong; Cai, Hui; Ma, Xiao; Lan, Qing; Gao, Yu-Tang; Jia, Wei; Shu, Xiao-Ou; Zheng, Wei

    2018-02-26

    Few prospective studies, and none in Asians, have systematically evaluated the relationship between blood metabolites and colorectal cancer risk. We conducted a nested case-control study to search for risk-associated metabolite biomarkers for colorectal cancer in an Asian population using blood samples collected prior to cancer diagnosis. Conditional logistic regression was performed to assess associations of metabolites with cancer risk. In this study, we included 250 incident cases with colorectal cancer and individually matched controls nested within two prospective Shanghai cohorts. We found 35 metabolites associated with risk of colorectal cancer after adjusting for multiple comparisons. Among them, 12 metabolites were glycerophospholipids including nine associated with reduced risk of colorectal cancer and three with increased risk [odds ratios per standard deviation increase of transformed metabolites: 0.31-1.98; p values: 0.002-1.25 × 10 -10 ]. The other 23 metabolites associated with colorectal cancer risk included nine lipids other than glycerophospholipid, seven aromatic compounds, five organic acids and four other organic compounds. After mutual adjustment, nine metabolites remained statistically significant for colorectal cancer. Together, these independently associated metabolites can separate cancer cases from controls with an area under the curve of 0.76 for colorectal cancer. We have identified that dysregulation of glycerophospholipids may contribute to risk of colorectal cancer. © 2018 UICC.

  6. 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

  7. Causes of anorexia in untreated hyperthyroidism: a prospective study.

    Science.gov (United States)

    Dai, W X; Meng, X W

    2000-05-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after antithyroid drug treatment in the two groups. This prospective study suggested that the causes of anorexia in untreated hyperthyroidism are complicated. Older age, abnormal liver function, and the level of anxiety are significantly related to anorexia in untreated hyperthyroidism, but hypercalcaemia was not confirmed to be related to anorexia in the study.

  8. 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…

  9. Prospect Theory: A Study of the Endowment Effect

    Directory of Open Access Journals (Sweden)

    Jurandir Sell Macedo

    2007-01-01

    Full Text Available Behavioral Finance is a recent field of study which contradicts the presupposition supported by Modern Finance that decision makers act rationally. Prospect Theory, developed by Kahneman and Tversky (1979, is presented as an alternative model to the Theory of Expected Utility in relation to the way people decide in face of possibilities of risk. According to Prospect Theory, people define gains and losses based on a given point of reference, which can be established on grounds of a given level of expected gain. This fact leads to the Endowment Effect - a behavioral trend investigated in this study – whereby investors are influenced by a portfolio which they have received as an inheritance or endowment. The reason this occurs is that individuals usually define their expectations of gain according to the future profitability of the portfolio received, and not according to the future profitability of the market. Using an investment simulation, the Endowment Effect was tested among 226 university students taking courses in the subject of capital markets. The results demonstrate that the students were influenced by the different initial portfolios, which were randomly assigned.

  10. 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 ...

  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. 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,

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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)

  6. Temporary loop ileostomy: prospective study of indications and complication

    International Nuclear Information System (INIS)

    Rajput, A.; Samad, A.; Khanzada, T.W.

    2007-01-01

    To asses the indications and complications of temporary loop ileostomy. This was a prospective cohort study conducted at Isra University Hospital, Hyderabad, Pakistan between February 2003 and August 2006. All patients who had temporary loop ileostomy during that period were included in this study. The indications and various postoperative complications were noted during postoperative hospital stay and subsequently during follow up till stoma were closed. Fifty six patients fulfilled the selection criteria during the study period. Typhoid (enteric) perforation was the most common indication of loop ileostomy accounting for about two thirds of all cases. Other indications were iatrogenic, covering ileostomy for rectal cancers, following resection anastomosis, tuberculosis, blunt abdominal trauma, anastomosis leak and rectovaginal fistula. Post operative skin excoriation was the most common complication while poor siting, transient edema, retraction and high output were other less common complications. Temporary loop ileostomy is the stoma of choice for temporary faecal diversion as most of its complications are manageable conservatively. (author)

  7. [Speed of ocular saccades in Huntington disease. Prospective study].

    Science.gov (United States)

    García Ruiz, P J; Cenjor, C; Ulmer, E; Hernández, J; Cantarero, S; Fanjul, S; García de Yébenes, J

    2001-02-01

    Oculomotor abnormalities, especially slow saccades, have long been recognized in Huntington's disease (HD). To study prospectively horizontal saccade velocity by videonystagmography in 21 patients with genetically confirmed HD. The study included a baseline analysis and a second evaluation after 18.8 +/- 7.1 months. We included a control group of 15 subjects. HD group exhibited decreased saccade velocity when compared with that from a control group (for predictive and unpredictive target). HD patients showed decreased saccade velocity with the passage of time (for predictive target, p < 0.01). Finally we found statistical significant correlation between saccade velocity and triplet length. The measurement of saccade velocity might be an objective method to study the natural evolution of HD, and thus evaluate the effectiveness of future therapies.

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. SUICIDAL HANGING IN URBAN YOUTH : A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Bhola Kumar Singh

    2015-02-01

    Full Text Available BACKGROUND : Suicide is among the top three causes of death among youth worldwide. Hanging is among the most common modes of suicide. OBJECTIVES: The purpose of this prospective study is to determine the Suicidal hanging in urban youth and determine the prevalence of suicidal hanging in our community. METHODS : In this descriptive, prospective, cross sectional study, all patients who pres ented to the department of emergency medicine with suicidal hanging during this study period of 12 months from January 2010 - December 2011 in . were included. RESULTS : Total number of males in the study is 32 (64%, females in the study is 18(36%. Mean age of the you th was 22.50± 8.15(SD years, Male 18.50± 12.15(SD years, Females 20.50 ±5.25(SD years; predominantly the patients were in the age group of 22 - 26 years. Number of male smokers in the study was 26 (81.25% female smokers were 4(22.22%, number of m ale alcoholics were 27(84.37% whereas female alcoholics were 6(33.33%, number of patients with pallor in males were 16(50% whereas females with pallor were 12(66.66%, number of males with skin changes were 6(18.75% when compared to females who had 8(4 4.44% skin changes, number of males wit oedema were 4(12.5% and 6(33.33% of females had oedema, the mean weight among males were 48±8.34kgs when compared to females which was 42±6.56kgs. Most of the patients who attempted suicide had varied personality issues from mood disorders to psychosis. CONCLUSION : There is significant percentage of patients who attempt suicide by hanging

  14. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study.

    Science.gov (United States)

    Barnes, Darryl E; Beckley, James M; Smith, Jay

    2015-01-01

    Elbow tendinopathy is the most common cause of elbow pain affecting active populations. Surgical excision is reserved for patients with refractory symptoms. Percutaneous ultrasonic tenotomy performed under local anesthesia also removes degenerated tissue and therefore provides an alternative treatment option to surgical excision. This investigation prospectively documented the safety and 1-year efficacy of ultrasonic percutaneous tenotomy performed by a single operator. Nineteen patients, aged 38 to 67 years, in whom >6 months of conservative management for medial (7) or lateral (12) elbow tendinopathy had failed were prospectively studied. All patients were treated with percutaneous ultrasonic tenotomy of the elbow by a single operator. Visual analog scale (VAS) for pain, the 11-item version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) index, and the Mayo Elbow Performance Score (MEPS) were assessed by an independent observer before treatment and at 6 weeks, 3 months, 6 months, and 12 months after treatment. No procedural complications occurred. Total treatment time was elbow tendinopathy up to 1 year after the procedure. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  15. [Dental agenesis. Results of a prospective study of 30 cases].

    Science.gov (United States)

    Romieux, G; Bonin, B; Laure, B; Van Hove, A; Goga, D

    2000-11-01

    We conducted a prospective study to determine the types of bone anomalies observed in different types of dental agenesia. This prospective series included 30 patients who attended our pluridisciplinary clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of syndromal agenesia. Patients consulted for a variety of reasons, no specific sign was found. The diagnosis was based on the panoramic x-ray and confirmed at the genetic consultation. Results were systemized by localization of the agenesia. In all cases, the height of the bone crest was preserved compared with the adjacent teeth. In the anterior part of the maxillary, the bone crest was thin showing a water drop aspect. In the posterior maxillary, there was a decrease in the subsinusal height due to invagination of the floor of the sinus. In the anterior part of the mandible, the crest had a knife blade aspect but no loss of height and in the posterior part, a preserved distance between the residual crest rim and the dental canal. In 60% of the solitary agenesias in the anterior part of the maxillary, augmentation was not required. A sinus graft was required in all cases involving the posterior maxillary. Multiple anterior or lateral agenesias were treated with a parietal graft.

  16. Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies.

    Science.gov (United States)

    Wang, Tiange; Heianza, Yoriko; Sun, Dianjianyi; Huang, Tao; Ma, Wenjie; Rimm, Eric B; Manson, JoAnn E; Hu, Frank B; Willett, Walter C; Qi, Lu

    2018-01-10

    To investigate whether improving adherence to healthy dietary patterns interacts with the genetic predisposition to obesity in relation to long term changes in body mass index and body weight. Prospective cohort study. Health professionals in the United States. 8828 women from the Nurses' Health Study and 5218 men from the Health Professionals Follow-up Study. Genetic predisposition score was calculated on the basis of 77 variants associated with body mass index. Dietary patterns were assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH), and Alternate Mediterranean Diet (AMED). Five repeated measurements of four year changes in body mass index and body weight over follow-up (1986 to 2006). During a 20 year follow-up, genetic association with change in body mass index was significantly attenuated with increasing adherence to the AHEI-2010 in the Nurses' Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction). In the combined cohorts, four year changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants with decreased AHEI-2010 score and -0.01 (0.02) among those with increased AHEI-2010 score, corresponding to 0.16 (0.05) kg versus -0.02 (0.05) kg weight change every four years (Pdietary patterns could attenuate the genetic association with weight gain. Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Improving adherence to healthy dietary patterns, genetic risk, and long term weight gain: gene-diet interaction analysis in two prospective cohort studies

    Science.gov (United States)

    Wang, Tiange; Heianza, Yoriko; Sun, Dianjianyi; Huang, Tao; Ma, Wenjie; Rimm, Eric B; Manson, JoAnn E; Hu, Frank B; Willett, Walter C

    2018-01-01

    Abstract Objective To investigate whether improving adherence to healthy dietary patterns interacts with the genetic predisposition to obesity in relation to long term changes in body mass index and body weight. Design Prospective cohort study. Setting Health professionals in the United States. Participants 8828 women from the Nurses’ Health Study and 5218 men from the Health Professionals Follow-up Study. Exposure Genetic predisposition score was calculated on the basis of 77 variants associated with body mass index. Dietary patterns were assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH), and Alternate Mediterranean Diet (AMED). Main outcome measures Five repeated measurements of four year changes in body mass index and body weight over follow-up (1986 to 2006). Results During a 20 year follow-up, genetic association with change in body mass index was significantly attenuated with increasing adherence to the AHEI-2010 in the Nurses’ Health Study (P=0.001 for interaction) and Health Professionals Follow-up Study (P=0.005 for interaction). In the combined cohorts, four year changes in body mass index per 10 risk allele increment were 0.07 (SE 0.02) among participants with decreased AHEI-2010 score and −0.01 (0.02) among those with increased AHEI-2010 score, corresponding to 0.16 (0.05) kg versus −0.02 (0.05) kg weight change every four years (Pdietary patterns could attenuate the genetic association with weight gain. Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity. PMID:29321156

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Four years of experience in our clinic regarding hysteroscopies for abnormal uterine hemorrhages

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    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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

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

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    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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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...

  14. [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.

  15. 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.

  16. Psychological stress during pregnancy and stillbirth: prospective study

    DEFF Research Database (Denmark)

    Wisborg, K.; Barklin, A.; Hedegaard, M.

    2008-01-01

    habits, alcohol and caffeine intake during pregnancy, education and cohabitation failed to change the result. The results remained essentially unchanged after exclusion of preterm deliveries. Exclusion of women with complications during pregnancy such as diabetes, hypertension, vaginal bleeding......OBJECTIVE: To study the association between psychological stress during pregnancy and stillbirth. DESIGN: Prospective follow-up study. SETTING: Aarhus University Hospital, Skejby, Denmark,1989-98. POPULATION: A total of 19 282 singleton pregnancies in women with valid information about...... psychological stress during pregnancy. METHODS: Information about psychological stress during pregnancy was obtained from questionnaires and measured by the 12-item General Health Questionnaires (GHQ). A score was generated by the sum of all the answers, each contributing a value between 0 (low psychological...

  17. A prospective, randomized multicenter study comparing APD and CAPD treatment

    DEFF Research Database (Denmark)

    Bro, S; Bjorner, J B; Tofte-Jensen, P

    2000-01-01

    , dialysis-related complications, dialysis-related expenses. RESULTS: The quality-of-life studies showed that significantly more time for work, family, and social activities was available to patients on APD compared to those on CAPD (p ...) treatment with respect to quality of life and clinical outcomes in relation to therapy costs. DESIGN: A prospective, randomized multicenter study. SETTING: Three Danish CAPD units. PATIENTS: Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included...... were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses. MAIN OUTCOME MEASURES: Quality-of-life parameters...

  18. Premorbid personality in schizophrenia spectrum: a prospective study

    DEFF Research Database (Denmark)

    Ekstrøm, Morten; Lykke Mortensen, Erik; Sørensen, Holger J

    2006-01-01

    Schizophrenia has been linked with premorbid character anomalies since it was first described. However, few prospective studies of premorbid personality characteristics in schizophrenia and related disorders have been conducted. This study evaluates premorbid personality in children who developed...... to these three diagnostic categories. Twelve-year-old children destined to develop a disorder in the schizophrenia spectrum deviated significantly from healthy controls on a number of personality characteristics: they were rated significantly lower than controls on intelligence, concentration, maturity......, friendliness, cooperation, self-control and significantly higher on aggression. Non-significant trends indicated that this group displayed more deviant personality scores than psychiatric controls. Children who later develop schizophrenia spectrum disorder differed from normal controls with respect to a number...

  19. Marine renewable energies: prospective foresight study for 2030

    International Nuclear Information System (INIS)

    Paillard, M.; Lacroix, D.; Lamblin, V.

    2009-01-01

    The ocean is a huge reservoir of renewable energy sources, such as wind, currents, tides, waves, marine biomass, thermal energy, osmotic power, and so on. Like other maritime nations in Europe, France enjoys significant potential to develop these energy sources, especially overseas. In March 2007, Ifremer's chairman launched a prospective foresight study on these energies for the time horizon of 2030. With support from the Futuribles consulting group, twenty French partners representing the main stakeholders in the sector carried out this work. Their objective was to identify the technologies, specify the socio-economic prerequisites for them to emerge and be competitive and assess their respective impacts on power sources and the environment. What was learned from this study can be applied well beyond France, at a time when a European maritime strategy is taking shape. (authors)

  20. Study of Tandem Accelerator Technology and Its Prospects

    International Nuclear Information System (INIS)

    Sigit-Hariyanto; Sudjatmoko; Djoko-S-Pudjorahardjo; Suryadi; Widdi-Usada; Suprapto; Djasiman; Tono-Wibowo; Agus-Purwadi

    2000-01-01

    Tandem accelerator is an ion acceleration tool in which negative ions injected in the accelerator tube and stripped to become positive ions, then accelerated by electrostatic high voltage such that its energy is multiplied. In this paper, we describe the prospect of accelerator application briefly in agriculture and biotechnology, industry, health and medicine, environment fields. Technical study on tandem accelerator included SNICS and alphatross ion sources, acceleration system and stripper system. The study result for many kinds of negative ions and its current which should be injected in the accelerator tube and the output of tandem accelerator H + , and the distribution of C + , Ni + , Au + , Br + ion on varying charge state is shown. (author)

  1. 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

  2. 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

    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.

  3. 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?”

  4. Early breastfeeding experiences of adolescent mothers: a qualitative prospective study

    Directory of Open Access Journals (Sweden)

    Smith Paige Hall

    2012-09-01

    Full Text Available Abstract Background Teen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S. Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively. The purpose of our qualitative prospective study was to understand the factors that contribute to the breastfeeding decisions and practices of teen mothers. Methods This prospective study took place from January through December 2009 in Greensboro, North Carolina in the U.S. We followed the cohort from pregnancy until two weeks after they ceased all breastfeeding and milk expression. We conducted semi-structured interviews at baseline and follow-up, and tracked infant feeding weekly by phone. We analyzed the data to create individual life and breastfeeding journeys and then identified themes that cut across the individual journeys. Results Four of the five teenagers breastfed at the breast for nine days: in contrast, one teen breastfed exclusively for five months. Milk expression by pumping was associated with significantly longer provision of human milk. Breastfeeding practices and cessation were closely connected with their experiences as new mothers in the context of ongoing multiple roles, complex living situations, youth and dependency, and poor knowledge of the fundamentals of breastfeeding and infant development. Breastfeeding cessation was influenced by inadequate breastfeeding skill, physically unpleasant and painful early experiences they were unprepared to manage, and inadequate health care response to real problems. Conclusions Continued breastfeeding depends on a complex interplay of multiple factors, including having made an informed choice and having the skills, support and experiences needed to sustain the belief that breastfeeding is the best choice for them and their baby given their life situation. Teenagers in the US context need to have

  5. 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

  6. 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.

  7. Prospective economical study of the nuclear power file

    International Nuclear Information System (INIS)

    Charpin, J.M.; Dessus, B.; Pellat, R.

    2000-07-01

    On May 7, 1999 an economical study of the overall nuclear file, and in particular, of the back-end part of the fuel cycle and including the reprocessing, was requested by the French Prime Minister. This study includes the cost comparisons with the other means of power production and takes into consideration the environmental costs. The study is shared into five chapters dealing with: 1 - the legacy of the past: todays park of nuclear plants, economical and material status; 2 - the international evolution: the dynamics of nuclear policies worldwide (existing parks and R and D programs), the rise of environmental problems worldwide (CO 2 and the climate convention, nuclear risks, attempts of including environment in the power costs), the choices made for the management of spent fuels in the main countries; 3 - the technological prospects for the power production and use: technologies for the mastery of power demand (residential, industrial and tertiary sectors, power transportation), technologies of power production (production from nuclear, fossil and renewable energies); 4 - prospective scenarios for France: two demand scenarios at the year 2050 vista (energy, electric power), power supply (supply structure with respect to scenarios, nuclear parks, power capacities), environmental aspects (CO 2 emissions, plutonium and minor actinides production); 5 - the economical status of the different scenarios: data preparation, fossil fuel price scenarios, investment and operation costs of the different power production means (nuclear, fossil and renewable energies, natural gas and power distribution networks), comparison between fluxes and cumulated economic costs linked with the different scenarios (investments, exploitation, fuels, R and D, status for 2000 to 2050), time structure of expenditures with respect to the different scenarios (chronology, statuses, kWh costs, sensitivity with respect to the rate of discount, valorization of existing parks in 2050), cost overruns

  8. 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.

  9. 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.

  10. Protective environment for marrow transplant recipients. A prospective study

    International Nuclear Information System (INIS)

    Buckner, C.D.; Clift, R.A.; Sanders, J.E.; Meyers, J.D.; Counts, G.W.; Farewell, V.T.; Thomas, E.D.

    1978-01-01

    Laminar air flow isolation and decontamination procedures were evaluated in a prospective randomized study in patients with aplastic anemia or acute leukemia undergoing marrow transplantation from HLA-matched siblings. Patients transplanted in the laminar air flow group had significantly less septicemia and major local infections than did patients in the control group. Nineteen of 46 laminar air flow patients and six of 44 control patients are alive at present. In patients with aplastic anemia the survival was 13 of 17 in the laminar air flow group compared with four of 17 in the control group. In patients with acute leukemia the survival was six of 29 in the laminar air flow group versus two of 27 in the control group. These differences were not statistically significant. Death in both the laminar air flow and control groups was predominantly due to interstitial pneumonitis or recurrent leukemia, which were unaffected by isolation and decontamination

  11. Vasoconstrictor response to cold in forestry workers: a prospective study

    DEFF Research Database (Denmark)

    Olsen, N; Nielsen, S L

    1988-01-01

    In a five year prospective study of the vasoconstrictor response to cold 37 forestry workers were investigated in 1978 and again in 1983. The subjects were classified into three groups: group A (n = 13): no subjective finger symptoms in 1978 and continued sawing until 1983; group B (n = 12......): no symptoms in 1978 and stopped sawing before 1983; group C (n = 12): vibration induced white finger (VWF) in 1978. A cold provocation test measuring the finger systolic blood pressure with a cuff and strain gauge technique during combined body cooling and finger cooling to 30 degrees, 15 degrees, and 6...... degrees C was applied to all subjects at both investigations. In 1978 all groups had an increased cold response when compared with that of 20 non-exposed controls (p less than 0.05), and the response was more exaggerated in group C than in groups A and B (p less than 0.01). From 1978 to 1983...

  12. Posttraumatic stress in intensive care unit survivors - a prospective study

    DEFF Research Database (Denmark)

    Ratzer, Mette; Brink, Ole; Knudsen, Linda

    2014-01-01

    Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through...... the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus...... of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21...

  13. Factors associated with endodontic flare-ups: a prospective study.

    Science.gov (United States)

    Imura, N; Zuolo, M L

    1995-09-01

    The purpose of this prospective study was to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment by the two authors in their respective practices during a period of one year, and also to examine the correlation with pre-operative and operative variables. The results showed an incidence of 1.58% for flare-ups from 1012 endodontically treated teeth. Statistical analysis using the chi-square test (Pflare-ups were found to be positively correlated with multiple appointments, retreatment cases, periradicular pain prior to treatment, presence of radiolucent lesions, and patients taking analgesic or anti-inflammatory drugs. In contrast, there was no correlation between flare-up, and age, sex, different arch/tooth groups and the status of the pulp.

  14. MANAGEMENT AND OUTCOMES FROM APPENDECTOMY: AN INTERNATIONAL, PROSPECTIVE, MULTICENTRE STUDY.

    Science.gov (United States)

    Camilleri-Brennan, J; Drake, T; Spence, R; Bhangu, A; Harrison, E

    2017-09-01

    To identify variation in surgical management and outcomes of appendicitis across low, middle and high Human Development Index (HDI) country groups. Multi-centre, international prospective cohort study of consecutive patients undergoing emergency appendectomy over a 6-month period. Follow-up lasted 30 days. Primary outcome measure was overall complication rate. 4546 patients from 52 countries underwent appendectomy (2499 high, 1540 middle and 507 low HDI groups). Complications were more frequent in low-HDI (OR 3.81, 95% CI 2.78 to 5.19, p accounting for case-mix, laparoscopy was still associated with fewer complications (OR 0.55, 95% CI 0.42 to 0.71, pintroduction of laparoscopy that if overcome, could result in significantly improved outcomes for patients in low-resource environments, with potential for wider health-system benefits.

  15. Incense use and respiratory tract carcinomas: a prospective cohort study

    DEFF Research Database (Denmark)

    Yuan, J.M.; Wang, R.; Koh, W.P.

    2008-01-01

    of cancer and ages 45 to 74 years completed a comprehensive interview regarding living conditions and dietary and lifestyle factors. Through linkage to population-based registries, the cohort was followed through 2005 and cancer occurrence determined. The relative risk for these cancers associated......BACKGROUND: Incense use is an integral part of daily life in large parts of Asia. The burning of incense is a powerful producer of particulate matter and the smoke contains a multitude of well-characterized carcinogens. However, to the authors' knowledge, no convincing association has been reported...... between exposure to incense smoke and the development of cancer. Therefore, the relation between incense use and the risk of respiratory tract carcinomas was analyzed in a prospective cohort study. METHODS: Between 1993 and 1998, a population-based cohort of 61,320 Singapore Chinese who were free...

  16. Early versus late rehabilitation for stroke survivors: A prospective study

    Directory of Open Access Journals (Sweden)

    Moshiur Rahman Khasru

    2017-11-01

    Full Text Available The aim of this study was to examine the optimum time of rehabilitation initiation after stroke in terms of disabilities, mobility and fall risk assessment. Data were collected prospectively at seven tertiary level health care centers in Bangladesh during the 36 months period from 2013 to 2016. All respondents were divided into four groups based on the initiation of rehabilitation as: a 0-24 hours, b 25-72 hours, c 4-7 days and d 8-60 days. Results show that significant improvement on stroke recovery, disabilities reduction, improvement in mobility restriction and reduction of fall risks in all the four groups but more improvement was observed in 0-24 hour’s group during follow-up after 3 and 12 weeks. On multinomial logistic regression analysis, the independent factors shows the mobility restriction and fall risk were more in the younger patients, male gender, married, hemorrhagic lesion and bilateral stroke.

  17. A population-based prospective study of optic neuritis

    DEFF Research Database (Denmark)

    Soelberg, K; Jarius, S; Skejoe, Hanne Pernille Bro

    2017-01-01

    BACKGROUND: Optic neuritis (ON) is often associated with multiple sclerosis (MS). Early diagnosis is critical to optimal patient management. OBJECTIVE: To estimate the incidence of acute ON and the rates of conversion to MS and antibody-mediated ON. METHOD: Population-based prospective study......-specific incidence was 3.28 (2.44-4.31) per 100,000 person years, 2.02 for men and 4.57 for women. At follow-up, 20 patients met the diagnostic criteria for MS, MRI lesions disseminated in space and time in 17/20 patients. AQP4-IgG was detected in none, MOG-IgG was detected in two patients. CONCLUSION...

  18. Immediate postoperative complications in transsphenoidal pituitary surgery: A prospective study

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2014-01-01

    Full Text Available Background: Considering the important role of pituitary gland in regulating various endocrine axes and its unique anatomical location, various postoperative complications can be anticipated resulting from surgery on pituitary tumors. We examined and categorized the immediate postoperative complications according to various tumor pathologies. Materials and Methods: We carried out a prospective study in 152 consecutive patients and noted various postoperative complications during neurosurgical intensive care unit stay (within 48 hrs of hospital stay in patients undergoing transsphenoidal removal of pituitary tumors. Results: In our series, various groups showed different postoperative complications out of which, cerebrospinal fluid leak was the commonest followed by diabetes insipidus, postoperative nausea and vomiting, and hematoma at operation site. Conclusion: Various immediate postoperative complications can be anticipated in transsphenoidal pituitary surgery even though, it is considered to be relatively safe.

  19. Prospective cohort study of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Bastiaens, Jesse; Dorfman, Benjamin J; Christos, Paul J; Nirenberg, Melissa J

    2013-03-01

    Impulse control disorders (ICDs) are potentially serious side effects of dopamine agonist therapy in Parkinson's disease (PD), but prospective data are lacking about their incidence, time course, and risk factors. This work was a 4-year, prospective cohort study of outpatients with PD and no previous ICDs (N = 164). All subjects treated with a dopamine agonist during the study were followed longitudinally for new-onset ICDs. Baseline characteristics were compared in groups with (ICD+) and without (ICD-) subsequent ICDs. Forty-six subjects were treated with a dopamine agonist, including 25 who were newly treated and 21 who received ongoing dopamine agonist therapy. Of these 46 subjects, 18 (39.1%) developed new-onset ICDs. The timing of ICD onset varied from 3.0 to 114.0 months (median, 23.0) after initiation of dopamine agonist therapy. Baseline demographic characteristics were similar in ICD+ and ICD- groups. At baseline, ICD+ subjects had a greater prevalence of motor complications (61.1% versus 25.0%; P = 0.01) than ICD- subjects, despite comparable total dopaminergic medication usage in both groups (median, 150.0 versus 150.0 levodopa equivalents; P = 0.61). Compared with ICD- subjects, ICD+ subjects had a greater baseline prevalence of caffeine use (100% versus 66.7%; P = 0.007) and higher lifetime prevalence of cigarette smoking (44.4% versus 14.3%; P = 0.04). Peak dopamine agonist doses were higher in ICD+ than ICD- subjects (median 300.0 versus 165.0 L-dopa equivalents; P = 0.03), but cumulative dopamine agonist exposure was similar in both groups. In summary, the timing of new-onset ICDs in PD is highly variable. Risk factors include cigarette smoking, caffeine use, motor complications, and higher peak dopamine agonist dosage. Copyright © 2013 Movement Disorders Society.

  20. 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

  1. 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.

  2. Taste disturbance following tonsillectomy--a prospective study.

    Science.gov (United States)

    Heiser, Clemens; Landis, Basile N; Giger, Roland; Cao Van, Helene; Guinand, Nils; Hörmann, Karl; Stuck, Boris A

    2010-10-01

    Persistent taste disturbance is a rare complication after tonsillectomy and mainly documented by case reports or a few retrospective and prospective trials with a limited number of patients. None could clarify frequency, time course, or prognosis of long-lasting dysgeusia after tonsillectomy. The aim of the study was to provide a symptom-based follow-up after tonsillectomy to assess postoperative taste disorders. Prospective clinical trial. From December 2007 to June 2009 adult patients undergoing tonsillectomy were asked to take part in the trial. Two hundred twenty-three patients (119 female, 104 male; mean age, 33 ± 13 years) were included. The day prior to surgery, and 2 weeks and 6 months after tonsillectomy a standardized questionnaire was completed by patients. The questionnaire focused on taste function, taste disorders, pain, foreign body sensation, and bleeding episodes after tonsillectomy. One hundred eighty-eight (2 weeks) and 181 (6 months) patients returned the questionnaires. Thirty-two percent (n = 60) of patients reported taste disorders after tonsillectomy 2 weeks postoperatively and 15 patients (8%) at 6-month follow-up. Metallic and bitter parageusia were most frequently reported. The mean ratings of gustatory function were significantly lower 2 weeks after surgery (P < .001) and reached preoperative values 6 months after surgery. Almost 30% of patients reported postoperative bleeding, 10% long-lasting postoperative pain, and 20% foreign body sensation. Long-lasting taste disturbance (metallic and bitter parageusia) after tonsillectomy is more frequent than previously reported. Long-lasting pain and foreign body sensation seem to be common symptoms. With regard to these results, a thorough preoperative explanation is mandatory.

  3. A Model of Microteaching Lesson Study Implementation in the Prospective History Teacher Education

    Science.gov (United States)

    Utami, Indah Wahyu Puji; Mashuri; Nafi'ah, Ulfatun

    2016-01-01

    Microteaching lesson study is a model to improve prospective teacher quality by incorporating several element of microteaching and lesson study. This study concern on the implementation of microteaching lesson study in prospective history teacher education. Microteaching lesson study model implemented in this study consist of three stages: plan,…

  4. 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,...

  5. Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

    Science.gov (United States)

    Sartelli, Massimo; Baiocchi, Gian L; Di Saverio, Salomone; Ferrara, Francesco; Labricciosa, Francesco M; Ansaloni, Luca; Coccolini, Federico; Vijayan, Deepak; Abbas, Ashraf; Abongwa, Hariscine K; Agboola, John; Ahmed, Adamu; Akhmeteli, Lali; Akkapulu, Nezih; Akkucuk, Seckin; Altintoprak, Fatih; Andreiev, Aurelia L; Anyfantakis, Dimitrios; Atanasov, Boiko; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Bellanova, Giovanni; Beltran, Marcelo; Melo, Renato Bessa; Bini, Roberto; Bouliaris, Konstantinos; Brunelli, Daniele; Castillo, Adrian; Catani, Marco; Che Jusoh, Asri; Chichom-Mefire, Alain; Cocorullo, Gianfranco; Coimbra, Raul; Colak, Elif; Costa, Silvia; Das, Koray; Delibegovic, Samir; Demetrashvili, Zaza; Di Carlo, Isidoro; Kiseleva, Nadezda; El Zalabany, Tamer; Faro, Mario; Ferreira, Margarida; Fraga, Gustavo P; Gachabayov, Mahir; Ghnnam, Wagih M; Giménez Maurel, Teresa; Gkiokas, Georgios; Gomes, Carlos A; Griffiths, Ewen; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S; Hodonou, Adrien; Hutan, Martin; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kauhanen, Saila; Kaushik, Robin; Kavalakat, Alfie; Kenig, Jakub; Khokha, Vladimir; Khor, Desmond; Kim, Dennis; Kim, Jae I; Kong, Victor; Lasithiotakis, Konstantinos; Leão, Pedro; Leon, Miguel; Litvin, Andrey; Lohsiriwat, Varut; López-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Maciel, James; Major, Piotr; Dimova, Ana; Manatakis, Dimitrios; Marinis, Athanasio; Martinez-Perez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesina, Cristian; Pędziwiatr, Michał; Michalopoulos, Nickos; Misiakos, Evangelos; Mohamedahmed, Ali; Moldovanu, Radu; Montori, Giulia; Mysore Narayana, Raghuveer; Negoi, Ionut; Nikolopoulos, Ioannis; Novelli, Giuseppe; Novikovs, Viktors; Olaoye, Iyiade; Omari, Abdelkarim; Ordoñez, Carlos A; Ouadii, Mouaqit; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M; Partecke, Lars I; Pata, Francesco; Pędziwiatr, Michał; Pereira Júnior, Gerson A; Pintar, Tadeja; Pisarska, Magdalena; Ploneda-Valencia, Cesar F; Pouggouras, Konstantinos; Prabhu, Vinod; Ramakrishnapillai, Padmakumar; Regimbeau, Jean-Marc; Reitz, Marianne; Rios-Cruz, Daniel; Saar, Sten; Sakakushev, Boris; Seretis, Charalampos; Sazhin, Alexander; Shelat, Vishal; Skrovina, Matej; Smirnov, Dmitry; Spyropoulos, Charalampos; Strzałka, Marcin; Talving, Peep; Teixeira Gonsaga, Ricardo A; Theobald, George; Tomadze, Gia; Torba, Myftar; Tranà, Cristian; Ulrych, Jan; Uzunoğlu, Mustafa Y; Vasilescu, Alin; Occhionorelli, Savino; Venara, Aurélien; Vereczkei, Andras; Vettoretto, Nereo; Vlad, Nutu; Walędziak, Maciej; Yilmaz, Tonguç U; Yuan, Kuo-Ching; Yunfeng, Cui; Zilinskas, Justas; Grelpois, Gérard; Catena, Fausto

    2018-01-01

    Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

  6. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies

    DEFF Research Database (Denmark)

    Andersen, JH; Kaergaard, A.; Mikkelsen, S.

    2003-01-01

    AIMS: To quantify the relative contribution of work related physical factors, psychosocial workplace factors, and individual factors and aspects of somatisation to the onset of neck/shoulder pain. METHODS: Four year prospective cohort study of workers from industrial and service companies...... in Denmark. Participants were 3123 workers, previously enrolled in a cross sectional study, where objective measurement of physical workplace factors was used. Eligible participants were followed on three subsequent occasions with approximately one year intervals. Outcomes of interest were: new onset of neck...... subsequent neck/shoulder pain, and neck/shoulder pain with pressure tenderness. CONCLUSIONS: High levels of distress, and physical and psychosocial workplace factors are predictors of onset of pain in the neck and/or shoulders, particularly pain with pressure tenderness in the muscles...

  7. Prospect-EPIC Utrecht: study design and characteristics of the cohort population. European Prospective Investigation into Cancer and Nutrition.

    Science.gov (United States)

    Boker, L K; van Noord, P A; van der Schouw, Y T; Koot, N V; Bueno de Mesquita, H B; Riboli, E; Grobbee, D E; Peeters, P H

    2001-01-01

    The European Prospective Investigation into Cancer and Nutrition (EPIC), which has been established in order to investigate the relations between nutrition and cancer, was initiated in 1990 and involves 10 European countries with heterogeneous dietary patterns and differing cancer incidence rates. This manuscript presents the design, recruitment and baseline characteristics of the Prospect-EPIC cohort co-ordinated in Utrecht, The Netherlands. The cohort is based on volunteers recruited among women participating in a regional breast cancer screening program. It comprises of 17,357 subjects aged 50-69 years at enrolment from Utrecht and vicinity, who have consented to participate in the study and its follow-up. Each participant filled out a general questionnaire and a food frequency questionnaire. Participants were also physically examined and have donated a blood sample. Participation rate was 34.5%. Blood samples were donated by most participants (97.5%) and detailed informed consents were obtained from 87.4% of participants. Mean age at enrolment was 57 years. Anthropometric, lifestyle and morbidity characteristics of the cohort population did not differ largely from those of similar study populations in The Netherlands. Based on the Prospect-EPIC population, we intend to conduct prospective total cohort, nested case-control or case-cohort studies, in order to investigate relations between consumption of certain food groups or nutrients and chronic diseases, including hormone dependant cancers such as breast, colon, endometrial and ovary cancers.

  8. Qingdao Port Cardiovascular Health Study: a prospective cohort study.

    Science.gov (United States)

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-12-09

    In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. For this study, from 2000 through 2013, 32,404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221,923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4-39.4%; diabetes: 3.3-8.9%; hyperlipidaemia: 5.0-33.6%; body mass index >28 m/kg(2): 14.1-18.6%). We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will

  9. Qingdao Port Cardiovascular Health Study: a prospective cohort study

    Science.gov (United States)

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-01-01

    Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge

  10. Cervical pap smear- A prospective study in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  11. Kartini Research Reactor prospective studies for neutron scattering application

    International Nuclear Information System (INIS)

    Widarto

    1999-01-01

    The Kartini Research Reactor (KRR) is located in Yogyakarta Nuclear Research Center, Yogyakarta - Indonesia. The reactor is operated for 100 kW thermal power used for research, experiments and training of nuclear technology. There are 4 beam ports and 1 column thermal are available at the reactor. Those beam ports have thermal neutron flux around 10 7 n/cm 2 s each other and used for sub critical assembly, neutron radiography studies and Neutron Activation Analysis (NAA). Design of neutron collimator has been done for piercing radial beam port and the calculation result of collimated neutron flux is around 10 9 n/cm 2 s. This paper describes experiment facilities and parameters of the Kartini research reactor, and further more the prospective studies for neutron scattering application. The purpose of this paper is to optimize in utilization of the beam ports facilities and enhance the manpower specialty. The special characteristic of the beam ports and preliminary studies, pre activities regarding with neutron scattering studies for KKR is presented. (author)

  12. The early growth and development study: a prospective adoption design.

    Science.gov (United States)

    Leve, Leslie D; Neiderhiser, Jenae M; Ge, Xiaojia; Scaramella, Laura V; Conger, Rand D; Reid, John B; Shaw, Daniel S; Reiss, David

    2007-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N=359 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study are recruited through adoption agencies located throughout the United States, following the birth of a child. Assessments occur at 6-month intervals until the child reaches 3 years of age. Data collection includes the following primary constructs: infant and toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described.

  13. Which young physicians are satisfied with their work? A prospective nationwide study in Norway

    Directory of Open Access Journals (Sweden)

    Ekeberg Oivind

    2005-06-01

    Full Text Available Abstract Background Few studies have investigated personality and medical school variables in regard to job satisfaction after graduation. It is of great importance to investigate these factors because this information may be used in the recruitment/admittance process to medical schools, and possibly to improve medical education. Methods We conducted a nationwide prospective 10-year follow-up study of medical students at all medical schools in Norway. They were approached three times during their medical training: at very beginning (T1, in the middle (T2, in the last year of medical school (T3, and then four years after graduation (T4. There were 210 participants who responded on all four occasions. Job satisfaction was measured with the Job Satisfaction Scale, which was used as the outcome variable. In addition to conducting multiple regression analysis for the total sample, we also conducted similar analyses separately for men and women. Results Among the demographic and personality variables, 'having a father who is a physician' and 'interpersonal functioning (being withdrawn' were significantly associated with job satisfaction at T4. Among the medical school variables, 'well-being with peers', 'identification with the doctor's role at the end of curriculum', 'perceived medical school stress', and 'perceived clinical skills' were significantly associated with job satisfaction. In the multiple regression analysis only 'father as a physician' and 'perceived clinical skills' yielded an independent influence on the outcome variable in separate analyses within sub-groups of male and female students, 'perceived clinical skills' differentiated among woman only, while 'well-being with peers' differentiated only among men. Conclusion The main finding of this study is that the young physicians who are the most satisfied in their work are those whose fathers are physicians and those who have a high level of perceived clinical skills at the end of

  14. 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.

  15. Prospective study of nutritional support during pelvic irradiation

    International Nuclear Information System (INIS)

    Kinsella, T.J.; Malcolm, A.W.; Bothe, A. Jr.; Valerio, D.; Blackburn, G.L.

    1981-01-01

    A prospective study of nutritional support during pelvic irradiation was carried out in 32 patients with a primary pelvic malignancy and prior weight loss. Both curative and palliative patients were eligible for the study. Seventeen patients were randomized to receive intravenous hyperalimentation (IVH) and fifteen patients served as controls who were maintained on their regular diet. Patients were stratified by percent body weight loss. Tolerance to therapy was assessed by evaluation of functional status and by using nutritional parameters of body weight change, change in serum protein levels, and response to delayed hypersensitivity skin tests. The curative IVH group tolerated therapy well by both functional and nutritional measurements. All curative IVH patients completed the planned radiation therapy without a treatment break and were fully active following treatment. Patients gained an average of 4.0 kg body weight during irradiation, which was significantly different from the curative control patients. They demonstrated a significant increase in serum transferrin reflecting an improvement in visceral protein. In addition, all showed a positive response to delayed hypersensitivity skin tests at the completion of irradiation. The palliative IVH patients often did poorly because of progression of disease and demonstrated only an elevation of serum transferrin during treatment. The results in the curative IVH group suggest a potential adjunctive role for intravenous hyperalimentation in the malnourished cancer patient undergoing pelvic irradiation. Clearly, further study of nutritional support during pelvic irradiation is needed using curative patients with a single tumor type and significant prior weight loss

  16. Ultrasound cervical length in predicting preterm birth: Prospective study

    Directory of Open Access Journals (Sweden)

    Achour Radhouane

    2017-08-01

    Full Text Available Background Preterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies. Aims The aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA” and the second trimester (20–24 Weeks of amenorrhea” WA” in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment. Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015. Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se, and specificity (Sp. Conclusion We conclude that ultrasound screening of preterm delivery is now highly recommended.

  17. Low organisational justice and heavy drinking: a prospective cohort study.

    Science.gov (United States)

    Kouvonen, Anne; Kivimäki, Mika; Elovainio, Marko; Väänänen, Ari; De Vogli, Roberto; Heponiemi, Tarja; Linna, Anne; Pentti, Jaana; Vahtera, Jussi

    2008-01-01

    To investigate whether low perceived organisational injustice predicts heavy drinking among employees. Data from a prospective occupational cohort study, the 10-Town Study, on 15 290 Finnish public sector local government employees nested in 2432 work units, were used. Non-drinkers were excluded. Procedural, interactional and total organisational justice, heavy drinking (>/=210 g of absolute alcohol per week) and other psychosocial factors were determined by means of questionnaire in 2000-2001 (phase 1) and 2004 (phase 2). Multilevel logistic regression analyses taking into account the hierarchical structure of the data were conducted and adjustments were made for sex, age, socio-economic status, marital status, baseline heavy drinking, psychological distress and other psychosocial risk factors such as job strain and effort/reward imbalance. After adjustments, participants who reported low procedural justice at phase 1 were approximately 1.2 times more likely to be heavy drinkers at phase 2 compared with their counterparts reporting high justice. Low perceived justice in interpersonal treatment and low perceived total organisational justice were associated with increased prevalence of heavy drinking only in the model adjusted for sociodemographics. This is the first longitudinal study to show that low procedural justice is weakly associated with an increased likelihood of heavy drinking.

  18. Surgical site infections in Italian Hospitals: a prospective multicenter study

    Directory of Open Access Journals (Sweden)

    Ippolito Giuseppe

    2008-03-01

    Full Text Available Abstract Background Surgical site infections (SSI remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital and postdisharge SSI, and the associated risk factors. Methods In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI. Results SSI occurred in 241 (5.2% of 4,665 patients, of which 148 (61.4% during in-hospital, and 93 (38.6% during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7% and 31 (33.3% were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%, gastric surgery (13.6%, and appendectomy (8.6%. If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI. Conclusion Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI

  19. Study of geothermal prospects in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    1976-08-20

    The commercial development potential of 13 underdeveloped geothermal prospects in the Western United States has been examined and the prospects have been ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. This criterion is obtained principally from expected reservoir temperatures and depths. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data. The Roosevelt, Utah, prospect ranks first in development potential followed in order by Beowawe, Nevada; Coso Hot Springs, California; Long Valley, California; and Brady's Hot Springs, Nevada.

  20. Study of geothermal prospects in the western United States

    Energy Technology Data Exchange (ETDEWEB)

    1975-01-01

    The commercial development potential of 13 underdeveloped geothermal prospects in the western United States has been examined and the prospects have been ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. This criterion is obtained principally from expected reservoir temperatures and depths. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data. The Roosevelt, Utah, prospect ranks first in development potential followed in order by Beowawe, Nevada; Coso Hot Springs, California; Long Valley, California; and Brady's Hot Springs, Nevada.

  1. Methodology and integrated studies for the strategic regional uranium prospects

    International Nuclear Information System (INIS)

    Andrade Tolentino, J. de.

    1984-01-01

    An integrated methodology alternative to the traditional one used for uranium prospecting is presented. For this purpose a detailed revision of some methods for finding uranium was made. Then a geological unit located in Minas Gerais, Brazil, was chosen due to its geographical proximity to the Lagoa Real deposit in the Brazilian Bahia State. The methodology applied to this unit gave a preliminary indications of areas to be prospected in detail. 36 refs, 44 figs, 20 tabs

  2. No causal relationship between Yersinia enterocolitica infection and autoimmune thyroid disease: evidence from a prospective study

    NARCIS (Netherlands)

    Effraimidis, G.; Tijssen, J. G. P.; Strieder, T. G. A.; Wiersinga, W. M.

    2011-01-01

    P>The objective of this study was to evaluate prospectively the relationship between Yersinia enterocolitica (YE) infection and the development of overt autoimmune hypo- or hyperthyroidism (study A) and the de novo occurrence of thyroid antibodies (study B). This was a prospective cohort study of

  3. Placental methylome analysis from a prospective autism study.

    Science.gov (United States)

    Schroeder, Diane I; Schmidt, Rebecca J; Crary-Dooley, Florence K; Walker, Cheryl K; Ozonoff, Sally; Tancredi, Daniel J; Hertz-Picciotto, Irva; LaSalle, Janine M

    2016-01-01

    Autism spectrum disorders (ASD) are increasingly prevalent neurodevelopmental disorders that are behaviorally diagnosed in early childhood. Most ASD cases likely arise from a complex mixture of genetic and environmental factors, an interface where the epigenetic marks of DNA methylation may be useful as risk biomarkers. The placenta is a potentially useful surrogate tissue characterized by a methylation pattern of partially methylated domains (PMDs) and highly methylated domains (HMDs) reflective of methylation patterns observed in the early embryo. In this study, we investigated human term placentas from the MARBLES (Markers of Autism Risk in Babies: Learning Early Signs) prospective study by whole genome bisulfite sequencing. We also examined the utility of PMD/HMDs in detecting methylation differences consistent with ASD diagnosis at age three. We found that while human placental methylomes have highly reproducible PMD and HMD locations, there is a greater variation between individuals in methylation levels over PMDs than HMDs due to both sampling and individual variability. In a comparison of methylation differences in placental samples from 24 ASD and 23 typically developing (TD) children, a HMD containing a putative fetal brain enhancer near DLL1 was found to reach genome-wide significance and was validated for significantly higher methylation in ASD by pyrosequencing. These results suggest that the placenta could be an informative surrogate tissue for predictive ASD biomarkers in high-risk families.

  4. Prospective study of injury in volleyball players: 6 year results.

    Science.gov (United States)

    Pastor, M F; Ezechieli, M; Classen, L; Kieffer, O; Miltner, O

    2015-01-01

    The volleyball game has a high complexity and thus entails a lot of strain to the players. Due to this high and different training and competition strain comprehensive and individual training plans should be developed with competing training objectives in order to prevent injuries. The aim of the study was to analyse prospectively over six seasons the acute and overuse injuries of a German male professional volleyball team. The study included 34 male national league players from season the 2007/08 to 2012/13. All players received a sport medicine examination and a functional diagnosis before each season. Based on the results the players received an individual training plan. The players suffered 186 injuries. The prevalence of acute injuries was 1.94 per player and overuse injuries 0.64 per player. The incidence of acute injuries was 3.3/1000 h volleyball and overuse injuries 1.08/1000 h volleyball. The largest number of injuries was found in the spine. The players had most likely minor injuries. The players had significantly fewer injuries in their second season (1.92) than in their first season (3.25; p= 0.004). It could be concluded that volleyball is a sport with a relative low prevalence of injuries compared to other team sports. The prevalence of injury is 2.58 per player. Due to an injury a player dropped out 16.91 days per season. An individual training program seems to reduce the incidence of injury.

  5. Gender effect on clinical features of achalasia: a prospective study

    Directory of Open Access Journals (Sweden)

    Mahdavinia Mahboobeh

    2006-04-01

    Full Text Available Abstract Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03. Although the occurrence of chest pain significantly reduced after treatment in both groups (P Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive.

  6. Prospective study of sunburn and sun behavior patterns during adolescence.

    Science.gov (United States)

    Dusza, Stephen W; Halpern, Allan C; Satagopan, Jaya M; Oliveria, Susan A; Weinstock, Martin A; Scope, Alon; Berwick, Marianne; Geller, Alan C

    2012-02-01

    Early childhood UV light radiation (UVR) exposures have been shown to be associated with melanoma development later in life. The objective of this study was to assess sunburn and changes in sunburn and sun behaviors during periadolescence. A prospective, population-based study was conducted in fifth-grade children (∼10 years of age) from Framingham, Massachusetts. Surveys were administered at baseline (September-October 2004) and again 3 years later (September-October 2007). Surveys were analyzed to assess prevalence of reported sunburn and sun behaviors and to examine changes in response over the follow-up period. Data were analyzed from 360 participants who had complete information regarding sunburn at both time points. In 2004, ∼53% of the students reported having at least 1 sunburn during the previous summer, and this proportion did not significantly change by 2007 (55%, P = .79), whereas liking a tan and spending time outside to get a tan significantly increased (P sunburns before age 11 and again 3 years later, targeting children in pediatric offices and community settings regarding unprotected UV exposure may be a practical approach. Because periadolescence is a time of volatility with regard to sun behaviors, learning more about children who receive sunburns versus those who avoid them is a critical research task.

  7. Nosocomial pneumonia in the ICU: a prospective cohort study.

    Science.gov (United States)

    Hyllienmark, Petra; Gårdlund, Bengt; Persson, Jan-Olov; Ekdahl, Karl

    2007-01-01

    Ventilator-associated pneumonia (VAP) is the most common intensive care unit (ICU)-acquired infection among patients requiring mechanical ventilation. A prospective surveillance programme of all patients has been implemented at the ICU, Karolinska University Hospital, Sweden since 2001. Within this programme, incidence and risk factors for ICU-acquired pneumonia and associated death over a 2-y period have been studied. Of 329 patients enrolled in the study, 221 required mechanical ventilation. 33 of 221 patients (15%) developed VAP, corresponding to a rate of 29 VAP/1000 ventilator d. Risk factors for VAP were aspiration (hazard ratio 3.79; 95% CI 1.48-9.68), recent surgery (HR 3.58; 95% CI 1.15-11.10) and trauma (HR 3.00; 95% CI 1.03-8.71). 11 patients of 33 (33%) with VAP died within 28 d compared to 46 of 288 (16%) without ICU-acquired pneumonia (odds ratio 2.73; 95% CI 0.97-7.63). We conclude that: 1) incidence of VAP was 15% and the most important risk factor was aspiration; 2) APACHE II score > or = 20 is a stronger predictor for poor outcome than VAP; 3) a minority of patients with APACHE II score > or = 20 develop VAP; and 4) continuous surveillance programmes are feasible and provide valuable data for improvement of quality of care.

  8. Prospective Clinical Study of Precision Oncology in Solid Tumors.

    Science.gov (United States)

    Sohal, Davendra P S; Rini, Brian I; Khorana, Alok A; Dreicer, Robert; Abraham, Jame; Procop, Gary W; Saunthararajah, Yogen; Pennell, Nathan A; Stevenson, James P; Pelley, Robert; Estfan, Bassam; Shepard, Dale; Funchain, Pauline; Elson, Paul; Adelstein, David J; Bolwell, Brian J

    2015-11-09

    Systematic studies evaluating clinical benefit of tumor genomic profiling are lacking. We conducted a prospective study in 250 patients with select solid tumors at the Cleveland Clinic. Eligibility required histopathologic diagnosis, age of 18 years or older, Eastern Cooperative Oncology Group performance status 0-2, and written informed consent. Tumors were sequenced using FoundationOne (Cambridge, MA). Results were reviewed at the Cleveland Clinic Genomics Tumor Board. Outcomes included feasibility and clinical impact. Colorectal (25%), breast (18%), lung (13%), and pancreatobiliary (13%) cancers were the most common diagnoses. Median time from consent to result was 25 days (range = 3-140). Of 223 evaluable samples, 49% (n = 109) of patients were recommended a specific therapy, but only 11% (n = 24) received such therapy: 12 on clinical trials, nine off-label, three on-label. Lack of clinical trial access (n = 49) and clinical deterioration (n = 29) were the most common reasons for nonrecommendation/nonreceipt of genomics-driven therapy. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Biomarkers in differentiating clinical dengue cases: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gary Kim Kuan Low

    2015-12-01

    Full Text Available Objective: To evaluate five biomarkers (neopterin, vascular endothelial growth factor-A, thrombomodulin, soluble vascular cell adhesion molecule 1 and pentraxin 3 in differentiating clinical dengue cases. Methods: A prospective cohort study was conducted whereby the blood samples were obtained at day of presentation and the final diagnosis were obtained at the end of patients’ follow-up. All patients included in the study were 15 years old or older, not pregnant, not infected by dengue previously and did not have cancer, autoimmune or haematological disorder. Median test was performed to compare the biomarker levels. A subgroup Mann-Whitney U test was analysed between severe dengue and non-severe dengue cases. Monte Carlo method was used to estimate the 2-tailed probability (P value for independent variables with unequal number of patients. Results: All biomarkers except thrombomodulin has P value < 0.001 in differentiating among the healthy subjects, non-dengue fever, dengue without warning signs and dengue with warning signs/severe dengue. Subgroup analysis for all the biomarkers between severe dengue and non-severe dengue cases was not statistically significant except vascular endothelial growth factor-A (P < 0.05. Conclusions: Certain biomarkers were able to differentiate the clinical dengue cases. This could be potentially useful in classifying and determining the severity of dengue infected patients in the hospital.

  10. A prospective study of marine phytoplankton and reported ...

    Science.gov (United States)

    BACKGROUND: Blooms of marine phytoplankton may adversely affect human health. The potential public health impact of low-level exposures is not well established, and few prospective cohort studies of recreational exposures to marine phytoplankton have been conducted.OBJECTIVE: We evaluated the association between phytoplankton cell counts and subsequent illness among recreational beachgoers.METHODS:We recruited beachgoers at Boquer6n Beach, Puerto Rico, during the summer of 2009. We conducted interviews at three time points to assess baseline health, water activities, and subsequent illness. Daily water samples were quantitatively assayed for phytoplankton cell count. Logistic regression models, adjusted for age and sex, were used to assess the association between exposure to three categories of phytoplankton concentration and subsequent illness.RESULTS: During 26 study days, 15,726 individuals successfully completed all three interviews. Daily total phytoplankton cell counts ranged from 346 to 2,012 cells/ml (median, 712 cells/ml). The category with the highest (≥75th percentile) total phytoplankton cell count was associated with eye irritation [adjusted odds ratio (OR) = 1.30; 95% confidence interval (Cl): 1.01, 1.66], rash (OR = 1.27; 95% Cl: 1.02, 1.57), and earache (OR = 1.25; 95% Cl: 0.88, 1.77). In phytoplankton group-specific analyses, the category with the highest Cyanobacteria counts was associated with respiratory illness (OR = 1.37; 95% Cl: 1.12, 1

  11. [Acute myocardial infarction in Djibouti: 2-year prospective study].

    Science.gov (United States)

    Maurin, O; Massoure, P L; de Regloix, S; Topin, F; Sbardella, F; Lamblin, G; Kaiser, E

    2012-01-01

    Acute myocardial infarction (AMI) is a life-threatening emergency. In Africa, the increasing prevalence of cardiovascular risk factors is leading to an epidemiological transition. No data have yet been reported about AMI in Djibouti. This study prospectively included all patients with acute coronary syndrome and persistent ST segment elevation admitted to the emergency department of Bouffard Military Hospital in Djibouti from January 2009 through December 2010. It analyzed their clinical data and management. The study included 35 patients. Their mean age was 52 ± 11 years [range: 29-76]. The sex ratio was 7.7 (men/women). Cardiovascular risk factors were: hypercholesterolemia (83%), tobacco use (60%), khat chewing (57%), diabetes (49%), hypertension (46%), and heredity (20%). AMI was anterior in 40% of cases. Fifteen patients (43%) arrived within 12 hours after the onset of symptoms (average 5 hours); thrombolysis was successful for 11 of them (73%). Seven patients (20%) died over the entire follow-up (11.3 ± 9 months), 5 within the first month. Mortality was significantly associated with diabetes (pDjibouti are 10 to 15 years younger than in Western countries. Their high level of cardiovascular risk is remarkable. Khat use did not significantly affect prognosis. The high mortality rate was similar to rates reported before the percutaneous coronary angioplasty era.

  12. Selective decontamination in pediatric liver transplants. A randomized prospective study.

    Science.gov (United States)

    Smith, S D; Jackson, R J; Hannakan, C J; Wadowsky, R M; Tzakis, A G; Rowe, M I

    1993-06-01

    Although it has been suggested that selective decontamination of the digestive tract (SDD) decreases postoperative aerobic Gram-negative and fungal infections in orthotopic liver transplantation (OLT), no controlled trials exist in pediatric patients. This prospective, randomized controlled study of 36 pediatric OLT patients examines the effect of short-term SDD on postoperative infection and digestive tract flora. Patients were randomized into two groups. The control group received perioperative parenteral antibiotics only. The SDD group received in addition polymyxin E, tobramycin, and amphotericin B enterally and by oropharyngeal swab postoperatively until oral intake was tolerated (6 +/- 4 days). Indications for operation, preoperative status, age, and intensive care unit and hospital length of stay were no different in SDD (n = 18) and control (n = 18) groups. A total of 14 Gram-negative infections (intraabdominal abscess 7, septicemia 5, pneumonia 1, urinary tract 1) developed in the 36 patients studied. Mortality was not significantly different in the two groups. However, there were significantly fewer patients with Gram-negative infections in the SDD group: 3/18 patients (11%) vs. 11/18 patients (50%) in the control group, P < 0.001. There was also significant reduction in aerobic Gram-negative flora in the stool and pharynx in patients receiving SDD. Gram-positive and anaerobic organisms were unaffected. We conclude that short-term postoperative SDD significantly reduces Gram-negative infections in pediatric OLT patients.

  13. 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.

  14. 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.

  15. 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)

  16. 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

  17. Independent and combined relationship of habitual unhealthy eating behaviors with depressive symptoms: A prospective study

    OpenAIRE

    Huang, Cong; Momma, Haruki; Cui, Yufei; Chujo, Masahiko; Otomo, Atsushi; Sugiyama, Shota; Ren, Zhongyu; Niu, Kaijun; Nagatomi, Ryoichi

    2016-01-01

    Background: Unhealthy eating has been found to be associated with the prevalence of depressive symptoms. However, prospective evidence of the combined effects of unhealthy eating and depressive symptoms has not been reported. This study aimed to elucidate the prospective relationship between habitual unhealthy eating habits and depressive symptoms. Methods: A 2-year prospective cohort study of 376 Japanese adults aged 24–83 years without depressive symptoms at baseline was conducted. Infor...

  18. Thrombocytopenia during Pregnancy and Its Outcome – A Prospective Study

    Directory of Open Access Journals (Sweden)

    Pallavi Satish Vishwekar

    2017-01-01

    Full Text Available Background: Thrombocytopenia is second to anemia as the most common hematological abnormality during pregnancy. Accurate etiological diagnosis is essential for optimal therapeutic management and thus can prevent maternal and fetal morbidity and mortality. Aims and Objectives: To determine various etiologies of maternal thrombocytopenia, their complications and fetomaternal outcome compared with normal pregnancy. Material and Methods: A prospective study was carried out in tertiary hospital, 1460 pregnant women who attended the Antenatal clinic regularly were enrolled. All were screened for thrombocytopenia in third trimester (after 28 weeks, women with normal platelet (n=1350 were taken in control group and those with low counts less than 150 x109/L (n=130 were included in study group. Etiology and fetomaternal outcome of thrombocytopenia in third trimester of pregnancy were evaluated and compared. Results: Gestational thrombocytopenia was the commonest etiology (68.46%. Incidence of thrombocytopenia due to severe preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP syndrome in study group was 18.46% and 7.69% of them had medical cause like malarial or dengue fever. Major causes were Gestational Thrombocytopenia (GT, Idiopathic Thrombocytopenic Purpura (ITP, preeclampsia, HELLP syndrome, malaria, and dengue. Maternal complications due to bleeding tendencies like placental abruption, postpartum hemorrhage were evident in the study population. Fetal complications were significantly higher in study group. Early neonatal thrombocytopenia depended on etiology rather than severity of maternal thrombocytopenia. Conclusions: Outcome of pregnancy with moderate to severe thrombocytopenia depends mainly on the etiology of thrombocytopenia. Adverse outcomes are especially seen with pregnancy complicated by preeclampsia and HELLP syndrome. Fetomaternal outcome is favorable in gestational thrombocytopenia. Thus accurate etiological

  19. Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years.

    Science.gov (United States)

    Quittner, Alexandra L; Cruz, Ivette; Barker, David H; Tobey, Emily; Eisenberg, Laurie S; Niparko, John K

    2013-02-01

    To examine the effects of observed maternal sensitivity (MS), cognitive stimulation (CS), and linguistic stimulation on the 4-year growth of oral language in young, deaf children receiving a cochlear implant. Previous studies of cochlear implants have not considered the effects of parental behaviors on language outcomes. In this prospective, multisite study, we evaluated parent-child interactions during structured and unstructured play tasks and their effects on oral language development in 188 deaf children receiving a cochlear implant and 97 normal-hearing children as controls. Parent-child interactions were rated on a 7-point scale using the National Institute of Child Health and Human Development's Early Childcare Study codes, which have well-established psychometric properties. Language was assessed using the MacArthur Bates Communicative Development Inventories, the Reynell Developmental Language Scales, and the Comprehensive Assessment of Spoken Language. We used mixed longitudinal modeling to test our hypotheses. After accounting for early hearing experience and child and family demographics, MS and CS predicted significant increases in the growth of oral language. Linguistic stimulation was related to language growth only in the context of high MS. The magnitude of effects of MS and CS on the growth of language was similar to that found for age at cochlear implantation, suggesting that addressing parenting behaviors is a critical target for early language learning after implantation. Copyright © 2013 Mosby, Inc. All rights reserved.

  20. 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

  1. Intrauterine temperature during intrapartum amnioinfusion: a prospective observational study.

    Science.gov (United States)

    Tomlinson, T M; Schaecher, C; Sadovsky, Y; Gross, G

    2012-07-01

    To determine the influence of routine intrapartum amnioinfusion (AI) on intrauterine temperature. Prospective observational study. Maternity unit, Barnes Jewish Hospital, St Louis, MO, USA. Forty women with singleton gestations and an indication for intrapartum intrauterine pressure catheter placement. Using a temperature probe, we digitally recorded intrauterine temperature every 10 minutes during labour. Amnioinfusion was administered according to a standard protocol using saline equilibrated to the ambient temperature. Mean intrauterine temperature during labour. Participants were monitored for a mean of 280 minutes (range 20-820). A total of 164 intrauterine temperature readings in the AI cohort were compared with 797 control measurements. When compared with controls, we observed a lower intrauterine temperature in the AI cohort (36.4 versus 37.4°C, P<0.01). More measurements in the AI cohort were recorded in the presence of intrapartum fever (40% versus 30%). A subgroup analysis of measurements recorded in afebrile parturients revealed an even greater effect of AI (1.5°C decrease, 37.3 versus 35.8°C, P<0.01). Routine intrapartum AI using saline equilibrated to a mean ambient temperature of 25.0°C reduces intrauterine temperature and may thereby affect fetal core temperature. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  2. Mild traumatic brain injury and fatigue: a prospective longitudinal study.

    Science.gov (United States)

    Norrie, Joan; Heitger, Marcus; Leathem, Janet; Anderson, Tim; Jones, Richard; Flett, Ross

    2010-01-01

    To examine fatigue prevalence, severity, predictors and co-variates over 6 months post-mild traumatic brain injury (MTBI). Longitudinal prospective study including 263 adults with MTBI. Participants completed the Fatigue Severity Scale (FSS), Rivermead Post-concussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence--RPSQ Item 6: severity--FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates. Post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months, respectively. There was a strong effect for time over the first 3 months and moderate-to-high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue; depression, but not anxiety was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases. Post-MTBI fatigue is a persistent post-concussion symptom, exacerbated by depression but not anxiety. It diminishes in the first 3 months and then becomes relatively stable, suggesting the optimum intervention placement is at 3 months or more post-MTBI.

  3. Postoperative Pain after Root Canal Treatment: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    M. Gotler

    2012-01-01

    Full Text Available Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP subsequent to root canal treatment (RCT in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (=274 who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp. than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp. or of retreated teeth (48.8%; 1.89 ± 1.1, resp.. No statistical relation was found between type of pain (spontaneous or stimulated and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.

  4. Pilot study on microvascular anastomosis: performance and future educational prospects.

    Science.gov (United States)

    Berretti, G; Colletti, G; Parrinello, G; Iavarone, A; Vannucchi, P; Deganello, A

    2017-11-30

    The introduction of microvascular free flaps has revolutionised modern reconstructive surgery. Unfortunately, access to training opportunities at standardised training courses is limited and expensive. We designed a pilot study on microvascular anastomoses with the aim of verifying if a short course, easily reproducible, could transmit microvascular skills to participants; if the chosen pre-test was predictive of final performance; and if age could influence the outcome. A total of 30 participants (10 students, 10 residents and 10 surgeons) without any previous microvascular experience were instructed and tested during a single 3 to 5 hour course. The two microanastomoses evaluated were the first ever performed by each participant. More than the half of the cohort was able to produce both patent microanastomoses in less than 2 hours; two-thirds of the attempted microanastomoses were patent. The pretest predicted decent scores from poor performances with a sensitivity of 61.5%, specificity of 100%, positive predictive value of 100% and negative predictive value of 40%. Students and residents obtained significantly higher scores than surgeons. Since our course model is short, cost-effective and highly reproducible, it could be introduced and implemented anywhere as an educational prospect for preselecting young residents showing talent and natural predisposition and having ambitions towards microvascular reconstructive surgery. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  5. European electricity; prospective study for 2050 between dreams and strategy

    International Nuclear Information System (INIS)

    Matheu, P.

    2015-01-01

    A number of road-maps for the future of the European electricity have been elaborated according to various hypotheses: support more or less important to wind or solar energies, success or failure of carbon capture and storage technologies, more or less gain in energy efficiency. All the prospective studies show a power demand in Europe nearing 4000 TWh in 2030 and less than 5000 TWh in 2050. Another common point is the progressive electrification which means first the de-carbonising of power production means and then the transfer to electricity of uses like heating and transport. All the scenario give a share of at least 50% for renewable energies in 2030 and between 60% and 80% in 2050. The share of nuclear power in the energy mix ranges between 2.5% and 19% while today's nuclear share is over 25%. An alternative roadmap designed by Eurelectric and based on the minimization of costs gives a more important share to nuclear power. (A.C.)

  6. Temporomandibular disorders after whiplash injury: a controlled, prospective study.

    Science.gov (United States)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter; Nyhuus, Lone; Jensen, Troels S

    2002-01-01

    Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were obtained at each visit. One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.

  7. Weight at birth and subsequent fecundability: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Cathrine Wildenschild

    Full Text Available To examine the association between a woman's birth weight and her subsequent fecundability.In this prospective cohort study, we included 2,773 Danish pregnancy planners enrolled in the internet-based cohort study "Snart-Gravid", conducted during 2007-2012. Participants were 18-40 years old at study entry, attempting to conceive, and were not receiving fertility treatment. Data on weight at birth were obtained from the Danish Medical Birth Registry and categorized as <2,500 grams, 2,500-2,999 grams, 3,000-3,999 grams, and ≥ 4,000 grams. In additional analyses, birth weight was categorized according to z-scores for each gestational week at birth. Time-to-pregnancy measured in cycles was used to compute fecundability ratios (FR and 95% confidence intervals (CI, using a proportional probabilities regression model.Relative to women with a birth weight of 3,000-3,999 grams, FRs adjusted for gestational age, year of birth, and maternal socio-demographic and medical factors were 0.99 (95% CI: 0.73;1.34, 0.99 (95% CI: 0.87;1.12, and 1.08 (95% CI: 0.94;1.24 for birth weight <2,500 grams, 2,500-2,999 grams, and ≥ 4,000 grams, respectively. Estimates remained unchanged after further adjustment for markers of the participant's mother's fecundability. We obtained similar results when we restricted to women who were born at term, and to women who had attempted to conceive for a maximum of 6 cycles before study entry. Results remained similar when we estimated FRs according to z-scores of birth weight.Our results indicate that birth weight appears not to be an important determinant of fecundability.

  8. Depression and incident diabetic foot ulcers: a prospective cohort study

    Science.gov (United States)

    Williams, Lisa H.; Rutter, Carolyn M.; Katon, Wayne J.; Reiber, Gayle E.; Ciechanowski, Paul; Heckbert, Susan R.; Lin, Elizabeth H.B.; Ludman, Evette J.; Oliver, Malia M.; Young, Bessie A.; Von Korff, Michael

    2010-01-01

    Objective To test whether depression is associated with an increased risk of incident diabetic foot ulcers. Methods The Pathways Epidemiologic Study is a population-based prospective cohort study of 4839 patients with diabetes in 2000–2007. The present analysis included 3474 adults with type 2 diabetes and no prior diabetic foot ulcers or amputations. Mean follow-up was 4.1 years. Major and minor depression assessed by the Patient Health Questionnaire-9 (PHQ-9) were the exposures of interest. The outcome of interest was incident diabetic foot ulcers. We computed the hazard ratio (HR) and 95% CI for incident diabetic foot ulcers, comparing patients with major and minor depression to those without depression and adjusting for sociodemographic characteristics, medical comorbidity, glycosylated hemoglobin (HbA1c), diabetes duration, insulin use, number of diabetes complications, body mass index, smoking status, and foot self-care. Sensitivity analyses also adjusted for peripheral neuropathy and peripheral arterial disease as defined by diagnosis codes. Results Compared to patients without depression, patients with major depression by PHQ-9 had a two-fold increase in the risk of incident diabetic foot ulcers (adjusted HR 2.00, 95% CI: 1.24, 3.25). There was no statistically significant association between minor depression by PHQ-9 and incident diabetic foot ulcers (adjusted HR 1.37, 95% CI: 0.77, 2.44). Conclusion Major depression by PHQ-9 is associated with a two-fold higher risk of incident diabetic foot ulcers. Future studies of this association should include better measures of peripheral neuropathy and peripheral arterial disease, which are possible confounders and/or mediators. PMID:20670730

  9. Sexual satisfaction following bariatric surgery: A prospective exploratory study.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Pomares-Callejón, María Ángeles; Fernández-Agis, Inmaculada; Belda-Lozano, Ricardo; Vidaña-Márquez, Elisabet; Soriano-Maldonado, Alberto

    2017-11-01

    Bariatric surgery improves sexual function in obese individuals, although the extent to which sexual satisfaction is improved following surgery is unknown. The aims of this study were 1) to describe sexual satisfaction in severely/morbidly obese men and women candidates for bariatric surgery; 2) to assess the effects of bariatric surgery on sexual satisfaction at 12-months follow-up; and 3) to assess whether weight changes at follow-up following bariatric surgery are associated with changes in sexual satisfaction. We conducted a prospective observational study from February 2011 to June 2014. A total of 44 patients with severe/morbid obesity participated in the study. Sexual satisfaction was assessed (at baseline and 12-months follow-up) through the Index of Sexual Satisfaction (ISS) questionnaire. Of 44 patients who completed the ISS at baseline (mean age 40.3 [SD=9.4] years and BMI 46.9 [SD=6.2] kg/m 2 ), 17 were lost to follow-up. The baseline ISS total scores were 32.0 (SD=20.1) in women and 24.4 (SD=16.0) in men (P>0.05). The proportion of sexually satisfied men and women at baseline was 62.5% and 46.4%, respectively (P=0.360). At follow-up, sexual satisfaction improved significantly in women (average difference 13.7 units; P=0.032) but not in men (average difference 3.6 units; P=0.717). The percentage of women with sexual satisfaction problems was reduced by 33% at follow-up (P=0.038). A relatively large percentage of severely/morbidly obese women and men present clinically significant sexual satisfaction problems before undergoing bariatric surgery. Sexual satisfaction improves significantly 12 months following bariatric surgery, particularly in women. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Respiratory support in oncology ward setting: a prospective descriptive study.

    Science.gov (United States)

    Mishra, Seema; Bhatnagar, Sushma; Gupta, Deepak; Goyal, Gaurav Nirvani; Agrawal, Ravi; Jain, Roopesh; Chauhan, Himanshu

    2009-01-01

    Mechanical ventilation in cancer patients is a critical issue The present prospective descriptive study was designed (1) to assess the patient population needing respirator support in ward setting at a premier state-run oncology institute in India, (2) to observe and analyze the course of their disease while on respirator, and (3) to coordinate better quality of life measures in cancer patients at the institute based on the present study's outcomes. Beginning from March 2005 to March 2006, all cancer patients who were connected to respirator in the wards were enrolled in the current study. Our anesthesiology department at the cancer institute also has primary responsibility for airway management and mechanical ventilation in high dependency units of oncology wards. Preventilation variables in cancer patients were assessed to judge the futility of mechanical ventilation in ward setting. Subsequently, patients were observed for disease course while on respirator. Final outcome with its etio-pathogenesis was correlated with predicted futility of mechanical ventilation. Over a period of 1 year, 132 (46 men and 86 women) cancer patients with median age 40 years (range 1-75 years) were connected to respirator in oncology wards. Based on the preventilation variables and indications for respirator support, right prediction of medical futility and hospital discharge was made in 77% of patients. Underestimation and overestimation of survival to hospital discharge was made in 10% cases and 13% cases, respectively. Based on preventilation variables, prediction of outcome in cancer patients needing respirator support can be made in 77% cases. This high probability of prediction can be used to educate patients, and their families and primary physicians, for well-informed and documented advance directives, formulated and regularly revised DNAR policies, and judicious use of respirator support for better quality-of-life outcomes.

  11. Injury among adolescents with intellectual disability: A prospective cohort study.

    Science.gov (United States)

    White, David; McPherson, Lyn; Lennox, Nicholas; Ware, Robert S

    2018-04-12

    Injury is the leading cause of mortality and morbidity in adolescents worldwide, and injury rates have been shown to be higher among youth with intellectual disability. Despite this, injury among adolescents with intellectual disability remains poorly investigated. This study aimed to identify characteristics associated with injury among adolescents with intellectual disability living in the community. A cohort of adolescents with intellectual disability living in southern Queensland, Australia was investigated prospectively between January 2006 and June 2010. Personal characteristics were collected via postal questionnaire. Injury information, including mechanism and location of injury, was extracted from general practitioner records. The association between demographic, social and clinical characteristics of participants and episodes of injury was investigated using negative binomial regression. A total of 289 injuries were recorded from 432 participants over 1627.3 years of study-time. The overall annual injury incidence was 17.5 (95%CI 14.7, 20.9) per 100 person years. Presence of ADHD and less severe disability was associated with increased risk of injury. Down syndrome and reduced verbal communication capacity were associated with decreased risk of injury. Falls accounted for the highest single mechanism of injury (19.0%) with the majority (73.2%) of injuries involving either upper or lower limbs. ADHD is a co-morbidity that increases risk of injury among adolescents with intellectual disability. A critical component of injury prevention is avoidance of the great variety of environmental risk factors for injury relevant to this population. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Pascal H Colson

    Full Text Available To estimate the incidence of active bleeding after cardiac surgery (AB based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications.AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications.Among 4,904 patients, 129 experienced AB (2.6%, among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16% but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication.A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  13. Prospective studies of infectious mononucleosis in university students

    Science.gov (United States)

    Grimm, Jennifer M; Schmeling, David O; Dunmire, Samantha K; Knight, Jennifer A; Mullan, Beth D; Ed, Julie A; Brundage, Richard C; Hogquist, Kristin A; Balfour, Henry H

    2016-01-01

    We performed an intensive prospective study designed to obtain as much data as possible on the incubation and early illness periods of primary Epstein–Barr virus (EBV) infection. Undergraduate students who lacked EBV antibody and oral EBV DNA (EBV-naive) were seen every 2 weeks during their freshman year. Clinical and behavioral data, oral washes and venous blood were obtained. EBV antibodies were quantified by enzyme immunoassay and viral loads by PCR. During a median 8 months of observation, 14/85 subjects experienced primary EBV infections (24 cases/100 person-years). The only significant risk factor for acquisition of EBV infection was deep kissing (P=0.02). Eleven subjects had infectious mononucleosis with a median duration of 21 days. Two subjects were hospitalized. Infections were initially identified in 12 subjects by finding EBV DNA in oral cells before onset of symptoms and in 2 subjects by symptom reporting. EBV DNA and viral capsid antigen (VCA) IgM and gp350 IgG antibodies were present in the blood before onset of illness. To provide a more robust evaluation of primary EBV infection in undergraduate university students, we combined data on risk factors and antibody responses from this and an earlier study that used the exact same clinical and laboratory methods. The observation that the only significant risk factor for acquisition of EBV infection was deep kissing was confirmed. Most importantly, higher amounts of gp350 antibody correlated significantly with a lower severity of infectious mononucleosis (P<0.0001), which strengthens the rationale for a gp350-based prophylactic EBV vaccine. PMID:27588199

  14. Sugammadex versus neostigmine in pediatric patients: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Turhan Kara

    2014-12-01

    Full Text Available Background and objectives: Acetylcholinesterase inhibitors may cause postoperative residual curarization when they are used for reversal of neuromuscular blockade. Sugammadex reverses neuromuscular blockade by chemical encapsulation and is not associated with the side effects that may occur with the use of anticholinesterase agents. Because of increased outpatient surgical procedures postoperative residual curarization and rapid postoperative recovery have a greater importance in the pediatric patient population. The aim of this study was to compare the efficacy of sugammadex and neostigmine on reversing neuromuscular blockade in pediatric patients undergoing outpatient surgical procedures. Methods: 80 patients, aged 2-12 years, scheduled for outpatient surgery were enrolled in this randomized prospective study. Neuromuscular blockade was achieved with 0.6 mgkg−1 rocuronium and monitorized with train-of-four. Group RN (n = 40 received 0.03 mgkg−1 neostigmine, Group RS (n = 40 received 2 mgkg−1 sugammadex for reversal of rocuronium. Extubation time (time from the reversal of neuromuscular blockade to extubation, train-of-four ratio during this time, time to reach train-of-four > 0.9, and probable complications were recorded. Results: There was no significant difference between the patients' characteristics. Extubation time and time to reach train-of-four > 0.9 were significantly higher in Group RN (p = 0.001, p = 0.002. Train-of-four at the time of neostigmine/sugammadex injection in Group RN were significantly higher than in the RS group (p = 0.020. Extubation train-of-four ratio was significantly lower in Group RN (p = 0.002. Conclusion: Sugammadex provides safer extubation with a shorter recovery time than neostigmine in pediatric patients undergoing outpatient surgical procedures.

  15. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Science.gov (United States)

    Colson, Pascal H; Gaudard, Philippe; Fellahi, Jean-Luc; Bertet, Héléna; Faucanie, Marie; Amour, Julien; Blanloeil, Yvonnick; Lanquetot, Hervé; Ouattara, Alexandre; Picot, Marie Christine

    2016-01-01

    To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  16. Optimism and Cause-Specific Mortality: A Prospective Cohort Study.

    Science.gov (United States)

    Kim, Eric S; Hagan, Kaitlin A; Grodstein, Francine; DeMeo, Dawn L; De Vivo, Immaculata; Kubzansky, Laura D

    2017-01-01

    Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemographic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses' Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociodemographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Skin Flap Necrosis After Mastectomy With Reconstruction: A Prospective Study.

    Science.gov (United States)

    Matsen, Cindy B; Mehrara, Babak; Eaton, Anne; Capko, Deborah; Berg, Anastasia; Stempel, Michelle; Van Zee, Kimberly J; Pusic, Andrea; King, Tari A; Cody, Hiram S; Pilewskie, Melissa; Cordeiro, Peter; Sclafani, Lisa; Plitas, George; Gemignani, Mary L; Disa, Joseph; El-Tamer, Mahmoud; Morrow, Monica

    2016-01-01

    Rates of mastectomy with immediate reconstruction are rising. Skin flap necrosis after this procedure is a recognized complication that can have an impact on cosmetic outcomes and patient satisfaction, and in worst cases can potentially delay adjuvant therapies. Many retrospective studies of this complication have identified variable event rates and inconsistent associated factors. A prospective study was designed to capture the rate of skin flap necrosis as well as pre-, intra-, and postoperative variables, with follow-up assessment to 8 weeks postoperatively. Uni- and multivariate analyses were performed for factors associated with skin flap necrosis. Of 606 consecutive procedures, 85 (14 %) had some level of skin flap necrosis: 46 mild (8 %), 6 moderate (1 %), 31 severe (5 %), and 2 uncategorized (0.3 %). Univariate analysis for any necrosis showed smoking, history of breast augmentation, nipple-sparing mastectomy, and time from incision to specimen removal to be significant. In multivariate models, nipple-sparing, time from incision to specimen removal, sharp dissection, and previous breast reduction were significant for any necrosis. Univariate analysis of only moderate or severe necrosis showed body mass index, diabetes, nipple-sparing mastectomy, specimen size, and expander size to be significant. Multivariate analysis showed nipple-sparing mastectomy and specimen size to be significant. Nipple-sparing mastectomy was associated with higher rates of necrosis at every level of severity. Rates of skin flap necrosis are likely higher than reported in retrospective series. Modifiable technical variables have limited the impact on rates of necrosis. Patients with multiple risk factors should be counseled about the risks, especially if they are contemplating nipple-sparing mastectomy.

  18. Dehydration in children with diabetic ketoacidosis: a prospective study.

    Science.gov (United States)

    Sottosanti, Maria; Morrison, Gavin C; Singh, Ram N; Sharma, Ajay P; Fraser, Douglas D; Alawi, Khalid; Seabrook, Jamie A; Kornecki, Alik

    2012-02-01

    To investigate the association between the degree of patient dehydration on presentation with diabetic ketoacidosis (DKA) and clinical and laboratory parameters obtained on admission. Prospective descriptive study. A tertiary care children's hospital. Thirty-nine paediatric patients (1 month-16 years) presenting with 42 episodes of DKA. Clinical and biochemical variables were collected on admission. Dehydration was calculated by measuring acute changes in body weight during the period of illness. All patients were treated according to a previously established protocol. Magnitude of dehydration, defined as % loss of body weight (LBW), was determined by the difference in body weight obtained at presentation and at discharge. The relationship between the magnitude of dehydration and the clinical assessment and biochemical parameters was examined. The median (25th-75th centiles) magnitude of dehydration at presentation was 5.7% (3.8-8.3%) (mean ± SD 6.8 ± 5%). Neither the initial clinical assessment nor the comprehensive biochemical profile at admission correlated with the magnitude of dehydration. Despite considerable variation in the degree of dehydration and biochemical disequilibrium, all patients recovered from DKA within 24 h with a standardised therapeutic approach. Furthermore, the rapidity of patient recovery did not correlate with the magnitude of dehydration on presentation or the amount of fluid administered (median (25th-75th centiles) 48.8 ml/kg (38.5-60.3)) in the first 12 h. The magnitude of dehydration in DKA is not reflected by either clinical or biochemical parameters. These findings need confirmation in larger studies.

  19. Postoperative infection risk after splenectomy: A prospective cohort study.

    Science.gov (United States)

    Barmparas, Galinos; Lamb, Alexander W; Lee, Debora; Nguyen, Brandon; Eng, Jamie; Bloom, Matthew B; Ley, Eric J

    2015-05-01

    Splenectomy is associated with a life-long risk for overwhelming infections. The risk for early post-operative infectious complications following traumatic and elective splenectomy is, however, understudied. This investigation aimed to determine if splenectomy increases the risk for post-operative infections. This was a retrospective review of prospectively collected data on patients admitted to the surgical intensive care unit (SICU) between 1/2011 and 7/2013 investigating the risk for infectious complications in patients undergoing a splenectomy compared with those undergoing any other abdominal surgery. During the 30-month study period, a total of 1884 patients were admitted to the SICU. Of those, 33 (2%) had a splenectomy and 493 (26%) had an abdominal surgery. The two groups were well balanced for age, APACHE IV score >20, and past medical history, including diabetes mellitus, cardiac history, renal failure or immunosuppression. Patients undergoing splenectomy were more likely to have sustained a traumatic injury (30% vs. 7%, p splenectomy was associated with increased risk for infectious complications (49% vs. 29%, Adjusted Odds Ratio (AOR) [95% CI]: 2.7 [1.3, 5.6], p = 0.01), including intra-abdominal abscess (9% vs. 3%, AOR [95% CI]: 4.3 [1.1, 16.2], p = 0.03). On a subgroup analysis, there were no differences between traumatic and elective splenectomy with regards to overall infectious complications (50% vs. 46%, p = 0.84), although, abdominal abscess developed only in those who had an elective splenectomy (0% vs. 12%, p = 0.55). Splenectomy increases the risk for post-operative infectious complications. Further studies identifying strategies to decrease the associated morbidity are necessary. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  20. A prospective study of blood splatter in ENT.

    Science.gov (United States)

    Lakhani, Raj; Loh, Yiwen; Zhang, Ting Ting; Kothari, Prasad

    2015-07-01

    Surgeons face an occupational risk of daily exposure to blood and body fluids. Potential sources of infection include sharps injuries and mucocutaneous contact. The transmission of blood-borne viruses, in particular human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C from the patient to healthcare workers is well documented in the literature. We studied the incidence and degree of blood splash in all otolaryngology (ENT) procedures undertaken in a single unit over a 12 week period. In addition, we investigated which intraoperative factors might predict the degree of splash. We undertook a prospective, non-blinded study of 102 patients undergoing a range of 'routine' elective ENT within one department over 12 weeks. A surgical mask with visor attached was worn in all procedures. Following each procedure, all splatter masks were collected and examined macroscopically and microscopically for blood splash. In addition, the procedure performed, technique used, total blood loss, operating time and grade of surgeon was noted. 54% of procedures resulted in splash mask contamination. The median number of splash spots per mask was 4.7 (range 0-63). Tonsillectomy was the most commonly performed procedure, accounting for over one-third of total procedures investigated. Each mask had an average of 8.2 splash marks. Tonsillectomy had a splash rate of 76.9%. Although the risk of developing HIV is low the operating surgeon has a duty to take all precautions to protect themselves during a procedure and therefore a protective mask and visor or suitable goggles must be worn.

  1. Prospective study of emergency presentation of abdominal tuberculosis

    Directory of Open Access Journals (Sweden)

    Akhilesh R. Mishra

    2016-08-01

    Full Text Available Background: In developing countries like India, where poverty, malnutrition and overcrowding prevail, tuberculosis continues to be one of the important causes of morbidity, mortality and loss of working man hours. Abdominal tuberculosis (TB can affect the gastrointestinal tract, the peritoneum, lymph nodes of the small bowel mesentery or the solid viscera (e.g. liver, spleen, pancreas etc Patient of abdominal Koch’s can present as those with a chronic undulating course and those with an acute or subacute abdominal catastrophe. In emergency the patient may present with various presentations like stricture causing obstruction or with perforation and require a different management from those routine such cases Aim and Objective: To study the varied presentation of patients with Abdominal Tuberculosis as acute surgical abdomen presenting in emergency setting to those with a subacute course. To evaluate the line of management whether operative or conservative, the operative details, post operative course and the final outcome of the disease. To study the incidence of HIV positivity in patients with abdominal tuberculosis. Methods and material: The study was designed as a prospective observational study conducted during a study period between June 2006 and June 2008 in a tertiary care centre in Mumbai. All patients with a clinical suspicion of abdominal tuberculosis were included in the study with confirmation on histopathological examination. Patient’s written informed valid consent was taken after explaining the nature of study. Result and Conclusion: Age group commonly affected was between 21-30 years with male predominance. Amongst the various complications of abdominal tuberculosis intestinal obstruction was the most common mainly due to stricture and less commonly due to hyperplastic ileocaecal mass. Next common complication observed was free perforation of the intestine which occurs at a site proximal to a tight stricture. All patients were

  2. 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

  3. 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...

  4. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study.

    LENUS (Irish Health Repository)

    Unterscheider, Julia

    2013-04-01

    The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile.

  5. Leflunomide in active rheumatoid arthritis : a prospective study in daily practice

    NARCIS (Netherlands)

    Van Roon, EN; Jansen, TLTA; Mourad, L; Houtman, PM; Bruyn, GAW; Griep, EN; Wilffert, B; Tobi, H; Brouwers, JRBJ

    Aims We prospectively studied the efficacy, incidence of adverse drug reactions and withdrawal from leflunomide in an outpatient population with rheumatoid arthritis in a setting of care-as-usual. Methods In this prospective case series study, from outpatient medical records a standard dataset was

  6. Leflunomide in active rheumatoid arthritis: A prospective study in daily practice

    NARCIS (Netherlands)

    Van Roon, E.N.; Jansen, T.L.Th.A.; Mourad, L.; Houtman, P.M.; Bruyn, G.A.W.; Griep, E.N.; Wilffert, B.; Tobi, H.; Brouwers, J.R.B.J.

    2004-01-01

    Aims: We prospectively studied the efficacy, incidence of adverse drug reactions and withdrawal from leflunomide in an outpatient population with rheumatoid arthritis in a setting of care-as-usual. Methods: In this prospective case series study, a standard dataset was collected from outpatient

  7. A Case Study on Mathematical Literacy of Prospective Elementary School Teachers

    Science.gov (United States)

    Suharta, I. Gusti Putu; Suarjana, I. Made

    2018-01-01

    The purpose of this study is to describe Mathematical Literacy (ML) of Prospective Elementary School Teachers with attention to aspects of mathematical skills and gender. The type of research is qualitative with the research design of Case Study. Respondents are assigned 12 Prospective Elementary School Teachers, consisting of 6 men and 6 women.…

  8. A prospective study of downhill mountain biking injuries.

    Science.gov (United States)

    Becker, Johannes; Runer, Armin; Neunhäuserer, Daniel; Frick, Nora; Resch, Herbert; Moroder, Philipp

    2013-05-01

    Downhill mountain biking (DMB) has become an increasingly popular extreme sport in the last few years with high velocities and bold manoeuvres. The goal of this study was to provide information on the pattern and causes of injuries in order to provide starting points for injury prevention measures. We performed a monthly e-mail-based prospective survey of 249 riders over one summer season ranging from April until September 2011. A total of 494 injuries occurred during the 29 401 h of downhill exposure recorded, of these 65% were mild, 22% moderate and 13% severe, of which 41% led to a total restriction greater than 28 days. The calculated overall injury rate was 16.8 injuries per 1000 h of exposure. For experts it was 17.9 injuries per 1000 h of exposure, which is significantly higher than the 13.4 for professional riders (OR 1.34; 95% CI, 1.02 to 1.75; p=0.03). A significantly higher rate of injury was reported during competition (20 per 1000 h) than during practice (13 per 1000 h) (OR 1.53; 95% CI, 1.16 to 2.01; p=0.0022). The most commonly injured body site was the lower leg (27%) followed by the forearm (25%). Most frequent injury types were abrasions (64%) and contusions (56%). Main causes of injury reported by the riders were riding errors (72%) and bad trail conditions (31%). According to our data DMB can be considered an extreme sport conveying a high risk of serious injury. Strategies of injury prevention should focus on improvements in riders' technique, checking of local trail conditions and protective equipment design.

  9. Pros and cons of a wandering mind: A prospective study

    Directory of Open Access Journals (Sweden)

    Cristina eOttaviani

    2013-08-01

    Full Text Available Mind wandering (MW has recently been associated with both adaptive (e.g., creativity enhancement and maladaptive (e.g., mood worsening consequences. This study aimed at investigating whether proneness to MW was prospectively associated with negative health outcomes. At time 0, 21 women, 19 men; mean age = 24.5 (4.9 underwent a 5-min baseline electrocardiogram (ECG, a 20-min laboratory tracking task with thought probes, and personality questionnaires. At time 1 (1 year follow-up, the same participants underwent a 24-hour Ecological Momentary Assessment characterized by ambulatory ECG recording and electronic diaries. First, we examined if the likelihood of being a ‘mind wanderer’ was associated with specific personality dispositions. Then, we tested if the occurrence of episodes of MW in the lab would be correlated with frequency of MW in daily life. Finally, multiple regression models were used to test if MW longitudinally acted as a risk factor for health, accounting for the effects of biobehavioral variables. Among dispositional traits, the frequency of MW episodes in daily life was inversely associated with the capacity of being mindful (i.e., aware of the present moment and non-judging. There was a positive correlation between frequency of MW in the lab and in daily life, suggesting that it is a stable disposition of the individual. When differentiated from perseverative cognition (i.e., rumination and worry, MW did not predict the presence of health risk factors one year later, however, a higher occurrence of episodes of MW was associated with short-term adverse consequences, such as increased 24-hour heart rate on the same day and difficulty falling asleep the subsequent night. Present findings suggest that MW may be associated with short term ‘side effects’ but argue against a long term dysfunctional view of this cognitive process.

  10. Returning to work after laparoscopic myomectomy: a prospective observational study.

    Science.gov (United States)

    Huff, Keren O; Aref-Adib, Mehrnoosh; Magama, Zwelihle; Vlachodimitropoulou, Evangelia K; Oliver, Reeba; Odejinmi, Funlayo

    2018-01-01

    Laparoscopic myomectomy offers women many benefits over conventional open surgery, including an expedited recovery and return to employment. Our study evaluates the time taken for women to return to work after laparoscopic myomectomy and identifies factors prolonging recovery to > 8 weeks. We prospectively evaluated 94 women undergoing laparoscopic myomectomy by a single surgeon between January 2012 and March 2015. Women had standardized preoperative counseling and completed a validated return to work questionnaire 3 months postoperatively via telephone, post or in clinic. In all, 71/94 (75.5%) women completed the questionnaire. Results were analyzed comparing women who returned to work in ≤ 8 weeks [43/71 (60.6%)] with those who returned > 8 weeks postoperatively [28/71 (39.4%)]. A higher proportion of Asian and Caucasian women returned to work in ≤ 8 weeks (24/29) compared with black African and Caribbean women (19/42) (p = 0.003). Mean number of fibroids removed (2.59 and 5.75, respectively) was the only significantly differing factor between the two groups (p = 0.004). There was a significant difference in body mass index (BMI) and time to return to normal activity between the ≤ 8-week and > 8-week groups (p = 0.027, p = 0.011, respectively). Logistic regression analysis demonstrated that BMI and time to return to normal activity were the only factors prolonging recovery to > 8 weeks (p = 0.039, p = 0.015, respectively). Time to return to normal activity and BMI significantly influenced the time taken for women to work after laparoscopic myomectomy. Further data would support clinicians in counseling women appropriately and optimizing their postoperative return to employment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma: a multicentre prospective cohort study

    International Nuclear Information System (INIS)

    Visser, Nicole C. M.; Bulten, Johan; Wurff, Anneke A. M. van der; Boss, Erik A.; Bronkhorst, Carolien M.; Feijen, Harrie W. H.; Haartsen, Joke E.; Herk, Hilde A. D. M. van; Kievit, Ineke M. de; Klinkhamer, Paul J. J. M.; Pijlman, Brenda M.; Snijders, Marc P. M. L.; Vandenput, Ingrid; Vos, M. Caroline; Wit, Peter E. J. de; Poll-Franse, Lonneke V. van de; Massuger, Leon F.A.G.; Pijnenborg, Johanna M. A.

    2015-01-01

    Endometrial carcinoma is the most common gynaecologic malignancy in industrialised countries and the incidence is still rising. Primary treatment is based on preoperative risk classification and consists in most cases of hysterectomy with bilateral salpingo-oophorectomy. In patients with serous and clear cell histology a complete surgical staging is mandatory. However, in routine clinical practice final histology regularly does not correspond with the preoperative histological diagnosis. This results in both over and under treatment. The aim of this multicentre, prospective cohort study is to select a panel of prognostic biomarkers to improve preoperative diagnosis of endometrial carcinoma in order to identify those patients that need extended surgery and/or additional treatment. Additionally, we will determine whether incorporation of cervical cytology and comorbidity could improve this preoperative risk classification. All patients treated for endometrial carcinoma in the participating hospitals from September 2011 till December 2013 are included. Patient characteristics, as well as comorbidity are registered. Patients without preoperative histology, history of hysterectomy and/or endometrial carcinoma or no surgical treatment including hysterectomy are excluded. The preoperative histology and final pathology will be reviewed and compared by expert pathologists. Additional immunohistochemical analysis of IMP3, p53, ER, PR, MLH1, PTEN, beta-catenin, p16, Ki-67, stathmin, ARID1A and L1CAM will be performed. Preoperative histology will be compared with the final pathology results. Follow-up will be at least 24 months to determine risk factors for recurrence and outcome. This study is designed to improve surgical treatment of endometrial carcinoma patients. A total of 432 endometrial carcinoma patients were enrolled between 2011 and 2013. Follow-up will be completed in 2015. Preoperative histology will be evaluated systematically and background endometrium will be

  12. Prospective Study of Fasting Blood Glucose and Intracerebral Hemorrhagic Risk.

    Science.gov (United States)

    Jin, Cheng; Li, Guohong; Rexrode, Kathryn M; Gurol, Mahmut E; Yuan, Xiaodong; Hui, Ying; Ruan, Chunyu; Vaidya, Anand; Wang, Yanxiu; Wu, Shouling; Gao, Xiang

    2018-01-01

    Although diabetes mellitus is an established independent risk factor for ischemic stroke, the association between fasting blood glucose and intracerebral hemorrhage (ICH) is limited and inconsistent. The objective of the current study was to examine the potential impact of long-term fasting blood glucose concentration on subsequent risk of ICH. This prospective study included 96 110 participants of the Kailuan study, living in Kailuan community, Tangshan city, China, who were free of cardiovascular diseases and cancer at baseline (2006). Fasting blood glucose concentration was measured in 2006, 2008, 2010, and 2012. Updated cumulative average fasting blood glucose concentration was used as primary exposure of the current study. Incident ICH from 2006 to 2015 was confirmed by review of medical records. During 817 531 person-years of follow-up, we identified 755 incident ICH cases. The nadir risk of ICH was observed at fasting blood glucose concentration of 5.3 mmol/L. The adjusted hazard ratios and their 95% confidence intervals (CIs) of ICH were 1.59 (95% CI, 1.26-2.02) for diabetes mellitus or fasting blood glucose ≥7.00 mmol/L, 1.31 (95% CI, 1.02-1.69) for impaired fasting blood glucose (fasting blood glucose, 6.10-6.99 mmol/L), 0.98 (95% CI, 0.78-1.22) for fasting blood glucose 5.60 to 6.09 mmol/L, and 2.04 (95% CI, 1.23-3.38) for hypoglycemia (fasting blood glucose, fasting blood glucose 4.00 to 5.59 mmol/L. The results persisted after excluding individuals who used hypoglycemic, aspirin, antihypertensive agents, or anticoagulants, and those with intracerebral hemorrhagic cases occurred in the first 2 years of follow-up. In this large community-based cohort, low (fasting blood glucose concentrations were associated with higher risk of incident ICH, relative to fasting blood glucose concentrations of 4.00 to 6.09 mmol/L. © 2017 American Heart Association, Inc.

  13. Injuries at a Canadian National Taekwondo Championships: a prospective study

    Directory of Open Access Journals (Sweden)

    Pieter Willy

    2004-07-01

    Full Text Available Abstract Background The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured. Methods Subjects (219 males, 99 females participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury. Results The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E. The males (79.9/1,000 A-E sustained significantly more injuries than the females (25.3/1,000 A-E. The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E, followed by the head and neck (18.3/1,000 A-E. Injuries to the spine (neck, upper back, low back and coccyx were the third most often injured body region in males (13.8/1,000 A-E. All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E. However, men's most common type of injury was the sprain (22.8/1,000 A-E followed by joint dysfunction (13.7/1,000A-E. Concussions were only reported in males (6.9/1,000 A-E. Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E. Conclusions Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction.

  14. A multicenter prospective study of surgical audit systems.

    Science.gov (United States)

    Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Takahashi, Tadateru; Ikenaga, Masakazu; Akiyama, Noriyoshi; Koike, Shoichiro; Koseki, Masato; Saitoh, Toshihiro

    2011-01-01

    This study was undertaken to evaluate a modified form of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for surgical audit comparing with other existing models. Although several scoring systems have been devised for surgical audit, no nation-wide survey has been performed yet. We modified our previous E-PASS surgical audit system by computing the weights of 41 procedures, using data from 4925 patients who underwent elective digestive surgery, designated it as mE-PASS. Subsequently, a prospective cohort study was conducted in 43 national hospitals in Japan from April 1, 2005, to April 8, 2007. Variables for the E-PASS and American Society of Anesthesiologists (ASA) status-based model were collected for 5272 surgically treated patients. Of the 5272 patients, we also collected data for the Portsmouth modification of Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in 3128 patients. The area under the receiver operative characteristic curve (AUC) was used to evaluate discrimination performance to detect in-hospital mortality. The ratio of observed to estimated in-hospital mortality rates (OE ratio) was defined as a measure of quality. The numbers of variables required were 10 for E-PASS, 7 for mE-PASS, 20 for P-POSSUM, and 4 for the ASA status-based model. The AUC (95% confidence interval) values were 0.86 (0.79-0.93) for E-PASS, 0.86 (0.79-0.92) for mE-PASS, 0.81 (0.75-0.88) for P-POSSUM, and 0.73 (0.63-0.83) for the ASA status-based model. The OE ratios for mE-PASS among large-volume hospitals significantly correlated with those for E-PASS (R = 0.93, N = 9, P = 0.00026), P-POSSUM (R = 0.96, N = 6, P = 0.0021), and ASA status-based model (R = 0.83, N = 9, P = 0.0051). Because of its features of easy use, accuracy, and generalizability, mE-PASS is a candidate for a nation-wide survey.

  15. Sleep-disordered breathing and mortality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naresh M Punjabi

    2009-08-01

    Full Text Available Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older.We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women died. Compared to those without sleep-disordered breathing (AHI: or=30.0 events/h sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08, 1.17 (95% CI: 0.97-1.42, and 1.46 (95% CI: 1.14-1.86, respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33. Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality.Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the article for the Editors' Summary.

  16. Maternal thyroid function and child educational attainment: prospective cohort study.

    Science.gov (United States)

    Nelson, Scott M; Haig, Caroline; McConnachie, Alex; Sattar, Naveed; Ring, Susan M; Smith, George D; Lawlor, Debbie A; Lindsay, Robert S

    2018-02-20

    To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Prospective cohort study. Avon Longitudinal Study of Parents and Children cohort in the UK. 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Maternal thyroid dysfunction in early pregnancy does not have a

  17. Monitoring in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants.

    Science.gov (United States)

    Jonas, René; Schaal, Thomas; Krimmel, Michael; Gülicher, Dirk; Reinert, Siegmar; Hoffmann, Jürgen

    2013-06-01

    In a prospective study, the characteristics and benefit of an invasive measurement of oxygen partial pressure (pO(2)) with the aid of a polarographic sensor were investigated in 125 microsurgical reconstructions of the head and neck area over a period of 45 months. Measurements were performed over 96 h in eight different types of microsurgically revascularized flaps for extra- and intraoral reconstructions and were evaluated separately for each flap type. Of 125 reconstructions the system indicated malperfusion in 18 cases. Salvage surgery was performed in 17 cases due to venous thrombosis (6 cases), arterial thrombosis (3 cases), a combination of arterial and venous thrombosis (2 cases), rheological problems (3 cases), venous insufficiency by hematoma (2 cases) and kinking of vessels (1 case). In 10 cases salvage surgery was successful, 7 flaps were lost despite salvage surgery. In all these cases, the polarographic probe indicated the necessity of salvage surgery correctly. After 96 h no malperfusion was seen. Postoperatively, a common and characteristic development of the oxygen partial pressure in different types of flaps was seen. Initially, a clear increase of pO(2) could be measured. During 96 h, a slow decrease of pO(2) was observed. In conclusion polarographic measurement of pO(2) can be an excellent apparative supplement for the postoperative clinical control of microsurgically revascularized transplants. In buried flaps, this technique represents the only reliable method for transplant monitoring. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Sexual Abuse in Cameroon: A Four-Year-Old Girl Victim of Rape in Buea Case Study.

    Science.gov (United States)

    Chishugi, John; Franke, Trixy

    2016-01-01

    A young girl was brought to the emergency unit after suffering sexual abuse by an older male. Additional abuses against women and girls include physical beating, forced marriage, female genital mutilation, breast ironing, widow's rites, psychological abuse, and discrimination in education, finance, employment, and legal access. Cameroon has adopted strategies aimed at eliminating violence against women, including ratification of international policies, penal codes, and support of local and international efforts that promote women; however, many of the laws remain in name only and are rarely enforced, given women's lack of financial access to quality lawyers and an unsympathetic male-dominated police force. Underreporting and culturally accepted abuses remain a challenge, too, as the country seeks to understand the extent of abuses and how to effectively fight against them. A complete paradigm shift in cultural attitude toward the female gender is required for abuses to cease.

  19. An Exploratory Case Study Examining Transformational Leadership and Organizational Change within the Presidency of a Small, Four-Year University

    Science.gov (United States)

    Filer, Daniel Matthew

    2013-01-01

    As both internal and external threats continue to arise and challenge the traditional mold of higher education, the role of the university president is becoming more and more important. The position is being required to serve in an ever-growing number of capacities in addition to steering the direction of the institution. The purpose of the…

  20. Expressive Vocabulary Development in Children from Bilingual and Monolingual Homes: A Longitudinal Study from Two to Four Years.

    Science.gov (United States)

    Hoff, Erika; Rumiche, Rosario; Burridge, Andrea; Ribot, Krystal M; Welsh, Stephanie N

    2014-10-01

    The early course of language development among children from bilingual homes varies in ways that are not well described and as a result of influences that are not well understood. Here, we describe trajectories of relative change in expressive vocabulary from 22 to 48 months and vocabulary achievement at 48 months in two groups of children from bilingual homes (children with one and children with two native Spanish-speaking parents [ n s = 15 and 11]) and in an SES-equivalent group of children from monolingual English homes ( n = 31). The two groups from bilingual homes differed in their mean levels of English and Spanish skills, in their developmental trajectories during this period, and in the relation between language use at home and their vocabulary development. Children with two native Spanish-speaking parents showed steepest gains in total vocabulary and were more nearly balanced bilinguals at 48 months. Children with one native Spanish- and one native English-speaking parent showed trajectories of relative decline in Spanish vocabulary. At 48 months, mean levels of English skill among the bilingual children were comparable to monolingual norms, but children with two native Spanish-speaking parents had lower English scores than the SES-equivalent monolingual group. Use of English at home was a significant positive predictor of English vocabulary scores only among children with a native English-speaking parent. These findings argue that efforts to optimize school readiness among children from immigrant families should facilitate their access to native speakers of the community language, and efforts to support heritage language maintenance should include encouraging heritage language use by native speakers in the home.

  1. Expressive Vocabulary Development in Children from Bilingual and Monolingual Homes: A Longitudinal Study from Two to Four Years

    OpenAIRE

    Hoff, Erika; Rumiche, Rosario; Burridge, Andrea; Ribot, Krystal M.; Welsh, Stephanie N.

    2014-01-01

    The early course of language development among children from bilingual homes varies in ways that are not well described and as a result of influences that are not well understood. Here, we describe trajectories of relative change in expressive vocabulary from 22 to 48 months and vocabulary achievement at 48 months in two groups of children from bilingual homes (children with one and children with two native Spanish-speaking parents [ns = 15 and 11]) and in an SES-equivalent group of children ...

  2. Reproducing a Prospective Clinical Study as a Computational Retrospective Study in MIMIC-II.

    Science.gov (United States)

    Kury, Fabrício S P; Huser, Vojtech; Cimino, James J

    2015-01-01

    In this paper we sought to reproduce, as a computational retrospective study in an EHR database (MIMIC-II), a recent large prospective clinical study: the 2013 publication, by the Japanese Association for Acute Medicine (JAAM), about disseminated intravascular coagulation, in the journal Critical Care (PMID: 23787004). We designed in SQL and Java a set of electronic phenotypes that reproduced the study's data sampling, and used R to perform the same statistical inference procedures. All produced source code is available online at https://github.com/fabkury/paamia2015. Our program identified 2,257 eligible patients in MIMIC-II, and the results remarkably agreed with the prospective study. A minority of the needed data elements was not found in MIMIC-II, and statistically significant inferences were possible in the majority of the cases.

  3. Can Subclinical Rickets Cause SCFE? A Prospective, Pilot Study.

    Science.gov (United States)

    Arkader, Alexandre; Woon, Regina P; Gilsanz, Vicente

    2015-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disorder of the growing hip; however, its etiology remains unknown. Vitamin D (25-OH) is a major regulator of bone homeostasis and calcium metabolism. Vitamin D deficiency is one of the major causes of rickets, and rickets has been associated with SCFE. Increased body mass index (BMI) has been linked to SCFE and obese children are known to have lower vitamin D levels. Therefore, we hypothesize that children who develop SCFE may have subclinical rickets predisposing them to the development of physeal disease. This was a pilot, prospective study designed to determine the relationship between vitamin D, bone, muscle, and fat in patients with SCFE. We enrolled 20 consecutive patients with idiopathic SCFE aged 9 to 14 years. Upon diagnosis, vitamin D, PTH, T4, and thyroid-stimulating hormone blood levels were obtained. A single-slice computed tomography was used to measure cortical bone density (CBD) of the femur. Demographics, BMI, and the results obtained were compared to generate a relationship between vitamin D levels and SCFE. Twenty patients were enrolled, 13 males and 7 females, at an average age of 12 years (range, 9 to 14 y), and mean BMI% was 93.9 (range, 81.3 to 99.5). There were 15 stable and 5 unstable SCFE. Overall, mean and SD values for vitamin D, 25-OH were within the normal range (43.9 ± 13.5). We found no difference in values in vitamin D between nonobese (BMI < 95%) and obese (BMI ≥ 95%) subjects (34.8 ± 16.8 vs. 51.6 ± 22.4, P = 0.144). Moreover, we found no difference in CBD between these 2 groups (1126 ± 33.1 vs. 1147 ± 41.2, P = 0.333). There was no relation between blood values of vitamin D and measures of CBD. Although obese children are known to have lower levels of vitamin D and a higher prevalence of SCFE, we found no correlation between low vitamin D and the development of SCFE in this subset of patients.

  4. Prospective study on laser-assisted laparascopic partial nephrectomy

    Science.gov (United States)

    Sroka, Ronald; Hennig, Georg; Zilinberg, Katja; Khoder, Wael Y.

    2012-02-01

    rinsing. Conclusion: This prospective in-vivo feasibility study shows that laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery as well as laparascopically. This application showed good haemostasis and minimal parenchymal damage. Further investigations and development are needed for on-line detection of the remain coagulation margin. An optimised treatment equipment will support the applicability of laser assisted laparoscopic partial nephrectomy.

  5. [Time of cord clamping and neonatal complications, a prospective study].

    Science.gov (United States)

    Rincón, D; Foguet, A; Rojas, M; Segarra, E; Sacristán, E; Teixidor, R; Ortega, A

    2014-09-01

    To assess the effects of early or late clamping of the umbilical cord in term newborns, assessing the levels of hemoglobin, hematocrit, and ferritin, and their correlation with some of the complications. A prospective study of healthy newborns at term or born by dystotic or eutocic delivery in our hospital between May 2009 until May 2010. Patients were assigned according to the time of clamping, group 1 (<60 seconds), group 2 (1 to<2 minutes), and group 3 (2 to 3 minutes). Laboratory tests were performed at birth and at 48 hours of life, assessing the levels of hemoglobin, hematocrit, ferritin, and bilirubin. The risk of polycythemia, respiratory distress syndrome, neonatal phototherapy or admission to the Intensive Care Unit and the hospital stay, were evaluated. A total of 242 patients were included: group 1 (g1=80), group 2 (g2=31) y group 3 (g3=131). The background maternal and neonatal characteristics were similar in all sets. The first test showed significant differences in ferritin levels in those infants with delayed clamping (g1: 111 mg/dl, g2: 125 mg/dl, g3: 173 mg/dl; p<0.01). In the second analysis the values of hemoglobin (g1: 17.3 g/dl, g2: 18.9 g/dl, g3: 19.2 g/dl; p<0.01), hematocrit (g1: 53.4%, g2: 58%, g3: 59%; p<0.01) and ferritin (g1: 254 mg/dl, g2: 254.7 mg/dl, g3: 313 mg/dl; p = 0.008) were statistically higher in this group. As regards complications, a significant increase was observed in the number of cases of polycythemia symptoms in group 3. The late cord clamping is associated with an increase in hematocrit, hemoglobin and ferritin at 48 hours of life, as well as an increased risk of polycythemia present with symptoms. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Benchmarking of surgical complications in gynaecological oncology: prospective multicentre study.

    Science.gov (United States)

    Burnell, M; Iyer, R; Gentry-Maharaj, A; Nordin, A; Liston, R; Manchanda, R; Das, N; Gornall, R; Beardmore-Gray, A; Hillaby, K; Leeson, S; Linder, A; Lopes, A; Meechan, D; Mould, T; Nevin, J; Olaitan, A; Rufford, B; Shanbhag, S; Thackeray, A; Wood, N; Reynolds, K; Ryan, A; Menon, U

    2016-12-01

    To explore the impact of risk-adjustment on surgical complication rates (CRs) for benchmarking gynaecological oncology centres. Prospective cohort study. Ten UK accredited gynaecological oncology centres. Women undergoing major surgery on a gynaecological oncology operating list. Patient co-morbidity, surgical procedures and intra-operative (IntraOp) complications were recorded contemporaneously by surgeons for 2948 major surgical procedures. Postoperative (PostOp) complications were collected from hospitals and patients. Risk-prediction models for IntraOp and PostOp complications were created using penalised (lasso) logistic regression using over 30 potential patient/surgical risk factors. Observed and risk-adjusted IntraOp and PostOp CRs for individual hospitals were calculated. Benchmarking using colour-coded funnel plots and observed-to-expected ratios was undertaken. Overall, IntraOp CR was 4.7% (95% CI 4.0-5.6) and PostOp CR was 25.7% (95% CI 23.7-28.2). The observed CRs for all hospitals were under the upper 95% control limit for both IntraOp and PostOp funnel plots. Risk-adjustment and use of observed-to-expected ratio resulted in one hospital moving to the >95-98% CI (red) band for IntraOp CRs. Use of only hospital-reported data for PostOp CRs would have resulted in one hospital being unfairly allocated to the red band. There was little concordance between IntraOp and PostOp CRs. The funnel plots and overall IntraOp (≈5%) and PostOp (≈26%) CRs could be used for benchmarking gynaecological oncology centres. Hospital benchmarking using risk-adjusted CRs allows fairer institutional comparison. IntraOp and PostOp CRs are best assessed separately. As hospital under-reporting is common for postoperative complications, use of patient-reported outcomes is important. Risk-adjusted benchmarking of surgical complications for ten UK gynaecological oncology centres allows fairer comparison. © 2016 Royal College of Obstetricians and Gynaecologists.

  7. Health services research in patients with breast cancer (CAMISS-prospective): study protocol for an observational prospective study.

    Science.gov (United States)

    García-Gutierrez, Susana; Orive, Miren; Sarasqueta, Cristina; Legarreta, Maria Jose; Gonzalez, Nerea; Redondo, Maximino; Rivero, Amado; Serrano-Aguilar, Pedro; Castells, Xavier; Quintana, Jose Maria; Sala, Maria

    2018-01-08

    Though breast cancer remains a major health problem, there is a lack of information on health care provided to patients with this disease and associated costs. In addition, there is a need to update and validate risk stratification tools in Spain. Our purpose is to evaluate the health services provided for breast cancer in Spain, from screening and diagnosis to treatment and prognosis. Prospective cohort study involving 13 hospitals in Spain with a follow-up period of up to 5 years after diagnostic biopsy. Eligibility criteria: Patients diagnosed with breast cancer between April 2013 and May 2015 that have consented to participate in the study. Data will be collected on the following: pre-intervention medical history, biological, clinical, and sociodemographic characteristics, mode of cancer detection, hospital admission, treatment, and outcomes up to 5 years after initial treatment. Questionnaires about quality of life (EuroQoL EQ-5D-5 L, the European Organization For Research And Treatment Of Cancer Core Quality Of Life Questionnaire EORTC QLQ-C30 join to the specific breast cancer module (QLQ-BR23), as well as Hospital Anxiety and Depression Scale were completed by the patients before the beginning of the initial treatment and at the end of follow-up period, 2 years later. The end-points of the study were changes in health-related quality of life, recurrence, complications and readmissions at 2 and 5 years after initial treatment. Descriptive statistics will be calculated and multivariate models will be used where appropriate to adjust for potential confounders. In order to create and validate a prediction model, split validation and bootstrapping will be performed. Cost analysis will be carried out from the perspective of a national health system. The results of this coordinated project are expected to generate scientifically valid and clinically and socially important information to inform the decision-making of managers and the authorities responsible for

  8. International prospective observational study of upper gastrointestinal haemorrhage: Does weekend admission affect outcome?

    DEFF Research Database (Denmark)

    Murray, Iain A.; Dalton, Harry R.; Stanley, Adrian J.

    2017-01-01

    Introduction Out of hours admissions have higher mortality for many conditions but upper gastrointestinal haemorrhage studies have produced variable outcomes. Methods Prospective study of 12 months consecutive admissions of upper gastrointestinal haemorrhage from four international high volume...

  9. Gender Variance in Childhood and Sexual Orientation in Adulthood: A Prospective Study

    NARCIS (Netherlands)

    Steensma, T.D.; van den Ende, J..; Verhulst, F.C.; Cohen-Kettenis, P.T.

    2013-01-01

    Introduction. Several retrospective and prospective studies have reported on the association between childhood gender variance and sexual orientation and gender discomfort in adulthood. In most of the retrospective studies, samples were drawn from the general population. The samples in the

  10. Sleep disturbances and fatigue : independent predictors of sickness absence? A prospective study among 6538 employees

    NARCIS (Netherlands)

    Bultmann, Ute; Nielsen, Maj Britt D.; Madsen, Ida E. H.; Burr, Hermann; Rugulies, Reiner

    Background: Although sleep disturbances and fatigue are common conditions, frequently shown to be associated with sickness absence, only a few studies have prospectively investigated their independent effects on sickness absence, while adjusting for depressive symptoms. This study aims (i) to

  11. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A Prospective Study

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E.; Ramakers, Geerte G. J.; Stegeman, Inge; Smit, Adriana L.; Van Zanten, Gijsbert A.; Stokroos, Robert J.; Hendrice, Nadia; Free, Rolien H.; Maat, Bert; Frijns, Johan H. M.; Mylanus, Emmanuel A. M.; Huinck, Wendy J.; Topsakal, Vedat; Tange, Rinze A.; Grolman, Wilko

    Objectives/HypothesisTo determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. Study DesignProspective study.

  12. Self reported stressful life events and exacerbations in multiple sclerosis: prospective study

    NARCIS (Netherlands)

    D. Buljevac (Dragan); W.C.J. Hop (Wim); W. Reedeker; A.C.J.W. Janssens (Cécile); F.G.A. van der Meché (Frans); P.A. van Doorn (Pieter); R.Q. Hintzen (Rogier)

    2003-01-01

    textabstractOBJECTIVE: To study the relation between self reported stressful life events not related to multiple sclerosis and the occurrence of exacerbations in relapsing-remitting multiple sclerosis. DESIGN: Longitudinal, prospective cohort study. SETTING: Outpatient clinic of

  13. 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.

  14. 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.

  15. 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)

  16. [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.

  17. Hepatic Dysfunction in Asphyxiated Neonates: Prospective Case-Controlled Study

    Directory of Open Access Journals (Sweden)

    Mukesh Choudhary

    2015-01-01

    Full Text Available Objective This study was performed to determine the occurrence of hypoxic hepatitis in full-term neonates after perinatal asphyxia and to correlate between the rise in enzymes and severity of asphyxia with Apgar score and hypoxic ischemic encephalopathy (HIE grading of the neonates. Method and Material This prospective case-controlled study was conducted in a tertiary-level hospital in India for a period of 12 months. The study group A comprised 70 newborns suffering from birth asphyxia, while 30 healthy neonates were included in group B (control. All biochemical parameters of liver function, ie, serum alanine transferase (ALT, aspartate transferase (AST, alkaline phosphatase (ALP, lactate dehydrogenase (LDH, total protein, serum albumin, bilirubin (total and direct, and international normalized ratio (INR, were measured on postnatal days 1, 3, and 10 in both study and control groups. Results In group A, 22.8% newborns had severe (Apgar score 0–3, 47.1% had moderate (Apgar score 4–5, and 30% had mild (Apgar score 6–7 birth asphyxia at five minutes. In all, 14.28% babies were in HIE stage I, 25.73% babies were in HIE stage II, and 11.42% babies were in HIE stage III. The rest of the newborns, 48.57%, were normal. The prevalence of liver function impairment was seen in 42.85% of asphyxiated neonates. On day 1, ALT, AST, ALP, LDH, PT, and INR were significantly higher, and total protein and serum albumin were significantly lower in group A than in group B. However, ALT and AST correlated well with increasing severity of HIE score. On day 3, there was a rising trend observed in the concentration of mean LDH as HIE staging of neonates progressed from stage 0 to stage III, and among various HIE stages, the difference in LDH was statistically significant. Conclusion We concluded that AST, ALT at 24 hours, and LDH at 72 hours of animation can be a utilitarian diagnostic tool to differentiate asphyxiated neonates from non-asphyxiated neonates and

  18. The INNOVATION Trial: four-year safety and effectiveness of the INCRAFT® AAA Stent-Graft System for endovascular repair.

    Science.gov (United States)

    Pratesi, Giovanni; Pratesi, Carlo; Chiesa, Roberto; Coppi, Gioacchino; Scheinert, Dierk; Brunkwall, Jan S; van der Meulen, Stefaan; Torsello, Giovanni

    2017-10-01

    This paper reports the 4-year safety and effectiveness of the INCRAFT® AAA Stent-Graft System (Cordis Corp., Milpitas, CA, USA), an ultra-low-profile device for the treatment of abdominal aortic aneurysms. The INNOVATION Trial is the prospective, first-in-human, multicenter trial to evaluate the safety and effectiveness of the INCRAFT® System. Patients underwent annual clinical and computed tomography angiography examination as part of the study protocol. The INCRAFT® AAA Stent-Graft System is a customizable tri-modular design, with an ultra-low profile (14-Fr) delivery system. Patient were treated under approved protocol, the prescribed clinical and imaging follow-up at annually through 5 years. Results analyzed and adjudicated by a clinical events committee, independent core laboratory, and a data safety and monitoring board. This manuscript reports results through 4 years of follow-up. A total of 60 patients were enrolled in the trial, all of whom were successfully treated. Follow-up rates at 1 and 4 years were 93% (56/60) and 85% (51/60), respectively. All-cause mortality at 4 years was 17.6% and no death was AAA-, device-, or procedure-related. The secondary reintervention rate at 1 year was 4.6%, primarily the result of stent thrombosis. In total, 10 patients required 13 post-procedure interventions within 4-years of follow-up (2 to repair a type I endoleak, 4 to repair a type II endoleak, 1 for stent thrombosis, 1 for renal stenosis, 1 for aneurysm enlargement, 2 for limb migration and 2 for prosthesis stenosis or occlusion). There were 4 cases (10%) of aneurysm enlargement reported at the 4 year follow-up. At 4 years, 38 out of 39 patients were free from type I and III endoleaks. There were no proximal type I or type III endoleaks at 4-year follow-up. Core laboratory evaluation of the postoperative imaging studies indicated absence of endograft migration while a single fracture was demonstrated without any clinical sequelae. The INCRAFT® AAA Stent

  19. Health correlates of workplace bullying: a 3-wave prospective follow-up study.

    Science.gov (United States)

    Bonde, Jens Peter; Gullander, Maria; Hansen, Åse Marie; Grynderup, Matias; Persson, Roger; Hogh, Annie; Willert, Morten Vejs; Kaerlev, Linda; Rugulies, Reiner; Kolstad, Henrik A

    2016-01-01

    This study aimed to examine the course of workplace bullying and health correlates among Danish employees across a four-year period. In total, 7502 public service and private sector employees participated in a 3-wave study from 2006 through 2011. Workplace bullying over the past 6-12 months and data on health characteristics were obtained by self-reports. We identified major depression using Schedules for Clinical Assessment in Neuropsychiatry interviews and the Major Depression Inventory. We performed cross-sectional and longitudinal analyses of outcomes according to self-labelled bullying at baseline using logistic regression. Reports of bullying were persistent across four years in 22.2% (57/257) of employees who initially reported bullying. Baseline associations between self-labelled bullying and sick-listing, poor self-rated health, poor sleep, and depressive symptoms were significant with adjusted odds ratios (OR) ranging from 1.8 [95% confidence interval (95% CI) 1.5-2.4] for poor sleep quality among those bullied "now and then" to 6.9 (95% CI 3.9-12.3) for depression among those reporting being bullied on a daily to monthly basis. In longitudinal analyses adjusting for bullying during follow-up, all health correlates except poor sleep quality persisted up to four years. Self-reported health correlates of workplace bullying including sick-listing, poor self-rated health, depressive symptoms, and a diagnosis of depression tend to persist for several years regardless of whether bullying is discontinued or not. Independent measures of bullying and outcomes are needed to learn whether these findings reflect long lasting health consequences of workplace bullying or whether self-labelled workplace bullying and health complaints are correlated because of common underlying factors.

  20. Personality factors and breast cancer development: a prospective longitudinal study.

    Science.gov (United States)

    Bleiker, E M; van der Ploeg, H M; Hendriks, J H; Adèr, H J

    1996-10-16

    It has been estimated that approximately 25% of all breast cancers in women can be explained by currently recognized somatic (i.e., hereditary and physiologic) risk factors. It has also been hypothesized that psychological factors may play a role in the development of breast cancer. We investigated the extent to which personality factors, in addition to somatic risk factors, may be associated with the development of primary breast cancer. We employed a prospective, longitudinal study design. From 1989 through 1990, a personality questionnaire was sent to all female residents of the Dutch city of Nijmegen who were 43 years of age or older. This questionnaire was sent as part of an invitation to participate in a population-based breast cancer screening program. Women who developed breast cancer among those who returned completed questionnaires were compared with women without such a diagnosis in regard to somatic risk factors and personality traits, including anxiety, anger, depression, rationality, anti-emotionality (i.e., an absence of emotional behavior or a lack of trust in one's own feelings), understanding, optimism, social support, and the expression and control of emotions. Conditional logistic regression analysis was used to identify variables that could best explain group membership (i.e., belonging to the case [breast cancer] or the control [without disease] group). Personality questionnaires were sent to 28 940 women, and 9705 (34%) were returned in such a way that they could be used for statistical analyses. Among the 9705 women who returned useable questionnaires, 131 were diagnosed with breast cancer during the period from 1989 through 1994. Seven hundred seventy-one age-matched control subjects (up to six per case patient) were selected for the analyses. Three variables were found to be statistically significantly associated with an increased risk of breast cancer: 1) having a first-degree family member with breast cancer (versus not having an

  1. 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

  2. Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults : a prospective cohort study

    NARCIS (Netherlands)

    van der Jagt-Willems, Hanna C.; de Groot, Maartje H.; van Campen, Jos P. C. M.; Lamoth, Claudine J. C.; Lems, Willem F.

    2015-01-01

    Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis

  3. Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study

    NARCIS (Netherlands)

    van der Jagt-Willems, H.C.; de Groot, M.H.; van Campen, J.P.C.M.; Lamoth, C.J.C.; Lems, W.F.

    2015-01-01

    Background: Vertebral fractures, an increased thoracic kyphosis and a flexed posture are associated with falls. However, this was not confirmed in prospective studies. We performed a prospective cohort study to investigate the association between vertebral fractures, increased thoracic kyphosis

  4. Alcohol consumption and risk of microvascular complications in type 1 diabetes patients; the EURODIAB Prospective Complications study

    NARCIS (Netherlands)

    Beulens, J.W.J.; Kruidhof, J.S.; Grobbee, D.E.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S.

    2008-01-01

    AIMS/HYPOTHESIS: The aim of this study was to investigate the association between alcohol consumption and risk of microvascular complications (retinopathy, neuropathy, nephropathy) in type 1 diabetes mellitus patients in the EURODIAB Prospective Complications Study. METHODS: The EURODIAB Prospective

  5. Serum homocysteine level in gestational diabetes: a prospective study

    Directory of Open Access Journals (Sweden)

    Davari Tanha F

    2009-08-01

    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:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; 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: Increased total plasma homocysteine (Hcy is an accepted risk factor of cardiovascular disease (CVD, stroke, preclampsia, recurrent abortion and diabetes type I and II. The aim of the current study was to assess serum homocysteine and its relation with serum folat, vitamine B12 and lipid profile in gestational diabetes mellitus and to compare these with those of pregnant women."n"n Methods: In a prospective controlled survey 80 pregnant women (24-28 weeks with uncomplicated pregnancies were evaluated. They were assigned to one of two groups according to the results of 100g-OGTT. In the case group there were pregnant women with gestational diabetes mellitus according to the OGTT and in the control group women who had normal OGTT results were put. Levels of fasting glucose, homocysteine, vit B12, and folic acid, uric acid, total cholesterol, triglyceride, Low Density Lipoprotein cholesterol (LDL and High Density Lipoprotein cholesterol (HDL were measured in both groups."n"nResults: The mean level of homocysteine in GDM group was significantly higher than control group (p=0.000. The mean level of folic acid and vit B12 was significantly lower than the level in control group (p=0.001, p=0.004 respectively. Body

  6. [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.

  7. 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.

  8. Job stress, absenteeism and coronary heart disease European cooperative study (the JACE study): Design of a multicentre prospective study

    NARCIS (Netherlands)

    Houtman, I.; Kornitzer, M.; Smet, P. de; Koyuncu, R.; Backer, G. de; Pelfrene, E.; Romon, M.; Boulenguez, C.; Ferrario, M.; Origgi, G.; Sans, S.; Perez, I.; Wilhelmsen, L.; Rosengren, A.; Isacsson, S.-O.; Östergren, P.-O.

    1999-01-01

    Background: The motives, objectives and design of a multicentre prospective study on job stress, absenteeism and coronary heart disease in Europe (the JACE study) is presented in this paper. Some specific gaps in the reviewed literature are explicitly tapped into by the JACE study. Its objectives

  9. Family system characteristics and psychological adjustment to cancer susceptibility genetic testing: a prospective study.

    NARCIS (Netherlands)

    Oostrom, I.I.H. van; Meijers-Heijboer, H.; Duivenvoorden, H.J.; Brocker-Vriends, A.H.; Asperen, C.J. van; Sijmons, R.H.; Seynaeve, C.; Gool, A.R. van; Klijn, J.G.M.; Tibben, A.

    2007-01-01

    This study examined prospectively the contribution of family functioning, differentiation to parents, family communication and support from relatives to psychological distress in individuals undergoing genetic susceptibility testing for a known familial pathogenic BRCA1/2 or Hereditary nonpolyposis

  10. Family system characteristics and psychological adjustment to cancer susceptibility genetic testing: a prospective study

    NARCIS (Netherlands)

    van Oostrom, I.; Meijers-Heijboer, H.; Duivenvoorden, H. J.; Bröcker-Vriends, A. H. J. T.; van Asperen, C. J.; Sijmons, R. H.; Seynaeve, C.; van Gool, A. R.; Klijn, J. G. M.; Tibben, A.

    2007-01-01

    This study examined prospectively the contribution of family functioning, differentiation to parents, family communication and support from relatives to psychological distress in individuals undergoing genetic susceptibility testing for a known familial pathogenic BRCA1/2 or Hereditary nonpolyposis

  11. Family system characteristics and psychological adjustment to cancer susceptibility genetic testing : a prospective study

    NARCIS (Netherlands)

    van Oostrom, I.; Meijers-Heijboer, H.; Duivenvoorden, H. J.; Brocker-Vriends, A. H. J. T.; van Asperen, C. J.; Sijmons, R. H.; Seynaeve, C.; Van Gool, A. R.; Klijn, J. G. M.; Tibben, A.

    This study examined prospectively the contribution of family functioning, differentiation to parents, family communication and support from relatives to psychological distress in individuals undergoing genetic susceptibility testing for a known familial pathogenic BRCA1/2 or Hereditary nonpolyposis

  12. Continuation of cinacalcet immediately after renal transplantation: a prospective cohort study.

    NARCIS (Netherlands)

    Aalten, J.; Wetzels, J.F.M.; Hoitsma, A.J.

    2010-01-01

    BACKGROUND: cinacalcet is used for treating secondary hyperparathyroidism in dialysis patients, but it is currently unknown whether it can safely be continued immediately after renal transplantation. METHODS: we prospectively studied renal transplant recipients with secondary hyperparathyroidism who

  13. Factors determining social participation in the first year after kidney transplantation : A prospective study

    NARCIS (Netherlands)

    van der Mei, Siirike F.; van Son, Willem J.; van Sonderen, Eric L. P.; de Jong, Paul E.; Groothoff, Johan W.; van den Heuvel, Wim J. A.

    2007-01-01

    Background. This study describes changes in social participation in the first year after kidney transplantation and examines the influence of clinical factors, health status, transplantation-related symptoms, and psychological characteristics on change in social participation. Methods. A prospective

  14. Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

    NARCIS (Netherlands)

    Iordens, Gijs I. T.; den Hartog, Dennis; van Lieshout, Esther M. M.; Tuinebreijer, Wim E.; de Haan, Jeroen; Patka, Peter; Verhofstad, Michael H. J.; Schep, Niels W. L.; Bronkhorst, M. W. G. A.; de Vries, M. R.; Goslings, J. C.; Rhemrev, S. J.; Roukema, G. R.; van der Meulen, H. G. W. M.; Verleisdonk, E. J. M. M.; Vroemen, J. P. A. M.; Wittich, Ph

    2015-01-01

    After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of prospective studies that

  15. Feasibility and cost efficiency of a diagnostic guideline for chronic polyneuropathy : a prospective implementation study

    NARCIS (Netherlands)

    Vrancken, A.F.J.E.; Kalmijn, S.; Buskens, E.; Franssen, H.; Wokke, J.H.J.; Notermans, N.C.

    2006-01-01

    Background: Extensive investigations are often performed to reveal the cause of chronic polyneuropathy. It is not known whether a restrictive diagnostic guideline improves cost efficiency without loss of diagnostic reliability. Methods: In a prospective multicentre study, a comparison was made

  16. Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study

    NARCIS (Netherlands)

    Huizink, A.C.; Ferdinand, R.F.; Ende, J. van den; Verhulst, F.C.

    2006-01-01

    Objective To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence. Design Prospective, longitudinal, population based study. Setting The Dutch province of

  17. Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study

    NARCIS (Netherlands)

    A.C. Huizink (Anja); R.F. Ferdinand (Robert); J. van der Ende (Jan); F.C. Verhulst (Frank)

    2006-01-01

    textabstractOBJECTIVE: To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence. DESIGN: Prospective, longitudinal, population based study SETTING: The Dutch

  18. Intracranial hypotension accompanied by trauma. A prospective study in Japan

    International Nuclear Information System (INIS)

    Maeda, Takeshi; Dohi, Kenji; Katayama, Yoichi

    2010-01-01

    To clarify the clinical characteristics of definite and non-definite diagnosis groups in intracranial hypotension accompanied by trauma (IHAT), we undertook investigations of registered patients (n=23) prospectively. The results revealed the following features of IHAT: definite diagnosis group, 4 cases; they had long periods from injury to onset (5.5±5.7 days), but these were markedly shorter than in the non-definite group; 75% of definite cases showed typical postural headache; 75% of definite cases showed dural enhancement on Gd-MRI; all 4 cases had confirmed cerebrospinal fluid (CFS) leakage based on imaging diagnosis with cervical lesions in 2 cases and cervical-thoracic lesions in 2 cases; and 6) good recovery was achieved in them by conservative therapy and blood patch, with a cure rate of 100%. These findings suggest that confirmed CFS leakage is indispensable for reaching definite diagnosis of IHAT. (author)

  19. Fatty liver: prospective comparative study with sonography and CT

    International Nuclear Information System (INIS)

    Kim, Sung Jin; Kim, Y. M.; Kim, W. S.; Choi, B. I.; Lee, J. S.; Han, C. K.; Kim, C. W.

    1990-01-01

    To identify the reasonable criteria in detection of the degree of Fatty liver, we prospectively evaluated sonograms and CT scans in 33 Patients With bright liver on sonography. On sonograms, we analyzed the echogenicity of the liver, acoustic attenuation, and visualization of the portal vein and the diaphragm, Each criterion was scored from 0 to 2. CT criterion for fatty liver was assessed by the attenuation difference between the liver and the spleen on nonocontrast CT scans, The average sonographic grade for CT Grade I was 1.3, Grade II was 2.1,and Grade III was 2.8. The accurate detection rate of each sonographic grade was as follows, Grade

  20. Sugammadex versus neostigmine in pediatric patients: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Turhan Kara

    2014-11-01

    Full Text Available Background and objectives: Acetylcholinesterase inhibitors may cause postoperative residual curarization when they are used for reversal of neuromuscular blockade. Sugammadex reverses neuromuscular blockade by chemical encapsulation and is not associated with the side effects that may occur with the use of anticholinesterase agents. Because of increased outpatient surgical procedures postoperative residual curarization and rapid postoperative recovery have a greater importance in the pediatric patient population. The aim of this study was to compare the efficacy of sugammadex and neostigmine on reversing neuromuscular blockade in pediatric patients undergoing outpatient surgical procedures. Methods: 80 patients, aged 2–12 years, scheduled for outpatient surgery were enrolled in this randomized prospective study. Neuromuscular blockade was achieved with 0.6 mg kg−1 rocuronium and monitorized with train-of-four. Group RN (n = 40 received 0.03 mg kg−1 neostigmine, Group RS (n = 40 received 2 mg kg−1 sugammadex for reversal of rocuronium. Extubation time (time from the reversal of neuromuscular blockade to extubation, train-of-four ratio during this time, time to reach train-of-four > 0.9, and probable complications were recorded. Results: There was no significant difference between the patients’ characteristics. Extubation time and time to reach train-of-four > 0.9 were significantly higher in Group RN (p = 0.001, p = 0.002. Train-of-four at the time of neostigmine/sugammadex injection in Group RN were significantly higher than in the RS group (p = 0.020. Extubation train-of-four ratio was significantly lower in Group RN (p = 0.002. Conclusion: Sugammadex provides safer extubation with a shorter recovery time than neostigmine in pediatric patients undergoing outpatient surgical procedures. Resumo: Justificativa e objetivos: Os inibidores da acetilcolinesterase podem causar curarização residual no p

  1. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Garg Arun

    2012-06-01

    Full Text Available Abstract Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A

  2. 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

  3. 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

  4. 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

  5. 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

  6. Prospective Elementary School Teachers’ Views about Socioscientific Issues: A Concurrent Parallel Design Study

    OpenAIRE

    Muhammet ÖZDEN

    2015-01-01

    The purpose of this research is to examine the prospective elementary school teachers’ perceptions on socioscientific issues. The research was conducted on prospective elementary school teachers studying at a university located in western Turkey. The researcher first taught the subjects of global warming and nuclear power plants from a perspective of socioscientific issues in the science and technology education course and then conducted the research. Concurrent parallel design, one of the mi...

  7. Quality of optometry referrals to neovascular age-related macular degeneration clinic: a prospective study

    OpenAIRE

    Muen, Wisam J; Hewick, Simon A

    2011-01-01

    Objectives To evaluate the quality of referrals to a neovascular age-related macular degeneration clinic from optometrists using the standard Rapid Access Referral Form (RARF) from the Royal College of Ophthalmologists. Design A prospective study. Prospective data were gathered from all optometry referrals using the RARF, between the periods of December 2006 to August 2009. These were assessed for accuracy of history, clinical signs and final diagnosis as compared to a macula expert. Setting ...

  8. The role of rostral prefrontal cortex in prospective memory: a voxel-based lesion study.

    Science.gov (United States)

    Volle, Emmanuelle; Gonen-Yaacovi, Gil; Costello, Angela de Lacy; Gilbert, Sam J; Burgess, Paul W

    2011-07-01

    Patients with lesions in rostral prefrontal cortex (PFC) often experience problems in everyday-life situations requiring multitasking. A key cognitive component that is critical in multitasking situations is prospective memory, defined as the ability to carry out an intended action after a delay period filled with unrelated activity. The few functional imaging studies investigating prospective memory have shown consistent activation in both medial and lateral rostral PFC but also in more posterior prefrontal regions and non-frontal regions. The aim of this study was to determine regions that are necessary for prospective memory performance, using the human lesion approach. We designed an experimental paradigm allowing us to assess time-based (remembering to do something at a particular time) and event-based (remembering to do something in a particular situation) prospective memory, using two types of material, words and pictures. Time estimation tasks and tasks controlling for basic attention, inhibition and multiple instructions processing were also administered. We examined brain-behaviour relationships with a voxelwise lesion method in 45 patients with focal brain lesions and 107 control subjects using this paradigm. The results showed that lesions in the right polar prefrontal region (in Brodmann area 10) were specifically associated with a deficit in time-based prospective memory tasks for both words and pictures. This deficit could not be explained by impairments in basic attention, detection, inhibition or multiple instruction processing, and there was also no deficit in event-based prospective memory conditions. In addition to their prospective memory difficulties, these polar prefrontal patients were significantly impaired in time estimation ability compared to other patients. The same region was found to be involved using both words and pictures, suggesting that right rostral PFC plays a material nonspecific role in prospective memory. This is the first

  9. 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

  10. Spinal injuries in professional rugby union: a prospective cohort study.

    Science.gov (United States)

    Fuller, Colin W; Brooks, John H M; Kemp, Simon P T

    2007-01-01

    To determine the incidence, severity, nature, and causes of cervical, thoracic, and lumbar spine injuries sustained during competition and training in professional rugby union. A 2 season prospective cohort design. Twelve English Premiership rugby union clubs. Five hundred and forty-six male rugby union players of whom 296 were involved in both seasons. Location, diagnosis, severity (number of days unavailable for training and matches), and cause of injury: incidence of match and training injuries (injuries/1000 player-hours). Player age, body mass, stature, playing position, use of headgear, and activity and period of season. The incidences of spinal injuries were 10.90 (9.43 to 12.60) per 1000 player match-hours and 0.37 (0.29 to 0.47) per 1000 player training-hours. No player sustained a catastrophic spinal injury, but 3 players sustained career-ending injuries. Overall, players were more likely to sustain a cervical injury during matches and a lumbar injury during training. Forwards were significantly more likely to sustain a spinal injury than backs during both matches (P accounting for 926 days (23%) and cervical nerve root injuries sustained during matches for 621 days (15%). During matches, more injuries were caused by tackles (37%), and during training more injuries were caused by weight-training (33%). The results showed that rugby union players were exposed to a high risk of noncatastrophic spinal injury during tackling, scrummaging, and weight-training activities; injury prevention strategies, therefore, should be focused on these activities.

  11. The Examining of Prospective Teachers? Views about Renewable and Non-Renewable Energy Sources: A Case Study of Turkey

    Science.gov (United States)

    Hasiloglu, Mehmet Akif

    2014-01-01

    The aim of this study is to determine prospective teachers? views about renewable and non-renewable energy sources. To collect data, a questionnaire with 5 open-ended questions was conveyed to 463 prospective teachers selected from Agri Ibrahim Cecen University. The results showed that almost three fourths of the prospective teachers tend to…

  12. 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

  13. 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.

  14. Prospective Chemistry and Science Teachers' Views and Metaphors about Chemistry and Chemical Studies

    Science.gov (United States)

    Onen Ozturk, Fatma; Aglarci, Oya

    2017-01-01

    Purpose: The aim of this study was to examine the metaphors created by prospective chemistry and science teachers and their views about how the studies in the field of chemistry are carried out in relation to the grade level and department. Research Methods: Case study as a qualitative research design was used. Participants in the study included…

  15. The impact of fMRI on multimodal navigation in surgery of cerebral lesions: four years clinical experience

    International Nuclear Information System (INIS)

    Wurm, Gabriele; Schnizer, Mathilde; Fellner, Claudia

    2008-01-01

    Neuronavigation with display of intraoperative structures, instrument locations, orientation and relationships to nearby structures can increase anatomic precision while enhancing the surgeon's confidence and his/her perception of safety. Combination of neuronavigation with functional imaging provides multimodal guidance for surgery of cerebral lesions. We evaluated the impact of functional MRI (fMRI) on surgical decision making and outcome. A neuronavigational device (StealthStation (tm), Medtronic Inc.) was used as platform to merge fMRI data with anatomic images, and to implement intraoperative multimodal guidance. In a 52-month period, where 977 surgical procedures were performed with the aid of neuronavigation, 88 patients underwent image-guided procedures using multimodal guidance. Patient, surgical and outcome data of this series was prospectively collected. Evaluation of 88 procedures on cerebral lesions in complex regions where fMRI data were integrated using the navigation system demonstrated that the additional information was presented in a user-friendly way. Computer assisted fMRI integration was found to be especially helpful in planning the best approach, in assessing alternative approaches, and in defining the extent of the surgical exposure. Furthermore, the surgeons found it more effective to interpret fMRI information when shown in a navigation system as compared to the traditional display on a light board or monitor. Multimodal navigation enhanced by fMRI was judged useful for optimization of surgery of cerebral lesions, especially in and around eloquent regions by experienced neurosurgeons. (orig.)

  16. Endogenous-cue prospective memory involving incremental updating of working memory: an fMRI study.

    Science.gov (United States)

    Halahalli, Harsha N; John, John P; Lukose, Ammu; Jain, Sanjeev; Kutty, Bindu M

    2015-11-01

    Prospective memory paradigms are conventionally classified on the basis of event-, time-, or activity-based intention retrieval. In the vast majority of such paradigms, intention retrieval is provoked by some kind of external event. However, prospective memory retrieval cues that prompt intention retrieval in everyday life are commonly endogenous, i.e., linked to a specific imagined retrieval context. We describe herein a novel prospective memory paradigm wherein the endogenous cue is generated by incremental updating of working memory, and investigated the hemodynamic correlates of this task. Eighteen healthy adult volunteers underwent functional magnetic resonance imaging while they performed a prospective memory task where the delayed intention was triggered by an endogenous cue generated by incremental updating of working memory. Working memory and ongoing task control conditions were also administered. The 'endogenous-cue prospective memory condition' with incremental working memory updating was associated with maximum activations in the right rostral prefrontal cortex, and additional activations in the brain regions that constitute the bilateral fronto-parietal network, central and dorsal salience networks as well as cerebellum. In the working memory control condition, maximal activations were noted in the left dorsal anterior insula. Activation of the bilateral dorsal anterior insula, a component of the central salience network, was found to be unique to this 'endogenous-cue prospective memory task' in comparison to previously reported exogenous- and endogenous-cue prospective memory tasks without incremental working memory updating. Thus, the findings of the present study highlight the important role played by the dorsal anterior insula in incremental working memory updating that is integral to our endogenous-cue prospective memory task.

  17. Toward Fully Automated Multicriterial Plan Generation: A Prospective Clinical Study

    International Nuclear Information System (INIS)

    Voet, Peter W.J.; Dirkx, Maarten L.P.; Breedveld, Sebastiaan; Fransen, Dennie; Levendag, Peter C.; Heijmen, Ben J.M.

    2013-01-01

    Purpose: To prospectively compare plans generated with iCycle, an in-house-developed algorithm for fully automated multicriterial intensity modulated radiation therapy (IMRT) beam profile and beam orientation optimization, with plans manually generated by dosimetrists using the clinical treatment planning system. Methods and Materials: For 20 randomly selected head-and-neck cancer patients with various tumor locations (of whom 13 received sequential boost treatments), we offered the treating physician the choice between an automatically generated iCycle plan and a manually optimized plan using standard clinical procedures. Although iCycle used a fixed “wish list” with hard constraints and prioritized objectives, the dosimetrists manually selected the beam configuration and fine tuned the constraints and objectives for each IMRT plan. Dosimetrists were not informed in advance whether a competing iCycle plan was made. The 2 plans were simultaneously presented to the physician, who then selected the plan to be used for treatment. For the patient group, differences in planning target volume coverage and sparing of critical tissues were quantified. Results: In 32 of 33 plan comparisons, the physician selected the iCycle plan for treatment. This highly consistent preference for the automatically generated plans was mainly caused by the improved sparing for the large majority of critical structures. With iCycle, the normal tissue complication probabilities for the parotid and submandibular glands were reduced by 2.4% ± 4.9% (maximum, 18.5%, P=.001) and 6.5% ± 8.3% (maximum, 27%, P=.005), respectively. The reduction in the mean oral cavity dose was 2.8 ± 2.8 Gy (maximum, 8.1 Gy, P=.005). For the swallowing muscles, the esophagus and larynx, the mean dose reduction was 3.3 ± 1.1 Gy (maximum, 9.2 Gy, P<.001). For 15 of the 20 patients, target coverage was also improved. Conclusions: In 97% of cases, automatically generated plans were selected for treatment because of

  18. A Prospective Study of Proton Beam Reirradiation for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Annemarie, E-mail: Annemarie.fernandes@gmail.com [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Berman, Abigail T. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Mick, Rosemarie [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Both, Stefan; Lelionis, Kristi; Lukens, John N.; Ben-Josef, Edgar; Metz, James M.; Plastaras, John P. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2016-05-01

    Purpose: Reirradiation to the esophagus carries a significant risk of complications. Proton therapy may offer an advantage in the reirradiation setting due to the lack of exit dose and potential sparing of previously radiated normal tissues. Methods and Materials: Between June 2010 and February 2014, 14 patients with a history of thoracic radiation and newly diagnosed or locally recurrent esophageal cancer began proton beam reirradiation on a prospective trial. Primary endpoints were feasibility and acute toxicity. Toxicity was graded according Common Toxicity Criteria version 4.0. Results: The median follow-up was 10 months (2-25 months) from the start of reirradiation. Eleven patients received concurrent chemotherapy. The median interval between radiation courses was 32 months (10-307 months). The median reirradiation prescription dose was 54.0 Gy (relative biological effectiveness [RBE]) (50.4-61.2 Gy[RBE]), and the median cumulative prescription dose was 109.8 Gy (76-129.4 Gy). Of the 10 patients who presented with symptomatic disease, 4 patients had complete resolution of symptoms, and 4 had diminished or stable symptoms. Two patients had progressive symptoms. The median time to symptom recurrence was 10 months. Maximum acute nonhematologic toxicity attributable to radiation was grade 2 (64%, N=9), 3 (29%, N=4), 4 (0%), and 5 (7%, N=1). The acute grade 5 toxicity was an esophagopleural fistula more likely related to tumor progression than radiation. Grade 3 nonhematologic acute toxicities included dysphagia, dehydration, and pneumonia. There was 1 late grade 5 esophageal ulcer more likely related to tumor progression than radiation. There were 4 late grade 3 toxicities: heart failure, esophageal stenosis requiring dilation, esophageal ulceration from tumor, and percutaneous endoscopic gastrostomy tube dependence. The median time to local failure was 10 months, and the median overall survival was 14 months. Conclusions: Our data demonstrate that

  19. Timing and approaches in congenital cataract surgery: a four-year, two-layer randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Jin-Chao Liu

    2017-12-01

    Full Text Available "AIM: To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches. METHODS: In this prospective, randomized controlled trial, we recruited congenital cataract patients aged 3mo or younger before cataract surgery. Sixty-one eligible patients were randomly assigned to two groups according to surgical timing: a 3-month-old group and a 6-month-old group. Each eye underwent one of three randomly assigned surgical procedures, as follows: surgery A, lens aspiration (I/A; surgery B, lens aspiration with posterior continuous curvilinear capsulorhexis (I/A+PCCC; and surgery C, lens aspiration with posterior continuous curvilinear capsulorhexis and anterior vitrectomy (I/A+PCCC+A-Vit. The long-term best-corrected visual acuity (BCVA and the incidence of complications in the different groups were compared and analyzed. RESULTS: A total of 57 participants (114 eyes with a mean follow-up period of 48.7mo were included in the final analysis. The overall logMAR BCVA in the 6-month-old group was better than that in the 3-month-old group (0.81±0.28 vs 0.96±0.30; P=0.02. The overall logMAR BCVA scores in the surgery B group were lower than the scores in the A and C groups (A: 0.80±0.29, B: 1.02±0.28, and C: 0.84±0.28; P=0.007. A multivariate linear regression revealed no significant relationships between the incidence of complications and long-term BCVA. CONCLUSION: It might be safer and more beneficial for bilateral total congenital cataract patients to undergo surgery at 6mo of age than 3mo. Moreover, with rigorous follow-up and timely intervention, the postoperative complications in these patients are treatable and do not compromise visual outcomes."

  20. Salt intake, cured meat consumption, refrigerator use and stomach cancer incidence: A prospective cohort study (Netherlands)

    NARCIS (Netherlands)

    Brandt, P.A. van den; Botterweck, A.A.M.; Goldbohm, R.A.

    2003-01-01

    Objective: Many case-control studies have reported that salt and cured meat intake are positively, and refrigerator use is inversely, associated with stomach cancer risk. In the current prospective study these associations were evaluated. Methods: The Netherlands Cohort Study consisted of 120,852