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  1. Identifying a Computer Forensics Expert: A Study to Measure the Characteristics of Forensic Computer Examiners

    Directory of Open Access Journals (Sweden)

    Gregory H. Carlton

    2010-03-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 The usage of digital evidence from electronic devices has been rapidly expanding within litigation, and along with this increased usage, the reliance upon forensic computer examiners to acquire, analyze, and report upon this evidence is also rapidly growing. This growing demand for forensic computer examiners raises questions concerning the selection of individuals qualified to perform this work. While courts have mechanisms for qualifying witnesses that provide testimony based on scientific data, such as digital data, the qualifying criteria covers a wide variety of characteristics including, education, experience, training, professional certifications, or other special skills. In this study, we compare task performance responses from forensic computer examiners with an expert review panel and measure the relationship with the characteristics of the examiners to their quality responses. The results of this analysis provide insight into identifying forensic computer examiners that provide high-quality responses. /* 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:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  2. Dementia and cognitive disorder identified at a forensic psychiatric examination - a study from Sweden.

    Science.gov (United States)

    Ekström, Anette; Kristiansson, Marianne; Björkstén, Karin Sparring

    2017-09-18

    Few studies have addressed the relationship between dementia and crime. We conducted a study of persons who got a primary or secondary diagnosis of dementia or cognitive disorder in a forensic psychiatric examination. In Sweden, annually about 500 forensic psychiatric examinations are carried out. All cases from 2008 to 2010 with the diagnoses dementia or cognitive disorder were selected from the database of the Swedish National Board of Forensic Medicine. Out of 1471 cases, there were 54 cases of dementia or cognitive disorder. Case files were scrutinized and 17 cases of dementia and 4 cases of cognitive disorder likely to get a dementia diagnosis in a clinical setting were identified and further studied. There were 18 men and 3 women; Median age 66 (n = 21; Range 35-77) years of age. Eleven men but no women had a previous criminal record. There were a total of 38 crimes, mostly violent, committed by the 21 persons. The crimes were of impulsive rather that pre-meditated character. According to the forensic psychiatric diagnoses, dementia was caused by cerebrovascular disorder (n = 4), alcohol or substance abuse (n = 3), cerebral haemorrhage and alcohol (n = 1), head trauma and alcohol (n = 2), Alzheimer's disease (n = 2), Parkinson's disease (n = 1), herpes encephalitis (n = 1) and unspecified (3). Out of four persons diagnosed with cognitive disorder, one also had delusional disorder and another one psychotic disorder and alcohol dependence. An alcohol-related diagnosis was established in ten cases. There were only two cases of Dementia of Alzheimer's type, one of whom also had alcohol intoxication. None was diagnosed with a personality disorder. All but one had a history of somatic or psychiatric comorbidity like head traumas, stroke, other cardio-vascular disorders, epilepsy, depression, psychotic disorders and suicide attempts. In this very ill group, the suggested verdict was probation in one case and different forms of care in the remaining

  3. An Examination of the Disparity between Self-Identified versus Legally Identified Rape Victimization: A Pilot Study

    Science.gov (United States)

    Marsil, Dorothy F.; McNamara, Corinne

    2016-01-01

    Objective: Researchers compared rape victimization based on self-identification to the current federal legal definition in a pilot study of college students. Methods: The sample was comprised of 1,648 (69.8% female; 30.2% male) college students who completed the Sexual Experiences Survey-Short Form Victimization (SES-SFV) online. Results: Based on…

  4. Identifying the risk: a prospective cohort study examining postpartum haemorrhage in a regional Australian health service.

    Science.gov (United States)

    Kearney, Lauren; Kynn, Mary; Reed, Rachel; Davenport, Lisa; Young, Jeanine; Schafer, Keppel

    2018-06-07

    In industrialised countries the incidence of postpartum haemorrhage (PPH) is increasing, for which exact etiology is not well understood. Studies have relied upon retrospective data with estimated blood loss as the primary outcome, known to be underestimated by clinicians. This study aimed to explore variables associated with PPH in a cohort of women birthing vaginally in coastal Queensland, Australia, using the gravimetric method to measure blood loss. Women were prospectively recruited to participate using an opt-out consent process. Maternal demographics; pregnancy history; model of care; mode of birth; third stage management practices; antenatal, intrapartum and immediate postpartum complications; gravimetric and estimated blood loss; and haematological laboratory data, were collected via a pre-designed data collection instrument. Descriptive statistics were used for demographic, intrapartum and birthing practices. A General Linear Model was used for multivariate analysis to examine relationship between gravimetric blood loss and demographic, birthing practices and intrapartum variables. The primary outcome was a postpartum haemorrhage (blood loss > 500 ml). 522 singleton births were included in the analysis. Maternal mean age was 29 years; 58% were multiparous. Most participants received active (291, 55.7%) or modified active management of third stage (191, 36.6%). Of 451 births with valid gravimetric blood loss recorded, 35% (n = 159) recorded a loss of 500 ml or more and 111 (70%) of these were recorded as PPH. Gravimetric blood loss was strongly correlated with estimated blood loss (r = 0.88; p gravimetric blood loss, about 78% of the measured value. High neonatal weight, perineal injury, complications during labour, separation of mother and baby, and observation of a gush of blood were associated with PPH. Nulliparity, labour induction and augmentation, syntocinon use were not associated with PPH. In contrast to previous study findings

  5. A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

    Science.gov (United States)

    Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

    2017-01-01

    Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

  6. A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians

    Directory of Open Access Journals (Sweden)

    Patel D

    2017-12-01

    Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization

  7. NDE of PWR fuel: Identifying candidates for hot cell examination

    International Nuclear Information System (INIS)

    Moon, J.E.; Bury, J.G.; Correal, O.A.; Kunishi, H.; Wilson, H.W.

    1992-05-01

    On-site examinations were performed at the Indian Point 3 and Callaway reactors to attempt to identify the leakage mechanism of several leaking fuel rods. The exams consisted of removing the leaking fuel rods from the assembly and performing a visual examination. These results, combined with other available on-site data on leaking fuel rods, were used to select fuel rods for shipment to a hot cell for detailed root cause examination. Three fuel rods from the Indian Point 3 reactor were found to be leaking due to debris-induced fretting. The examinations at Callaway were terminated prior to completion due to utility scheduler conflicts. Rods from the Callaway reactor were selected for shipment to the hot cell along with the rods from the Byron 1 and 2 and V.C. Summer reactors. The data presented in the report summarize the coolant activity history, the UT examination results, and a summary of the review of the fabrication records. The basis for the selection of the rods to be sent to the hot cells is also summarized

  8. Identifying Students at Risk: An Examination of Computer-Adaptive Measures and Latent Class Growth Analysis

    Science.gov (United States)

    Keller-Margulis, Milena; McQuillin, Samuel D.; Castañeda, Juan Javier; Ochs, Sarah; Jones, John H.

    2018-01-01

    Multitiered systems of support depend on screening technology to identify students at risk. The purpose of this study was to examine the use of a computer-adaptive test and latent class growth analysis (LCGA) to identify students at risk in reading with focus on the use of this methodology to characterize student performance in screening.…

  9. Examining the Psychometric Properties of the Identify as a Professional Social Worker Subscale

    Science.gov (United States)

    Farmer, Antoinette Y.

    2017-01-01

    The purpose of this study was to examine the psychometric properties of the Identify as a Professional Social Worker Subscale, which assessed the Council on Social Work Education--prescribed competency "identify as a professional social worker and conduct oneself accordingly." The results of confirmatory factory analysis indicated that…

  10. Examining Preservice Science Teachers' Skills of Formulating Hypotheses and Identifying Variables

    Science.gov (United States)

    Aydogdu, Bülent

    2015-01-01

    The aim of this study is to examine preservice science teachers' skills of formulating hypotheses and identifying variables. The research has a phenomenological research design. The data was gathered qualitatively. In this study, preservice science teachers were first given two scenarios (Scenario-1 & Scenario-2) containing two different…

  11. Identifying Best Practices for and Utilities of the Pharmacy Curriculum Outcome Assessment Examination.

    Science.gov (United States)

    Mok, Timothy Y; Romanelli, Frank

    2016-12-25

    Objective. A review was conducted to determine implementation strategies, utilities, score interpretation, and limitations of the Pharmacy Curriculum Outcome Assessment (PCOA) examination. Methods. Articles were identified through the PubMed and American Journal of Pharmaceutical Education , and International Pharmaceutical Abstracts databases using the following terms: "Pharmacy Curriculum Outcomes Assessment," "pharmacy comprehensive examination," and "curricular assessment." Studies containing information regarding implementation, utility, and predictive values for US student pharmacists, curricula, and/or PGY1/PGY2 residents were included. Publications from the Academic Medicine Journal , the Accreditation Council for Pharmacy Education (ACPE), and the American Association of Colleges of Pharmacy (ACCP) were included for background information and comparison of predictive utilities of comprehensive examinations in medicine. Results. Ten PCOA and nine residency-related publications were identified. Based on published information, the PCOA may be best used as an additional tool to identify knowledge gaps for third-year student pharmacists. Conclusion. Administering the PCOA to students after they have completed their didactic coursework may yield scores that reflect student knowledge. Predictive utility regarding the North American Pharmacy Licensure Examination (NAPLEX) and potential applications is limited, and more research is required to determine ways to use the PCOA.

  12. A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions.

    Science.gov (United States)

    Nanwa, Natasha; Sander, Beate; Krahn, Murray; Daneman, Nick; Lu, Hong; Austin, Peter C; Govindarajan, Anand; Rosella, Laura C; Cadarette, Suzanne M; Kwong, Jeffrey C

    2017-01-01

    Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection (CDI). We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data (emergency department visits and hospital admissions) in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011. We evaluated all-cause mortality and costs (unadjusted and adjusted for survival) from the healthcare payer perspective (2014 Canadian dollars). During our study period, we identified 7,950 infected subjects. The mean age was 63.5 years (standard deviation = 22.0), 62.7% were female, and 45.0% were very high users of the healthcare system. The relative risk for 30-day, 180-day, and 1-year mortality were 7.32 (95% confidence interval [CI], 5.94-9.02), 3.55 (95%CI, 3.17-3.97), and 2.59 (95%CI, 2.37-2.83), respectively. Mean attributable cumulative 30-day, 180-day, and 1-year costs (unadjusted for survival) were $7,434 (95%CI, $7,122-$7,762), $12,517 (95%CI, $11,687-$13,366), and $13,217 (95%CI, $12,062-$14,388). Mean attributable cumulative 1-, 2-, and 3-year costs (adjusted for survival) were $10,700 (95%CI, $9,811-$11,645), $13,312 (95%CI, $12,024-$14,682), and $15,812 (95%CI, $14,159-$17,571). Infected subjects had considerably higher risk of all-cause mortality and costs compared with uninfected subjects. This study provides insight on an understudied patient group. Our study findings will facilitate assessment of interventions to prevent community-onset CDI.

  13. A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions

    Science.gov (United States)

    Nanwa, Natasha; Sander, Beate; Krahn, Murray; Daneman, Nick; Lu, Hong; Austin, Peter C.; Govindarajan, Anand; Rosella, Laura C.; Cadarette, Suzanne M.; Kwong, Jeffrey C.

    2017-01-01

    Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection (CDI). We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data (emergency department visits and hospital admissions) in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011. We evaluated all-cause mortality and costs (unadjusted and adjusted for survival) from the healthcare payer perspective (2014 Canadian dollars). During our study period, we identified 7,950 infected subjects. The mean age was 63.5 years (standard deviation = 22.0), 62.7% were female, and 45.0% were very high users of the healthcare system. The relative risk for 30-day, 180-day, and 1-year mortality were 7.32 (95% confidence interval [CI], 5.94–9.02), 3.55 (95%CI, 3.17–3.97), and 2.59 (95%CI, 2.37–2.83), respectively. Mean attributable cumulative 30-day, 180-day, and 1-year costs (unadjusted for survival) were $7,434 (95%CI, $7,122-$7,762), $12,517 (95%CI, $11,687-$13,366), and $13,217 (95%CI, $12,062-$14,388). Mean attributable cumulative 1-, 2-, and 3-year costs (adjusted for survival) were $10,700 (95%CI, $9,811-$11,645), $13,312 (95%CI, $12,024-$14,682), and $15,812 (95%CI, $14,159-$17,571). Infected subjects had considerably higher risk of all-cause mortality and costs compared with uninfected subjects. This study provides insight on an understudied patient group. Our study findings will facilitate assessment of interventions to prevent community-onset CDI. PMID:28257438

  14. Can vehicle longitudinal jerk be used to identify aggressive drivers? An examination using naturalistic driving data.

    Science.gov (United States)

    Feng, Fred; Bao, Shan; Sayer, James R; Flannagan, Carol; Manser, Michael; Wunderlich, Robert

    2017-07-01

    This paper investigated the characteristics of vehicle longitudinal jerk (change rate of acceleration with respect to time) by using vehicle sensor data from an existing naturalistic driving study. The main objective was to examine whether vehicle jerk contains useful information that could be potentially used to identify aggressive drivers. Initial investigation showed that there are unique characteristics of vehicle jerk in drivers' gas and brake pedal operations. Thus two jerk-based metrics were examined: (1) driver's frequency of using large positive jerk when pressing the gas pedal, and (2) driver's frequency of using large negative jerk when pressing the brake pedal. To validate the performance of the two metrics, drivers were firstly divided into an aggressive group and a normal group using three classification methods (1) traveling at excessive speed (speeding), (2) following too closely to a front vehicle (tailgating), and (3) their association with crashes or near-crashes in the dataset. The results show that those aggressive drivers defined using any of the three methods above were associated with significantly higher values of the two jerk-based metrics. Between the two metrics the frequency of using large negative jerk seems to have better performance in identifying aggressive drivers. A sensitivity analysis shows the findings were largely consistent with varying parameters in the analysis. The potential applications of this work include developing quantitative surrogate safety measures to identify aggressive drivers and aggressive driving, which could be potentially used to, for example, provide real-time or post-ride performance feedback to the drivers, or warn the surrounding drivers or vehicles using the connected vehicle technologies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

    Science.gov (United States)

    Cadogan, Angela; McNair, Peter J; Laslett, Mark; Hing, Wayne A

    2016-01-01

    The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP. In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR. Combinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

  16. Examining Gender Bias in Studies of Innovation

    OpenAIRE

    Crowden, N.

    2003-01-01

    This paper examines the presence of a gender bias in studies of innovation. Using the Innovation Systems Research Network (ISRN) and its interview guide as a case study, this research project examines how accurately and completely such innovation studies present gender differences in the innovation process.

  17. Cellular signaling identifiability analysis: a case study.

    Science.gov (United States)

    Roper, Ryan T; Pia Saccomani, Maria; Vicini, Paolo

    2010-05-21

    Two primary purposes for mathematical modeling in cell biology are (1) simulation for making predictions of experimental outcomes and (2) parameter estimation for drawing inferences from experimental data about unobserved aspects of biological systems. While the former purpose has become common in the biological sciences, the latter is less common, particularly when studying cellular and subcellular phenomena such as signaling-the focus of the current study. Data are difficult to obtain at this level. Therefore, even models of only modest complexity can contain parameters for which the available data are insufficient for estimation. In the present study, we use a set of published cellular signaling models to address issues related to global parameter identifiability. That is, we address the following question: assuming known time courses for some model variables, which parameters is it theoretically impossible to estimate, even with continuous, noise-free data? Following an introduction to this problem and its relevance, we perform a full identifiability analysis on a set of cellular signaling models using DAISY (Differential Algebra for the Identifiability of SYstems). We use our analysis to bring to light important issues related to parameter identifiability in ordinary differential equation (ODE) models. We contend that this is, as of yet, an under-appreciated issue in biological modeling and, more particularly, cell biology. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  18. Accuracy of the abdominal examination for identifying children with blunt intra-abdominal injuries.

    Science.gov (United States)

    Adelgais, Kathleen M; Kuppermann, Nathan; Kooistra, Joshua; Garcia, Madelyn; Monroe, David J; Mahajan, Prashant; Menaker, Jay; Ehrlich, Peter; Atabaki, Shireen; Page, Kent; Kwok, Maria; Holmes, James F

    2014-12-01

    To determine the accuracy of complaints of abdominal pain and findings of abdominal tenderness for identifying children with intra-abdominal injury (IAI) stratified by Glasgow Coma Scale (GCS) score. This was a prospective, multicenter observational study of children with blunt torso trauma and a GCS score ≥13. We calculated the sensitivity of abdominal findings for IAI with 95% CI stratified by GCS score. We examined the association of isolated abdominal pain or tenderness with IAI and that undergoing acute intervention (therapeutic laparotomy, angiographic embolization, blood transfusion, or ≥2 nights of intravenous fluid therapy). Among the 12 044 patients evaluated, 11 277 (94%) had a GCS score of ≥13 and were included in this analysis. Sensitivity of abdominal pain for IAI was 79% (95% CI, 76%-83%) for patients with a GCS score of 15, 51% (95% CI, 37%-65%) for patients with a GCS score of 14, and 32% (95% CI, 14%-55%) for patients with a GCS score of 13. Sensitivity of abdominal tenderness for IAI also decreased with decreasing GCS score: 79% (95% CI, 75%-82%) for a GCS score of 15, 57% (95% CI, 42%-70%) for a GCS score of 14, and 37% (95% CI, 19%-58%) for a GCS score of 13. Among patients with isolated abdominal pain and/or tenderness, the rate of IAI was 8% (95% CI, 6%-9%) and the rate of IAI undergoing acute intervention was 1% (95% CI, 1%-2%). The sensitivity of abdominal findings for IAI decreases as GCS score decreases. Although abdominal computed tomography is not mandatory, the risk of IAI is sufficiently high that diagnostic evaluation is warranted in children with isolated abdominal pain or tenderness. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    NARCIS (Netherlands)

    Nijhuis, Esther R.; van der Zee, Ate G. J.; In 't Hout, Bertha A.; Boomgaard, Jantine J.; de Hullu, Joanne A.; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Jijman, Hans W.; Willemse, Pax H. B.; Mourits, Marian J. E.

    2006-01-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective

  20. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery.

    NARCIS (Netherlands)

    Nijhuis, E.R.; Zee, A.G. van der; Hout, B.A. van; Boomgaard, J.J.; Hullu, J.A. de; Pras, E.; Hollema, H.; Aalders, J.G.; Nijman, H.W.; Willemse, P.H.B.; Mourits, M.J.E.

    2006-01-01

    PURPOSE: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. METHODS AND MATERIALS: In a retrospective

  1. In Search of Black Swans: Identifying Students at Risk of Failing Licensing Examinations.

    Science.gov (United States)

    Barber, Cassandra; Hammond, Robert; Gula, Lorne; Tithecott, Gary; Chahine, Saad

    2018-03-01

    To determine which admissions variables and curricular outcomes are predictive of being at risk of failing the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1), how quickly student risk of failure can be predicted, and to what extent predictive modeling is possible and accurate in estimating future student risk. Data from five graduating cohorts (2011-2015), Schulich School of Medicine & Dentistry, Western University, were collected and analyzed using hierarchical generalized linear models (HGLMs). Area under the receiver operating characteristic curve (AUC) was used to evaluate the accuracy of predictive models and determine whether they could be used to predict future risk, using the 2016 graduating cohort. Four predictive models were developed to predict student risk of failure at admissions, year 1, year 2, and pre-MCCQE1. The HGLM analyses identified gender, MCAT verbal reasoning score, two preclerkship course mean grades, and the year 4 summative objective structured clinical examination score as significant predictors of student risk. The predictive accuracy of the models varied. The pre-MCCQE1 model was the most accurate at predicting a student's risk of failing (AUC 0.66-0.93), while the admissions model was not predictive (AUC 0.25-0.47). Key variables predictive of students at risk were found. The predictive models developed suggest, while it is not possible to identify student risk at admission, we can begin to identify and monitor students within the first year. Using such models, programs may be able to identify and monitor students at risk quantitatively and develop tailored intervention strategies.

  2. Identifying Relevant Studies in Software Engineering

    DEFF Research Database (Denmark)

    Zhang, He; Ali Babar, Muhammad; Tell, Paolo

    2011-01-01

    Context: Systematic literature review (SLR) has become an important research methodology in software engineering since the introduction of evidence-based software engineering (EBSE) in 2004. One critical step in applying this methodology is to design and execute appropriate and effective search....... Objective: The main objective of the research reported in this paper is to improve the search step of undertaking SLRs in software engineering (SE) by devising and evaluating systematic and practical approaches to identifying relevant studies in SE. Method: We have systematically selected and analytically...

  3. Identifying the most efficient items from the Mini-Mental State Examination for cognitive function assessment in older Taiwanese patients.

    Science.gov (United States)

    Lou, Meei-Fang; Dai, Yu-Tzu; Huang, Guey-Shiun; Yu, Po-Jui

    2007-03-01

    The purpose of the study was to identify the most efficient items from the Mini-Mental State Examination for assessment of cognitive function. The Mini-Mental State Examination is the most frequently used cognitive screening instrument. However, the Mini-Mental State Examination has been criticized for insensitivity to mild cognitive dysfunction, limited memory assessment and variability in level of difficulty of the individual items. This study used secondary data analysis. Item response theory two-parameter model was used to analyse the data from the admission assessment of mental status by the Mini-Mental State Examination for 801 patients. By using item response analysis, 16 items were selected from the original 30-item Mini-Mental State Examination. The 16 items included mainly the measures of orientation, recall and attention and calculation. The internal consistency of the 16-item Mini-Mental State Examination was 0.84. The proposed new cut-off point for the 16-item Mini-Mental State Examination was 11. The correct classification rate was 0.94, the sensitivity was 100% and the specificity was 97.4%, when compared with the original 30-item Mini-Mental State Examination from the cut-off point of 24. This new cut-off point was determined for the purpose of over-identifying patients at risk so as to ensure early detection of and prevention from the onset of cognitive disturbance. Only a few items are needed to describe the subject's cognitive status. Using item response theory analysis, the study found that the Mini-Mental State Examination could be simplified. Deleting the items with less variation makes this assessment tool not only shorter, easier to administer and less strenuous for respondents, but also enables one to maintain validity as a cognitive function test for clinical setting.

  4. Returning to the bedside: using the history and physical examination to identify rotator cuff tears.

    Science.gov (United States)

    Litaker, D; Pioro, M; El Bilbeisi, H; Brems, J

    2000-12-01

    To determine the value of elements of the bedside history and physical examination in predicting arthrography results in older patients with suspected rotator cuff tear (RCT). Retrospective chart review Orthopedic practice limited to disorders of the shoulder 448 consecutive patients with suspected RCT referred for arthrography over a 4-year period Presence of partial or complete RCT on arthrogram 301 patients (67.2%) had evidence of complete or partial RCT. Clinical findings in the univariate analysis most closely associated with rotator cuff tear included infra- and supraspinatus atrophy (P or = 65 (AOR 4.05(2.47, 16.07)), and night pain (AOR 2.61 (1.004, 7.39)) best predicted the presence of RCT. A five-point scoring system developed from this model was applied in the remaining patient sample (n = 216) to test validity. No significant differences in performance were noted using ROC curve comparison. Using likelihood ratios, a clinical score = 4 was superior in predicting RCT to the diagnostic prediction of an expert clinician. This score had specificity equivalent to magnetic resonance imaging or ultrasonography in diagnosis of RCT. The presence of three simple features in the history and physical examination of the shoulder can identify RCT efficiently. This approach offers a valuable strategy to diagnosis at the bedside without compromising sensitivity or specificity.

  5. Delivering Online Examinations: A Case Study

    Directory of Open Access Journals (Sweden)

    John MESSING

    2004-07-01

    Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

  6. Study Identifies New Lymphoma Treatment Target

    Science.gov (United States)

    NCI researchers have identified new therapeutic targets for diffuse large B-cell lymphoma. Drugs that hit these targets are under clinical development and the researchers hope to begin testing them in clinical trials of patients with DLBCL.

  7. Identifying intestinal malrotation on magnetic resonance examinations ordered for unrelated indications

    International Nuclear Information System (INIS)

    Fay, Jill S.; Chernyak, Victoria; Taragin, Benjamin H.

    2017-01-01

    Anatomical imaging findings indicating normal bowel rotation can be identified on cross-sectional imaging, including magnetic resonance imaging (MRI) performed for non-related indications. The goal of our study was to assess whether non-targeted MRI can accurately assess intestinal malrotation. Four anatomical landmarks were assessed on MRIs of the chest, spine or abdomen performed from January 2006 to June 2014, on patients who also had upper gastrointestinal series (UGI) performed within 10 years of the MRI date: 1) retroperitoneal duodenum, 2) left upper quadrant duodenojejunal junction, 3) superior mesenteric artery to the left of the superior mesenteric vein, and 4) right lower quadrant cecum. Two attending radiologists, one pediatric and one abdominal radiologist, independently reviewed the MR images. The pediatric radiologist reviewed images from UGI (considered the gold standard) to determine the intestinal rotation for each case. Validation of the criteria was performed on new patients imaged through January 2016. The original cohort included 109 MRIs (15 chest, 41 spine and 53 abdomen) done on 109 patients (42% males, mean age: 10.2 years). If each of the 4 anatomical questions were answered ''yes'' (4-YES), specificity was 100% for each radiologist and malrotation was appropriately excluded. Using the 4-YES criteria, the pediatric radiologist excluded malrotation in 71 patients (65%) and the abdominal radiologist excluded it in 65 (60%), with concurrence for 57 patients. Validation of the 4-YES criteria in 23 new patients appropriately proved the 4-YES rule, with neither labeling the one new malrotation case 4-YES. If a radiologist can confidently answer ''yes'' to the four questions evaluated in this study, then intestinal rotation can be safely considered normal. Normal bowel rotation should be commented upon in MRI reports when these four anatomical locations are imaged, thus helping patients avoid unnecessary

  8. Identifying intestinal malrotation on magnetic resonance examinations ordered for unrelated indications

    Energy Technology Data Exchange (ETDEWEB)

    Fay, Jill S.; Chernyak, Victoria; Taragin, Benjamin H. [Montefiore Medical Center, Department of Diagnostic Radiology, Bronx, NY (United States)

    2017-10-15

    Anatomical imaging findings indicating normal bowel rotation can be identified on cross-sectional imaging, including magnetic resonance imaging (MRI) performed for non-related indications. The goal of our study was to assess whether non-targeted MRI can accurately assess intestinal malrotation. Four anatomical landmarks were assessed on MRIs of the chest, spine or abdomen performed from January 2006 to June 2014, on patients who also had upper gastrointestinal series (UGI) performed within 10 years of the MRI date: 1) retroperitoneal duodenum, 2) left upper quadrant duodenojejunal junction, 3) superior mesenteric artery to the left of the superior mesenteric vein, and 4) right lower quadrant cecum. Two attending radiologists, one pediatric and one abdominal radiologist, independently reviewed the MR images. The pediatric radiologist reviewed images from UGI (considered the gold standard) to determine the intestinal rotation for each case. Validation of the criteria was performed on new patients imaged through January 2016. The original cohort included 109 MRIs (15 chest, 41 spine and 53 abdomen) done on 109 patients (42% males, mean age: 10.2 years). If each of the 4 anatomical questions were answered ''yes'' (4-YES), specificity was 100% for each radiologist and malrotation was appropriately excluded. Using the 4-YES criteria, the pediatric radiologist excluded malrotation in 71 patients (65%) and the abdominal radiologist excluded it in 65 (60%), with concurrence for 57 patients. Validation of the 4-YES criteria in 23 new patients appropriately proved the 4-YES rule, with neither labeling the one new malrotation case 4-YES. If a radiologist can confidently answer ''yes'' to the four questions evaluated in this study, then intestinal rotation can be safely considered normal. Normal bowel rotation should be commented upon in MRI reports when these four anatomical locations are imaged, thus helping patients avoid unnecessary

  9. Identifying Critical Elements of Treatment: Examining the Use of Turn Taking in Autism Intervention

    Science.gov (United States)

    Reith, Sarah R.; Stahmer, Aubyn C.; Suhrheinrich, Jessica; Schreibman, Laura; Kennedy, Joanna; Ross, Benjamin

    2014-01-01

    Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation…

  10. Physical Examination Tools Used to Identify Swollen and Tender Lower Limb Joints in Juvenile Idiopathic Arthritis: A Scoping Review.

    Science.gov (United States)

    Fellas, Antoni; Singh-Grewal, Davinder; Santos, Derek; Coda, Andrea

    2018-01-01

    Juvenile idiopathic arthritis (JIA) is the most common form of rheumatic disease in childhood and adolescents, affecting between 16 and 150 per 100,000 young persons below the age of 16. The lower limb is commonly affected in JIA, with joint swelling and tenderness often observed as a result of active synovitis. The objective of this scoping review is to identify the existence of physical examination (PE) tools to identify and record swollen and tender lower limb joints in children with JIA. Two reviewers individually screened the eligibility of titles and abstracts retrieved from the following online databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL. Studies that proposed and validated a comprehensive lower limb PE tool were included in this scoping review. After removal of duplicates, 1232 citations were retrieved, in which twelve were identified as potentially eligible. No studies met the set criteria for inclusion. Further research is needed in developing and validating specific PE tools for clinicians such as podiatrists and other allied health professionals involved in the management of pathological lower limb joints in children diagnosed with JIA. These lower limb PE tools may be useful in conjunction with existing disease activity scores to optimise screening of the lower extremity and monitoring the efficacy of targeted interventions.

  11. Inter-examiner reproducibility of clinical tests and criteria to identify subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Vind, Mikkel; Bogh, Søren Bie; Larsen, Camilla Marie

    2011-01-01

    for cases was ≥3, and for controls ≤1 positive test out of four. Cohen's κ statistics were used for calculating agreement. Results In the overall agreement phase, an agreement of 0.90 was obtained, while in the study phase it was 0.98 with a κ of 0.95 for SIS. κ Values for the individual tests varied...... was followed, consisting of a training, an overall agreement and a study phase. To proceed to the study phase, an overall agreement of 0.80 was required. In total 10, 20 and 44 subjects were included in the three phases, respectively. The case prevalence in the study phase was 50%. The inclusion criterion...

  12. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    International Nuclear Information System (INIS)

    Nijhuis, Esther R.; Zee, Ate G.J. van der; Hout, Bertha A. in 't; Boomgaard, Jantine J.; Hullu, Joanne A. de; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Nijman, Hans W.; Willemse, Pax H.B.; Mourits, Marian J.E.

    2006-01-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective cohort study data of all cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IB1 to IVA treated with (chemo) radiation between 1994 and 2001 were analyzed. Patients underwent gynecologic examination under anesthesia 8 to 10 weeks after completion of treatment. Cervical biopsy samples were taken from patients judged to be operable. In case of residual cancer, salvage surgery was performed. Results: Between 1994 and 2001, 169 consecutive cervical cancer patients received primary (chemo) radiation, of whom 4 were lost to follow-up. Median age was 56 years (interquartile range [IQR], 44-71) and median follow-up was 3.5 years (IQR, 1.5-5.9). In each of 111 patients a biopsy sample was taken, of which 90 (81%) showed no residual tumor. Vital tumor cells were found in 21 of 111 patients (19%). Salvage surgery was performed in 13 of 21 (62%) patients; of these patients, 5 (38%) achieved long-term, complete remission after salvage surgery (median follow-up, 5.2 years; range, 3.9-8.8 years). All patients with residual disease who did not undergo operation (8/21) died of progressive disease. Locoregional control was more often obtained in patients who underwent operation (7 of 13) than in patients who were not selected for salvage surgery (0 of 8 patients) (p < 0.05). Conclusions: Gynecologic examination under anesthesia 8 to 10 weeks after (chemo) radiation with cervical biopsies allows identification of those cervical cancer patients who have residual local disease, of whom a small but significant proportion may be salvaged by surgery

  13. Identifying the trauma recovery needs of maltreated children: An examination of child welfare workers' effectiveness in screening for traumatic stress.

    Science.gov (United States)

    Whitt-Woosley, Adrienne; Sprang, Ginny; Royse, David G

    2018-07-01

    Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms. Descriptive and correlational analyses were conducted regarding a sample of children (N = 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms. Four hierarchical regression models were also examined to determine whether workers' screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on clinical measures. The analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models supported workers' efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the symptoms of arousal. These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for related practice, policy and training efforts in child welfare. Published by Elsevier Ltd.

  14. Social network analysis in identifying influential webloggers: A preliminary study

    Science.gov (United States)

    Hasmuni, Noraini; Sulaiman, Nor Intan Saniah; Zaibidi, Nerda Zura

    2014-12-01

    In recent years, second generation of internet-based services such as weblog has become an effective communication tool to publish information on the Web. Weblogs have unique characteristics that deserve users' attention. Some of webloggers have seen weblogs as appropriate medium to initiate and expand business. These webloggers or also known as direct profit-oriented webloggers (DPOWs) communicate and share knowledge with each other through social interaction. However, survivability is the main issue among DPOW. Frequent communication with influential webloggers is one of the way to keep survive as DPOW. This paper aims to understand the network structure and identify influential webloggers within the network. Proper understanding of the network structure can assist us in knowing how the information is exchanged among members and enhance survivability among DPOW. 30 DPOW were involved in this study. Degree centrality and betweenness centrality measurement in Social Network Analysis (SNA) were used to examine the strength relation and identify influential webloggers within the network. Thus, webloggers with the highest value of these measurements are considered as the most influential webloggers in the network.

  15. Mis-fitting Menstrual Hygiene Products: An Examination of Advertisements to Identify Gaps in the Diffusion of Innovation

    Directory of Open Access Journals (Sweden)

    Arpan Yagnik

    2012-12-01

    Full Text Available This research examines advertisements for menstrual hygiene products to discover the roadblocks in the diffusion of innovation of menstrual hygiene products. The objective is to evaluate the advertisements to comprehend the cultural relevance of the diffusion, justify the rate of diffusion of innovation, identify the bottlenecks prohibiting the diffusion, and suggest ideas for a successful diffusion of innovation. A convenient sample of 75 television advertisements and print advertisements of sanitary hygiene products was selected for analysis. Using thematic analysis this research identifies and extracts themes that are the potential bottlenecks to successful diffusion of innovation. The main themes identified were the assumption regarding the knowledge of usage, knowledge of disposal, knowledge of sharing, existing clothing standards, affordability, role of woman, and comfort with insertion. The discovery of themes not only demonstrate ignorance and incompetent market research but also give us a sense of the glacial diffusion of menstrual hygiene products in the recipient country.

  16. Oral-Fluid Thiol-Detection Test Identifies Underlying Active Periodontal Disease Not Detected by the Visual Awake Examination.

    Science.gov (United States)

    Queck, Katherine E; Chapman, Angela; Herzog, Leslie J; Shell-Martin, Tamara; Burgess-Cassler, Anthony; McClure, George David

    Periodontal disease in dogs is highly prevalent but can only be accurately diagnosed by performing an anesthetized oral examination with periodontal probing and dental radiography. In this study, 114 dogs had a visual awake examination of the oral cavity and were administered an oral-fluid thiol-detection test prior to undergoing a a full-mouth anesthetized oral examination and digital dental radiographs. The results show the visual awake examination underestimated the presence and severity of active periodontal disease. The thiol-detection test was superior to the visual awake examination at detecting the presence and severity of active periodontal disease and was an indicator of progression toward alveolar bone loss. The thiol-detection test detected active periodontal disease at early stages of development, before any visual cues were present, indicating the need for intervention to prevent periodontal bone loss. Early detection is important because without intervention, dogs with gingivitis (active periodontal disease) progress to irreversible periodontal bone loss (stage 2+). As suggested in the current AAHA guidelines, a thiol-detection test administered in conjunction with the visual awake examination during routine wellness examinations facilitates veterinarian-client communication and mitigates under-diagnosis of periodontal disease and underutilization of dental services. The thiol-detection test can be used to monitor the periodontal health status of the conscious patient during follow-up examinations based on disease severity.

  17. IDGenerator: unique identifier generator for epidemiologic or clinical studies

    Directory of Open Access Journals (Sweden)

    Matthias Olden

    2016-09-01

    Full Text Available Abstract Background Creating study identifiers and assigning them to study participants is an important feature in epidemiologic studies, ensuring the consistency and privacy of the study data. The numbering system for identifiers needs to be random within certain number constraints, to carry extensions coding for organizational information, or to contain multiple layers of numbers per participant to diversify data access. Available software can generate globally-unique identifiers, but identifier-creating tools meeting the special needs of epidemiological studies are lacking. We have thus set out to develop a software program to generate IDs for epidemiological or clinical studies. Results Our software IDGenerator creates unique identifiers that not only carry a random identifier for a study participant, but also support the creation of structured IDs, where organizational information is coded into the ID directly. This may include study center (for multicenter-studies, study track (for studies with diversified study programs, or study visit (baseline, follow-up, regularly repeated visits. Our software can be used to add a check digit to the ID to minimize data entry errors. It facilitates the generation of IDs in batches and the creation of layered IDs (personal data ID, study data ID, temporary ID, external data ID to ensure a high standard of data privacy. The software is supported by a user-friendly graphic interface that enables the generation of IDs in both standard text and barcode 128B format. Conclusion Our software IDGenerator can create identifiers meeting the specific needs for epidemiologic or clinical studies to facilitate study organization and data privacy. IDGenerator is freeware under the GNU General Public License version 3; a Windows port and the source code can be downloaded at the Open Science Framework website: https://osf.io/urs2g/ .

  18. A Study of Scientometric Methods to Identify Emerging Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL

    2011-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

  19. Guidance for Identifying, Selecting and Evaluating Open Literature Studies

    Science.gov (United States)

    This guidance for Office of Pesticide Program staff will assist in their evaluation of open literature studies of pesticides. It also describes how we identify, select, and ensure that data we use in risk assessments is of sufficient scientific quality.

  20. TMI-2 core-examination program: INEL facilities readiness study

    International Nuclear Information System (INIS)

    McLaughlin, T.B.

    1983-02-01

    This report reviews the capability and readiness of remote handling facilities at the Idaho National Engineering Laboratory (INEL) to receive, and store the TMI-2 core, and to examine and analyze TMI-2 core samples. To accomplish these objectives, the facilities must be able to receive commercial casks, unload canisters from the casks, store the canisters, open the canisters, handle the fuel debris and assemblies, and perform various examinations. The report identifies documentation, including core information, necessary to INEL before receiving the entire TMI-2 core. Also identified are prerequisites to INEL's receipt of the first canister: costs, schedules, and a preliminary project plan for the tasks

  1. Early studies of instant-fMRI for routine examination

    International Nuclear Information System (INIS)

    Sakurai, Yuuki; Harada, Kuniaki; Nagahama, Hiroshi; Akatsuka, Yoshihiro; Shinozaki, Jun

    2010-01-01

    Authors are developing a low-burden, short-time acquisition method of functional magnetic resonance imaging (fMRI) with 3T machine, named ''Instant-fMRI'', aiming for its application to routine examinations, of which results of early studies on identification of the language hemisphere are reported. Subjects were 10 healthy volunteers (8 males, 2 females, mean age 34.2 y, 8 right-handers) and 5 right-hander patients with brain tumor (4 males, 1 female, mean age 50 y). The machine was GE Signa HDx 3.0T ver. 14, using 8 channel head coil. For Instant-fMRI, T1-weighted imaging sequence for mapping was in fast spoiled gradient recalled acquisition in the steady state (fSPGR) mode (scan time: 1 min 44 sec) and fMRI sequence, in GRE-EPI (scan time: 1 min), which thus required only about 3 min in total. Reference was defined to be the anterior-posterior commissure line, to which parallel sections involving centriciput and cerebellum were acquired. Rest (30 sec)-task (shiritori language game, 30 sec) cycle was to be one in instant-fMRI in contrast to three in the conventional fMRI. Volunteers received both instant-fMRI and conventional fMRI and patients, the former alone. Data were analyzed by GE Brain Wave PA. Right and left hemisphere of the left and right hander, respectively, was identified to be activated by instant-fMRI in 9 of 10 volunteers and in all patients, and by the conventional fMRI, in all volunteers. The instant-fMRI can be a useful examination of other brain functions as well as identifying the language field when acquisition parameters for desired diagnostic purpose are optimized. (T.T.)

  2. Vascular abnormalities of the distal deep digital flexor tendon in 8 draught horses identified on histological examination.

    Science.gov (United States)

    Crişan, Melania Ioana; Damian, Aurel; Gal, Adrian; Miclăuş, Viorel; Cernea, Cristina L; Denoix, Jean-Marie

    2013-08-01

    The purpose of this study was to provide a detailed description of the vascular changes in the distal part of deep digital flexor tendon (DDFT). Eight isolated forelimbs were collected from 8 horses with DDF tendinopathy diagnosed post-mortem by ultrasound and gross anatomopathological examination. The samples were fixed in 10% neutral buffered formalin, softened in 4% phenol and dehydrated with ethylic alcohol. Goldner's Trichrome staining method was used. The histopathological examination revealed vascular proliferation associated with structural disorders of blood vessels. Angiogenesis, fibroplasia and consecutive hypertrophy of the vascular wall with or without vascular occlusion were the most common findings. Other histopathological findings were: endothelial cell edema, progressive metaplasia from squamous to cubic cells, vascular wall hyalinization, endothelial cells apoptosis/necrosis and endothelial desquamation. These results demonstrated damage of the distal deep digital flexor tendon vasculature which may progressively alter the structural integrity of the tendon and contribute to degenerative lesions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Transformational change in healthcare: an examination of four case studies.

    Science.gov (United States)

    Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

    2016-04-01

    Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

  4. Videoconference-based mini mental state examination: a validation study.

    Science.gov (United States)

    Timpano, Francesca; Pirrotta, Fabio; Bonanno, Lilla; Marino, Silvia; Marra, Angela; Bramanti, Placido; Lanzafame, Pietro

    2013-12-01

    Neuropsychological testing is a prime criterion of good practice to document cognitive deficits in a rapidly aging population. Telecommunication technologies may overcome limitations related to test administration. We compared performance of the Italian videoconference-based version of the Mini Mental State Examination (VMMSE) with performance of the standard MMSE administered face-to-face (F2F), to validate the Italian version of the 28-item VMMSE. To validate the Italian version of the VMMSE, we compared its performance with standard F2F. The sample (n=342) was administered three VMMSEs within 6 weeks after F2F testing. We identified the optimal cutoff through the receiver operating characteristic curve, as well as the VMMSE consistency through inter- and intrarater reliability (Inter/RR and Intra/RR) analysis. We found high levels of sensitivity and specificity for the optimal VMMSE cutoff identification and an accuracy of 0.96 (95% confidence interval 0.94-0.98). Intra/RR and inter/RR were highly significant. This study demonstrates that VMMSE is a valid instrument in clinical and research screening and monitoring of subjects affected by cognitive disorders. This study shows a significant correlation between videoconference assessment and the F2F one, providing an important impetus to expand studies and the knowledge about the usefulness of tele-assistance services. Our findings have important implications for both longitudinal assistance and clinical care of demented patients.

  5. Study on Accuracy of Judgments by Chinese Fingerprint Examiners

    Directory of Open Access Journals (Sweden)

    Shiquan Liu

    2015-01-01

    Full Text Available The interpretation of fingerprint evidence depends on the judgments of fingerprint examiners. This study assessed the accuracy of different judgments made by fingerprint examiners following the Analysis, Comparison, and Evaluation (ACE process. Each examiner was given five marks for analysis, comparison, and evaluation. We compared the experts′ judgments against the ground truth and used an annotation platform to evaluate how Chinese fingerprint examiners document their comparisons during the identification process. The results showed that different examiners demonstrated different accuracy of judgments and different mechanisms to reach them.

  6. Genome-wide association study identifies five new schizophrenia loci

    NARCIS (Netherlands)

    Ripke, S.; Sanders, A. R.; Kendler, K. S.; Levinson, D. F.; Sklar, P.; Holmans, P. A.; Lin, D. Y.; Duan, J.; Ophoff, R. A.; Andreassen, O. A.; Scolnick, E.; Cichon, S.; St Clair, D.; Corvin, A.; Gurling, H.; Werge, T.; Rujescu, D.; Blackwood, D. H.; Pato, C. N.; Malhotra, A. K.; Purcell, S.; Dudbridge, F.; Neale, B. M.; Rossin, L.; Visscher, P. M.; Posthuma, D.; Ruderfer, D. M.; Fanous, A.; Stefansson, H.; Steinberg, S.; Mowry, B. J.; Golimbet, V.; de Hert, M.; Jonsson, E. G.; Bitter, I.; Pietilainen, O. P.; Collier, D. A.; Tosato, S.; Agartz, I.; Albus, M.; Alexander, M.; Amdur, R. L.; Amin, F.; Bass, N.; Bergen, S. E.; Black, D. W.; Borglum, A. D.; Brown, M. A.; Bruggeman, R.; Buccola, N. G.; Byerley, W. F.; Cahn, W.; Cantor, R. M.; Carr, V. J.; Catts, S. V.; Choudhury, K.; Cloninger, C. R.; Cormican, P.; Craddock, N.; Danoy, P. A.; Datta, S.; de Haan, L.; Demontis, D.; Dikeos, D.; Djurovic, S.; Donnely, P.; Donohoe, G.; Duong, L.; Dwyer, S.; Fink-Jensen, A.; Freedman, R.; Freimer, N. B.; Friedl, M.; Georgieva, L.; Giegling, I.; Gill, M.; Glenthoj, B.; Godard, S.; Hamshere, M.; Hansen, M.; Hartmann, A. M.; Henskens, F. A.; Hougaard, D. M.; Hultman, C. M.; Ingason, A.; Jablensky, A. V.; Jakobsen, K. D.; Jay, M.; Jurgens, G.; Kahn, R. S.; Keller, M. C.; Kenis, G.; Kenny, E.; Kim, Y.; Kirov, G. K.; Konnerth, H.; Konte, B.; Krabbendam, L.; Krasucki, R.; Lasseter, V. K.; Laurent, C.; Lawrence, J.; Lencz, T.; Lerer, F. B.; Liang, K. Y.; Lichtenstein, P.; Lieberman, J. A.; Linszen, D. H.; Lonnqvist, J.; Loughland, C. M.; Maclean, A. W.; Maher, B. S.; Maier, W.; Mallet, J.; Malloy, P.; Mattheisen, M.; Mattingsdal, M.; McGhee, K. A.; McGrath, J. J.; McIntosh, A.; McLean, D. E.; McQuillin, A.; Melle, I.; Michie, P. T.; Milanova, V.; Morris, D. W.; Mors, O.; Mortensen, P. B.; Moskvina, V.; Muglia, P.; Myin-Germeys, I.; Nertney, D. A.; Nestadt, G.; Nielsen, J.; Nikolov, I.; Nordentoft, M.; Norton, N.; Nothen, M. M.; O'Dushlaine, C. T.; Olincy, A.; Olsen, L.; O'Neill, F. A.; Orntoft, T. F.; Owen, M. J.; Pantelis, C.; Papadimitriou, G.; Pato, M. T.; Peltonen, L.; Petursson, H.; Pickard, B.; Pimm, J.; Pulver, A. E.; Puri, V.; Quested, D.; Quinn, E. M.; Rasmussen, H. B.; Rethelyi, J. M.; Ribble, R.; Rietschel, M.; Riley, B. P.; Ruggeri, M.; Schall, U.; Schulze, T. G.; Schwab, S. G.; Scott, R. J.; Shi, J.; Sigurdsson, E.; Silvermann, J. M.; Spencer, C. C.; Stefansson, K.; Strange, A.; Strengman, E.; Stroup, T. S.; Suvisaari, J.; Terenius, L.; Thirumalai, S.; Thygesen, J. H.; Timm, S.; Toncheva, D.; van den Oord, E.; van Os, J.; van Winkel, R.; Veldink, J.; Walsh, D.; Wang, A. G.; Wiersma, D.; Wildenauer, D. B.; Williams, H. J.; Williams, N. M.; Wormley, B.; Zammit, S.; Sullivan, P. F.; O'Donovan, M. C.; Daly, M. J.; Gejman, P. V.

    2011-01-01

    We examined the role of common genetic variation in schizophrenia in a genome-wide association study of substantial size: a stage 1 discovery sample of 21,856 individuals of European ancestry and a stage 2 replication sample of 29,839 independent subjects. The combined stage 1 and 2 analysis yielded

  7. Identifying nurses' rewards: a qualitative categorization study in Belgium

    Directory of Open Access Journals (Sweden)

    Du Bois Cindy

    2006-07-01

    Full Text Available Abstract Background Rewards are important in attracting, motivating and retaining the most qualified employees, and nurses are no exception to this rule. This makes the establishment of an efficient reward system for nurses a true challenge for every hospital manager. A reward does not necessarily have a financial connotation: non-financial rewards may matter too, or may even be more important. Therefore, the present study examines nurses' reward perceptions, in order to identify potential reward options. Methods To answer the research question "What do nurses consider a reward and how can these rewards be categorized?", 20 in-depth semi-structured interviews with nurses were conducted and analysed using discourse and content analyses. In addition, the respondents received a list of 34 rewards (derived from the literature and were asked to indicate the extent to which they perceived each of them to be rewarding. Results Discourse analysis revealed three major reward categories: financial, non-financial and psychological, each containing different subcategories. In general, nurses more often mentioned financial rewards spontaneously in the interview, compared to non-financial and psychological rewards. The questionnaire results did not, however, indicate a significant difference in the rewarding potential of these three categories. Both the qualitative and quantitative data revealed that a number of psychological and non-financial rewards were important for nurses in addition to their monthly pay and other remunerations. In particular, appreciation for their work by others, compliments from others, presents from others and contact with patients were highly valued. Moreover, some demographical variables influenced the reward perceptions. Younger and less experienced nurses considered promotion possibilities as more rewarding than the older and more senior ones. The latter valued job security and working for a hospital with a good reputation higher

  8. Sampling challenges in a study examining refugee resettlement.

    Science.gov (United States)

    Sulaiman-Hill, Cheryl Mr; Thompson, Sandra C

    2011-03-15

    As almost half of all refugees currently under United Nations protection are from Afghanistan or Iraq and significant numbers have already been resettled outside the region of origin, it is likely that future research will examine their resettlement needs. A number of methodological challenges confront researchers working with culturally and linguistically diverse groups; however, few detailed articles are available to inform other studies. The aim of this paper is to outline challenges with sampling and recruitment of socially invisible refugee groups, describing the method adopted for a mixed methods exploratory study assessing mental health, subjective wellbeing and resettlement perspectives of Afghan and Kurdish refugees living in New Zealand and Australia. Sampling strategies used in previous studies with similar refugee groups were considered before determining the approach to recruitment A snowball approach was adopted for the study, with multiple entry points into the communities being used to choose as wide a range of people as possible to provide further contacts and reduce selection bias. Census data was used to assess the representativeness of the sample. A sample of 193 former refugee participants was recruited in Christchurch (n = 98) and Perth (n = 95), 47% were of Afghan and 53% Kurdish ethnicity. A good gender balance (males 52%, females 48%) was achieved overall, mainly as a result of the sampling method used. Differences in the demographic composition of groups in each location were observed, especially in relation to the length of time spent in a refugee situation and time since arrival, reflecting variations in national humanitarian quota intakes. Although some measures were problematic, Census data comparison to assess reasonable representativeness of the study sample was generally reassuring. Snowball sampling, with multiple initiation points to reduce selection bias, was necessary to locate and identify participants, provide reassurance and

  9. Sampling challenges in a study examining refugee resettlement

    Directory of Open Access Journals (Sweden)

    Thompson Sandra C

    2011-03-01

    Full Text Available Abstract Background As almost half of all refugees currently under United Nations protection are from Afghanistan or Iraq and significant numbers have already been resettled outside the region of origin, it is likely that future research will examine their resettlement needs. A number of methodological challenges confront researchers working with culturally and linguistically diverse groups; however, few detailed articles are available to inform other studies. The aim of this paper is to outline challenges with sampling and recruitment of socially invisible refugee groups, describing the method adopted for a mixed methods exploratory study assessing mental health, subjective wellbeing and resettlement perspectives of Afghan and Kurdish refugees living in New Zealand and Australia. Sampling strategies used in previous studies with similar refugee groups were considered before determining the approach to recruitment Methods A snowball approach was adopted for the study, with multiple entry points into the communities being used to choose as wide a range of people as possible to provide further contacts and reduce selection bias. Census data was used to assess the representativeness of the sample. Results A sample of 193 former refugee participants was recruited in Christchurch (n = 98 and Perth (n = 95, 47% were of Afghan and 53% Kurdish ethnicity. A good gender balance (males 52%, females 48% was achieved overall, mainly as a result of the sampling method used. Differences in the demographic composition of groups in each location were observed, especially in relation to the length of time spent in a refugee situation and time since arrival, reflecting variations in national humanitarian quota intakes. Although some measures were problematic, Census data comparison to assess reasonable representativeness of the study sample was generally reassuring. Conclusions Snowball sampling, with multiple initiation points to reduce selection bias, was

  10. Identifying, studying and making good use of macromolecular crystals

    Energy Technology Data Exchange (ETDEWEB)

    Calero, Guillermo [University of Pittsburgh Medical School, Pittsburgh, PA 15261 (United States); Cohen, Aina E. [SLAC National Accelerator Laboratory, Stanford University, Menlo Park, CA 94025 (United States); Luft, Joseph R. [Hauptman–Woodward Medical Research Institute, 700 Ellicott Street, Buffalo, NY 14203 (United States); State University of New York at Buffalo, 700 Ellicott Street, Buffalo, NY 14203 (United States); Newman, Janet [CSIRO Collaborative Crystallisation Centre, 343 Royal Parade, Parkville, Victoria 3052 (Australia); Snell, Edward H., E-mail: esnell@hwi.buffalo.edu [Hauptman–Woodward Medical Research Institute, 700 Ellicott Street, Buffalo, NY 14203 (United States); State University of New York at Buffalo, 700 Ellicott Street, Buffalo, NY 14203 (United States); University of Pittsburgh Medical School, Pittsburgh, PA 15261 (United States)

    2014-07-25

    As technology advances, the crystal volume that can be used to collect useful X-ray diffraction data decreases. The technologies available to detect and study growing crystals beyond the optical resolution limit and methods to successfully place the crystal into the X-ray beam are discussed. Structural biology has contributed tremendous knowledge to the understanding of life on the molecular scale. The Protein Data Bank, a depository of this structural knowledge, currently contains over 100 000 protein structures, with the majority stemming from X-ray crystallography. As the name might suggest, crystallography requires crystals. As detectors become more sensitive and X-ray sources more intense, the notion of a crystal is gradually changing from one large enough to embellish expensive jewellery to objects that have external dimensions of the order of the wavelength of visible light. Identifying these crystals is a prerequisite to their study. This paper discusses developments in identifying these crystals during crystallization screening and distinguishing them from other potential outcomes. The practical aspects of ensuring that once a crystal is identified it can then be positioned in the X-ray beam for data collection are also addressed.

  11. Identifying, studying and making good use of macromolecular crystals

    International Nuclear Information System (INIS)

    Calero, Guillermo; Cohen, Aina E.; Luft, Joseph R.; Newman, Janet; Snell, Edward H.

    2014-01-01

    As technology advances, the crystal volume that can be used to collect useful X-ray diffraction data decreases. The technologies available to detect and study growing crystals beyond the optical resolution limit and methods to successfully place the crystal into the X-ray beam are discussed. Structural biology has contributed tremendous knowledge to the understanding of life on the molecular scale. The Protein Data Bank, a depository of this structural knowledge, currently contains over 100 000 protein structures, with the majority stemming from X-ray crystallography. As the name might suggest, crystallography requires crystals. As detectors become more sensitive and X-ray sources more intense, the notion of a crystal is gradually changing from one large enough to embellish expensive jewellery to objects that have external dimensions of the order of the wavelength of visible light. Identifying these crystals is a prerequisite to their study. This paper discusses developments in identifying these crystals during crystallization screening and distinguishing them from other potential outcomes. The practical aspects of ensuring that once a crystal is identified it can then be positioned in the X-ray beam for data collection are also addressed

  12. The study on quality control of bedside CR examination

    International Nuclear Information System (INIS)

    Yang Xufeng; Luo Xiaomei; Xu Qiaolan; Wu Tengfang; Wen Xingwei

    2007-01-01

    Objective: To study the quality controll of bedside CR examination and improves the imaging quality. Methods: X-ray examination with CR system were performed on 3,300 patients. All CR cassettes were encoded. The imaging plate and cassettes were cleaned regularly. Results: With and without quality control, the percentage of first-rate film was 58.2% and 51%, the second-rate film was 40% and 45.5%, the third-rate film was 1.3% and 2%, respectively. Corxespondingly, the ratio of re-examination decreased from 1.5% to 0.5% after quality control, and imaging quality was stable. Conclusion: The quality control of bedside CR examination can improve the image quality as well as lighten the labor of radiographers. (authors)

  13. Functional examination of MLH1, MSH2, and MSH6 intronic mutations identified in Danish colorectal cancer patients.

    Science.gov (United States)

    Petersen, Sanne M; Dandanell, Mette; Rasmussen, Lene J; Gerdes, Anne-Marie; Krogh, Lotte N; Bernstein, Inge; Okkels, Henrik; Wikman, Friedrik; Nielsen, Finn C; Hansen, Thomas V O

    2013-10-03

    Germ-line mutations in the DNA mismatch repair genes MLH1, MSH2, and MSH6 predispose to the development of colorectal cancer (Lynch syndrome or hereditary nonpolyposis colorectal cancer). These mutations include disease-causing frame-shift, nonsense, and splicing mutations as well as large genomic rearrangements. However, a large number of mutations, including missense, silent, and intronic variants, are classified as variants of unknown clinical significance. Intronic MLH1, MSH2, or MSH6 variants were investigated using in silico prediction tools and mini-gene assay to asses the effect on splicing. We describe in silico and in vitro characterization of nine intronic MLH1, MSH2, or MSH6 mutations identified in Danish colorectal cancer patients, of which four mutations are novel. The analysis revealed aberrant splicing of five mutations (MLH1 c.588 + 5G > A, MLH1 c.677 + 3A > T, MLH1 c.1732-2A > T, MSH2 c.1276 + 1G > T, and MSH2 c.1662-2A > C), while four mutations had no effect on splicing compared to wild type (MLH1 c.117-34A > T, MLH1 c.1039-8 T > A, MSH2 c.2459-18delT, and MSH6 c.3439-16C > T). In conclusion, we classify five MLH1/MSH2 mutations as pathogenic, whereas four MLH1/MSH2/MSH6 mutations are classified as neutral. This study supports the notion that in silico prediction tools and mini-gene assays are important for the classification of intronic variants, and thereby crucial for the genetic counseling of patients and their family members.

  14. Identifying Primary Spontaneous Pneumothorax from Administrative Databases: A Validation Study

    Directory of Open Access Journals (Sweden)

    Eric Frechette

    2016-01-01

    Full Text Available Introduction. Primary spontaneous pneumothorax (PSP is a disorder commonly encountered in healthy young individuals. There is no differentiation between PSP and secondary pneumothorax (SP in the current version of the International Classification of Diseases (ICD-10. This complicates the conduct of epidemiological studies on the subject. Objective. To validate the accuracy of an algorithm that identifies cases of PSP from administrative databases. Methods. The charts of 150 patients who consulted the emergency room (ER with a recorded main diagnosis of pneumothorax were reviewed to define the type of pneumothorax that occurred. The corresponding hospital administrative data collected during previous hospitalizations and ER visits were processed through the proposed algorithm. The results were compared over two different age groups. Results. There were 144 cases of pneumothorax correctly coded (96%. The results obtained from the PSP algorithm demonstrated a significantly higher sensitivity (97% versus 81%, p=0.038 and positive predictive value (87% versus 46%, p<0.001 in patients under 40 years of age than in older patients. Conclusions. The proposed algorithm is adequate to identify cases of PSP from administrative databases in the age group classically associated with the disease. This makes possible its utilization in large population-based studies.

  15. A study on the re-identifiability of Dutch citizens

    OpenAIRE

    Koot, M.R.; van 't Noordende, G.; de Laat, C.; Serjantov, A.; Troncoso, C.

    2010-01-01

    This paper analyses the re-identifiability of Dutch citizens by various demographics. Our analysis is based on registry office data of 2.7 million Dutch citizens, ~16% of the total population. We provide overall statistics on re-identifiability for a range of quasi-identifiers, and present an in-depth analysis of quasi-identifiers found in two de-identified data sets. We found that 67.0% of the sampled population is unambiguously identifiable by date of birth and four-digit postal code alone,...

  16. Identifying the educational needs of menopausal women: a feasibility study.

    Science.gov (United States)

    Trudeau, Kimberlee J; Ainscough, Jessica L; Trant, Meredith; Starker, Joan; Cousineau, Tara M

    2011-01-01

    The goal of this project was to identify the educational needs of menopausal women and test the feasibility of an online self management program based on social learning theory. The four stages included 1) a needs assessment using a) focus groups with 24 women ages 40 to 55 and b) phone interviews with eight health experts; 2) the use of concept mapping methodology for quantifying qualitative data from stage 1 to identify the core programmatic concepts; 3) development of a demonstration program; and 4) a pilot study with 35 women and 9 health experts to assess knowledge gained and program satisfaction. Results show that women desire more information about normalcy of menopause and symptom management and found the program to meet a need for menopausal education otherwise perceived as unavailable. The women significantly increased their menopausal knowledge after brief exposure (t(34) = 3.64; p = .001). This project provides support for an online health education program for menopausal women and content ideas for inclusion in women's health education curriculum. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks

    DEFF Research Database (Denmark)

    Demenais, Florence; Margaritte-Jeannin, Patricia; Barnes, Kathleen C

    2018-01-01

    We examined common variation in asthma risk by conducting a meta-analysis of worldwide asthma genome-wide association studies (23,948 asthma cases, 118,538 controls) of individuals from ethnically diverse populations. We identified five new asthma loci, found two new associations at two known...

  18. Multiancestry association study identifies new asthma risk loci that colocalize with immune-cell enhancer marks

    NARCIS (Netherlands)

    Demenais, Florence; Margaritte-Jeannin, Patricia; Barnes, Kathleen C; Cookson, William O C; Altmüller, Janine; Ang, Wei; Barr, R Graham; Beaty, Terri H; Becker, Allan B; Beilby, John; Bisgaard, Hans; Bjornsdottir, Unnur Steina; Bleecker, Eugene; Bønnelykke, Klaus; Boomsma, Dorret I; Bouzigon, Emmanuelle; Brightling, Christopher E; Brossard, Myriam; Brusselle, Guy G; Burchard, Esteban; Burkart, Kristin M; Bush, Andrew; Chan-Yeung, Moira; Chung, Kian Fan; Couto Alves, Alexessander; Curtin, John A; Custovic, Adnan; Daley, Denise; de Jongste, Johan C; Del-Rio-Navarro, Blanca E; Donohue, Kathleen M; Duijts, Liesbeth; Eng, Celeste; Eriksson, Johan G; Farrall, Martin; Fedorova, Yuliya; Feenstra, Bjarke; Ferreira, Manuel A; Freidin, Maxim B; Gajdos, Zofia; Gauderman, Jim; Gehring, Ulrike; Geller, Frank; Genuneit, Jon; Gharib, Sina A; Gilliland, Frank; Granell, Raquel; Graves, Penelope E; Gudbjartsson, Daniel F; Haahtela, Tari; Heckbert, Susan R; Heederik, Dick; Heinrich, Joachim; Heliövaara, Markku; Henderson, John; Himes, Blanca E; Hirose, Hiroshi; Hirschhorn, Joel N; Hofman, Albert; Holt, Patrick; Hottenga, Jouke; Hudson, Thomas J; Hui, Jennie; Imboden, Medea; Ivanov, Vladimir; Jaddoe, Vincent W V; James, Alan; Janson, Christer; Jarvelin, Marjo-Riitta; Jarvis, Deborah; Jones, Graham; Jonsdottir, Ingileif; Jousilahti, Pekka; Kabesch, Michael; Kähönen, Mika; Kantor, David B; Karunas, Alexandra S; Khusnutdinova, Elza; Koppelman, Gerard H; Kozyrskyj, Anita L; Kreiner, Eskil; Kubo, Michiaki; Kumar, Rajesh; Kumar, Ashish; Kuokkanen, Mikko; Lahousse, Lies; Laitinen, Tarja; Laprise, Catherine; Lathrop, Mark; Lau, Susanne; Lee, Young-Ae; Lehtimäki, Terho; Letort, Sébastien; Levin, Albert M; Li, Guo; Liang, Liming; Loehr, Laura R; London, Stephanie J; Loth, Daan W; Manichaikul, Ani; Marenholz, Ingo; Martinez, Fernando J; Matheson, Melanie C; Mathias, Rasika A; Matsumoto, Kenji; Mbarek, Hamdi; McArdle, Wendy L; Melbye, Mads; Melén, Erik; Meyers, Deborah; Michel, Sven; Mohamdi, Hamida; Musk, Arthur W; Myers, Rachel A; Nieuwenhuis, Maartje A E; Noguchi, Emiko; O'Connor, George T; Ogorodova, Ludmila M; Palmer, Cameron D; Palotie, Aarno; Park, Julie E; Pennell, Craig E; Pershagen, Göran; Polonikov, Alexey; Postma, Dirkje S; Probst-Hensch, Nicole; Puzyrev, Valery P; Raby, Benjamin A; Raitakari, Olli T; Ramasamy, Adaikalavan; Rich, Stephen S; Robertson, Colin F; Romieu, Isabelle; Salam, Muhammad T; Salomaa, Veikko; Schlünssen, Vivi; Scott, Robert; Selivanova, Polina A; Sigsgaard, Torben; Simpson, Angela; Siroux, Valérie; Smith, Lewis J; Solodilova, Maria; Standl, Marie; Stefansson, Kari; Strachan, David P; Stricker, Bruno H; Takahashi, Atsushi; Thompson, Philip J; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Tiesler, Carla M T; Torgerson, Dara G; Tsunoda, Tatsuhiko; Uitterlinden, André G; van der Valk, Ralf J P; Vaysse, Amaury; Vedantam, Sailaja; von Berg, Andrea; von Mutius, Erika; Vonk, Judith M; Waage, Johannes; Wareham, Nick J; Weiss, Scott T; White, Wendy B; Wickman, Magnus; Widén, Elisabeth; Willemsen, Gonneke; Williams, L Keoki; Wouters, Inge M; Yang, James J; Zhao, Jing Hua; Moffatt, Miriam F; Ober, Carole; Nicolae, Dan L

    We examined common variation in asthma risk by conducting a meta-analysis of worldwide asthma genome-wide association studies (23,948 asthma cases, 118,538 controls) of individuals from ethnically diverse populations. We identified five new asthma loci, found two new associations at two known asthma

  19. Clinical neurological examination vs electrophysiological studies: Reflections from experiences in occupational medicine

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2015-01-01

    a diagnosis requires the identification of the responsible pathology and the involved tissues and structures. Consequently, improved diagnostic approaches are needed. This editorial discusses the potentials of using the clinical neurologic examination in patients with upper limb complaints related to work....... It is argued that a simple but systematic physical approach permits the examiner to frequently identify patterns of neurological findings that suggest nerve afflictions and their locations, and that electrophysiological studies are less likely to identify pathology. A diagnostic algorithm for the physical...... assessment is provided to assist the clinician. Failure to include representative neurological items in the physical examination may result in patients being misinterpreted, misdiagnosed and mistreated....

  20.   Information and acceptance of prenatal examinations - a qualitative study

    DEFF Research Database (Denmark)

    Fleron, Stina Lou; Dahl, Katja; Risør, Mette Bech

    by the health care system offering it. By prenatal examinations the pregnant women want to be giving the choice of future management should there be something wrong with their child. Conclusions:Participation in prenatal examinations is not based on a thorough knowledge of pros and contra of the screening tests......  Background:In 2004 The Danish National Board of Health issued new guidelines on prenatal examinations. The importance of informed decision making is strongly emphasised and any acceptance of the screenings tests offered should be based on thorough and adequate information. Objective...... and hypothesis:To explore the influence of information in the decision-making process of prenatal screenings tests offered, the relation between information, knowledge and up-take rates and reasons for accepting or declining the screenings tests offered.  Methods:The study is based on a qualitative approach...

  1. Identifying early indicators in bipolar disorder: a qualitative study.

    Science.gov (United States)

    Benti, Liliane; Manicavasagar, Vijaya; Proudfoot, Judy; Parker, Gordon

    2014-06-01

    The identification of early markers has become a focus for early intervention in bipolar disorder. Using a retrospective, qualitative methodology, the present study compares the early experiences of participants with bipolar disorder to those with unipolar depression up until their first diagnosed episode. The study focuses on differences in early home and school environments as well as putative differences in personality characteristics between the two groups. Finally we a compare and contrast prodromal symptoms in these two populations. Thirty-nine participants, 20 diagnosed with unipolar depression and 19 diagnosed with bipolar disorder, took part in the study. A semi-structured interview was developed to elicit information about participants' experiences prior to their first episode. Participants with bipolar disorder reported disruptive home environments, driven personality features, greater emotion dysregulation and adverse experiences during the school years, whereas participants with depression tended to describe more supportive home environments, and more compliant and introvert personality traits. Retrospective data collection and no corroborative evidence from other family members. No distinction was made between bipolar I and bipolar II disorder nor between melancholic and non-melancholic depression in the sample. Finally the study spanned over a 12-month period which does not allow for the possibility of diagnostic reassignment of some of the bipolar participants to the unipolar condition. These findings indicate that there may be benefits in combining both proximal and distal indicators in identifying a bipolar disorder phenotype which, in turn, may be relevant to the development of early intervention programs for young people with bipolar disorder.

  2. Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

    Science.gov (United States)

    Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

    2010-12-01

    We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  3. Parents of Youth Who Identify as Transgender: An Exploratory Study

    Science.gov (United States)

    Johnson, Danielle; Sikorski, Jonathon; Savage, Todd A.; Woitaszewski, Scott A.

    2014-01-01

    This article explores the experiences, perceptions, support systems, and coping strategies on which parents of youth who identify as transgender rely. Based on data gathered via interviews with parents of youth who identify as transgender and analyzed using the consensual qualitative research method, parental challenges and concerns about their…

  4. Genome-wide association study identifies five new schizophrenia loci.

    LENUS (Irish Health Repository)

    Ripke, Stephan

    2011-10-01

    We examined the role of common genetic variation in schizophrenia in a genome-wide association study of substantial size: a stage 1 discovery sample of 21,856 individuals of European ancestry and a stage 2 replication sample of 29,839 independent subjects. The combined stage 1 and 2 analysis yielded genome-wide significant associations with schizophrenia for seven loci, five of which are new (1p21.3, 2q32.3, 8p23.2, 8q21.3 and 10q24.32-q24.33) and two of which have been previously implicated (6p21.32-p22.1 and 18q21.2). The strongest new finding (P = 1.6 × 10(-11)) was with rs1625579 within an intron of a putative primary transcript for MIR137 (microRNA 137), a known regulator of neuronal development. Four other schizophrenia loci achieving genome-wide significance contain predicted targets of MIR137, suggesting MIR137-mediated dysregulation as a previously unknown etiologic mechanism in schizophrenia. In a joint analysis with a bipolar disorder sample (16,374 affected individuals and 14,044 controls), three loci reached genome-wide significance: CACNA1C (rs4765905, P = 7.0 × 10(-9)), ANK3 (rs10994359, P = 2.5 × 10(-8)) and the ITIH3-ITIH4 region (rs2239547, P = 7.8 × 10(-9)).

  5. Nitrogen-15 studies on identifying fertilizer excess in environmental systems

    International Nuclear Information System (INIS)

    Freyer, H.D.; Aly, A.I.M.

    1975-01-01

    The feasibility of identifying fertilizer excesses in surface and ground waters on the basis of variations in the isotope ratio of nitrogen has been studied. The isotope ratio of the commonly used ammonium and nitrate fertilizers is similar to that of atmospheric nitrogen. These ratios are shifted when fertilizers are added to the soil. In the soil, fertilizer ammonium is oxidized and the nitrate formed is reduced in the heavy isotope. The fractionation factors are calculated. This artificially added nitrate becomes mixed with natural nitrate which, in general, is enriched in the heavy isotope. Only 50% (or even less) of the nitrate formed may stem from the added fertilizer. The mixing ratios are time-dependent, and different for various types and conditions of soil. In spite of this complexity, information on this isotopic process should be obtainable, if the isotope ratios of artificial and natural nitrate, respectively, are substantially different. Surface waters, in general, show no significant correlation between nitrate content and isotope ratio due to additions of sewage waters. Some data on ground waters from agricultural areas, however, where the nitrate content apparently resulted from fertilizers, gave a negative correlation of lower isotope ratios with higher nitrate contents. An inverse correlation was found in the isotope ratios of nitrate in untouched surface waters, and they even reflect the composition of the total soil nitrogen. (author)

  6. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  7. TCGA study identifies genomic features of cervical cancer

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have identified novel genomic and molecular characteristics of cervical cancer that will aid in subclassification of the disease and may help target therapies that are most appropriate for each patient.

  8. Identifying Future Sacred Heart Administrators by Examining the Characteristics, Commonalities, and Personal Motivations of Current School Leaders

    Science.gov (United States)

    Teixeira, Julie Brill

    2012-01-01

    Since their inception, all schools of the Sacred Heart have been headed by nuns of the Religious of the Sacred Heart of Jesus [RSCJ]. As the years have passed, many RSCJ nuns have aged and retired leaving vacancies that have proven difficult to fill. In this qualitative study, the characteristics, commonalities, and personal motivations of Sacred…

  9. Drill-back studies examine fractured, heated rock

    International Nuclear Information System (INIS)

    Wollenberg, H.A.; Flexser, S.; Myer, L.R.

    1990-01-01

    To investigate the effects of heating on the mineralogical, geochemical, and mechanical properties of rock by high-level radioactive waste, cores are being examined from holes penetrating locations where electric heaters simulated the presence of a waste canister, and from holes penetration natural hydrothermal systems. Results to date indicate the localized mobility and deposition of uranium in an open fracture in heated granitic rock, the mobility of U in a breccia zone in an active hydrothermal system in tuff, and the presence of U in relatively high concentration in fracture-lining material in tuff. Mechanical -- property studies indicate that differences in compressional- and shear-wave parameters between heated and less heated rock can be attributed to differences in the density of microcracks. Emphasis has shifted from initial studies of granitic rock at Stripa, Sweden to current investigations of welded tuff at the Nevada Test Site. 7 refs., 8 figs

  10. Maintaining students’ Speaking Fluency through Exhibition Examination in Sociolinguistic Studies

    Directory of Open Access Journals (Sweden)

    Khusnul Qhotimah Yuliatuty

    2013-07-01

    Full Text Available Using exhibition for the final project in Sociolinguistic study is really interesting for Universitas Siswa Bangsa Internasional students, especially for 2011 English Department students. Exhibition becomes interesting because this is the new thing to conduct the final project for English Department students’ cohort 2011 at Universitas Siswa Bangsa Internasional. The lecturer divides the students into pairs and each pairs should master one content or topic in Sociolinguistic study.  The students will do the exhibition about the topic that they get in a pairs. The lecturer also gives the students rubric sheet to fill by the visitors. The exhibition will make the students prepare themselves well because they will face many questions about the content which will be delivered by them. Beside, this exhibition also maintains students’ fluency in speaking English because they will explain and answer the questions from visitors with English. This paper tries to focus on how exhibition examination can maintain students’ fluency in speaking English.

  11. Patient dosimetry study of a paediatric CT examination

    International Nuclear Information System (INIS)

    Hranitzky, C.; Stadtmann, H.

    2011-01-01

    Dosimetry studies are of increasing interest in diagnostic high-dose applications such as computed tomography especially for examinations of children. A routine CT scan protocol for paediatric head and neck imaging was investigated at a new multi-detector CT scanner using LiF:Mg,Cu,P thermoluminescence dosemeters (TLDs) and a 0.125 cm 3 thimble ionization chamber. Calibrations of the detectors in terms of absorbed dose to water were carried out at the Dosimetry Laboratory Seibersdorf in standard radiation fields. The dosimetry method was validated in the spiral CT X-ray field by comparing TLD and ionization chamber measurement results in cylindrical PMMA phantoms. Absorbed dose results were within stated uncertainties. An anthropomorphic phantom representing a child of about 5 years was loaded with TLD chips at various organ and tissue positions in the head and neck region as well as at some critical organ locations. Organ dose values were calculated from TLD based average absorbed dose with about 5% total uncertainty, e.g. 22 mGy (eyes), 21 mGy (thyroid), 19 mGy (brain), 3.4 mGy (thymus), and 0.03 mGy (testes). For comparison purposes an effective dose of 1.9 mSv was estimated for the investigated paediatric CT examination based on ICRP-103 age-independent tissue-weighting factors.

  12. Examining the need assessment process by identifying the need profiles of elderly care recipients in the Ten-year Long-Term Care Project (TLTCP) of Taiwan.

    Science.gov (United States)

    Liu, Li-Fan; Yao, Hui-Ping

    2014-12-01

    To deal with the increasing long-term care (LTC) needs of elderly people in Taiwan, the government launched the Ten-year Long-term Care Project (TLTCP) in 2007, and through the care management system, care plans for those in need were distributed and implemented by care managers according to the single assessment process. Based on the emphasis of linking the right need assessment to the care plan, this study aimed to explore the need profiles of LTC recipients with regard to their health indicators to serve as a validity check on the identified dependency levels and care plans in the current care management system. A model based on latent class analysis (LCA) was used for dealing with the issue of health heterogeneity. LCA provides an empirical method that examines the interrelationships among health indicators and characterizes the underlying set of mutually exclusive latent classes that account for the observed indicators. The analysis included a total of 2901 elderly care recipients in the LTC dataset from a southern city, 1 of the 5 major metropolitan areas in Taiwan. The identified dependency levels of the samples and their care plans in need assessment were compared and discussed. Four need profiles were explored in the LTC dataset. Apart from the low (LD) (32.95%) and moderate dependent groups (MD) (17.48%), there were 2 groups identified among the high-dependency levels, including the severe physical and psychological dependency (SPP) (26.37%) and the comorbidities and severe dependency (CSD) groups (23.20%), which in sum were approximately identified as high dependency (HD) by care managers in the LTC dataset. In addition, the CSD group currently costs more for their care plans on average in LTC services (NT. 277,081.15, approximately 9200 USD) than the SPP group (NT. 244,084.21) and the other groups. Need assessment is a key to success in care management in LTC. The results of this study showed the importance of focusing on multifacet indicators

  13. Sedation for pediatric neuroradiological examinations. Retrospective study of 160 cases

    International Nuclear Information System (INIS)

    Shose, Yoshiteru; Oi, Shizuo

    1995-01-01

    A retrospective study of 160 pediatric neuroradiological examinations was conducted to determine the efficacy and safety of two sedation regimens (figs. 1, 2). For CT purposes, 150 patients (fig. 3) were orally given monosodium trichlorethyl phosphate syrup (100 mg/kg, with repeat 50 mg/kg if necessary), and for cerebral angiography, 15 patients (fig. 4) were intramuscularly administered a modified D.P.T. cocktail (pentazocine, chlorpromadine, promethazine). Failure rate in the oral syrup group was 6%, and in the D.P.T. group 6.7%. Diagnostic-quality images were obtained in 99.3% and 100%, respectively, of the two groups. There were neither mortality nor significant complications (table 3). It was concluded that each method had proved acceptably safe and effective, and that measures can be taken to further decrease complications and sedation failures. (author)

  14. DIETFITS Study (Diet Intervention Examining The Factors Interacting with Treatment Success) – Study Design and Methods

    Science.gov (United States)

    Stanton, Michael; Robinson, Jennifer; Kirkpatrick, Susan; Farzinkhou, Sarah; Avery, Erin; Rigdon, Joseph; Offringa, Lisa; Trepanowski, John; Hauser, Michelle; Hartle, Jennifer; Cherin, Rise; King, Abby C.; Ioannidis, John P.A.; Desai, Manisha; Gardner, Christopher D.

    2017-01-01

    Numerous studies have attempted to identify successful dietary strategies for weight loss, and many have focused on Low-Fat vs. Low-Carbohydrate comparisons. Despite relatively small between-group differences in weight loss found in most previous studies, researchers have consistently observed relatively large between-subject differences in weight loss within any given diet group (e.g., ~25 kg weight loss to ~5 kg weight gain). The primary objective of this study was to identify predisposing individual factors at baseline that help explain differential weight loss achieved by individuals assigned to the same diet, particularly a pre-determined multi-locus genotype pattern and insulin resistance status. Secondary objectives included discovery strategies for further identifying potential genetic risk scores. Exploratory objectives included investigation of an extensive set of physiological, psychosocial, dietary, and behavioral variables as moderating and/or mediating variables and/or secondary outcomes. The target population was generally healthy, free-living adults with BMI 28-40 kg/m2 (n=600). The intervention consisted of a 12-month protocol of 22 one-hour evening instructional sessions led by registered dietitians, with ~15-20 participants/class. Key objectives of dietary instruction included focusing on maximizing the dietary quality of both Low-Fat and Low-Carbohydrate diets (i.e., Healthy Low-Fat vs. Healthy Low-Carbohydrate), and maximally differentiating the two diets from one another. Rather than seeking to determine if one dietary approach was better than the other for the general population, this study sought to examine whether greater overall weight loss success could be achieved by matching different people to different diets. Here we present the design and methods of the study. PMID:28027950

  15. DIETFITS study (diet intervention examining the factors interacting with treatment success) - Study design and methods.

    Science.gov (United States)

    Stanton, Michael V; Robinson, Jennifer L; Kirkpatrick, Susan M; Farzinkhou, Sarah; Avery, Erin C; Rigdon, Joseph; Offringa, Lisa C; Trepanowski, John F; Hauser, Michelle E; Hartle, Jennifer C; Cherin, Rise J; King, Abby C; Ioannidis, John P A; Desai, Manisha; Gardner, Christopher D

    2017-02-01

    Numerous studies have attempted to identify successful dietary strategies for weight loss, and many have focused on Low-Fat vs. Low-Carbohydrate comparisons. Despite relatively small between-group differences in weight loss found in most previous studies, researchers have consistently observed relatively large between-subject differences in weight loss within any given diet group (e.g., ~25kg weight loss to ~5kg weight gain). The primary objective of this study was to identify predisposing individual factors at baseline that help explain differential weight loss achieved by individuals assigned to the same diet, particularly a pre-determined multi-locus genotype pattern and insulin resistance status. Secondary objectives included discovery strategies for further identifying potential genetic risk scores. Exploratory objectives included investigation of an extensive set of physiological, psychosocial, dietary, and behavioral variables as moderating and/or mediating variables and/or secondary outcomes. The target population was generally healthy, free-living adults with BMI 28-40kg/m 2 (n=600). The intervention consisted of a 12-month protocol of 22 one-hour evening instructional sessions led by registered dietitians, with ~15-20 participants/class. Key objectives of dietary instruction included focusing on maximizing the dietary quality of both Low-Fat and Low-Carbohydrate diets (i.e., Healthy Low-Fat vs. Healthy Low-Carbohydrate), and maximally differentiating the two diets from one another. Rather than seeking to determine if one dietary approach was better than the other for the general population, this study sought to examine whether greater overall weight loss success could be achieved by matching different people to different diets. Here we present the design and methods of the study. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Identifying heat-related deaths by using medical examiner and vital statistics data: Surveillance analysis and descriptive epidemiology - Oklahoma, 1990-2011.

    Science.gov (United States)

    Johnson, Matthew G; Brown, Sheryll; Archer, Pam; Wendelboe, Aaron; Magzamen, Sheryl; Bradley, Kristy K

    2016-10-01

    Approximately 660 deaths occur annually in the United States associated with excess natural heat. A record heat wave in Oklahoma during 2011 generated increased interest concerning heat-related mortality among public health preparedness partners. We aimed to improve surveillance for heat-related mortality and better characterize heat-related deaths in Oklahoma during 1990-2011, and to enhance public health messaging during future heat emergencies. Heat-related deaths were identified by querying vital statistics (VS) and medical examiner (ME) data during 1990-2011. Case inclusion criteria were developed by using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and ME investigation narrative. We calculated sensitivity and predictive value positive (PVP) for heat-related mortality surveillance by using VS and ME data and performed a descriptive analysis. During the study period, 364 confirmed and probable heat-related deaths were identified when utilizing both data sets. ME reports had 87% sensitivity and 74% PVP; VS reports had 80% sensitivity and 52% PVP. Compared to Oklahoma's general population, decedents were disproportionately male (67% vs. 49%), aged ≥65 years (46% vs. 14%), and unmarried (78% vs. 47%). Higher rates of heat-related mortality were observed among Blacks. Of 95 decedents with available information, 91 (96%) did not use air conditioning. Linking ME and VS data sources together and using narrative description for case classification allows for improved case ascertainment and surveillance data quality. Males, Blacks, persons aged ≥65 years, unmarried persons, and those without air conditioning carry a disproportionate burden of the heat-related deaths in Oklahoma. Published by Elsevier Inc.

  17. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    Science.gov (United States)

    Townsend, Lori; Hofer, Amy R.; Hanick, Silvia Lin; Brunetti, Korey

    2016-01-01

    This study used the Delphi method to engage expert practitioners on the topic of threshold concepts--core ideas and processes in a discipline that students need to grasp in order to progress in their learning, but that are often unspoken or unrecognized by expert practitioners--for information literacy. A panel of experts considered two questions:…

  18. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    Directory of Open Access Journals (Sweden)

    Lori Townsend

    2016-06-01

    Full Text Available This study used the Delphi method to engage expert practitioners on the topic of threshold concepts for information literacy. A panel of experts considered two questions. First, is the threshold concept approach useful for information literacy instruction? The panel unanimously agreed that the threshold concept approach holds potential for information literacy instruction. Second, what are the threshold concepts for information literacy instruction? The panel proposed and discussed over fifty potential threshold concepts, finally settling on six information literacy threshold concepts.

  19. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    OpenAIRE

    Lori Townsend; Amy R. Hofer; Silvia Lin Hanick; Korey Brunetti

    2016-01-01

    This study used the Delphi method to engage expert practitioners on the topic of threshold concepts for information literacy. A panel of experts considered two questions. First, is the threshold concept approach useful for information literacy instruction? The panel unanimously agreed that the threshold concept approach holds potential for information literacy instruction. Second, what are the threshold concepts for information literacy instruction? The panel proposed and discussed over fift...

  20. Study on determination method of identifying irradiated chicken

    International Nuclear Information System (INIS)

    Guo Liping; Yu Xuejun; Yu Menghong; Fu Junjie; Zhang Shimin; Bao Jinsong

    2003-01-01

    The effects of gamma irradiation on the activities of aleipsis, peroxidase, perhydrol catalase and the peroxide values in chicken oil and effects of different storage time on self-oxidation of fat and lipa in irradiated chicken were studied. The results showed that the activities of aleipsis and perhydrol catalase in irradiated chicken decreased with increasing doses, and the peroxide activity and peroxide value of lipa increased with increase of doses. No significant effect of storage time on peroxide value was observed in the irradiated chicken

  1. Learning and Study Strategies Inventory subtests and factors as predictors of National Board of Chiropractic Examiners Part 1 examination performance.

    Science.gov (United States)

    Schutz, Christine M; Dalton, Leanne; Tepe, Rodger E

    2013-01-01

    This study was designed to extend research on the relationship between chiropractic students' learning and study strategies and national board examination performance. Sixty-nine first trimester chiropractic students self-administered the Learning and Study Strategies Inventory (LASSI). Linear trends tests (for continuous variables) and Mantel-Haenszel trend tests (for categorical variables) were utilized to determine if the 10 LASSI subtests and 3 factors predicted low, medium and high levels of National Board of Chiropractic Examiners (NBCE) Part 1 scores. Multiple regression was performed to predict overall mean NBCE examination scores using the 3 LASSI factors as predictor variables. Four LASSI subtests (Anxiety, Concentration, Selecting Main Ideas, Test Strategies) and one factor (Goal Orientation) were significantly associated with NBCE examination levels. One factor (Goal Orientation) was a significant predictor of overall mean NBCE examination performance. Learning and study strategies are predictive of NBCE Part 1 examination performance in chiropractic students. The current study found LASSI subtests Anxiety, Concentration, Selecting Main Ideas, and Test Strategies, and the Goal-Orientation factor to be significant predictors of NBCE scores. The LASSI may be useful to educators in preparing students for academic success. Further research is warranted to explore the effects of learning and study strategies training on GPA and NBCE performance.

  2. Examining Capacity and Functioning of Bicycle Coalitions: A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Melissa Bopp

    2017-11-01

    Full Text Available BackgroundBicycle coalitions represent a strong partner in creating bike-friendly communities through advocacy for physical infrastructure, encouragement for biking, or education about safety. Despite their versatility, little is known about their functioning. Therefore, the purpose of this study was to examine capacity, strengths, and weaknesses of these organizations.MethodsBicycle coalitions/advocacy groups from English-speaking countries were recruited to take part in an online survey via email invitation. The survey addressed basic information about the coalition (community demographics, location, leadership, communication strategies, coalition priorities, barriers to programming/activities, and partners.ResultsCoalitions (n = 56 from four countries completed the survey. Most coalitions operated as a non-profit (n = 44, 95.7%, 45% (n = 21 have paid staff as leaders, while 37% (n = 17 have volunteers as leaders. The following skills were represented in coalitions’ leadership: fundraising (n = 31, 53.4%, event planning (n = 31, 53.4%, urban planning (n = 26, 44%, and policy/legislation expertise (n = 26, 44.8%. Education (n = 26, 63.4% and encouragement (n = 25, 61.6% were viewed as top priorities and the safety of bicyclists (n = 21, 46.7% and advocacy for infrastructure and policy (n = 22, 48.9% is the focus of most activities. A lack of financial resources (n = 36, 81.8% and capable personnel (n = 25, 56.8% were significant barriers to offering programming in the community and that the availability of grants to address issues (n = 38, 86.4% would be the top motivator for improvements.ConclusionBike coalitions represent a critical partner in creating activity-friendly environments and understanding their capacity allows for creating skill/capacity building intervention programs, development of effective toolkits and fostering strong collaborations to address physical inactivity.

  3. Identifying service quality strengths and weaknesses using SERVQUAL: a study of dental services.

    Science.gov (United States)

    Kaldenberg, D; Becker, B W; Browne, B A; Browne, W G

    1997-01-01

    The goal of this study was to examine responses among dental patients to the most recent version of SERVQUAL, and to evaluate that instrument as a tool for measuring satisfaction in a dental practice. Items on the reliability and responsiveness dimensions produced the lowest satisfaction ratings, while improvements in providing services as promised and instilling confidence have the greatest potential for producing higher satisfaction among patients. Finally, using open-ended questions, we identified a number of patient events or experiences which caused either high or low scores on individual SERVQUAL items.

  4. Study of skin markers for magnetic resonance imaging examinations

    International Nuclear Information System (INIS)

    Takatsu, Yasuo; Umezaki, Yoshie; Miyati, Tosiaki; Yamamura, Kenichirou

    2013-01-01

    In magnetic resonance imaging (MRI), skin markers are used as a landmark in order to make plans for examinations. However, there isn't a lot of research about the material and shape of skin markers. The skin marker's essential elements are safety, good cost performance, high signal intensity for T 1 weighted image (T 1 WI) and T 2 weighted image (T 2 WI), and durable. In order to get a high signal-to-noise ratio (SNR) of T 1 WI and T 2 WI, baby oil, salad oil and olive oil were chosen, because these materials were easy to obtain and safe for the skin. The SNR of baby oil was the best. Baby oil was injected into the infusion tube, and the tube was solvent welded and cut by a heat sealer. In order to make ring shaped skin markers, both ends of the tube were stuck with adhesive tape. Three different diameters of markers were made (3, 5, 10 cmφ). Ring shaped skin markers were put on to surround the examination area, therefore, the edge of the examination area could be seen at every cross section. Using baby oil in the ring shaped infusion tube is simple, easy, and a highly useful skin marker. (author)

  5. Willingness to Study Abroad: An Examination of Kuwaiti Students

    Science.gov (United States)

    Hackney, Kaylee; Boggs, David; Kathawala, Yunus; Hayes, John

    2014-01-01

    International education is an increasingly important part of business programs throughout the world. This paper investigates the willingness of Kuwaiti business students to study abroad. It tests the hypotheses that student willingness to study abroad is related to a number of variables, including self-efficacy, perceived benefit of study abroad,…

  6. Examining the Reproducibility of 6 Published Studies in Public Health Services and Systems Research.

    Science.gov (United States)

    Harris, Jenine K; B Wondmeneh, Sarah; Zhao, Yiqiang; Leider, Jonathon P

    2018-02-23

    Research replication, or repeating a study de novo, is the scientific standard for building evidence and identifying spurious results. While replication is ideal, it is often expensive and time consuming. Reproducibility, or reanalysis of data to verify published findings, is one proposed minimum alternative standard. While a lack of research reproducibility has been identified as a serious and prevalent problem in biomedical research and a few other fields, little work has been done to examine the reproducibility of public health research. We examined reproducibility in 6 studies from the public health services and systems research subfield of public health research. Following the methods described in each of the 6 papers, we computed the descriptive and inferential statistics for each study. We compared our results with the original study results and examined the percentage differences in descriptive statistics and differences in effect size, significance, and precision of inferential statistics. All project work was completed in 2017. We found consistency between original and reproduced results for each paper in at least 1 of the 4 areas examined. However, we also found some inconsistency. We identified incorrect transcription of results and omitting detail about data management and analyses as the primary contributors to the inconsistencies. Increasing reproducibility, or reanalysis of data to verify published results, can improve the quality of science. Researchers, journals, employers, and funders can all play a role in improving the reproducibility of science through several strategies including publishing data and statistical code, using guidelines to write clear and complete methods sections, conducting reproducibility reviews, and incentivizing reproducible science.

  7. DIETFITS Study (Diet Intervention Examining The Factors Interacting with Treatment Success) – Study Design and Methods

    OpenAIRE

    Stanton, Michael; Robinson, Jennifer; Kirkpatrick, Susan; Farzinkhou, Sarah; Avery, Erin; Rigdon, Joseph; Offringa, Lisa; Trepanowski, John; Hauser, Michelle; Hartle, Jennifer; Cherin, Rise; King, Abby C.; Ioannidis, John P.A.; Desai, Manisha; Gardner, Christopher D.

    2016-01-01

    Numerous studies have attempted to identify successful dietary strategies for weight loss, and many have focused on Low-Fat vs. Low-Carbohydrate comparisons. Despite relatively small between-group differences in weight loss found in most previous studies, researchers have consistently observed relatively large between-subject differences in weight loss within any given diet group (e.g., ~25 kg weight loss to ~5 kg weight gain). The primary objective of this study was to identify predisposing ...

  8. Examining the Role of Orthographic Coding Ability in Elementary Students with Previously Identified Reading Disability, Speech or Language Impairment, or Comorbid Language and Learning Disabilities

    Science.gov (United States)

    Haugh, Erin Kathleen

    2017-01-01

    The purpose of this study was to examine the role orthographic coding might play in distinguishing between membership in groups of language-based disability types. The sample consisted of 36 second and third-grade subjects who were administered the PAL-II Receptive Coding and Word Choice Accuracy subtest as a measure of orthographic coding…

  9. Genome-wide association study identifies a novel canine glaucoma locus.

    Directory of Open Access Journals (Sweden)

    Saija J Ahonen

    Full Text Available Glaucoma is an optic neuropathy and one of the leading causes of blindness. Its hereditary forms are classified into primary closed-angle (PCAG, primary open-angle (POAG and primary congenital glaucoma (PCG. Although many loci have been mapped in human, only a few genes have been identified that are associated with the development of glaucoma and the genetic basis of the disease remains poorly understood. Glaucoma has also been described in many dog breeds, including Dandie Dinmont Terriers (DDT in which it is a late-onset (>7 years disease. We designed clinical and genetic studies to better define the clinical features of glaucoma in the DDT and to identify the genetic cause. Clinical diagnosis was based on ophthalmic examinations of the affected dogs and 18 additionally investigated unaffected DDTs. We collected DNA from over 400 DTTs and a genome wide association study was performed in a cohort of 23 affected and 23 controls, followed by a fine mapping, a replication study and candidate gene sequencing. The clinical study suggested that ocular abnormalities including abnormal iridocorneal angles and pectinate ligament dysplasia are common (50% and 72%, respectively in the breed and the disease resembles human PCAG. The genetic study identified a novel 9.5 Mb locus on canine chromosome 8 including the 1.6 Mb best associated region (p = 1.63 × 10(-10, OR = 32 for homozygosity. Mutation screening in five candidate genes did not reveal any causative variants. This study indicates that although ocular abnormalities are common in DDTs, the genetic risk for glaucoma is conferred by a novel locus on CFA8. The canine locus shares synteny to a region in human chromosome 14q, which harbors several loci associated with POAG and PCG. Our study reveals a new locus for canine glaucoma and ongoing molecular studies will likely help to understand the genetic etiology of the disease.

  10. Two Studies Examining Argumentation in Asynchronous Computer Mediated Communication

    Science.gov (United States)

    Joiner, Richard; Jones, Sarah; Doherty, John

    2008-01-01

    Asynchronous computer mediated communication (CMC) would seem to be an ideal medium for supporting development in student argumentation. This paper investigates this assumption through two studies. The first study compared asynchronous CMC with face-to-face discussions. The transactional and strategic level of the argumentation (i.e. measures of…

  11. The influence of students' gender on equity in Peer Physical Examination: a qualitative study.

    Science.gov (United States)

    Vnuk, Anna K; Wearn, Andy; Rees, Charlotte E

    2017-08-01

    Peer Physical Examination (PPE) is an educational tool used globally for learning early clinical skills and anatomy. In quantitative research, there are differences in students' preferences and actual participation in PPE by gender. This novel study qualitatively explores the effect that gender has on medical students' experiences of learning physical examination through PPE. We employ an interpretative approach to uncover the PPE experiences of students from a European, graduate-entry medical school. Volunteers participated in either individual or group interviews. The data were transcribed, de-identified and analysed using thematic analysis. There was evidence of gender inequity in PPE, with students describing significant imbalances in participation. Male students adopted roles that generated significant personal discomfort and led to fewer experiences as examiners. Assumptions were made by tutors and students about gender roles: male students' ready acceptance of exposure to be examined and female students' need to be protected from particular examinations. In contrast with the first assumption, male students did feel coerced or obliged to be examined. Students described their experiences of taking action to break down the gender barrier. Importantly, students reported that tutors played a role in perpetuating inequities. These findings, whilst relating to one university, have implications for all settings where PPE is used. Educators should be vigilant about gender issues and the effect that they may have on students' participation in PPE to ensure that students are not disadvantaged in their learning.

  12. Action Research of a Color-Coded, Onset-Rime Decoding Intervention: Examining the Effects with First Grade Students Identified as at Risk

    Science.gov (United States)

    Wall, Candace A.; Rafferty, Lisa A.; Camizzi, Mariya A.; Max, Caroline A.; Van Blargan, David M.

    2016-01-01

    Many students who struggle to obtain the alphabetic principle are at risk for being identified as having a reading disability and would benefit from additional explicit phonics instruction as a remedial measure. In this action research case study, the research team conducted two experiments to investigate the effects of a color-coded, onset-rime,…

  13. Animal-Assisted Literacy Instruction for Students with Identified Learning Disabilities: Examining the Effects of Incorporating a Therapy Dog into Guided Oral Reading Sessions

    Science.gov (United States)

    Treat, Wendy Abigail

    2013-01-01

    Literacy acquisition is imperative to successful academic progress and to successful participation in our society. Students with identified learning disabilities are often among those who struggle to acquire literacy skills. The following dissertation shares the results of a reading intervention study in which nine students with identified…

  14. A cross-sectional study examining factors related to critical thinking in nursing.

    Science.gov (United States)

    Lang, Gary Morris; Beach, Nick Lee; Patrician, Patricia A; Martin, Cheryl

    2013-01-01

    The purpose of this study was to examine critical thinking skills among registered nurses who work in a military hospital. Sixty-five nurses were administered the Health Sciences Reasoning Test to obtain scores in inductive reasoning, deductive reasoning, interpretation, analysis, and evaluation skills. Results showed no significant association between critical thinking skills and years of experience; however, differences were identified among racial/ethnic groups. It is hoped that findings from this study create a platform for dialogue among staff development nurses who are best situated to develop strategies that address these issues.

  15. Improving healthcare practice behaviors: an exploratory study identifying effective and ineffective behaviors in healthcare.

    Science.gov (United States)

    Van Fleet, David D; Peterson, Tim O

    2016-01-01

    The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients. The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups. The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities. The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners' instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997). With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers. The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider. Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as

  16. Genome-wide association study identifies three novel genetic markers associated with elite endurance performance

    DEFF Research Database (Denmark)

    Ahmetov, Ii; Kulemin, Na; Popov, Dv

    2015-01-01

    To investigate the association between multiple single-nucleotide polymorphisms (SNPs), aerobic performance and elite endurance athlete status in Russians. By using GWAS approach, we examined the association between 1,140,419 SNPs and relative maximal oxygen consumption rate ([Formula: see text]O2......max) in 80 international-level Russian endurance athletes (46 males and 34 females). To validate obtained results, we further performed case-control studies by comparing the frequencies of the most significant SNPs (with P endurance athletes and opposite cohorts (192...... Russian controls, 1367 European controls, and 230 Russian power athletes). Initially, six 'endurance alleles' were identified showing discrete associations with [Formula: see text]O2max both in males and females. Next, case-control studies resulted in remaining three SNPs (NFIA-AS2 rs1572312, TSHR rs...

  17. A contemporary examination of workplace learning culture: an ethnomethodology study.

    Science.gov (United States)

    Newton, Jennifer M; Henderson, Amanda; Jolly, Brian; Greaves, Judith

    2015-01-01

    Creating and maintaining a sustainable workforce is currently an international concern. Extensive literature suggest that students and staff need to be 'engaged', that is they need to interact with the health team if they are to maximise learning opportunities. Despite many studies since the 1970s into what creates a 'good' learning environment, ongoing issues continue to challenge healthcare organisations and educators. A 'good' learning environment has been an intangible element for many professions as learning is hindered by the complexity of practice and by limitations on practitioners' time available to assist and guide novices. This study sought to explore the nature of the learning interactions and experiences in clinical nursing practice that enhance a 'good' workplace learning culture for both nursing students and qualified nurses. An ethnomethodology study. A range of clinical settings in Victoria and Queensland, Australia. Students and registered nurses (n=95). Fieldwork observations were carried out on student nurses and registered nurses, followed by an individual interview with each participant. An iterative approach to analysis was undertaken; field notes of observations were reviewed, interviews transcribed verbatim and entered into NVivo10. Major themes were then extracted. Three central themes: learning by doing, navigating through communication, and 'entrustability', emerged providing insights into common practices potentially enhancing or detracting from learning in the workplace. Students' and registered nurses' learning is constrained by a myriad of interactions and embedded workplace practices, which can either enhance the individual's opportunities for learning or detract from the richness of affordances that healthcare workplace settings have to offer. Until the culture/or routine practices of the healthcare workplace are challenged, the trust and meaningful communication essential to learning in practice, will be achievable only

  18. A pilot study examining density of suppression measurement in strabismus.

    Science.gov (United States)

    Piano, Marianne; Newsham, David

    2015-01-01

    Establish whether the Sbisa bar, Bagolini filter (BF) bar, and neutral density filter (NDF) bar, used to measure density of suppression, are equivalent and possess test-retest reliability. Determine whether density of suppression is altered when measurement equipment/testing conditions are changed. Our pilot study had 10 subjects aged ≥18 years with childhood-onset strabismus, no ocular pathologies, and no binocular vision when manifest. Density of suppression upon repeated testing, with clinic lights on/off, and using a full/reduced intensity light source, was investigated. Results were analysed for test-retest reliability, equivalence, and changes with alteration of testing conditions. Test-retest reliability issues were present for the BF bar (median 6 filter change from first to final test, p = 0.021) and NDF bar (median 5 filter change from first to final test, p = 0.002). Density of suppression was unaffected by environmental illumination or fixation light intensity variations. Density of suppression measurements were higher when measured with the NDF bar (e.g. NDF bar = 1.5, medium suppression, vs BF bar = 6.5, light suppression). Test-retest reliability issues may be present for the two filter bars currently still under manufacture. Changes in testing conditions do not significantly affect test results, provided the same filter bar is used consistently for testing. Further studies in children with strabismus having active amblyopia treatment would be of benefit. Despite extensive use of these tests in the UK, this is to our knowledge the first study evaluating filter bar equivalence/reliability.

  19. Overactive pelvic floor muscles (OPFM): improving diagnostic accuracy with clinical examination and functional studies.

    Science.gov (United States)

    Aw, Hau Choong; Ranasinghe, Weranja; Tan, Philip Huang Min; O'Connell, Helen E

    2017-07-01

    To identify the functional correlation of overactive pelvic floor muscles (OPFM) with cystoscopic and fluoroscopic urodynamic studies (FUDS), including urethral pressure measurements. Patients refractory to conservative therapy including bladder retraining, medications and pelvic muscle exercises for a variety of gamut of storage and voiding disorders were evaluated. Prospective data for 201 patients across both genders who underwent flexible cystoscopy and urodynamics for lower urinary tract symptoms (LUTS) refractory to conservative management between 01 Jan 2014 and 01 Jan 2016 was collected. Factors studied included history of LUTS, voiding patterns, physical examination, cystoscopic findings and functional studies, with maximum urethral closing pressure (MUCP). A total of 201 were patients recruited. The 85 were diagnosed with OPFM based on clinical presentation and presence of pelvic floor tenderness on examination. Significant differences were noted on functional studies with FUDS and urethral pressure measurement. Subjects with pelvic floor tenderness were found to have a higher (MUCP) at 93.1 cm H2O compared to 80.6 cm H2O (P=0.015). There are distinct characteristics of OPFM on clinical examination and functional studies, in particular MUCP. In patients refractory to conservative treatments, specific urodynamics tests are useful in sub-categorising patients. When OPFM is diagnosed, the impact on patient management is significant, and targeted intervention with pelvic floor physiotherapy is central in the multimodal approach of this complex condition.

  20. Ultrastructural and histological findings on examination of skin in osteogenesis imperfecta: a novel study.

    Science.gov (United States)

    Balasubramanian, Meena; Wagner, Bart E; Peres, Luiz C; Sobey, Glenda J; Parker, Michael J; Dalton, Ann; Arundel, Paul; Bishop, Nicholas J

    2015-04-01

    Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of bone formation, resulting in low bone mass and an increased propensity for fractures. It is a variable condition with a range of clinical severities. The histological and ultrastructural findings in the skin of patients with OI have not been described in detail in the previously published literature. Although protein analysis of cultured fibroblasts has historically been used in the diagnostic work-up of OI patients, other aspects of skin examination are not routinely performed as part of the diagnostic pathway in patients with OI. The aims of this study were to perform histological and ultrastructural examination of skin biopsies in patients with OI. This was to identify common and distinguishing features in the numerous genetically distinct subtypes of OI and compare the findings with those in patients who did not present with fractures, and to enable the use of the results thus obtained to aid in the diagnostic work-up of patients with OI. As part of a larger research study set-up to identify clinical features and natural history in patients with atypical features of OI, skin biopsy and examination (histology and electron microscopy) were undertaken. Genetic analysis and ancillary investigations were also performed to identify similarities within this group and to differentiate this group from the 'normal' population. At the end of this study, we were able to demonstrate that the histological and electron microscopic findings on a skin biopsy may be an indicator of the likelihood of identifying a pathogenic mutation in type 1 collagen genes. This is because patients with specific findings on examination, such as elastic fibre area fraction (on histological analysis), collagen fibril diameter variability, deviation from the expected mean and collagen flowers (on electron microscopy), are more likely to be positive on genetic analyses. This has, in turn, provided more insight into the

  1. A STUDY OF THE REQUIRED PUBLIC ACCOUNTING PROGRAM IN PUBLIC COMPETITIVE EXAMINATIONS HELD BY CESPE

    Directory of Open Access Journals (Sweden)

    Fátima de Souza Freire

    2012-11-01

    Full Text Available With a view to standardizing the contents offered to future Accounting professionals, the Federal Accounting Council (CFC elaborated the National Proposal for Undergraduate Accountancy Program Contents. Thus, the curriculum that Higher Education Institutions (HEI adopt serves as an ally for students’ professional conquests. Stability and favorable job conditions attract many people to the dispute for a public function, with a growing Braz ilian public competitive examination market. According to the National Association for Protection and Support to Public Competitive Examinations (Anpac, between 2003 and 2009, the number of public servants in the executive power with a higher education degree in Brazil increased by 26%. The aim of this study was to confront the CFC’s suggested knowledge with the contents required during tests applied in public competitive examinations for Accountancy professionals. The intent is to identify what Public Accounting knowledge is demanded from candidates for the public career. Through a documentary research, 561 calls from public competitive examinations exclusively for Accountancy professionals were selected for the study sample. They were classified according to the proposed program contents, the test questions by the Center for Selection and Event Promotion (Cespe, between 2000 and 2009. In conclusion, the most frequent required Public Accounting areas are contents related to Public Equity and Budget. The results demonstrate that the CFC’s suggested content is in line with the knowledge required from candidates for public functions.

  2. A case study examination of structure and function in a state health department chronic disease unit.

    Science.gov (United States)

    Alongi, Jeanne

    2015-04-01

    I explored the structural and operational practices of the chronic disease prevention and control unit of a state health department and proposed a conceptual model of structure, function, and effectiveness for future study. My exploratory case study examined 7 elements of organizational structure and practice. My interviews with staff and external stakeholders of a single chronic disease unit yielded quantitative and qualitative data that I coded by perspective, process, relationship, and activity. I analyzed these for patterns and emerging themes. Chi-square analysis revealed significant correlations among collaboration with goal ambiguity, political support, and responsiveness, and evidence-based decisions with goal ambiguity and responsiveness. Although my study design did not permit conclusions about causality, my findings suggested that some elements of the model might facilitate effectiveness for chronic disease units and should be studied further. My findings might have important implications for identifying levers around which capacity can be built that may strengthen effectiveness.

  3. Examining the Use of a Visual Analytics System for Sensemaking Tasks: Case Studies with Domain Experts.

    Science.gov (United States)

    Kang, Youn-Ah; Stasko, J

    2012-12-01

    While the formal evaluation of systems in visual analytics is still relatively uncommon, particularly rare are case studies of prolonged system use by domain analysts working with their own data. Conducting case studies can be challenging, but it can be a particularly effective way to examine whether visual analytics systems are truly helping expert users to accomplish their goals. We studied the use of a visual analytics system for sensemaking tasks on documents by six analysts from a variety of domains. We describe their application of the system along with the benefits, issues, and problems that we uncovered. Findings from the studies identify features that visual analytics systems should emphasize as well as missing capabilities that should be addressed. These findings inform design implications for future systems.

  4. Upper gastrointestinal examinations: a radiographic study of clinically normal Beagle puppies

    International Nuclear Information System (INIS)

    Miyabayashi, T.; Morgan, J.P.

    1991-01-01

    A total of 24 upper gastrointestinal examinations were performed on four weanling beagle puppies over six weeks, using liquid barium (10 ml/kg body weight of 60 per cent w/v barium sulphate suspension] and barium food (8 g/kg of crushed kibble dog food and 7 ml/kg body weight of 60 per cent w/v barium sulphate suspension) as contrast media. The radiographic appearance was similar to that noted in adult dogs except for the consistent location of the pylorus on or near the midline. Duodenal pseudoulcers were seen more often with liquid barium and the caecal shadows were identified more often with the longer examination time with barium food. The stomach of the puppies appeared to have discriminatory emptying function; that is, semi-solid food was emptied from the stomach at a slower rate (210 to 450 minutes) than liquid (60 to 90 minutes). Solid meals emptied faster in puppies than in adult dogs. Dosages of 13 to 15 mg/kg body weight for the liquid barium examination and 14 g of ground kibble and 16 ml of barium sulphate suspension per m2 of body surface area for the barium food examination are suggested as more appropriate for contrast studies in puppies

  5. Identifying subgroups of obesity using the product of triglycerides and glucose: the Korea National Health and Nutrition Examination Survey, 2008-2010.

    Science.gov (United States)

    Lee, Seung-Hwan; Han, Kyungdo; Yang, Hae Kyung; Kim, Mee Kyoung; Yoon, Kun-Ho; Kwon, Hyuk-Sang; Park, Yong-Moon

    2015-02-01

    To determine whether the TyG index, a product of the levels of triglycerides and glucose, may be a valuable marker for identifying metabolically obese but normal weight (MONW) or metabolically healthy but obese (MHO) individuals. A total of 17 029 nondiabetic subjects (7185 men and 9844 women) were selected from the Korea National Health and Nutrition Examination Survey conducted in 2008-2010. Individuals with a normal body mass index (BMI) (≥18·5 and index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. The levels of the TyG index paralleled with various metabolic risk parameters. The index was significantly higher in the MONW group and lower in the MHO group when compared with the non-MONW group and the non-MHO group, respectively. The odds ratios (ORs) of being categorized into the MONW group were approximately fourfold higher in the highest vs lowest quartiles of the TyG index (3·999: 95% CI, 2·508-6·376 in men; 4·737: 95% CI, 3·418-6·565 in women) among normal weight subjects. Conversely, there was a stepwise decrease in the OR of being categorized into the MHO group across the TyG index quartiles among obese subjects. These data highlight the value of the TyG index in discriminating those subjects with higher risks of metabolic diseases. © 2014 John Wiley & Sons Ltd.

  6. Identifying county characteristics associated with resident well-being: A population based study.

    Science.gov (United States)

    Roy, Brita; Riley, Carley; Herrin, Jeph; Spatz, Erica S; Arora, Anita; Kell, Kenneth P; Welsh, John; Rula, Elizabeth Y; Krumholz, Harlan M

    2018-01-01

    Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents. We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black); social and economic (child poverty, education level [divorced); clinical care (% eligible women obtaining mammography, preventable hospital stays per 100,000, number of federally qualified health centers); and physical environment (% commuting by bicycle and by public transit). Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.

  7. Identifying county characteristics associated with resident well-being: A population based study.

    Directory of Open Access Journals (Sweden)

    Brita Roy

    Full Text Available Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being.We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents.We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black; social and economic (child poverty, education level [

  8. Post-hoc principal component analysis on a largely illiterate elderly population from North-west India to identify important elements of mini-mental state examination

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Raina

    2016-01-01

    Full Text Available Background: Mini-mental state examination (MMSE scale measures cognition using specific elements that can be isolated, defined, and subsequently measured. This study was conducted with the aim to analyze the factorial structure of MMSE in a largely, illiterate, elderly population in India and to reduce the number of variables to a few meaningful and interpretable combinations. Methodology: Principal component analysis (PCA was performed post-hoc on the data generated by a research project conducted to estimate the prevalence of dementia in four geographically defined habitations in Himachal Pradesh state of India. Results: Questions on orientation and registration account for high percentage of cumulative variance in comparison to other questions. Discussion: The PCA conducted on the data derived from a largely, illiterate population reveals that the most important components to consider for the estimation of cognitive impairment in illiterate Indian population are temporal orientation, spatial orientation, and immediate memory.

  9. Post-hoc principal component analysis on a largely illiterate elderly population from North-west India to identify important elements of mini-mental state examination.

    Science.gov (United States)

    Raina, Sunil Kumar; Chander, Vishav; Raina, Sujeet; Grover, Ashoo

    2016-01-01

    Mini-mental state examination (MMSE) scale measures cognition using specific elements that can be isolated, defined, and subsequently measured. This study was conducted with the aim to analyze the factorial structure of MMSE in a largely, illiterate, elderly population in India and to reduce the number of variables to a few meaningful and interpretable combinations. Principal component analysis (PCA) was performed post-hoc on the data generated by a research project conducted to estimate the prevalence of dementia in four geographically defined habitations in Himachal Pradesh state of India. Questions on orientation and registration account for high percentage of cumulative variance in comparison to other questions. The PCA conducted on the data derived from a largely, illiterate population reveals that the most important components to consider for the estimation of cognitive impairment in illiterate Indian population are temporal orientation, spatial orientation, and immediate memory.

  10. Identifying Opportunities for Peer Learning: An Observational Study of Medical Students on Clinical Placements.

    Science.gov (United States)

    Tai, Joanna H; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

    2017-01-01

    Phenomenon: Peer assisted learning (PAL) is frequently employed and researched in preclinical medical education. Fewer studies have examined PAL in the clinical context: These have focused mainly on the accuracy of peer assessment and potential benefits to learner communication and teamwork skills. Research has also examined the positive and negative effects of formal, structured PAL activities in the clinical setting. Given the prevalence of PAL activities during preclinical years, and the unstructured nature of clinical placements, it is likely that nonformal PAL activities are also undertaken. How PAL happens formally and informally and why students find PAL useful in this clinical setting remain poorly understood. This study aimed to describe PAL activities within the context of clinical placement learning and to explore students' perceptions of these activities. An ethnographic study was conducted to gather empirical data on engagement in clinical placement learning activities, including observations and interviews with students in their 1st clinical year, along with their supervising clinicians. Thematic analysis was used to interrogate the data. On average, students used PAL for 5.19 hours per week in a range of activities, of a total of 29.29 hours undertaking placements. PAL was recognized as a means of vicarious learning and had greater perceived value when an educator was present to guide or moderate the learning. Trust between students was seen as a requirement for PAL to be effective. Students found passive observation a barrier to PAL and were able to identify ways to adopt an active stance when observing peers interacting with patients. For example, learners reported that the expectation that they had to provide feedback to peers after task observation, resulted in them taking on a more critical gaze where they were encouraged to consider notions of good practice. Insights: Students use PAL in formal (i.e., tutorial) and nonformal (e.g., peer

  11. Validation of search filters for identifying pediatric studies in PubMed

    NARCIS (Netherlands)

    Leclercq, Edith; Leeflang, Mariska M. G.; van Dalen, Elvira C.; Kremer, Leontien C. M.

    2013-01-01

    To identify and validate PubMed search filters for retrieving studies including children and to develop a new pediatric search filter for PubMed. We developed 2 different datasets of studies to evaluate the performance of the identified pediatric search filters, expressed in terms of sensitivity,

  12. The assessment of neurovascular coupling with the Addenbrooke's Cognitive Examination: a functional transcranial Doppler ultrasonographic study.

    Science.gov (United States)

    Beishon, Lucy C; Williams, Claire A L; Panerai, Ronney B; Robinson, Thompson G; Haunton, Victoria J

    2018-03-01

    Cerebrovascular dysfunction occurs early in dementia and can be identified by transcranial Doppler ultrasonography (TCD). Few studies have examined cerebral blood flow velocity (CBFv) responses to a detailed cognitive battery. This study aimed to characterize all CBFv responses, and the effect of hemispheric dominance, to the Addenbrooke's Cognitive Examination (ACE-III) in healthy volunteers. Forty volunteers underwent continuous bilateral TCD, beat-to-beat blood pressure (MAP; Finapres), heart rate (HR; electrocardiogram), and end-tidal CO 2 (ETCO 2 ; capnography) monitoring. After a 5-min baseline period, all tasks from the ACE-III were performed in 3 sections (A: attention, fluency, memory; B: language; C: visuospatial, memory). Data are population mean normalized percentage (PM%) change from a 20-s baseline period before task initiation. Forty bilateral data sets were obtained (27 women, 37 right-hand dominant). All paradigms produced a sharp increase in CBFv in both dominant (PM% range: 3.29 to 9.70%) and nondominant (PM% range: 4.34 to 11.63%) hemispheres at task initiation, with associated increases in MAP (PM% range: 3.06 to 16.04%). ETCO 2 did not differ significantly at task initiation (PM% range: -1.1 to 2.4%, P > 0.05). HR differed significantly across A and C tasks at initiation (PM% range: -1.1 to 2.4%, P cognitively impaired population. NEW & NOTEWORTHY This study is the first to provide a normative data set of cerebral blood flow velocity (CBFv) responses to a complete cognitive assessment (Addenbrooke's Cognitive Examination, ACE-III) in a large sample ( n = 40) of healthy volunteers. All tasks produced peak and sustained increases in CBFv to different extents. The ACE-III is a feasible tool to assess neurovascular coupling with transcranial Doppler ultrasonography. These data can be used to inform the most appropriate cognitive task to elicit CBFv responses for future studies.

  13. A Pilot Study Examining the Effects of Time Constraints on Student Performance in Accounting Classes

    Science.gov (United States)

    Morris, David E., Sr.; Scott, John

    2017-01-01

    The purpose of this study was to examine the effects, if any, of time constraints on the success of accounting students completing exams. This study examined how time allowed to take exams affected the grades on examinations in three different accounting classes. Two were sophomore classes and one was a senior accounting class. This limited pilot…

  14. Secure E-Examination Systems Compared: Case Studies from Two Countries

    Directory of Open Access Journals (Sweden)

    Andrew E. Fluck

    2017-04-01

    Full Text Available Aim/Purpose: Electronic examinations have some inherent problems. Students have expressed negative opinions about electronic examinations (e-examinations due to a fear of, or unfamiliarity with, the technology of assessment, and a lack of knowledge about the methods of e-examinations. Background: Electronic examinations are now a viable alternative method of assessing student learning. They provide freedom of choice, in terms of the location of the examination, and can provide immediate feedback; students and institutions can be assured of the integrity of knowledge testing. This in turn motivates students to strive for deeper learning and better results, in a higher quality and more rigorous educational process. Methodology\t: This paper compares an e-examination system at FUT Minna Nigeria with one in Australia, at the University of Tasmania, using case study analysis. The functions supported, or inhibited, by each of the two e-examination systems, with different approaches to question types, cohort size, technology used, and security features, are compared. Contribution: The researchers’ aim is to assist stakeholders (including lecturers, invigilators, candidates, computer instructors, and server operators to identify ways of improving the process. The relative convenience for students, administrators, and lecturer/assessors and the reliability and security of the two systems are considered. Challenges in conducting e-examinations in both countries are revealed by juxtaposing the systems. The authors propose ways of developing more effective e-examination systems. Findings: The comparison of the two institutions in Nigeria and Australia shows e-examinations have been implemented for the purpose of selecting students for university courses, and for their assessment once enrolled. In Nigeria, there is widespread systemic adoption for university entrance merit selection. In Australia this has been limited to one subject in one state, rather

  15. Genome wide association study identifies KCNMA1 contributing to human obesity

    DEFF Research Database (Denmark)

    Jiao, Hong; Arner, Peter; Hoffstedt, Johan

    2011-01-01

    Recent genome-wide association (GWA) analyses have identified common single nucleotide polymorphisms (SNPs) that are associated with obesity. However, the reported genetic variation in obesity explains only a minor fraction of the total genetic variation expected to be present in the population....... Thus many genetic variants controlling obesity remain to be identified. The aim of this study was to use GWA followed by multiple stepwise validations to identify additional genes associated with obesity....

  16. The Whiteley Index-6: An Examination of Measurement Invariance Among Self-Identifying Black, Latino, and White Respondents in Primary Care.

    Science.gov (United States)

    Fergus, Thomas A; Kelley, Lance P; Griggs, Jackson O

    2018-03-01

    Brief measures that are comparable across disparate groups are particularly likely to be useful in primary care settings. Prior research has supported a six-item short form of the Whiteley Index (WI), a commonly used measure of health anxiety, among English-speaking respondents. This study examined the measurement invariance of the WI-6 among Black ( n = 183), Latino ( n = 173), and White ( n = 177) respondents seeking treatment at a U.S. community health center. Results supported a bifactor model of the WI-6 among the composite sample ( N = 533), suggesting the presence of a general factor and two domain-specific factors. Results supported the incremental validity of one of the domain-specific factors in accounting for unique variance in somatic symptom severity scores beyond the general factor. Multiple-groups confirmatory factor analysis supported the configural, metric, ands scalar invariance of the bifactor WI-6 model across the three groups of respondents. Results provide support for the measurement invariance of the WI-6 among Black, Latino, and White respondents. The potential use of the WI-6 in primary care, and broader, settings is discussed.

  17. Genome-wide Association Study Identifies Five Susceptibility Loci for Follicular Lymphoma outside the HLA Region

    NARCIS (Netherlands)

    Skibola, Christine F.; Berndt, Sonja I.; Vijai, Joseph; Conde, Lucia; Wang, Zhaoming; Yeager, Meredith; de Bakker, Paul I. W.; Birmann, Brenda M.; Vajdic, Claire M.; Foo, Jia-Nee; Bracci, Paige M.; Vermeulen, Roel C. H.; Slager, Susan L.; de Sanjose, Silvia; Wang, Sophia S.; Linet, Martha S.; Salles, Gilles; Lan, Qing; Severi, Gianluca; Hjalgrim, Henrik; Lightfoot, Tracy; Melbye, Mads; Gu, Jian; Ghesquieres, Herve; Link, Brian K.; Morton, Lindsay M.; Holly, Elizabeth A.; Smith, Alex; Tinker, Lesley F.; Teras, Lauren R.; Kricker, Anne; Becker, Nikolaus; Purdue, Mark P.; Spinelli, John J.; Zhang, Yawei; Giles, Graham G.; Vineis, Paolo; Monnereau, Alain; Bertrand, Kimberly A.; Albanes, Demetrius; Zeleniuch-Jacquotte, Anne; Gabbas, Attilio; Chung, Charles C.; Burdett, Laurie; Hutchinson, Amy; Lawrence, Charles; Montalvan, Rebecca; Liang, Liming; Huang, Jinyan; Ma, Baoshan; Liu, Jianjun; Adami, Hans-Olov; Glimelius, Bengt; Ye, Yuanqing; Nowakowski, Grzegorz S.; Dogan, Ahmet; Thompson, Carrie A.; Habermann, Thomas M.; Novak, Anne J.; Liebow, Mark; Witzig, Thomas E.; Weiner, George J.; Schenk, Maryjean; Hartge, Patricia; De Roos, Anneclaire J.; Cozen, Wendy; Zhi, Degui; Akers, Nicholas K.; Riby, Jacques; Smith, Martyn T.; Lacher, Mortimer; Villano, Danylo J.; Maria, Ann; Roman, Eve; Kane, Eleanor; Jackson, Rebecca D.; North, Kari E.; Diver, W. Ryan; Turner, Jenny; Armstrong, Bruce K.; Benavente, Yolanda; Boffetta, Paolo; Brennan, Paul; Foretova, Lenka; Maynadie, Marc; Staines, Anthony; McKay, James; Brooks-Wilson, Angela R.; Zheng, Tongzhang; Holford, Theodore R.; Chamosa, Saioa; Kaaks, Rudolph; Kelly, Rachel S.; Ohlsson, Bodil; Travis, Ruth C.; Weiderpass, Elisabete; Clave, Jacqueline; Giovannucci, Edward; Kraft, Peter; Virtamo, Jarmo; Mazza, Patrizio; Cocco, Pierluigi; Ennas, Maria Grazia; Chiu, Brian C. H.; Fraumeni, Joseph R.; Nieters, Alexandra; Offit, Kenneth; Wu, Xifeng; Cerhan, James R.; Smedby, Karin E.; Chanock, Stephen J.; Rothman, Nathaniel

    2014-01-01

    Genome-wide association studies (GWASs) of follicular lymphoma (FL) have previously identified human leukocyte antigen (HLA) gene variants. To identify additional FL susceptibility loci, we conducted a large-scale two-stage GWAS in 4,523 case subjects and 13,344 control subjects of European

  18. Review of Factor Analytic Studies Examining Symptoms of Autism Spectrum Disorders

    Science.gov (United States)

    Shuster, Jill; Perry, Adrienne; Bebko, James; Toplak, Maggie E.

    2014-01-01

    Factor analytic studies have been conducted to examine the inter-relationships and degree of overlap among symptoms in Autism Spectrum Disorder (ASD). This paper reviewed 36 factor analytic studies that have examined ASD symptoms, using 13 different instruments. Studies were grouped into three categories: Studies with all DSM-IV symptoms, studies…

  19. RADAR study: protocol for an observational cohort study to identify early warning signals on the pathways to alcohol use disorder.

    Science.gov (United States)

    Slade, Tim; Swift, Wendy; Mewton, Louise; Kypri, Kypros; Lynskey, Michael T; Butterworth, Peter; Tibbetts, Joel; McCraw, Stacey; Upton, Emily

    2017-08-21

    Harmful alcohol consumption, particularly alcohol use disorder (AUD), is a worldwide health priority, contributing substantially to global morbidity and mortality. The peak age of onset of AUD is 18-24, thus a deeper understanding of the young adult experience is vital if we are to identify modifiable risk factors and intervene early in the developmental course of this disabling disorder. Critical unanswered questions include: How soon after drinking initiation do AUD symptoms begin to emerge? Which symptoms come first? Do the symptoms unfold in a predictable pattern? In what ways do the emerging symptoms interact with individual, peer, family and environmental risk factors to impact on the transition to disorder? The proposed RADAR study will examine the prospective development of AUD symptoms over the young adulthood (18-24) years. We will capitalise on an existing cohort of 1911 community-based adolescents who were recruited at age 13 and have completed a baseline and five annual follow-up assessments as part of an observational cohort study. We will interview these adolescents every 6 months between the ages of 19 and 23 to derive monthly histories of both alcohol use and AUD symptomatology, along with a comprehensive battery of risk and protective factor scales hypothesised to predict the emergence and course of AUD. The results of this study will inform the natural history of AUD and will be used to identify specific targets for prevention and early intervention of AUD. Ethical approval has already been granted for the study (UNSW HREC 10144). We will disseminate the results of the study through published manuscripts, conferences and seminar presentations. Data used in published manuscripts will be made available through a suitable online repository (eg, Dryad-datadryad.org). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  20. A Study of Scientometric Methods to Identify Emerging Technologies via Modeling of Milestones

    Energy Technology Data Exchange (ETDEWEB)

    Abercrombie, Robert K [ORNL; Udoeyop, Akaninyene W [ORNL; Schlicher, Bob G [ORNL

    2012-01-01

    This work examines a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, patents, news archives, and online mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain we investigated.

  1. Examining the symptom of fatigue in primary care: a comparative study using electronic medical records

    Directory of Open Access Journals (Sweden)

    Kathryn Nicholson

    2015-01-01

    Full Text Available Background The symptom of fatigue is one of the top five most frequently presented health complaints in primary care, yet it remains underexplored in the Canadian primary care context.Objective The objective of this study was to examine the prevalence and impact of patients presenting with fatigue in primary care, using the only known electronic database in Canada to capture patient-reported symptoms.Methods Data were extracted from the Deliver Primary Healthcare Information (DELPHI database, an electronic medical record database located in Ontario, Canada. Patients were identified using the International Classification of Primary Care, Revised Second Edition coding system. Two groups of patients (fatigue or non-fatigue symptom were followed for one year and compared. Both descriptive and multivariable analyses were conducted.Results A total of 103 fatigue symptom patients, and 103 non-fatigue symptom patients, were identified in the DELPHI database. The period prevalence of fatigue presentation was 8.2%, with the majority of patients being female and over 60 years of age. These patients experienced numerous co-occurring morbidities, in addition to the fatigue itself. During the one year follow-up period, fatigue symptom patients had significantly higher rates of subsequent visits (IRR = 1.19, p = 0.038 and investigations (IRR = 1.68, p < 0.001, and markedly high levels of referrals following their index visit.Conclusions This research used an electronic database to examine the symptom, fatigue. Using these data, fatigue symptom patients were found to have higher rates of health care utilisation, compared to non-fatigue symptom patients.

  2. Examination of the Microbial Spectrum in the Etiology of Erythema Nodosum: A Retrospective Descriptive Study

    Directory of Open Access Journals (Sweden)

    Ozlem Ozbagcivan

    2017-01-01

    Full Text Available Even though infections are the most common cause of erythema nodosum (EN, only certain microorganisms take the great interest such as streptococci in knowledge. Our aim was to examine the frequency and type of infections in EN, to determine the characteristics of patients with an infectious etiology, and to discuss the role of these microbes in EN pathology in the context of their interactions with humans. Charts of 81 patients with EN who were seen between 2003 and 2017 were retrospectively reviewed. Identified etiological factors were classified into three groups: infectious, noninfectious, and idiopathic. While there were no significant demographic and clinical differences between the infectious and idiopathic groups, systemic symptoms (p=0.034 and the number of EN lesions (p=0.016 were significantly lower; the mean erythrocyte sedimentation rate was significantly higher (p=0.049, but the mean aspartate aminotransferase value was significantly lower in the infectious group compared to the noninfectious group (p=0.019. Besides streptococci, many other microbes, including the ones living on and inside us, were identified in the etiology of EN. There is a need for large-scale prospective studies involving control groups for a better understanding of the microbial immunopathology of EN.

  3. Exploring Management Strategies to Reduce Cheating in Written Examinations: Case Study of Midlands State University

    Science.gov (United States)

    Taderera, Ever; Nyikahadzoi, Loveness; Matamande, Wilson; Mandimika, Elinah

    2014-01-01

    This study was concerned about cheating in written examinations at Midlands State University (MSU). The study revealed that both male and female students cheat in written examination; business studies students cheat more than other faculties, and younger (lower class) students cheat more than (upper class) older students. Factors influencing…

  4. Genome-wide association study identifies genetic loci associated with iron deficiency.

    Directory of Open Access Journals (Sweden)

    Christine E McLaren

    2011-03-01

    Full Text Available The existence of multiple inherited disorders of iron metabolism in man, rodents and other vertebrates suggests genetic contributions to iron deficiency. To identify new genomic locations associated with iron deficiency, a genome-wide association study (GWAS was performed using DNA collected from white men aged≥25 y and women≥50 y in the Hemochromatosis and Iron Overload Screening (HEIRS Study with serum ferritin (SF≤12 µg/L (cases and iron replete controls (SF>100 µg/L in men, SF>50 µg/L in women. Regression analysis was used to examine the association between case-control status (336 cases, 343 controls and quantitative serum iron measures and 331,060 single nucleotide polymorphism (SNP genotypes, with replication analyses performed in a sample of 71 cases and 161 controls from a population of white male and female veterans screened at a US Veterans Affairs (VA medical center. Five SNPs identified in the GWAS met genome-wide statistical significance for association with at least one iron measure, rs2698530 on chr. 2p14; rs3811647 on chr. 3q22, a known SNP in the transferrin (TF gene region; rs1800562 on chr. 6p22, the C282Y mutation in the HFE gene; rs7787204 on chr. 7p21; and rs987710 on chr. 22q11 (GWAS observed P<1.51×10(-7 for all. An association between total iron binding capacity and SNP rs3811647 in the TF gene (GWAS observed P=7.0×10(-9, corrected P=0.012 was replicated within the VA samples (observed P=0.012. Associations with the C282Y mutation in the HFE gene also were replicated. The joint analysis of the HEIRS and VA samples revealed strong associations between rs2698530 on chr. 2p14 and iron status outcomes. These results confirm a previously-described TF polymorphism and implicate one potential new locus as a target for gene identification.

  5. Elucidating novel dysfunctional pathways in Alzheimer's disease by integrating loci identified in genetic and epigenetic studies

    Directory of Open Access Journals (Sweden)

    Adam R. Smith

    2016-06-01

    Full Text Available Alzheimer's disease is a complex neurodegenerative disorder. A large number of genome-wide association studies have been performed, which have been supplemented more recently by the first epigenome-wide association studies, leading to the identification of a number of novel loci altered in disease. Twin studies have shown monozygotic twin discordance for Alzheimer's disease (Gatz et al., 2006, leading to the conclusion that a combination of genetic and epigenetic mechanisms is likely to be involved in disease etiology (Lunnon & Mill, 2013. This review focuses on identifying overlapping pathways between published genome-wide association studies and epigenome-wide association studies, highlighting dysfunctional synaptic, lipid metabolism, plasma membrane/cytoskeleton, mitochondrial, and immune cell activation pathways. Identifying common pathways altered in genetic and epigenetic studies will aid our understanding of disease mechanisms and identify potential novel targets for pharmacological intervention.

  6. A systematic review of dyadic studies examining relationship quality in couples facing colorectal cancer together.

    Science.gov (United States)

    Kayser, Karen; Acquati, Chiara; Reese, Jennifer Barsky; Mark, Kristen; Wittmann, Daniela; Karam, Eli

    2018-01-01

    Despite the adverse effects that treatment for colorectal cancer can have on patients' quality of life and, in particular, their intimate relationships, very little research has been conducted on the psychosocial adjustment for both patients and their partners/spouses. The aim of this systematic review was to examine dyadic studies of adjustment in couples in which one partner has been diagnosed with colorectal cancer. Pub Med, PsychINFO, MEDLINE, Social Sciences Abstracts (EBSCO), and the Cochrane Library were systematically searched for studies reporting quality of life outcomes for colorectal cancer patients and their partners/spouses. Only studies that included dyads in the sample were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was used to evaluate each study. A total of 277 studies were identified, of which 9 studies met the inclusion criteria (N = 388 couples). The methodological quality of the studies was high in that they used standardized instruments validated with their samples, conducted dyadic data analyses (when appropriate), and used longitudinal designs. A synthesis of the studies revealed that (1) relationship factors (eg, support, communication, dyadic coping, and relationship satisfaction) affect adjustment to cancer; (2) cancer-related distress impacts each partner's adjustment or the relationship; and (3) gender, role (patient/caregiver), and clinical characteristics (treatment, mental health) can mediate adjustment to cancer. The quality of the relationship can influence patients' and their partners' adjustment to colorectal cancer. Psychosocial interventions that address relationship issues may be beneficial to couples facing the challenges of colorectal cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Brief Alcohol Intervention by Newly Trained Workers Versus Leaflets: Comparison of Effect in Older Heavy Drinkers Identified in a Population Health Examination Survey: A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Hansen, Anders Blædel Gottlieb; Becker, Ulrik; Nielsen, Anette Søgaard

    2011-01-01

    Aims: To test if a brief motivational intervention (BMI) in a non-treatment seeking population of heavy drinkers results in a reduced alcohol intake. Methods: Screening of 12,364 participants in a Danish health examination survey led to 1026 heavy drinkers of whom 772 were included and randomized...

  8. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    Science.gov (United States)

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  9. Breast self-examination: do religious beliefs matter? A descriptive study.

    Science.gov (United States)

    Montazeri, Ali; Haji-Mahmoodi, Mehregan; Jarvandi, Soghra

    2003-06-01

    A descriptive study was conducted in Tehran, Iran, to investigate the beliefs of Muslim women and their practices regarding screening modalities of breast cancer. A questionnaire was specially designed and validated to collect data and was completed by 410 Muslim women. A vast majority of women (90 per cent) said that breast self-examination is not against their religious beliefs. With regard to clinical breast examination, although 58 per cent preferred to be examined by a female physician, 47 per cent said that clinical breast examination by a male physician is not against their Islamic beliefs. However, only 6 per cent of respondents performed breast self-examination on a regular basis (monthly). The study findings suggest that most Muslim women do not perceive breast self-examination as being against their Islamic beliefs and that they believe clinical breast examination by a male physician does not interfere with their religious beliefs.

  10. Examination of staphylococcal stethoscope contamination in the emergency department (pilot) study (EXSSCITED pilot study).

    Science.gov (United States)

    Tang, Patrick H P; Worster, Andrew; Srigley, Jocelyn A; Main, Cheryl L

    2011-07-01

    The objective of this study was to determine the prevalence of Staphylococcus-contaminated stethoscopes belonging to emergency department (ED) staff and to identify the proportion of these that were Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA). We conducted a prospective observational cohort study of bacterial cultures from 100 ED staff members' stethoscopes at three EDs. Study participants were asked to complete a questionnaire. Fifty-four specimens grew coagulase-negative staphylococci and one grew methicillin-susceptible S. aureus. No MRSA was cultured. Only 8% of participants, all of whom were nurses, reported cleaning their stethoscope before or after each patient assessment. Alcohol-based wipes were most commonly used to clean stethoscopes. A lack of time, being too busy, and forgetfulness were the most frequently reported reasons for not cleaning the stethoscope in the ED. This study indicates that although stethoscope contamination rates in these EDs are high, the prevalence of S. aureus or MRSA on stethoscopes is low.

  11. Genome-wide association study identifies multiple risk loci for chronic lymphocytic leukemia

    OpenAIRE

    Berndt, S.I.; Skibola, C.F.; Joseph, V.; Camp, N.J.; Nieters, A.; Wang, Z.; Cozen, W.; Monnereau, A.; Wang, S.S.; Kelly, R.S.; Lan, Q.; Teras, L.R.; Chatterjee, N.; Chung, C.C.; Yeager, M.

    2013-01-01

    Genome-wide association studies (GWAS) have previously identified 13 loci associated with risk of chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL). To identify additional CLL susceptibility loci, we conducted the largest meta-analysis for CLL thus far, including four GWAS with a total of 3,100 individuals with CLL (cases) and 7,667 controls. In the meta-analysis, we identified ten independent associated SNPs in nine new loci at 10q23.31 (ACTA2 or FAS (ACTA2/FAS), P = 1.22 × 10...

  12. Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study.

    Science.gov (United States)

    Van den Heuvel, S C G H; Goossens, P J J; Terlouw, C; Van Achterberg, T; Schoonhoven, L

    2015-12-01

    Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face

  13. Basic heart examination: feasibility study of first-trimester systematic simplified fetal echocardiography.

    Science.gov (United States)

    Quarello, E; Lafouge, A; Fries, N; Salomon, L J

    2017-02-01

    First-trimester fetal cardiac screening examinations in low-risk populations should not have to meet the specifications required for high-risk populations. Our aim was to evaluate a simplified fetal echocardiographic ('basic heart') examination for early detection of severe congenital heart defects in a low-risk population. This was a first-trimester national 'flash study', performed over a 2-week period. Each observer was requested to perform simplified echocardiography without modifying the time and methods deemed necessary for the routine first-trimester ultrasound examination, in fetuses with crown-rump length between 45 and 84 mm. This basic heart assessment used targeted cross-sections of the four-chamber view (4CV) and of the three vessels and trachea (3VT) view, using color and/or directional power Doppler. All examinations were then reviewed offline and scored for quality by a qualified expert. Sixty observers performed a total of 597 first-trimester ultrasound examinations, each performing an average of 10 (range, 1-26) procedures. Examinations were conducted transabdominally (79%; 472/597), transvaginally (3%; 17/597) or both (18%; 108/597). In 8% (45/597) of cases, the fetal back was anterior, in 18% (108/597) it was on the left side, in 63% (377/597) it was posterior and in 11% (67/597) it was on the right side. It became clear during scoring by the expert that, unlike the Herman quality score for nuchal translucency measurement, it was difficult to assess the quality of these images without taking into account normality of the heart itself. Analysis of scores showed that the 4CV was obtained successfully and was deemed normal in 86% (512/597) of the patients, in 7% (41/597) it was deemed technically infeasible and in 7% (44/597) it was deemed feasible but atypical, which may have been due to the presence of an abnormality or to poor quality of the image. The 3VT view was obtained successfully and was normal in 79% (472/597) of the patients, in 13

  14. Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study.

    Science.gov (United States)

    Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso

    2014-12-01

    Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.

  15. Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

    Science.gov (United States)

    Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

    2016-01-01

    To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

  16. [Computer optical topography: a study of the repeatability of the results of human body model examination].

    Science.gov (United States)

    Sarnadskiĭ, V N

    2007-01-01

    The problem of repeatability of the results of examination of a plastic human body model is considered. The model was examined in 7 positions using an optical topograph for kyphosis diagnosis. The examination was performed under television camera monitoring. It was shown that variation of the model position in the camera view affected the repeatability of the results of topographic examination, especially if the model-to-camera distance was changed. A study of the repeatability of the results of optical topographic examination can help to increase the reliability of the topographic method, which is widely used for medical screening of children and adolescents.

  17. TMI-2 core-examination program: INEL facilities-readiness study

    International Nuclear Information System (INIS)

    McLaughlin, T.B.

    1982-09-01

    This document is a review of the Idaho National Engineering Laboratory's (INEL) remote handling facilities. Their availability and readiness to conduct examination and analyses of TMI-2 core samples was determined. Examination of these samples require that the facilities be capable of receiving commercial casks, unloading canisters from the casks, opening the canisters, handling the fuel debris and assemblies, and performing various examinations. The documentation that was necessary for the INEL to have before the receipt of the core material was identified. The core information was also required for input to these documents. The costs, schedules, and a preliminary-project plan are presented for the tasks which are identified as prerequisites to the receipt of the first core sample

  18. Validation of search filters for identifying pediatric studies in PubMed.

    Science.gov (United States)

    Leclercq, Edith; Leeflang, Mariska M G; van Dalen, Elvira C; Kremer, Leontien C M

    2013-03-01

    To identify and validate PubMed search filters for retrieving studies including children and to develop a new pediatric search filter for PubMed. We developed 2 different datasets of studies to evaluate the performance of the identified pediatric search filters, expressed in terms of sensitivity, precision, specificity, accuracy, and number needed to read (NNR). An optimal search filter will have a high sensitivity and high precision with a low NNR. In addition to the PubMed Limits: All Child: 0-18 years filter (in May 2012 renamed to PubMed Filter Child: 0-18 years), 6 search filters for identifying studies including children were identified: 3 developed by Kastner et al, 1 developed by BestBets, one by the Child Health Field, and 1 by the Cochrane Childhood Cancer Group. Three search filters (Cochrane Childhood Cancer Group, Child Health Field, and BestBets) had the highest sensitivity (99.3%, 99.5%, and 99.3%, respectively) but a lower precision (64.5%, 68.4%, and 66.6% respectively) compared with the other search filters. Two Kastner search filters had a high precision (93.0% and 93.7%, respectively) but a low sensitivity (58.5% and 44.8%, respectively). They failed to identify many pediatric studies in our datasets. The search terms responsible for false-positive results in the reference dataset were determined. With these data, we developed a new search filter for identifying studies with children in PubMed with an optimal sensitivity (99.5%) and precision (69.0%). Search filters to identify studies including children either have a low sensitivity or a low precision with a high NNR. A new pediatric search filter with a high sensitivity and a low NNR has been developed. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. A Classical Delphi Study to Identify the Barriers of Pursuing Green Information and Communication Technologies

    Science.gov (United States)

    Gotay, Jose Antonio

    2013-01-01

    This qualitative, classical Delphi study served to explore the apparent lack of corporate commitment to prioritized Green Information Communication Technologies (ICTs), which could delay the economic and social benefits for maximizing the use of natural energy resources in a weak economy. The purpose of this study was to examine the leadership…

  20. Strategies to design clinical studies to identify predictive biomarkers in cancer research.

    Science.gov (United States)

    Perez-Gracia, Jose Luis; Sanmamed, Miguel F; Bosch, Ana; Patiño-Garcia, Ana; Schalper, Kurt A; Segura, Victor; Bellmunt, Joaquim; Tabernero, Josep; Sweeney, Christopher J; Choueiri, Toni K; Martín, Miguel; Fusco, Juan Pablo; Rodriguez-Ruiz, Maria Esperanza; Calvo, Alfonso; Prior, Celia; Paz-Ares, Luis; Pio, Ruben; Gonzalez-Billalabeitia, Enrique; Gonzalez Hernandez, Alvaro; Páez, David; Piulats, Jose María; Gurpide, Alfonso; Andueza, Mapi; de Velasco, Guillermo; Pazo, Roberto; Grande, Enrique; Nicolas, Pilar; Abad-Santos, Francisco; Garcia-Donas, Jesus; Castellano, Daniel; Pajares, María J; Suarez, Cristina; Colomer, Ramon; Montuenga, Luis M; Melero, Ignacio

    2017-02-01

    The discovery of reliable biomarkers to predict efficacy and toxicity of anticancer drugs remains one of the key challenges in cancer research. Despite its relevance, no efficient study designs to identify promising candidate biomarkers have been established. This has led to the proliferation of a myriad of exploratory studies using dissimilar strategies, most of which fail to identify any promising targets and are seldom validated. The lack of a proper methodology also determines that many anti-cancer drugs are developed below their potential, due to failure to identify predictive biomarkers. While some drugs will be systematically administered to many patients who will not benefit from them, leading to unnecessary toxicities and costs, others will never reach registration due to our inability to identify the specific patient population in which they are active. Despite these drawbacks, a limited number of outstanding predictive biomarkers have been successfully identified and validated, and have changed the standard practice of oncology. In this manuscript, a multidisciplinary panel reviews how those key biomarkers were identified and, based on those experiences, proposes a methodological framework-the DESIGN guidelines-to standardize the clinical design of biomarker identification studies and to develop future research in this pivotal field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Identifying the Local Impacts of National ATE Centers on Their Host Institutions: An Exploratory Study

    Science.gov (United States)

    Henderson, Charles; Fynewever, Herb; Petcovic, Heather; Bierema, Andrea

    2012-01-01

    The purpose of this study is to identify the local impacts of national advanced technological education (ATE) centers on their host institutions. A sample of three mature, national ATE centers are chosen, with each center serving as a case for a mixed-methods, collective case study research design. Results, drawn from interviews and surveys,…

  2. A Quantitative Study Identifying Political Strategies Used by Principals of Dual Language Programs

    Science.gov (United States)

    Girard, Guadalupe

    2017-01-01

    Purpose. The purpose of this quantitative study was to identify the external and internal political strategies used by principals that allow them to successfully navigate the political environment surrounding dual language programs. Methodology. This quantitative study used descriptive research to collect, analyze, and report data that identified…

  3. A meta-study of qualitative research examining determinants of children's independent active free play.

    Science.gov (United States)

    Lee, Homan; Tamminen, Katherine A; Clark, Alexander M; Slater, Linda; Spence, John C; Holt, Nicholas L

    2015-01-24

    To produce a meta-study by completing a systematic review of qualitative research examining determinants of independent active free play in children. Following systematic electronic and manual searches and application of inclusion/exclusion criteria, 46 studies were retained and subjected to meta-method, meta-theory, and meta-data analyses, followed by a final meta-synthesis. Identified determinants of independent active free play were child characteristics (age, competence, and gender), parental restrictions (safety concerns and surveillance), neighborhood and physical environment (fewer children to play with, differences in preferences for play spaces between parents and children, accessibility and proximity, and maintenance), societal changes (reduced sense of community, good parenting ideal, changing roles of parents, privatization of playtime and play spaces), and policy issues (need to give children voice). An ecological model depicting these factors, and the relationships therein, was created. This comprehensive meta-study helps establish a knowledge base for children's independent active free play research by synthesizing a previously fragmented set of studies. Parents' perceived safety concerns are the primary barrier to children's active free play. These safety concerns are moderated by child-level factors (age, competence, gender) and broader social issues. Interventions should focus on community-level solutions that include children's perspectives. From a methods perspective, the reviewed studies used a range of data collection techniques, but methodological details were often inadequately reported. The theoretical sophistication of research in this area could be improved. To this end, the synthesis reported in this study provides a framework for guiding future research.

  4. Dynamics Of Human Motion The Case Study of an Examination Hall

    Science.gov (United States)

    Ogunjo, Samuel; Ajayi, Oluwaseyi; Fuwape, Ibiyinka; Dansu, Emmanuel

    Human behaviour is difficult to characterize and generalize due to ITS complex nature. Advances in mathematical models have enabled human systems such as love interaction, alcohol abuse, admission problem to be described using models. This study investigates one of such problems, the dynamics of human motion in an examination hall with limited computer systems such that students write their examination in batches. The examination is characterized by time (t) allocated to each students and difficulty level (dl) associated with the examination. A stochastic model based on the difficulty level of the examination was developed for the prediction of student's motion around the examination hall. A good agreement was obtained between theoretical predictions and numerical simulation. The result obtained will help in better planning of examination session to maximize available resources. Furthermore, results obtained in the research can be extended to other areas such as banking hall, customer service points where available resources will be shared amongst many users.

  5. Males Perform Better in Identifying Voices During Menstruation Than Females: A Pilot Study.

    Science.gov (United States)

    Wang, Xue; Xu, Xin; Liu, Yangyang

    2016-10-01

    The objective of the present study is to investigate gender differences in the ability to identify females' voice during menstruation. In Study 1, 55 male participants (M age = 19.6 years, SD = 1.0) were asked to listen to vocal samples from women during both ovulation and menstruation and to identify which recordings featured menstruating women. The results showed that the accuracy of men's responses (M = 56.73%, SD = 0.21) was significantly higher than 50%. In Study 2, 118 female students (M age = 19.4 years, SD = 1.6) completed the same task. The results indicated that the accuracy of women's performance was nearly 50%. These preliminary findings suggest that men are better able to identify women's voices during menstruation than women. Future work could consider several significant variables for the purpose of validating the results. © The Author(s) 2016.

  6. Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study.

    Science.gov (United States)

    Chaput, J-P; Katzmarzyk, P T; Barnes, J D; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tudor-Locke, C; Zhao, P; Tremblay, M S

    2017-12-01

    No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data. In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings. © 2016 World Obesity Federation.

  7. Normative study of theme identifiability: Instructions with and without explanation of the false memory effect.

    Science.gov (United States)

    Beato, Maria Soledad; Cadavid, Sara

    2016-12-01

    False-memory illusions have been widely studied using the Deese/Roediger-McDermott paradigm (DRM). In this paradigm, words semantically related to a single nonpresented critical word are studied. In a later memory test, critical words are often falsely recalled and recognized. The present normative study was conducted to measure the theme identifiability of 60 associative word lists in Spanish that include six words (e.g., stove, coat, blanket, scarf, chill, and bonnet) that are simultaneously associated with three critical words (e.g., HEAT, COLD, and WINTER; Beato & Díez, Psicothema, 26, 457-463, 2011). Different levels of backward associative strength were used in the construction of the DRM lists. In addition, we used two types of instructions to obtain theme identifiability. In the without-explanation condition, traditional instructions were used, requesting participants to write the theme list. In the with-explanation condition, the false-memory effect and how the lists were built were explained, and an example of a DRM list and critical words was shown. Participants then had to discover the critical words. The results showed that all lists produced theme identifiability. Moreover, some lists had a higher theme identifiability rate (e.g., 61 % for the critical words LOVE, BOYFRIEND, COUPLE) than others (e.g., 24 % for CITY, PLACE, VILLAGE). After comparing the theme identifiabilities in the different conditions, the results indicated higher theme identifiability when the false-memory effect was explained than without such an explanation. Overall, these new normative data provide a useful tool for those experiments that, for example, aim to analyze the wide differences observed in false memory with DRM lists and the role of theme identifiability.

  8. Sensitivity of the Mini-Mental State Examination, Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination III to everyday activity impairments in dementia: an exploratory study.

    Science.gov (United States)

    Giebel, Clarissa M; Challis, David

    2017-10-01

    The Mini-Mental State Examination (MMSE) is one of the most frequently used cognitive measures for dementia severity and linked to deficits in everyday functioning. Recently, the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination III (ACE-III) increasingly substitute for the MMSE. However, there are no specific cutoffs in the ACE-III for mild dementia. The objectives of this exploratory study were to assess the sensitivity of each scale to everyday functioning and to examine the cutoffs between mild and moderate dementia on the ACE-III. People with mild dementia completed the MMSE, MoCA and ACE-III, whilst informal carers completed the Revised Interview for Deteriorations in Daily Living Activities for Dementia to rate their relative's initiative and performance of instrumental activities of daily living and the Katz activities of daily living scale. Data were analysed using correlation analysis, raw score comparisons, Cohen's kappa and receiver operating characteristics analysis. Thirty-three dyads completed the measures. The ACE-III was the most sensitive tool for everyday functioning performance, whilst its language subscale was specifically related to initiation of activities. The most suitable cutoff on the ACE-III between mild and moderate dementia was 61. Findings suggest the ACE-III more efficiently identifies everyday functional impairments. Further research is required to confirm these exploratory analyses of the cutoff between mild and moderate dementia on the ACE-III. Both functional impairment and stage of dementia are needed in the diagnostic process and in the clinical assessment of people with dementia. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Physical examination of dizziness in athletes after a concussion: A descriptive study.

    Science.gov (United States)

    Reneker, Jennifer C; Cheruvu, Vinay K; Yang, Jingzhen; James, Mark A; Cook, Chad E

    2018-04-01

    Dizziness is commonly reported after concussion. With the forces experienced at the time of the injury, several anatomical locations may have been altered, causing dizziness. Describe an objective examination and the types of impairment/dysfunction implicated by the results of clinical examination tests in subjects with dizziness after a concussion. Cross-Sectional. Athletes between ages 10-23 were enrolled with a diagnosis of concussion. An examination was completed to identify areas potentially contributing to dizziness, including tests of oculomotor control, the vestibular system, neuromotor control, and musculoskeletal components of the cervical spine. Descriptive analyses were completed to define the anatomical areas/types of dysfunction identified by positive findings of the examination tests. All (n = 41; 100%) subjects had examination findings consistent with central dysfunction. Of these, 36 (97.8%) had oculomotor control deficits; 29 (70.7%) demonstrated motion sensitivity; and 6 (15%) had central vestibular deficits. Nineteen (46.3%) had peripheral dysfunction, including 18 (43.9%) with unilateral hypofunction, and 2 (4.9%) with Benign Paroxysmal Positional Vertigo. Thirty-four (82.9%) had cervical dysfunction, with 11 (26.8%) presenting with cervicogenic dizziness, and 31 (75.6%) with altered neuromotor control. Functional injury to centrally-mediated pathways, specifically oculomotor control, and afferent and efferent pathways in the cervical spine are commonly identified through clinical examination tests in individuals with a complaint of dizziness post-concussion. According to results presented here, a high majority (90%) of the participants demonstrated dizziness that appeared to be multifactorial in nature and was not attributable to one main type of dysfunction. The common pathways between the systems make it difficult to isolate only one anatomical area as a contributor to dizziness. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  11. Identifying Dieters Who Will Develop an Eating Disorder: A Prospective, Population-Based Study

    Science.gov (United States)

    Fairburn, Christopher G.; Cooper, Zafra; Doll, Helen A.; Davies, Beverley A.

    2010-01-01

    Objective The aims of the study were to identify the characteristics of the dieters most at risk of subsequently developing an eating disorder and to evaluate the feasibility of using a brief questionnaire to identify such dieters in advance. Method A general population cohort of 2,992 young women who were dieting was identified. On four occasions over the subsequent 2 years, this cohort was sent a questionnaire concerning eating habits and attitudes. Participants whose responses suggested that they had developed an eating disorder were interviewed to establish their true case status. The baseline questionnaires of those who did and did not subsequently develop an eating disorder were compared to identify features that predicted future case status. Results One hundred four of the dieters developed an eating disorder of clinical severity during the 2 years of follow-up. Their baseline questionnaire scores differed in many respects from those who had not developed an eating disorder. Items associated with developing an eating disorder were selected by using three different statistical methods. A simple case-predicting instrument based on one of five items scoring above an optimal cut point had a sensitivity of 71% and a specificity of 72% (overall efficiency of 72%). Conclusions Dieters who will develop an eating disorder within the next 2 years have distinctive features. It is feasible to identify them in advance with reasonable efficiency with a brief questionnaire. This questionnaire could be incorporated into routine health assessments, thereby identifying those at high risk. PMID:16330587

  12. Validation of de-identified record linkage to ascertain hospital admissions in a cohort study

    Directory of Open Access Journals (Sweden)

    English Dallas R

    2011-04-01

    Full Text Available Abstract Background Cohort studies can provide valuable evidence of cause and effect relationships but are subject to loss of participants over time, limiting the validity of findings. Computerised record linkage offers a passive and ongoing method of obtaining health outcomes from existing routinely collected data sources. However, the quality of record linkage is reliant upon the availability and accuracy of common identifying variables. We sought to develop and validate a method for linking a cohort study to a state-wide hospital admissions dataset with limited availability of unique identifying variables. Methods A sample of 2000 participants from a cohort study (n = 41 514 was linked to a state-wide hospitalisations dataset in Victoria, Australia using the national health insurance (Medicare number and demographic data as identifying variables. Availability of the health insurance number was limited in both datasets; therefore linkage was undertaken both with and without use of this number and agreement tested between both algorithms. Sensitivity was calculated for a sub-sample of 101 participants with a hospital admission confirmed by medical record review. Results Of the 2000 study participants, 85% were found to have a record in the hospitalisations dataset when the national health insurance number and sex were used as linkage variables and 92% when demographic details only were used. When agreement between the two methods was tested the disagreement fraction was 9%, mainly due to "false positive" links when demographic details only were used. A final algorithm that used multiple combinations of identifying variables resulted in a match proportion of 87%. Sensitivity of this final linkage was 95%. Conclusions High quality record linkage of cohort data with a hospitalisations dataset that has limited identifiers can be achieved using combinations of a national health insurance number and demographic data as identifying variables.

  13. ABCC-JNIH Adult Health Study. Report 3. 1958-1960 cycle of examinations, Hiroshima

    Energy Technology Data Exchange (ETDEWEB)

    Finch, S C; Anderson, Jr, P S

    1963-10-29

    Results of 10,368 examinations of participants in the ABCC-JNIH Adult Health Study, Hiroshima, were tabulated and discussed. About 82% of the entire sample was examined at least once during the 1958-60 cycle. Physical and laboratory findings as well as major diagnoses were considered by comparison group, age, and sex. 8 references, 7 figures, 13 tables.

  14. Examination of Student Outcomes in Play Therapy: A Qualitative Case Study Design

    Science.gov (United States)

    Dillman Taylor, Dalena L.; Blount, Ashley J.; Bloom, Zachary

    2017-01-01

    Outcome research examining the effectiveness of teaching methods in counselor education is sparse. The researchers conducted a qualitative investigation utilizing an instrumental case study to examine the influence of a constructivist-developmental format on a play therapy counseling course in a large CACREP accredited university in the…

  15. A Two-Study Examination of Work-Family Conflict, Production Deviance and Gender

    Science.gov (United States)

    Ferguson, Merideth; Carlson, Dawn; Hunter, Emily M.; Whitten, Dwayne

    2012-01-01

    Building on the spillover and crossover literatures of work-family conflict and the theoretical framework of Conservation of Resources Theory (Hobfoll, 1989) we examine the effects of conflict on production deviance. Using a two-study constructive replication and extension design, we examine how partner work-to-family conflict contributes to job…

  16. A Comparative Study Examining Academic Cohorts with Transnational Migratory Intentions towards Canada and Australia

    Science.gov (United States)

    Hopkins, John

    2016-01-01

    This research examines the issue of transnational academic mobility of academic staff, those choosing to migrate to higher education institutions in different countries as part of their career development, and performs a comparative study between the characteristics of academics examining Australia as a possible migratory destination with those…

  17. Examining the Approaches of Customer Segmentation in a Cosmetic Company: A Case Study on L'oreal Malaysia SDN BHD

    OpenAIRE

    Ong, Poh Choo

    2010-01-01

    Purpose – The purpose of this study is to examine the market segmentation approaches available and identify which segmentation approaches best suit for L’Oreal Malaysia. Design/methodology/approach – Questionnaires were distributed to 80 L’Oreal cosmetic users in Malaysia and 55 completed questionnaires were analyzed. Besides, two interviews being conducted at L’Oreal Malaysia office and the result were analyzed too. Findings – The results were as follows. First, analysis of L’Oreal cos...

  18. Comparison of screening questionnaires to identify psoriatic arthritis in a primary-care population: a cross-sectional study.

    Science.gov (United States)

    Coates, L C; Savage, L; Waxman, R; Moverley, A R; Worthington, S; Helliwell, P S

    2016-09-01

    Many questionnaires are available for assessment of psoriatic arthritis (PsA), but there is little evidence comparing them. To test the proposed CONTEST questionnaire, which was developed to identify patients with psoriasis who have undiagnosed PsA, and compare it with the validated Psoriasis Epidemiology Screening Tool (PEST) questionnaire in a primary-care setting. A random sample of adult patients with psoriasis and no diagnosis of arthritis was identified from five general practice surgeries in Yorkshire, U.K. Consenting patients completed both questionnaires and were assessed by a dermatologist and rheumatologist. Diagnosis of PsA was made by the assessing rheumatologist. Receiver operator characteristic (ROC) curve analysis examined the sensitivity and specificity of potential cut points. In total 932 packs were sent to recruit 191 (20·5%) participants. Of these, 169 (88·5%) were confirmed to have current or previous psoriasis. Using physician diagnosis 17 (10·1%) were found to have previously undiagnosed PsA, while 90 (53·3%) had another musculoskeletal complaint and 62 (36·7%) had no musculoskeletal problems. Using ROC curve analysis, all of the questionnaires showed a significant ability to identify PsA. The area under the curve (AUC) for the CONTEST questionnaires was slightly higher than that of PEST (0·69 and 0·70 vs. 0·65), but there was no significant difference identified. Examining the sensitivities and specificities for the different cut points suggested that a PEST score ≥ 2 would perform better in this dataset, and the optimal scores for CONTEST and CONTEST plus joint manikin were 3 and 4, respectively. The accuracy of the questionnaires to identify PsA appeared similar, with a slightly higher AUC for the CONTEST questionnaires. The optimal cut points in this study appeared lower than in previous studies. © 2016 British Association of Dermatologists.

  19. A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

    Science.gov (United States)

    Wylie, C E; Newton, J R

    2018-05-01

    Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

  20. Seven prostate cancer susceptibility loci identified by a multi-stage genome-wide association study

    DEFF Research Database (Denmark)

    Kote-Jarai, Zsofia; Olama, Ali Amin Al; Giles, Graham G

    2011-01-01

    Prostate cancer (PrCa) is the most frequently diagnosed male cancer in developed countries. We conducted a multi-stage genome-wide association study for PrCa and previously reported the results of the first two stages, which identified 16 PrCa susceptibility loci. We report here the results of st...

  1. Genome-wide association study identifies multiple susceptibility loci for diffuse large B cell lymphoma

    NARCIS (Netherlands)

    Cerhan, James R.; Berndt, Sonja I.; Vijai, Joseph; Ghesquières, Hervé; McKay, James; Wang, Sophia S.; Wang, Zhaoming; Yeager, Meredith; Conde, Lucia; De Bakker, Paul I W; Nieters, Alexandra; Cox, David; Burdett, Laurie; Monnereau, Alain; Flowers, Christopher R.; De Roos, Anneclaire J.; Brooks-Wilson, Angela R.; Lan, Qing; Severi, Gianluca; Melbye, Mads; Gu, Jian; Jackson, Rebecca D.; Kane, Eleanor; Teras, Lauren R.; Purdue, Mark P.; Vajdic, Claire M.; Spinelli, John J.; Giles, Graham G.; Albanes, Demetrius; Kelly, Rachel S.; Zucca, Mariagrazia; Bertrand, Kimberly A.; Zeleniuch-Jacquotte, Anne; Lawrence, Charles; Hutchinson, Amy; Zhi, Degui; Habermann, Thomas M.; Link, Brian K.; Novak, Anne J.; Dogan, Ahmet; Asmann, Yan W.; Liebow, Mark; Thompson, Carrie A.; Ansell, Stephen M.; Witzig, Thomas E.; Weiner, George J.; Veron, Amelie S.; Zelenika, Diana; Tilly, Hervé; Haioun, Corinne; Molina, Thierry Jo; Hjalgrim, Henrik; Glimelius, Bengt; Adami, Hans Olov; Bracci, Paige M.; Riby, Jacques; Smith, Martyn T.; Holly, Elizabeth A.; Cozen, Wendy; Hartge, Patricia; Morton, Lindsay M.; Severson, Richard K.; Tinker, Lesley F.; North, Kari E.; Becker, Nikolaus; Benavente, Yolanda; Boffetta, Paolo; Brennan, Paul; Foretova, Lenka; Maynadie, Marc; Staines, Anthony; Lightfoot, Tracy; Crouch, Simon; Smith, Alex; Roman, Eve; Diver, W. Ryan; Offit, Kenneth; Zelenetz, Andrew; Klein, Robert J.; Villano, Danylo J.; Zheng, Tongzhang; Zhang, Yawei; Holford, Theodore R.; Kricker, Anne; Turner, Jenny; Southey, Melissa C.; Clavel, Jacqueline; Virtamo, Jarmo; Weinstein, Stephanie; Riboli, Elio; Vineis, Paolo; Kaaks, Rudolph; Trichopoulos, Dimitrios; Vermeulen, Roel C H; Boeing, Heiner; Tjonneland, Anne; Angelucci, Emanuele; Di Lollo, Simonetta; Rais, Marco; Birmann, Brenda M.; Laden, Francine; Giovannucci, Edward; Kraft, Peter; Huang, Jinyan; Ma, Baoshan; Ye, Yuanqing; Chiu, Brian C H; Sampson, Joshua; Liang, Liming; Park, Ju Hyun; Chung, Charles C.; Weisenburger, Dennis D.; Chatterjee, Nilanjan; Fraumeni, Joseph F.; Slager, Susan L.; Wu, Xifeng; De Sanjose, Silvia; Smedby, Karin E.; Salles, Gilles; Skibola, Christine F.; Rothman, Nathaniel; Chanock, Stephen J.

    2014-01-01

    Diffuse large B cell lymphoma (DLBCL) is the most common lymphoma subtype and is clinically aggressive. To identify genetic susceptibility loci for DLBCL, we conducted a meta-analysis of 3 new genome-wide association studies (GWAS) and 1 previous scan, totaling 3,857 cases and 7,666 controls of

  2. Identifying Core Mobile Learning Faculty Competencies Based Integrated Approach: A Delphi Study

    Science.gov (United States)

    Elbarbary, Rafik Said

    2015-01-01

    This study is based on the integrated approach as a concept framework to identify, categorize, and rank a key component of mobile learning core competencies for Egyptian faculty members in higher education. The field investigation framework used four rounds Delphi technique to determine the importance rate of each component of core competencies…

  3. Application of multi-locus analytical methods to identify interacting loci in case-control studies.

    NARCIS (Netherlands)

    Vermeulen, S.; Heijer, M. den; Sham, P.; Knight, J.

    2007-01-01

    To identify interacting loci in genetic epidemiological studies the application of multi-locus methods of analysis is warranted. Several more advanced classification methods have been developed in the past years, including multiple logistic regression, sum statistics, logic regression, and the

  4. Genome-wide association study identifies three novel loci for type 2 diabetes

    DEFF Research Database (Denmark)

    Hara, Kazuo; Fujita, Hayato; Johnson, Todd A

    2014-01-01

    Although over 60 loci for type 2 diabetes (T2D) have been identified, there still remains a large genetic component to be clarified. To explore unidentified loci for T2D, we performed a genome-wide association study (GWAS) of 6 209 637 single-nucleotide polymorphisms (SNPs), which were directly g...

  5. Exploration to Identify Professional Dispositions of School Librarians: A Delphi Study

    Science.gov (United States)

    Bush, Gail; Jones, Jami L.

    2010-01-01

    This article reports the findings of an exploratory study to identify professional dispositions of school librarians. The authors employed the Delphi method, a qualitative research method that emphasizes expert knowledge and consensus within a particular field. The Delphi panel consisted of members of the editorial boards of nationally recognized…

  6. A validation study of the Chinese-Cantonese Addenbrooke's Cognitive Examination Revised (C-ACER).

    Science.gov (United States)

    Wong, Ll; Chan, Cc; Leung, Jl; Yung, Cy; Wu, Kk; Cheung, Syy; Lam, Clm

    2013-01-01

    There is no valid instrument for multidomain cognitive assessment to aid the detection of mild cognitive impairment (MCI) and mild dementia in Hong Kong. This study aimed to validate the Cantonese Addenbrooke's Cognitive Examination Revised (C-ACER) in the identification of MCI and dementia. 147 participants (Dementia, n = 54; MCI, n = 50; controls, n = 43) aged 60 or above were assessed by a psychiatrist using C-ACER. The C-ACER scores were validated against the expert diagnosis according to DSM-IV criteria for dementia and Petersen criteria for MCI. Statistical analysis was performed using the receiver operating characteristic method and regression analyses. The optimal cut-off score for the C-ACER to differentiate MCI from normal controls was 79/80, giving the sensitivity of 0.74, specificity of 0.84 and area under curve (AUC) of 0.84. At the optimal cut-off of 73/74, C-ACER had satisfactory sensitivity (0.93), specificity (0.95) and AUC (0.98) to identify dementia from controls. Performance of C-ACER, as reflected by AUC, was not affected after adjustment of the effect of education level. Total C-ACER scores were significantly correlated with scores of global deterioration scale (Spearman's rho = -0.73, P cognitive abilities, and to detect MCI and dementia of different severity. It can be used and interpreted with ease, without the need to adjust for education level in persons aged 60 or above.

  7. How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Simon Steven R

    2002-01-01

    Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

  8. Using Extreme Phenotype Sampling to Identify the Rare Causal Variants of Quantitative Traits in Association Studies

    OpenAIRE

    Li, Dalin; Lewinger, Juan Pablo; Gauderman, William J.; Murcray, Cassandra Elizabeth; Conti, David

    2011-01-01

    Variants identified in recent genome-wide association studies based on the common-disease common-variant hypothesis are far from fully explaining the hereditability of complex traits. Rare variants may, in part, explain some of the missing hereditability. Here, we explored the advantage of the extreme phenotype sampling in rare-variant analysis and refined this design framework for future large-scale association studies on quantitative traits. We first proposed a power calculation approach fo...

  9. IDENTIFYING MARKETING EFFECTIVENESS METRICS (Case study: East Azerbaijan`s industrial units)

    OpenAIRE

    Faridyahyaie, Reza; Faryabi, Mohammad; Bodaghi Khajeh Noubar, Hossein

    2012-01-01

    The Paper attempts to identify marketing eff ectiveness metrics in industrial units. The metrics investigated in this study are completely applicable and comprehensive, and consequently they can evaluate marketing eff ectiveness in various industries. The metrics studied include: Market Share, Profitability, Sales Growth, Customer Numbers, Customer Satisfaction and Customer Loyalty. The findings indicate that these six metrics are impressive when measuring marketing effectiveness. Data was ge...

  10. Genome-wide association study identifies 74 loci associated with educational attainment

    OpenAIRE

    Okbay, Aysu; Beauchamp, Jonathan; Fontana, M.A. (Mark Alan); Lee, James J.; Pers, Tune; Rietveld, C.A. (Cornelius A.); Turley, Patrick; Chen, G.-B. (Guo-Bo); Emilsson, Valur; Meddens, S.F.W. (S. Fleur W.); Oskarsson, S. (Sven); Pickrell, J.K. (Joseph K.); Thom, K. (Kevin); Timshel, P. (Pascal); Vlaming, Ronald

    2016-01-01

    textabstractEducational attainment is strongly influenced by social and other environmental factors, but genetic factors are estimated to account for at least 20% of the variation across individuals. Here we report the results of a genome-wide association study (GWAS) for educational attainment that extends our earlier discovery sample of 101,069 individuals to 293,723 individuals, and a replication study in an independent sample of 111,349 individuals from the UK Biobank. We identify 74 geno...

  11. A Study Identifying Causes of Construction Waste Production and Applying Safety Management on Construction Site

    Directory of Open Access Journals (Sweden)

    Ali Asghar Najafpoor

    2014-09-01

    Full Text Available Background and purpose: In a recent century, the amount of construction waste has increased significantly. Although the building industry has a considerable role in the development of a society, it is regarded as an environmentally destructive. Source reduction is the highest goal in the waste management hierarchy and is in priority. It also has economic benefits by reducing costs associated with transportation, disposal or recycling of wastes. The present study is aimed to identify activities generating the wastes in design, transportation and storage and procurement of building materials. Materials and Methods: This was questionnaire survey. A total of 94 professionals in the construction industry were attended in this study. To determine the validity and reliability of the instrument, content validity method and Cronbach’s alpha coefficient (0.79 were used. Data were analyzed using SPSS for Windows. Frequencies, percentage, mean and standard deviation were determined in this research. Results: The results showed that handling and storage have been chosen as the most causative factor of waste production in construction activity. Improper material storage was identified major factor in producing waste in handling and storage phase. Usage of low-quality material in design stage and material price changes in procurement were recognized as major causes of waste production in these stages. Conclusion: All studied phases in this research were identified as causative factors in producing of waste. Identifying causes of construction waste production will help us decide better how to control this sort of wastes.

  12. Automated cross-identifying radio to infrared surveys using the LRPY algorithm: a case study

    Science.gov (United States)

    Weston, S. D.; Seymour, N.; Gulyaev, S.; Norris, R. P.; Banfield, J.; Vaccari, M.; Hopkins, A. M.; Franzen, T. M. O.

    2018-02-01

    Cross-identifying complex radio sources with optical or infra red (IR) counterparts in surveys such as the Australia Telescope Large Area Survey (ATLAS) has traditionally been performed manually. However, with new surveys from the Australian Square Kilometre Array Pathfinder detecting many tens of millions of radio sources, such an approach is no longer feasible. This paper presents new software (LRPY - Likelihood Ratio in PYTHON) to automate the process of cross-identifying radio sources with catalogues at other wavelengths. LRPY implements the likelihood ratio (LR) technique with a modification to account for two galaxies contributing to a sole measured radio component. We demonstrate LRPY by applying it to ATLAS DR3 and a Spitzer-based multiwavelength fusion catalogue, identifying 3848 matched sources via our LR-based selection criteria. A subset of 1987 sources have flux density values for all IRAC bands which allow us to use criteria to distinguish between active galactic nuclei (AGNs) and star-forming galaxies (SFG). We find that 936 radio sources ( ≈ 47 per cent) meet both of the Lacy and Stern AGN selection criteria. Of the matched sources, 295 have spectroscopic redshifts and we examine the radio to IR flux ratio versus redshift, proposing an AGN selection criterion below the Elvis radio-loud AGN limit for this dataset. Taking the union of all three AGNs selection criteria we identify 956 as AGNs ( ≈ 48 per cent). From this dataset, we find a decreasing fraction of AGNs with lower radio flux densities consistent with other results in the literature.

  13. Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children: a cohort study.

    Science.gov (United States)

    Moller, Sanne Pagh; Hjern, Anders; Andersen, Anne-Marie Nybo; Norredam, Marie

    2016-04-01

    Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48-0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47-0.50). Adjusting the analysis for parental income increased the HRs by 10-20 %. This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children. •Uptake of immunisation and child health examination is associated with low household income, unemployment and low educational status among the parents. •Uptake may be even lower among refugee families as they constitute a vulnerable group regarding access to healthcare. What is New: •Refugee children had lower uptake of immunisations and child health examinations compared to Danish-born children. •Several predictors of uptake were identified including region of origin and duration of residence.

  14. Prognostic model based on nailfold capillaroscopy for identifying Raynaud's phenomenon patients at high risk for the development of a scleroderma spectrum disorder: PRINCE (prognostic index for nailfold capillaroscopic examination).

    Science.gov (United States)

    Ingegnoli, Francesca; Boracchi, Patrizia; Gualtierotti, Roberta; Lubatti, Chiara; Meani, Laura; Zahalkova, Lenka; Zeni, Silvana; Fantini, Flavio

    2008-07-01

    To construct a prognostic index based on nailfold capillaroscopic examinations that is capable of predicting the 5-year transition from isolated Raynaud's phenomenon (RP) to RP secondary to scleroderma spectrum disorders (SSDs). The study involved 104 consecutive adult patients with a clinical history of isolated RP, and the index was externally validated in another cohort of 100 patients with the same characteristics. Both groups were followed up for 1-8 years. Six variables were examined because of their potential prognostic relevance (branching, enlarged and giant loops, capillary disorganization, microhemorrhages, and the number of capillaries). The only factors that played a significant prognostic role were the presence of giant loops (hazard ratio [HR] 2.64, P = 0.008) and microhemorrhages (HR 2.33, P = 0.01), and the number of capillaries (analyzed as a continuous variable). The adjusted prognostic role of these factors was evaluated by means of multivariate regression analysis, and the results were used to construct an algorithm-based prognostic index. The model was internally and externally validated. Our prognostic capillaroscopic index identifies RP patients in whom the risk of developing SSDs is high. This model is a weighted combination of different capillaroscopy parameters that allows physicians to stratify RP patients easily, using a relatively simple diagram to deduce the prognosis. Our results suggest that this index could be used in clinical practice, and its further inclusion in prospective studies will undoubtedly help in exploring its potential in predicting treatment response.

  15. Genome-wide association study identifies candidate genes for starch content regulation in maize kernels

    Directory of Open Access Journals (Sweden)

    Na Liu

    2016-07-01

    Full Text Available Kernel starch content is an important trait in maize (Zea mays L. as it accounts for 65% to 75% of the dry kernel weight and positively correlates with seed yield. A number of starch synthesis-related genes have been identified in maize in recent years. However, many loci underlying variation in starch content among maize inbred lines still remain to be identified. The current study is a genome-wide association study that used a set of 263 maize inbred lines. In this panel, the average kernel starch content was 66.99%, ranging from 60.60% to 71.58% over the three study years. These inbred lines were genotyped with the SNP50 BeadChip maize array, which is comprised of 56,110 evenly spaced, random SNPs. Population structure was controlled by a mixed linear model (MLM as implemented in the software package TASSEL. After the statistical analyses, four SNPs were identified as significantly associated with starch content (P ≤ 0.0001, among which one each are located on chromosomes 1 and 5 and two are on chromosome 2. Furthermore, 77 candidate genes associated with starch synthesis were found within the 100-kb intervals containing these four QTLs, and four highly associated genes were within 20-kb intervals of the associated SNPs. Among the four genes, Glucose-1-phosphate adenylyltransferase (APS1; Gene ID GRMZM2G163437 is known as an important regulator of kernel starch content. The identified SNPs, QTLs, and candidate genes may not only be readily used for germplasm improvement by marker-assisted selection in breeding, but can also elucidate the genetic basis of starch content. Further studies on these identified candidate genes may help determine the molecular mechanisms regulating kernel starch content in maize and other important cereal crops.

  16. Feasibility of identifying families for genetic studies of birth defects using the National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Nolan Vikki G

    2004-05-01

    Full Text Available Abstract Background The purpose of this study was to determine whether the National Health Interview Survey is a useful source to identify informative families for genetic studies of birth defects. Methods The 1994/1995 National Health Interview Survey (NHIS was used to identify households where individuals with two or more birth defects reside. Four groups of households were identified: 1 single non-familial (one individual with one birth defect; 2 single familial (more than one individual with one birth defect; 3 multiple non-familial (one individual with more than one birth defect, and 4 multiple familial (more than one individual with more than one birth defect. The March 2000 U.S. Census on households was used to estimate the total number of households in which there are individuals with birth defects. Results Of a total of 28,094 households and surveyed about birth defects and impairments, 1,083 single non-familial, 55 multiple non-familial, 54 single familial, and 8 multiple familial households were identified. Based on the 2000 U.S. census, it is estimated that there are 4,472,385 households where at least one person has one birth defect in the United States and in 234,846 of them there are at least two affected individuals. Western states had the highest prevalence rates. Conclusions Population-based methods, such as the NHIS, are modestly useful to identify the number and the regions where candidate families for genetic studies of birth defects reside. Clinic based studies and birth defects surveillance systems that collect family history offer better probability of ascertainment.

  17. A preliminary study of the mini-mental state examination in a Spanish child population.

    Science.gov (United States)

    Rubial-Alvarez, Sandra; Machado, María-Clara; Sintas, Elena; de Sola, Susana; Böhm, Peter; Peña-Casanova, Jordi

    2007-11-01

    The Mini-Mental State Examination is one of the most widely used screening tests for the adult population in daily neurologic practice. The aim of this study was to describe and to analyze the results of the Mini-Mental State Examination administered to Spanish children and to assess the relationship between Mini-Mental State Examination scores and the child's mental age/intelligence quotient. The study population included 181 children whose ages ranged between 4 and 12 years. The neuropsychologic battery consisted of the Mini-Mental State Examination and Kaufman Brief Intelligence Test. Percentiles were obtained for the Mini-Mental State Examination total score according to age ranges. Performance gradually increased from 4 to 10 years of age when a plateau in the total Mini-Mental State Examination score was reached. At the age of 6 years, results exceeded 24 on average. Pairwise mean comparisons showed statistically significant differences between the age groups (P Mini-Mental State Examination score correlated significantly with the child's chronologic (r = 0.80, P mental (r = 0.76, P Mini-Mental State Examination in a Spanish child population as well as a first step for the assessment of the usefulness of this instrument as a cognitive screening tool for children's development.

  18. Molecular docking and NMR binding studies to identify novel inhibitors of human phosphomevalonate kinase

    Energy Technology Data Exchange (ETDEWEB)

    Boonsri, Pornthip [Chemical Proteomics Facility at Marquette, Department of Chemistry, Marquette University, Milwaukee, WI 53201 (United States); Department of Chemistry, NANOTEC Center of Nanotechnology, National Nanotechnology Center, Faculty of Science, Kasetsart University, Bangkok 10900 (Thailand); Neumann, Terrence S.; Olson, Andrew L.; Cai, Sheng [Chemical Proteomics Facility at Marquette, Department of Chemistry, Marquette University, Milwaukee, WI 53201 (United States); Herdendorf, Timothy J.; Miziorko, Henry M. [Division of Molecular Biology and Biochemistry, School of Biological Sciences, University of Missouri-Kansas City, Kansas City, MO 64110 (United States); Hannongbua, Supa [Department of Chemistry, NANOTEC Center of Nanotechnology, National Nanotechnology Center, Faculty of Science, Kasetsart University, Bangkok 10900 (Thailand); Sem, Daniel S., E-mail: daniel.sem@cuw.edu [Chemical Proteomics Facility at Marquette, Department of Chemistry, Marquette University, Milwaukee, WI 53201 (United States)

    2013-01-04

    Highlights: Black-Right-Pointing-Pointer Natural and synthetic inhibitors of human phosphomevalonate kinase identified. Black-Right-Pointing-Pointer Virtual screening yielded a hit rate of 15%, with inhibitor K{sub d}'s of 10-60 {mu}M. Black-Right-Pointing-Pointer NMR studies indicate significant protein conformational changes upon binding. -- Abstract: Phosphomevalonate kinase (PMK) phosphorylates mevalonate-5-phosphate (M5P) in the mevalonate pathway, which is the sole source of isoprenoids and steroids in humans. We have identified new PMK inhibitors with virtual screening, using autodock. Promising hits were verified and their affinity measured using NMR-based {sup 1}H-{sup 15}N heteronuclear single quantum coherence (HSQC) chemical shift perturbation and fluorescence titrations. Chemical shift changes were monitored, plotted, and fitted to obtain dissociation constants (K{sub d}). Tight binding compounds with K{sub d}'s ranging from 6-60 {mu}M were identified. These compounds tended to have significant polarity and negative charge, similar to the natural substrates (M5P and ATP). HSQC cross peak changes suggest that binding induces a global conformational change, such as domain closure. Compounds identified in this study serve as chemical genetic probes of human PMK, to explore pharmacology of the mevalonate pathway, as well as starting points for further drug development.

  19. Identifying management competencies for health care executives: review of a series of Delphi studies.

    Science.gov (United States)

    Hudak, R P; Brooke, P P; Finstuen, K

    2000-01-01

    This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.

  20. Examining mortality among formerly homeless adults enrolled in Housing First: An observational study.

    Science.gov (United States)

    Henwood, Benjamin F; Byrne, Thomas; Scriber, Brynn

    2015-12-04

    Adults who experience prolonged homelessness have mortality rates 3 to 4 times that of the general population. Housing First (HF) is an evidence-based practice that effectively ends chronic homelessness, yet there has been virtually no research on premature mortality among HF enrollees. In the United States, this gap in the literature exists despite research that has suggested chronically homeless adults constitute an aging cohort, with nearly half aged 50 years old or older. This observational study examined mortality among formerly homeless adults in an HF program. We examined death rates and causes of death among HF participants and assessed the timing and predictors of death among HF participants following entry into housing. We also compared mortality rates between HF participants and (a) members of the general population and (b) individuals experiencing homelessness. We supplemented these analyses with a comparison of the causes of death and characteristics of decedents in the HF program with a sample of adults identified as homeless in the same city at the time of death through a formal review process. The majority of decedents in both groups were between the ages of 45 and 64 at their time of death; the average age at death for HF participants was 57, compared to 53 for individuals in the homeless sample. Among those in the HF group, 72% died from natural causes, compared to 49% from the homeless group. This included 21% of HF participants and 7% from the homeless group who died from cancer. Among homeless adults, 40% died from an accident, which was significantly more than the 14% of HF participants who died from an accident. HIV or other infectious diseases contributed to 13% of homeless deaths compared to only 2% of HF participants. Hypothermia contributed to 6% of homeless deaths, which was not a cause of death for HF participants. Results suggest HF participants face excess mortality in comparison to members of the general population and that mortality

  1. Examination of the Professional Self-Esteem of Teacher Candidates Studying at a Faculty of Education

    Science.gov (United States)

    Aral, Neriman; Gursoy, Figen; Ceylan, Remziye; Bicakci, Mudriye Yildiz

    2009-01-01

    This study aims to determine the professional self-esteem levels of teacher candidates studying at the Faculty of Education, Ahi Evran University, Kirsehir, Turkey, to examine whether certain variables create any differences in their professional self-esteem levels and to propose suggestions in accordance with the results. The study was conducted…

  2. Examining Intertextual Connections in Written Arguments: A Study of Student Writing as Social Participation and Response

    Science.gov (United States)

    Olsen, Allison Wynhoff; VanDerHeide, Jennifer; Goff, Brenton; Dunn, Mandie B.

    2018-01-01

    Writing studies scholarship has long understood the need for context-based studies of student writing. Few studies, however, have closely examined how students use intertextual relationships in the context of learning to compose argumentative essays. Drawing on a 17-day argumentative writing unit in a ninth-grade humanities classroom, this article…

  3. A cross-study gene set enrichment analysis identifies critical pathways in endometriosis

    Directory of Open Access Journals (Sweden)

    Bai Chunyan

    2009-09-01

    Full Text Available Abstract Background Endometriosis is an enigmatic disease. Gene expression profiling of endometriosis has been used in several studies, but few studies went further to classify subtypes of endometriosis based on expression patterns and to identify possible pathways involved in endometriosis. Some of the observed pathways are more inconsistent between the studies, and these candidate pathways presumably only represent a fraction of the pathways involved in endometriosis. Methods We applied a standardised microarray preprocessing and gene set enrichment analysis to six independent studies, and demonstrated increased concordance between these gene datasets. Results We find 16 up-regulated and 19 down-regulated pathways common in ovarian endometriosis data sets, 22 up-regulated and one down-regulated pathway common in peritoneal endometriosis data sets. Among them, 12 up-regulated and 1 down-regulated were found consistent between ovarian and peritoneal endometriosis. The main canonical pathways identified are related to immunological and inflammatory disease. Early secretory phase has the most over-represented pathways in the three uterine cycle phases. There are no overlapping significant pathways between the dataset from human endometrial endothelial cells and the datasets from ovarian endometriosis which used whole tissues. Conclusion The study of complex diseases through pathway analysis is able to highlight genes weakly connected to the phenotype which may be difficult to detect by using classical univariate statistics. By standardised microarray preprocessing and GSEA, we have increased the concordance in identifying many biological mechanisms involved in endometriosis. The identified gene pathways will shed light on the understanding of endometriosis and promote the development of novel therapies.

  4. A Systematic Approach to Identify Promising New Items for Small to Medium Enterprises: A Case Study

    Directory of Open Access Journals (Sweden)

    Sukjae Jeong

    2016-11-01

    Full Text Available Despite the growing importance of identifying new business items for small and medium enterprises (SMEs, most previous studies focus on conglomerates. The paucity of empirical studies has also led to limited real-life applications. Hence, this study proposes a systematic approach to find new business items (NBIs that help the prospective SMEs develop, evaluate, and select viable business items to survive the competitive environment. The proposed approach comprises two stages: (1 the classification of diversification of SMEs; and (2 the searching and screening of business items. In the first stage, SMEs are allocated to five groups, based on their internal technological competency and external market conditions. In the second stage, based on the types of SMEs identified in the first stage, a set of alternative business items is derived by combining the results of portfolio analysis and benchmarking analysis. After deriving new business items, a market and technology-driven matrix analysis is utilized to screen suitable business items, and the Bruce Merrifield-Ohe (BMO method is used to categorize and identify prospective items based on market attractiveness and internal capability. To illustrate the applicability of the proposed approach, a case study is presented.

  5. Identifying women with dense breasts at high risk for interval cancer: a cohort study.

    Science.gov (United States)

    Kerlikowske, Karla; Zhu, Weiwei; Tosteson, Anna N A; Sprague, Brian L; Tice, Jeffrey A; Lehman, Constance D; Miglioretti, Diana L

    2015-05-19

    Twenty-one states have laws requiring that women be notified if they have dense breasts and that they be advised to discuss supplemental imaging with their provider. To better direct discussions of supplemental imaging by determining which combinations of breast cancer risk and Breast Imaging Reporting and Data System (BI-RADS) breast density categories are associated with high interval cancer rates. Prospective cohort. Breast Cancer Surveillance Consortium (BCSC) breast imaging facilities. 365,426 women aged 40 to 74 years who had 831,455 digital screening mammography examinations. BI-RADS breast density, BCSC 5-year breast cancer risk, and interval cancer rate (invasive cancer ≤12 months after a normal mammography result) per 1000 mammography examinations. High interval cancer rate was defined as more than 1 case per 1000 examinations. High interval cancer rates were observed for women with 5-year risk of 1.67% or greater and extremely dense breasts or 5-year risk of 2.50% or greater and heterogeneously dense breasts (24% of all women with dense breasts). The interval rate of advanced-stage disease was highest (>0.4 case per 1000 examinations) among women with 5-year risk of 2.50% or greater and heterogeneously or extremely dense breasts (21% of all women with dense breasts). Five-year risk was low to average (0% to 1.66%) for 51.0% of women with heterogeneously dense breasts and 52.5% with extremely dense breasts, with interval cancer rates of 0.58 to 0.63 and 0.72 to 0.89 case per 1000 examinations, respectively. The benefit of supplemental imaging was not assessed. Breast density should not be the sole criterion for deciding whether supplemental imaging is justified because not all women with dense breasts have high interval cancer rates. BCSC 5-year risk combined with BI-RADS breast density can identify women at high risk for interval cancer to inform patient-provider discussions about alternative screening strategies. National Cancer Institute.

  6. Symptoms of major depressive disorder subsequent to child maltreatment: Examining change across multiple levels of analysis to identify transdiagnostic risk pathways.

    Science.gov (United States)

    Shenk, Chad E; Griffin, Amanda M; O'Donnell, Kieran J

    2015-11-01

    Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: neuroendocrine, autonomic, affective, and emotion regulation. Female adolescents (N = 110; age range = 14-19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed 18 months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed.

  7. Symptoms of Major Depressive Disorder Subsequent to Child Maltreatment: Examining Change across Multiple Levels of Analysis to Identify Transdiagnostic Risk Pathways

    Science.gov (United States)

    Shenk, Chad E.; Griffin, Amanda M.; O’Donnell, Kieran J.

    2016-01-01

    Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: 1) neuroendocrine, 2) autonomic, 3) affective, and 4) emotion regulation. Female adolescents (N=110; Age range: 14–19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed eighteen months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed. PMID:26535940

  8. Developing the Blueprint for a General Surgery Technical Skills Certification Examination: A Validation Study.

    Science.gov (United States)

    de Montbrun, Sandra; Louridas, Marisa; Szasz, Peter; Harris, Kenneth A; Grantcharov, Teodor P

    There is a recognized need to develop high-stakes technical skills assessments for decisions of certification and resident promotion. High-stakes examinations requires a rigorous approach in accruing validity evidence throughout the developmental process. One of the first steps in development is the creation of a blueprint which outlines the potential content of examination. The purpose of this validation study was to develop an examination blueprint for a Canadian General Surgery assessment of technical skill certifying examination. A Delphi methodology was used to gain consensus amongst Canadian General Surgery program directors as to the content (tasks or procedures) that could be included in a certifying Canadian General Surgery examination. Consensus was defined a priori as a Cronbach's α ≥ 0.70. All procedures or tasks reaching a positive consensus (defined as ≥80% of program directors rated items as ≥4 on the 5-point Likert scale) were then included in the final examination blueprint. Two Delphi rounds were needed to reach consensus. Of the 17 General Surgery Program directors across the country, 14 (82.4%) and 10 (58.8%) program directors responded to the first and second round, respectively. A total of 59 items and procedures reached positive consensus and were included in the final examination blueprint. The present study has outlined the development of an examination blueprint for a General Surgery certifying examination using a consensus-based methodology. This validation study will serve as the foundational work from which simulated model will be developed, pilot tested and evaluated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Identifying amyloid pathology?related cerebrospinal fluid biomarkers for Alzheimer's disease in a multicohort study

    OpenAIRE

    Leung, Yuk Yee; Toledo, Jon B.; Nefedov, Alexey; Polikar, Robi; Raghavan, Nandini; Xie, Sharon X.; Farnum, Michael; Schultz, Tim; Baek, Young; Van Deerlin, Vivianna M.; Hu, William T.; Holtzman, David M.; Fagan, Anne M.; Perrin, Richard J.; Grossman, Murray

    2015-01-01

    Introduction The dynamic range of cerebrospinal fluid (CSF) amyloid ? (A?1?42) measurement does not parallel to cognitive changes in Alzheimer's disease (AD) and cognitively normal (CN) subjects across different studies. Therefore, identifying novel proteins to characterize symptomatic AD samples is important. Methods Proteins were profiled using a multianalyte platform by Rules Based Medicine (MAP-RBM). Due to underlying heterogeneity and unbalanced sample size, we combined subjects (344 AD ...

  10. STUDY OF IDENTIFYING AND PRIORITIZING THE AFFECTING FACTORS ON BANK BRAND CUSTOMER LOYALTY

    OpenAIRE

    Zahra Aliyari; Yosef Beygzadeh

    2017-01-01

    Today, customer loyalty is the key to business success. By increased customers’ loyalty, market share and profitability level of enterprises will rise. Market perception along with planning and adopting appropriate strategies for making customers loyal and enhancing their rate of loyalty leads to long-term benefits for the enterprises. Given the importance of the issue, the goal of this study was to identify and prioritize the factors affecting loyalty to a banking brand from perspective of K...

  11. Automated Source Code Analysis to Identify and Remove Software Security Vulnerabilities: Case Studies on Java Programs

    OpenAIRE

    Natarajan Meghanathan

    2013-01-01

    The high-level contribution of this paper is to illustrate the development of generic solution strategies to remove software security vulnerabilities that could be identified using automated tools for source code analysis on software programs (developed in Java). We use the Source Code Analyzer and Audit Workbench automated tools, developed by HP Fortify Inc., for our testing purposes. We present case studies involving a file writer program embedded with features for password validation, and ...

  12. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

    Directory of Open Access Journals (Sweden)

    Jayne Hutchinson

    2015-05-01

    Full Text Available Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling and physical activity (92 studies or sedentary behaviors (19 studies. Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14, including organic food, locally-sourced food and plate waste and other health behaviors ((n = 20 smoking, dietary intake, alcohol. These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

  13. [On the necessity to prepare new "Rules for the organization and conduction of forensic biological examination and studies by the State Forensic Examination Boards of the Russian Federation"].

    Science.gov (United States)

    Gusarov, A A

    2010-01-01

    The author substantiates the necessity to prepare new "Rules for the organization and conduction of forensic biological examination and studies by the State Forensic Examination Boards of the Russian Federation". Their long-term absence of the reviewed document has negatively influenced the quality of work of these facilities. The structure and contents of the three previous versions of the Rules for the study of material evidence (1934, 1956, and 1996) are analysed. The structure of the new variant is designed to optimize the work of forensic medical examination bureaus and the performance of relevant studies.

  14. Pilot study on the use of data mining to identify cochlear implant candidates.

    Science.gov (United States)

    Grisel, Jedidiah J; Schafer, Erin; Lam, Anne; Griffin, Terry

    2018-05-01

    The goal of this pilot study was to determine the clinical utility of data-mining software that screens for cochlear implant (CI) candidacy. The Auditory Implant Initiative developed a software module that screens for CI candidates via integration with a software system (Noah 4) that serves as a depository for hearing test data. To identify candidates, patient audiograms from one practice were exported into the screening module. Candidates were tracked to determine if any eventually underwent implantation. After loading 4836 audiograms from the Noah 4 system, the screening module identified 558 potential CI candidates. After reviewing the data for the potential candidates, 117 were targeted and invited to an educational event. Following the event, a total of six candidates were evaluated, and two were implanted. This objective approach to identifying candidates has the potential to address the gross underutilization of CIs by removing any bias or lack of knowledge regarding the management of severe to profound sensorineural hearing loss with CIs. The screening module was an effective tool for identifying potential CI candidates at one ENT practice. On a larger scale, the screening module has the potential to impact thousands of CI candidates worldwide.

  15. Thinking ahead of the surgeon. An interview study to identify scrub nurses' non-technical skills.

    Science.gov (United States)

    Mitchell, Lucy; Flin, Rhona; Yule, Steven; Mitchell, Janet; Coutts, Kathy; Youngson, George

    2011-07-01

    Efforts to reduce adverse event rates in healthcare have revealed the importance of identifying the essential non-technical (cognitive and social) skills for safe and effective performance. Previous research on non-technical skills for operating theatre staff has concentrated on doctors rather than nursing professionals. The aim of the study was to identify the critical non-technical skills that are essential for safe and effective performance as an operating theatre scrub nurse. Experienced scrub nurses (n = 25) and consultant surgeons (n = 9) from four Scottish hospitals were interviewed using a semi-structured format. The protocols were designed to identify the main social and cognitive skills required by scrub nurses. Interviews were digitally recorded, transcribed verbatim and independently coded to extract behaviours in order to produce a list of the main non-technical skills for safe and effective scrub nurse performance. The non-technical skills of situation awareness, communication, teamwork, task management and coping with stress were identified as key to successful scrub nurse task performance. Component sets of behaviours for each of these categories were also noted. The interviews with subject matter experts from scrub nursing and surgery produced preliminary evidence that situation awareness, communication, teamwork and coping with stress are the principal non-technical skills required for effective performance as a scrub nurse. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Influenza-associated Encephalitis/Encephalopathy Identified by the Australian Childhood Encephalitis Study 2013-2015.

    Science.gov (United States)

    Britton, Philip N; Dale, Russell C; Blyth, Christopher C; Macartney, Kristine; Crawford, Nigel W; Marshall, Helen; Clark, Julia E; Elliott, Elizabeth J; Webster, Richard I; Cheng, Allen C; Booy, Robert; Jones, Cheryl A

    2017-11-01

    Influenza-associated encephalitis/encephalopathy (IAE) is an important cause of acute encephalitis syndrome in children. IAE includes a series of clinicoradiologic syndromes or acute encephalopathy syndromes that have been infrequently reported outside East Asia. We aimed to describe cases of IAE identified by the Australian Childhood Encephalitis study. Children ≤ 14 years of age with suspected encephalitis were prospectively identified in 5 hospitals in Australia. Demographic, clinical, laboratory, imaging, and outcome at discharge data were reviewed by an expert panel and cases were categorized by using predetermined case definitions. We extracted cases associated with laboratory identification of influenza virus for this analysis; among these cases, specific IAE syndromes were identified where clinical and radiologic features were consistent with descriptions in the published literature. We identified 13 cases of IAE during 3 southern hemisphere influenza seasons at 5 tertiary children's hospitals in Australia; 8 children with specific acute encephalopathy syndromes including: acute necrotizing encephalopathy, acute encephalopathy with biphasic seizures and late diffusion restriction, mild encephalopathy with reversible splenial lesion, and hemiconvulsion-hemiplegia syndrome. Use of influenza-specific antiviral therapy and prior influenza vaccination were infrequent. In contrast, death or significant neurologic morbidity occurred in 7 of the 13 children (54%). The conditions comprising IAE are heterogeneous with varied clinical features, magnetic resonance imaging changes, and outcomes. Overall, outcome of IAE is poor emphasizing the need for optimized prevention, early recognition, and empiric management.

  17. Study of problems associated with the ultrasonic examination of repeatedly repaired austenitic stainless steel welds

    International Nuclear Information System (INIS)

    Subbaratnam, R.; Palaniappan, M.; Baskaran, A.; Chandramohan, R.

    1994-01-01

    In recent years the ultrasonic examination of austenitic stainless steel weldments has gained increased importance as an NDE technique for the volumetric examination in the nuclear power plant construction and other industries. A study has been undertaken to evaluate the effects of multiple repairs on austenitic stainless steel weldments, for the successful ultrasonic examination. The test welds have been subjected to repeated welding cycles and the ultrasonic parameters including the defect characterization have been evaluated for analysis. The paper discusses the approach followed, analysis, results obtained and the recommendations based on the above. 1 fig., 2 tabs

  18. Identifying at-risk profiles and protective factors for problem gambling: A longitudinal study across adolescence and early adulthood.

    Science.gov (United States)

    Allami, Youssef; Vitaro, Frank; Brendgen, Mara; Carbonneau, René; Tremblay, Richard E

    2018-05-01

    Past studies have identified various risk and protective factors for problem gambling (PG). However, no study has examined the interplay between these factors using a combination of person-centered and variable-centered approaches embedded within a longitudinal design. The present study aimed to (a) identify distinct profiles in early adolescence based on a set of risk factors commonly associated with PG (impulsivity, depression, anxiety, drug-alcohol use, aggressiveness, and antisociality), (b) explore the difference in reported gambling problems between these profiles during midadolescence and early adulthood, and (c) identify family- and peer-related variables that could operate as protective or compensatory factors in this context. Two samples were used: (a) a population sample (N = 1,033) living in low socioeconomic-status neighborhoods and (b) a population sample (N = 3,017) representative of students attending Quebec schools. Latent profile analyses were conducted to identify at-risk profiles based on individual risk factors measured at age 12 years. Negative binomial regression models were estimated to compare profiles in terms of their reported gambling problems at ages 16 and 23. Finally, family- and peer-related variables measured at age 14 were included to test their protective or compensatory role with respect to the link between at-risk profiles and gambling problems. Four profiles were identified: well-adjusted, internalizing, externalizing, and comorbid. Compared to the well-adjusted profile, the externalizing and comorbid profiles reported more gambling problems at ages 16 and 23, but the internalizing profile did not differ significantly. Various protective and compensatory factors emerged for each profile at both time points. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. Physical Examination for Men and Women With Urologic Chronic Pelvic Pain Syndrome: A MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Network Study.

    Science.gov (United States)

    Yang, Claire C; Miller, Jane L; Omidpanah, Adam; Krieger, John N

    2018-06-01

    To examine the feasibility of implementing a standardized, clinically relevant genitourinary examination for both men and women, and to identify physical examination findings characteristic of urologic chronic pelvic pain syndrome (UCPPS). This study analyzed 2 samples: men and women with UCPPS who participated in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping (EP) Study, and age-matched controls who were either positive for chronic fatigue syndrome or healthy (pain-free). We compared physical examination findings in both positive and healthy controls with UCPPS cases: findings from both the EP examinations and from an extended genitourinary examination. EP and extended examinations were performed on 143 participants: 62 UCPPS cases (30 women, 32 men), 42 positive controls (15 women, 27 men), and 39 healthy controls (22 women, 17 men). EP examinations showed that pelvic floor tenderness was more prevalent in cases (55.0%) than in positive (14.6%) or healthy controls (10.5%). Extended examinations revealed specific areas of tenderness in the pelvic floor musculature. Cases were also more likely than healthy controls to report tenderness in multiple areas, including suprapubic, symphysis pubis, and posterior superior iliac spine, and on bimanual examination. No comparative findings were specific to biological sex, and no evidence of pudendal neuropathy was observed on extended examination of cases or controls. The extended genitourinary examination is an easily administered addition to the assessment of men and women during evaluation for UCPPS. Physical findings may help to better categorize patients with UCPPS into clinically relevant subgroups for optimal treatment. Published by Elsevier Inc.

  20. A Validation Study of the Japanese Version of the Addenbrooke's Cognitive Examination-Revised

    OpenAIRE

    dos Santos Kawata, Kelssy Hitomi; Hashimoto, Ryusaku; Nishio, Yoshiyuki; Hayashi, Atsuko; Ogawa, Nanayo; Kanno, Shigenori; Hiraoka, Kotaro; Yokoi, Kayoko; Iizuka, Osamu; Mori, Etsuro

    2012-01-01

    The aim of this study was to validate the Japanese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R) [Mori: Japanese Edition of Hodges JR’s Cognitive Assessment for Clinicians, 2010] designed to detect dementia, and to compare its diagnostic accuracy with that of the Mini-Mental State Examination. The ACE-R was administered to 85 healthy individuals and 126 patients with dementia. The reliability assessment revealed a strong correlation in both groups. The internal consistenc...

  1. Systematic reviews identify important methodological flaws in stroke rehabilitation therapy primary studies: review of reviews.

    Science.gov (United States)

    Santaguida, Pasqualina; Oremus, Mark; Walker, Kathryn; Wishart, Laurie R; Siegel, Karen Lohmann; Raina, Parminder

    2012-04-01

    A "review of reviews" was undertaken to assess methodological issues in studies evaluating nondrug rehabilitation interventions in stroke patients. MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from January 2000 to January 2008 within the stroke rehabilitation setting. Electronic searches were supplemented by reviews of reference lists and citations identified by experts. Eligible studies were systematic reviews; excluded citations were narrative reviews or reviews of reviews. Review characteristics and criteria for assessing methodological quality of primary studies within them were extracted. The search yielded 949 English-language citations. We included a final set of 38 systematic reviews. Cochrane reviews, which have a standardized methodology, were generally of higher methodological quality than non-Cochrane reviews. Most systematic reviews used standardized quality assessment criteria for primary studies, but not all were comprehensive. Reviews showed that primary studies had problems with randomization, allocation concealment, and blinding. Baseline comparability, adverse events, and co-intervention or contamination were not consistently assessed. Blinding of patients and providers was often not feasible and was not evaluated as a source of bias. The eligible systematic reviews identified important methodological flaws in the evaluated primary studies, suggesting the need for improvement of research methods and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Decision Tree Identified Risk Groups with High Suicidal Ideation in South Korea: A Population-Based Study.

    Science.gov (United States)

    Kim, Hyun Kyung; Kim, Ji Young; Kim, Jong Hyen; Hyoung, Hee Kyoung

    2016-01-01

    The aim of this study was to identify risk groups with high suicidal ideation among South Korean adults. A descriptive cross-sectional design was adopted using secondary data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5,963 adults aged 19 years and older who participated in the 2011 KNHANES served as participants. The prevalence of suicidal ideation and its related factors, including physical, psychological, health behavioral, and sociodemographic characteristics, were examined. Descriptive statistics and a decision tree were used for data analysis. Nine groups with high suicidal ideation were identified. The coexistence of depression and high levels of stress increased the prevalence of suicidal ideation. The highest risk group was widowed or divorced adults with depression and high levels of stress, and 82.5% of these participants had suicidal ideation (the prevalence rate of this group was 5.7 times higher than the mean suicidal ideation prevalence rate in this study). Public health nurses and community mental health professionals should recognize risk groups with high suicidal ideation, and target these groups when implementing preventive interventions. © 2015 Wiley Periodicals, Inc.

  3. Three principles to define the success of a diagnostic study could be identified

    DEFF Research Database (Denmark)

    Vach, Werner; Gerke, Oke; Høilund-Carlsen, Poul Flemming

    2012-01-01

    of a diagnostic study on a single binary test and investigation of common statistical approaches in relation to these criteria. RESULTS: Three criteria for defining the overall success of a diagnostic study could be identified: a strong criterion, a liberal criterion, and a weak criterion. The strong criterion...... can be implemented by comparing the lower bounds of the confidence intervals for sensitivity and specificity with prespecified target values, as is typically done in many diagnostic studies. The liberal criterion allows a clinically meaningful compensation between sensitivity and specificity and can...... be implemented in different ways. If the liberal criterion is applied instead of the strong criterion, this can lead to a substantial reduction in the sample size required for a diagnostic study. The weak criterion is not very adequate for defining the success of a diagnostic study. CONCLUSION: When planning...

  4. Effectively identifying regulatory hotspots while capturing expression heterogeneity in gene expression studies

    Science.gov (United States)

    2014-01-01

    Expression quantitative trait loci (eQTL) mapping is a tool that can systematically identify genetic variation affecting gene expression. eQTL mapping studies have shown that certain genomic locations, referred to as regulatory hotspots, may affect the expression levels of many genes. Recently, studies have shown that various confounding factors may induce spurious regulatory hotspots. Here, we introduce a novel statistical method that effectively eliminates spurious hotspots while retaining genuine hotspots. Applied to simulated and real datasets, we validate that our method achieves greater sensitivity while retaining low false discovery rates compared to previous methods. PMID:24708878

  5. Identifying experimental methods to determine the effect of pain on attention: a review of pain, caffeine, alcohol and nicotine studies.

    Science.gov (United States)

    Moore, David J; Keogh, Edmund; Eccleston, Christopher

    2009-12-01

    To review published studies of the effects that pain and common psychopharmacological substances have on the attentional performance of healthy adults. To identify which attentional tasks have the greatest potential to investigate the effect of pain on attention and provide recommendations for future research. A search was conducted for reports of experimental studies of attention in the context of pain. This was supplemented with studies on attention and caffeine, nicotine and alcohol. Studies were included if they used a healthy adult sample, used experimental or quasi-experimental methods, were relevant to the study of attention or interruption of pain and/or examined the acute effects of a substance on attention. Thirty-two papers, with 49 different experimental studies were identified (12 pain, 21 nicotine, 7 caffeine, 9 alcohol). Fourteen different tasks were reviewed across six domains of attention. The most promising measures of attention were the continuous performance task, flanker task, endogenous pre-cuing task, n-back task, inhibition task and dual task. There are reliable tasks that could be used to determine the effects of pain on attention. Future research is required that develops the utility of these tasks to improve our understanding of the effects pain and analgesia have on attentional performance. Copyright (c) 2009 John Wiley & Sons, Ltd.

  6. Genome-wide Association Study Identifies New Loci for Resistance to Leptosphaeria maculans in Canola

    Directory of Open Access Journals (Sweden)

    Harsh Raman

    2016-10-01

    Full Text Available Blackleg, caused by Leptosphaeria maculans, is a significant disease which affects the sustainable production of canola. This study reports a genome-wide association study based on 18,804 polymorphic SNPs to identify loci associated with qualitative and quantitative resistance to L. maculans. Genomic regions delimited with 503 significant SNP markers, that are associated with resistance evaluated using 12 single spore isolates and pathotypes from four canola stubble were identified. Several significant associations were detected at known disease resistance loci including in the vicinity of recently cloned Rlm2/LepR3 genes, and at new loci on chromosomes A01/C01, A02/C02, A03/C03, A05/C05, A06, A08, and A09. In addition, we validated statistically significant associations on A01, A07 and A10 in four genetic mapping populations, demonstrating that GWAS marker loci are indeed associated with resistance to L. maculans. One of the novel loci identified for the first time, Rlm12, conveys adult plant resistance and mapped within 13.2 kb from Arabidopsis R gene of TIR-NBS class. We showed that resistance loci are located in the vicinity of R genes of A. thaliana and B. napus on the sequenced genome of B. napus cv. Darmor-bzh. Significantly associated SNP markers provide a valuable tool to enrich germplasm for favorable alleles in order to improve the level of resistance to L. maculans in canola.

  7. Biochemometrics to Identify Synergists and Additives from Botanical Medicines: A Case Study with Hydrastis canadensis (Goldenseal).

    Science.gov (United States)

    Britton, Emily R; Kellogg, Joshua J; Kvalheim, Olav M; Cech, Nadja B

    2018-03-23

    A critical challenge in the study of botanical natural products is the difficulty of identifying multiple compounds that may contribute additively, synergistically, or antagonistically to biological activity. Herein, it is demonstrated how combining untargeted metabolomics with synergy-directed fractionation can be effective toward accomplishing this goal. To demonstrate this approach, an extract of the botanical goldenseal ( Hydrastis canadensis) was fractionated and tested for its ability to enhance the antimicrobial activity of the alkaloid berberine (4) against the pathogenic bacterium Staphylococcus aureus. Bioassay data were combined with untargeted mass spectrometry-based metabolomics data sets (biochemometrics) to produce selectivity ratio (SR) plots, which visually show which extract components are most strongly associated with the biological effect. Using this approach, the new flavonoid 3,3'-dihydroxy-5,7,4'-trimethoxy-6,8- C-dimethylflavone (29) was identified, as were several flavonoids known to be active. When tested in combination with 4, 29 lowered the IC 50 of 4 from 132.2 ± 1.1 μM to 91.5 ± 1.1 μM. In isolation, 29 did not demonstrate antimicrobial activity. The current study highlights the importance of fractionation when utilizing metabolomics for identifying bioactive components from botanical extracts and demonstrates the power of SR plots to help merge and interpret complex biological and chemical data sets.

  8. Learning and examination strategies: a case study of students of a ...

    African Journals Online (AJOL)

    Learning and examination strategies: a case study of students of a public university in Ghana. ... Journal of Business Research ... A focus group of three categories of Bachelor of Science Marketing students of the university who were in final year (level 400) of their programme of study were used as respondents. Each focus ...

  9. Examining College Students' Culture Learning before and after Summer Study Abroad in Japan

    Science.gov (United States)

    Paik, Chie Matsuzawa; Anzai, Shinobu; Zimmerman, Erica

    2011-01-01

    With study abroad becoming an integral part of the American higher-education curriculum, home-institution instructors face the challenge of understanding the type and content of learning taking place abroad. We report on a study conducted at a service academy on the U.S. East Coast to examine American college students' cultural learning in the…

  10. Virtual study groups and online Observed Structured Clinical Examinations practices - enabling trainees to enable themselves.

    Science.gov (United States)

    Davidson, Dennisa; Evans, Lois

    2018-03-01

    To explore online study groups as augmentation tools in preparing for the Royal Australian and New Zealand College of Psychiatrists Observed Structured Clinical Examinations (OSCE) for fellowship. An online survey of New Zealand trainees was carried out to assess exam preparedness and openness to virtual study groups and results analysed. Relevant material around virtual study groups for fellowship examinations was reviewed and used to inform a pilot virtual study group. Four New Zealand trainees took part in the pilot project, looking at using a virtual platform to augment OSCE preparation. Of the 50 respondents 36% felt adequately prepared for the OSCE. Sixty-four per cent were interested in using a virtual platform to augment their study. Virtual study groups were noted to be especially important for rural trainees, none of whom felt able to form study groups for themselves. The pilot virtual study group was trialled successfully. All four trainees reported the experience as subjectively beneficial to their examination preparation. Virtual platforms hold promise as an augmentation strategy for exam preparation, especially for rural trainees who are more geographically isolated and less likely to have peers preparing for the same examinations.

  11. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    Directory of Open Access Journals (Sweden)

    Findlay-Reece Barbara

    2010-01-01

    Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

  12. PAPA: a flexible tool for identifying pleiotropic pathways using genome-wide association study summaries.

    Science.gov (United States)

    Wen, Yan; Wang, Wenyu; Guo, Xiong; Zhang, Feng

    2016-03-15

    : Pleiotropy is common in the genetic architectures of complex diseases. To the best of our knowledge, no analysis tool has been developed for identifying pleiotropic pathways using multiple genome-wide association study (GWAS) summaries by now. Here, we present PAPA, a flexible tool for pleiotropic pathway analysis utilizing GWAS summary results. The performance of PAPA was validated using publicly available GWAS summaries of body mass index and waist-hip ratio of the GIANT datasets. PAPA identified a set of pleiotropic pathways, which have been demonstrated to be involved in the development of obesity. PAPA program, document and illustrative example are available at http://sourceforge.net/projects/papav1/files/ : fzhxjtu@mail.xjtu.edu.cn Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Identifying the essential components of cultural competence in a Chinese nursing context: A qualitative study.

    Science.gov (United States)

    Cai, Duanying; Kunaviktikul, Wipada; Klunklin, Areewan; Sripusanapan, Acharaporn; Avant, Patricia Kay

    2017-06-01

    This qualitative study using semi-structured interviews was conducted to identify the essential components of cultural competence from the perspective of Chinese nurses. A purposive sample of 20 nurse experts, including senior clinical nurses, nurse administrators, and educators in transcultural nursing, was recruited. Using thematic analysis, four themes: awareness, attitudes, knowledge, and skills, with two subthemes for each, were identified. Notably, culture in China was understood in a broad way. The participants' responses focused upon demographic attributes, individuality, and efforts to facilitate quality care rather than on the cultural differences of ethnicity and race and developing the capacity to change discrimination or health disparities. A greater understanding of cultural competence in the Chinese nursing context, in which a dominant cultural group exists, is essential to facilitate the provision of culturally competent care to diverse populations. © 2016 John Wiley & Sons Australia, Ltd.

  14. Genome-wide association study identifies variants in HORMAD2 associated with tonsillectomy

    DEFF Research Database (Denmark)

    Feenstra, Bjarke; Bager, Peter; Liu, Xueping

    2017-01-01

    BACKGROUND: Inflammation of the tonsils is a normal response to infection, but some individuals experience recurrent, severe tonsillitis and massive hypertrophy of the tonsils in which case surgical removal of the tonsils may be considered. OBJECTIVE: To identify common genetic variants associate...... the molecular mechanisms underlying the genetic association involve general lymphoid hyper-reaction throughout the mucosa-associated lymphoid tissue system.......BACKGROUND: Inflammation of the tonsils is a normal response to infection, but some individuals experience recurrent, severe tonsillitis and massive hypertrophy of the tonsils in which case surgical removal of the tonsils may be considered. OBJECTIVE: To identify common genetic variants associated...... with tonsillectomy. METHODS: We used tonsillectomy information from Danish health registers and carried out a genome-wide association study comprising 1464 patients and 12 019 controls of Northwestern European ancestry, with replication in an independent sample set of 1575 patients and 1367 controls. RESULTS...

  15. A comparative study on radiological and endoscopic examinations of the stomach cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Sook; Lee, Yong Chul; Kim, Han Suk [National Medical Center, Seoul (Korea, Republic of)

    1985-12-15

    An analysis was done for the diagnostic accuracy of radiological and endoscopic examinations in 132 cases of the histologically proved stomach cancer at the national Medical Center from Jan. 1975 to Jan. 1979. The problem in radiological misdiagnosis was especially discussed aimed to improve the further diagnostic accuracy. The following results were obtained: 1. The incidence of the stomach cancer was higher in male than that of female, and was most prevalent in 5th and 6th decades. 2. The misdiagnosis rate of radiological examination of the stomach cancer was 13.5% (18 cases), that of endoscopic examination was 8.3% (11 cases) and that of both examination was 4.6% (6 cases). 3. In most cases of misdiagnosis, the majority were diagnosed as benign gastric ulcer. 4. The causative factors of misdiagnosis in radiological examination were interpretation error in 8 cases and technically poor, unsatisfactory study in 10 cases. 5. In order to decrease the misdiagnosis rate, standardization of radiological examination and careful interpretation are necessary. 6. Complementary examinations of radiology and endoscopy can decrease the misdiagnosis rate.

  16. Mixed Method Study Examines Undergraduate Student Researchers’ Knowledge and Perceptions About Scholarly Communication Practices

    Directory of Open Access Journals (Sweden)

    Melissa Goertzen

    2017-09-01

    Full Text Available A Review of: Riehle, C. F., & Hensley, M. K. (2017. What do undergraduate students know about scholarly communication?: A mixed methods study. Portal: Libraries and the Academy, 17(1, 145–178. http://dx.doi.org/10.1353/pla.2017.0009 Abstract Objective – To examine undergraduate student researchers’ perception and understanding of scholarly communication practices and issues. Design – Mixed method study involving a survey and semi-structured interviews. Setting – Two major undergraduate universities in the Midwest region of the United States. Subjects – Undergraduate students who participated in or had completed undergraduate research experiences with faculty mentors. Method – The method was first approved by Institutional Review Board offices at both campuses involved in the study. Then, students received invitations to participate in a survey via email (Campus 1 = 221 students; Campus 2 = 345 students. Identical online surveys ran separately on each campus; both remained open for a period of three weeks. All respondents received a reminder email one week before the survey closed. Participants answered twelve questions related to demographics and scholarly communication practices. The survey examined knowledge and experience across five areas: the peer review process, author and publisher rights, publication and access models, impact of research, and data management. All students who completed the survey were entered in a drawing for a $50 Amazon card. The response rates were 34.8% (Campus 1 and 18.6% (Campus 2. Surveys on both campuses were administered using different software: campus 1 utilized Qualtrics survey software while campus 2 used an institution-specific survey software. Data sets were normed and merged later in the study to enable comparison and identify broad themes. Survey respondents were also invited to participate in a 15 to 20 minute follow-up interview and were compensated with a $20 Amazon gift card. The

  17. Identifying Potential Child Abuse through Oral Examination

    Directory of Open Access Journals (Sweden)

    Jillian N. Printz

    2017-01-01

    Full Text Available Limited reports of oropharyngeal trauma exist in the literature even though this type of injury is extremely common in pediatric populations. There are no widely agreed upon diagnostic and management tools for such injuries in abuse cases, emphasizing the importance of reporting rare cases of orofacial trauma. This case report of a soft palate laceration demonstrates an instance of initially unrecognized potential child abuse. We aim to clarify understanding of such injuries. Furthermore, the report highlights the need for recognition of oral signs of child abuse in order to promote early detection, reporting, and appropriate management.

  18. Exome-wide Association Study Identifies GREB1L Mutations in Congenital Kidney Malformations.

    Science.gov (United States)

    Sanna-Cherchi, Simone; Khan, Kamal; Westland, Rik; Krithivasan, Priya; Fievet, Lorraine; Rasouly, Hila Milo; Ionita-Laza, Iuliana; Capone, Valentina P; Fasel, David A; Kiryluk, Krzysztof; Kamalakaran, Sitharthan; Bodria, Monica; Otto, Edgar A; Sampson, Matthew G; Gillies, Christopher E; Vega-Warner, Virginia; Vukojevic, Katarina; Pediaditakis, Igor; Makar, Gabriel S; Mitrotti, Adele; Verbitsky, Miguel; Martino, Jeremiah; Liu, Qingxue; Na, Young-Ji; Goj, Vinicio; Ardissino, Gianluigi; Gigante, Maddalena; Gesualdo, Loreto; Janezcko, Magdalena; Zaniew, Marcin; Mendelsohn, Cathy Lee; Shril, Shirlee; Hildebrandt, Friedhelm; van Wijk, Joanna A E; Arapovic, Adela; Saraga, Marijan; Allegri, Landino; Izzi, Claudia; Scolari, Francesco; Tasic, Velibor; Ghiggeri, Gian Marco; Latos-Bielenska, Anna; Materna-Kiryluk, Anna; Mane, Shrikant; Goldstein, David B; Lifton, Richard P; Katsanis, Nicholas; Davis, Erica E; Gharavi, Ali G

    2017-11-02

    Renal agenesis and hypodysplasia (RHD) are major causes of pediatric chronic kidney disease and are highly genetically heterogeneous. We conducted whole-exome sequencing in 202 case subjects with RHD and identified diagnostic mutations in genes known to be associated with RHD in 7/202 case subjects. In an additional affected individual with RHD and a congenital heart defect, we found a homozygous loss-of-function (LOF) variant in SLIT3, recapitulating phenotypes reported with Slit3 inactivation in the mouse. To identify genes associated with RHD, we performed an exome-wide association study with 195 unresolved case subjects and 6,905 control subjects. The top signal resided in GREB1L, a gene implicated previously in Hoxb1 and Shha signaling in zebrafish. The significance of the association, which was p = 2.0 × 10 -5 for novel LOF, increased to p = 4.1 × 10 -6 for LOF and deleterious missense variants combined, and augmented further after accounting for segregation and de novo inheritance of rare variants (joint p = 2.3 × 10 -7 ). Finally, CRISPR/Cas9 disruption or knockdown of greb1l in zebrafish caused specific pronephric defects, which were rescued by wild-type human GREB1L mRNA, but not mRNA containing alleles identified in case subjects. Together, our study provides insight into the genetic landscape of kidney malformations in humans, presents multiple candidates, and identifies SLIT3 and GREB1L as genes implicated in the pathogenesis of RHD. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  19. Quasi-experimental study designs series-paper 8: identifying quasi-experimental studies to inform systematic reviews.

    Science.gov (United States)

    Glanville, Julie; Eyers, John; Jones, Andrew M; Shemilt, Ian; Wang, Grace; Johansen, Marit; Fiander, Michelle; Rothstein, Hannah

    2017-09-01

    This article reviews the available evidence and guidance on methods to identify reports of quasi-experimental (QE) studies to inform systematic reviews of health care, public health, international development, education, crime and justice, and social welfare. Research, guidance, and examples of search strategies were identified by searching a range of databases, key guidance documents, selected reviews, conference proceedings, and personal communication. Current practice and research evidence were summarized. Four thousand nine hundred twenty-four records were retrieved by database searches, and additional documents were obtained by other searches. QE studies are challenging to identify efficiently because they have no standardized nomenclature and may be indexed in various ways. Reliable search filters are not available. There is a lack of specific resources devoted to collecting QE studies and little evidence on where best to search. Searches to identify QE studies should search a range of resources and, until indexing improves, use strategies that focus on the topic rather than the study design. Better definitions, better indexing in databases, prospective registers, and reporting guidance are required to improve the retrieval of QE studies and promote systematic reviews of what works based on the evidence from such studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Examining Education Leadership Communication Practices around Basic and Advanced Skill Sets: A Multiple Case Study

    Science.gov (United States)

    Minger, Leslie

    2017-01-01

    The purpose of this multiple case study was to explore and describe the leadership communication practices of school principals in Southern California schools with demonstrated high levels of academic performance in order to identify practices that might be replicated in other schools. Communication practices were studied in relation to two…

  1. .\tA Study on Cervical Pap Smear Examination in Patient Living with HIV.

    Directory of Open Access Journals (Sweden)

    Dr. Devanshi Gosai

    2016-12-01

    Full Text Available Background: Extensive screening programme of cervical Pap smear examination can detect the precancerous and cancerous lesions at an early stage and mortality & morbidity due to these lesions can be reduced. HPV infection is a known etiological agent for cervical cancer. HIV infected women are at higher risk of contracting HPV infection due to immune compromised status. Objective: Present study has been undertaken mainly to detect precancerous & cancerous lesions as well as inflammatory lesions in female patients living with HIV & to emphasize the fact that Pap smear examination should be established as a part of routine protocol for examination in HIV infected women. Methods: The study was carried out on 369 HIV infected females attending Integrated Counselling &Testing Centre of government institute. As controls, 142 females (not falling under high risk category, attending the Obstetrics& Gynaecology OPD with various gynaecological complaints were taken & results were compared. Results: Squamous cell abnormalities were found about four times high as compared to control group. High incidences of squamous cell abnormalities were noted in patients with high parity (parity three or more. Conclusion: Regular gynaecological examination including Pap smear examinations is highly recommended for HIV infected females. Pap smear examination is a simple, cheap, safe & practical diagnostic tool for early detection of cervical cancer in high risk population.

  2. Tacit knowledge of public health nurses in identifying community health problems and need for new services: a case study.

    Science.gov (United States)

    Yoshioka-Maeda, Kyoko; Murashima, Sachiyo; Asahara, Kiyomi

    2006-09-01

    The purpose of this study was to explore the tacit knowledge of public health nurses in identifying community health problems and developing relevant new projects. Previous research only roughly showed those skills for creating new community health services, such as lobbying. Nine Japanese public health nurses who had created new projects in their municipalities were selected by theoretical sampling and interviewed in 2002-2003. Yin's Case Study Method, especially the multiple-case study design, was used. All 9 public health nurses used similar approaches in identifying community health problems and the need for creating new services, even though their experiences differed and the kinds of projects varied. They identified the difficulties of clients, recognized clients who had the same problems, elucidated the limitations of existing services, and forecasted outcomes from the neglect of the clients' problems. Then they succeeded in creating a new project by examining individual health problems in the context of their community's characteristics, societal factors, and using existing policies to support their clients. This is the first study to explore the skills of public health nurses and their intention to use such skills in creating new projects as well as the exact process. They could identify community health problems that will be the basis for developing new services to provide care for individual clients. This is different from the traditional community assessment approach that requires the collection of a huge amount of information to clarify community health problems. The tacit knowledge of public health nurses will help to create needs-oriented new services more smoothly.

  3. A novel data mining method to identify assay-specific signatures in functional genomic studies

    Directory of Open Access Journals (Sweden)

    Guidarelli Jack W

    2006-08-01

    Full Text Available Abstract Background: The highly dimensional data produced by functional genomic (FG studies makes it difficult to visualize relationships between gene products and experimental conditions (i.e., assays. Although dimensionality reduction methods such as principal component analysis (PCA have been very useful, their application to identify assay-specific signatures has been limited by the lack of appropriate methodologies. This article proposes a new and powerful PCA-based method for the identification of assay-specific gene signatures in FG studies. Results: The proposed method (PM is unique for several reasons. First, it is the only one, to our knowledge, that uses gene contribution, a product of the loading and expression level, to obtain assay signatures. The PM develops and exploits two types of assay-specific contribution plots, which are new to the application of PCA in the FG area. The first type plots the assay-specific gene contribution against the given order of the genes and reveals variations in distribution between assay-specific gene signatures as well as outliers within assay groups indicating the degree of importance of the most dominant genes. The second type plots the contribution of each gene in ascending or descending order against a constantly increasing index. This type of plots reveals assay-specific gene signatures defined by the inflection points in the curve. In addition, sharp regions within the signature define the genes that contribute the most to the signature. We proposed and used the curvature as an appropriate metric to characterize these sharp regions, thus identifying the subset of genes contributing the most to the signature. Finally, the PM uses the full dataset to determine the final gene signature, thus eliminating the chance of gene exclusion by poor screening in earlier steps. The strengths of the PM are demonstrated using a simulation study, and two studies of real DNA microarray data – a study of

  4. Enriched pathways for major depressive disorder identified from a genome-wide association study.

    Science.gov (United States)

    Kao, Chung-Feng; Jia, Peilin; Zhao, Zhongming; Kuo, Po-Hsiu

    2012-11-01

    Major depressive disorder (MDD) has caused a substantial burden of disease worldwide with moderate heritability. Despite efforts through conducting numerous association studies and now, genome-wide association (GWA) studies, the success of identifying susceptibility loci for MDD has been limited, which is partially attributed to the complex nature of depression pathogenesis. A pathway-based analytic strategy to investigate the joint effects of various genes within specific biological pathways has emerged as a powerful tool for complex traits. The present study aimed to identify enriched pathways for depression using a GWA dataset for MDD. For each gene, we estimated its gene-wise p value using combined and minimum p value, separately. Canonical pathways from the Kyoto Encyclopedia of Genes and Genomes (KEGG) and BioCarta were used. We employed four pathway-based analytic approaches (gene set enrichment analysis, hypergeometric test, sum-square statistic, sum-statistic). We adjusted for multiple testing using Benjamini & Hochberg's method to report significant pathways. We found 17 significantly enriched pathways for depression, which presented low-to-intermediate crosstalk. The top four pathways were long-term depression (p⩽1×10-5), calcium signalling (p⩽6×10-5), arrhythmogenic right ventricular cardiomyopathy (p⩽1.6×10-4) and cell adhesion molecules (p⩽2.2×10-4). In conclusion, our comprehensive pathway analyses identified promising pathways for depression that are related to neurotransmitter and neuronal systems, immune system and inflammatory response, which may be involved in the pathophysiological mechanisms underlying depression. We demonstrated that pathway enrichment analysis is promising to facilitate our understanding of complex traits through a deeper interpretation of GWA data. Application of this comprehensive analytic strategy in upcoming GWA data for depression could validate the findings reported in this study.

  5. Radionuclide examination of motility disorders of the esophagus: a comparative study with manometry

    International Nuclear Information System (INIS)

    Heukelem, H.A. van.

    1985-01-01

    The primary aim of this investigation is to determine the value of radionuclide studies for clinical diagnostics in the light of its advantages over the manometric examination by means of available casuistics. A general review of the development of the examinations for assessment of the motility of the esophagus is given and both normal and disturbed motor function are described. The details of the patient groups and the techniques used in this study are presented. The results obtained for normal subjects and patients with achalasia, diffuse esophageal spasm, systemic connective tissue diseases with esophageal involvement and reflux esophagitis are reported and discussed. (Auth.)

  6. Identifying 'unhealthy' food advertising on television: a case study applying the UK Nutrient Profile model.

    Science.gov (United States)

    Jenkin, Gabrielle; Wilson, Nick; Hermanson, Nicole

    2009-05-01

    To evaluate the feasibility of the UK Nutrient Profile (NP) model for identifying 'unhealthy' food advertisements using a case study of New Zealand television advertisements. Four weeks of weekday television from 15.30 hours to 18.30 hours was videotaped from a state-owned (free-to-air) television channel popular with children. Food advertisements were identified and their nutritional information collected in accordance with the requirements of the NP model. Nutrient information was obtained from a variety of sources including food labels, company websites and a national nutritional database. From the 60 h sample of weekday afternoon television, there were 1893 advertisements, of which 483 were for food products or retailers. After applying the NP model, 66 % of these were classified as advertising high-fat, high-salt and high-sugar (HFSS) foods; 28 % were classified as advertising non-HFSS foods; and the remaining 2 % were unclassifiable. More than half (53 %) of the HFSS food advertisements were for 'mixed meal' items promoted by major fast-food franchises. The advertising of non-HFSS food was sparse, covering a narrow range of food groups, with no advertisements for fresh fruit or vegetables. Despite the NP model having some design limitations in classifying real-world televised food advertisements, it was easily applied to this sample and could clearly identify HFSS products. Policy makers who do not wish to completely restrict food advertising to children outright should consider using this NP model for regulating food advertising.

  7. Evaluation of MRI acquisition workflow with lean six sigma method: case study of liver and knee examinations.

    Science.gov (United States)

    Roth, Christopher J; Boll, Daniel T; Wall, Lisa K; Merkle, Elmar M

    2010-08-01

    The purpose of this investigation was to assess workflow for medical imaging studies, specifically comparing liver and knee MRI examinations by use of the Lean Six Sigma methodologic framework. The hypothesis tested was that the Lean Six Sigma framework can be used to quantify MRI workflow and to identify sources of inefficiency to target for sequence and protocol improvement. Audio-video interleave streams representing individual acquisitions were obtained with graphic user interface screen capture software in the examinations of 10 outpatients undergoing MRI of the liver and 10 outpatients undergoing MRI of the knee. With Lean Six Sigma methods, the audio-video streams were dissected into value-added time (true image data acquisition periods), business value-added time (time spent that provides no direct patient benefit but is requisite in the current system), and non-value-added time (scanner inactivity while awaiting manual input). For overall MRI table time, value-added time was 43.5% (range, 39.7-48.3%) of the time for liver examinations and 89.9% (range, 87.4-93.6%) for knee examinations. Business value-added time was 16.3% of the table time for the liver and 4.3% of the table time for the knee examinations. Non-value-added time was 40.2% of the overall table time for the liver and 5.8% for the knee examinations. Liver MRI examinations consume statistically significantly more non-value-added and business value-added times than do knee examinations, primarily because of respiratory command management and contrast administration. Workflow analyses and accepted inefficiency reduction frameworks can be applied with use of a graphic user interface screen capture program.

  8. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Directory of Open Access Journals (Sweden)

    Rebecca Colman

    Full Text Available INTRODUCTION: Patients with pulmonary hypertension (PH often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV. However, there is no consensus regarding the diagnostic utility of the physical examination in PH. METHODS: We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013 and EMBASE (1947-2013. We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists" who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD, tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5 of the likelihood that the patient had pulmonary hypertension was provided by each examiner. RESULTS: 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2. In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg. The physical sign with the highest likelihood ratio (LR was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  9. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013) and EMBASE (1947-2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists") who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could consistently rule out PH (negative LRs 0

  10. Utility of the Physical Examination in Detecting Pulmonary Hypertension. A Mixed Methods Study

    Science.gov (United States)

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Introduction Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. Methods We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946–2013) and EMBASE (1947–2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 “specialists” and 3 “generalists”) who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1–5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. Results 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  11. Peer feedback for examiner quality assurance on MRCGP International South Asia: a mixed methods study.

    Science.gov (United States)

    Perera, D P; Andrades, Marie; Wass, Val

    2017-12-08

    The International Membership Examination (MRCGP[INT]) of the Royal College of General Practitioners UK is a unique collaboration between four South Asian countries with diverse cultures, epidemiology, clinical facilities and resources. In this setting good quality assurance is imperative to achieve acceptable standards of inter rater reliability. This study aims to explore the process of peer feedback for examiner quality assurance with regard to factors affecting the implementation and acceptance of the method. A sequential mixed methods approach was used based on focus group discussions with examiners (n = 12) and clinical examination convenors who acted as peer reviewers (n = 4). A questionnaire based on emerging themes and literature review was then completed by 20 examiners at the subsequent OSCE exam. Qualitative data were analysed using an iterative reflexive process. Quantitative data were integrated by interpretive analysis looking for convergence, complementarity or dissonance. The qualitative data helped understand the issues and informed the process of developing the questionnaire. The quantitative data allowed for further refining of issues, wider sampling of examiners and giving voice to different perspectives. Examiners stated specifically that peer feedback gave an opportunity for discussion, standardisation of judgments and improved discriminatory abilities. Interpersonal dynamics, hierarchy and perception of validity of feedback were major factors influencing acceptance of feedback. Examiners desired increased transparency, accountability and the opportunity for equal partnership within the process. The process was stressful for examiners and reviewers; however acceptance increased with increasing exposure to receiving feedback. The process could be refined to improve acceptability through scrupulous attention to training and selection of those giving feedback to improve the perceived validity of feedback and improved reviewer feedback

  12. Identifying research priorities for patient safety in mental health: an international expert Delphi study

    Science.gov (United States)

    Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

    2018-01-01

    Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096

  13. Systematic enrichment analysis of gene expression profiling studies identifies consensus pathways implicated in colorectal cancer development

    Directory of Open Access Journals (Sweden)

    Jesús Lascorz

    2011-01-01

    Full Text Available Background: A large number of gene expression profiling (GEP studies on colorectal carcinogenesis have been performed but no reliable gene signature has been identified so far due to the lack of reproducibility in the reported genes. There is growing evidence that functionally related genes, rather than individual genes, contribute to the etiology of complex traits. We used, as a novel approach, pathway enrichment tools to define functionally related genes that are consistently up- or down-regulated in colorectal carcinogenesis. Materials and Methods: We started the analysis with 242 unique annotated genes that had been reported by any of three recent meta-analyses covering GEP studies on genes differentially expressed in carcinoma vs normal mucosa. Most of these genes (218, 91.9% had been reported in at least three GEP studies. These 242 genes were submitted to bioinformatic analysis using a total of nine tools to detect enrichment of Gene Ontology (GO categories or Kyoto Encyclopedia of Genes and Genomes (KEGG pathways. As a final consistency criterion the pathway categories had to be enriched by several tools to be taken into consideration. Results: Our pathway-based enrichment analysis identified the categories of ribosomal protein constituents, extracellular matrix receptor interaction, carbonic anhydrase isozymes, and a general category related to inflammation and cellular response as significantly and consistently overrepresented entities. Conclusions: We triaged the genes covered by the published GEP literature on colorectal carcinogenesis and subjected them to multiple enrichment tools in order to identify the consistently enriched gene categories. These turned out to have known functional relationships to cancer development and thus deserve further investigation.

  14. Identifying areas at risk of low birth weight using spatial epidemiology: A small area surveillance study.

    Science.gov (United States)

    Insaf, Tabassum Z; Talbot, Thomas

    2016-07-01

    To assess the geographic distribution of Low Birth Weight (LBW) in New York State among singleton births using a spatial regression approach in order to identify priority areas for public health actions. LBW was defined as birth weight less than 2500g. Geocoded data from 562,586 birth certificates in New York State (years 2008-2012) were merged with 2010 census data at the tract level. To provide stable estimates and maintain confidentiality, data were aggregated to yield 1268 areas of analysis. LBW prevalence among singleton births was related with area-level behavioral, socioeconomic and demographic characteristics using a Poisson mixed effects spatial error regression model. Observed low birth weight showed statistically significant auto-correlation in our study area (Moran's I 0.16 p value 0.0005). After over-dispersion correction and accounting for fixed effects for selected social determinants, spatial autocorrelation was fully accounted for (Moran's I-0.007 p value 0.241). The proportion of LBW was higher in areas with larger Hispanic or Black populations and high smoking prevalence. Smoothed maps with predicted prevalence were developed to identify areas at high risk of LBW. Spatial patterns of residual variation were analyzed to identify unique risk factors. Neighborhood racial composition contributes to disparities in LBW prevalence beyond differences in behavioral and socioeconomic factors. Small-area analyses of LBW can identify areas for targeted interventions and display unique local patterns that should be accounted for in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Detailed examination of the lower cervical spine facet joints in a road traffic crash fatality - a case study

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Nielsen, Edith; Vesterby, Annie

    2005-01-01

    The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques. No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Examination of stained...... histological sections visualised the morphology and integrity of the facet joints in detail. Occult injuries to and in close proximity of the cervical spine facet joints were identified only on histological examination....

  16. Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

    International Nuclear Information System (INIS)

    Poulos, Ann; Balandin, Susan; Llewellyn, Gwynnyth; McCarthy, Louella; Dark, Leigha

    2011-01-01

    Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

  17. Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

    Energy Technology Data Exchange (ETDEWEB)

    Poulos, Ann, E-mail: ann.poulos@sydney.edu.a [University of Sydney, Faculty of Health Sciences, Discipline of Medical Radiation Sciences, PO Box 170, Lidcombe, NSW 1825 (Australia); Balandin, Susan [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia); Avdeling for helse- og sosialfag, Hogskolen i Molde, Postboks 2110, 6402 Molde (Norway); Llewellyn, Gwynnyth; McCarthy, Louella [University of Sydney, Faculty of Health Sciences, Discipline of Occupational Therapy, PO Box 170, Lidcombe, NSW 1825 (Australia); Dark, Leigha [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia)

    2011-02-15

    Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

  18. A review of the reporting of web searching to identify studies for Cochrane systematic reviews.

    Science.gov (United States)

    Briscoe, Simon

    2018-03-01

    The literature searches that are used to identify studies for inclusion in a systematic review should be comprehensively reported. This ensures that the literature searches are transparent and reproducible, which is important for assessing the strengths and weaknesses of a systematic review and re-running the literature searches when conducting an update review. Web searching using search engines and the websites of topically relevant organisations is sometimes used as a supplementary literature search method. Previous research has shown that the reporting of web searching in systematic reviews often lacks important details and is thus not transparent or reproducible. Useful details to report about web searching include the name of the search engine or website, the URL, the date searched, the search strategy, and the number of results. This study reviews the reporting of web searching to identify studies for Cochrane systematic reviews published in the 6-month period August 2016 to January 2017 (n = 423). Of these reviews, 61 reviews reported using web searching using a search engine or website as a literature search method. In the majority of reviews, the reporting of web searching was found to lack essential detail for ensuring transparency and reproducibility, such as the search terms. Recommendations are made on how to improve the reporting of web searching in Cochrane systematic reviews. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Comparing chemical analysis with literature studies to identify micropollutants in a catchment of Copenhagen (DK)

    DEFF Research Database (Denmark)

    Lützhøft, Hans-Christian Holten; Birch, Heidi; Eriksson, Eva

    2011-01-01

    on urban surface runoff originating from a well defined catchment of Copenhagen (Denmark) with an inventory of potential pollution sources for the same catchment. The selected catchment covers an area with roads, a shopping centre, a parking lot, office buildings, a gymnasium and some restaurants....... The literature approach is limited to the range of included PSs and to how and which information is compiled, whereas the analytical chemical approach is limited to the selection of analyzed substances, sensitivity and precision. Comparing the two approaches of chemical analysis with literature study to identify...

  20. An improved approach to identify irradiated dog feed by electron paramagnetic resonance study and thermoluminescence measurements

    Energy Technology Data Exchange (ETDEWEB)

    Sanyal, Bhaskar, E-mail: bhaskar_sanyal@rediffmail.co [Food Technology Division, Bhabha Atomic Research Centre, Mumbai-400 085 (India); Chawla, S.P.; Sharma, Arun [Food Technology Division, Bhabha Atomic Research Centre, Mumbai-400 085 (India)

    2011-05-15

    In the present study, probably for the first time, a detailed analysis of the radiation induced radical species and thermoluminescence measurements of irradiated dog feed are reported. The EPR spectrum of non-irradiated ready-to-eat dog feed was characterized by singlet g=2.0047{+-}0.0003. Irradiated samples exhibited a complex EPR spectrum. During high power (50.0 mW) EPR spectroscopy, a visible change in the shape of the EPR spectrum was observed and characterized by EPR spectrum simulation technique. An axially symmetric anisotropic signal with g{sub ||}=2.0028 and g{sub perpendicular}=1.9976 was identified. However, a negligible change in the matrix of irradiated edible dog chew was observed using EPR spectroscopy. Therefore, thermoluminescence study of the isolated minerals from dog chew was carried out. The composition of the poly-minerals was studied using SEM and EDX analysis and a complete verdict on identification of irradiation is proposed.

  1. An improved approach to identify irradiated dog feed by electron paramagnetic resonance study and thermoluminescence measurements

    International Nuclear Information System (INIS)

    Sanyal, Bhaskar; Chawla, S.P.; Sharma, Arun

    2011-01-01

    In the present study, probably for the first time, a detailed analysis of the radiation induced radical species and thermoluminescence measurements of irradiated dog feed are reported. The EPR spectrum of non-irradiated ready-to-eat dog feed was characterized by singlet g=2.0047±0.0003. Irradiated samples exhibited a complex EPR spectrum. During high power (50.0 mW) EPR spectroscopy, a visible change in the shape of the EPR spectrum was observed and characterized by EPR spectrum simulation technique. An axially symmetric anisotropic signal with g || =2.0028 and g perpendicular =1.9976 was identified. However, a negligible change in the matrix of irradiated edible dog chew was observed using EPR spectroscopy. Therefore, thermoluminescence study of the isolated minerals from dog chew was carried out. The composition of the poly-minerals was studied using SEM and EDX analysis and a complete verdict on identification of irradiation is proposed.

  2. Genome-wide association studies identify four ER negative-specific breast cancer risk loci

    DEFF Research Database (Denmark)

    Garcia-Closas, Montserrat; Couch, Fergus J; Lindstrom, Sara

    2013-01-01

    differences in genetic predisposition. To identify susceptibility loci specific to ER-negative disease, we combined in a meta-analysis 3 genome-wide association studies of 4,193 ER-negative breast cancer cases and 35,194 controls with a series of 40 follow-up studies (6,514 cases and 41,455 controls......), genotyped using a custom Illumina array, iCOGS, developed by the Collaborative Oncological Gene-environment Study (COGS). SNPs at four loci, 1q32.1 (MDM4, P = 2.1 × 10(-12) and LGR6, P = 1.4 × 10(-8)), 2p24.1 (P = 4.6 × 10(-8)) and 16q12.2 (FTO, P = 4.0 × 10(-8)), were associated with ER-negative but not ER...

  3. USING GIS TO IDENTIFY POTENTIAL AREAS SUSCEPTIBLE TO FLOOD. CASE STUDY: SOLONEŢ RIVER

    Directory of Open Access Journals (Sweden)

    V. TIPLEA

    2011-03-01

    Full Text Available Using GIS to Identify Potential Areas Susceptible to Flood. Case Study: Soloneţ River. In this study, we aim to analyze the impact of different peak flows in territory and also a better understanding of the dynamic of a river flow. The methodology used for flood zone delimitation is based on a quantitative analysis model which requires the use of mathematical, physical and statistical operations in order to emphasize the relations between the different variables that were implied (discharges, grain size, terrain morphology, soil saturation, vegetation etc.. The results cannot be expected to be completely accurate but can provide a good representation of the process. Validation of results will inevitably be difficult and should be measured in the field. The information resulting from this study could be useful for raising awareness about both hazards and possible mitigation measure, a key component of disaster risk reduction planning.

  4. Case study to identify the causes of stock-out of a textile retailer

    Directory of Open Access Journals (Sweden)

    Fernando Henrique Aguiar

    2014-05-01

    Full Text Available One of the main problems faced by large retailers is related to the lack of supply in display racks, the so called stock-out points. Studies have been made since the sixties, which show that progress related to this subject is limited. Stock-out levels are around 8.3%. Furthermore, literature on the subject is insufficient, as very few studies have been dedicated to investigating the causes of stock-out. The present study aims to collect stock-out data from a large textile retailer for a product category and elaborate a tree of stock-out causes. Qualitative and quantitative methods were used in this research, through software and interviews, in order to generate and refine our results. From this approach, it was possible to identify that 38% of the causes of stock-outs are within the store, that is, the product is not available in the sales area, but in the back end.

  5. Exploring Specialized STEM High Schools: Three Dissertation Studies Examining Commonalities and Differences Across Six Case Studies

    Science.gov (United States)

    Tofel-Grehl, Colby

    This dissertation is comprised of three independently conducted analyses of a larger investigation into the practices and features of specialized STEM high schools. While educators and policy makers advocate the development of many new specialized STEM high schools, little is known about the unique features and practices of these schools. The results of these manuscripts add to the literature exploring the promise of specialized STEM schools. Manuscript 1¹ is a qualitative investigation of the common features of STEM schools across multiple school model types. Schools were found to possess common cultural and academic features regardless of model type. Manuscript 2² builds on the findings of manuscript 1. With no meaningful differences found attributable to model type, the researchers used grounded theory to explore the relationships between observed differences among programs as related to the intensity of the STEM experience offered at schools. Schools were found to fall into two categories, high STEM intensity (HSI) and low STEM intensity (LSI), based on five major traits. Manuscript 3³ examines the commonalities and differences in classroom discourse and teachers' questioning techniques in STEM schools. It explicates these discursive practices in order to explore instructional practices across schools. It also examines factors that may influence classroom discourse such as discipline, level of teacher education, and course status as required or elective. Collectively, this research furthers the agenda of better understanding the potential advantages of specialized STEM high schools for preparing a future scientific workforce. ¹Tofel-Grehl, C., Callahan, C., & Gubbins, E. (2012). STEM high school communities: Common and differing features. Manuscript in preparation. ²Tofel-Grehl, C., Callahan, C., & Gubbins, E. (2012). Variations in the intensity of specialized science, technology, engineering, and mathematics (STEM) high schools. Manuscript in preparation

  6. A genome-wide association study identified AFF1 as a susceptibility locus for systemic lupus eyrthematosus in Japanese.

    Directory of Open Access Journals (Sweden)

    Yukinori Okada

    2012-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an autoimmune disease that causes multiple organ damage. Although recent genome-wide association studies (GWAS have contributed to discovery of SLE susceptibility genes, few studies has been performed in Asian populations. Here, we report a GWAS for SLE examining 891 SLE cases and 3,384 controls and multi-stage replication studies examining 1,387 SLE cases and 28,564 controls in Japanese subjects. Considering that expression quantitative trait loci (eQTLs have been implicated in genetic risks for autoimmune diseases, we integrated an eQTL study into the results of the GWAS. We observed enrichments of cis-eQTL positive loci among the known SLE susceptibility loci (30.8% compared to the genome-wide SNPs (6.9%. In addition, we identified a novel association of a variant in the AF4/FMR2 family, member 1 (AFF1 gene at 4q21 with SLE susceptibility (rs340630; P = 8.3×10(-9, odds ratio = 1.21. The risk A allele of rs340630 demonstrated a cis-eQTL effect on the AFF1 transcript with enhanced expression levels (P<0.05. As AFF1 transcripts were prominently expressed in CD4(+ and CD19(+ peripheral blood lymphocytes, up-regulation of AFF1 may cause the abnormality in these lymphocytes, leading to disease onset.

  7. Examining the link between traumatic events and delinquency among juvenile delinquent girls: A longitudinal study

    Science.gov (United States)

    Marsiglio, Mary C.; Chronister, Krista M.; Gibson, Brandon; Leve, Leslie D.

    2014-01-01

    Researchers have postulated associations between childhood trauma and delinquency, but few have examined the direction of these relationships prospectively and, specifically, with samples of delinquent girls. The purpose of this study was to examine the relationship between traumatic events and delinquency for girls in the juvenile justice system using a cross-lagged model. Developmental differences in associations as a function of high school entry status were also examined. The sample included 166 girls in the juvenile justice system who were mandated to community-based out-of-home care due to chronic delinquency. Overall, study results provide evidence that trauma and delinquency risk pathways vary according to high school entry status. Implications for future research and practice are discussed. PMID:25580179

  8. Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

    Science.gov (United States)

    Atkinson, Robyn; McElroy, Theresa

    2016-04-01

    Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Eating in moderation and the essential role of awareness. A Dutch longitudinal study identifying psychosocial predictors.

    Science.gov (United States)

    Walthouwer, Michel Jean Louis; Oenema, Anke; Candel, Math; Lechner, Lilian; de Vries, Hein

    2015-04-01

    Eating in moderation, i.e. the attempt to monitor and limit the intake of energy-dense foods, is a promising strategy in the prevention of weight gain. The purpose of this study was to examine which psychosocial factors derived from the I-Change Model (ICM) were associated with eating in moderation, and whether these factors differed between adults with a correct (aware) or incorrect (unaware) perception of their dietary behaviour. This study used a longitudinal design with measurements at baseline (N = 483) and six-month follow-up (N = 379). Eating in moderation was defined as the average daily energy intake from energy-dense food products and was measured by a validated food frequency questionnaire. Linear regression analyses were used to assess the associations between the ICM factors and eating in moderation. The moderating role of awareness was examined by including interactions between awareness and the ICM factors in the regression analyses using the pick-a-point approach to further examine the associations for aware and unaware participants. Participants who were aware of their dietary behaviour had a significantly lower average daily energy intake compared to those who were unaware. Eating in moderation was predicted by awareness, risk perception, social influence and intention. Among the aware participants, eating in moderation was predicted by risk perception, attitude, social influence and intention. Among the unaware participants, only risk perception and self-efficacy were significantly associated with eating in moderation. Our findings show that psychosocial factors may only predict eating in moderation when people are aware of their risk behaviour. Therefore, interventions aimed at promoting complex behaviours, such as eating in moderation, should first focus on improving individuals' awareness of their risk behaviour before targeting motivational factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Using aggregated, de-identified electronic health record data for multivariate pharmacosurveillance: a case study of azathioprine.

    Science.gov (United States)

    Patel, Vishal N; Kaelber, David C

    2014-12-01

    To demonstrate the use of aggregated and de-identified electronic health record (EHR) data for multivariate post-marketing pharmacosurveillance in a case study of azathioprine (AZA). Using aggregated, standardized, normalized, and de-identified, population-level data from the Explore platform (Explorys, Inc.) we searched over 10 million individuals, of which 14,580 were prescribed AZA based on RxNorm drug orders. Based on logical observation identifiers names and codes (LOINC) and vital sign data, we examined the following side effects: anemia, cell lysis, fever, hepatotoxicity, hypertension, nephrotoxicity, neutropenia, and neutrophilia. Patients prescribed AZA were compared to patients prescribed one of 11 other anti-rheumatologic drugs to determine the relative risk of side effect pairs. Compared to AZA case report trends, hepatotoxicity (marked by elevated transaminases or elevated bilirubin) did not occur as an isolated event more frequently in patients prescribed AZA than other anti-rheumatic agents. While neutropenia occurred in 24% of patients (RR 1.15, 95% CI 1.07-1.23), neutrophilia was also frequent (45%) and increased in patients prescribed AZA (RR 1.28, 95% CI 1.22-1.34). After constructing a pairwise side effect network, neutropenia had no dependencies. A reduced risk of neutropenia was found in patients with co-existing elevations in total bilirubin or liver transaminases, supporting classic clinical knowledge that agranulocytosis is a largely unpredictable phenomenon. Rounding errors propagated in the statistically de-identified datasets for cohorts as small as 40 patients only contributed marginally to the calculated risk. Our work demonstrates that aggregated, standardized, normalized and de-identified population level EHR data can provide both sufficient insight and statistical power to detect potential patterns of medication side effect associations, serving as a multivariate and generalizable approach to post-marketing drug surveillance

  11. Iterative Outlier Removal: A Method for Identifying Outliers in Laboratory Recalibration Studies.

    Science.gov (United States)

    Parrinello, Christina M; Grams, Morgan E; Sang, Yingying; Couper, David; Wruck, Lisa M; Li, Danni; Eckfeldt, John H; Selvin, Elizabeth; Coresh, Josef

    2016-07-01

    Extreme values that arise for any reason, including those through nonlaboratory measurement procedure-related processes (inadequate mixing, evaporation, mislabeling), lead to outliers and inflate errors in recalibration studies. We present an approach termed iterative outlier removal (IOR) for identifying such outliers. We previously identified substantial laboratory drift in uric acid measurements in the Atherosclerosis Risk in Communities (ARIC) Study over time. Serum uric acid was originally measured in 1990-1992 on a Coulter DACOS instrument using an uricase-based measurement procedure. To recalibrate previous measured concentrations to a newer enzymatic colorimetric measurement procedure, uric acid was remeasured in 200 participants from stored plasma in 2011-2013 on a Beckman Olympus 480 autoanalyzer. To conduct IOR, we excluded data points >3 SDs from the mean difference. We continued this process using the resulting data until no outliers remained. IOR detected more outliers and yielded greater precision in simulation. The original mean difference (SD) in uric acid was 1.25 (0.62) mg/dL. After 4 iterations, 9 outliers were excluded, and the mean difference (SD) was 1.23 (0.45) mg/dL. Conducting only one round of outlier removal (standard approach) would have excluded 4 outliers [mean difference (SD) = 1.22 (0.51) mg/dL]. Applying the recalibration (derived from Deming regression) from each approach to the original measurements, the prevalence of hyperuricemia (>7 mg/dL) was 28.5% before IOR and 8.5% after IOR. IOR is a useful method for removal of extreme outliers irrelevant to recalibrating laboratory measurements, and identifies more extraneous outliers than the standard approach. © 2016 American Association for Clinical Chemistry.

  12. Identifying fallacious arguments in a qualitative study of antipsychotic prescribing in dementia.

    Science.gov (United States)

    Donyai, Parastou

    2017-10-01

    Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings. Fallacious arguments have the potential to become unremarkable discourses that construct and validate practices which are counter to guidelines. This qualitative study involved interviews with 28 care-home managers and health professionals involved in caring for patients with dementia. Potentially fallacious arguments were identified using qualitative content analysis and a coding framework constructed from existing explanatory models of fallacious reasoning. Fallacious arguments were identified in a range of explanations and reasons that participants gave for in answer to questions about initiating, reducing doses of and stopping antipsychotics in dementia. The dominant fallacy was false dichotomy. Appeal to popularity, tradition, consequence, emotion, or fear, and the slippery slope argument was also identified. Fallacious arguments were often formulated to present convincing cases whereby prescribing antipsychotics or maintaining existing doses (versus not starting medication or reducing the dose, for example) appeared as the only acceptable decision but this is not always the case. The findings could help health professionals to recognise and mitigate the effect of logic-based errors in decisions about the prescribing of antipsychotics in dementia. © 2016 Royal Pharmaceutical Society.

  13. A Delphi study to identify the core components of nurse to nurse handoff.

    Science.gov (United States)

    O'Rourke, Jennifer; Abraham, Joanna; Riesenberg, Lee Ann; Matson, Jeff; Lopez, Karen Dunn

    2018-03-08

    The aim of this study was to identify the core components of nurse-nurse handoffs. Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified. This lack of identification is a significant gap in moving towards a standardized approach for nurse-nurse handoff. Mixed methods design using the Delphi technique. From May 2016 - October 2016, using a series of iterative steps, a panel of handoff experts gave feedback on the nurse-nurse handoff core components and the content in each component to be passed from one nurse to the next during a typical unit-based shift handoff. Consensus was defined as 80% agreement or higher. After three rounds of participant review, 17 handoff experts with backgrounds in clinical nursing practice, academia and handoff research came to consensus on the core components of handoff: patient summary, action plan and nurse-nurse synthesis. This is the first study to identify the core components of nurse-nurse handoff. Subsequent testing of the core components will involve evaluating the handoff approach in a simulated and then actual patient care environment. Our long-term goal is to improve patient safety outcomes by validating an evidence-based handoff framework and handoff curriculum for pre-licensure nursing programmes that strengthen the quality of their handoff communication as they enter clinical practice. © 2018 John Wiley & Sons Ltd.

  14. Genome-wide association study identified CNP12587 region underlying height variation in Chinese females.

    Directory of Open Access Journals (Sweden)

    Yin-Ping Zhang

    Full Text Available Human height is a highly heritable trait considered as an important factor for health. There has been limited success in identifying the genetic factors underlying height variation. We aim to identify sequence variants associated with adult height by a genome-wide association study of copy number variants (CNVs in Chinese.Genome-wide CNV association analyses were conducted in 1,625 unrelated Chinese adults and sex specific subgroup for height variation, respectively. Height was measured with a stadiometer. Affymetrix SNP6.0 genotyping platform was used to identify copy number polymorphisms (CNPs. We constructed a genomic map containing 1,009 CNPs in Chinese individuals and performed a genome-wide association study of CNPs with height.We detected 10 significant association signals for height (p<0.05 in the whole population, 9 and 11 association signals for Chinese female and male population, respectively. A copy number polymorphism (CNP12587, chr18:54081842-54086942, p = 2.41 × 10(-4 was found to be significantly associated with height variation in Chinese females even after strict Bonferroni correction (p = 0.048. Confirmatory real time PCR experiments lent further support for CNV validation. Compared to female subjects with two copies of the CNP, carriers of three copies had an average of 8.1% decrease in height. An important candidate gene, ubiquitin-protein ligase NEDD4-like (NEDD4L, was detected at this region, which plays important roles in bone metabolism by binding to bone formation regulators.Our findings suggest the important genetic variants underlying height variation in Chinese.

  15. Genome-wide association study identifies variants associated with autoimmune hepatitis type 1.

    Science.gov (United States)

    de Boer, Ynto S; van Gerven, Nicole M F; Zwiers, Antonie; Verwer, Bart J; van Hoek, Bart; van Erpecum, Karel J; Beuers, Ulrich; van Buuren, Henk R; Drenth, Joost P H; den Ouden, Jannie W; Verdonk, Robert C; Koek, Ger H; Brouwer, Johannes T; Guichelaar, Maureen M J; Vrolijk, Jan M; Kraal, Georg; Mulder, Chris J J; van Nieuwkerk, Carin M J; Fischer, Janett; Berg, Thomas; Stickel, Felix; Sarrazin, Christoph; Schramm, Christoph; Lohse, Ansgar W; Weiler-Normann, Christina; Lerch, Markus M; Nauck, Matthias; Völzke, Henry; Homuth, Georg; Bloemena, Elisabeth; Verspaget, Hein W; Kumar, Vinod; Zhernakova, Alexandra; Wijmenga, Cisca; Franke, Lude; Bouma, Gerd

    2014-08-01

    Autoimmune hepatitis (AIH) is an uncommon autoimmune liver disease of unknown etiology. We used a genome-wide approach to identify genetic variants that predispose individuals to AIH. We performed a genome-wide association study of 649 adults in The Netherlands with AIH type 1 and 13,436 controls. Initial associations were further analyzed in an independent replication panel comprising 451 patients with AIH type 1 in Germany and 4103 controls. We also performed an association analysis in the discovery cohort using imputed genotypes of the major histocompatibility complex region. We associated AIH with a variant in the major histocompatibility complex region at rs2187668 (P = 1.5 × 10(-78)). Analysis of this variant in the discovery cohort identified HLA-DRB1*0301 (P = 5.3 × 10(-49)) as a primary susceptibility genotype and HLA-DRB1*0401 (P = 2.8 × 10(-18)) as a secondary susceptibility genotype. We also associated AIH with variants of SH2B3 (rs3184504, 12q24; P = 7.7 × 10(-8)) and CARD10 (rs6000782, 22q13.1; P = 3.0 × 10(-6)). In addition, strong inflation of association signal was found with single-nucleotide polymorphisms associated with other immune-mediated diseases, including primary sclerosing cholangitis and primary biliary cirrhosis, but not with single-nucleotide polymorphisms associated with other genetic traits. In a genome-wide association study, we associated AIH type 1 with variants in the major histocompatibility complex region, and identified variants of SH2B3and CARD10 as likely risk factors. These findings support a complex genetic basis for AIH pathogenesis and indicate that part of the genetic susceptibility overlaps with that for other immune-mediated liver diseases. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Robust Intratumor Partitioning to Identify High-Risk Subregions in Lung Cancer: A Pilot Study

    International Nuclear Information System (INIS)

    Wu, Jia; Gensheimer, Michael F.; Dong, Xinzhe; Rubin, Daniel L.; Napel, Sandy; Diehn, Maximilian; Loo, Billy W.; Li, Ruijiang

    2016-01-01

    Purpose: To develop an intratumor partitioning framework for identifying high-risk subregions from "1"8F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) imaging and to test whether tumor burden associated with the high-risk subregions is prognostic of outcomes in lung cancer. Methods and Materials: In this institutional review board–approved retrospective study, we analyzed the pretreatment FDG-PET and CT scans of 44 lung cancer patients treated with radiation therapy. A novel, intratumor partitioning method was developed, based on a 2-stage clustering process: first at the patient level, each tumor was over-segmented into many superpixels by k-means clustering of integrated PET and CT images; next, tumor subregions were identified by merging previously defined superpixels via population-level hierarchical clustering. The volume associated with each of the subregions was evaluated using Kaplan-Meier analysis regarding its prognostic capability in predicting overall survival (OS) and out-of-field progression (OFP). Results: Three spatially distinct subregions were identified within each tumor that were highly robust to uncertainty in PET/CT co-registration. Among these, the volume of the most metabolically active and metabolically heterogeneous solid component of the tumor was predictive of OS and OFP on the entire cohort, with a concordance index or CI of 0.66-0.67. When restricting the analysis to patients with stage III disease (n=32), the same subregion achieved an even higher CI of 0.75 (hazard ratio 3.93, log-rank P=.002) for predicting OS, and a CI of 0.76 (hazard ratio 4.84, log-rank P=.002) for predicting OFP. In comparison, conventional imaging markers, including tumor volume, maximum standardized uptake value, and metabolic tumor volume using threshold of 50% standardized uptake value maximum, were not predictive of OS or OFP, with CI mostly below 0.60 (log-rank P>.05). Conclusion: We propose a robust intratumor

  17. Robust Intratumor Partitioning to Identify High-Risk Subregions in Lung Cancer: A Pilot Study.

    Science.gov (United States)

    Wu, Jia; Gensheimer, Michael F; Dong, Xinzhe; Rubin, Daniel L; Napel, Sandy; Diehn, Maximilian; Loo, Billy W; Li, Ruijiang

    2016-08-01

    To develop an intratumor partitioning framework for identifying high-risk subregions from (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) imaging and to test whether tumor burden associated with the high-risk subregions is prognostic of outcomes in lung cancer. In this institutional review board-approved retrospective study, we analyzed the pretreatment FDG-PET and CT scans of 44 lung cancer patients treated with radiation therapy. A novel, intratumor partitioning method was developed, based on a 2-stage clustering process: first at the patient level, each tumor was over-segmented into many superpixels by k-means clustering of integrated PET and CT images; next, tumor subregions were identified by merging previously defined superpixels via population-level hierarchical clustering. The volume associated with each of the subregions was evaluated using Kaplan-Meier analysis regarding its prognostic capability in predicting overall survival (OS) and out-of-field progression (OFP). Three spatially distinct subregions were identified within each tumor that were highly robust to uncertainty in PET/CT co-registration. Among these, the volume of the most metabolically active and metabolically heterogeneous solid component of the tumor was predictive of OS and OFP on the entire cohort, with a concordance index or CI of 0.66-0.67. When restricting the analysis to patients with stage III disease (n=32), the same subregion achieved an even higher CI of 0.75 (hazard ratio 3.93, log-rank P=.002) for predicting OS, and a CI of 0.76 (hazard ratio 4.84, log-rank P=.002) for predicting OFP. In comparison, conventional imaging markers, including tumor volume, maximum standardized uptake value, and metabolic tumor volume using threshold of 50% standardized uptake value maximum, were not predictive of OS or OFP, with CI mostly below 0.60 (log-rank P>.05). We propose a robust intratumor partitioning method to identify clinically relevant, high

  18. Robust Intratumor Partitioning to Identify High-Risk Subregions in Lung Cancer: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Jia; Gensheimer, Michael F.; Dong, Xinzhe [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Rubin, Daniel L. [Department of Radiology, Stanford University School of Medicine, Stanford, California (United States); Department of Medicine (Biomedical Informatics Research), Stanford University School of Medicine, Stanford, California (United States); Napel, Sandy [Department of Radiology, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Li, Ruijiang, E-mail: rli2@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States)

    2016-08-01

    Purpose: To develop an intratumor partitioning framework for identifying high-risk subregions from {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) imaging and to test whether tumor burden associated with the high-risk subregions is prognostic of outcomes in lung cancer. Methods and Materials: In this institutional review board–approved retrospective study, we analyzed the pretreatment FDG-PET and CT scans of 44 lung cancer patients treated with radiation therapy. A novel, intratumor partitioning method was developed, based on a 2-stage clustering process: first at the patient level, each tumor was over-segmented into many superpixels by k-means clustering of integrated PET and CT images; next, tumor subregions were identified by merging previously defined superpixels via population-level hierarchical clustering. The volume associated with each of the subregions was evaluated using Kaplan-Meier analysis regarding its prognostic capability in predicting overall survival (OS) and out-of-field progression (OFP). Results: Three spatially distinct subregions were identified within each tumor that were highly robust to uncertainty in PET/CT co-registration. Among these, the volume of the most metabolically active and metabolically heterogeneous solid component of the tumor was predictive of OS and OFP on the entire cohort, with a concordance index or CI of 0.66-0.67. When restricting the analysis to patients with stage III disease (n=32), the same subregion achieved an even higher CI of 0.75 (hazard ratio 3.93, log-rank P=.002) for predicting OS, and a CI of 0.76 (hazard ratio 4.84, log-rank P=.002) for predicting OFP. In comparison, conventional imaging markers, including tumor volume, maximum standardized uptake value, and metabolic tumor volume using threshold of 50% standardized uptake value maximum, were not predictive of OS or OFP, with CI mostly below 0.60 (log-rank P>.05). Conclusion: We propose a robust

  19. Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

    Science.gov (United States)

    Hsu, Pi-Sui

    2016-01-01

    The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

  20. Examining the Teaching of Science, and Technology and Engineering Content and Practices: An Instrument Modification Study

    Science.gov (United States)

    Love, Tyler S.; Wells, John G.; Parkes, Kelly A.

    2017-01-01

    A modified Reformed Teaching Observation Protocol (RTOP) (Piburn & Sawada, 2000) instrument was used to separately examine eight technology and engineering (T&E) educators' teaching of science, and T&E content and practices, as called for by the "Standards for Technological Literacy: Content for the Study of Technology"…

  1. Examination of "Art Literacy" Levels of Students Studying in the Education Faculties

    Science.gov (United States)

    Koksoy, Aylin Mentis

    2018-01-01

    Art literacy refers to achieving artistic knowledge, evaluating this knowledge and integrating it with experiences. The aim of the study is to examine the ''art literacy'' levels of the students attending the educational faculty in terms of grade level, gender, the fact that they love art books, the fact that they love doing research in library,…

  2. Using Peer Reviews to Examine Micropolitics and Disciplinary Development of Engineering Education: A Case Study

    Science.gov (United States)

    Beddoes, Kacey

    2014-01-01

    This article presents a case study of the peer review process for a feminist article submitted to an engineering education journal. It demonstrates how an examination of peer review can be a useful approach to further understanding the development of feminist thought in education fields. Rather than opposition to feminist thought per se, my…

  3. Examining Elementary Teachers' Use of Online Learning Environments: An Exploratory Study

    Science.gov (United States)

    Beach, Pamela

    2018-01-01

    This article presents the results of a study that examined elementary teachers' use of online learning environments for their informal professional learning in literacy instruction. Forty-five elementary teachers from a metropolitan area in Ontario, Canada, completed an online survey and participated in a semistructured interview. Survey and…

  4. Examining the Perceptions of Curriculum Leaders on Primary School Reform: A Case Study of Hong Kong

    Science.gov (United States)

    Cheung, Alan C. K.; Yuen, Timothy W. W.

    2017-01-01

    In an effort to enhance the quality of teachers and teaching, and to lead internal curriculum development in primary schools, the Hong Kong Education Bureau created a new curriculum leader post entitled primary school master/mistress (curriculum development) or PSMCD for short. The main purpose of the study was to examine the perceptions of these…

  5. TOGAF version 9 foundation study guide preparation for the TOGAF 9 Part 1 examination

    CERN Document Server

    Harrison, Rachel

    2009-01-01

    This document is a Study Guide for TOGAF™ 9 Foundation.It gives an overview of every learning objective for the TOGAF 9 Foundation Syllabus and in-depth coverage on preparing and taking the TOGAF 9 Part 1 Examination. It is specifically designed to help individuals prepare for certification.

  6. A Constructivist Case Study Examining the Leadership Development of Undergraduate Students in Campus Recreational Sports

    Science.gov (United States)

    Hall, Stacey L.; Forrester, Scott; Borsz, Melissa

    2008-01-01

    This constructivist case study examined undergraduate student leadership development. Twenty-one student leaders, 13 females and 8 males, in a campus recreational sports department were interviewed using a semi-structured interview protocol. Seven broad themes: organizing, planning, and delegating; balancing academic, personal and professional…

  7. Examining an Evolution: A Case Study of Organizational Change Accompanying the Community College Baccalaureate

    Science.gov (United States)

    McKinney, Lyle; Morris, Phillip A.

    2010-01-01

    This study examined the nature and degree of organizational change that occurs when community colleges offer their own baccalaureate degree programs. Utilizing qualitative research methodology, we investigated how executive administrators at two Florida colleges managed this momentous change process and how this transformation has affected their…

  8. A Quantitative Study Examining Teacher Stress, Burnout, and Self-Efficacy

    Science.gov (United States)

    Stephenson, Timar D.

    2012-01-01

    The purpose of this quantitative, correlational study was to examine the relationships between stress, burnout, and self-efficacy in public school teachers in the Turks and Caicos Islands. The Teacher Stress Inventory was used to collect data on teacher stress, the Maslach Burnout Inventory Educators Survey was used to obtain data on teacher…

  9. Rock disposal problems identified

    Energy Technology Data Exchange (ETDEWEB)

    Knox, R

    1978-06-01

    Mathematical models are the only way of examining the return of radioactivity from nuclear waste to the environment over long periods of time. Work in Britain has helped identify areas where more basic data is required, but initial results look very promising for final disposal of high level waste in hard rock repositories. A report by the National Radiological Protection Board of a recent study, is examined.

  10. Genome-wide association study identifies novel breast cancer susceptibility loci

    Science.gov (United States)

    Easton, Douglas F.; Pooley, Karen A.; Dunning, Alison M.; Pharoah, Paul D. P.; Thompson, Deborah; Ballinger, Dennis G.; Struewing, Jeffery P.; Morrison, Jonathan; Field, Helen; Luben, Robert; Wareham, Nicholas; Ahmed, Shahana; Healey, Catherine S.; Bowman, Richard; Meyer, Kerstin B.; Haiman, Christopher A.; Kolonel, Laurence K.; Henderson, Brian E.; Marchand, Loic Le; Brennan, Paul; Sangrajrang, Suleeporn; Gaborieau, Valerie; Odefrey, Fabrice; Shen, Chen-Yang; Wu, Pei-Ei; Wang, Hui-Chun; Eccles, Diana; Evans, D. Gareth; Peto, Julian; Fletcher, Olivia; Johnson, Nichola; Seal, Sheila; Stratton, Michael R.; Rahman, Nazneen; Chenevix-Trench, Georgia; Bojesen, Stig E.; Nordestgaard, Børge G.; Axelsson, Christen K.; Garcia-Closas, Montserrat; Brinton, Louise; Chanock, Stephen; Lissowska, Jolanta; Peplonska, Beata; Nevanlinna, Heli; Fagerholm, Rainer; Eerola, Hannaleena; Kang, Daehee; Yoo, Keun-Young; Noh, Dong-Young; Ahn, Sei-Hyun; Hunter, David J.; Hankinson, Susan E.; Cox, David G.; Hall, Per; Wedren, Sara; Liu, Jianjun; Low, Yen-Ling; Bogdanova, Natalia; Schürmann, Peter; Dörk, Thilo; Tollenaar, Rob A. E. M.; Jacobi, Catharina E.; Devilee, Peter; Klijn, Jan G. M.; Sigurdson, Alice J.; Doody, Michele M.; Alexander, Bruce H.; Zhang, Jinghui; Cox, Angela; Brock, Ian W.; MacPherson, Gordon; Reed, Malcolm W. R.; Couch, Fergus J.; Goode, Ellen L.; Olson, Janet E.; Meijers-Heijboer, Hanne; van den Ouweland, Ans; Uitterlinden, André; Rivadeneira, Fernando; Milne, Roger L.; Ribas, Gloria; Gonzalez-Neira, Anna; Benitez, Javier; Hopper, John L.; McCredie, Margaret; Southey, Melissa; Giles, Graham G.; Schroen, Chris; Justenhoven, Christina; Brauch, Hiltrud; Hamann, Ute; Ko, Yon-Dschun; Spurdle, Amanda B.; Beesley, Jonathan; Chen, Xiaoqing; Mannermaa, Arto; Kosma, Veli-Matti; Kataja, Vesa; Hartikainen, Jaana; Day, Nicholas E.; Cox, David R.; Ponder, Bruce A. J.; Luccarini, Craig; Conroy, Don; Shah, Mitul; Munday, Hannah; Jordan, Clare; Perkins, Barbara; West, Judy; Redman, Karen; Driver, Kristy; Aghmesheh, Morteza; Amor, David; Andrews, Lesley; Antill, Yoland; Armes, Jane; Armitage, Shane; Arnold, Leanne; Balleine, Rosemary; Begley, Glenn; Beilby, John; Bennett, Ian; Bennett, Barbara; Berry, Geoffrey; Blackburn, Anneke; Brennan, Meagan; Brown, Melissa; Buckley, Michael; Burke, Jo; Butow, Phyllis; Byron, Keith; Callen, David; Campbell, Ian; Chenevix-Trench, Georgia; Clarke, Christine; Colley, Alison; Cotton, Dick; Cui, Jisheng; Culling, Bronwyn; Cummings, Margaret; Dawson, Sarah-Jane; Dixon, Joanne; Dobrovic, Alexander; Dudding, Tracy; Edkins, Ted; Eisenbruch, Maurice; Farshid, Gelareh; Fawcett, Susan; Field, Michael; Firgaira, Frank; Fleming, Jean; Forbes, John; Friedlander, Michael; Gaff, Clara; Gardner, Mac; Gattas, Mike; George, Peter; Giles, Graham; Gill, Grantley; Goldblatt, Jack; Greening, Sian; Grist, Scott; Haan, Eric; Harris, Marion; Hart, Stewart; Hayward, Nick; Hopper, John; Humphrey, Evelyn; Jenkins, Mark; Jones, Alison; Kefford, Rick; Kirk, Judy; Kollias, James; Kovalenko, Sergey; Lakhani, Sunil; Leary, Jennifer; Lim, Jacqueline; Lindeman, Geoff; Lipton, Lara; Lobb, Liz; Maclurcan, Mariette; Mann, Graham; Marsh, Deborah; McCredie, Margaret; McKay, Michael; McLachlan, Sue Anne; Meiser, Bettina; Milne, Roger; Mitchell, Gillian; Newman, Beth; O'Loughlin, Imelda; Osborne, Richard; Peters, Lester; Phillips, Kelly; Price, Melanie; Reeve, Jeanne; Reeve, Tony; Richards, Robert; Rinehart, Gina; Robinson, Bridget; Rudzki, Barney; Salisbury, Elizabeth; Sambrook, Joe; Saunders, Christobel; Scott, Clare; Scott, Elizabeth; Scott, Rodney; Seshadri, Ram; Shelling, Andrew; Southey, Melissa; Spurdle, Amanda; Suthers, Graeme; Taylor, Donna; Tennant, Christopher; Thorne, Heather; Townshend, Sharron; Tucker, Kathy; Tyler, Janet; Venter, Deon; Visvader, Jane; Walpole, Ian; Ward, Robin; Waring, Paul; Warner, Bev; Warren, Graham; Watson, Elizabeth; Williams, Rachael; Wilson, Judy; Winship, Ingrid; Young, Mary Ann; Bowtell, David; Green, Adele; deFazio, Anna; Chenevix-Trench, Georgia; Gertig, Dorota; Webb, Penny

    2009-01-01

    Breast cancer exhibits familial aggregation, consistent with variation in genetic susceptibility to the disease. Known susceptibility genes account for less than 25% of the familial risk of breast cancer, and the residual genetic variance is likely to be due to variants conferring more moderate risks. To identify further susceptibility alleles, we conducted a two-stage genome-wide association study in 4,398 breast cancer cases and 4,316 controls, followed by a third stage in which 30 single nucleotide polymorphisms (SNPs) were tested for confirmation in 21,860 cases and 22,578 controls from 22 studies. We used 227,876 SNPs that were estimated to correlate with 77% of known common SNPs in Europeans at r2>0.5. SNPs in five novel independent loci exhibited strong and consistent evidence of association with breast cancer (P<10−7). Four of these contain plausible causative genes (FGFR2, TNRC9, MAP3K1 and LSP1). At the second stage, 1,792 SNPs were significant at the P<0.05 level compared with an estimated 1,343 that would be expected by chance, indicating that many additional common susceptibility alleles may be identifiable by this approach. PMID:17529967

  11. Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.

    Science.gov (United States)

    Linder, Suzanne K; Kamath, Geetanjali R; Pratt, Gregory F; Saraykar, Smita S; Volk, Robert J

    2015-04-01

    To compare the effectiveness of two search methods in identifying studies that used the Control Preferences Scale (CPS), a health care decision-making instrument commonly used in clinical settings. We searched the literature using two methods: (1) keyword searching using variations of "Control Preferences Scale" and (2) cited reference searching using two seminal CPS publications. We searched three bibliographic databases [PubMed, Scopus, and Web of Science (WOS)] and one full-text database (Google Scholar). We report precision and sensitivity as measures of effectiveness. Keyword searches in bibliographic databases yielded high average precision (90%) but low average sensitivity (16%). PubMed was the most precise, followed closely by Scopus and WOS. The Google Scholar keyword search had low precision (54%) but provided the highest sensitivity (70%). Cited reference searches in all databases yielded moderate sensitivity (45-54%), but precision ranged from 35% to 75% with Scopus being the most precise. Cited reference searches were more sensitive than keyword searches, making it a more comprehensive strategy to identify all studies that use a particular instrument. Keyword searches provide a quick way of finding some but not all relevant articles. Goals, time, and resources should dictate the combination of which methods and databases are used. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Analysis on actual state of selective upper gastrointestinal study in medical examination

    International Nuclear Information System (INIS)

    Kang, Seong Ho; Son, Soon Yong; Joo, Mi Hwa; Kim, Chang Bok; Kim, Keon Chung

    1999-01-01

    The purpose of this study is to present controversial point and reform measurements by analysing factors having important effect on selection of upper gastrointestinal study in total health promotion. We examined 200 persons for this study, who visited for upper gastrointestinal study from January to February in 1999. We classified this group into Endoscopy, Upper gastrointestinal series, and sleeping endoscopy. We also investigated standard of satisfaction and factors having effect on selection of each study. As is results, in the motive of selection, Item of 'making accurate observation' and 'without pain' was 39.3% and 34.7%, respectively. In this study, sleeping endoscopy was 45.7%, but on the other side upper gastrointestinal series was low 22.6%(P<0.05). In the standard of preference of study, the man was 55.7% in the endoscopy, and the woman was 61.8% in the upper gastrointestinal series(P<0.05). The standard of preference of upper gastrointestinal series show that it was satisfied on the whole irrespective of sex, dwelling place, age, occupation, and level of education. In the selection of study, one's own will was showed the highest frequency, and family inducement was showed second(P<0.05). Persons over 60% were examined before the same study. Selection of upper gastrointestinal series was 47.9% of person with normal findings, and endoscopy and sleeping endoscopy was over 70% with gastritis, gastric and duodenal(P<0.01). For one's accurate selection of examination, it is important that objective and credible information should be given to a recipient for examination

  13. Analysis on actual state of selective upper gastrointestinal study in medical examination

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Seong Ho; Son, Soon Yong; Joo, Mi Hwa; Kim, Chang Bok; Kim, Keon Chung [Asan Medical Center, Asan (Korea, Republic of)

    1999-04-01

    The purpose of this study is to present controversial point and reform measurements by analysing factors having important effect on selection of upper gastrointestinal study in total health promotion. We examined 200 persons for this study, who visited for upper gastrointestinal study from January to February in 1999. We classified this group into Endoscopy, Upper gastrointestinal series, and sleeping endoscopy. We also investigated standard of satisfaction and factors having effect on selection of each study. As is results, in the motive of selection, Item of 'making accurate observation' and 'without pain' was 39.3% and 34.7%, respectively. In this study, sleeping endoscopy was 45.7%, but on the other side upper gastrointestinal series was low 22.6%(P<0.05). In the standard of preference of study, the man was 55.7% in the endoscopy, and the woman was 61.8% in the upper gastrointestinal series(P<0.05). The standard of preference of upper gastrointestinal series show that it was satisfied on the whole irrespective of sex, dwelling place, age, occupation, and level of education. In the selection of study, one's own will was showed the highest frequency, and family inducement was showed second(P<0.05). Persons over 60% were examined before the same study. Selection of upper gastrointestinal series was 47.9% of person with normal findings, and endoscopy and sleeping endoscopy was over 70% with gastritis, gastric and duodenal(P<0.01). For one's accurate selection of examination, it is important that objective and credible information should be given to a recipient for examination.

  14. A study of correlations between identified charged hadrons in hadronic Z0 decays

    International Nuclear Information System (INIS)

    Abe, K.; Abe, K.; Abe, T.

    1998-06-01

    The authors present a preliminary study of correlations in rapidity between pairs of identified pions, kaons and protons in hadronic Z 0 decays into light flavors. Short range charge correlations are observed between all combinations of these hadron species, confirming that charge, strangeness and baryon number are conserved locally in the jet fragmentation process. The range of this effect is found to be independent of momentum. A strong long-range correlation is observed for high-momentum charged kaon pairs, and weaker long-range π + -π - , π + -K - and p-K - correlations are observed. The SLC electron beam polarization is used to tag the quark hemisphere in each event, allowing the first study of rapidities signed such that positive rapidity is along the quark rather than antiquark direction. Distributions of signed rapidities and of ordered differences between signed rapidities provide new insights into leading particle production and several new tests of fragmentation models

  15. An exploratory study to identify critical factors of innovation culture in organizations

    Directory of Open Access Journals (Sweden)

    Hamed Asgari

    2013-07-01

    Full Text Available During the past two decades, there has been a growing trend on knowledge-based organizations. Innovation, on the other hand, plays essential role on building competitive business units. In this paper, we present an exploratory study to identify critical factors of innovation culture in organizations. We detect important factors influencing innovation culture in construction industry based on the implementation of factor analysis. The proposed study designs a questionnaire and distributes it among 400 experts who are involved in construction industry. Cronbach alpha has been calculated as 0.779, which validates the overall questionnaire. The results of factor analysis have indicated that six factors of building cultural infrastructures, education, organizational vision, established culture, strategic culture and flexible culture are the most important items influencing innovation culture.

  16. Identifying Students Struggling in Courses by Analyzing Exam Grades, Self-reported Measures and Study Activities

    DEFF Research Database (Denmark)

    Christensen, Bianca Clavio; Bemman, Brian; Knoche, Hendrik

    2018-01-01

    . In this paper, we present a set of instrument`s designed to identify at-risk undergraduate students in a Problem-based Learning (PBL) university, using an introductory programming course between two campus locations as a case study. Collectively, these instruments form the basis of a proposed learning ecosystem...... in the prediction model. Results of a multiple linear regression model found several significant assessment predictors related to how often students attempted self-guided course assignments and their self-reported programming experience, among others.......Technical educations often experience poor student performance and consequently high rates of attrition. Providing students with early feedback on their learning progress can assist students in self-study activities or in their decision-making process regarding a change in educational direction...

  17. Study protocol: identifying and delivering point-of-care information to improve care coordination.

    Science.gov (United States)

    Hysong, Sylvia J; Che, Xinxuan; Weaver, Sallie J; Petersen, Laura A

    2015-10-19

    The need for deliberately coordinated care is noted by many national-level organizations. The Department of Veterans Affairs (VA) recently transitioned primary care clinics nationwide into Patient Aligned Care Teams (PACTs) to provide more accessible, coordinated, comprehensive, and patient-centered care. To better serve this purpose, PACTs must be able to successfully sequence and route interdependent tasks to appropriate team members while also maintaining collective situational awareness (coordination). Although conceptual frameworks of care coordination exist, few explicitly articulate core behavioral markers of coordination or the related information needs of team members attempting to synchronize complex care processes across time for a shared patient population. Given this gap, we partnered with a group of frontline primary care personnel at ambulatory care sites to identify the specific information needs of PACT members that will enable them to coordinate their efforts to provide effective, coordinated care. The study has three objectives: (1) development of measurable, prioritized point-of-care criteria for effective PACT coordination; (2) identifying the specific information needed at the point of care to optimize coordination; and (3) assessing the effect of adopting the aforementioned coordination standards on PACT clinicians' coordination behaviors. The study consists of three phases. In phase 1, we will employ the Productivity Measurement and Enhancement System (ProMES), a structured approach to performance measure creation from industrial/organizational psychology, to develop coordination measures with a design team of 6-10 primary care personnel; in phase 2, we will conduct focus groups with the phase 1 design team to identify point-of-care information needs. Phase 3 is a two-arm field experiment (n PACT = 28/arm); intervention arm PACTs will receive monthly feedback reports using the measures developed in phase 1 and attend brief monthly

  18. Comparative genetics: synergizing human and NOD mouse studies for identifying genetic causation of type 1 diabetes.

    Science.gov (United States)

    Driver, John P; Chen, Yi-Guang; Mathews, Clayton E

    2012-01-01

    Although once widely anticipated to unlock how human type 1 diabetes (T1D) develops, extensive study of the nonobese diabetic (NOD) mouse has failed to yield effective treatments for patients with the disease. This has led many to question the usefulness of this animal model. While criticism about the differences between NOD and human T1D is legitimate, in many cases disease in both species results from perturbations modulated by the same genes or different genes that function within the same biological pathways. Like in humans, unusual polymorphisms within an MHC class II molecule contributes the most T1D risk in NOD mice. This insight supports the validity of this model and suggests the NOD has been improperly utilized to study how to cure or prevent disease in patients. Indeed, clinical trials are far from administering T1D therapeutics to humans at the same concentration ranges and pathological states that inhibit disease in NOD mice. Until these obstacles are overcome it is premature to label the NOD mouse a poor surrogate to test agents that cure or prevent T1D. An additional criticism of the NOD mouse is the past difficulty in identifying genes underlying T1D using conventional mapping studies. However, most of the few diabetogenic alleles identified to date appear relevant to the human disorder. This suggests that rather than abandoning genetic studies in NOD mice, future efforts should focus on improving the efficiency with which diabetes susceptibility genes are detected. The current review highlights why the NOD mouse remains a relevant and valuable tool to understand the genes and their interactions that promote autoimmune diabetes and therapeutics that inhibit this disease. It also describes a new range of technologies that will likely transform how the NOD mouse is used to uncover the genetic causes of T1D for years to come.

  19. Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study.

    Science.gov (United States)

    Ronaldson, Sarah J; Dyson, Lisa; Clark, Laura; Hewitt, Catherine E; Torgerson, David J; Cooper, Brendan G; Kearney, Matt; Laughey, William; Raghunath, Raghu; Steele, Lisa; Rhodes, Rebecca; Adamson, Joy

    2018-06-01

    Early identification of chronic obstructive pulmonary disease (COPD) results in patients receiving appropriate management for their condition at an earlier stage in their disease. The determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease (DOC) study was a case-finding study to enhance early identification of COPD in primary care, which evaluated the diagnostic accuracy of a series of simple lung function tests and symptom-based case-finding questionnaires. Current smokers aged 35 or more were invited to undertake a series of case-finding tools, which comprised lung function tests (specifically, spirometry, microspirometry, peak flow meter, and WheezoMeter) and several case-finding questionnaires. The effectiveness of these tests, individually or in combination, to identify small airways obstruction was evaluated against the gold standard of spirometry, with the quality of spirometry tests assessed by independent overreaders. The study was conducted with general practices in the Yorkshire and Humberside area, in the UK. Six hundred eighty-one individuals met the inclusion criteria, with 444 participants completing their study appointments. A total of 216 (49%) with good-quality spirometry readings were included in the analysis. The most effective case-finding tools were found to be the peak flow meter alone, the peak flow meter plus WheezoMeter, and microspirometry alone. In addition to the main analysis, where the severity of airflow obstruction was based on fixed ratios and percent of predicted values, sensitivity analyses were conducted by using lower limit of normal values. This research informs the choice of test for COPD identification; case-finding by use of the peak flow meter or microspirometer could be used routinely in primary care for suspected COPD patients. Only those testing positive to these tests would move on to full spirometry, thereby reducing unnecessary spirometric testing. © 2018 John Wiley

  20. A qualitative case study to identify possible barriers that limit effective elementary science education

    Science.gov (United States)

    Foster, Donald Carey

    The purpose of this case study was to identify barriers that limit the effectiveness of elementary teachers in the teaching of science. It is of the utmost urgency that barriers be first identified, so that possible solutions can be explored to bring about the improvement of elementary science education. This urgency has been imposed by the scheduled national testing of students in science by 2007, as mandated by the No Child Left Behind Act of 2001. Using qualitative case study methods, the researcher conducted interviews with 8 elementary teachers from two schools within one school district who taught 3rd, 4th, and 5th grade. These interviews were designed to gain insight into barriers these elementary teachers perceived as factors limiting their effectiveness in teaching science and preparing students for high-stakes testing. Barriers in the areas of teacher background, typical teaching day, curriculum, inservices, and legislative influences were explored. This study concluded that the barriers explored do have a substantial negative affect on the teaching and learning of science in the elementary grades. Specifically, the barriers revealed in this study include the limited science background of elementary teachers, inadequate class time devoted to science, non-comprehensive curriculum, ineffective or lack of inservice training, and pressures from legislated mandates. But it is also clear that these barriers are so intertwined that one cannot remove these barriers one at a time. It will take a collective effort from all involved, including legislators, administrators, teachers, parents, and students, to alleviate these barriers and discover effective solutions to improve elementary science education.

  1. Cross-study analysis of gene expression data for intermediate neuroblastoma identifies two biological subtypes

    International Nuclear Information System (INIS)

    Warnat, Patrick; Oberthuer, André; Fischer, Matthias; Westermann, Frank; Eils, Roland; Brors, Benedikt

    2007-01-01

    Neuroblastoma patients show heterogeneous clinical courses ranging from life-threatening progression to spontaneous regression. Recently, gene expression profiles of neuroblastoma tumours were associated with clinically different phenotypes. However, such data is still rare for important patient subgroups, such as patients with MYCN non-amplified advanced stage disease. Prediction of the individual course of disease and optimal therapy selection in this cohort is challenging. Additional research effort is needed to describe the patterns of gene expression in this cohort and to identify reliable prognostic markers for this subset of patients. We combined gene expression data from two studies in a meta-analysis in order to investigate differences in gene expression of advanced stage (3 or 4) tumours without MYCN amplification that show contrasting outcomes (alive or dead) at five years after initial diagnosis. In addition, a predictive model for outcome was generated. Gene expression profiles from 66 patients were included from two studies using different microarray platforms. In the combined data set, 72 genes were identified as differentially expressed by meta-analysis at a false discovery rate (FDR) of 8.33%. Meta-analysis detected 34 differentially expressed genes that were not found as significant in either single study. Outcome prediction based on data of both studies resulted in a predictive accuracy of 77%. Moreover, the genes that were differentially expressed in subgroups of advanced stage patients without MYCN amplification accurately separated MYCN amplified tumours from low stage tumours without MYCN amplification. Our findings support the hypothesis that neuroblastoma consists of two biologically distinct subgroups that differ by characteristic gene expression patterns, which are associated with divergent clinical outcome

  2. An exploratory study identifying where local government public health decision makers source their evidence for policy.

    Science.gov (United States)

    Stoneham, Melissa; Dodds, James

    2014-08-01

    The Western Australian (WA) Public Health Bill will replace the antiquated Health Act 1911. One of the proposed clauses of the Bill requires all WA local governments to develop a Public Health Plan. The Bill states that Public Health Plans should be based on evidence from all levels, including national and statewide priorities, community needs, local statistical evidence, and stakeholder data. This exploratory study, which targeted 533 WA local government officers, aimed to identify the sources of evidence used to generate the list of public health risks to be included in local government Public Health Plans. The top four sources identified for informing local policy were: observation of the consequences of the risks in the local community (24.5%), statewide evidence (17.6%), local evidence (17.6%) and coverage in local media (16.2%). This study confirms that both hard and soft data are used to inform policy decisions at the local level. Therefore, the challenge that this study has highlighted is in the definition or constitution of evidence. SO WHAT? Evidence is critical to the process of sound policy development. This study highlights issues associated with what actually constitutes evidence in the policy development process at the local government level. With the exception of those who work in an extremely narrow field, it is difficult for local government officers, whose role includes policymaking, to read the vast amount of information that has been published in their area of expertise. For those who are committed to the notion of evidence-based policymaking, as advocated within the WA Public Health Bill, this presents a considerable challenge.

  3. An examination of the relationships between psychiatric disorders and traumatic brain injury: a prospective study

    OpenAIRE

    Gould, Kate Rachel

    2017-01-01

    Psychiatric disorders are commonly associated with traumatic brain injury (TBI). However, pre- and post-injury frequencies of disorders are variable, and their course, associated risk factors and relationship with psychosocial outcome are poorly understood due to methodological inconsistencies. No studies have prospectively examined the full range of Axis I psychiatric disorders using semi-structured clinical interview. Accordingly, the main aims of the current study were to (a) investigate t...

  4. Intraoperative Physical Examination for Diagnosis of Interosseous Ligament Rupture-Cadaveric Study.

    Science.gov (United States)

    Kachooei, Amir Reza; Rivlin, Michael; Wu, Fei; Faghfouri, Aram; Eberlin, Kyle R; Ring, David

    2015-09-01

    To study the intraobserver and interobserver reliability of the diagnosis of interosseous ligament (IOL) rupture in a cadaver model. On 12 fresh frozen cadavers, radial heads were cut using an identical incision and osteotomy. After randomization, the soft tissues of the limbs were divided into 4 groups: both IOL and triangular fibrocartilage (TFCC) intact; IOL disruption but TFCC intact; both IOL and TFCC divided; and IOL intact but TFCC divided. All incisions had identical suturing. After standard instruction and demonstration of radius pull-push and radius lateral pull tests, 10 physician evaluators with different levels of experience examined the cadaver limbs in a standardized way (elbow at 90° with the forearm held in both supination and pronation) and were asked to classify them into one of the 4 groups. Next, the same examiners were asked to re-examine the limbs after randomly changing the order of examination. The interobserver reliability of agreement for the diagnosis of IOL injury (groups 2 and 3) was fair in both rounds of examination and the intraobserver reliability was moderate. The intra- and interobserver reliabilities of agreement for the 4 groups of injuries among the examiners were fair in both rounds of examination. The sensitivity, specificity, accuracy, positive, and negative predictive values were all around 70%. The likelihood of a positive test corresponding with the presence of IOL rupture (positive likelihood ratio) was 2.2. The likelihood of a negative test correctly diagnosing an intact IOL was 0.40. In cadavers, intraoperative tests had fair reliability and 70% accuracy for the diagnosis of IOL rupture using the push-pull and lateral pull maneuvers. The level of experience did not have any effect on the correct diagnosis of intact versus disrupted IOL. Although not common, some failure of surgeries for traumatic elbow fracture-dislocations is because of failure in timely diagnosis of IOL disruption. Copyright © 2015 American

  5. Effect Size (Cohen's d of Cognitive Screening Instruments Examined in Pragmatic Diagnostic Accuracy Studies

    Directory of Open Access Journals (Sweden)

    Andrew J. Larner

    2014-07-01

    Full Text Available Background/Aims: Many cognitive screening instruments (CSI are available to clinicians to assess cognitive function. The optimal method comparing the diagnostic utility of such tests is uncertain. The effect size (Cohen's d, calculated as the difference of the means of two groups divided by the weighted pooled standard deviations of these groups, may permit such comparisons. Methods: Datasets from five pragmatic diagnostic accuracy studies, which examined the Mini-Mental State Examination (MMSE, the Mini-Mental Parkinson (MMP, the Six-Item Cognitive Impairment Test (6CIT, the Montreal Cognitive Assessment (MoCA, the Test Your Memory test (TYM, and the Addenbrooke's Cognitive Examination-Revised (ACE-R, were analysed to calculate the effect size (Cohen's d for the diagnosis of dementia versus no dementia and for the diagnosis of mild cognitive impairment versus no dementia (subjective memory impairment. Results: The effect sizes for dementia versus no dementia diagnosis were large for all six CSI examined (range 1.59-1.87. For the diagnosis of mild cognitive impairment versus no dementia, the effect sizes ranged from medium to large (range 0.48-1.45, with MoCA having the largest effect size. Conclusion: The calculation of the effect size (Cohen's d in diagnostic accuracy studies is straightforward. The routine incorporation of effect size calculations into diagnostic accuracy studies merits consideration in order to facilitate the comparison of the relative value of CSI.

  6. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.

    Science.gov (United States)

    Hernan, Andrea L; Giles, Sally J; Fuller, Jeffrey; Johnson, Julie K; Walker, Christine; Dunbar, James A

    2015-09-01

    Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

  7. A Validation Study of the Japanese Version of the Addenbrooke's Cognitive Examination-Revised.

    Science.gov (United States)

    Dos Santos Kawata, Kelssy Hitomi; Hashimoto, Ryusaku; Nishio, Yoshiyuki; Hayashi, Atsuko; Ogawa, Nanayo; Kanno, Shigenori; Hiraoka, Kotaro; Yokoi, Kayoko; Iizuka, Osamu; Mori, Etsuro

    2012-01-01

    The aim of this study was to validate the Japanese version of the Addenbrooke's Cognitive Examination-Revised (ACE-R) [Mori: Japanese Edition of Hodges JR's Cognitive Assessment for Clinicians, 2010] designed to detect dementia, and to compare its diagnostic accuracy with that of the Mini-Mental State Examination. The ACE-R was administered to 85 healthy individuals and 126 patients with dementia. The reliability assessment revealed a strong correlation in both groups. The internal consistency was excellent (α-coefficient = 0.88). Correlation with the Clinical Dementia Rating sum of boxes score was significant (r(s) = -0.61, p Examination. The cut-off score of 80 showed a sensitivity of 94% and a specificity of 94%. Like the original ACE-R and the versions designed for other languages, the Japanese version of the ACE-R is a reliable and valid test for the detection of dementia.

  8. Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

    Science.gov (United States)

    Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

    2017-04-20

    Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

  9. Strategy for improving the detailed examination rate for colorectal cancer screening. New approach for detailed colorectal cancer examination. Study for optimal pre-treatment for CT colonography

    International Nuclear Information System (INIS)

    Mitsushima, Toru; Fujiwara, Masanori; Nagata, Koichi

    2012-01-01

    In order to drastically improve the detailed examination rate for strategic colorectal cancer examination in Japan, it is necessary to introduce CT colonography (CTC) as a detailed examination method for colorectal cancer examination, in addition to colonoscopy (CS) which is the conventional detailed examination method. In our study, a cleansing enema/contrast solution (3% Nif-C) was prepared by adding 60 ml of a water-soluble iodine-based contrast agent (Gastrografin) and water to an oral cleansing enema agent (Niflec) in solid (powder) form to a final amount of 2000 ml. The solution was compared with a Niflec solution. In terms of patient's acceptability, more than half of the examined patients answered ''easier to drink than the Niflec solution'' or ''as easy to drink as the Niflec solution. '' Also, the Nif-C solution was comparable or superior to the Niflec solution in terms of cleansing enema effects. Regarding imaging effects essential for CTC, the CT level was found to be 200 HU or greater for any large intestine region upon CTC using the Nif-C solution. Thus, practically sufficient imaging effects were achieved. In conclusion, CTC with pretreatment involving a cleansing enema with oral administration of 3% Nif-C is superior to CS in terms of patient's acceptability. In addition, at least in view of the overseas reports on CTC, there is no particular problem in terms of diagnostic accuracy. Thus, CTC is expected to resolve various problems related to colorectal cancer examination in Japan. (author)

  10. Ultrasonographic findings in patients examined in cataract detection-andtreatment campaigns: a retrospective study

    Directory of Open Access Journals (Sweden)

    Marcio Henrique Mendes

    2009-01-01

    Full Text Available INTRODUCTION: A cataract is defined as an opacity of any portion of the lens, regardless of visual acuity. In some advanced cases of cataracts, in which good fundus visualization is not possible, an ultrasound examination provides better assessment of the posterior segment of the globe. OBJECTIVES: This study aims to evaluate the ultrasonographic records of patients with advanced cataracts who were examined during cataract campaigns. METHODS: The ultrasonographic findings obtained from 215 patients examined in cataract campaigns conducted by the Hospital das Clínicas Department of Ophthalmology of the Faculdade de Medicina da Universidade de São Paulo between the years of 2005 and 2007 were evaluated, and the utility of this exam in changing the treatment procedures was studied. RESULTS: A total of 289 eyes from 215 patients were examined. Of the eyes examined, 77.5% presented with findings in the vitreous cavity and the posterior pole. A posterior vitreous detachment with no other complications was observed in 47.4% of the eyes. The remaining 30.1% presented with eye diseases that could result in a reduced visual function after surgery. The most frequent eye diseases observed were diffuse vitreous opacity (12.1% of the eyes and detachment of the retina (9.3% of the eyes. DISCUSSION: In many cases, the ultrasonographic evaluation of the posterior segment revealed significant anomalies that changed the original treatment plan or contra-indicated surgery. At the very least, the evaluation was useful for patient counseling. CONCLUSION: The ultrasonographic examination revealed and differentiated between eyes with cataracts and eyes with ocular abnormalities other than cataracts as the cause of poor vision, thereby indicating the importance of its use during ocular evaluation.

  11. Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study.

    Science.gov (United States)

    Ramjan, Lucie M; Stewart, Lyn; Salamonson, Yenna; Morris, Maureen M; Armstrong, Lyn; Sanchez, Paula; Flannery, Liz

    2014-03-01

    It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2

  12. A Genome-Wide Association Study Identifies Five Loci Influencing Facial Morphology in Europeans

    Science.gov (United States)

    Liu, Fan; van der Lijn, Fedde; Schurmann, Claudia; Zhu, Gu; Chakravarty, M. Mallar; Hysi, Pirro G.; Wollstein, Andreas; Lao, Oscar; de Bruijne, Marleen; Ikram, M. Arfan; van der Lugt, Aad; Rivadeneira, Fernando; Uitterlinden, André G.; Hofman, Albert; Niessen, Wiro J.; Homuth, Georg; de Zubicaray, Greig; McMahon, Katie L.; Thompson, Paul M.; Daboul, Amro; Puls, Ralf; Hegenscheid, Katrin; Bevan, Liisa; Pausova, Zdenka; Medland, Sarah E.; Montgomery, Grant W.; Wright, Margaret J.; Wicking, Carol; Boehringer, Stefan; Spector, Timothy D.; Paus, Tomáš; Martin, Nicholas G.; Biffar, Reiner; Kayser, Manfred

    2012-01-01

    Inter-individual variation in facial shape is one of the most noticeable phenotypes in humans, and it is clearly under genetic regulation; however, almost nothing is known about the genetic basis of normal human facial morphology. We therefore conducted a genome-wide association study for facial shape phenotypes in multiple discovery and replication cohorts, considering almost ten thousand individuals of European descent from several countries. Phenotyping of facial shape features was based on landmark data obtained from three-dimensional head magnetic resonance images (MRIs) and two-dimensional portrait images. We identified five independent genetic loci associated with different facial phenotypes, suggesting the involvement of five candidate genes—PRDM16, PAX3, TP63, C5orf50, and COL17A1—in the determination of the human face. Three of them have been implicated previously in vertebrate craniofacial development and disease, and the remaining two genes potentially represent novel players in the molecular networks governing facial development. Our finding at PAX3 influencing the position of the nasion replicates a recent GWAS of facial features. In addition to the reported GWA findings, we established links between common DNA variants previously associated with NSCL/P at 2p21, 8q24, 13q31, and 17q22 and normal facial-shape variations based on a candidate gene approach. Overall our study implies that DNA variants in genes essential for craniofacial development contribute with relatively small effect size to the spectrum of normal variation in human facial morphology. This observation has important consequences for future studies aiming to identify more genes involved in the human facial morphology, as well as for potential applications of DNA prediction of facial shape such as in future forensic applications. PMID:23028347

  13. A genome-wide association study identifies five loci influencing facial morphology in Europeans.

    Directory of Open Access Journals (Sweden)

    Fan Liu

    2012-09-01

    Full Text Available Inter-individual variation in facial shape is one of the most noticeable phenotypes in humans, and it is clearly under genetic regulation; however, almost nothing is known about the genetic basis of normal human facial morphology. We therefore conducted a genome-wide association study for facial shape phenotypes in multiple discovery and replication cohorts, considering almost ten thousand individuals of European descent from several countries. Phenotyping of facial shape features was based on landmark data obtained from three-dimensional head magnetic resonance images (MRIs and two-dimensional portrait images. We identified five independent genetic loci associated with different facial phenotypes, suggesting the involvement of five candidate genes--PRDM16, PAX3, TP63, C5orf50, and COL17A1--in the determination of the human face. Three of them have been implicated previously in vertebrate craniofacial development and disease, and the remaining two genes potentially represent novel players in the molecular networks governing facial development. Our finding at PAX3 influencing the position of the nasion replicates a recent GWAS of facial features. In addition to the reported GWA findings, we established links between common DNA variants previously associated with NSCL/P at 2p21, 8q24, 13q31, and 17q22 and normal facial-shape variations based on a candidate gene approach. Overall our study implies that DNA variants in genes essential for craniofacial development contribute with relatively small effect size to the spectrum of normal variation in human facial morphology. This observation has important consequences for future studies aiming to identify more genes involved in the human facial morphology, as well as for potential applications of DNA prediction of facial shape such as in future forensic applications.

  14. Identifying the most successful dose (MSD) in dose-finding studies in cancer.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2006-01-01

    For a dose finding study in cancer, the most successful dose (MSD), among a group of available doses, is that dose at which the overall success rate is the highest. This rate is the product of the rate of seeing non-toxicities together with the rate of tumor response. A successful dose finding trial in this context is one where we manage to identify the MSD in an efficient manner. In practice we may also need to consider algorithms for identifying the MSD which can incorporate certain restrictions, the most common restriction maintaining the estimated toxicity rate alone below some maximum rate. In this case the MSD may correspond to a different level than that for the unconstrained MSD and, in providing a final recommendation, it is important to underline that it is subject to the given constraint. We work with the approach described in O'Quigley et al. [Biometrics 2001; 57(4):1018-1029]. The focus of that work was dose finding in HIV where both information on toxicity and efficacy were almost immediately available. Recent cancer studies are beginning to fall under this same heading where, as before, toxicity can be quickly evaluated and, in addition, we can rely on biological markers or other measures of tumor response. Mindful of the particular context of cancer, our purpose here is to consider the methodology developed by O'Quigley et al. and its practical implementation. We also carry out a study on the doubly under-parameterized model, developed by O'Quigley et al. but not

  15. Using death certificates and medical examiner records for adolescent occupational fatality surveillance and research: a case study.

    Science.gov (United States)

    Rauscher, Kimberly J; Runyan, Carol W; Radisch, Deborah

    2012-01-01

    Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. This study investigated the utility of using these data sources for surveillance and research pertaining to adolescent work-related fatalities. Using the state of North Carolina as a case study, we analyzed data from the death certificates and medical examiner records of all work-related fatalities data among 11- to 17-year-olds between 1990-2008 (N = 31). We compared data sources on case identification, of completeness, and consistency information. Variables examined included those on the injury (e.g., means), occurrence (e.g., place), demographics, and employment (e.g., occupation). Medical examiner records (90%) were more likely than death certificates (71%) to identify adolescent work-related fatalities. Data completeness was generally high yet varied between sources. The most marked difference being that in medical examiner records, type of business/industry and occupation were complete in 72 and 67% of cases, respectively, while on the death certificates these fields were complete in 90 and 97% of cases, respectively. Taking the two sources together, each field was complete in upward of 94% of cases. Although completeness was high, data were not always of good quality and sometimes conflicted across sources. In many cases, the decedent's occupation was misclassified as "student" and their employer as "school" on the death certificate. Even though each source has its weaknesses, medical examiner records and death certificates, especially when used together, can be useful for conducting surveillance and research on adolescent work-related fatalities. However, extra care is needed by data recorders to ensure that

  16. Genome-wide association study identifies 74 loci associated with educational attainment

    Science.gov (United States)

    Okbay, Aysu; Beauchamp, Jonathan P.; Fontana, Mark A.; Lee, James J.; Pers, Tune H.; Rietveld, Cornelius A.; Turley, Patrick; Chen, Guo-Bo; Emilsson, Valur; Meddens, S. Fleur W.; Oskarsson, Sven; Pickrell, Joseph K.; Thom, Kevin; Timshel, Pascal; de Vlaming, Ronald; Abdellaoui, Abdel; Ahluwalia, Tarunveer S.; Bacelis, Jonas; Baumbach, Clemens; Bjornsdottir, Gyda; Brandsma, Johannes H.; Concas, Maria Pina; Derringer, Jaime; Furlotte, Nicholas A.; Galesloot, Tessel E.; Girotto, Giorgia; Gupta, Richa; Hall, Leanne M.; Harris, Sarah E.; Hofer, Edith; Horikoshi, Momoko; Huffman, Jennifer E.; Kaasik, Kadri; Kalafati, Ioanna P.; Karlsson, Robert; Kong, Augustine; Lahti, Jari; van der Lee, Sven J.; de Leeuw, Christiaan; Lind, Penelope A.; Lindgren, Karl-Oskar; Liu, Tian; Mangino, Massimo; Marten, Jonathan; Mihailov, Evelin; Miller, Michael B.; van der Most, Peter J.; Oldmeadow, Christopher; Payton, Antony; Pervjakova, Natalia; Peyrot, Wouter J.; Qian, Yong; Raitakari, Olli; Rueedi, Rico; Salvi, Erika; Schmidt, Börge; Schraut, Katharina E.; Shi, Jianxin; Smith, Albert V.; Poot, Raymond A.; Pourcain, Beate; Teumer, Alexander; Thorleifsson, Gudmar; Verweij, Niek; Vuckovic, Dragana; Wellmann, Juergen; Westra, Harm-Jan; Yang, Jingyun; Zhao, Wei; Zhu, Zhihong; Alizadeh, Behrooz Z.; Amin, Najaf; Bakshi, Andrew; Baumeister, Sebastian E.; Biino, Ginevra; Bønnelykke, Klaus; Boyle, Patricia A.; Campbell, Harry; Cappuccio, Francesco P.; Davies, Gail; De Neve, Jan-Emmanuel; Deloukas, Panos; Demuth, Ilja; Ding, Jun; Eibich, Peter; Eisele, Lewin; Eklund, Niina; Evans68, David M.; Faul, Jessica D.; Feitosa, Mary F.; Forstner, Andreas J.; Gandin, Ilaria; Gunnarsson, Bjarni; Halldórsson, Bjarni V.; Harris, Tamara B.; Heath, Andrew C.; Hocking, Lynne J.; Holliday, Elizabeth G.; Homuth, Georg; Horan, Michael A.; Hottenga, Jouke-Jan; de Jager, Philip L.; Joshi, Peter K.; Jugessur, Astanand; Kaakinen, Marika A.; Kähönen, Mika; Kanoni, Stavroula; Keltigangas-Järvinen, Liisa; Kiemeney, Lambertus A.L.M.; Kolcic, Ivana; Koskinen, Seppo; Kraja, Aldi T.; Kroh, Martin; Kutalik, Zoltan; Latvala, Antti; Launer, Lenore J.; Lebreton, Maël P.; Levinson, Douglas F.; Lichtenstein, Paul; Lichtner, Peter; Liewald, David C.M.; Loukola, Anu; Madden, Pamela A.; Mägi, Reedik; Mäki-Opas, Tomi; Marioni, Riccardo E.; Marques-Vidal, Pedro; Meddens, Gerardus A.; McMahon, George; Meisinger, Christa; Meitinger, Thomas; Milaneschi, Yusplitri; Milani, Lili; Montgomery, Grant W.; Myhre, Ronny; Nelson, Christopher P.; Nyholt, Dale R.; Ollier, William E.R.; Palotie, Aarno; Paternoster, Lavinia; Pedersen, Nancy L.; Petrovic, Katja E.; Porteous, David J.; Räikkönen, Katri; Ring, Susan M.; Robino, Antonietta; Rostapshova, Olga; Rudan, Igor; Rustichini, Aldo; Salomaa, Veikko; Sanders, Alan R.; Sarin, Antti-Pekka; Schmidt, Helena; Scott, Rodney J.; Smith, Blair H.; Smith, Jennifer A.; Staessen, Jan A.; Steinhagen-Thiessen, Elisabeth; Strauch, Konstantin; Terracciano, Antonio; Tobin, Martin D.; Ulivi, Sheila; Vaccargiu, Simona; Quaye, Lydia; van Rooij, Frank J.A.; Venturini, Cristina; Vinkhuyzen, Anna A.E.; Völker, Uwe; Völzke, Henry; Vonk, Judith M.; Vozzi, Diego; Waage, Johannes; Ware, Erin B.; Willemsen, Gonneke; Attia, John R.; Bennett, David A.; Berger, Klaus; Bertram, Lars; Bisgaard, Hans; Boomsma, Dorret I.; Borecki, Ingrid B.; Bultmann, Ute; Chabris, Christopher F.; Cucca, Francesco; Cusi, Daniele; Deary, Ian J.; Dedoussis, George V.; van Duijn, Cornelia M.; Eriksson, Johan G.; Franke, Barbara; Franke, Lude; Gasparini, Paolo; Gejman, Pablo V.; Gieger, Christian; Grabe, Hans-Jörgen; Gratten, Jacob; Groenen, Patrick J.F.; Gudnason, Vilmundur; van der Harst, Pim; Hayward, Caroline; Hinds, David A.; Hoffmann, Wolfgang; Hyppönen, Elina; Iacono, William G.; Jacobsson, Bo; Järvelin, Marjo-Riitta; Jöckel, Karl-Heinz; Kaprio, Jaakko; Kardia, Sharon L.R.; Lehtimäki, Terho; Lehrer, Steven F.; Magnusson, Patrik K.E.; Martin, Nicholas G.; McGue, Matt; Metspalu, Andres; Pendleton, Neil; Penninx, Brenda W.J.H.; Perola, Markus; Pirastu, Nicola; Pirastu, Mario; Polasek, Ozren; Posthuma, Danielle; Power, Christine; Province, Michael A.; Samani, Nilesh J.; Schlessinger, David; Schmidt, Reinhold; Sørensen, Thorkild I.A.; Spector, Tim D.; Stefansson, Kari; Thorsteinsdottir, Unnur; Thurik, A. Roy; Timpson, Nicholas J.; Tiemeier, Henning; Tung, Joyce Y.; Uitterlinden, André G.; Vitart, Veronique; Vollenweider, Peter; Weir, David R.; Wilson, James F.; Wright, Alan F.; Conley, Dalton C.; Krueger, Robert F.; Smith, George Davey; Hofman, Albert; Laibson, David I.; Medland, Sarah E.; Meyer, Michelle N.; Yang, Jian; Johannesson, Magnus; Visscher, Peter M.; Esko, Tõnu; Koellinger, Philipp D.; Cesarini, David; Benjamin, Daniel J.

    2016-01-01

    Summary Educational attainment (EA) is strongly influenced by social and other environmental factors, but genetic factors are also estimated to account for at least 20% of the variation across individuals1. We report the results of a genome-wide association study (GWAS) for EA that extends our earlier discovery sample1,2 of 101,069 individuals to 293,723 individuals, and a replication in an independent sample of 111,349 individuals from the UK Biobank. We now identify 74 genome-wide significant loci associated with number of years of schooling completed. Single-nucleotide polymorphisms (SNPs) associated with educational attainment are disproportionately found in genomic regions regulating gene expression in the fetal brain. Candidate genes are preferentially expressed in neural tissue, especially during the prenatal period, and enriched for biological pathways involved in neural development. Our findings demonstrate that, even for a behavioral phenotype that is mostly environmentally determined, a well-powered GWAS identifies replicable associated genetic variants that suggest biologically relevant pathways. Because EA is measured in large numbers of individuals, it will continue to be useful as a proxy phenotype in efforts to characterize the genetic influences of related phenotypes, including cognition and neuropsychiatric disease. PMID:27225129

  17. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  18. A systematic review of studies identifying predictors of poor return to work outcomes following workplace injury.

    Science.gov (United States)

    Street, Tamara D; Lacey, Sarah J

    2015-06-05

    Injuries occurring in the workplace can have serious implications for the health of the individual, the productivity of the employer and the overall economic community. The objective of this paper is to increase the current state of understanding of individual demographic and psychosocial characteristics associated with extended absenteeism from the workforce due to a workplace injury. Studies included in this systematic literature review tracked participants' return to work status over a minimum of three months, identified either demographic, psychosocial or general injury predictors of poor return to work outcomes and included a heterogeneous sample of workplace injuries. Identified predictors of poor return to work outcomes included older age, female gender, divorced marital status, two or more dependent family members, lower education levels, employment variables associated with reduced labour market desirability, severity or sensitive injury locations, negative attitudes and outcome perceptions of the participant. There is a need for clear and consistent definition and measurement of return to work outcomes and a holistic theoretical model integrating injury, psychosocial and demographic predictors of return to work. Through greater understanding of the nature of factors affecting return to work, improved outcomes could be achieved.

  19. Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

    Science.gov (United States)

    Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

    2017-07-01

    Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

  20. Recruitment and Ongoing Engagement in a UK Smartphone Study Examining the Association Between Weather and Pain: Cohort Study.

    Science.gov (United States)

    Druce, Katie L; McBeth, John; van der Veer, Sabine N; Selby, David A; Vidgen, Bertie; Georgatzis, Konstantinos; Hellman, Bruce; Lakshminarayana, Rashmi; Chowdhury, Afiqul; Schultz, David M; Sanders, Caroline; Sergeant, Jamie C; Dixon, William G

    2017-11-01

    The huge increase in smartphone use heralds an enormous opportunity for epidemiology research, but there is limited evidence regarding long-term engagement and attrition in mobile health (mHealth) studies. The objective of this study was to examine how representative the Cloudy with a Chance of Pain study population is of wider chronic-pain populations and to explore patterns of engagement among participants during the first 6 months of the study. Participants in the United Kingdom who had chronic pain (≥3 months) and enrolled between January 20, 2016 and January 29, 2016 were eligible if they were aged ≥17 years and used the study app to report any of 10 pain-related symptoms during the study period. Participant characteristics were compared with data from the Health Survey for England (HSE) 2011. Distinct clusters of engagement over time were determined using first-order hidden Markov models, and participant characteristics were compared between the clusters. Compared with the data from the HSE, our sample comprised a higher proportion of women (80.51%, 5129/6370 vs 55.61%, 4782/8599) and fewer persons at the extremes of age (16-34 and 75+). Four clusters of engagement were identified: high (13.60%, 865/6370), moderate (21.76%, 1384/6370), low (39.35%, 2503/6370), and tourists (25.44%, 1618/6370), between which median days of data entry ranged from 1 (interquartile range; IQR: 1-1; tourist) to 149 (124-163; high). Those in the high-engagement cluster were typically older, whereas those in the tourist cluster were mostly male. Few other differences distinguished the clusters. Cloudy with a Chance of Pain demonstrates a rapid and successful recruitment of a large, representative, and engaged sample of people with chronic pain and provides strong evidence to suggest that smartphones could provide a viable alternative to traditional data collection methods. ©Katie L Druce, John McBeth, Sabine N van der Veer, David A Selby, Bertie Vidgen, Konstantinos Georgatzis

  1. Identifying environmental risk to male reproductive function by occupational sperm studies: logistics and design options.

    Science.gov (United States)

    Bonde, J P; Giwercman, A; Ernst, E

    1996-01-01

    Malfunction of the male reproductive system might be a sensitive marker of environmental hazards, the effects of which may extend beyond reproductive function. The testis is more vulnerable to heat and ionising radiation than any other organ of the body and several xenobiotics are known to disrupt spermatogenesis after low level exposure. Studies of environmental impact on human health are often most informative and accurate when carried out in the workplace where exposures can be high and easy to document. Semen analysis provides readily obtainable information on testicular function. The main advantages in comparison with functional measures such as fertility rates and time taken to conceive are the possibilities to examine men independently of marriage and pregnancy, to find changes of fecundity with different exposures within the same person and to detect adverse effects when no alteration of fertility is yet taking place. In the implementation of an occupational sperm study considerable attention must be paid to logistic issues. A mobile laboratory unit for initial semen preparation and processing may in some situations increase worker compliance and the quality of sperm cell motility. The cross sectional design which has been used in almost all male reproductive studies so far has several severe limitations including selection bias because of differential participation, difficulties in defining a suitable reference group, and lack of information about the time dimension of the cause-effect relation. The longitudinal design deals adequately with most of these constraints. Semen samples are collected before, during, and possibly after exposure to the risk factor of interest and causal inferences are based upon change of semen variables within a man over time rather than upon differences between men. The logistics of the longitudinal study may benefit from pre-employment health examinations to enrol newly hired workers and require fewer participants to obtain

  2. Identifying factors to improve oral cancer screening uptake: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Fatemeh Vida Zohoori

    Full Text Available To engage with high risk groups to identify knowledge and awareness of oral cancer signs and symptoms and the factors likely to contribute to improved screening uptake.Focus group discussions were undertaken with 18 males; 40+ years of age; smokers and/or drinkers (15+ cigarettes per day and/or 15+ units of alcohol per week, irregular dental attenders living in economically deprived areas of Teesside.There was a striking reported lack of knowledge and awareness of oral cancer and its signs and symptoms among the participants. When oral/mouth cancer leaflets produced by Cancer Research UK were presented to the participants, they claimed that they would seek help on noticing such a condition. There was a preference to seek help from their general practitioner rather than their dentist due to perceptions that a dentist is 'inaccessible' on a physical and psychological level, costly, a 'tooth specialist' not a 'mouth specialist', and also not able to prescribe medication and make referrals to specialists. Interestingly, none of the 18 participants who were offered a free oral cancer examination at a dental practice took up this offer.The uptake of oral cancer screening may be improved by increasing knowledge of the existence and signs and symptoms of oral cancer. Other factors that may increase uptake are increased awareness of the role of dentists in diagnosing oral cancer, promotion of oral cancer screening by health professionals during routine health checks, and the use of a "health" screening setting as opposed to a "dental" setting for such checks.

  3. Preservice Teacher Preparation in International Contexts: A Case-Study Examination of the International Student Teacher Programs

    Directory of Open Access Journals (Sweden)

    W. James Jacob

    2010-12-01

    Full Text Available This article examines the teacher preparation experiences of preservice teachers in six international contexts: China, Fiji, Kiribati, Mexico, Samoa, and Tonga. More specifically, it looks at the value-added components in an international teacher education program, with an emphasis on effective teaching and employability. Theoretically the study is based on Straus and Corbin’s (1998a substantive grounded theory and Patton’s (1997 Theory of Action Framework. Verbal and non-verbal forms of feedback were identified as essential aspects of the international preservice training experience. Cultural diversity, teaching English as a second language, collaboration, and exposure to a different educational system were identified among several components as advantages to individuals who conduct their preservice teacher training in international settings.

  4. A study to identify winning strategies for the business community during the next pandemic.

    Science.gov (United States)

    Spriggs, Martin

    2013-01-01

    This study examines the relationship between the healthcare system and the corporate sector to answer the following research question: how does the healthcare system best prepare small to medium-sized businesses for the next pandemic influenza? Data were collected and collated through a literature review, electronic survey and semi-structured follow-up telephone interviews. The participants were businesses with membership in the Alberta Chambers of Commerce, a provincial lobby group in Alberta, Canada. The findings indicate strategies that were effective in minimising impact to the business community during the H1N1 pandemic and suggest areas for the business community to improve in preparation for the next pandemic influenza. Recommendations focus on establishing new links for communication between the business community and the healthcare sector and improving strategies to increase the resilience of small to medium-sized businesses for the next pandemic influenza.

  5. Software Development Initiatives to Identify and Mitigate Security Threats - Two Systematic Mapping Studies

    Directory of Open Access Journals (Sweden)

    Paulina Silva

    2016-12-01

    Full Text Available Software Security and development experts have addressed the problem of building secure software systems. There are several processes and initiatives to achieve secure software systems. However, most of these lack empirical evidence of its application and impact in building secure software systems. Two systematic mapping studies (SM have been conducted to cover the existent initiatives for identification and mitigation of security threats. The SMs created were executed in two steps, first in 2015 July, and complemented through a backward snowballing in 2016 July. Integrated results of these two SM studies show a total of 30 relevant sources were identified; 17 different initiatives covering threats identification and 14 covering the mitigation of threats were found. All the initiatives were associated to at least one activity of the Software Development Lifecycle (SDLC; while 6 showed signs of being applied in industrial settings, only 3 initiatives presented experimental evidence of its results through controlled experiments, some of the other selected studies presented case studies or proposals.

  6. Molecular genetic studies in Saudi population; identified variants from GWAS and meta-analysis in stroke.

    Science.gov (United States)

    Alharbi, Khalid Khalaf; Ali Khan, Imran; Alotaibi, Mohammad Abdullah; Saud Aloyaid, Abdullah; Al-Basheer, Haifa Abdulaziz; Alghamdi, Naelah Abdullah; Al-Baradie, Raid Saleem; Al-Sulaiman, A M

    2018-01-01

    Stroke is a multifactorial and heterogeneous disorder, correlates with heritability and considered as one of the major diseases. The prior reports performed the variable models such as genome-wide association studies (GWAS), replication, case-control, cross-sectional and meta-analysis studies and still, we lack diagnostic marker in the global world. There are limited studies were carried out in Saudi population, and we aim to investigate the molecular association of single nucleotide polymorphisms (SNPs) identified through GWAS and meta-analysis studies in stroke patients in the Saudi population. In this case-control study, we have opted gender equality of 207 cases and 207 controls from the capital city of Saudi Arabia in King Saud University Hospital. The peripheral blood (5 ml) sample will be collected in two different vacutainers, and three mL of the coagulated blood will be used for lipid analysis (biochemical tests) and two mL will be used for DNA analysis (molecular tests). Genomic DNA will be extracted with the collected blood samples, and specific primers will be designed for the opted SNPs ( SORT1 -rs646218 and OLR1 -rs11053646 polymorphisms) and PCR-RFLP will be performed and randomly DNA sequencing will be carried out to cross check the results. The rs646218 and rs11053646 polymorphisms were significantly associated with allele, genotype and dominant models with and without crude odds ratios (OR's) and Multiple logistic regression analysis (p Saudi population. The current results were in the association with the prior study results documented through GWAS and meta-analysis association. However, other ethnic population studies should be performed to rule out in the human hereditary diseases.

  7. Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study.

    Science.gov (United States)

    Eskelinen, Saana; Sailas, Eila; Joutsenniemi, Kaisla; Holi, Matti; Koskela, Tuomas H; Suvisaari, Jaana

    2017-08-01

    Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.

  8. Factors influencing medical students' self-assessment of examination performance accuracy: A United Arab Emirates study.

    Science.gov (United States)

    Shaban, Sami; Aburawi, Elhadi H; Elzubeir, Khalifa; Elango, Sambandam; El-Zubeir, Margaret

    2016-01-01

    Assessment of one's academic capabilities is essential to being an effective, self-directed, life-long learner. The primary objective of this study was to analyze self-assessment accuracy of medical students attending the College of Medicine and Health Sciences, United Arab Emirates University, by examining their ability to assess their own performance on an MCQ examination. 1 st and 2 nd year medical students (n = 235) self-assessed pre and post-examination performance were compared with objectively measured scores (actual examination performance). Associations between accuracy of score prediction (pre and post assessment), and students' gender, year of education, perceived preparation, confidence and anxiety were also determined. Expected mark correlated significantly with objectively assessed marks (r = 0.407; P self-assessment accuracy. Findings reinforce existing evidence indicating that medical students are poor self-assessors. There are potentially multiple explanations for misjudgment of this multidimensional construct that require further investigation and change in learning cultures. The study offers clear targets for change aimed at optimizing self-assessment capabilities.

  9. Genome-wide association study identifies 74 loci associated with educational attainment

    DEFF Research Database (Denmark)

    Okbay, Aysu; P. Beauchamp, Jonathan; Alan Fontana, Mark

    2016-01-01

    -nucleotide polymorphisms associated with educational attainment are disproportionately found in genomic regions regulating gene expression in the fetal brain. Candidate genes are preferentially expressed in neural tissue, especially during the prenatal period, and enriched for biological pathways involved in neural......Educational attainment is strongly influenced by social and other environmental factors, but genetic factors are estimated to account for at least 20% of the variation across individuals1. Here we report the results of a genome-wide association study (GWAS) for educational attainment that extends...... development. Our findings demonstrate that, even for a behavioural phenotype that is mostly environmentally determined, a well-powered GWAS identifies replicable associated genetic variants that suggest biologically relevant pathways. Because educational attainment is measured in large numbers of individuals...

  10. How well do discharge diagnoses identify hospitalised patients with community-acquired infections? - a validation study

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Nielsen, Stig Lønberg; Laursen, Christian Borbjerg

    2014-01-01

    -10 diagnoses was 79.9% (95%CI: 78.1-81.3%), specificity 83.9% (95%CI: 82.6-85.1%), positive likelihood ratio 4.95 (95%CI: 4.58-5.36) and negative likelihood ratio 0.24 (95%CI: 0.22-0.26). The two most common sites of infection, the lower respiratory tract and urinary tract, had positive likelihood......BACKGROUND: Credible measures of disease incidence, trends and mortality can be obtained through surveillance using manual chart review, but this is both time-consuming and expensive. ICD-10 discharge diagnoses are used as surrogate markers of infection, but knowledge on the validity of infections...... in general is sparse. The aim of the study was to determine how well ICD-10 discharge diagnoses identify patients with community-acquired infections in a medical emergency department (ED), overall and related to sites of infection and patient characteristics. METHODS: We manually reviewed 5977 patients...

  11. Local acceptance of wind energy: Factors of success identified in French and German case studies

    International Nuclear Information System (INIS)

    Jobert, Arthur; Laborgne, Pia; Mimler, Solveig

    2007-01-01

    The objective of this paper is to identify and analyse factors that are important for winning acceptance of wind-energy parks on the local level. The developers of wind-energy parks need to know how to manage 'social acceptance' at the different stages of planning, realisation and operation. Five case studies in France and Germany focused on factors of success in developing a wind-energy project on a given site and illuminated how policy frameworks influence local acceptance. Our hypothesis is that these factors fall into two categories: institutional conditions, such as economic incentives and regulations; and site-specific conditions (territorial factors), such as the local economy, the local geography, local actors, and the actual on-site planning process (project management)

  12. Investigation of 95 variants identified in a genome-wide study for association with mortality after acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Winkelmann Bernhard R

    2011-09-01

    Full Text Available Abstract Background Genome-wide association studies (GWAS have identified new candidate genes for the occurrence of acute coronary syndrome (ACS, but possible effects of such genes on survival following ACS have yet to be investigated. Methods We examined 95 polymorphisms in 69 distinct gene regions identified in a GWAS for premature myocardial infarction for their association with post-ACS mortality among 811 whites recruited from university-affiliated hospitals in Kansas City, Missouri. We then sought replication of a positive genetic association in a large, racially diverse cohort of myocardial infarction patients (N = 2284 using Kaplan-Meier survival analyses and Cox regression to adjust for relevant covariates. Finally, we investigated the apparent association further in 6086 additional coronary artery disease patients. Results After Cox adjustment for other ACS risk factors, of 95 SNPs tested in 811 whites only the association with the rs6922269 in MTHFD1L was statistically significant, with a 2.6-fold mortality hazard (P = 0.007. The recessive A/A genotype was of borderline significance in an age- and race-adjusted analysis of the entire combined cohort (N = 3095; P = 0.052, but this finding was not confirmed in independent cohorts (N = 6086. Conclusions We found no support for the hypothesis that the GWAS-identified variants in this study substantially alter the probability of post-ACS survival. Large-scale, collaborative, genome-wide studies may be required in order to detect genetic variants that are robustly associated with survival in patients with coronary artery disease.

  13. Characteristics of Effective Simulation (Preclinical) Teachers as Identified by Dental Students: A Qualitative Study.

    Science.gov (United States)

    McAndrew, Maureen; Mucciolo, Thomas W; Jahangiri, Leila

    2016-11-01

    The aim of this qualitative research study was to identify and categorize criteria for simulation teacher quality preferences as reported by dental students. Second-year dental students at New York University College of Dentistry in 2015 were given a two-question, open-ended survey asking what qualities they liked most and least in a simulation or preclinical teacher. Responses were collected until data saturation was reached. Key words in the responses were identified and coded based on similar relationships and then were grouped into defined categories. A total of 168 respondents out of the target group of 363 students (46.3%) provided 1,062 written comments. Three core themes-character, competence, and communication-emerged from 16 defined categories, which were validated using references from the educational literature. The theme of character encompassed eight of the defined categories (motivation, available, caring, patience, professionalism, empathy, fairness, and happiness) and accounted for 50% of the total student responses. The theme of competence comprised five categories (expertise, knowledgeable, efficient, skillful, and effective) and represented 34% of all responses. The communication theme covered the remaining three categories (feedback, approachable, and interpersonal communication) and contained 17% of the responses. Positive and negative comments in the category of motivation accounted for 11.2% of all student responses. Expertise was the next highest category with 9.3% of the responses, followed closely by 9.1% in the category of available. Among these students, the top five attributes of simulation teachers were motivation, expertise, available, caring, and feedback. While the study did not attempt to correlate these findings with improved student performance, the results can be used in the development of assessment tools for faculty and targeted faculty development programs.

  14. A Qualitative Study to Identify Skills and Competency Required for Hospital Managers

    Science.gov (United States)

    Barati, Omid; Sadeghi, Ahmad; Khammarnia, Mohammad; Siavashi, Elham; Oskrochi, Gholamreza

    2016-01-01

    Introduction Hospital managers aim to improve the efficiency and effectiveness of their institutions through leadership and guidance of medical personnel. Fulfilling these objectives requires a holistic approach to both the management of people and institutional prioritization. The aim of this study was to identify the skills and competencies that hospital managers must demonstrate in order to achieve their objectives. Methods In 2015, a regional, multi-center qualitative study was undertaken in Shiraz, Iran. Interviews and focus group discussions were conducted with university hospital managers, senior managers, faculty members, and post-graduate students, and the results were analyzed using the content analysis method by MAXQDA software. Results Eight key skill themes (communication, experience, appreciation of institution logistics/infrastructure, management skills, motivation, systematic problem solving, ethics, and financial/legal awareness) were identified among the hospital managers. The common challenges that face hospital institutions include problems with hierarchical and organizational structure, excessive rules and regulations, lack of resources, poor post-graduate education, and overall management. Recurring themes with respect to how these could be addressed included changing the culture and belief structure of the hospital, restructuring the organizational hierarchy, and empowering the people. Conclusion In our cohort, practical skills, such as communication and experience, were considered more important than theoretical skills for the effective management and administration of hospitals. Therefore, we suggest that practical, skill-based training should be emphasized for students of these disciplines so they will be better suited to deal with real world challenges. Further organizational improvements also can be attained by the active and constructive involvement of senior university managers. PMID:27504159

  15. Meta-analysis of Drosophila circadian microarray studies identifies a novel set of rhythmically expressed genes.

    Directory of Open Access Journals (Sweden)

    Kevin P Keegan

    2007-11-01

    Full Text Available Five independent groups have reported microarray studies that identify dozens of rhythmically expressed genes in the fruit fly Drosophila melanogaster. Limited overlap among the lists of discovered genes makes it difficult to determine which, if any, exhibit truly rhythmic patterns of expression. We reanalyzed data from all five reports and found two sources for the observed discrepancies, the use of different expression pattern detection algorithms and underlying variation among the datasets. To improve upon the methods originally employed, we developed a new analysis that involves compilation of all existing data, application of identical transformation and standardization procedures followed by ANOVA-based statistical prescreening, and three separate classes of post hoc analysis: cross-correlation to various cycling waveforms, autocorrelation, and a previously described fast Fourier transform-based technique. Permutation-based statistical tests were used to derive significance measures for all post hoc tests. We find application of our method, most significantly the ANOVA prescreening procedure, significantly reduces the false discovery rate relative to that observed among the results of the original five reports while maintaining desirable statistical power. We identify a set of 81 cycling transcripts previously found in one or more of the original reports as well as a novel set of 133 transcripts not found in any of the original studies. We introduce a novel analysis method that compensates for variability observed among the original five Drosophila circadian array reports. Based on the statistical fidelity of our meta-analysis results, and the results of our initial validation experiments (quantitative RT-PCR, we predict many of our newly found genes to be bona fide cyclers, and suggest that they may lead to new insights into the pathways through which clock mechanisms regulate behavioral rhythms.

  16. Genome-wide association study of blood pressure extremes identifies variant near UMOD associated with hypertension.

    Directory of Open Access Journals (Sweden)

    Sandosh Padmanabhan

    2010-10-01

    Full Text Available Hypertension is a heritable and major contributor to the global burden of disease. The sum of rare and common genetic variants robustly identified so far explain only 1%-2% of the population variation in BP and hypertension. This suggests the existence of more undiscovered common variants. We conducted a genome-wide association study in 1,621 hypertensive cases and 1,699 controls and follow-up validation analyses in 19,845 cases and 16,541 controls using an extreme case-control design. We identified a locus on chromosome 16 in the 5' region of Uromodulin (UMOD; rs13333226, combined P value of 3.6 × 10⁻¹¹. The minor G allele is associated with a lower risk of hypertension (OR [95%CI]: 0.87 [0.84-0.91], reduced urinary uromodulin excretion, better renal function; and each copy of the G allele is associated with a 7.7% reduction in risk of CVD events after adjusting for age, sex, BMI, and smoking status (H.R. = 0.923, 95% CI 0.860-0.991; p = 0.027. In a subset of 13,446 individuals with estimated glomerular filtration rate (eGFR measurements, we show that rs13333226 is independently associated with hypertension (unadjusted for eGFR: 0.89 [0.83-0.96], p = 0.004; after eGFR adjustment: 0.89 [0.83-0.96], p = 0.003. In clinical functional studies, we also consistently show the minor G allele is associated with lower urinary uromodulin excretion. The exclusive expression of uromodulin in the thick portion of the ascending limb of Henle suggests a putative role of this variant in hypertension through an effect on sodium homeostasis. The newly discovered UMOD locus for hypertension has the potential to give new insights into the role of uromodulin in BP regulation and to identify novel drugable targets for reducing cardiovascular risk.

  17. Identifying the Neural Substrates of Procrastination: a Resting-State fMRI Study.

    Science.gov (United States)

    Zhang, Wenwen; Wang, Xiangpeng; Feng, Tingyong

    2016-09-12

    Procrastination is a prevalent problematic behavior that brings serious consequences to individuals who suffer from it. Although this phenomenon has received increasing attention from researchers, the underpinning neural substrates of it is poorly studied. To examine the neural bases subserving procrastination, the present study employed resting-state fMRI. The main results were as follows: (1) the behavioral procrastination was positively correlated with the regional activity of the ventromedial prefrontal cortex (vmPFC) and the parahippocampal cortex (PHC), while negatively correlated with that of the anterior prefrontal cortex (aPFC). (2) The aPFC-seed connectivity with the anterior medial prefrontal cortex and the posterior cingulate cortex was positively associated with procrastination. (3) The connectivity between vmPFC and several other regions, such as the dorsomedial prefrontal cortex, the bilateral inferior prefrontal cortex showed a negative association with procrastination. These results suggested that procrastination could be attributed to, on the one hand, hyper-activity of the default mode network (DMN) that overrides the prefrontal control signal; while on the other hand, the failure of top-down control exerted by the aPFC on the DMN. Therefore, the present study unravels the biomarkers of procrastination and provides treatment targets for procrastination prevention.

  18. Adult health study Hiroshima analysis of participation in examinations, July 1958-December 1960

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Jr, P S

    1961-07-19

    The participation data for Adult Health Study examinations conducted in Hiroshima during the period July 1958 to December 31, 1960, are presented. The continuing medical examination program includes approximately 13,700 individuals who form the Adult Health Study population of ABCC in Hiroshima. The Adult Health Study population is composed of four exposure groups of equal size, matched by age and sex. Participation scores are analyzed with respect to exposure, age, sex, and socioeconomic variables as well as history of previous contact with the ABCC programs. Significant differences were demonstrated between the participation scores by age, marital status, history of prior contact with ABCC, and occupation; this latter category was significant only for males. Although differences were observed for these variables, the significance was usually attributable to one category in each of the variables, often the least populated, such as separated or divorced for marital status; and previous history unknown for prior ABCC contact. A trend was apparent with respect to exposure, with the lowest participation noted in the nonexposed and the highest participation in the exposed group with symptoms. Sex differences were not significant. Although relatively minor differences were demonstrated for some variables, the outstanding features of this program are the remarkable high participation scores. Only 9 percent of the population were in the so-called refusal category and over 80 percent of the living Adult Health Study population, including non-Hiroshima residents, were examined during the period considered by this report. 6 references, 1 figure, 9 tables.

  19. Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders : prospective cohort study with 2-year follow-up

    NARCIS (Netherlands)

    van Hoffen, Marieke F. A.; Joling, Catelijne I.; Heymans, Martijn W.; Twisk, Jos W. R.; Roelen, Corne A. M.

    2015-01-01

    Background: Mental health problems are a leading cause of long-term sickness absence (LTSA). Workers at risk of mental LTSA should preferably be identified before they report sick. The objective of this study was to examine mental health symptoms as predictors of future mental LTSA in non-sicklisted

  20. Genome-wide association studies identify four ER negative–specific breast cancer risk loci

    Science.gov (United States)

    Garcia-Closas, Montserrat; Couch, Fergus J; Lindstrom, Sara; Michailidou, Kyriaki; Schmidt, Marjanka K; Brook, Mark N; orr, Nick; Rhie, Suhn Kyong; Riboli, Elio; Feigelson, Heather s; Le Marchand, Loic; Buring, Julie E; Eccles, Diana; Miron, Penelope; Fasching, Peter A; Brauch, Hiltrud; Chang-Claude, Jenny; Carpenter, Jane; Godwin, Andrew K; Nevanlinna, Heli; Giles, Graham G; Cox, Angela; Hopper, John L; Bolla, Manjeet K; Wang, Qin; Dennis, Joe; Dicks, Ed; Howat, Will J; Schoof, Nils; Bojesen, Stig E; Lambrechts, Diether; Broeks, Annegien; Andrulis, Irene L; Guénel, Pascal; Burwinkel, Barbara; Sawyer, Elinor J; Hollestelle, Antoinette; Fletcher, Olivia; Winqvist, Robert; Brenner, Hermann; Mannermaa, Arto; Hamann, Ute; Meindl, Alfons; Lindblom, Annika; Zheng, Wei; Devillee, Peter; Goldberg, Mark S; Lubinski, Jan; Kristensen, Vessela; Swerdlow, Anthony; Anton-Culver, Hoda; Dörk, Thilo; Muir, Kenneth; Matsuo, Keitaro; Wu, Anna H; Radice, Paolo; Teo, Soo Hwang; Shu, Xiao-Ou; Blot, William; Kang, Daehee; Hartman, Mikael; Sangrajrang, Suleeporn; Shen, Chen-Yang; Southey, Melissa C; Park, Daniel J; Hammet, Fleur; Stone, Jennifer; Veer, Laura J Van’t; Rutgers, Emiel J; Lophatananon, Artitaya; Stewart-Brown, Sarah; Siriwanarangsan, Pornthep; Peto, Julian; Schrauder, Michael G; Ekici, Arif B; Beckmann, Matthias W; Silva, Isabel dos Santos; Johnson, Nichola; Warren, Helen; Tomlinson, Ian; Kerin, Michael J; Miller, Nicola; Marme, Federick; Schneeweiss, Andreas; Sohn, Christof; Truong, Therese; Laurent-Puig, Pierre; Kerbrat, Pierre; Nordestgaard, Børge G; Nielsen, Sune F; Flyger, Henrik; Milne, Roger L; Perez, Jose Ignacio Arias; Menéndez, Primitiva; Müller, Heiko; Arndt, Volker; Stegmaier, Christa; Lichtner, Peter; Lochmann, Magdalena; Justenhoven, Christina; Ko, Yon-Dschun; Muranen, Taru A; Aittomäki, Kristiina; Blomqvist, Carl; Greco, Dario; Heikkinen, Tuomas; Ito, Hidemi; Iwata, Hiroji; Yatabe, Yasushi; Antonenkova, Natalia N; Margolin, Sara; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Balleine, Rosemary; Tseng, Chiu-Chen; Van Den Berg, David; Stram, Daniel O; Neven, Patrick; Dieudonné, Anne-Sophie; Leunen, Karin; Rudolph, Anja; Nickels, Stefan; Flesch-Janys, Dieter; Peterlongo, Paolo; Peissel, Bernard; Bernard, Loris; Olson, Janet E; Wang, Xianshu; Stevens, Kristen; Severi, Gianluca; Baglietto, Laura; Mclean, Catriona; Coetzee, Gerhard A; Feng, Ye; Henderson, Brian E; Schumacher, Fredrick; Bogdanova, Natalia V; Labrèche, France; Dumont, Martine; Yip, Cheng Har; Taib, Nur Aishah Mohd; Cheng, Ching-Yu; Shrubsole, Martha; Long, Jirong; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Kauppila, Saila; knight, Julia A; Glendon, Gord; Mulligan, Anna Marie; Tollenaar, Robertus A E M; Seynaeve, Caroline M; Kriege, Mieke; Hooning, Maartje J; Van den Ouweland, Ans M W; Van Deurzen, Carolien H M; Lu, Wei; Gao, Yu-Tang; Cai, Hui; Balasubramanian, Sabapathy P; Cross, Simon S; Reed, Malcolm W R; Signorello, Lisa; Cai, Qiuyin; Shah, Mitul; Miao, Hui; Chan, Ching Wan; Chia, Kee Seng; Jakubowska, Anna; Jaworska, Katarzyna; Durda, Katarzyna; Hsiung, Chia-Ni; Wu, Pei-Ei; Yu, Jyh-Cherng; Ashworth, Alan; Jones, Michael; Tessier, Daniel C; González-Neira, Anna; Pita, Guillermo; Alonso, M Rosario; Vincent, Daniel; Bacot, Francois; Ambrosone, Christine B; Bandera, Elisa V; John, Esther M; Chen, Gary K; Hu, Jennifer J; Rodriguez-gil, Jorge L; Bernstein, Leslie; Press, Michael F; Ziegler, Regina G; Millikan, Robert M; Deming-Halverson, Sandra L; Nyante, Sarah; Ingles, Sue A; Waisfisz, Quinten; Tsimiklis, Helen; Makalic, Enes; Schmidt, Daniel; Bui, Minh; Gibson, Lorna; Müller-Myhsok, Bertram; Schmutzler, Rita K; Hein, Rebecca; Dahmen, Norbert; Beckmann, Lars; Aaltonen, Kirsimari; Czene, Kamila; Irwanto, Astrid; Liu, Jianjun; Turnbull, Clare; Rahman, Nazneen; Meijers-Heijboer, Hanne; Uitterlinden, Andre G; Rivadeneira, Fernando; Olswold, Curtis; Slager, Susan; Pilarski, Robert; Ademuyiwa, Foluso; Konstantopoulou, Irene; Martin, Nicholas G; Montgomery, Grant W; Slamon, Dennis J; Rauh, Claudia; Lux, Michael P; Jud, Sebastian M; Bruning, Thomas; Weaver, Joellen; Sharma, Priyanka; Pathak, Harsh; Tapper, Will; Gerty, Sue; Durcan, Lorraine; Trichopoulos, Dimitrios; Tumino, Rosario; Peeters, Petra H; Kaaks, Rudolf; Campa, Daniele; Canzian, Federico; Weiderpass, Elisabete; Johansson, Mattias; Khaw, Kay-Tee; Travis, Ruth; Clavel-Chapelon, Françoise; Kolonel, Laurence N; Chen, Constance; Beck, Andy; Hankinson, Susan E; Berg, Christine D; Hoover, Robert N; Lissowska, Jolanta; Figueroa, Jonine D; Chasman, Daniel I; Gaudet, Mia M; Diver, W Ryan; Willett, Walter C; Hunter, David J; Simard, Jacques; Benitez, Javier; Dunning, Alison M; Sherman, Mark E; Chenevix-Trench, Georgia; Chanock, Stephen J; Hall, Per; Pharoah, Paul D P; Vachon, Celine; Easton, Douglas F; Haiman, Christopher A; Kraft, Peter

    2013-01-01

    Estrogen receptor (ER)-negative tumors represent 20–30% of all breast cancers, with a higher proportion occurring in younger women and women of African ancestry1. The etiology2 and clinical behavior3 of ER-negative tumors are different from those of tumors expressing ER (ER positive), including differences in genetic predisposition4. To identify susceptibility loci specific to ER-negative disease, we combined in a meta-analysis 3 genome-wide association studies of 4,193 ER-negative breast cancer cases and 35,194 controls with a series of 40 follow-up studies (6,514 cases and 41,455 controls), genotyped using a custom Illumina array, iCOGS, developed by the Collaborative Oncological Gene-environment Study (COGS). SNPs at four loci, 1q32.1 (MDM4, P = 2.1 × 10−12 and LGR6, P = 1.4 × 10−8), 2p24.1 (P = 4.6 × 10−8) and 16q12.2 (FTO, P = 4.0 × 10−8), were associated with ER-negative but not ER-positive breast cancer (P > 0.05). These findings provide further evidence for distinct etiological pathways associated with invasive ER-positive and ER-negative breast cancers. PMID:23535733

  1. Genome-wide association studies identify four ER negative-specific breast cancer risk loci.

    Science.gov (United States)

    Garcia-Closas, Montserrat; Couch, Fergus J; Lindstrom, Sara; Michailidou, Kyriaki; Schmidt, Marjanka K; Brook, Mark N; Orr, Nick; Rhie, Suhn Kyong; Riboli, Elio; Feigelson, Heather S; Le Marchand, Loic; Buring, Julie E; Eccles, Diana; Miron, Penelope; Fasching, Peter A; Brauch, Hiltrud; Chang-Claude, Jenny; Carpenter, Jane; Godwin, Andrew K; Nevanlinna, Heli; Giles, Graham G; Cox, Angela; Hopper, John L; Bolla, Manjeet K; Wang, Qin; Dennis, Joe; Dicks, Ed; Howat, Will J; Schoof, Nils; Bojesen, Stig E; Lambrechts, Diether; Broeks, Annegien; Andrulis, Irene L; Guénel, Pascal; Burwinkel, Barbara; Sawyer, Elinor J; Hollestelle, Antoinette; Fletcher, Olivia; Winqvist, Robert; Brenner, Hermann; Mannermaa, Arto; Hamann, Ute; Meindl, Alfons; Lindblom, Annika; Zheng, Wei; Devillee, Peter; Goldberg, Mark S; Lubinski, Jan; Kristensen, Vessela; Swerdlow, Anthony; Anton-Culver, Hoda; Dörk, Thilo; Muir, Kenneth; Matsuo, Keitaro; Wu, Anna H; Radice, Paolo; Teo, Soo Hwang; Shu, Xiao-Ou; Blot, William; Kang, Daehee; Hartman, Mikael; Sangrajrang, Suleeporn; Shen, Chen-Yang; Southey, Melissa C; Park, Daniel J; Hammet, Fleur; Stone, Jennifer; Veer, Laura J Van't; Rutgers, Emiel J; Lophatananon, Artitaya; Stewart-Brown, Sarah; Siriwanarangsan, Pornthep; Peto, Julian; Schrauder, Michael G; Ekici, Arif B; Beckmann, Matthias W; Dos Santos Silva, Isabel; Johnson, Nichola; Warren, Helen; Tomlinson, Ian; Kerin, Michael J; Miller, Nicola; Marme, Federick; Schneeweiss, Andreas; Sohn, Christof; Truong, Therese; Laurent-Puig, Pierre; Kerbrat, Pierre; Nordestgaard, Børge G; Nielsen, Sune F; Flyger, Henrik; Milne, Roger L; Perez, Jose Ignacio Arias; Menéndez, Primitiva; Müller, Heiko; Arndt, Volker; Stegmaier, Christa; Lichtner, Peter; Lochmann, Magdalena; Justenhoven, Christina; Ko, Yon-Dschun; Muranen, Taru A; Aittomäki, Kristiina; Blomqvist, Carl; Greco, Dario; Heikkinen, Tuomas; Ito, Hidemi; Iwata, Hiroji; Yatabe, Yasushi; Antonenkova, Natalia N; Margolin, Sara; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Balleine, Rosemary; Tseng, Chiu-Chen; Berg, David Van Den; Stram, Daniel O; Neven, Patrick; Dieudonné, Anne-Sophie; Leunen, Karin; Rudolph, Anja; Nickels, Stefan; Flesch-Janys, Dieter; Peterlongo, Paolo; Peissel, Bernard; Bernard, Loris; Olson, Janet E; Wang, Xianshu; Stevens, Kristen; Severi, Gianluca; Baglietto, Laura; McLean, Catriona; Coetzee, Gerhard A; Feng, Ye; Henderson, Brian E; Schumacher, Fredrick; Bogdanova, Natalia V; Labrèche, France; Dumont, Martine; Yip, Cheng Har; Taib, Nur Aishah Mohd; Cheng, Ching-Yu; Shrubsole, Martha; Long, Jirong; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Kauppila, Saila; Knight, Julia A; Glendon, Gord; Mulligan, Anna Marie; Tollenaar, Robertus A E M; Seynaeve, Caroline M; Kriege, Mieke; Hooning, Maartje J; van den Ouweland, Ans M W; van Deurzen, Carolien H M; Lu, Wei; Gao, Yu-Tang; Cai, Hui; Balasubramanian, Sabapathy P; Cross, Simon S; Reed, Malcolm W R; Signorello, Lisa; Cai, Qiuyin; Shah, Mitul; Miao, Hui; Chan, Ching Wan; Chia, Kee Seng; Jakubowska, Anna; Jaworska, Katarzyna; Durda, Katarzyna; Hsiung, Chia-Ni; Wu, Pei-Ei; Yu, Jyh-Cherng; Ashworth, Alan; Jones, Michael; Tessier, Daniel C; González-Neira, Anna; Pita, Guillermo; Alonso, M Rosario; Vincent, Daniel; Bacot, Francois; Ambrosone, Christine B; Bandera, Elisa V; John, Esther M; Chen, Gary K; Hu, Jennifer J; Rodriguez-Gil, Jorge L; Bernstein, Leslie; Press, Michael F; Ziegler, Regina G; Millikan, Robert M; Deming-Halverson, Sandra L; Nyante, Sarah; Ingles, Sue A; Waisfisz, Quinten; Tsimiklis, Helen; Makalic, Enes; Schmidt, Daniel; Bui, Minh; Gibson, Lorna; Müller-Myhsok, Bertram; Schmutzler, Rita K; Hein, Rebecca; Dahmen, Norbert; Beckmann, Lars; Aaltonen, Kirsimari; Czene, Kamila; Irwanto, Astrid; Liu, Jianjun; Turnbull, Clare; Rahman, Nazneen; Meijers-Heijboer, Hanne; Uitterlinden, Andre G; Rivadeneira, Fernando; Olswold, Curtis; Slager, Susan; Pilarski, Robert; Ademuyiwa, Foluso; Konstantopoulou, Irene; Martin, Nicholas G; Montgomery, Grant W; Slamon, Dennis J; Rauh, Claudia; Lux, Michael P; Jud, Sebastian M; Bruning, Thomas; Weaver, Joellen; Sharma, Priyanka; Pathak, Harsh; Tapper, Will; Gerty, Sue; Durcan, Lorraine; Trichopoulos, Dimitrios; Tumino, Rosario; Peeters, Petra H; Kaaks, Rudolf; Campa, Daniele; Canzian, Federico; Weiderpass, Elisabete; Johansson, Mattias; Khaw, Kay-Tee; Travis, Ruth; Clavel-Chapelon, Françoise; Kolonel, Laurence N; Chen, Constance; Beck, Andy; Hankinson, Susan E; Berg, Christine D; Hoover, Robert N; Lissowska, Jolanta; Figueroa, Jonine D; Chasman, Daniel I; Gaudet, Mia M; Diver, W Ryan; Willett, Walter C; Hunter, David J; Simard, Jacques; Benitez, Javier; Dunning, Alison M; Sherman, Mark E; Chenevix-Trench, Georgia; Chanock, Stephen J; Hall, Per; Pharoah, Paul D P; Vachon, Celine; Easton, Douglas F; Haiman, Christopher A; Kraft, Peter

    2013-04-01

    Estrogen receptor (ER)-negative tumors represent 20-30% of all breast cancers, with a higher proportion occurring in younger women and women of African ancestry. The etiology and clinical behavior of ER-negative tumors are different from those of tumors expressing ER (ER positive), including differences in genetic predisposition. To identify susceptibility loci specific to ER-negative disease, we combined in a meta-analysis 3 genome-wide association studies of 4,193 ER-negative breast cancer cases and 35,194 controls with a series of 40 follow-up studies (6,514 cases and 41,455 controls), genotyped using a custom Illumina array, iCOGS, developed by the Collaborative Oncological Gene-environment Study (COGS). SNPs at four loci, 1q32.1 (MDM4, P = 2.1 × 10(-12) and LGR6, P = 1.4 × 10(-8)), 2p24.1 (P = 4.6 × 10(-8)) and 16q12.2 (FTO, P = 4.0 × 10(-8)), were associated with ER-negative but not ER-positive breast cancer (P > 0.05). These findings provide further evidence for distinct etiological pathways associated with invasive ER-positive and ER-negative breast cancers.

  2. Simulation Study on Identifiability of UHE Gamma-ray Air Showers

    International Nuclear Information System (INIS)

    Wada, Y.; Inoue, N.; Miyazawa, K.; Vankov, H.P.

    2008-01-01

    The chemical composition of Ultra-High-Energy (UHE) comic rays is one of unsolved mysteries, and its study will give us fruitful information on the origin and acceleration mechanism of UHE cosmic rays. Especially, a detection of UHE gamma-rays by hybrid experiments, such as AUGER and TA, will be a key to solve these questions. The characteristics of UHE gamma-ray showers have been studied by comparing the lateral and longitudinal structures of shower particles calculated with AIRES and our own simulation code, so far. There are apparent differences in a slope of lateral distribution (η) and a depth of shower maximum (Xmax) between gamma-ray and proton induced showers because UHE gamma-ray showers are affected by the LPM effect and the geomagnetic cascading process in an energy region of >10 19.5 eV. Different features between gamma-ray and proton showers are pointed out from the simulation study and an identifiability of gamma-ray showers from proton ones is also discussed by the method of Neural-Network-Analysis

  3. Simulation Study on Identifiability of UHE Gamma-ray Air Showers

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Y.; Inoue, N.; Miyazawa, K. [Graduate School of Science and Engineering, Saitama University, Saitama 338-8570 (Japan); Vankov, H.P. [Institute for Nuclear Research and Nuclear Energy, Bulgaria Academy, Sofia (Bulgaria)

    2008-01-15

    The chemical composition of Ultra-High-Energy (UHE) comic rays is one of unsolved mysteries, and its study will give us fruitful information on the origin and acceleration mechanism of UHE cosmic rays. Especially, a detection of UHE gamma-rays by hybrid experiments, such as AUGER and TA, will be a key to solve these questions. The characteristics of UHE gamma-ray showers have been studied by comparing the lateral and longitudinal structures of shower particles calculated with AIRES and our own simulation code, so far. There are apparent differences in a slope of lateral distribution ({eta}) and a depth of shower maximum (Xmax) between gamma-ray and proton induced showers because UHE gamma-ray showers are affected by the LPM effect and the geomagnetic cascading process in an energy region of >10{sup 19.5}eV. Different features between gamma-ray and proton showers are pointed out from the simulation study and an identifiability of gamma-ray showers from proton ones is also discussed by the method of Neural-Network-Analysis.

  4. A comparative study to identify a suitable model of ownership for Iran football pro league clubs

    Directory of Open Access Journals (Sweden)

    Saeed Amirnejad

    2018-01-01

    Full Text Available Today the government ownership of the professional football clubs is absolutely illogical view point. Most of sports clubs are conducted by private sector using different models of ownership all over the world. In Iran, government credits benefit was main reason that the professional sport was firstly developed by government firms and organizations. Therefore, the sports team ownership is without the professionalization standards. The present comparative study was to examine the different football club ownership structures of the top leagues and the current condition of Iran football pro league ownership and then present a suitable ownership structure of Iran football clubs to leave behind the government club ownership. Among the initial 120 scientific texts, the thirty two cases including papers, books and reports were found relevant to this study. We studied the ownership prominence and several football club models of ownership focused on stock listing model of ownership, private investor model of ownership, supporter trust model of ownership and Japan partnership model of ownership; theoretical concepts, empirical studies, main findings, strengths and weaknesses were covered in analysis procedure. According to various models of ownership in leagues and the models’ productivity in football clubs, each model of ownership considering national environmental, economic, social conditions has strengths and weaknesses. So, we cannot present a definite model of ownership for Iran football pro league clubs due to different micro-environments of Iran clubs. We need a big planning to provide a supporter-investor mixed model of ownership to Iranian clubs. Considering strengths and weaknesses in the models of ownership as well as the micro and macro environment of Iran football clubs, German model and Japan partnership model are offered as suitable ones to probable new model of ownership in Iran pro league clubs. Consequently, more studies are required

  5. Design considerations for identifying breast cancer risk factors in a population-based study in Africa.

    Science.gov (United States)

    Brinton, Louise A; Awuah, Baffour; Nat Clegg-Lamptey, Joe; Wiafe-Addai, Beatrice; Ansong, Daniel; Nyarko, Kofi M; Wiafe, Seth; Yarney, Joel; Biritwum, Richard; Brotzman, Michelle; Adjei, Andrew A; Adjei, Ernest; Aitpillah, Francis; Edusei, Lawrence; Dedey, Florence; Nyante, Sarah J; Oppong, Joseph; Osei-Bonsu, Ernest; Titiloye, Nicholas; Vanderpuye, Verna; Brew Abaidoo, Emma; Arhin, Bernard; Boakye, Isaac; Frempong, Margaret; Ohene Oti, Naomi; Okyne, Victoria; Figueroa, Jonine D

    2017-06-15

    Although breast cancer is becoming more prevalent in Africa, few epidemiologic studies have been undertaken and appropriate methodologic approaches remain uncertain. We therefore conducted a population-based case-control study in Accra and Kumasi, Ghana, enrolling 2,202 women with lesions suspicious for breast cancer and 2,161 population controls. Biopsy tissue for cases prior to neoadjuvant therapy (if given), blood, saliva and fecal samples were sought for study subjects. Response rates, risk factor prevalences and odds ratios for established breast cancer risk factors were calculated. A total of 54.5% of the recruited cases were diagnosed with malignancies, 36.0% with benign conditions and 9.5% with indeterminate diagnoses. Response rates to interviews were 99.2% in cases and 91.9% in controls, with the vast majority of interviewed subjects providing saliva (97.9% in cases vs. 98.8% in controls) and blood (91.8% vs. 82.5%) samples; lower proportions (58.1% vs. 46.1%) provided fecal samples. While risk factor prevalences were unique as compared to women in other countries (e.g., less education, higher parity), cancer risk factors resembled patterns identified elsewhere (elevated risks associated with higher levels of education, familial histories of breast cancer, low parity and larger body sizes). Subjects with benign conditions were younger and exhibited higher socioeconomic profiles (e.g., higher education and lower parity) than those with malignancies, suggesting selective referral influences. While further defining breast cancer risk factors in Africa, this study showed that successful population-based interdisciplinary studies of cancer in Africa are possible but require close attention to diagnostic referral biases and standardized and documented approaches for high-quality data collection, including biospecimens. © 2017 UICC.

  6. A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices Used By Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Valerie J.M. Watzlaf

    2017-11-01

    Full Text Available The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P. PubMed, CINAHL and INSPEC from 2003 – 2016 were searched and returned 25,404 papers (after duplications were removed. Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth.  Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen’s kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions. Keywords: Computer security, Health personnel, Privacy, Systematic review, Telehealth

  7. Active Commuting among K-12 Educators: A Study Examining Walking and Biking to Work

    OpenAIRE

    Bopp, Melissa; Hastmann, Tanis J.; Norton, Alyssa N.

    2013-01-01

    Background. Walking and biking to work, active commuting (AC) is associated with many health benefits, though rates of AC remain low in the US. K-12 educators represent a significant portion of the workforce, and employee health and associated costs may have significant economic impact. Therefore, the purpose of this study was to examine the current rates of AC and factors associated with AC among K-12 educators. Methods. A volunteer sample of K-12 educators (n = 437) was recruited to partici...

  8. Cardiometabolic implication of sarcopenia: The Korea National Health and Nutrition Examination Study (KNHANES) 2008–2010

    OpenAIRE

    Kyoung Min Kim; Soo Lim; Sung Hee Choi; Jung Hee Kim; Chan Soo Shin; Kyong Soo Park; Hak Chul Jang

    2014-01-01

    Background: Sarcopenia, the loss of muscle mass, contributes to various adverse health outcomes in the elderly. It may be associated with cardiometabolic risk. The aim of this study was to investigate the relationships between sarcopenia and cardiometabolic risks and to determine an appropriate operational definition for sarcopenia from a cardiometabolic perspective. Material and methods: Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2010 (n = 20,812, ≥20 ...

  9. Examining the Effect of Endorser Credibility on the Consumers' Buying Intentions: An Empirical Study in Turkey

    OpenAIRE

    Sertoglu, Aysegul Ermec; Catlı, Ozlem; Korkmaz, Sezer

    2014-01-01

    The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise) have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a pos...

  10. EXAMINING THE EFFECT OF ENDORSER CREDIBILITY ON THE CONSUMERS' BUYING INTENTIONS: AN EMPIRICAL STUDY IN TURKEY

    OpenAIRE

    Aysegul Ermec Sertoglu; Ozlem Catli; Sezer Korkmaz

    2014-01-01

    The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise) have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a pos...

  11. In-vivo study and histological examination of laser reshaping of cartilage

    Science.gov (United States)

    Sviridov, Alexander P.; Sobol, Emil N.; Bagratashvili, Victor N.; Omelchenko, Alexander I.; Ovchinnikov, Yuriy M.; Shekhter, Anatoliy B.; Svistushkin, Valeriy M.; Shinaev, Andrei A.; Nikiforova, G.; Jones, Nicholas

    1999-06-01

    The results of recent study of cartilage reshaping in vivo are reported. The ear cartilage of piglets of 8-12 weeks old have been reshaped in vivo using the radiation of a holmium laser. The stability of the shape and possible side effects have been examined during four months. Histological investigation shown that the healing of irradiated are could accompany by the regeneration of ear cartilage. Finally, elastic type cartilage has been transformed into fibrous cartilage or cartilage of hyaline type.

  12. Identifying Opinion Leaders to Promote Organ Donation on Social Media: Network Study

    Science.gov (United States)

    Salmon, Charles T

    2018-01-01

    Background In the recent years, social networking sites (SNSs, also called social media) have been adopted in organ donation campaigns, and recruiting opinion leaders for such campaigns has been found effective in promoting behavioral changes. Objective The aim of this paper was to focus on the dissemination of organ donation tweets on Weibo, the Chinese equivalent of Twitter, and to examine the opinion leadership in the retweet network of popular organ donation messages using social network analysis. It also aimed to investigate how personal and social attributes contribute to a user’s opinion leadership on the topic of organ donation. Methods All messages about organ donation posted on Weibo from January 1, 2015 to December 31, 2015 were extracted using Python Web crawler. A retweet network with 505,047 nodes and 545,312 edges of the popular messages (n=206) was constructed and analyzed. The local and global opinion leaderships were measured using network metrics, and the roles of personal attributes, professional knowledge, and social positions in obtaining the opinion leadership were examined using general linear model. Results The findings revealed that personal attributes, professional knowledge, and social positions predicted individual’s local opinion leadership in the retweet network of popular organ donation messages. Alternatively, personal attributes and social positions, but not professional knowledge, were significantly associated with global opinion leadership. Conclusions The findings of this study indicate that health campaign designers may recruit peer leaders in SNS organ donation promotions to facilitate information sharing among the target audience. Users who are unverified, active, well connected, and experienced with information and communications technology (ICT) will accelerate the sharing of organ donation messages in the global environment. Medical professionals such as organ transplant surgeons who can wield a great amount of

  13. Identifying Opinion Leaders to Promote Organ Donation on Social Media: Network Study.

    Science.gov (United States)

    Shi, Jingyuan; Salmon, Charles T

    2018-01-09

    In the recent years, social networking sites (SNSs, also called social media) have been adopted in organ donation campaigns, and recruiting opinion leaders for such campaigns has been found effective in promoting behavioral changes. The aim of this paper was to focus on the dissemination of organ donation tweets on Weibo, the Chinese equivalent of Twitter, and to examine the opinion leadership in the retweet network of popular organ donation messages using social network analysis. It also aimed to investigate how personal and social attributes contribute to a user's opinion leadership on the topic of organ donation. All messages about organ donation posted on Weibo from January 1, 2015 to December 31, 2015 were extracted using Python Web crawler. A retweet network with 505,047 nodes and 545,312 edges of the popular messages (n=206) was constructed and analyzed. The local and global opinion leaderships were measured using network metrics, and the roles of personal attributes, professional knowledge, and social positions in obtaining the opinion leadership were examined using general linear model. The findings revealed that personal attributes, professional knowledge, and social positions predicted individual's local opinion leadership in the retweet network of popular organ donation messages. Alternatively, personal attributes and social positions, but not professional knowledge, were significantly associated with global opinion leadership. The findings of this study indicate that health campaign designers may recruit peer leaders in SNS organ donation promotions to facilitate information sharing among the target audience. Users who are unverified, active, well connected, and experienced with information and communications technology (ICT) will accelerate the sharing of organ donation messages in the global environment. Medical professionals such as organ transplant surgeons who can wield a great amount of influence on their direct connections could also effectively

  14. Brain pathology after mild traumatic brain injury: an exploratory study by repeated magnetic resonance examination.

    Science.gov (United States)

    Lannsjö, Marianne; Raininko, Raili; Bustamante, Mariana; von Seth, Charlotta; Borg, Jörgen

    2013-09-01

    To explore brain pathology after mild traumatic brain injury by repeated magnetic resonance examination. A prospective follow-up study. Nineteen patients with mild traumatic brain injury presenting with Glasgow Coma Scale (GCS) 14-15. The patients were examined on day 2 or 3 and 3-7 months after the injury. The magnetic resonance protocol comprised conventional T1- and T2-weighted sequences including fluid attenuated inversion recovery (FLAIR), two susceptibility-weighted sequences to reveal haemorrhages, and diffusion-weighted sequences. Computer-aided volume comparison was performed. Clinical outcome was assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Hospital Anxiety and Depression Scale (HADS) and Glasgow Outcome Scale Extended (GOSE). At follow-up, 7 patients (37%) reported ≥  3 symptoms in RPQ, 5 reported some anxiety and 1 reported mild depression. Fifteen patients reported upper level of good recovery and 4 patients lower level of good recovery (GOSE 8 and 7, respectively). Magnetic resonance pathology was found in 1 patient at the first examination, but 4 patients (21%) showed volume loss at the second examination, at which 3 of them reported GOSE scores of 8. Loss of brain volume, demonstrated by computer-aided magnetic resonance imaging volumetry, may be a feasible marker of brain pathology after mild traumatic brain injury.

  15. A study of amount of information in x-ray examination of gastric diseases

    International Nuclear Information System (INIS)

    Yamamoto, Akiro

    1981-01-01

    Gastrointestinal X-ray examinations are widely utilized to find gastric cancers because of the high incidence of this disease in Japan. Because of the high frequency of this examination relatively high gonad and bone marrow radiation exposure due to this kind of examination cannot be ignored. The relationship between exposed doses and amount of information are in inverse proportion. Therefore, this study of the relationship between amount of information and accuracy in gastric X-ray diagnosis was carried out to determine the necessary amount of information in this examination. To intentionally reduce the amount of information air gap method is utilized. Five each copies were made from various original G.I. tract films, and when copies were made air gap is intentionally reduced between original and duplicating films. The air gaps were 0, 5, 10, 15 and 20 mm. Fifty original films were prepared thus 250 copies (50 sets of 5 each copies) were made. These copied films were read by 10 radiologists and results were scored as true positive and false positive. The results showed that increase of amount of information itself does not mean the increase of diagnostic accuracy. Also it is suggested that the limit of diagnostic accuracy lies between 5 and 10 mm air spaced films. Diagnoses of early gastric cancer and scar of gastric ulcer are easily effected by sharpness of image, but gastric ulcer are relatively not. (author)

  16. Study of amount of information in x-ray examination of gastric diseases

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, A [Kyoto Prefectural Univ. of Medicine (Japan)

    1981-08-01

    Gastrointestinal X-ray examinations are widely utilized to find gastric cancers because of the high incidence of this disease in Japan. Because of the high frequency of this examination relatively high gonad and bone marrow radiation exposure due to this kind of examination cannot be ignored. The relationship between exposed doses and amount of information are in inverse proportion. Therefore, this study of the relationship between amount of information and accuracy in gastric X-ray diagnosis was carried out to determine the necessary amount of information in this examination. To intentionally reduce the amount of information air gap method is utilized. Five each copies were made from various original G.I. tract films, and when copies were made air gap is intentionally reduced between original and duplicating films. The air gaps were 0, 5, 10, 15 and 20 mm. Fifty original films were prepared thus 250 copies (50 sets of 5 each copies) were made. These copied films were read by 10 radiologists and results were scored as true positive and false positive. The results showed that increase of amount of information itself does not mean the increase of diagnostic accuracy. Also it is suggested that the limit of diagnostic accuracy lies between 5 and 10 mm air spaced films. Diagnoses of early gastric cancer and scar of gastric ulcer are easily effected by sharpness of image, but gastric ulcer are relatively not.

  17. Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination.

    Science.gov (United States)

    Londos, Elisabet; Hanxsson, Oskar; Alm Hirsch, Ingrid; Janneskog, Anna; Bülow, Margareta; Palmqvist, Sebastian

    2013-10-07

    Dysphagia, which can result in aspiration pneumonia and death, is a well-known problem in patients with dementia and Parkinson's disease. There are few studies on dysphagia in patients with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), especially studies objectively documenting the type of swallowing dysfunction. The aim of this study was therefore to investigate the prevalence, and define the actual swallowing dysfunction according to a videofluoroscopic swallowing examination (VFSE) in patients with DLB and PDD. Eighty-two consecutive patients with DLB or PDD in a clinical follow-up program were asked about symptoms of dysphagia. Those experiencing dysphagia were examined with VFSE. Prevalence and type of swallowing dysfunction was recorded. Twenty-six patients (32%) reported symptoms of dysphagia such as swallowing difficulties or coughing. Twenty-four (92%) of these had a documented swallowing dysfunction on VFSE. Eighty-eight percent suffered from pharyngeal dysfunction. Almost all DLB or PDD patients with subjective signs of dysphagia had pathologic results on VFSE, the majority of pharyngeal type. This type of dysphagia has not been reported in DLB before. The results have clinical implications and highlight the importance of asking for and examining swallowing function to prevent complications such as aspiration.

  18. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study.

    Science.gov (United States)

    Artemiou, Elpida; Gilbert, Gregory E; Sithole, Fortune; Koster, Liza S

    2017-09-27

    Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog's Ear, Volume 1 . Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS) Depression, Fatigue-Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  19. The Effects of Music during a Physical Examination Skills Practice: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Elpida Artemiou

    2017-09-01

    Full Text Available Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog’s Ear, Volume 1. Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS Depression, Fatigue–Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

  20. CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children.

    Science.gov (United States)

    Bishop, D V M; Snowling, Margaret J; Thompson, Paul A; Greenhalgh, Trisha

    2016-01-01

    Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

  1. Identifying desertification risk areas using fuzzy membership and geospatial technique - A case study, Kota District, Rajasthan

    Science.gov (United States)

    Dasgupta, Arunima; Sastry, K. L. N.; Dhinwa, P. S.; Rathore, V. S.; Nathawat, M. S.

    2013-08-01

    Desertification risk assessment is important in order to take proper measures for its prevention. Present research intends to identify the areas under risk of desertification along with their severity in terms of degradation in natural parameters. An integrated model with fuzzy membership analysis, fuzzy rule-based inference system and geospatial techniques was adopted, including five specific natural parameters namely slope, soil pH, soil depth, soil texture and NDVI. Individual parameters were classified according to their deviation from mean. Membership of each individual values to be in a certain class was derived using the normal probability density function of that class. Thus if a single class of a single parameter is with mean μ and standard deviation σ, the values falling beyond μ + 2 σ and μ - 2 σ are not representing that class, but a transitional zone between two subsequent classes. These are the most important areas in terms of degradation, as they have the lowest probability to be in a certain class, hence highest probability to be extended or narrowed down in next or previous class respectively. Eventually, these are the values which can be easily altered, under extrogenic influences, hence are identified as risk areas. The overall desertification risk is derived by incorporating the different risk severity of each parameter using fuzzy rule-based interference system in GIS environment. Multicriteria based geo-statistics are applied to locate the areas under different severity of desertification risk. The study revealed that in Kota, various anthropogenic pressures are accelerating land deterioration, coupled with natural erosive forces. Four major sources of desertification in Kota are, namely Gully and Ravine erosion, inappropriate mining practices, growing urbanization and random deforestation.

  2. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

    Science.gov (United States)

    Essers, Geurt; van Dulmen, Sandra; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

    2011-12-13

    Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication. A purposive sample of real-life videotaped GP consultations was analyzed (N = 17). As a frame of reference we chose the MAAS-Global, a widely used assessment instrument for medical communication. By inductive reasoning, we analyzed the GP behaviour in the consultation leading to poor item scores on the MAAS-Global. In these cases we looked for the presence of an intervening context factor, and how this might explain the actual GP communication behaviour. We reached saturation after having viewed 17 consultations. We identified 19 context factors that could potentially explain the deviation from generic recommendations on communication skills. These context factors can be categorized into doctor-related, patient-related, and consultation-related factors. Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings.

  3. Genome-wide association study identifies shared risk loci common to two malignancies in golden retrievers.

    Directory of Open Access Journals (Sweden)

    Noriko Tonomura

    2015-02-01

    Full Text Available Dogs, with their breed-determined limited genetic background, are great models of human disease including cancer. Canine B-cell lymphoma and hemangiosarcoma are both malignancies of the hematologic system that are clinically and histologically similar to human B-cell non-Hodgkin lymphoma and angiosarcoma, respectively. Golden retrievers in the US show significantly elevated lifetime risk for both B-cell lymphoma (6% and hemangiosarcoma (20%. We conducted genome-wide association studies for hemangiosarcoma and B-cell lymphoma, identifying two shared predisposing loci. The two associated loci are located on chromosome 5, and together contribute ~20% of the risk of developing these cancers. Genome-wide p-values for the top SNP of each locus are 4.6×10-7 and 2.7×10-6, respectively. Whole genome resequencing of nine cases and controls followed by genotyping and detailed analysis identified three shared and one B-cell lymphoma specific risk haplotypes within the two loci, but no coding changes were associated with the risk haplotypes. Gene expression analysis of B-cell lymphoma tumors revealed that carrying the risk haplotypes at the first locus is associated with down-regulation of several nearby genes including the proximal gene TRPC6, a transient receptor Ca2+-channel involved in T-cell activation, among other functions. The shared risk haplotype in the second locus overlaps the vesicle transport and release gene STX8. Carrying the shared risk haplotype is associated with gene expression changes of 100 genes enriched for pathways involved in immune cell activation. Thus, the predisposing germ-line mutations in B-cell lymphoma and hemangiosarcoma appear to be regulatory, and affect pathways involved in T-cell mediated immune response in the tumor. This suggests that the interaction between the immune system and malignant cells plays a common role in the tumorigenesis of these relatively different cancers.

  4. CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children.

    Directory of Open Access Journals (Sweden)

    D V M Bishop

    Full Text Available Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA. The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2. Consensus (percentage reporting 'agree' or 'strongly agree' was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

  5. Source Water Protection Planning for Ontario First Nations Communities: Case Studies Identifying Challenges and Outcomes

    Directory of Open Access Journals (Sweden)

    Leslie Collins

    2017-07-01

    Full Text Available After the Walkerton tragedy in 2000, where drinking water contamination left seven people dead and many suffering from chronic illness, the Province of Ontario, Canada implemented policies to develop Source Water Protection (SWP plans. Under the Clean Water Act (2006, thirty-six regional Conservation Authorities were mandated to develop watershed-based SWP plans under 19 Source Protection Regions. Most First Nations in Ontario are outside of these Source Protection Regions and reserve lands are under Federal jurisdiction. This paper explores how First Nations in Ontario are attempting to address SWP to improve drinking water quality in their communities even though these communities are not part of the Ontario SWP framework. The case studies highlight the gap between the regulatory requirements of the Federal and Provincial governments and the challenges for First Nations in Ontario from lack of funding to implement solutions to address the threats identified in SWP planning. This analysis of different approaches taken by Ontario First Nations shows that the Ontario framework for SWP planning is not an option for the majority of First Nations communities, and does not adequately address threats originating on reserve lands. First Nations attempting to address on-reserve threats to drinking water are using a variety of resources and approaches to develop community SWP plans. However, a common theme of all the cases surveyed is a lack of funding to support implementing solutions for the threats identified by the SWP planning process. Federal government initiatives to address the chronic problem of boil water advisories within Indigenous communities do not recognize SWP planning as a cost-effective tool for improving drinking water quality.

  6. Genome-wide association study identifies candidate genes for male fertility traits in humans.

    Science.gov (United States)

    Kosova, Gülüm; Scott, Nicole M; Niederberger, Craig; Prins, Gail S; Ober, Carole

    2012-06-08

    Despite the fact that hundreds of genes are known to affect fertility in animal models, relatively little is known about genes that influence natural fertility in humans. To broadly survey genes contributing to variation in male fertility, we conducted a genome-wide association study (GWAS) of two fertility traits (family size and birth rate) in 269 married men who are members of a founder population of European descent that proscribes contraception and has large family sizes. Associations between ∼250,000 autosomal SNPs and the fertility traits were examined. A total of 41 SNPs with p ≤ 1 × 10(-4) for either trait were taken forward to a validation study of 123 ethnically diverse men from Chicago who had previously undergone semen analyses. Nine (22%) of the SNPs associated with reduced fertility in the GWAS were also associated with one or more of the ten measures of reduced sperm quantity and/or function, yielding 27 associations with p values LRRC32, which encodes a latent transforming growth factor β (TGF-β) receptor on regulatory T cells. We suggest that mutations in these genes that are more severe may account for some of the unexplained infertility (or subfertility) in the general population. Copyright © 2012 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  7. A genome-wide association study identifies protein quantitative trait loci (pQTLs.

    Directory of Open Access Journals (Sweden)

    David Melzer

    2008-05-01

    Full Text Available There is considerable evidence that human genetic variation influences gene expression. Genome-wide studies have revealed that mRNA levels are associated with genetic variation in or close to the gene coding for those mRNA transcripts - cis effects, and elsewhere in the genome - trans effects. The role of genetic variation in determining protein levels has not been systematically assessed. Using a genome-wide association approach we show that common genetic variation influences levels of clinically relevant proteins in human serum and plasma. We evaluated the role of 496,032 polymorphisms on levels of 42 proteins measured in 1200 fasting individuals from the population based InCHIANTI study. Proteins included insulin, several interleukins, adipokines, chemokines, and liver function markers that are implicated in many common diseases including metabolic, inflammatory, and infectious conditions. We identified eight Cis effects, including variants in or near the IL6R (p = 1.8x10(-57, CCL4L1 (p = 3.9x10(-21, IL18 (p = 6.8x10(-13, LPA (p = 4.4x10(-10, GGT1 (p = 1.5x10(-7, SHBG (p = 3.1x10(-7, CRP (p = 6.4x10(-6 and IL1RN (p = 7.3x10(-6 genes, all associated with their respective protein products with effect sizes ranging from 0.19 to 0.69 standard deviations per allele. Mechanisms implicated include altered rates of cleavage of bound to unbound soluble receptor (IL6R, altered secretion rates of different sized proteins (LPA, variation in gene copy number (CCL4L1 and altered transcription (GGT1. We identified one novel trans effect that was an association between ABO blood group and tumour necrosis factor alpha (TNF-alpha levels (p = 6.8x10(-40, but this finding was not present when TNF-alpha was measured using a different assay , or in a second study, suggesting an assay-specific association. Our results show that protein levels share some of the features of the genetics of gene expression. These include the presence of strong genetic effects in cis

  8. A Case Study with an Identified Bully: Policy and Practice Implications

    Directory of Open Access Journals (Sweden)

    Huddleston, Lillie

    2011-07-01

    Full Text Available Objective: Bullying is a serious public health problem that may include verbal or physical injury as well as social isolation or exclusion. As a result, research is needed to establish a database for policies and interventions designed to prevent bullying and its negative effects. This paper presented a case study that contributed to the literature by describing an intervention for bullies that has implications for research, practice and related policies regarding bullying.Methods: An individualized intervention for an identified bully was implemented using the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004 with a seventh-grade middle school student. Ecological and culture-specific perspectives were used to develop and implement the intervention that included psychoeducational sessions with the student and consultation with the parent and school personnel. A mixed methods intervention design was used with the following informants: the target student, the mother of the student, a teacher and the school counselor. Qualitative data included semi-structured interviews with the parent, teacher and student, narrative classroom observations and evaluation/feedback forms filled out by the student and interventionist. Quantitative data included the following quantitative surveys (i.e., Child Posttraumatic Stress Reaction Index [CPTS-RI] and the Behavior Assessment Scale for Children, 2nd Edition. Both qualitative and quantitative data were used to evaluate the acceptability, integrity and efficacy of this intervention.Results: The process of intervention design, implementation and evaluation are described through an illustrative case study. Qualitative and quantitative findings indicated a decrease in internalizing, externalizing and bullying behaviors as reported by the teacher and the mother, and a high degree of acceptability and treatment integrity as reported by multiple stakeholders.Conclusion: This case

  9. Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study.

    Science.gov (United States)

    Mikkilä, V; Räsänen, L; Raitakari, O T; Pietinen, P; Viikari, J

    2005-06-01

    Dietary patterns are useful in nutritional epidemiology, providing a comprehensive alternative to the traditional approach based on single nutrients. The Cardiovascular Risk in Young Finns Study is a prospective cohort study with a 21-year follow-up. At baseline, detailed quantitative information on subjects' food consumption was obtained using a 48 h dietary recall method (n 1768, aged 3-18 years). The interviews were repeated after 6 and 21 years (n 1200 and n 1037, respectively). We conducted a principal component analysis to identify major dietary patterns at each study point. A set of two similar patterns was recognised throughout the study. Pattern 1 was positively correlated with consumption of traditional Finnish foods, such as rye, potatoes, milk, butter, sausages and coffee, and negatively correlated with fruit, berries and dairy products other than milk. Pattern 1 type of diet was more common among male subjects, smokers and those living in rural areas. Pattern 2, predominant among female subjects, non-smokers and in urban areas, was characterised by more health-conscious food choices such as vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and also by consumption of alcoholic beverages. Tracking of the pattern scores was observed, particularly among subjects who were adolescents at baseline. Of those originally belonging to the uppermost quintile of pattern 1 and 2 scores, 41 and 38 % respectively, persisted in the same quintile 21 years later. Our results suggest that food behaviour and concrete food choices are established already in childhood or adolescence and may significantly track into adulthood.

  10. A study of correlations between identified charged hadrons in hadronic Z{sup 0} decays

    Energy Technology Data Exchange (ETDEWEB)

    Abe, K. [Aomori Univ. (Japan); Abe, K. [Nagoya Univ. (Japan); Abe, T. [Stanford Univ., CA (US). Stanford Linear Accelerator Center] [and others; SLD Collaboration

    1998-06-01

    The authors present a preliminary study of correlations in rapidity between pairs of identified pions, kaons and protons in hadronic Z{sup 0} decays into light flavors. Short range charge correlations are observed between all combinations of these hadron species, confirming that charge, strangeness and baryon number are conserved locally in the jet fragmentation process. The range of this effect is found to be independent of momentum. A strong long-range correlation is observed for high-momentum charged kaon pairs, and weaker long-range {pi}{sup +}-{pi}{sup -}, {pi}{sup +}-K{sup -} and p-K{sup -} correlations are observed. The SLC electron beam polarization is used to tag the quark hemisphere in each event, allowing the first study of rapidities signed such that positive rapidity is along the quark rather than antiquark direction. Distributions of signed rapidities and of ordered differences between signed rapidities provide new insights into leading particle production and several new tests of fragmentation models.

  11. Geological study for identifying potential aquifer zone in Pakes and Bandung Villages, Konang District, Bangkalan Region

    International Nuclear Information System (INIS)

    I Gde Sukadana

    2010-01-01

    Konang District has a problem on fresh water supply particularly in dry season. Two villages in the district, namely Pakes and Konang, are densely populated areas having agriculture activities, so available of sufficient fresh water is necessary. A fresh water source that can be developed in this area is deep groundwater source from potential aquifers. A geological study has been conducted to identify potential aquifer based on lithological aspect and geological structure. According to the regional stratigraphy. the study area consists of Tawun Formation and Ngrayong Formation. They compose of carbonaceous clay stone (the oldest rock unit), carbonaceous clay stone with sandy limestone intercalations, sandy limestone interbed with carbonaceous clay stone, tuff sandstone with clay stone intercalations, and reef limestone (the youngest) respectively. Strike and dip positions of the rocks layers are N110°E/22° - N150°E/26°, located on the south anticline axis with wavy plan to gentle slope of hilly morphology. Among the rock unit, only sandy limestone has fine sand with sub angular in shape and open pack. Qualitatively. this rock has good porosity and permeability and is enables to save and to flow subsurface water. Thus. the sandy limestone is considered as a potential zone for fresh water resources. Whereas, carbonaceous clay stone with clay grain size has low porosity and permeability, so it is potential as a cap rock. (author)

  12. Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure

    Science.gov (United States)

    Wain, Louise V; Verwoert, Germaine C; O’Reilly, Paul F; Shi, Gang; Johnson, Toby; Johnson, Andrew D; Bochud, Murielle; Rice, Kenneth M; Henneman, Peter; Smith, Albert V; Ehret, Georg B; Amin, Najaf; Larson, Martin G; Mooser, Vincent; Hadley, David; Dörr, Marcus; Bis, Joshua C; Aspelund, Thor; Esko, Tõnu; Janssens, A Cecile JW; Zhao, Jing Hua; Heath, Simon; Laan, Maris; Fu, Jingyuan; Pistis, Giorgio; Luan, Jian’an; Arora, Pankaj; Lucas, Gavin; Pirastu, Nicola; Pichler, Irene; Jackson, Anne U; Webster, Rebecca J; Zhang, Feng; Peden, John F; Schmidt, Helena; Tanaka, Toshiko; Campbell, Harry; Igl, Wilmar; Milaneschi, Yuri; Hotteng, Jouke-Jan; Vitart, Veronique; Chasman, Daniel I; Trompet, Stella; Bragg-Gresham, Jennifer L; Alizadeh, Behrooz Z; Chambers, John C; Guo, Xiuqing; Lehtimäki, Terho; Kühnel, Brigitte; Lopez, Lorna M; Polašek, Ozren; Boban, Mladen; Nelson, Christopher P; Morrison, Alanna C; Pihur, Vasyl; Ganesh, Santhi K; Hofman, Albert; Kundu, Suman; Mattace-Raso, Francesco US; Rivadeneira, Fernando; Sijbrands, Eric JG; Uitterlinden, Andre G; Hwang, Shih-Jen; Vasan, Ramachandran S; Wang, Thomas J; Bergmann, Sven; Vollenweider, Peter; Waeber, Gérard; Laitinen, Jaana; Pouta, Anneli; Zitting, Paavo; McArdle, Wendy L; Kroemer, Heyo K; Völker, Uwe; Völzke, Henry; Glazer, Nicole L; Taylor, Kent D; Harris, Tamara B; Alavere, Helene; Haller, Toomas; Keis, Aime; Tammesoo, Mari-Liis; Aulchenko, Yurii; Barroso, Inês; Khaw, Kay-Tee; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Eyheramendy, Susana; Org, Elin; Sõber, Siim; Lu, Xiaowen; Nolte, Ilja M; Penninx, Brenda W; Corre, Tanguy; Masciullo, Corrado; Sala, Cinzia; Groop, Leif; Voight, Benjamin F; Melander, Olle; O’Donnell, Christopher J; Salomaa, Veikko; d’Adamo, Adamo Pio; Fabretto, Antonella; Faletra, Flavio; Ulivi, Sheila; Del Greco, M Fabiola; Facheris, Maurizio; Collins, Francis S; Bergman, Richard N; Beilby, John P; Hung, Joseph; Musk, A William; Mangino, Massimo; Shin, So-Youn; Soranzo, Nicole; Watkins, Hugh; Goel, Anuj; Hamsten, Anders; Gider, Pierre; Loitfelder, Marisa; Zeginigg, Marion; Hernandez, Dena; Najjar, Samer S; Navarro, Pau; Wild, Sarah H; Corsi, Anna Maria; Singleton, Andrew; de Geus, Eco JC; Willemsen, Gonneke; Parker, Alex N; Rose, Lynda M; Buckley, Brendan; Stott, David; Orru, Marco; Uda, Manuela; van der Klauw, Melanie M; Zhang, Weihua; Li, Xinzhong; Scott, James; Chen, Yii-Der Ida; Burke, Gregory L; Kähönen, Mika; Viikari, Jorma; Döring, Angela; Meitinger, Thomas; Davies, Gail; Starr, John M; Emilsson, Valur; Plump, Andrew; Lindeman, Jan H; ’t Hoen, Peter AC; König, Inke R; Felix, Janine F; Clarke, Robert; Hopewell, Jemma C; Ongen, Halit; Breteler, Monique; Debette, Stéphanie; DeStefano, Anita L; Fornage, Myriam; Mitchell, Gary F; Smith, Nicholas L; Holm, Hilma; Stefansson, Kari; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Samani, Nilesh J; Preuss, Michael; Rudan, Igor; Hayward, Caroline; Deary, Ian J; Wichmann, H-Erich; Raitakari, Olli T; Palmas, Walter; Kooner, Jaspal S; Stolk, Ronald P; Jukema, J Wouter; Wright, Alan F; Boomsma, Dorret I; Bandinelli, Stefania; Gyllensten, Ulf B; Wilson, James F; Ferrucci, Luigi; Schmidt, Reinhold; Farrall, Martin; Spector, Tim D; Palmer, Lyle J; Tuomilehto, Jaakko; Pfeufer, Arne; Gasparini, Paolo; Siscovick, David; Altshuler, David; Loos, Ruth JF; Toniolo, Daniela; Snieder, Harold; Gieger, Christian; Meneton, Pierre; Wareham, Nicholas J; Oostra, Ben A; Metspalu, Andres; Launer, Lenore; Rettig, Rainer; Strachan, David P; Beckmann, Jacques S; Witteman, Jacqueline CM; Erdmann, Jeanette; van Dijk, Ko Willems; Boerwinkle, Eric; Boehnke, Michael; Ridker, Paul M; Jarvelin, Marjo-Riitta; Chakravarti, Aravinda; Abecasis, Goncalo R; Gudnason, Vilmundur; Newton-Cheh, Christopher; Levy, Daniel; Munroe, Patricia B; Psaty, Bruce M; Caulfield, Mark J; Rao, Dabeeru C

    2012-01-01

    Numerous genetic loci influence systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans 1-3. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N=74,064) and follow-up studies (N=48,607), we identified at genome-wide significance (P= 2.7×10-8 to P=2.3×10-13) four novel PP loci (at 4q12 near CHIC2/PDGFRAI, 7q22.3 near PIK3CG, 8q24.12 in NOV, 11q24.3 near ADAMTS-8), two novel MAP loci (3p21.31 in MAP4, 10q25.3 near ADRB1) and one locus associated with both traits (2q24.3 near FIGN) which has recently been associated with SBP in east Asians. For three of the novel PP signals, the estimated effect for SBP was opposite to that for DBP, in contrast to the majority of common SBP- and DBP-associated variants which show concordant effects on both traits. These findings indicate novel genetic mechanisms underlying blood pressure variation, including pathways that may differentially influence SBP and DBP. PMID:21909110

  13. Feasibility Study to Identify Potential Reductions in Energy Use in Tribal Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, Willie [Confederated Salish and Kootenai Tribes, Pablo, MT (United States)

    2017-03-30

    Under this project, the Confederated Salish and Kootenai Tribes (CSKT) assessed the technical and economic feasibility of energy efficiency improvements to existing Tribally-owned buildings. The feasibility study followed a systematic approach in identifying, selecting, and ranking recommended measures, recognizing that the appropriateness of a measure would depend not only on technical issues but also on institutional and organizational issues, such as financing options and occupant requirements. The completed study provided the Tribes with the information needed to commit necessary resources to reduce the energy use and cost in approximately 40 Tribal buildings, including the changes that may be needed in each facility’s operation and maintenance and personnel requirements. It also presented an economic analysis of energy-efficiency capital improvements and an annotated list of financing options and possible funding sources for implementation and an overall strategy for implementation. This project was located in various Tribal communities located throughout the Flathead Indian Reservation in Western Montana. Notice: The following is a compilation of Annual Program Review Presentations, Award Modifications, and Quarterly Progress Reports submitted to the Department of Energy’s (DOE) Office of Indian Energy Policy and Programs by the Confederated Salish and Kootenai Tribes under agreement DE-EE0005171. This report covers project activities from September 30, 2011 through December 31, 2014 and has been uploaded to OSTI by DOE as a substitute for the required Final Technical Report which was not received by DOE from the project recipient.

  14. A Study of Correlations Between Identified Charged Hadrons in Hadronic Z0 Decays

    International Nuclear Information System (INIS)

    Burrows, Phil

    2000-01-01

    The authors present a preliminary study of correlations in rapidity between pairs of identified charged pions, kaons and protons using the entire SLD data sample of 550,000 hadronic Z 0 decays. Short range charge correlations are observed between all combinations of these hadron species, indicating local conservation of quantum numbers and charge ordering in the jet fragmentation process. The rapidity range of this effect is found to be independent of particle momentum. A strong long-range K + -K - correlation is observed at high-momentum and weaker long-range pi + -pi - , pi + -K - p-K - and p anti-p correlations are observed in light flavor events, providing new information on leading particle production in u, d and s jets. The long-range correlations observed in c anti-c and b anti-b events are markedly different and consistent with expectations based on known decay properties of the leading heavy hadrons. In addition, the SLC electron beam polarization is used to tag the quark hemisphere in each event, allowing the first study of rapidities signed such that positive rapidity is along the quark rather than antiquark direction. Distributions of ordered differences in signed rapidity between pairs of particles provide a direct probe of quantum number ordering along the quark-antiquark axis and other new insights into the fragmentation process

  15. Unmet health needs identified by Haitian women as priorities for attention: a qualitative study.

    Science.gov (United States)

    Peragallo Urrutia, Rachel; Merisier, Delson; Small, Maria; Urrutia, Eugene; Tinfo, Nicole; Walmer, David K

    2012-06-01

    This 2009 qualitative study investigated Haitian women's most pressing health needs, barriers to meeting those needs and proposed solutions, and how they thought the community and outside organizations should be involved in addressing their needs. The impetus for the study was to get community input into the development of a Family Health Centre in Leogane, Haiti. Individual interviews and focus group discussions were conducted with 52 adult women in six communities surrounding Leogane. The most pressing health needs named by the women were accessible, available and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation and education, including health education. Institutional corruption, lack of infrastructure and social organization, the cost of health care, distance from services and lack of transport as barriers to care were also important themes. The involvement of foreign organizations and local community groups, including grassroots women's groups who would work in the best interests of other women, were identified as the most effective solutions. Organizations seeking to improve women's health care in Haiti should develop services and interventions that prioritize community partnership and leadership, foster partnerships with government, and focus on public health needs. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. Examination of studies on technology-assisted collaborative learning published between 2010-2014

    Directory of Open Access Journals (Sweden)

    Ahmet Arnavut

    2016-09-01

    Full Text Available Abstract This study is a content analysis of the articles about technology-assisted collaborative learning published in Science Direct database between the years of 2010 and 2014. Developing technology has become a topic that we encounter in every aspect of our lives. Educators deal with the contribution and integration of technology into education. Therefore, in this study it was aimed to examine how integration of collaborative learning into technology would contribute to education or it would contribute to education or not. According to the results of the studies obtained from Science Direct database, there are many research related with technology-assisted collaborative learning. However, since all of the studies did not fulfill our search criteria for content analysis, a total number of 58 articles published between the years of 2010 and 2014 were used in this study.

  17. Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain

    Directory of Open Access Journals (Sweden)

    Tropp Hans

    2005-06-01

    Full Text Available Abstract Background The tissue origin of low back pain (LBP or referred lower extremity symptoms (LES may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216 with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement

  18. Using the SAPAS to identify risk for personality disorders among psychiatric outpatients in India: A feasibility study.

    Science.gov (United States)

    Innocent, Simeon; Podder, Priyanka; Ram, Jai Ranjan; Barnicot, Kirsten; Sen, Piyal

    2018-02-01

    Personality disorders (PDs) are common among psychiatric outpatients and are associated with increased morbidity and worse treatment outcomes. Epidemiological research conducted among this population in Asian countries is limited, reflecting a significant gap in the current literature. One barrier to this research is the lack of appropriate screening tools. The current research assessed the feasibility of using the SAPAS (Standardized Assessment of Personality-Abbreviated Scale) screening tool to identify individuals at high risk of PD in an Indian psychiatric outpatient population and provides an initial estimate of PD prevalence by using a validated diagnostic interview, the ICD-10 International Personality Disorder Examination. The findings suggest that whilst use of the SAPAS was feasible, acceptable to patients and led to clinically useful findings, when using the recommended cut-off score of 4, the SAPAS largely overdiagnoses the risk for PD in psychiatric outpatients in India (positive predictive value = 26.3%). The estimated prevalence of personality disorder in the sample was 11.1%, based on administering the International Personality Disorder Examination diagnostic interview to high-risk patients scoring 4 and above on the SAPAS, which is higher than previous estimates for this population and still likely to be an underestimation. Future studies should translate the measure into Bengali and evaluate its sensitivity and specificity at different cut-off points in order to optimize its use in Indian populations. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Identifying bottlenecks in the iron and folic acid supply chain in Bihar, India: a mixed-methods study.

    Science.gov (United States)

    Wendt, Amanda S; Stephenson, Rob; Young, Melissa F; Verma, Pankaj; Srikantiah, Sridhar; Webb-Girard, Amy; Hogue, Carol J; Ramakrishnan, Usha; Martorell, Reynaldo

    2018-04-12

    Maternal anaemia prevalence in Bihar, India remains high despite government mandated iron supplementation targeting pregnant women. Inadequate supply has been identified as a potential barrier to iron and folic acid (IFA) receipt. Our study objective was to examine the government health system's IFA supply and distribution system and identify bottlenecks contributing to insufficient IFA supply. Primary data collection was conducted in November 2011 and July 2012 across 8 districts in Bihar, India. A cross-sectional, observational, mixed methods approach was utilized. Auxiliary Nurse Midwives were surveyed on current IFA supply and practices. In-depth interviews (n = 59) were conducted with health workers at state, district, block, health sub-centre, and village levels. Overall, 44% of Auxiliary Nurse Midwives were out of IFA stock. Stock levels and supply chain practices varied greatly across districts. Qualitative data revealed specific bottlenecks impacting IFA forecasting, procurement, storage, disposal, lack of personnel, and few training opportunities for key players in the supply chain. Inadequate IFA supply is a major constraint to the IFA supplementation program, the extent of which varies widely across districts. Improvements at all levels of infrastructure, practices, and effective monitoring will be critical to strengthen the IFA supply chain in Bihar.

  20. Identifying cognitive preferences for attractive female faces: an event-related potential experiment using a study-test paradigm.

    Science.gov (United States)

    Zhang, Yan; Kong, Fanchang; Chen, Hong; Jackson, Todd; Han, Li; Meng, Jing; Yang, Zhou; Gao, Jianguo; Najam ul Hasan, Abbasi

    2011-11-01

    In this experiment, sensitivity to female facial attractiveness was examined by comparing event-related potentials (ERPs) in response to attractive and unattractive female faces within a study-test paradigm. Fourteen heterosexual participants (age range 18-24 years, mean age 21.67 years) were required to judge 84 attractive and 84 unattractive face images as either "attractive" or "unattractive." They were then asked whether they had previously viewed each face in a recognition task in which 50% of the images were novel. Analyses indicated that attractive faces elicited more enhanced ERP amplitudes than did unattractive faces in judgment (N300 and P350-550 msec) and recognition (P160 and N250-400 msec and P400-700 msec) tasks on anterior locations. Moreover, longer reaction times and higher accuracy rate were observed in identifying attractive faces than unattractive faces. In sum, this research identified neural and behavioral bases related to cognitive preferences for judging and recognizing attractive female faces. Explanations for the results are that attractive female faces arouse more intense positive emotions in participants than do unattractive faces, and they also represent reproductive fitness and mating value from the evolutionary perspective. Copyright © 2011 Wiley-Liss, Inc.

  1. HISTOPATHOLOGICAL PROFILE OF LIVER LESIONS IN AUTOPSY EXAMINATION- A HOSPITAL-BASED STUDY

    Directory of Open Access Journals (Sweden)

    Ratan Konjengbam

    2017-06-01

    Full Text Available BACKGROUND Liver is the main site of various primary and secondary diseases including variety of external agents. Most of the chronic liver diseases remained asymptomatic even in the late stage. In apparently healthy persons, many liver lesions are detected incidentally following a postmortem examination. MATERIALS AND METHODS The present study was done for a period of 5 years in a tertiary hospital to evaluate the histopathological profile of liver specimen in autopsy examination. Haematoxylin and Eosin sections of liver specimen were studied. A total of 352 samples were evaluated with male predominates the female sex in the ratio of 5.2:1. RESULTS The most common lesion was fatty liver (19% followed by cirrhosis (11.8%, venous congestion (11.5%, portal triaditis (10.9%, chronic hepatitis (6.2%, granulomatous hepatitis (2.1%, autolysis (16% and others (0.96%. Liver finding was normal in 14% of the cases. CONCLUSION Silent liver diseases are a quite regular finding in autopsy cases and thereby may implicate a common occurrence in general population. Autopsy examination of liver is a must for detection of silent liver diseases like fatty change, cirrhosis and chronic hepatitis.

  2. [A school-level longitudinal study of clinical performance examination scores].

    Science.gov (United States)

    Park, Jang Hee

    2015-06-01

    This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

  3. A study comparing MRI with clinical examinations on wrists with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Wang Jun; Niu Jinliang; Xie Weina; Song Zhizhen; Zheng Jie; Ma Qiang

    2004-01-01

    Objective: To study the appearances of rheumatoid arthritis (RA) on MRI, and compare MRI with clinical examinations on wrists with RA. Methods: Fifty patients, fulfilled 1987 American Rheumatism Association (ARA) revised criteria, and 10 age-matched healthy controls entered the study. T 1 -weighted spin echo, short time inversion recovery (STIR) of both wrists, gadolinium contrast material-enhanced sequences of dominant wrists were performed in the coronal planes. MRl, plain wrist radiographs, clinical date, including swollen joint, patient global assessment (AIMS), and laboratory examinations including ESR, RF, APF, and AKA were obtained at the same time. Functional disability was assessed using the Health Assessment Questionnaire Disability Score. Results: In 50 patients, all had pannus on MRI of wrists, 38 patients had enhanced signal intensity for pannus, 21 patients had bone marrow edema, 37 patients had joint effusion, and 37 patients had bone erosions. There were significant difference in the ESR, HAQ, AIMS as well as swollen joint count between patients with bone marrow edema and patients without bone marrow edema (P 2 =5.06, P=0.025; χ 2 =5.59, P=0.018). Number of patients with MRI erosion of wrists was associated with the number of patients without MRI bone marrow edema of wrists (χ 2 =5.11, P=0.024). Conclusion: MRI can find the appearances of wrists with RA. Comparing MRI with clinical examinations on wrists with RA, authors can assess and evaluate the role of MRI on RA

  4. Active commuting among K-12 educators: a study examining walking and biking to work.

    Science.gov (United States)

    Bopp, Melissa; Hastmann, Tanis J; Norton, Alyssa N

    2013-01-01

    Walking and biking to work, active commuting (AC) is associated with many health benefits, though rates of AC remain low in the US. K-12 educators represent a significant portion of the workforce, and employee health and associated costs may have significant economic impact. Therefore, the purpose of this study was to examine the current rates of AC and factors associated with AC among K-12 educators. A volunteer sample of K-12 educators (n = 437) was recruited to participate in an online survey. Participants responded about AC patterns and social ecological influences on AC (individual, interpersonal, institutional, community, and environmental factors). t-tests and ANOVAs examined trends in AC, and Pearson correlations examined the relationship between AC and dependent variables. Multiple regression analysis determined the relative influence of individual, interpersonal, institutional, community, and environmental levels on AC. Participants actively commuted 0.51 ± 1.93 times/week. There were several individual, interpersonal, institutional, community, and environmental factors significantly related to AC. The full model explained 60.8% of the variance in AC behavior. This study provides insight on the factors that determine K-12 educators mode of commute and provide some insight for employee wellness among this population.

  5. Active Commuting among K-12 Educators: A Study Examining Walking and Biking to Work

    Directory of Open Access Journals (Sweden)

    Melissa Bopp

    2013-01-01

    Full Text Available Background. Walking and biking to work, active commuting (AC is associated with many health benefits, though rates of AC remain low in the US. K-12 educators represent a significant portion of the workforce, and employee health and associated costs may have significant economic impact. Therefore, the purpose of this study was to examine the current rates of AC and factors associated with AC among K-12 educators. Methods. A volunteer sample of K-12 educators ( was recruited to participate in an online survey. Participants responded about AC patterns and social ecological influences on AC (individual, interpersonal, institutional, community, and environmental factors. -tests and ANOVAs examined trends in AC, and Pearson correlations examined the relationship between AC and dependent variables. Multiple regression analysis determined the relative influence of individual, interpersonal, institutional, community, and environmental levels on AC. Results. Participants actively commuted times/week. There were several individual, interpersonal, institutional, community, and environmental factors significantly related to AC. The full model explained 60.8% of the variance in AC behavior. Conclusions. This study provides insight on the factors that determine K-12 educators mode of commute and provide some insight for employee wellness among this population.

  6. A study looking at the effectiveness of developmental screening in identifying learning disabilities in early childhood.

    Science.gov (United States)

    Flanagan, O; Nualláin, S O

    2001-05-01

    This is a retrospective study of children under six years of age referred to the Brothers of Charity Early Intervention Services in County Galway, a service that caters for children under 6 years with learning disabilities. The aim in doing this study was to assess the value of routine developmental screening in identifying children with learning difficulties. This study also investigates the patterns and sources of referral to the remedial services provided by the Brothers of Charity and highlights possible avoidable delays in referral. The results showed that many children were referred for remedial services late. The reasons for late referral included late identification of some children with problems, insufficient co-ordination of community-based services and a lack of awareness of the importance of early intervention in some cases. As some communication disorders such as autism, autistic spectrum disorders and specific language delay may not express themselves until the later part of the second year of life, the 18-24 month developmental assessment is of vital importance. However identification of these disorders can present difficulties and may call for additional training for professionals involved in the developmental screening of children in that age group. The interval between initial identification and referral for remedial care in many cases was more than twelve months. We propose that, in order to minimize this time, children requiring a more in-depth assessment should be assessed by a community-based multidisciplinary team, enabling integrated assessment by the different disciplines and thus speedier referral to remedial services.

  7. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people.

    Science.gov (United States)

    Priest, Naomi; Paradies, Yin; Trenerry, Brigid; Truong, Mandy; Karlsen, Saffron; Kelly, Yvonne

    2013-10-01

    Racial discrimination is increasingly recognised as a determinant of racial and ethnic health inequalities, with growing evidence of strong associations between racial discrimination and adult health outcomes. There is a growing body of literature that considers the effects of racial discrimination on child and youth health. The aim of this paper is to provide a systematic review of studies that examine relationships between reported racial discrimination and child and youth health. We describe the characteristics of 121 studies identified by a comprehensive search strategy, including definitions and measurements of racial discrimination and the nature of reported associations. Most studies were published in the last seven years, used cross-sectional designs and were conducted in the United States with young people aged 12-18 years. African American, Latino/a, and Asian populations were most frequently included in these studies. Of the 461 associations examined in these studies, mental health outcomes (e.g. depression, anxiety) were most commonly reported, with statistically significant associations with racial discrimination found in 76% of outcomes examined. Statistically significant associations were also found for over 50% of associations between racial discrimination and positive mental health (e.g. self esteem, resilience), behaviour problems, wellbeing, and pregnancy/birth outcomes. The field is currently limited by a lack of longitudinal studies, limited psychometrically validated exposure instruments and poor conceptualisation and definition of racial discrimination. There is also a need to investigate the complex and varying pathways by which reported racial discrimination affect child and youth health. Ensuring study quality in this field will allow future research to reveal the complex role that racial discrimination plays as a determinant of child and youth health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. A study of requested CT head examinations and their positive yield rate

    International Nuclear Information System (INIS)

    Coakley, K.S.

    2004-01-01

    Full text: Requests for CT examinations are ever increasing, partly due to the excellent clinical information they can provide for patient management and partly due to a perceived need for 'evidence' that everything has been done to diagnose a patient correctly. This has led to many CT examinations being done on patients where many of the radiology community does not necessarily feel CT will yield a positive finding, i.e. in their eyes - a possible unjustified use of radiation. To determine whether this was in fact true, or merely a perception, a study was performed by medical imaging and physics staff at the Royal Brisbane Hospital to determine statistics of positive yield for CT head exams. 600 CT head examinations from the Emergency Department at the Royal Brisbane Hospital were retrospectively examined and their findings were tabulated under various clinical categories to determine positive yield statistics. These categories were also tabulated with the radiologists advice as to whether they would have expected a positive finding. For several categories the positive yield for CT head exams was so low as to be considered negligible. Other categories, although low were still considered significant. These will be presented to the emergency department along with a suggested protocol for requesting CT head exams. It was unfortunate that this study had to be performed to prove to clinical staff that medical imaging staff members do in general have an excellent idea of what will show up in an x-ray and what will not! However, it was useful to be able to categorise 'positive yield' statistics into such specific classes. The next step is to try and communicate these findings to staff to create more trust and better communication between departments. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  9. Gas-fired cogeneration and cooling: new study identifies major benefits

    International Nuclear Information System (INIS)

    Watt, G.

    2001-01-01

    A research paper- 'Gas Fired Cogeneration and Cooling: Markets, Technologies and Greenhouse Gas Savings'- launched at last month's Australian Gas Association 2001 Convention, reveals that gas cooling could replace 25 PJ of electricity summer demand, and reduce greenhouse gas emissions by 58 percent compared with electrical technologies. Commissioned by the AGA's Gas Cooling Task Force and supported by the Sustainable Energy Authority of Victoria and the Sustainable Energy Development Authority of NSW, the study examined market opportunities and environmental outcomes for the combined gas cogeneration and cooling technologies. It shows that the penetration of gas into the distributed cooling and power generation market is being driven by the following developments: the uncertainty and volatility of electricity costs, particularly during summer, electricity market structural changes which encourage distributed generation, high and uncertain world oil prices, the relative stability of Australian gas prices, the encouragement of demand and energy management strategies by regulators, greenhouse gas emission reduction policies, indoor air quality issues, product and productivity improvements in industry and CFC phase-out opportunities

  10. Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

    Science.gov (United States)

    Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

    2018-02-22

    Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

  11. Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination.

    Science.gov (United States)

    Smeds, Matthew R; Thrush, Carol R; McDaniel, Faith K; Gill, Roop; Kimbrough, Mary K; Shames, Brian D; Sussman, Jeffrey J; Galante, Joseph M; Wittgen, Catherine M; Ansari, Parswa; Allen, Steven R; Nussbaum, Michael S; Hess, Donald T; Knight, David C; Bentley, Frederick R

    2017-09-01

    The American Board of Surgery In-Training Examination (ABSITE) is used by programs to evaluate the knowledge and readiness of trainees to sit for the general surgery qualifying examination. It is often used as a tool for resident promotion and may be used by fellowship programs to evaluate candidates. Burnout has been associated with job performance and satisfaction; however, its presence and effects on surgical trainees' performance are not well studied. We sought to understand factors including burnout and study habits that may contribute to performance on the ABSITE examination. Anonymous electronic surveys were distributed to all residents at 10 surgical residency programs (n = 326). Questions included demographics as well as study habits, career interests, residency characteristics, and burnout scores using the Oldenburg Burnout Inventory, which assesses burnout because of both exhaustion and disengagement. These surveys were then linked to the individual's 2016 ABSITE and United States Medical Licensing Examination (USMLE) step 1 and 2 scores provided by the programs to determine factors associated with successful ABSITE performance. In total, 48% (n = 157) of the residents completed the survey. Of those completing the survey, 48 (31%) scored in the highest ABSITE quartile (≥75th percentile) and 109 (69%) scored less than the 75th percentile. In univariate analyses, those in the highest ABSITE quartile had significantly higher USMLE step 1 and step 2 scores (P shop compared with at home; P < 0.04), and used active rather than passive study strategies (P < 0.04). Gender, marital status, having children, and debt burden had no correlation with examination success. Backward stepwise multiple regression analysis identified the following independent predictors of ABSITE scores: study location (P < 0.0001), frequency of reading (P = 0.0001), Oldenburg Burnout Inventory exhaustion (P = 0.02), and USMLE step 1 and 2 scores (P = 0.007 and 0

  12. Identifying predictors of attitudes towards local onshore wind development with reference to an English case study

    International Nuclear Information System (INIS)

    Jones, Christopher R.; Eiser, J. Richard

    2009-01-01

    The threats posed by climate change are placing governments under increasing pressure to meet electricity demand from low-carbon sources. In many countries, including the UK, legislation is in place to ensure the continued expansion of renewable energy capacity. Onshore wind turbines are expected to play a key role in achieving these aims. However, despite high levels of public support for onshore wind development in principle, specific projects often experience local opposition. Traditionally this difference in general and specific attitudes has been attributed to NIMBYism (not in my back yard), but evidence is increasingly calling this assumption into question. This study used multiple regression analysis to identify what factors might predict attitudes towards mooted wind development in Sheffield, England. We report on the attitudes of two groups; one group (target) living close to four sites earmarked for development and an unaffected comparison group (comparison). We found little evidence of NIMBYism amongst members of the target group; instead, differences between general and specific attitudes appeared attributable to uncertainty regarding the proposals. The results are discussed with respect to literature highlighting the importance of early, continued and responsive community involvement in combating local opposition and facilitating the deployment of onshore wind turbines.

  13. BIBLIOGRAPHIC STUDY IN RISK MANAGEMENT AIMED TO IDENTIFY MORE REFERENCED TOOLS, METHODS AND RELATIONSHIPS

    Directory of Open Access Journals (Sweden)

    Alamir Costa Louro

    2015-06-01

    Full Text Available The objective of this paper is to identify and discuss trends in tools and methods used in project risk management and its relationship to other matters, using current scientific articles. The focus isn´t in understanding how they work in technical terms, but think about the possibilities of deepening in academic studies, including making several suggestions for future research. Adjacent to the article there is a discussion about an alleged "one best way" imperative normativity approach. It was answered the following research questions: what subjects and theories are related to project risk management tools and methods? The first contribution is related to the importance of the academic Chris Chapman as an author who has more published and also more referenced in the survey. There are several contributions on various subjects such as: the perception of the existence of many conceptual papers; papers about construction industry, problematization of contracts according to agency theory, IT and ERPs issues. Other contributions came from the bibliometric method that brings lot of consolidated information about terms, topics, authors, references, periods and, of course, methods and tools about Project Risk Management.

  14. A RELAP5 study to identify flow regime in natural circulation phenomenon

    Energy Technology Data Exchange (ETDEWEB)

    Sabundjian, Gaiane; Torres, Walmir M.; Macedo, Luiz A.; Mesquita, Roberto N.; Andrade, Delvonei A.; Umbehaun, Pedro E.; Conti, Thadeu N.; Masotti, Paulo H.F.; Belchior Junior, Antonio; Angelo, Gabriel, E-mail: gdjian@ipen.b, E-mail: umbehaun@ipen.b, E-mail: wmtorres@ipen.b, E-mail: tnconti@ipen.b, E-mail: rnavarro@ipen.b, E-mail: lamacedo@ipen.b, E-mail: pmasotti@ipen.b, E-mail: abelchior@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    There has been a crescent interest in the scientific community in the study of natural circulation phenomenon. New generation of compact nuclear reactors uses the natural circulation of the fluid as a system of cooling and of residual heat removal in case of accident or shutdown. The objective of this paper is to compare the flow patterns of experimental data and numerical simulation for the natural circulation phenomenon in two-phase flow regime. An experimental circuit built with glass tubes is used for the experiments. Thus, it allows the thermal hydraulic phenomena visualization. There is an electric heater as the heat source, a heat exchanger as the heat sink and an expansion tank to accommodate fluid density excursions. The circuit instrumentation consists of thermocouples and pressure meters to better keep track of the flow and heat transfer phenomena. Data acquisition is performed through a computer interface developed with LABVIEW. The characteristic of the regime is identified using photography techniques. Numerical modeling and simulation is done with the thermal hydraulic code RELAP5, which is widely used for this purpose. This numerical simulation is capable to reproduce some of the flow regimes which are present in the circuit for the natural circulation phenomenon. Comparison between experimental and numerical simulation is presented in this work. (author)

  15. Truncation studies of alpha-melanotropin peptides identify tripeptide analogues exhibiting prolonged agonist bioactivity.

    Science.gov (United States)

    Haskell-Luevano, C; Sawyer, T K; Hendrata, S; North, C; Panahinia, L; Stum, M; Staples, D J; Castrucci, A M; Hadley, M F; Hruby, V J

    1996-01-01

    Truncation studies of alpha-melanotropin peptides identify tripeptide analogues exhibiting prolonged agonist bioactivity: PEPTIDES 17(6) 995-1002, 1996.-Systematic analysis of fragment derivatives of the superpotent alpha-MSH analogue. Ac-Ser.Tyr-Ser-Nle4-Glu- His-DPhe7-Arg-Trp-Gly-Lys-Pro-Val-NH2(NDP-MSH), led to the discovery of tripeptide agonists possessing prolonged bioactivity in the frog skin assay. Of particular significance to this discovery was Ac-DPhe-Arg-DTrp-NH2, which was the most potent tripeptide in this series exhibiting sustained melanotropic activity. Different pharmacophore models appear to exist that are dependent on the substructure and stereochemistry of the MSH(6-9) "active site." The tripeptides Ac-DPhe-Arg-Trp-NH2, Ac-DPhe-Arg-DTrp-NH2, and Ac-DPhe-DArg-Trp-NH2 stereo-chemical combinations require only Phe7-Xaa8-Trp9, whereas Ac-DPhe-DArg-DTrp-NH2, Ac-Phe-Arg-DTrp-NH2, and Ac-Phe-Arg-Trp-NH2 additionally require His4 for minimal biological activity. Ac-DPhe-Arg-DTrp-NH2 represents a novel prototype lead for the development of MSH-based peptidomimetic agonists.

  16. Identifying Risk Factors of Boot Procurement: A Case Study of Stadium Australia

    Directory of Open Access Journals (Sweden)

    Marcus Jefferies

    2012-11-01

    Full Text Available Private sector input into the procurement of public works and services is continuing to increase. This has partly arisen out of a requirement for infrastructure development to be undertaken at a rate that maintains and allows growth. This has become a major challange for the construction industry that cannot be met by government alone. The emergence of Build-Own-Operate-Transfer (BOOT schemes as a response to this challange provides a means for developing the infrastructure of a country without directly impacting on the governments budgetary constraints. The concepts of BOOT are without doubt extremely complex arrangements, which bring to the construction sector risks not experienced previously. Many of the infrastructure partnerships between public and private sector in the pastare yet to provide evidence of successful completion, since few of the concession periods have expired. This paper provides an identified list of risk factors to a case study of Stadium Australia. The most significant risk associated with Stadium Australia include the bidding process, the high level of public scrutiny, post-Olympic Games facility revenue and the complicated nature of the consortium structure.  

  17. Identifying Risk Factors of Boot Procurement: A Case Study of Stadium Australia

    Directory of Open Access Journals (Sweden)

    Marcus Jefferies

    2012-11-01

    Full Text Available Private sector input into the procurement of public works and services is continuing to increase. This has partly arisen out of a requirement for infrastructure development to be undertaken at a rate that maintains and allows growth. This has become a major challange for the construction industry that cannot be met by government alone. The emergence of Build-Own-Operate-Transfer (BOOT schemes as a response to this challange provides a means for developing the infrastructure of a country without directly impacting on the governments budgetary constraints. The concepts of BOOT are without doubt extremely complex arrangements, which bring to the construction sector risks not experienced previously. Many of the infrastructure partnerships between public and private sector in the pastare yet to provide evidence of successful completion, since few of the concession periods have expired. This paper provides an identified list of risk factors to a case study of Stadium Australia. The most significant risk associated with Stadium Australia include the bidding process, the high level of public scrutiny, post-Olympic Games facility revenue and the complicated nature of the consortium structure.

  18. The Sports Challenge international programme for identified 'at risk' children and adolescents: a Singapore study.

    Science.gov (United States)

    Tester, G J; Watkins, G G; Rouse, I

    1999-01-01

    The current world wide phenomena of youth suicide which became a major issue for countries in the early nineties, is still growing exponentially. The Sports Challenge program was initiated in 1992 in Western Australia to identify 'at risk' children and adolescents who display: a low sense of basic trust, a sense of shame and doubt, a sense of inferiority and a sense of identity confusion with common characteristics of low self esteem. The subsequent program is based on a strong statistical paradigm encompassing current and historical information with reliable and objective evaluation measures. To this end, since 1992, Sports Challenge has been recognised as a 'World Best Practice' in redressing the issue of 'at risk' children and adolescents. The program now operates in over 150 schools and communities throughout Australia and 24 schools and Detention Centres in Singapore. This paper will allow a window into the development of the program and the successful transfer of the project into Singapore. The Singapore study which began in 1996 has revealed the success of the Sports Challenge program cross culturally with improvement in self esteem and self concept of 'at risk' groups in the range of 18% to 44%.

  19. EXAMINING THE EFFECT OF ENDORSER CREDIBILITY ON THE CONSUMERS' BUYING INTENTIONS: AN EMPIRICAL STUDY IN TURKEY

    Directory of Open Access Journals (Sweden)

    Aysegul Ermec Sertoglu

    2014-01-01

    Full Text Available The purpose of this study is to test whether the source credibility affects buying intention and measure the perceived credibility differences between created spokesperson and celebrity endorser. The influence that endorser credibility dimensions (i.e. attractiveness, trustworthiness and expertise have on purchase intentions of 326 young consumers has been examined. The results showed that all of the three credibility dimensions for both celebrity endorser and created spokesperson have a positive relationship with purchase intention. Created spokesperson is perceived to be more trustworthy and competent whereas the celebrity endorser is found to be more attractive by the respondents. This study is unique in a way that it covers fairly new and rapidly growing Turkish market. One factor that makes this study unique in Turkey, in which the usage of celebrity endorsers holds significant part in the marketing of products, is the lack of studies that would measure the effectiveness of this method.

  20. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    Directory of Open Access Journals (Sweden)

    Moreno Victor

    2011-08-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. Methods CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. Results None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive, rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive, rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant, and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive. In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1

  1. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    International Nuclear Information System (INIS)

    Abulí, Anna; Morillas, Juan D; Rigau, Joaquim; Latorre, Mercedes; Fernández-Bañares, Fernando; Peña, Elena; Riestra, Sabino; Payá, Artemio; Jover, Rodrigo; Xicola, Rosa M; Llor, Xavier; Fernández-Rozadilla, Ceres; Carvajal-Carmona, Luis; Villanueva, Cristina M; Moreno, Victor; Piqué, Josep M; Carracedo, Angel; Castells, Antoni; Andreu, Montserrat; Ruiz-Ponte, Clara; Castellví-Bel, Sergi; Alonso-Espinaco, Virginia; Muñoz, Jenifer; Gonzalo, Victoria; Bessa, Xavier; González, Dolors; Clofent, Joan; Cubiella, Joaquin

    2011-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value < 0.05 in EPICOLON stage 1 [rs698 in ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive), rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive), rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant), and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1

  2. Cheating in Examinations: A Study of Academic Dishonesty in a Malaysian College

    Directory of Open Access Journals (Sweden)

    Sara Asmawati Shariffuddin

    2009-12-01

    Full Text Available Recent empirical studies indicate that cheating by post-secondary students is prevalent in many countries. This study attempts to explore academic dishonesty among students at Terengganu Advanced Technical Institute University College (TATiUC in Malaysia. Cheating techniques, preventive measures and the support required by lecturers to handle cheating incidents were examined. Six former students who were confirmed cheaters and two lecturers and administrators at TATiUC participated in the study. Data were collected by using narrative responses and interviews. The results showed that creative and innovative techniques were used to cheat successfully. It was also found that participants believed that even if preventive measures were taken, it was not possible to stop academic cheating entirely although it could be deterred to a certain extent. Furthermore, it was discovered that there were variations in the implementation of examination rules and regulations by lecturers. Finally, the study revealed that support in terms of training and courses was needed to deal with academic dishonesty.

  3. Cooperative Group Performance in Graduate Research Methodology Courses: The Role of Study Coping and Examination-Taking Coping Strategies

    Science.gov (United States)

    Jiao, Qun G.; Collins, Kathleen M. T.; Onwuegbuzie, Anthony J.

    2013-01-01

    This study seeks to examine the extent to which cooperative group members' levels of coping strategies (study and examination-taking coping strategies) and the degree that heterogeneity (variability of study coping strategies and examination-taking coping strategies) predict cooperative groups' levels of achievement in research methodology…

  4. Identifying the Education Needs of the Business Analyst: An Australian Study

    Directory of Open Access Journals (Sweden)

    Deborah Richards

    2014-06-01

    Full Text Available The Business Analyst (BA plays a key role in ensuring that technology is appropriately used to achieve the organisation’s goals. This important mediating role is currently in high (unmet demand in many English-speaking countries and thus more people need to be trained for this role. To determine the educational and/or training needs of a BA we conducted a survey in the Information and Communication Technology industry in Australia. The survey items are based on prior studies of information systems educational requirements and the internationally-developed Skills Framework for the Information Age (SFIA that has been endorsed by the Australian Computer Society. From the literature we identified three types of skills: soft, business and technical. With the increasing importance of GreenIT and the pivotal role that the BA could play in green decision making, we added a fourth type of skill: green. The survey considers 85 skills, their importance, the level of attainment of that skill, skill gaps and types of skills. Results show that all soft skills were considered to be important with the smallest knowledge gaps. Selected business skills and green skills were seen to be important. Technical skills were considered less important, but also where the largest knowledge gaps existed. Further we asked respondents whether each skill should be acquired via an undergraduate or postgraduate degree and/or industry training and experience. We found that the workplace was considered the most appropriate place to acquire and/or develop all skills, except the ability to innovate. While we found that softskills should be taught almost equally at the undergraduate and postgraduate level, business and green skills were more appropriate in a postgraduate degree. In contrast, technical skills were best acquired in an undergraduate program of study.

  5. Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Taro Takeshima

    Full Text Available (1 To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER of community hospitals, and (2 to test the validity of that rule with a separate, independent set of data.Multicenter retrospective cohort study.To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation. We tested the rule using data from one other community hospital (validation, which was not among the three "derivation" hospitals.Adults (age ≥ 16 years old who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients, and for the validation data n = 467 (from 823 patients.We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the "ID-BactER" score. Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC were computed.There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation and 0.74 (validation. For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively.The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity.

  6. Results of the study of entrance surface dose from conventional examinations in diagnostic radiology

    International Nuclear Information System (INIS)

    Martinez, A.; Jova, L.; Carrazana, J.; Diaz, E.; Mora, R. de la; Guevara, C.; Fleitas, I.

    2001-01-01

    The wide diffusion of X-ray diagnostic together with the quick development and expansion that has come with experiencing the technology in this practice, has motivated the emission of recommendations in the Basic Safety Standards of the IAEA for the establishment of guidance levels for different radiological examinations in each country that allow the optimization of the medical exposure. Considering the above-mentioned and the existence in Cuba in a great number of conventional X-ray equipment, with an average of over 10 years of use which influences directly on the patient dose, in 1999, an investigation began in the country on the patient exposure in this practice. This work shows the first results of measurements carried out in 9 major hospitals of several provinces of the country. The doses were evaluated in the examinations of lumbar spine AP, lumbar spine LAT, thorax PA, skull AP and skull LAT. The determination of the doses in these examinations was carried out by 'in-vivo' measurements on the patients, placing in the center of the irradiation field TLD of LiF. The distributions obtained in the studies are compared with the guidance levels that is shown in the Basic Safety Standards of the IAEA. (author)

  7. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Science.gov (United States)

    Xie, Yue; Gao, Ya; Jia, Jianjun; Wang, Xiaohong; Wang, Zhenfu; Xie, Hengge

    2014-01-01

    Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P physical examination population. PMID:25436227

  8. Utility of AD8 for Cognitive Impairment in a Chinese Physical Examination Population: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Yue Xie

    2014-01-01

    Full Text Available Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population. Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0. Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P<0.05. 260 subjects were scored equal to or greater than 2. The abnormal rate was 16.9%. All the participants were stratified into 9 groups by age; the prevalence of dementia was highly correlated with age (P<0.01. Conclusion. AD8 scale is a convenient and effective tool for cognitive screening in routine physical examination population.

  9. A Validation Study of the Japanese Version of the Addenbrooke’s Cognitive Examination-Revised

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    Kelssy Hitomi dos Santos Kawata

    2012-03-01

    Full Text Available The aim of this study was to validate the Japanese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R [Mori: Japanese Edition of Hodges JR’s Cognitive Assessment for Clinicians, 2010] designed to detect dementia, and to compare its diagnostic accuracy with that of the Mini-Mental State Examination. The ACE-R was administered to 85 healthy individuals and 126 patients with dementia. The reliability assessment revealed a strong correlation in both groups. The internal consistency was excellent (α-coefficient = 0.88. Correlation with the Clinical Dementia Rating sum of boxes score was significant (rs = –0.61, p < 0.001. The area under the curve was 0.98 for the ACE-R and 0.96 for the Mini-Mental State Examination. The cut-off score of 80 showed a sensitivity of 94% and a specificity of 94%. Like the original ACE-R and the versions designed for other languages, the Japanese version of the ACE-R is a reliable and valid test for the detection of dementia.

  10. A prospective cohort study examining the preferred learning styles of acute care registered nurses.

    Science.gov (United States)

    McCrow, Judy; Yevchak, Andrea; Lewis, Peter

    2014-03-01

    This paper reports on the preferred learning styles of Registered Nurses practicing in acute care environments and relationships between gender, age, post-graduate experience and the identified preferred learning styles. A prospective cohort study design was used. Participants completed a demographic questionnaire and the Felder-Silverman Index of Learning Styles (ILS) questionnaire to determine preferred learning styles. Most of the Registered Nurse participants were balanced across the Active-Reflective (n = 77, 54%), and Sequential-Global (n = 96, 68%) scales. Across the other scales, sensing (n = 97, 68%) and visual (n = 76, 53%) were the most common preferred learning style. There were only a small proportion who had a preferred learning style of reflective (n = 21, 15%), intuitive (n = 5, 4%), verbal (n = 11, 8%) or global learning (n = 15, 11%). Results indicated that gender, age and years since undergraduate education were not related to the identified preferred learning styles. The identification of Registered Nurses' learning style provides information that nurse educators and others can use to make informed choices about modification, development and strengthening of professional hospital-based educational programs. The use of the Index of Learning Styles questionnaire and its ability to identify 'balanced' learning style preferences may potentially yield additional preferred learning style information for other health-related disciplines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Screening of the pelvic organ prolapse without a physical examination; (a community based study

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    Tehrani Fahimeh

    2011-11-01

    Full Text Available Abstract Background Pelvic organ prolapse (POP is a silent disorder with a huge impact on women's quality of life. There is limited data from community-based studies conducted to determine the prevalence of POP as its assessment needs a pelvic examination. We aimed to develop a simple screening inventory for identification of pelvic organ prolapse and then evaluate its sensitivity and specificity. Methods This study had two phases. In the first phase in order to develop a simple inventory for assessment of POP, the Pelvic Floor Disorder Inventory (PFDI was completed for a convenience sample of 200 women, aged 18-45 years, referred for annual gynecologic examination, and their pelvic organ prolapse was assessed using the standard protocol. The most sensitive and specific questions were selected as pelvic organ prolapse simple screening inventory (POPSSI. In the second phase, using a stratified multistage probability cluster sampling method, the sensitivity and specificity of the POPSSI was investigated in a non selected sample of 954 women recruited from among reproductive aged women living in four randomly selected provinces of Iran. Results The sensitivity and specificity of POPSSI for identification of pelvic organ prolapse in the general population were 45.5 and 87.4% respectively; these values were 96.7 and 20% among those women who were aware of their pelvic dysfunction. Conclusion Community based screening studies on pelvic organ prolapse could be facilitated by using the POPSSI, the sensitivity of which would be enhanced through conducting of public awareness programs.

  12. Failure Mode and Effect Analysis (FMEA) Applications to Identify Iron Sand Reject and Losses in Cement Industry : A Case Study

    Science.gov (United States)

    Helia, V. N.; Wijaya, W. N.

    2017-06-01

    One of the main raw materials required in the manufacture of cement is iron sand. Data from the Procurement Department on XYZ Company shows that the number of defective iron sand (reject) fluctuates every month. Iron sand is an important raw material in the cement production process, so that the amount of iron sand reject and losses got financial and non-financial impact. This study aims to determine the most dominant activity as the cause of rejection and losses of iron sands and suggest improvements that can be made by using the approach of FMEA (Failure Mode and Effect Analysis). Data collection techniques in this study was using the method of observation, interviews, and focus group discussion (FGD) as well as the assessment of the experts to identify it. Results from this study is there are four points of the most dominant cause of the defect of iron sand (mining activities, acceptance, examination and delivery). Recommendation for overcoming these problem is presented (vendor improvement).

  13. Study on the identifying of meat's visible spectrum based on BP artificial neural network

    Science.gov (United States)

    Li, Xiaotian; Zhang, Tieqiang; Li, Bo; Jiang, Yongheng; Liu, Binghui; Li, Zhaokai

    2006-01-01

    A method to identify different meat by the visible and reflected spectra of meat with BP artificial neural net (BP-ANN) was introduced in this paper. The visible and reflected spectra (from 420 to 535nm) of different meat (beef and pork) were measured with fiber sensor spectrometer. A kind of ANN with a double-hidden layer was created to identify the different meat automatically. Its right ratio reaches 92.71%.

  14. Genetic association study identifies HSPB7 as a risk gene for idiopathic dilated cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Klaus Stark

    2010-10-01

    Full Text Available Dilated cardiomyopathy (DCM is a structural heart disease with strong genetic background. Monogenic forms of DCM are observed in families with mutations located mostly in genes encoding structural and sarcomeric proteins. However, strong evidence suggests that genetic factors also affect the susceptibility to idiopathic DCM. To identify risk alleles for non-familial forms of DCM, we carried out a case-control association study, genotyping 664 DCM cases and 1,874 population-based healthy controls from Germany using a 50K human cardiovascular disease bead chip covering more than 2,000 genes pre-selected for cardiovascular relevance. After quality control, 30,920 single nucleotide polymorphisms (SNP were tested for association with the disease by logistic regression adjusted for gender, and results were genomic-control corrected. The analysis revealed a significant association between a SNP in HSPB7 gene (rs1739843, minor allele frequency 39% and idiopathic DCM (p = 1.06 × 10⁻⁶, OR  = 0.67 [95% CI 0.57-0.79] for the minor allele T. Three more SNPs showed p < 2.21 × 10⁻⁵. De novo genotyping of these four SNPs was done in three independent case-control studies of idiopathic DCM. Association between SNP rs1739843 and DCM was significant in all replication samples: Germany (n =564, n = 981 controls, p = 2.07 × 10⁻³, OR = 0.79 [95% CI 0.67-0.92], France 1 (n = 433 cases, n = 395 controls, p =3.73 × 10⁻³, OR  = 0.74 [95% CI 0.60-0.91], and France 2 (n = 249 cases, n = 380 controls, p = 2.26 × 10⁻⁴, OR  = 0.63 [95% CI 0.50-0.81]. The combined analysis of all four studies including a total of n = 1,910 cases and n = 3,630 controls showed highly significant evidence for association between rs1739843 and idiopathic DCM (p = 5.28 × 10⁻¹³, OR= 0.72 [95% CI 0.65-0.78]. None of the other three SNPs showed significant results in the replication stage.This finding of the HSPB7 gene from a genetic search for idiopathic DCM using

  15. Identifying clinical correlates for suicide among epilepsy patients in South Korea: A case-control study.

    Science.gov (United States)

    Park, Sung-Jin; Lee, Hochang Benjamin; Ahn, Myung Hee; Park, Subin; Choi, Eun Ju; Lee, Hoon-Jin; Ryu, Han Uk; Kang, Joong-Koo; Hong, Jin Pyo

    2015-12-01

    Suicide is a major cause of premature mortality in patients with epilepsy. We aimed to identify the clinical correlates of suicide in these patients. We conducted a matched, case-control study based on a clinical case registry of epilepsy patients (n = 35,638) treated between January 1994 and December 2011 at an academic tertiary medical center in Seoul, Korea. Each epilepsy patient in the suicide group (n = 74) was matched with three epilepsy patients in the nonsuicide group (n = 222) by age, gender, and approximate time at first treatment. The clinical characteristics of the patients in both groups were then compared. In a univariate analysis, seizure frequency during the year before suicide, use of antiepileptic drug polytherapy, lack of aura before seizure, diagnosis of temporal lobe epilepsy, use of levetiracetam, psychiatric comorbidity, and use of antidepressants were all significantly higher in the suicide group than in the nonsuicide group. Multivariate analysis revealed that a high seizure frequency (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.04-10.2), a lack of aura before seizure (OR 4.0, 95% CI 1.7-9.3), temporal lobe epilepsy (OR 3.7, 95% CI 1.6-8.6), and use of levetiracetam (OR 7.6, 95% CI 1.1-53.7) and antidepressants (OR 7.2, 95% CI 1.5-34.1) were all associated with a higher probability of suicide. Patients with temporal lobe epilepsy who experience seizures weekly or more frequently, experience a lack of aura, use levetiracetam, or take antidepressants are all at a higher risk of suicide and should be monitored closely. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  16. Developing a workflow to identify inconsistencies in volunteered geographic information: a phenological case study

    Science.gov (United States)

    Mehdipoor, Hamed; Zurita-Milla, Raul; Rosemartin, Alyssa; Gerst, Katharine L.; Weltzin, Jake F.

    2015-01-01

    Recent improvements in online information communication and mobile location-aware technologies have led to the production of large volumes of volunteered geographic information. Widespread, large-scale efforts by volunteers to collect data can inform and drive scientific advances in diverse fields, including ecology and climatology. Traditional workflows to check the quality of such volunteered information can be costly and time consuming as they heavily rely on human interventions. However, identifying factors that can influence data quality, such as inconsistency, is crucial when these data are used in modeling and decision-making frameworks. Recently developed workflows use simple statistical approaches that assume that the majority of the information is consistent. However, this assumption is not generalizable, and ignores underlying geographic and environmental contextual variability that may explain apparent inconsistencies. Here we describe an automated workflow to check inconsistency based on the availability of contextual environmental information for sampling locations. The workflow consists of three steps: (1) dimensionality reduction to facilitate further analysis and interpretation of results, (2) model-based clustering to group observations according to their contextual conditions, and (3) identification of inconsistent observations within each cluster. The workflow was applied to volunteered observations of flowering in common and cloned lilac plants (Syringa vulgaris and Syringa x chinensis) in the United States for the period 1980 to 2013. About 97% of the observations for both common and cloned lilacs were flagged as consistent, indicating that volunteers provided reliable information for this case study. Relative to the original dataset, the exclusion of inconsistent observations changed the apparent rate of change in lilac bloom dates by two days per decade, indicating the importance of inconsistency checking as a key step in data quality

  17. Identifying functional zones of denitrification in heterogeneous aquifer systems by numerical simulations - a case study

    Science.gov (United States)

    Jang, E.; Kalbacher, T.; He, W.; Shao, H.; Schueth, C.; Kolditz, O.

    2014-12-01

    Nitrate contamination in shallow groundwater is still one of the common problems in many countries. Because of its high solubility and anionic nature, nitrate can easily leach through soil and persist in groundwater for decades. High nitrate concentration has been suggested as a major cause of accelerated eutrophication, methemoglobinemia and gastric cancer. There are several factors influencing the fate of nitrate in groundwater system, which is e.g. distribution of N- sources to soil and groundwater, distribution and amount of reactive substances maintaining denitrification, rate of nitrate degradation and its kinetics, and geological characteristics of the aquifer. Nitrate transport and redox transformation processes are closely linked to complex and spatially distributed physical and chemical interaction, therefore it is difficult to predict and quantify in the field and laboratory experiment. Models can play a key role in elucidation of nitrate reduction pathway in groundwater system and in the design and evaluation of field tests to investigate in situ remediation technologies as well. The goal of the current study is to predict groundwater vulnerability to nitrate, to identify functional zones of denitrification in heterogeneous aquifer systems and to describe the uncertainty of the predictions due to scale effects. For this aim, we developed a kinetic model using multi-component mass transport code OpenGeoSys coupling with IPhreeqc module of the geochemical solver PHREEQC. The developed model included sequential aerobic and nitrate-based respiration, multi-Monod kinetics, multi-species biogeochemical reactions, and geological characteristics of the groundwater aquifer. Moreover water-rock interaction such as secondary mineral precipitation was also included in this model. In this presentation, we focused on the general modelling approach and present the simulation results of nitrate transport simulation in a hypothetical aquifer systems based on data from

  18. Identifying objective criterion to determine a complicated task – A comparative study

    International Nuclear Information System (INIS)

    Park, Jinkyun; Jung, Wondea

    2015-01-01

    Highlights: • Reliable estimation on the likelihood of human error is very critical. • Still there is no clear and objective criterion on a complicated task. • Subjective difficulty scores rated by 75 high speed train drivers are collected. • Collected difficulty scores are compared with the associated TACOM scores. • Criteria for task complexity level seem to be determined by the TACOM measure. - Abstract: A reliable estimation on the likelihood of human error is very critical for evaluating the safety of a large process control system such as NPPs (Nuclear Power Plants). In this regard, one of the determinants is to decide the level of an important PSF (Performance Shaping Factor) through a clear and objective manner along with the context of a given task. Unfortunately, it seems that there are no such decision criteria for certain PSFs including the complexity of a task. Therefore, the feasibility of the TACOM (Task Complexity) measure in providing objective criteria that are helpful for distinguishing the level of a task complexity is investigated in this study. To this end, subjective difficulty scores rated by 75 high-speed train drivers are collected for 38 tasks. After that, subjective difficulty scores are compared with the associated TACOM scores being quantified based on these tasks. As a result, it is observed that there is a significant correlation between subjective difficulty scores rated by high-speed train drivers and the associated TACOM scores. Accordingly, it is promising to expect that the TACOM measure can be used as an objective tool to identify the level of a task complexity in terms of an HRA (Human Reliability Analysis)

  19. Developing a Workflow to Identify Inconsistencies in Volunteered Geographic Information: A Phenological Case Study.

    Science.gov (United States)

    Mehdipoor, Hamed; Zurita-Milla, Raul; Rosemartin, Alyssa; Gerst, Katharine L; Weltzin, Jake F

    2015-01-01

    Recent improvements in online information communication and mobile location-aware technologies have led to the production of large volumes of volunteered geographic information. Widespread, large-scale efforts by volunteers to collect data can inform and drive scientific advances in diverse fields, including ecology and climatology. Traditional workflows to check the quality of such volunteered information can be costly and time consuming as they heavily rely on human interventions. However, identifying factors that can influence data quality, such as inconsistency, is crucial when these data are used in modeling and decision-making frameworks. Recently developed workflows use simple statistical approaches that assume that the majority of the information is consistent. However, this assumption is not generalizable, and ignores underlying geographic and environmental contextual variability that may explain apparent inconsistencies. Here we describe an automated workflow to check inconsistency based on the availability of contextual environmental information for sampling locations. The workflow consists of three steps: (1) dimensionality reduction to facilitate further analysis and interpretation of results, (2) model-based clustering to group observations according to their contextual conditions, and (3) identification of inconsistent observations within each cluster. The workflow was applied to volunteered observations of flowering in common and cloned lilac plants (Syringa vulgaris and Syringa x chinensis) in the United States for the period 1980 to 2013. About 97% of the observations for both common and cloned lilacs were flagged as consistent, indicating that volunteers provided reliable information for this case study. Relative to the original dataset, the exclusion of inconsistent observations changed the apparent rate of change in lilac bloom dates by two days per decade, indicating the importance of inconsistency checking as a key step in data quality

  20. Identifying optimal areas for REDD intervention: East Kalimantan, Indonesia as a case study

    International Nuclear Information System (INIS)

    Harris, Nancy L; Petrova, Silvia; Brown, Sandra; Stolle, Fred

    2008-01-01

    International discussions on reducing emissions from deforestation and degradation (REDD) as a greenhouse gas (GHG) abatement strategy are ongoing under the United Nations Framework Convention on Climate Change (UNFCCC). In the light of these discussions, it behooves countries to be able to determine the relative likelihood of deforestation over a landscape and perform a first order estimation of the potential reduction in GHGs associated with various protection scenarios. This would allow countries to plan their interventions accordingly to maximize carbon benefits, alongside other environmental and socioeconomic benefits, because forest protection programs might be chosen in places where the perceived threat of deforestation is high whereas in reality the threat is low. In this case study, we illustrate a method for creating deforestation threat maps and estimating potential reductions in GHGs from eighteen protected areas in East Kalimantan, Indonesia, that would occur if protection of these areas was well enforced. Results from our analysis indicate that a further 230 720 ha of East Kalimantan's forest area would be lost and approximately 305 million t CO 2 would be emitted from existing protected areas between 2003 and 2013 if the historical rate of deforestation continued unabated. In other words, the emission of 305 million t CO 2 into the atmosphere would be avoided during this period if protection of the existing areas was well enforced. At a price of $4 per ton of CO 2 (approximate price on the Chicago Climate Exchange in August 2008), this represents an estimated gross income stream of about $120 million per year. We also identified additional areas with high carbon stocks under high deforestation threat that would be important to protect if the carbon benefits of avoided deforestation activities are to be maximized in this region

  1. Case control study to identify risk factors for acute hepatitis C virus infection in Egypt

    Directory of Open Access Journals (Sweden)

    Kandeel Amr M

    2012-11-01

    Full Text Available Abstract Background Identification of risk factors of acute hepatitis C virus (HCV infection in Egypt is crucial to develop appropriate prevention strategies. Methods We conducted a case–control study, June 2007-September 2008, to investigate risk factors for acute HCV infection in Egypt among 86 patients and 287 age and gender matched controls identified in two infectious disease hospitals in Cairo and Alexandria. Case-patients were defined as: any patient with symptoms of acute hepatitis; lab tested positive for HCV antibodies and negative for HBsAg, HBc IgM, HAV IgM; and 7-fold increase in the upper limit of transaminase levels. Controls were selected from patients’ visitors with negative viral hepatitis markers. Subjects were interviewed about previous exposures within six months, including community-acquired and health-care associated practices. Results Case-patients were more likely than controls to have received injection with a reused syringe (OR=23.1, CI 4.7-153, to have been in prison (OR=21.5, CI 2.5-479.6, to have received IV fluids in a hospital (OR=13.8, CI 5.3-37.2, to have been an IV drug user (OR=12.1, CI 4.6-33.1, to have had minimal surgical procedures (OR=9.7, CI 4.2-22.4, to have received IV fluid as an outpatient (OR=8, CI 4–16.2, or to have been admitted to hospital (OR=7.9, CI 4.2-15 within the last 6 months. Multivariate analysis indicated that unsafe health facility practices are the main risk factors associated with transmission of HCV infection in Egypt. Conclusion In Egypt, focusing acute HCV prevention measures on health-care settings would have a beneficial impact.

  2. Studying the interactive effects of menthol and nicotine among youth: An examination using e-cigarettes.

    Science.gov (United States)

    Krishnan-Sarin, Suchitra; Green, Barry G; Kong, Grace; Cavallo, Dana A; Jatlow, Peter; Gueorguieva, Ralitza; Buta, Eugenia; O'Malley, Stephanie S

    2017-11-01

    Tobacco products containing menthol are widely used by youth. We used e-cigarettes to conduct an experimental evaluation of the independent and interactive effects of menthol and nicotine among youth. Pilot chemosensory experiments with fourteen e-cigarette users identified low (barely perceptible, 0.5%) and high (similar to commercial e-liquid, 3.5%) menthol concentrations. Sixty e-cigarette users were randomized to a nicotine concentration (0mg/ml, 6mg/ml, 12mg/ml) and participated in 3 laboratory sessions. During each session, they received their assigned nicotine concentration, along with one of three menthol concentrations in random counterbalanced order across sessions (0, 0.5%, 3.5%), and participated in three fixed-dose, and an ad-lib, puffing period. Urinary menthol glucuronide and salivary nicotine levels validated menthol and nicotine exposure. We examined changes in e-cigarette liking/wanting and taste, coolness, stimulant effects, nicotine withdrawal and ad-lib use. Overall, the high concentration of menthol (3.5%) significantly increased e-cigarette liking/wanting relative to no menthol (pe-cigarettes among youth. Further, menthol enhances positive rewarding effects of high nicotine-containing e-cigarettes among youth. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. A Study of Automation for Examination Analysis of Inservice Inspection for Nuclear Power Plant (I)

    International Nuclear Information System (INIS)

    Kim, W.

    1985-01-01

    The developing country, KOREA where does not possess the natural resources for traditional energy such as oil and gas, so. The nuclear energy is the most single reliable source available for closing the energy gap. For these reason, It is inavoidable to construct the nuclear power plant and to develop technology related nuclear energy. The rate of operation in large nuclear power facilities depends upon the performance of work system through design and construction, and also the applied technology. Especially, it is the most important element that safety and reliability in operation of nuclear power plant. In view of this aspects, Nuclear power plant is performed severe examinations during perceives and inservice inspection. This study provide an automation of analysis for volumetric examination which is required to nuclear power plant components. It is composed as follows: I. Introduction II. Inservice Inspection of Nuclear Power Plant * General Requirement. * Principle and Methods of Ultrasonic Test. * Study of Flaw Evaluation and Design of Classifying Formula for Flaws. III. Design of Automation for Flaw Evaluation. IV. An Example V. Conclusion In this theory, It is classifying the flaws, the formula of classifying flaws and the design of automation that is the main important point. As motioned the above, Owing to such as automatic design, more time could be allocated to practical test than that of evaluation of defects, Protecting against subjective bias tester by himself and miscalculation by dint of various process of computation. For the more, adopting this method would be used to more retaining for many test data and comparative evaluating during successive inspection intervals. Inspire of limitation for testing method and required application to test components, it provide useful application to flow evaluation for volumetric examination. Owing to the characteristics of nuclear power plant that is highly skill intensive industry and has huge system, the

  4. A comparative study of postmortem MR imaging and pathological examination of human brain specimens

    International Nuclear Information System (INIS)

    Shiga, Tohru

    1998-01-01

    This study was designed to assess the value of MRI of the postmortem brain specimens by comparing MRI findings with neuropathological findings. Postmortem MRI was performed in 17 consecutive formalin-fixed whole brains comprising 3 with primary CNS neoplasm, 1 with metastatic brain tumor, 6 with cerebral vascular disease (CVD), 1 with degenerative disease, 1 with spongy state in thalamus, and 5 with no abnormality. Postmortem T2WI detected all neuropathological abnormalities but sparsely distributed tumor cells without edema. In one case of CNS neoplasm, the tumor lesions with little necrosis or edema showed isointensity to brain tissue, while others with large amounts of necrosis and edema showed high signal intensity on T2WI. In the cases of CVD, the major signal changes on T2WI were due to edema, necrosis, and damage of the organization as observed on neuropathological studies. There was one case in which both MRI and neuropathological examination showed an abnormality, which was pathologically unexplainable. In two cases, findings of postmortem MRI were more apparent than those of macroscopic examination. Postmortem MRI appeared different from premortem MRI in one of the rest three cases whereas the postmortem MRI correlated well with neuropathological findings. Progression of the disease immediately before death may have caused this difference. In conclusion, the correlations between MRI and neuropathological findings facilitate understanding the mechanisms responsible for MRI abnormalities. An increase in free water in edema, necrosis, and damage in brain tissue can explain an increased signal intensity on T2WI. Postmortem MRI may contribute to the effective pathological examination by pointing out subtle abnormalities before brain cutting. (author)

  5. Genome-wide association study identifies novel loci associated with circulating phospho- and sphingolipid concentrations.

    Directory of Open Access Journals (Sweden)

    Ayşe Demirkan

    study identified nine novel phospho- and sphingolipid loci, substantially increasing our knowledge of the genetic basis for these traits.

  6. Diagnostic accuracy of prostate health index to identify aggressive prostate cancer. An Institutional validation study.

    Science.gov (United States)

    Morote, J; Celma, A; Planas, J; Placer, J; Ferrer, R; de Torres, I; Pacciuci, R; Olivan, M

    2016-01-01

    New generations of tumor markers used to detect prostate cancer (PCa) should be able to discriminate men with aggressive PCa of those without PCa or nonaggressive tumors. The objective of this study has been to validate Prostate Health Index (PHI) as a marker of aggressive PCa in one academic institution. PHI was assessed in 357 men scheduled to prostatic biopsy between June of 2013 and July 2014 in one academic institution. Thereafter a subset of 183 men younger than 75 years and total PSA (tPSA) between 3.0 and 10.0 ng/mL, scheduled to it first prostatic biopsy, was retrospectively selected for this study. Twelve cores TRUS guided biopsy, under local anaesthesia, was performed in all cases. Total PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) and prostate volume were determined before the procedure and %fPSA, PSA density (PSAd) and PHI were calculated. Aggressive tumors were considered if any Gleason 4 pattern was found. PHI was compared to %fPSA and PSAd through their ROC curves. Thresholds to detect 90%, 95% of all tumors and 95% and 100% of aggressive tumors were estimated and rates of unnecessary avoided biopsies were calculated and compared. The rate of PCa detection was 37.2% (68) and the rate of aggressive tumors was 24.6% (45). The PHI area under the curve was higher than those of %fPSA and PSAd to detect any PCa (0.749 vs 0.606 and 0.668 respectively) or to detect only aggressive tumors (0.786 vs 0.677 and 0.708 respectively), however, significant differences were not found. The avoided biopsy rates to detect 95% of aggressive tumors were 20.2% for PHI, 14.8% for %fPSA, and 23.5% for PSAd. Even more, to detect all aggressive tumors these rates dropped to 4.9% for PHI, 9.3% for %fPSA, and 7.9% for PSAd. PHI seems a good marker to PCa diagnosis. However, PHI was not superior to %fPSA and PSAd to identify at least 95% of aggressive tumors. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Genome-wide DNA methylation study in human placenta identifies novel loci associated with maternal smoking during pregnancy.

    Science.gov (United States)

    Morales, Eva; Vilahur, Nadia; Salas, Lucas A; Motta, Valeria; Fernandez, Mariana F; Murcia, Mario; Llop, Sabrina; Tardon, Adonina; Fernandez-Tardon, Guillermo; Santa-Marina, Loreto; Gallastegui, Mara; Bollati, Valentina; Estivill, Xavier; Olea, Nicolas; Sunyer, Jordi; Bustamante, Mariona

    2016-10-01

    We conducted an epigenome-wide association study (EWAS) of DNA methylation in placenta in relation to maternal tobacco smoking during pregnancy and examined whether smoking-induced changes lead to low birthweight. DNA methylation in placenta was measured using the Illumina HumanMethylation450 BeadChip in 179 participants from the INfancia y Medio Ambiente (INMA) birth cohort. Methylation levels across 431 311 CpGs were tested for differential methylation between smokers and non-smokers in pregnancy. We took forward three top-ranking loci for further validation and replication by bisulfite pyrosequencing using data of 248 additional participants of the INMA cohort. We examined the association of methylation at smoking-associated loci with birthweight by applying a mediation analysis and a two-sample Mendelian randomization approach. Fifty CpGs were differentially methylated in placenta between smokers and non-smokers during pregnancy [false discovery rate (FDR) < 0.05]. We validated and replicated differential methylation at three top-ranking loci: cg27402634 located between LINC00086 and LEKR1, a gene previously related to birthweight in genome-wide association studies; cg20340720 (WBP1L); and cg25585967 and cg12294026 (TRIO). Dose-response relationships with maternal urine cotinine concentration during pregnancy were confirmed. Differential methylation at cg27402634 explained up to 36% of the lower birthweight in the offspring of smokers (Sobel P-value < 0.05). A two-sample Mendelian randomization analysis provided evidence that decreases in methylation levels at cg27402634 lead to decreases in birthweight. We identified novel loci differentially methylated in placenta in relation to maternal smoking during pregnancy. Adverse effects of maternal smoking on birthweight of the offspring may be mediated by alterations in the placental methylome. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International

  8. Longitudinal Examination of Aggression and Study Skills From Middle to High School: Implications for Dropout Prevention.

    Science.gov (United States)

    Orpinas, Pamela; Raczynski, Katherine; Hsieh, Hsien-Lin; Nahapetyan, Lusine; Horne, Arthur M

    2018-03-01

    High school completion provides health and economic benefits. The purpose of this study is to describe dropout rates based on longitudinal trajectories of aggression and study skills using teacher ratings. The sample consisted of 620 randomly selected sixth graders. Every year from Grade 6 to 12, a teacher completed a nationally normed behavioral rating scale. We used latent class mixture modeling to identify the trajectories. Participants followed 3 trajectories of aggression (Low, Medium Desisting, and High Desisting) and 5 trajectories of study skills (Low, Average-Low, Decreasing, Increasing, and High). Over three-quarters of the sample were in stable trajectories of study skills over time. Most students in the High Desisting Aggression group were in the Low Study Skills group, and all students in the High Study Skills group were in the Low Aggression group. The overall dropout rate was 17%, but varied dramatically across combined aggression and study skills groups, ranging from 2% to 50%. The results highlight the importance of early prevention that combines academic enhancement and behavioral management for reducing school dropout. © 2018, American School Health Association.

  9. Impact of periodic health examination on surgical treatment for uterine fibroids in Beijing: a case-control study

    Directory of Open Access Journals (Sweden)

    Yang Ling-Ling

    2010-12-01

    Full Text Available Abstract Background During the past 2 decades, there has been a rapid proliferation of "health examination center (HEC" across China. The effects of their services on public's health have not been systemically investigated. This study aimed to assess the impact of periodic health examination (PHE at HEC on surgical treatment for uterine fibroids in Beijing residents. Methods We identified 224 patients with a primary diagnosis of uterine fibroids who had surgical treatment at four Level-1 general hospitals in Beijing, from June 1, 2009 to October 20, 2009. Controls were women who did not have surgery for uterine fibroids, matched (1:1 ratio for age (within 2 years. A standard questionnaire was used to inquire about whether participants had PHE at HEC during the previous 2 years. Results PHE at HEC within 2 years were associated with surgical treatment for uterine fibroids. Odds ratios was 4.05 (95% CI, 2.61-6.29 P Conclusions Our study showed PHE currently provided at HEC in China were associated with significantly increased use of surgical treatment for uterine fibroids in women. Further studies are needed to assess the effects of PHE on clinical as well as on broad societal outcomes in Chinese in contemporary medical settings.

  10. Genome-wide association study identifies TF as a significant modifier gene of iron metabolism in HFE hemochromatosis.

    Science.gov (United States)

    de Tayrac, Marie; Roth, Marie-Paule; Jouanolle, Anne-Marie; Coppin, Hélène; le Gac, Gérald; Piperno, Alberto; Férec, Claude; Pelucchi, Sara; Scotet, Virginie; Bardou-Jacquet, Edouard; Ropert, Martine; Bouvet, Régis; Génin, Emmanuelle; Mosser, Jean; Deugnier, Yves

    2015-03-01

    Hereditary hemochromatosis (HH) is the most common form of genetic iron loading disease. It is mainly related to the homozygous C282Y/C282Y mutation in the HFE gene that is, however, a necessary but not a sufficient condition to develop clinical and even biochemical HH. This suggests that modifier genes are likely involved in the expressivity of the disease. Our aim was to identify such modifier genes. We performed a genome-wide association study (GWAS) using DNA collected from 474 unrelated C282Y homozygotes. Associations were examined for both quantitative iron burden indices and clinical outcomes with 534,213 single nucleotide polymorphisms (SNP) genotypes, with replication analyses in an independent sample of 748 C282Y homozygotes from four different European centres. One SNP met genome-wide statistical significance for association with transferrin concentration (rs3811647, GWAS p value of 7×10(-9) and replication p value of 5×10(-13)). This SNP, located within intron 11 of the TF gene, had a pleiotropic effect on serum iron (GWAS p value of 4.9×10(-6) and replication p value of 3.2×10(-6)). Both serum transferrin and iron levels were associated with serum ferritin levels, amount of iron removed and global clinical stage (pHFE-associated HH (HFE-HH) patients, identified the rs3811647 polymorphism in the TF gene as the only SNP significantly associated with iron metabolism through serum transferrin and iron levels. Because these two outcomes were clearly associated with the biochemical and clinical expression of the disease, an indirect link between the rs3811647 polymorphism and the phenotypic presentation of HFE-HH is likely. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  11. Psoriasis and wound healing outcomes: A retrospective cohort study examining wound complications and antibiotic use.

    Science.gov (United States)

    Young, Paulina M; Parsi, Kory K; Schupp, Clayton W; Armstrong, April W

    2017-11-15

    Little is known about wound healing in psoriasis. We performed a cohort study examining differences in wound healing complications between patients with and without psoriasis. Psoriasis patients with traumatic wounds were matched 1:3 to non-psoriasis patients with traumatic wounds based on age, gender, and body mass index (BMI). We examined theincidence of wound complications including infection, necrosis, and hematoma as well as incident antibiotic use within three months following diagnosis of a traumatic wound. The study included 164 patients with traumatic wounds, comprised of 41 patients with psoriasis matched to 123 patients without psoriasis. No statistically significant differences were detected in the incidence of overall wound complications between wound patients with psoriasis and wound patients without psoriasis (14.6% versus. 13.0%, HR 1.18, CI 0.39-3.56). After adjustment for diabetes, peripheral vascular disease, and smoking, no statistically significant differences were detected in the incidence of overall wound complications between patients with and without psoriasis (HR 1.11, CI 0.34-3.58). Specifically, the adjusted rates of antibiotic use were not significantly different between those with and without psoriasis (HR 0.65, CI 0.29-1.46). The incidence of wound complications following traumatic wounds of the skin was found to be similar between patients with and without psoriasis.

  12. Evaluation of radiation dose in pediatric head CT examination: a phantom study

    Science.gov (United States)

    Norhasrina Nik Din, Nik; Zainon, Rafidah; Rahman, Ahmad Taufek Abdul

    2018-01-01

    The aim of this study was to evaluate the radiation dose in pediatric head Computed Tomography examination. It was reported that decreasing tube voltage in CT examination can reduce the dose to patients significantly. A head phantom was scanned with dual-energy CT at 80 kV and 120 kV. The tube current was set using automatic exposure control mode and manual setting. The pitch was adjusted to 1.4, 1.45 and 1.5 while the slice thickness was set at 5 mm. The dose was measured based on CT Dose Index (CTDI). Results from this study have shown that the image noise increases substantially with low tube voltage. The average dose was 2.60 mGy at CT imaging parameters of 80 kV and 10 - 30 mAs. The dose increases up to 17.19 mGy when the CT tube voltage increases to 120 kV. With the reduction of tube voltage from 120 kV to 80 kV, the radiation dose can be reduced by 12.1% to 15.1% without degradation of contrast-to-noise ratio.

  13. Genome-wide association study identifies a single major locus contributing to survival into old age; the APOE locus revisited

    DEFF Research Database (Denmark)

    Deelen, Joris; Beekman, Marian; Uh, Hae-Won

    2011-01-01

    By studying the loci which contribute to human longevity, we aim to identify mechanisms that contribute to healthy aging. To identify such loci, we performed a genome-wide association study (GWAS) comparing 403 unrelated nonagenarians from long-living families included in the Leiden Longevity Stu...

  14. A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci.

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2008-03-01

    Full Text Available A genome-wide association study was performed to identify genetic factors involved in susceptibility to psoriasis (PS and psoriatic arthritis (PSA, inflammatory diseases of the skin and joints in humans. 223 PS cases (including 91 with PSA were genotyped with 311,398 single nucleotide polymorphisms (SNPs, and results were compared with those from 519 Northern European controls. Replications were performed with an independent cohort of 577 PS cases and 737 controls from the U.S., and 576 PSA patients and 480 controls from the U.K.. Strongest associations were with the class I region of the major histocompatibility complex (MHC. The most highly associated SNP was rs10484554, which lies 34.7 kb upstream from HLA-C (P = 7.8x10(-11, GWA scan; P = 1.8x10(-30, replication; P = 1.8x10(-39, combined; U.K. PSA: P = 6.9x10(-11. However, rs2395029 encoding the G2V polymorphism within the class I gene HCP5 (combined P = 2.13x10(-26 in U.S. cases yielded the highest ORs with both PS and PSA (4.1 and 3.2 respectively. This variant is associated with low viral set point following HIV infection and its effect is independent of rs10484554. We replicated the previously reported association with interleukin 23 receptor and interleukin 12B (IL12B polymorphisms in PS and PSA cohorts (IL23R: rs11209026, U.S. PS, P = 1.4x10(-4; U.K. PSA: P = 8.0x10(-4; IL12B:rs6887695, U.S. PS, P = 5x10(-5 and U.K. PSA, P = 1.3x10(-3 and detected an independent association in the IL23R region with a SNP 4 kb upstream from IL12RB2 (P = 0.001. Novel associations replicated in the U.S. PS cohort included the region harboring lipoma HMGIC fusion partner (LHFP and conserved oligomeric golgi complex component 6 (COG6 genes on chromosome 13q13 (combined P = 2x10(-6 for rs7993214; OR = 0.71, the late cornified envelope gene cluster (LCE from the Epidermal Differentiation Complex (PSORS4 (combined P = 6.2x10(-5 for rs6701216; OR 1.45 and a region of LD at 15q21 (combined P = 2.9x10(-5 for rs

  15. Studies To Examine Potential Tolerability Differences between the 5-HT2C Receptor Selective Agonists Lorcaserin and CP-809101.

    Science.gov (United States)

    Higgins, Guy A; Silenieks, Leonardo B; Patrick, Amy; De Lannoy, Ines A M; Fletcher, Paul J; Parker, Linda A; MacLusky, Neil J; Sullivan, Laura C; Chavera, Teresa A; Berg, Kelly A

    2017-05-17

    Lorcaserin (LOR) is a selective 5-HT 2C receptor agonist that has been FDA approved as a treatment for obesity. The most frequently reported side-effects of LOR include nausea and headache, which can be dose limiting. We have previously reported that in the rat, while LOR produced unconditioned signs characteristic of nausea/malaise, the highly selective 5-HT 2C agonist CP-809101 (CP) produced fewer equivalent signs. Because this may indicate a subclass of 5-HT 2C agonists having better tolerability, the present studies were designed to further investigate this apparent difference. In a conditioned gaping model, a rodent test of nausea, LOR produced significantly higher gapes compared to CP consistent with it having higher emetogenic properties. Subsequent studies were designed to identify features of each drug that may account for such differences. In rats trained to discriminate CP-809101 from saline, both CP and LOR produced full generalization suggesting a similar interoceptive cue. In vitro tests of functional selectivity designed to examine signaling pathways activated by both drugs in CHO (Chinese hamster ovary) cells expressing h5-HT 2C receptors failed to identify evidence for biased signaling differences between LOR and CP. Thus, both drugs showed similar profiles across PLC, PLA 2 , and ERK signaling pathways. In studies designed to examine pharmacokinetic differences between LOR and CP, while drug plasma levels correlated with increasing dose, CSF levels did not. CSF levels of LOR increased proportionally with dose; however CSF levels of CP plateaued from 6 to 12 mg/kg. Thus, the apparently improved tolerability of CP likely reflects a limit to CNS levels attained at relatively high doses.

  16. ABCC-JNIH Adult Health Study. Report 2. 1958-1960 cycle of examinations Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Sagan, L; Seigel, D

    1963-10-29

    This report has presented the basic data collected during the 1958 to 1960 cycle of examinations in the ABCC-JNIH Adult Health Study in Nagasaki. No large differences were found among the 4 comparison groups. The only exceptions are to be found in a number of nonspecific complaints elicited during the review of systems. Inevitably in a review of this size some differences appeared between groups. These are pointed out in the text whenever possible. None were so large, nor so consistent within specific age and sex groups, however, that they could be categorically attributed to radiation. It will be necessary to compare them with subsequent medical experience in this study group and in Hiroshima. 13 references, 41 tables.

  17. TOGAF 9 foundation study guide preparation for the TOGAF 9 part 1 examination

    CERN Document Server

    Harrison, Rachel

    2013-01-01

    This title is a Study Guide for Togaf® 9 Foundation. It gives an overview of every learning objective for the Togaf 9 Foundation Syllabus and in-depth coverage on preparing and taking the Togaf 9 Part 1 Examination. It is specifically designed to help individuals prepare for certification. This Study Guide is excellent material for: * Individuals who require a basic understanding of Togaf 9; * Professionals who are working in roles associated with an architecture project such as those responsible for planning, execution, development, delivery, and operation; * Architects who are looking for a first introduction to Togaf 9; * Architects who want to achieve Level 2 certification in a stepwise manner and have not previously qualified as Togaf 8 Certified. A prior knowledge of enterprise architecture is advantageous but not required.

  18. Results of a dosimetry study in the European Community on frequent X ray examinations in infants

    International Nuclear Information System (INIS)

    Schneider, K.; Fendel, H.; Bakowski, C.

    1992-01-01

    This Europe-wide dosimetry study, covering 89 departments in 11 EC countries, measured entrance surface dose (ESD) using TLDs, and surveyed X ray equipment and radiographic techniques used for frequent paediatric X ray examinations of the chest, abdomen, pelvis, skull and spine. The survey was limited to infants (10 months, 4 months and prematures of ∼ 1 kg). Data analysis showed widely differing radiographic techniques. This was one of the reasons for the large variations in ESD of an order of magnitude of 1:50. A substantial number of departments used either very old X ray generators and/or techniques poorly suited for paediatric radiology. Significant dose reduction was seen when recommended guidelines for good radiographic technique were followed. This study emphasises the necessity for the adherence to easily followed guidelines for the improvement of training and equipment in paediatric radiology. (author)

  19. Results of a dosimetry study in the European Community on frequent X ray examinations in infants

    International Nuclear Information System (INIS)

    Schneider, K.; Fendel, H.; Bakowski, C.; Stein, E.; Kohn, M.; Kellner, M.; Schweighofer, K.; Cartagena, G.; Panzer, W.; Scheurer, C.; Wall, B.

    1992-01-01

    This Europe-wide dosimetry study, covering 89 departments in 11 EC countries, measured entrance surface dose (ESD) using TLDs, and surveyed X ray equipment and radiographic techniques used for frequent paediatric X ray examinations of the chest, abdomen, pelvis, skull and spine. The survey was limited to infants (10 months, 4 months and prematures of ∼ 1 kg). Data analysis shows that radiographic techniques differed widely. This was one of the reasons for the large variations in ESD of an order of magnitude of 1:50. A substantial number of departments used either very old X ray generators and/or techniques which are poorly suited for paediatric radiology. A significant dose reduction was seen when recommended guidelines for good radiographic technique were followed. The results of this study emphasize the necessity for the adherence to easily followed guidelines for the improvement of training and equipment in paediatric radiology

  20. Examining Procrastination Across Multiple Goal Stages: A Longitudinal Study of Temporal Motivation Theory

    Directory of Open Access Journals (Sweden)

    Piers Steel

    2018-04-01

    Full Text Available Procrastination is among the most common of motivational failures, putting off despite expecting to be worse off. We examine this dynamic phenomenon in a detailed and realistic longitudinal design (Study 1 as well as in a large correlational data set (N = 7400; Study 2. The results are largely consistent with temporal motivation theory. People’s pacing style reflects a hyperbolic curve, with the steepness of the curve predicted by self-reported procrastination. Procrastination is related to intention-action gaps, but not intentions. Procrastinators are susceptible to proximity of temptation and to the temporal separation between their intention and the planned act; the more distal, the greater the gap. Critical self-regulatory skills in explaining procrastination are attention control, energy regulation and automaticity, accounting for 74% of the variance. Future research using this design is recommended, as it provides an almost ideal blend of realism and detailed longitudinal assessment.

  1. Examining Procrastination Across Multiple Goal Stages: A Longitudinal Study of Temporal Motivation Theory.

    Science.gov (United States)

    Steel, Piers; Svartdal, Frode; Thundiyil, Tomas; Brothen, Thomas

    2018-01-01

    Procrastination is among the most common of motivational failures, putting off despite expecting to be worse off. We examine this dynamic phenomenon in a detailed and realistic longitudinal design (Study 1) as well as in a large correlational data set ( N = 7400; Study 2). The results are largely consistent with temporal motivation theory. People's pacing style reflects a hyperbolic curve, with the steepness of the curve predicted by self-reported procrastination. Procrastination is related to intention-action gaps, but not intentions. Procrastinators are susceptible to proximity of temptation and to the temporal separation between their intention and the planned act; the more distal, the greater the gap. Critical self-regulatory skills in explaining procrastination are attention control, energy regulation and automaticity, accounting for 74% of the variance. Future research using this design is recommended, as it provides an almost ideal blend of realism and detailed longitudinal assessment.

  2. Atomic structure of a peptide coated gold nanocluster identified using theoretical and experimental studies

    Science.gov (United States)

    Wang, Hui; Li, Xu; Gao, Liang; Zhai, Jiao; Liu, Ru; Gao, Xueyun; Wang, Dongqi; Zhao, Lina

    2016-06-01

    Peptide coated gold nanoclusters (AuNCs) have a precise molecular formula and atomic structure, which are critical for their unique applications in targeting specific proteins either for protein analysis or drug design. To date, a study of the crystal structure of peptide coated AuNCs is absent primarily due to the difficulty of obtaining their crystalline phases in an experiment. Here we study a typical peptide coated AuNC (Au24Peptide8, Peptide = H2N-CCYKKKKQAGDV-COOH, Anal. Chem., 2015, 87, 2546) to figure out its atomic structure and electronic structure using a theoretical method for the first time. In this work, we identify the explicit configuration of the essential structure of Au24Peptide8, Au24(Cys-Cys)8, using density functional theory (DFT) computations and optical spectroscopic experiments, where Cys denotes cysteine without H bonded to S. As the first multidentate ligand binding AuNC, Au24(Cys-Cys)8 is characterized as a distorted Au13 core with Oh symmetry covered by two Au(Cys-Cys) and three Au3(Cys-Cys)2 staple motifs in its atomic structure. The most stable configuration of Au24(Cys-Cys)8 is confirmed by comparing its UV-vis absorption spectrum from time-dependent density-functional theory (TDDFT) calculations with optical absorption measurements, and these results are consistent with each other. Furthermore, we carry out frontier molecular orbital (FMO) calculations to elucidate that the electronic structure of Au24(Cys-Cys)8 is different from that of Au24(SR)20 as they have a different Au/S ratio, where SR represents alkylthiolate. Importantly, the different ligand coatings, Cys-Cys and SR, in Au24(Cys-Cys)8 and Au24(SR)20 cause the different Au/S ratios in the coated Au24. The reason is that the Au/S ratio is crucial in determining the size of the Au core of the ligand protected AuNC, and the size of the Au core corresponds to a specific electronic structure. By the adjustment of ligand coatings from alkylthiolate to peptide, the Au/S ratio

  3. Hypofractionated regional nodal irradiation for breast cancer: Examining the data and potential for future studies

    International Nuclear Information System (INIS)

    Badiyan, Shahed N.; Shah, Chirag; Arthur, Douglas; Khan, Atif J.; Freedman, Gary; Poppe, Matthew M.; Vicini, Frank A.

    2014-01-01

    Limited data are available examining the role of hypofractionated radiation schedules in the management of women requiring regional nodal irradiation (RNI). The purpose of this review is to examine the available literature for the efficacy (where available) and toxicity of hypofractionated radiation schedules in breast cancer with RNI limited to the axilla and supraclavicular regions. Multiple randomized and prospective studies have documented the safety and efficacy of hypofractionated schedules delivering whole breast irradiation (WBI) alone. Subsets from these randomized trials and smaller prospective/single-institution studies have documented the feasibility of hypofractionated RNI but the limited numbers prevent definitive conclusions and limited efficacy data are available. With regard to possible toxicity affecting organs at risk with RNI, key structures include the breast, skin, heart, lungs, axilla (lymphedema), and brachial plexus. Based on data from several randomized trials, hypofractionated radiation is not associated with significant changes in breast toxicity/cosmesis or cardiac toxicity; the addition of hypofractionated RNI would not be expected to change the rates of breast or cardiac toxicity. While RNI has been shown to increase rates of pulmonary toxicity, hypofractionated RNI has not been associated with more frequent pulmonary complications than standard RNI. Moving forward, future studies will have to evaluate for increased lung toxicity. With regard to lymphedema, data from randomized hypofractionated WBI trials failed to demonstrate an increase in lymphedema and smaller studies utilizing hypofractionated RNI have failed to as well. Data from head and neck cancer as well as hypofractionated breast radiation with RNI have failed to demonstrate an increase in brachial plexopathy with the exception of older trials that used much larger dose per fraction (>4 Gy/fraction) schedules. At this time, published data support the feasibility of

  4. Use of AUDIT-based measures to identify unhealthy alcohol use and alcohol dependence in primary care: a validation study.

    Science.gov (United States)

    Johnson, J Aaron; Lee, Anna; Vinson, Daniel; Seale, J Paul

    2013-01-01

    As programs for screening, brief intervention, and referral to treatment (SBIRT) for unhealthy alcohol use disseminate, evidence-based approaches for identifying patients with unhealthy alcohol use and alcohol dependence (AD) are needed. While the National Institute on Alcohol Abuse and Alcoholism Clinician Guide suggests use of a single alcohol screening question (SASQ) for screening and Diagnostic and Statistical Manual checklists for assessment, many SBIRT programs use alcohol use disorders identification test (AUDIT) "zones" for screening and assessment. Validation data for these zones are limited. This study used primary care data from a bi-ethnic southern U.S. population to examine the ability of the AUDIT zones and other AUDIT-based approaches to identify unhealthy alcohol use and dependence. Existing data were analyzed from interviews with 625 female and male adult drinkers presenting to 5 southeastern primary care practices. Timeline follow-back was used to identify at-risk drinking, and diagnostic interview schedule was used to identify alcohol abuse and dependence. Validity measures compared performance of AUDIT, AUDIT-C, and AUDIT dependence domains scores, with and without a 30-day binge drinking measure, for detecting unhealthy alcohol use and dependence. Optimal AUDIT scores for detecting unhealthy alcohol use were lower than current commonly used cutoffs (5 for men, 3 for women). Improved performance was obtained by combining AUDIT cutoffs of 6 for men and 4 for women with a 30-day binge drinking measure. AUDIT scores of 15 for men and 13 for women detected AD with 100% specificity but low sensitivity (20 and 18%, respectively). AUDIT dependence subscale scores of 2 or more showed similar specificity (99%) and slightly higher sensitivity (31% for men, 24% for women). Combining lower AUDIT cutoff scores and binge drinking measures may increase the detection of unhealthy alcohol use in primary care. Use of lower cutoff scores and dependence subscale

  5. Trunk Muscle Size and Composition Assessment in Older Adults with Chronic Low Back Pain: An Intra-Examiner and Inter-Examiner Reliability Study.

    Science.gov (United States)

    Sions, Jaclyn Megan; Smith, Andrew Craig; Hicks, Gregory Evan; Elliott, James Matthew

    2016-08-01

     To evaluate intra- and inter-examiner reliability for the assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area, i.e., total cross-sectional area minus intramuscular fat, from T1-weighted magnetic resonance images obtained in older adults with chronic low back pain.  Reliability study.  n = 13 (69.3 ± 8.2 years old)  After lumbar magnetic resonance imaging, two examiners produced relative cross-sectional area measurements of multifidi, erector spinae, psoas, and quadratus lumborum by tracing regions of interest just inside fascial borders. Pixel-intensity summaries were used to determine muscle-to-fat infiltration indices; relative muscle cross-sectional area was calculated. Intraclass correlation coefficients were used to estimate intra- and inter-examiner reliability; standard error of measurement was calculated.  Intra-examiner intraclass correlation coefficient point estimates for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area were excellent for multifidi and erector spinae across levels L2-L5 (ICC = 0.77-0.99). At L3, intra-examiner reliability was excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area for both psoas and quadratus lumborum (ICC = 0.81-0.99). Inter-examiner intraclass correlation coefficients ranged from poor to excellent for relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area.  Assessment of relative cross-sectional area, muscle-to-fat infiltration indices, and relative muscle cross-sectional area in older adults with chronic low back pain can be reliably determined by one examiner from T1-weighted images. Such assessments provide valuable information, as muscle-to-fat infiltration indices and relative muscle cross-sectional area indicate that a substantial amount of

  6. 'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa

    Directory of Open Access Journals (Sweden)

    Amadi Beatrice

    2010-09-01

    Full Text Available Abstract Background Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive. This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production. Methods Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial. Results A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition. The form which these anxieties took, such as rumours

  7. A pilot study to examine maturation of body temperature control in preterm infants.

    Science.gov (United States)

    Knobel, Robin B; Levy, Janet; Katz, Laurence; Guenther, Bob; Holditch-Davis, Diane

    2013-01-01

    To test instrumentation and develop analytic models to use in a larger study to examine developmental trajectories of body temperature and peripheral perfusion from birth in extremely low-birth-weight (EBLW) infants. A case study design. The study took place in a Level 4 neonatal intensive care unit (NICU) in North Carolina. Four ELBW infants, fewer than 29 weeks gestational age at birth. Physiologic data were measured every minute for the first 5 days of life: peripheral perfusion using perfusion index by Masimo and body temperature using thermistors. Body temperature was also measured using infrared thermal imaging. Stimulation and care events were recorded over the first 5 days using video which was coded with Noldus Observer software. Novel analytical models using the state space approach to time-series analysis were developed to explore maturation of neural control over central and peripheral body temperature. Results from this pilot study confirmed the feasibility of using multiple instruments to measure temperature and perfusion in ELBW infants. This approach added rich data to our case study design and set a clinical context with which to interpret longitudinal physiological data. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  8. Simulation platform developed to study and identify critical cases in a future smart grid

    DEFF Research Database (Denmark)

    Mihet-Popa, Lucian; Zong, Yi; You, Shi

    2016-01-01

    simulation and planning tools, with a particular objective on the challenges faced by the introduction of Smart Grid technologies. Another important issue of the paper is to identify critical load cases, as well as the voltage variations with the highest potential, able to implement the grid model...

  9. Identifying and Combating Sexism in EFL Textbooks--With a Case Study into China

    Science.gov (United States)

    Tao, Baiqiang

    2008-01-01

    This paper explores methodologies of identifying and combating sexism in EFL (English as a Foreign Language) textbooks. The writer of this paper has found out there exists sexism or gender inequality in the Chinese high school EFL textbooks. The writer hopes that future EFL curriculum designers, EFL textbook writers, textbook censors in textbook…

  10. Identifying Competencies for Volunteer Administrators for the Coming Decade: A National Delphi Study.

    Science.gov (United States)

    Boyd, Barry L.

    2003-01-01

    A Delphi panel of 13 experts categorized 33 competencies for volunteer administration into 5 constructs: organizational leadership, systems leadership, organizational culture, personal skills, and management skills. Twelve barriers to acquiring competencies and 21 methods to address them were identified. (Contains 24 references.) (SK)

  11. Identifying sustainability issues using participatory SWOT analysis - A case study of egg production in the Netherlands

    NARCIS (Netherlands)

    Mollenhorst, H.; Boer, de I.J.M.

    2004-01-01

    The aim of this paper was to demonstrate how participatory strengths, weaknesses, opportunities and threats (SWOT) analysis can be used to identify relevant economic, ecological and societal (EES) issues for the assessment of sustainable development. This is illustrated by the case of egg production

  12. A prospective study on the risk of contrast induced nephropathy in the patients who underwent contrast-enhanced CT examination

    International Nuclear Information System (INIS)

    Zhang Baocui; Zhang Yudong; Zhao Kai; Wang Xiaoying; Jiang Xuexiang

    2013-01-01

    Objective: To investigate the incidence of contrast induced nephropathy (CIN) among different patient groups after contrast agent injection. Methods: A total of 1243 patients were included in this study (male = 694, female = 549). The SCr level one week before and 72 hours after the CT examination and the incidence of CIN were recorded and comparison was made among groups according to sex, age, body mass index (BMI), the history of high blood pressure (HBP), diabetes mellitus (DM), chronic kidney disease (CKD), chronic heart failure (CHF), tumor, nephrotoxicity drug (NTD) usage. The frequency, type, dose and injection velocity of the contrast media (CM) were also recorded. Multivariate predictors of CIN were identified by Logistic regression using step-wise selection with entry and exit criteria of P 1). Conclusion: Women, age ≥ 75 years, LOCM, NTD, tumor, and the frequency of using CM more than once per month were more likely to develop CIN. (authors)

  13. A synthesis of tagging studies examining the behaviour and survival of anadromous salmonids in marine environments.

    Directory of Open Access Journals (Sweden)

    S Matthew Drenner

    Full Text Available This paper synthesizes tagging studies to highlight the current state of knowledge concerning the behaviour and survival of anadromous salmonids in the marine environment. Scientific literature was reviewed to quantify the number and type of studies that have investigated behaviour and survival of anadromous forms of Pacific salmon (Oncorhynchus spp., Atlantic salmon (Salmo salar, brown trout (Salmo trutta, steelhead (Oncorhynchus mykiss, and cutthroat trout (Oncorhynchus clarkii. We examined three categories of tags including electronic (e.g. acoustic, radio, archival, passive (e.g. external marks, Carlin, coded wire, passive integrated transponder [PIT], and biological (e.g. otolith, genetic, scale, parasites. Based on 207 papers, survival rates and behaviour in marine environments were found to be extremely variable spatially and temporally, with some of the most influential factors being temperature, population, physiological state, and fish size. Salmonids at all life stages were consistently found to swim at an average speed of approximately one body length per second, which likely corresponds with the speed at which transport costs are minimal. We found that there is relatively little research conducted on open-ocean migrating salmonids, and some species (e.g. masu [O. masou] and amago [O. rhodurus] are underrepresented in the literature. The most common forms of tagging used across life stages were various forms of external tags, coded wire tags, and acoustic tags, however, the majority of studies did not measure tagging/handling effects on the fish, tag loss/failure, or tag detection probabilities when estimating survival. Through the interdisciplinary application of existing and novel technologies, future research examining the behaviour and survival of anadromous salmonids could incorporate important drivers such as oceanography, tagging/handling effects, predation, and physiology.

  14. Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication.

    Science.gov (United States)

    Keyworth, C; Nelson, P A; Bundy, C; Pye, S R; Griffiths, C E M; Cordingley, L

    2018-08-01

    Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor  of increased BI for both alcohol reduction (β = .290, p framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.

  15. Understanding the scatter radiation distribution during C-arm CT examination. A body phantom study

    International Nuclear Information System (INIS)

    Norimasa, Toshiyo; Kakimi, Akihiko; Takao, Yoshinori; Sasaki, Shohei; Katayama, Yutaka; Himoto, Daisuke; Izuta, Shinichiro; Ichida, Takao

    2016-01-01

    The purpose of this study was to understand the scatter radiation distribution during C-arm CT examination in the interventional radiography (IVR) room to show the escaped area and the radiation protective method. The C-arm rotates 200deg in 5 s. The tube voltage was 90 kV, and the entrance dose to the detector was 0.36 μGy/frame during C-arm CT examination. The scattered doses were measured each 50 cm from the isocenter like a grid pattern. The heights of the measurement were 50, 100, and 150 cm from the floor. The maximum scattered doses were 38.23 ± 0.60 μGy at 50 cm, 43.86 ± 20 μGy at 100 cm, and 25.78 ± 0.37 μGy at 150 cm. The scatter radiation distribution at 100 cm was the highest scattered dose. The operator should protect their reproductive gland, thyroid, and lens. The scattered dose was low behind the C-arm body and the bed, so they will be able to become the escaped area for staff. (author)

  16. Will it hurt? Patients' experience of X-ray examinations: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Chesson, Rosemary A. [Health Services Research Group, Robert Gordon University, Aberdeen (United Kingdom); Good, Maureen [Royal Aberdeen Children' s Hospital, Aberdeen (United Kingdom); Hart, Cleone L. [Department of Child and Adolescent Psychiatry, Moray Health Services, Elgin (United Kingdom)

    2002-01-01

    Background: There is a worldwide trend towards involving patients in health care, but little is known about children's expectations of routine radiological procedures. Objective: To determine children's perceptions of X-ray examinations. Materials and methods: A convenience sample was selected from consecutive patients referred to a children's hospital in Scotland. Children were allocated either to a drawing study (n=20) or a two-stage interview (n=25). The investigation was restricted to first-time users of the radiological service aged 7-14 years if accompanied by a parent and consent having been obtained. Children were excluded if pain control was administered in the Accident and Emergency Department. Children's drawings were reported on by an art therapist and a child psychiatrist. Results: All children approached agreed to participate. Seventeen children provided accurate pictures of the X-ray examination room. Concordance existed between the psychiatrist's and art therapist's reports. Children at interview had at least a minimal level of knowledge of X-rays and this was from (1) family, friends and neighbours, (2) the school classroom, and (3) television programmes. Conclusions: Children had anxieties revealed through drawings and interviews. We recommend drawings for establishing children's views of radiology. (orig.)

  17. Comparative study of colorectal carcinoma examination with four postprocessing of CT colonography

    Energy Technology Data Exchange (ETDEWEB)

    Mingyue, Luo; Kangrong, Zhou [The 3rd Affilated Hospital Sun Yat-sen Univ. of Medical Sciences, Guangzhou (China). Dept. of Radiology

    2001-10-01

    Objective: To study the clinical value of colorectal carcinoma examination by comparison of different postprocessing techniques such as multiplanar reformation (MPR), CT virtual colonoscopy (CTVC), shaded surface display (SSD) and Raysum. Methods: 64 patients with colorectal carcinomas underwent volume scanning using spiral CT. MPR, CTVC, SSD and Raysum images were obtained by using 4 different software in workstation. All cases were proved by surgical or CC biotic histology. The results were compared and analyzed according to the circumferential extension, length and pathologic patterns of colorectal carcinoma with MPR, CTVC, SSD and Raysum. Results: The correction rate of determination the circumferential extension of colorectal carcinoma with MPR, CTVC, SSD and Raysum were 100.0%, 82.8%, 79.7% and 79.7%, respectively. There was significant statistical difference between MPR and CTVC; The accuracy of judging the length of carcinoma were 89.1%, 76.6%, 95.3% and 100.0%, respectively. There was statistical difference between CTVC and SSD; The accuracy of showing carcinoma pathologic patterns were 81.3%, 92.2%, 71.9% and 71.0%, respectively. There was statistical difference between CTVC and SSD, too. MPR could correctly determine the circumferential extension of colorectal carcinoma. In determination the length of carcinoma, Raysum was more accurate than SSD. CTVC could be more helpful in showing carcinoma pathologic patterns. Conclusion: There were advantages and disadvantages in colorectal carcinoma examination with MPR, CTVC, SSD and Raysum, and the combination could display colorectal carcinoma more completely and comprehensively.

  18. Comparative study of colorectal carcinoma examination with four postprocessing of CT colonography

    International Nuclear Information System (INIS)

    Luo Mingyue; Zhou Kangrong

    2001-01-01

    Objective: To study the clinical value of colorectal carcinoma examination by comparison of different postprocessing techniques such as multiplanar reformation (MPR), CT virtual colonoscopy (CTVC), shaded surface display (SSD) and Raysum. Methods: 64 patients with colorectal carcinomas underwent volume scanning using spiral CT. MPR, CTVC, SSD and Raysum images were obtained by using 4 different software in workstation. All cases were proved by surgical or CC biotic histology. The results were compared and analyzed according to the circumferential extension, length and pathologic patterns of colorectal carcinoma with MPR, CTVC, SSD and Raysum. Results: The correction rate of determination the circumferential extension of colorectal carcinoma with MPR, CTVC, SSD and Raysum were 100.0%, 82.8%, 79.7% and 79.7%, respectively. There was significant statistical difference between MPR and CTVC; The accuracy of judging the length of carcinoma were 89.1%, 76.6%, 95.3% and 100.0%, respectively. There was statistical difference between CTVC and SSD; The accuracy of showing carcinoma pathologic patterns were 81.3%, 92.2%, 71.9% and 71.0%, respectively. There was statistical difference between CTVC and SSD, too. MPR could correctly determine the circumferential extension of colorectal carcinoma. In determination the length of carcinoma, Raysum was more accurate than SSD. CTVC could be more helpful in showing carcinoma pathologic patterns. Conclusion: There were advantages and disadvantages in colorectal carcinoma examination with MPR, CTVC, SSD and Raysum, and the combination could display colorectal carcinoma more completely and comprehensively

  19. A PROSPECTIVE RANDOMISED STUDY OF THE EFFECT OF DILTIAZEM IN THE DRE AND PROCTOSCOPIC EXAMINATION

    Directory of Open Access Journals (Sweden)

    R. C. Thampan

    2018-01-01

    Full Text Available BACKGROUND Digital Rectal Examination (DRE and proctoscopy is an important routine investigation done by surgeons, gastroenterologists’, etc. Most of the patients complain of pain and discomfort during the procedure. Anal sphincter complex contracts to the penetrating index finger as a voluntary reflex try to avoid hurting. A good lubricant jelly (with 2% lignocaine and extreme gentleness should be the rule to this procedure to avoid discomfort and pain to the patients. Even with maximum precautions, majority of patients complain discomfort or pain during the procedure. To overcome this problem, we tried lubricant jelly and diltiazem gel combination. MATERIALS AND METHODS We evaluated 500 patients in this trial during the period 2010 to 2015 from the OPD of our institution with lubricant jelly alone and with diltiazem in the interval of two weeks. Analysis showed most of the patients is comfortable with combination lubricant jelly and diltiazem gel rather than lubricant jelly alone. RESULTS A total of 625 patients were screened for this study, but only 560 considered and enrolled (mean age 40 years. 60 patients failed to attend for the second examination, hence they were excluded from the final analysis. CONCLUSION The importance of DRE and proctoscopy known to every clinician, since it provides valuable information about anorectal pathology. Some patients are reluctant to give consent thinking that it will hurt them. By mixing lubricant jelly with diltiazem, the procedure becomes really comfortable due to good relaxation of anal sphincter complex.

  20. Will it hurt? Patients' experience of X-ray examinations: a pilot study

    International Nuclear Information System (INIS)

    Chesson, Rosemary A.; Good, Maureen; Hart, Cleone L.

    2002-01-01

    Background: There is a worldwide trend towards involving patients in health care, but little is known about children's expectations of routine radiological procedures. Objective: To determine children's perceptions of X-ray examinations. Materials and methods: A convenience sample was selected from consecutive patients referred to a children's hospital in Scotland. Children were allocated either to a drawing study (n=20) or a two-stage interview (n=25). The investigation was restricted to first-time users of the radiological service aged 7-14 years if accompanied by a parent and consent having been obtained. Children were excluded if pain control was administered in the Accident and Emergency Department. Children's drawings were reported on by an art therapist and a child psychiatrist. Results: All children approached agreed to participate. Seventeen children provided accurate pictures of the X-ray examination room. Concordance existed between the psychiatrist's and art therapist's reports. Children at interview had at least a minimal level of knowledge of X-rays and this was from (1) family, friends and neighbours, (2) the school classroom, and (3) television programmes. Conclusions: Children had anxieties revealed through drawings and interviews. We recommend drawings for establishing children's views of radiology. (orig.)

  1. Mixed methods study examining work reintegration experiences from perspectives of Veterans with mental health disorders.

    Science.gov (United States)

    Kukla, Marina; Rattray, Nicholas A; Salyers, Michelle P

    2015-01-01

    Recent findings have demonstrated that reintegration for Veterans is often challenging. One difficult aspect of reintegration—transitioning into the civilian workplace—has not been fully explored in the literature. To address this gap and examine work reintegration, this mixed methods study examined the perspectives of Veterans with mental health disorders receiving Department of Veterans Affairs healthcare. Forty Veterans rated factors that affect work success; participants also provided narratives on their most and least successful work experiences. We used t-tests and qualitative analysis to compare participants who did and did not serve in combat. Several themes relevant to work reintegration emerged in the narratives, particularly for Veterans who served in combat. An array of work difficulties were reported in the months following military discharge. In addition, Veterans who served in combat reported significantly more work barriers than Veterans who did not serve in combat, particularly health-related barriers. In conclusion, Veterans with mental health disorders who served in combat experienced more work reintegration difficulty than their counterparts who did not serve in combat. The role of being a Veteran affected how combat Veterans formed their self-concept, which also shaped their work success and community reintegration, especially during the early transition period.

  2. Examination performances of German and international medical students in the preclinical studying-term--a descriptive study.

    Science.gov (United States)

    Huhn, D; Resch, F; Duelli, R; Möltner, A; Huber, J; Karimian Jazi, K; Amr, A; Eckart, W; Herzog, W; Nikendei, C

    2014-01-01

    Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations.

  3. Examination performances of German and international medical students in the preclinical studying-term – A descriptive study

    Science.gov (United States)

    Huhn, D.; Resch, F.; Duelli, R.; Möltner, A.; Huber, J.; Karimian Jazi, K.; Amr, A.; Eckart, W.; Herzog, W.; Nikendei, C.

    2014-01-01

    Introduction: Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. Method: A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). Results: German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations. PMID:25228931

  4. Examining why ethics is taught to veterinary students: a qualitative study of veterinary educators' perspectives.

    Science.gov (United States)

    Magalhães-Sant'Ana, Manuel; Lassen, Jesper; Millar, Kate M; Sandøe, Peter; Olsson, I Anna S

    2014-01-01

    Although it is widely agreed that veterinary students need to be introduced to ethics, there is limited empirical research investigating the reasons why veterinary ethics is being taught. This study presents the first extensive investigation into the reasons for teaching veterinary ethics and reports data collected in semi-structured interviews with educators involved in teaching undergraduate veterinary ethics at three European schools: the University of Copenhagen, the University of Nottingham, and the Technical University of Lisbon (curricular year 2010-2011). The content of the interview transcripts were analyzed using Toulmin's argumentative model. Ten objectives in teaching veterinary ethics were identified, which can be grouped into four overarching themes: ethical awareness, ethical knowledge, ethical skills, and individual and professional qualities. These objectives include recognizing values and ethical viewpoints, identifying norms and regulations, developing skills of communication and decision making, and contributing to a professional identity. Whereas many of the objectives complement each other, there is tension between the view that ethics teaching should promote knowledge of professional rules and the view that ethics teaching should emphasize critical reasoning skills. The wide range of objectives and the possible tensions between them highlight the challenges faced by educators as they attempt to prioritize among these goals of ethics teaching within a crowded veterinary curriculum.

  5. A qualitative study to examine older adults' perceptions of health: Keys to aging successfully.

    Science.gov (United States)

    Tkatch, Rifky; Musich, Shirley; MacLeod, Stephanie; Kraemer, Sandra; Hawkins, Kevin; Wicker, Ellen R; Armstrong, Douglas G

    Older adult health is often defined in clinical terms. Research has demonstrated that many older adults self-report aging successfully regardless of clinical health status. This qualitative study used claims data to identify older adults on three levels of health status: healthy and active, managing diseases, or very sick, to better understand how health is defined and maintained. In total, 32 participants from two cities were interviewed. Interviews were audio- and video-recorded and then transcribed. Thematic analysis identified five themes: disconnectedness between objective and subjective health; health defined to include psychological and social components; resilience and coping mechanisms indicative of successful aging; social support systems integral to health; and the goal of maintaining functioning. These results indicate the importance of individual perceptions of health rather than just counts of chronic diseases. Health management programs should provide holistic approaches to maximize health outcomes and to promote successful aging. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  6. An Examination of XMOOCs: An Embedded Single Case Study Based on Conole’s 12 Dimensions

    Directory of Open Access Journals (Sweden)

    Serpil KOCDAR

    2017-10-01

    Full Text Available This study intends to examine the xMOOCs offered by one of the mainstream MOOC platforms in Conole’s 12 dimensions. For this purpose, the research employed an embedded single case study using heuristic inquiry to collect data. The researchers participated in three xMOOCs and took into consideration the characteristics of these MOOCs by rating them as low, medium or high in terms of Conole’s 12 dimensions. Inter-rater reliability was 92 percent. The study showed that the openness, massiveness, diversity, use of multimedia, communication among learners, learning pathway and amount of reflection dimensions were high. The communication with instructors, degree of collaboration and autonomy dimensions were medium, and the quality assurance, certification, and formal learning dimensions were low. After explaining characteristics of xMOOCs from the perspective of open learning, the study highlighted that xMOOCs dramatically differ with regard to the implementation of the freemium business model to education and course delivery methods. It was concluded that MOOCs are not a new form of learning, but a new form of organizing learning similar to the open university movement, but which promises more flexibility and access than open universities.

  7. Validation Study of the Mini-Mental State Examination in Urdu Language for Pakistani Population.

    Science.gov (United States)

    Awan, Safia; Shahbaz, Naila; Akhtar, Syed Wasim; Ahmad, Arsalan; Iqbal, Sadaf; Ahmed, Sellal; Naqvi, Haider; Wasay, Mohammad

    2015-01-01

    Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani's and study the effects of gender and education on the MMSE performance in our population. Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p<0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia. These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population.

  8. Genome-wide association study identifies novel locus for neuroticism and shows polygenic association with Major Depressive Disorder

    Science.gov (United States)

    de Moor, Marleen H.M.; van den Berg, Stéphanie M.; Verweij, Karin J.H.; Krueger, Robert F.; Luciano, Michelle; Vasquez, Alejandro Arias; Matteson, Lindsay K.; Derringer, Jaime; Esko, Tõnu; Amin, Najaf; Gordon, Scott D.; Hansell, Narelle K.; Hart, Amy B.; Seppälä, Ilkka; Huffman, Jennifer E.; Konte, Bettina; Lahti, Jari; Lee, Minyoung; Miller, Mike; Nutile, Teresa; Tanaka, Toshiko; Teumer, Alexander; Viktorin, Alexander; Wedenoja, Juho; Abecasis, Goncalo R.; Adkins, Daniel E.; Agrawal, Arpana; Allik, Jüri; Appel, Katja; Bigdeli, Timothy B.; Busonero, Fabio; Campbell, Harry; Costa, Paul T.; Smith, George Davey; Davies, Gail; de Wit, Harriet; Ding, Jun; Engelhardt, Barbara E.; Eriksson, Johan G.; Fedko, Iryna O.; Ferrucci, Luigi; Franke, Barbara; Giegling, Ina; Grucza, Richard; Hartmann, Annette M.; Heath, Andrew C.; Heinonen, Kati; Henders, Anjali K.; Homuth, Georg; Hottenga, Jouke-Jan; Janzing, Joost; Jokela, Markus; Karlsson, Robert; Kemp, John P.; Kirkpatrick, Matthew G.; Latvala, Antti; Lehtimäki, Terho; Liewald, David C.; Madden, Pamela A.F.; Magri, Chiara; Magnusson, Patrik K.E.; Marten, Jonathan; Maschio, Andrea; Medland, Sarah E.; Mihailov, Evelin; Milaneschi, Yuri; Montgomery, Grant W.; Nauck, Matthias; Ouwens, Klaasjan G.; Palotie, Aarno; Pettersson, Erik; Polasek, Ozren; Qian, Yong; Pulkki-Råback, Laura; Raitakari, Olli T.; Realo, Anu; Rose, Richard J.; Ruggiero, Daniela; Schmidt, Carsten O.; Slutske, Wendy S.; Sorice, Rossella; Starr, John M.; Pourcain, Beate St; Sutin, Angelina R.; Timpson, Nicholas J.; Trochet, Holly; Vermeulen, Sita; Vuoksimaa, Eero; Widen, Elisabeth; Wouda, Jasper; Wright, Margaret J.; Zgaga, Lina; Scotland, Generation; Porteous, David; Minelli, Alessandra; Palmer, Abraham A.; Rujescu, Dan; Ciullo, Marina; Hayward, Caroline; Rudan, Igor; Metspalu, Andres; Kaprio, Jaakko; Deary, Ian J.; Räikkönen, Katri; Wilson, James F.; Keltikangas-Järvinen, Liisa; Bierut, Laura J.; Hettema, John M.; Grabe, Hans J.; van Duijn, Cornelia M.; Evans, David M.; Schlessinger, David; Pedersen, Nancy L.; Terracciano, Antonio; McGue, Matt; Penninx, Brenda W.J.H.; Martin, Nicholas G.; Boomsma, Dorret I.

    2015-01-01

    Importance Neuroticism is a personality trait that is briefly defined by emotional instability. It is a robust genetic risk factor for Major Depressive Disorder (MDD) and other psychiatric disorders. Hence, neuroticism is an important phenotype for psychiatric genetics. The Genetics of Personality Consortium (GPC) has created a resource for genome-wide association analyses of personality traits in over 63,000 participants (including MDD cases). Objective To identify genetic variants associated with neuroticism by performing a meta-analysis of genome-wide association (GWA) results based on 1000Genomes imputation, to evaluate if common genetic variants as assessed by Single Nucleotide Polymorphisms (SNPs) explain variation in neuroticism by estimating SNP-based heritability, and to examine whether SNPs that predict neuroticism also predict MDD. Setting 30 cohorts with genome-wide genotype, personality and MDD data from the GPC. Participants The study included 63,661 participants from 29 discovery cohorts and 9,786 participants from a replication cohort. Participants came from Europe, the United States or Australia. Main outcome measure(s) Neuroticism scores harmonized across all cohorts by Item Response Theory (IRT) analysis, and clinically assessed MDD case-control status. Results A genome-wide significant SNP was found in the MAGI1 gene (rs35855737; P=9.26 × 10−9 in the discovery meta-analysis, and P=2.38 × 10−8 in the meta-analysis of all 30 cohorts). Common genetic variants explain 15% of the variance in neuroticism. Polygenic scores based on the meta-analysis of neuroticism in 27 of the discovery cohorts significantly predicted neuroticism in 2 independent cohorts. Importantly, polygenic scores also predicted MDD in these cohorts. Conclusions and relevance This study identifies a novel locus for neuroticism. The variant is located in a known gene that has been associated with bipolar disorder and schizophrenia in previous studies. In addition, the study

  9. Examining perceptions about IQOS heated tobacco product: consumer studies in Japan and Switzerland.

    Science.gov (United States)

    Hair, Elizabeth C; Bennett, Morgane; Sheen, Emily; Cantrell, Jennifer; Briggs, Jodie; Fenn, Zoe; Willett, Jeffrey G; Vallone, Donna

    2018-05-15

    To examine consumer perceptions, attitudes and behaviours regarding the heated tobacco product, IQOS, as well as to document the product's marketing strategies to determine its potential for appealing to youth and young adults. Truth Initiative, in collaboration with Flamingo, collected qualitative data via: (1) expert interviews, (2) semiotic analysis of IQOS packing and marketing materials, and (3) 12 focus groups with adults in Switzerland (ages 19-44 years; June 6-9, 2016) and Japan (ages 20-39 years; June 22-24, 2016) (n=68 for both groups). Expert interviews and IQOS packing and marketing analyses revealed the product is being marketed as a clean, chic and pure product, which resonated very well in Japan given the strong cultural values of order, cleanliness, quality and respect for others. Focus groups results indicated Japanese IQOS users used the product for socialising with non-smokers. Focus group participants in both Japan and Switzerland reported lower levels of satisfaction with the product relative to combustible cigarettes, although many found the product packaging to be appealing. While participants identified several benefits and barriers related to IQOS, few reported any potential health benefits of use compared with combustible tobacco products. IQOS was marketed as a sophisticated, high tech and aspirational product. Because youth and young adults are more interested in such product positioning, this approach raises some concern about youth appeal. This research shows cultural factors appeared to affect the appeal of this messaging, indicating that prevalence and uptake data will likely not be similar from country to country. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. The third space: The use of self-study to examine the culture of a science classroom

    Science.gov (United States)

    Magee, Dashia M.

    Science educators are in the position to create bridges between their students and the world of science (Aikenhead, 1996, 1999). This connection has often been described as the third space (Bhabha, 1994; Moje, Collazo, Carrillo, & Marx, 2001; Wallace, 2004), which is represented as a combination or a meeting of the students' world and the world of science. In this study, I examined my role in creating the third space through the use of self-study. Self-