WorldWideScience

Sample records for monoxide primary national

  1. Protective Effect of Edaravone against Carbon Monoxide Induced Apoptosis in Rat Primary Cultured Astrocytes

    Directory of Open Access Journals (Sweden)

    Xiaodan Xu

    2017-01-01

    Full Text Available Objective. To observe the protective effect of edaravone (Eda on astrocytes after prolonged exposure to carbon monoxide (CO and further to investigate the potential mechanisms of Eda against CO-induced apoptosis. Methods. The rat primary cultured astrocytes were cultured in vitro and exposed to 1% CO for 24 h after being cultured with different concentrations of Eda. MTT assay was used to detect the cytotoxicity of CO. Flow cytometry was used to detect the apoptosis rate, membrane potential of mitochondria, and ROS level. The mRNA and protein expressions of Bcl-2, Bax, and caspase-3 were assessed by real-time PCR and Western blotting analysis, respectively. Results. Eda can significantly suppress cytotoxicity of CO, and it can significantly increase membrane potential of mitochondria and Bcl-2 expressions and significantly suppress the apoptosis rate, ROS level, Bax, and caspase-3 expressions. Conclusion. Eda protects against CO-induced apoptosis in rat primary cultured astrocytes through decreasing ROS production and subsequently inhibiting mitochondrial apoptosis pathway.

  2. Carbon Monoxide Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Carbon Monoxide and have...

  3. Occult Carbon Monoxide Poisoning

    OpenAIRE

    Kirkpatrick, John N.

    1987-01-01

    A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms ...

  4. Occult carbon monoxide poisoning.

    Science.gov (United States)

    Kirkpatrick, J N

    1987-01-01

    A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells.

  5. Carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    The document identifies the main sources of carbon monoxide (CO) in the general outdoor atmosphere, describes methods of measuring and monitoring its concentration levels in the United Kingdom, and discusses the effects of carbon monoxide on human health. Following its review, the Panel has put forward a recommendation for an air quality standard for carbon monoxide in the United Kingdom of 10 ppm, measured as a running 8-hour average. The document includes tables and graphs of emissions of CO, in total and by emission source, and on the increase in blood levels of carboxyhaemoglobin with continuing exposure to CO. 11 refs., 4 figs., 4 tabs.

  6. Career Planning: Developing the Nation's Primary Resource.

    Science.gov (United States)

    Jarvis, Phillip S.

    Career planning is the most critical ingredient in developing a nation's primary resource, its workers. A 1988 Gallup Poll showed that 62 percent of U.S. workers had no career goal when they began their first job, and more than 50 percent felt they were in the wrong job. The same results probably could be applied to Canada. Career planning skills…

  7. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Education Centers Carbon Monoxide Information Center Carbon Monoxide Information Center En Español The Invisible Killer Carbon monoxide, ... Install one and check its batteries regularly. View Information About CO Alarms Other CO Topics Safety Tips ...

  8. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Education Safety Education Centers Carbon Monoxide Information Center Carbon Monoxide Information Center En Español The Invisible Killer Carbon monoxide, also known as CO, is called the " ...

  9. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). NewSearch

    Energy Technology Data Exchange (ETDEWEB)

    1994-10-01

    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains a minimum of 137 citations and includes a subject term index and title list.)

  10. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). Published Search

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography.(Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  11. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection database). Published Search

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  12. Carbon monoxide toxicity. (Latest citations from the Life Sciences Collection data base). Published Search

    Energy Technology Data Exchange (ETDEWEB)

    1992-08-01

    The bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide (CO) exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include studies of the carbon monoxide binding affinity with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels resulting from tobacco and marijuana smoke, occupational exposure and the NIOSH (National Institute for Occupational Safety and Health) biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (Contains a minimum of 172 citations and includes a subject term index and title list.)

  13. Carbon Monoxide Safety

    Science.gov (United States)

    ... with the Media Fire Protection Technology Carbon monoxide safety outreach materials Keep your community informed about the ... KB | Spanish PDF 592 KB Handout: carbon monoxide safety Download this handout and add your organization's logo ...

  14. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... main content Languages 简体中文 English Bahasa Indonesia 한국어 Español ภาษาไทย Tiếng Việt Text Size: Decrease Font Increase ... Monoxide Information Center Carbon Monoxide Information Center En Español The Invisible Killer Carbon monoxide, also known as ...

  15. Protect Yourself from Carbon Monoxide Poisoning

    Centers for Disease Control (CDC) Podcasts

    2007-11-20

    Learn about carbon monoxide - a colorless, odorless gas - and how to protect yourself and your family.  Created: 11/20/2007 by CDC National Center for Environmental Health.   Date Released: 12/4/2007.

  16. Induction of HO-1 by carbon monoxide releasing molecule-2 attenuates thrombin-induced COX-2 expression and hypertrophy in primary human cardiomyocytes

    International Nuclear Information System (INIS)

    Chien, Peter Tzu-Yu; Lin, Chih-Chung; Hsiao, Li-Der; Yang, Chuen-Mao

    2015-01-01

    Carbon monoxide (CO) is one of the cytoprotective byproducts of heme oxygenase (HO)-1 and exerts anti-inflammatory action in various models. However, the detailed mechanisms underlying CO-induced HO-1 expression in primary human cardiomyocytes remain largely unidentified. We used primary left ventricle myocytes as a model and applied CO releasing molecule (CORM)-2 to investigate the relationship of CO and HO-1 expression. We herein used Western blot, real-time PCR, promoter activity and EIA to investigate the role of HO-1 expression protecting against thrombin-mediated responses. We found that thrombin-induced COX-2 expression, PGE 2 release and cardiomyocyte hypertrophy markers (increase in ANF/BNP, α-actin expression and cell surface area) was attenuated by pretreatment with CORM-2 which was partially reversed by hemoglobin (Hb) or ZnPP (an inhibitor of HO-1 activity), suggesting that HO-1/CO system may be of clinical importance to ameliorate heart failure through inhibition of inflammatory responses. CORM-2-induced HO-1 protein expression, mRNA and promoter was attenuated by pretreatment with the inhibitors of Pyk2 (PF431396), PDGFR (AG1296), PI3K (LY294002), Akt (SH-5), p38 (SB202530), JNK1/2 (SP600125), FoxO1 (AS1842856) and Sp1 (mithramycin A). The involvement of these signaling components was further confirmed by transfection with respective siRNAs, consistent with those of pharmacological inhibitors. These results suggested that CORM-2-induced HO-1 expression is mediated through a Pyk2/PDGFR/PI3K/Akt/FoxO1/Sp1-dependent manner and exerts a cytoprotective effect in human cardiomyocytes. - Graphical abstract: In summary, CORM-2 treatment induces Pyk2 transactivated PDGFR, which induces PI3K/Akt/MAPK activation, and then recruits Sp1/Foxo1 transcriptional factors to regulate HO-1 gene expression in primary human cardiomyocytes. - Highlights: • CORM-2 induces HO-1 expression. • Pyk2-dependent PDGFR activates PI3K/Akt/MAPK pathway in CORM-2-induced HO-1

  17. Induction of HO-1 by carbon monoxide releasing molecule-2 attenuates thrombin-induced COX-2 expression and hypertrophy in primary human cardiomyocytes

    Energy Technology Data Exchange (ETDEWEB)

    Chien, Peter Tzu-Yu [Department of Physiology and Pharmacology and Health Ageing Research Center, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan (China); Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan (China); Lin, Chih-Chung; Hsiao, Li-Der [Department of Anesthetics, Chang Gung Memorial Hospital at Lin-Kou and College of Medicine, Chang Gung University, Kwei-San, Tao-Yuan, Taiwan (China); Yang, Chuen-Mao, E-mail: chuenmao@mail.cgu.edu.tw [Department of Physiology and Pharmacology and Health Ageing Research Center, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan (China); Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan (China); Research Center for Industry of Human Ecology and Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan (China)

    2015-12-01

    Carbon monoxide (CO) is one of the cytoprotective byproducts of heme oxygenase (HO)-1 and exerts anti-inflammatory action in various models. However, the detailed mechanisms underlying CO-induced HO-1 expression in primary human cardiomyocytes remain largely unidentified. We used primary left ventricle myocytes as a model and applied CO releasing molecule (CORM)-2 to investigate the relationship of CO and HO-1 expression. We herein used Western blot, real-time PCR, promoter activity and EIA to investigate the role of HO-1 expression protecting against thrombin-mediated responses. We found that thrombin-induced COX-2 expression, PGE{sub 2} release and cardiomyocyte hypertrophy markers (increase in ANF/BNP, α-actin expression and cell surface area) was attenuated by pretreatment with CORM-2 which was partially reversed by hemoglobin (Hb) or ZnPP (an inhibitor of HO-1 activity), suggesting that HO-1/CO system may be of clinical importance to ameliorate heart failure through inhibition of inflammatory responses. CORM-2-induced HO-1 protein expression, mRNA and promoter was attenuated by pretreatment with the inhibitors of Pyk2 (PF431396), PDGFR (AG1296), PI3K (LY294002), Akt (SH-5), p38 (SB202530), JNK1/2 (SP600125), FoxO1 (AS1842856) and Sp1 (mithramycin A). The involvement of these signaling components was further confirmed by transfection with respective siRNAs, consistent with those of pharmacological inhibitors. These results suggested that CORM-2-induced HO-1 expression is mediated through a Pyk2/PDGFR/PI3K/Akt/FoxO1/Sp1-dependent manner and exerts a cytoprotective effect in human cardiomyocytes. - Graphical abstract: In summary, CORM-2 treatment induces Pyk2 transactivated PDGFR, which induces PI3K/Akt/MAPK activation, and then recruits Sp1/Foxo1 transcriptional factors to regulate HO-1 gene expression in primary human cardiomyocytes. - Highlights: • CORM-2 induces HO-1 expression. • Pyk2-dependent PDGFR activates PI3K/Akt/MAPK pathway in CORM-2-induced HO

  18. Carbon monoxide poisoning

    Science.gov (United States)

    ... Animals can also be poisoned by carbon monoxide. People who have pets at home may notice that their animals become ... or unresponsive from carbon monoxide exposure. Often the pets will ... these conditions. This can lead to a delay in getting help.

  19. Emission factors of fine particulate matter, organic and elemental carbon, carbon monoxide, and carbon dioxide for four solid fuels commonly used in residential heating by the U.S. Navajo Nation.

    Science.gov (United States)

    Champion, Wyatt M; Connors, Lea; Montoya, Lupita D

    2017-09-01

    Most homes in the Navajo Nation use wood as their primary heating fuel, often in combination with locally mined coal. Previous studies observed health effects linked to this solid-fuel use in several Navajo communities. Emission factors (EFs) for common fuels used by the Navajo have not been reported using a relevant stove type. In this study, two softwoods (ponderosa pine and Utah juniper) and two high-volatile bituminous coals (Black Mesa and Fruitland) were tested with an in-use residential conventional wood stove (homestove) using a modified American Society for Testing and Materials/U.S. Environmental Protection Agency (ASTM/EPA) protocol. Filter sampling quantified PM 2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) and organic (OC) and elemental (EC) carbon in the emissions. Real-time monitoring quantified carbon monoxide (CO), carbon dioxide (CO 2 ), and total suspended particles (TSP). EFs for these air pollutants were developed and normalized to both fuel mass and energy consumed. In general, coal had significantly higher mass EFs than wood for all pollutants studied. In particular, coal emitted, on average, 10 times more PM 2.5 than wood on a mass basis, and 2.4 times more on an energy basis. The EFs developed here were based on fuel types, stove design, and operating protocols relevant to the Navajo Nation, but they could be useful to other Native Nations with similar practices, such as the nearby Hopi Nation. Indoor wood and coal combustion is an important contributor to public health burdens in the Navajo Nation. Currently, there exist no emission factors representative of Navajo homestoves, fuels, and practices. This study developed emission factors for PM 2.5 , OC, EC, CO, and CO 2 using a representative Navajo homestove. These emission factors may be utilized in regional-, national-, and global-scale health and environmental models. Additionally, the protocols developed and results presented here may inform on-going stove design of

  20. Whiteness and National Identity: Teacher Discourses in Australian Primary Schools

    Science.gov (United States)

    Walton, Jessica; Priest, Naomi; Kowal, Emma; White, Fiona; Fox, Brandi; Paradies, Yin

    2018-01-01

    The study examines how white teachers talked to children about national identity and cultural diversity by drawing on qualitative research with eight- to 12-year-old students and their teachers from four Australian primary schools with different racial, ethnic and cultural demographics. Despite a range of explicit and implicit approaches that…

  1. The Quest for Strategic Malaysian Quality National Primary School Leaders

    Science.gov (United States)

    Ali, Hairuddin Mohd

    2012-01-01

    Purpose: The purpose of this paper is to investigate the nine-point strategic leadership characteristics of Malaysian Quality National Primary School Leaders (QNPSL) and to indicate the implications of these findings for the current educational management and leadership practices in their quest for Malaysian quality education.…

  2. An unusual case of carbon monoxide poisoning.

    Science.gov (United States)

    Auger, P L; Levesque, B; Martel, R; Prud'homme, H; Bellemare, D; Barbeau, C; Lachance, P; Rhainds, M

    1999-01-01

    Carbon monoxide, a gas originating from incomplete combustion of carbon-based fuels, is an important cause of human deaths. In this paper, we describe an unusual carbon monoxide poisoning in a dwelling without obvious sources of combustion gases, for which two adults had to be treated in a hyperbaric chamber. Carbon monoxide readings were taken in the house and in the neighboring homes. Methane gas and nitrogen oxide levels were also monitored in the house air. Soil samples were collected around the house and tested for hydrocarbon residues. The investigation revealed the presence of a pocket of carbon monoxide under the foundation of the house. The first readings revealed carbon monoxide levels of 500 ppm in the basement. The contamination lasted for a week. The investigation indicated that the probable source of contamination was the use of explosives at a nearby rain sewer construction site. The use of explosives in a residential area can constitute a major source of carbon monoxide for the neighboring populations. This must be investigated, and public health authorities, primary-care physicians, governmental authorities, and users and manufacturers of explosives must be made aware of this problem. Images Figure 1 Figure 2 PMID:10379009

  3. An unusual case of carbon monoxide poisoning.

    Science.gov (United States)

    Auger, P L; Levesque, B; Martel, R; Prud'homme, H; Bellemare, D; Barbeau, C; Lachance, P; Rhainds, M

    1999-07-01

    Carbon monoxide, a gas originating from incomplete combustion of carbon-based fuels, is an important cause of human deaths. In this paper, we describe an unusual carbon monoxide poisoning in a dwelling without obvious sources of combustion gases, for which two adults had to be treated in a hyperbaric chamber. Carbon monoxide readings were taken in the house and in the neighboring homes. Methane gas and nitrogen oxide levels were also monitored in the house air. Soil samples were collected around the house and tested for hydrocarbon residues. The investigation revealed the presence of a pocket of carbon monoxide under the foundation of the house. The first readings revealed carbon monoxide levels of 500 ppm in the basement. The contamination lasted for a week. The investigation indicated that the probable source of contamination was the use of explosives at a nearby rain sewer construction site. The use of explosives in a residential area can constitute a major source of carbon monoxide for the neighboring populations. This must be investigated, and public health authorities, primary-care physicians, governmental authorities, and users and manufacturers of explosives must be made aware of this problem.

  4. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Unites States die every year from accidental non-fire related CO poisoning associated with consumer products, including ... CO Blogs Research & Statistics JANUARY 07, 2016 Non-Fire Carbon Monoxide Deaths Associated with the Use of ...

  5. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... On Safety Blogs: CO Safety More CO Blogs Research & Statistics JANUARY 07, 2016 Non-Fire Carbon Monoxide ... Related Links Recalls Safety Education Regulations, Laws & Standards Research & Statistics Business & Manufacturing Small Business Resources OnSafety Blogs ...

  6. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Community Outreach Resource Center Toy Recall Statistics CO Poster Contest Pool Safely Business & Manufacturing Business & Manufacturing Business ... Featured Resources CPSC announces winners of carbon monoxide poster contest Video View the blog Clues You Can ...

  7. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Import Surveillance International Recall Guidance Civil and Criminal Penalties Federal Court Orders & ... 07, 2016 Non-Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products 2012 ...

  8. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Statistics JANUARY 07, 2016 Non-Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products 2012 Annual Estimates OCTOBER 13, 2015 Incidents, Deaths, and In-Depth Investigations Associated with Non-Fire ...

  9. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Safety Blogs: CO Safety More CO Blogs Research & Statistics JANUARY 07, 2016 Non-Fire Carbon Monoxide Deaths ... 2011 Annual Estimates View All CO-Related Injury Statistics and Technical Reports Related Links Recalls Safety Education ...

  10. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... CONSUMER PRODUCT SAFETY COMMISSION Search CPSC Search Menu Home Recalls Recall List CPSC Recall API Recall Lawsuits ... and Bans Report an Unsafe Product Consumers Businesses Home Safety Education Safety Education Centers Carbon Monoxide Information ...

  11. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  12. Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Kamal Mishra

    2016-01-01

    Full Text Available Introduction: Carbon monoxide is known as the silent killer, being colorless, odourless, and tasteless. Initially non-irritating, it is very difficult for people to detect Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply that prevents complete oxidation of carbon to C02. During World War II, Nazis used gas vans to kill an estimated over 700,000 prisoners by carbon monoxide poisoning. This method was also used in the gas chambers ofseveral death camps. The true number of incidents of carbon monoxide poisoning is unknown, since many non-lethal exposures go undetected From the available data, carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Clinical features and management: The signs of carbon monoxide poisoning vary with concentration and length of exposure. Subtle cardiovascular or neurobehavioural effects occur at low concentration. The onset of chronic poisoning is usually insidious and easily mistaken for viral prodrome, depression, or gastroenteritis in children. The classic sign of carbon monoxide poisoning which is actually more often seen in the dead than the living is appearing red-cheeked and healthy. Cherry pink colour develops in nails, skin and mucosa. In acute poisoning, common abnormalities of posture and tone are cogwheel rigidity, opisthotonus, spasticity or flaccidity and seizures. Retinal haemorrhages and the classic cherry red skin colour are seldom seen. Different people andpopulations may have different carbon monoxide tolerance levels. On average, exposures at 100ppm or greater is dangerous to human health. Treatment and prevention: The mainstay of treatment is 100% oxygen administration until the COHb level is normal When the patient is stable enough to be transported, hyperbaric oxygen (HBOT should be considered This treatment is safe and well tolerated Public education about the danger of carbon monoxide, with

  13. Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Alisa Wray

    2016-07-01

    Full Text Available Audience: This oral boards case is appropriate for all emergency medicine learners (residents, interns, and medical students. Introduction: Carbon monoxide (CO is a colorless and odorless gas that typically results from combustion. It binds hemoglobin, dissociating oxygen, causing headache, weakness, confusion and possible seizure or coma. Pulse oxygen levels may be falsely elevated. Practitioners should maintain a high index of suspicion for carbon monoxide poisoning. If caught early CO poisoning is reversible with oxygen or hyperbaric oxygen therapy. Objectives: The learner will assess a patient with altered mental status and weakness, ultimately identifying that the patient has carbon monoxide poisoning. The learner will treat the patient with oxygen and admit/transfer the patient for hyperbaric oxygenation. Method: Oral boards case

  14. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Investigations Associated with Non-Fire Carbon Monoxide from Engine-Driven Generators and Other Engine-Driven Tools, 2004–2014 JANUARY 08, 2015 Non- ... outside of the Federal Government. CPSC does not control this external site or its privacy policy and ...

  15. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Español The Invisible Killer Carbon monoxide, also known as CO, is called the "Invisible Killer" because it's ... used or incorrectly-vented fuel-burning appliances such as furnaces, stoves, water heaters and fireplaces. Watch This ...

  16. Search of medical literature for indoor carbon monoxide exposure

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, T.; Ivanovich, M.

    1995-12-01

    This report documents a literature search on carbon monoxide. The search was limited to the medical and toxicological databases at the National Library of Medicine (MEDLARS). The databases searched were Medline, Toxline and TOXNET. Searches were performed using a variety of strategies. Combinations of the following keywords were used: carbon, monoxide, accidental, residential, occult, diagnosis, misdiagnosis, heating, furnace, and indoor. The literature was searched from 1966 to the present. Over 1000 references were identified and summarized using the following abbreviations: The major findings of the search are: (1) Acute and subacute carbon monoxide exposures result in a large number of symptoms affecting the brain, kidneys, respiratory system, retina, and motor functions. (2) Acute and subacute carbon monoxide (CO) poisonings have been misdiagnosed on many occasions. (3) Very few systematic investigations have been made into the frequency and consequences of carbon monoxide poisonings.

  17. Optimization of the National Ignition Facility primary shield design

    International Nuclear Information System (INIS)

    Annese, C.E.; Watkins, E.F.; Greenspan, E.; Miller, W.F.

    1993-10-01

    Minimum cost design concepts of the primary shield for the National Ignition laser fusion experimental Facility (NIF) are searched with the help of the optimization code SWAN. The computational method developed for this search involves incorporating the time dependence of the delayed photon field within effective delayed photon production cross sections. This method enables one to address the time-dependent problem using relatively simple, time-independent transport calculations, thus significantly simplifying the design process. A novel approach was used for the identification of the optimal combination of constituents that will minimize the shield cost; it involves the generation, with SWAN, of effectiveness functions for replacing materials on an equal cost basis. The minimum cost shield design concept was found to consist of a mixture of polyethylene and low cost, low activation materials such as SiC, with boron added near the shield boundaries

  18. Physics and national socialism an anthology of primary sources

    CERN Document Server

    1996-01-01

    This anthology of primary sources is a collection of 121 documents in English translation portraying the role of physics, both perceived and actual, in the Nazi state. These texts were written predominantly by influential German scientists, particularly physicists, both inside and outside Germany in the period from 1933 to 1945. The semipopular articles, private correspondence, and official memoranda selected for the volume reflect the contemporary developments in science as well as the change in political climate and working conditions after the National Socialists' rise to power. The extensive annotation is clearly distinguished from the original text, and the appendix provides an aid to the reader with biographical information on the more important figures and brief outlines of frequently mentioned institutions, journals and companies. The introduction surveys the latest results in the secondary literature.   ------    (…) the envisaged audience includes not only scholars and students of science, hist...

  19. Bacterium oxidizing carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Kistner, A

    1953-01-01

    Present-day knowledge of the microbiological oxidation of carbon monoxide is based on doubtful observations and imperfect experimental procedures. By making use of shake cultures in contact with gas mixtures containing high concentrations of CO and by employing liquid enrichment media with a low content of organic matter and solid media of the same composition with not more than 1.2% agar, it proved possible to isolate a co-oxidizing bacterium of the genus hydrogenomonas from sewage sludge. For the first time irrefutable proof has been given of the oxidation of carbon monoxide by a pure culture of a bacterium, both in growing cultures and in resting cell suspensions. 12 references.

  20. Incidence of the geometric parameters and of flow in the primary ventilation rate and of carbon monoxide emissions in burning atmospherics of medium and high pressure

    International Nuclear Information System (INIS)

    Amell A, Andres; Hernandez V, Jaime; Cortes T, Jaime

    2000-01-01

    In this kind of atmospheric burners, high-pressure gas supply and Venturi geometry guarantee a good primary air entrance for combustion. In this project we analyze the most important burner geometric parameters (outlet diameter, injection diameter and mixer geometry) and gas flux conditions (supply pressure) that have an influence over primary aeration rate. The results of this investigation will contribute with the methodology design improvement, focused to use this kind of burners in our country

  1. Implementing primary health care: some problems of creating national programmes.

    Science.gov (United States)

    Vaughan, J P; Walt, G

    1984-07-01

    While there is a great deal of agreement about the principles underlying Primary Health Care (PHC), there exist many problems, political, planning and management, involved in putting the approach into effect. Some of these difficulties are discussed. It is clear that the PHC approach is essentially political; the way it is implemented in each country will reflect the political priorities and systems of that country. Moreover, ministries of health are not known for their strong position in the ministerial pecking order. Finance and planning ministeries would have to be won over to the importance of the concept of PHC to try to eexpand the health budget and to change the emphasis of existing resource allocation patterns. Costs incurred by a PHC approach ( e.g., expensive transport and communication systems), and resources needed to finance it may be available; however, they may not be channelled to the politically less articulate groups in rural areas. Political implications are not limited to national levels; considerable conflict may exist between different status groups and classes at the village level, thus sabotaging PHC plans. Professional politics will also be played at all levels. It is equally essential to recognize the historical context in which PHC is being introduced. Many countries have inherited colonial infrastructures. Changing the values, perceptions, expectations, administration and organization that accompany such systems is extremely hard, and to put PHC into effect demands radical changes. The planning difficulties which beset PHC are related to the still large private provision of social services like health, and to a flourishing traditional private sector in many developing countries. These may limit the implementation of a national health policy and PHC may thus result in a very patchy service throughout the country. The level of centralized planning will also affect resource allocation and therefore the policy, planning and implementation

  2. Radon in Irish primary and post-primary schools. The results of a national survey

    International Nuclear Information System (INIS)

    Synnott, H.; Fennell, S.; Pollard, D.; Colgan, P.A.; Hanley, O.; O'Colmain, M.; Maloney, L.

    2004-05-01

    This report presents the results of a survey of radon concentrations in schools in the Republic of Ireland. The survey was carried out by the Radiological Protection Institute of Ireland (RPII) on behalf of the Department of Education and Science. A workplace Reference Level of 400 Bq/m3 is set down in national legislation. However, in the case of schools the RPII has recommended that, wherever possible, radon concentrations should be reduced to below 200 Bq/m3. The objective of the survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. The survey was carried out on a phased basis from 1998 to 2002. All schools in the Free Education System were invited to participate. Indoor radon concentrations were measured using passive alpha track-etch detectors with a measurement period of one academic year from September to the following June. Measurements were completed in the ground floor classrooms and offices of 3444 schools, representing over 85% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 898 had radon concentrations greater than 200 Bq/m3 and 307 had radon concentrations in excess of the national Reference Level for workplaces of 400 Bq/m3 in one or more ground floor rooms. The average radon concentration in the schools surveyed was 93 Bq/m3. Different remediation strategies have been adopted for schools with maximum radon concentrations between 200 and 400 Bq/m3 and for schools with radon concentrations in excess of 400 Bq/m3. In schools with radon concentrations below 400 Bq/m3, passive remediation through increased background ventilation is, where practicable, being used to reduce the radon concentrations. Where the initial radon concentration exceeded 400 Bq/m3, a remediation consultant assessed the school and remedial measures specific to each school have been designed. In the majority of these cases active remediation in the

  3. 78 FR 10269 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2013-02-13

    ... Illness CWS--Community Water System DBP--Disinfection Byproduct DWC--Drinking Water Committee EA--Economic... 141 and 142 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule; Final...-9684-8] RIN 2040-AD94 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule...

  4. 76 FR 9409 - National Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting

    Science.gov (United States)

    2011-02-17

    ... National Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting; Proposed Rule #0;#0... Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting AGENCY: Environmental Protection... standards for hazardous air pollutants (NESHAP) for Primary Lead Smelting to address the results of the...

  5. Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

    Science.gov (United States)

    Susilana, Rudi; Asra

    2013-01-01

    The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

  6. Iron monoxide photodissociation

    Science.gov (United States)

    Chestakov, D. A.; Parker, D. H.; Baklanov, A. V.

    2005-02-01

    The photodissociation of Fe56O was studied by means of the velocity map imaging technique. A molecular beam of iron atoms and iron monoxide molecules was created using an electrical discharge with an iron electrode in a supersonic expansion of molecular oxygen. The ground state iron atom Fe(D45) and FeO concentrations in the molecular beam have been estimated. The dissociation energy of the FeO XΔ5 ground electronic state was found to be D00(FeO )=4.18±0.01eV. The effective absorption cross section of FeO at 252.39nm (vac), leading to the Fe(D45)+O(P3) dissociation channel, is ˜1.2×10-18cm2. A (1+1) resonantly enhanced multiphoton ionization spectrum of Fe56O in the region 39550-39580 cm-1 with rotational structure has been observed, but not assigned. Angular distributions of Fe(D45) and Fe(D35) products for the channel FeO →Fe(D4,35)+O(P3) have been measured at several points in the 210-260nm laser light wavelength region. The anisotropy parameter varies strongly with wavelength for both channels.

  7. Clinical findings confirm national guidelines regarding primary gastroscopy for upper gastrointestinal symptoms

    DEFF Research Database (Denmark)

    Rolff, Hans Christian; Simonsen, Louise Rolighed; Rosenberg, Jacob

    2011-01-01

    This study describes unsedated transnasal oesophagogastroduodenoscopy (UT-OGD) in the office setting. Evaluation of national guidelines regarding primary endoscopy for the investigation of upper gastrointestinal (GI) symptoms was also a focus of this study....

  8. Primary Aluminum Reduction Industry - National Emission Standards for Hazardous Air Pollutants (NESHAP)

    Science.gov (United States)

    National emission standards for each new or existing potline, paste production operation, and anode bake furnace associated with a primary aluminum reduction plant. Includes rule history, implementation information and additional resources.

  9. Catalytic hydrogenation of carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Wayland, B.B.

    1992-12-01

    This project is focused on developing strategies to accomplish the reduction and hydrogenation of carbon monoxide to produce organic oxygenates at mild conditions. Our approaches to this issue are based on the recognition that rhodium macrocycles have unusually favorable thermodynamic values for producing a series of intermediate implicated in the catalytic hydrogenation of CO. Observations of metalloformyl complexes produced by reactions of H{sub 2} and CO, and reductive coupling of CO to form metallo {alpha}-diketone species have suggested a multiplicity of routes to organic oxygenates that utilize these species as intermediates. Thermodynamic and kinetic-mechanistic studies are used in constructing energy profiles for a variety of potential pathways, and these schemes are used in guiding the design of new metallospecies to improve the thermodynamic and kinetic factors for individual steps in the overall process. Variation of the electronic and steric effects associated with the ligand arrays along with the influences of the reaction medium provide the chemical tools for tuning these factors. Emerging knowledge of the factors that contribute to M-H, M-C and M-O bond enthalpies is directing the search for ligand arrays that will expand the range of metal species that have favorable thermodynamic parameters to produce the primary intermediates for CO hydrogenation. Studies of rhodium complexes are being extended to non-macrocyclic ligand complexes that emulate the favorable thermodynamic features associated with rhodium macrocycles, but that also manifest improved reaction kinetics. Multifunctional catalyst systems designed to couple the ability of rhodium complexes to produce formyl and diketone intermediates with a second catalyst that hydrogenates these imtermediates are promising approaches to accomplish CO hydrogenation at mild conditions.

  10. Constructing a Successful Cross-National Virtual Learning Environment in Primary and Secondary Education

    NARCIS (Netherlands)

    Ligorio, Maria Beatrice; van Veen, Klaas

    2006-01-01

    Virtual environments are more and more used in primary schools. One of the most interesting potentialities of these environments is to foster cross-national applications. Yet, this specific feature is not fully exploited. This paper presents a successful virtual learning environment for primary

  11. Expanding Global Language Education in Public Primary Schools: The National English Programme in Mexico

    Science.gov (United States)

    Sayer, Peter

    2015-01-01

    The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…

  12. Comparing primary energy attributed to renewable energy with primary energy equivalent to determine carbon abatement in a national context.

    Science.gov (United States)

    Gallachóir, Brian P O; O'Leary, Fergal; Bazilian, Morgan; Howley, Martin; McKeogh, Eamon J

    2006-01-01

    The current conventional approach to determining the primary energy associated with non-combustible renewable energy (RE) sources such as wind energy and hydro power is to equate the electricity generated from these sources with the primary energy supply. This paper compares this with an approach that was formerly used by the IEA, in which the primary energy equivalent attributed to renewable energy was equated with the fossil fuel energy it displaces. Difficulties with implementing this approach in a meaningful way for international comparisons lead to most international organisations abandoning the primary energy equivalent methodology. It has recently re-emerged in prominence however, as efforts grow to develop baseline procedures for quantifying the greenhouse gas (GHG) emissions avoided by renewable energy within the context of the Kyoto Protocol credit trading mechanisms. This paper discusses the primary energy equivalent approach and in particular the distinctions between displacing fossil fuel energy in existing plant or in new plant. The approach is then extended provide insight into future primary energy displacement by renewable energy and to quantify the amount of CO2 emissions avoided by renewable energy. The usefulness of this approach in quantifying the benefits of renewable energy is also discussed in an energy policy context, with regard to increasing security of energy supply as well as reducing energy-related GHG (and other) emissions. The approach is applied in a national context and Ireland is case study country selected for this research. The choice of Ireland is interesting in two respects. The first relates to the high proportion of electricity only fossil fuel plants in Ireland resulting in a significant variation between primary energy and primary energy equivalent. The second concerns Ireland's poor performance to date in limiting GHG emissions in line with its Kyoto target and points to the need for techniques to quantify the potential

  13. MLS/Aura L2 Chlorine Monoxide (ClO) Mixing Ratio V002

    Data.gov (United States)

    National Aeronautics and Space Administration — ML2CLO is the EOS Aura Microwave Limb Sounder (MLS) standard product for chlorine monoxide derived from radiances measured primarily by the 640 GHz radiometer. The...

  14. Findings from the 2013 NZCER Primary and Intermediate Schools National Survey

    Science.gov (United States)

    New Zealand Council for Educational Research, 2014

    2014-01-01

    The New Zealand Council for Educational Research (NZCER) primary and intermediate schools national survey was carried out in July-August 2013. NZCER questioned principals, teachers and trustees at a representative sample of schools, and sought the views of a random sample of 1 in 4 parents in 36 of these schools. In all, the survey gathered data…

  15. Arts Shoved Aside: Changing Art Practices in Primary Schools since the Introduction of National Standards

    Science.gov (United States)

    Irwin, Michael Ray

    2018-01-01

    This article reports on the understandings and practices of primary teachers in implementing the arts curriculum since the 2010 introduction of National Standards in Numeracy and Literacy within the New Zealand Education system. The ever-mounting pressure on schools to perform to these standards has resulted in a reduction of emphasis and time…

  16. The National Singing Programme for Primary Schools in England: An Initial Baseline Study

    Science.gov (United States)

    Welch, G. F.; Himonides, E.; Papageorgi, I.; Saunders, J.; Rinta, T.; Stewart, C.; Preti, C.; Lani, J.; Vraka, M.; Hill, J.

    2009-01-01

    The "Sing Up" National Singing Programme for primary schools in England was launched in November 2007 under the UK government's "Music Manifesto". "Sing Up" is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as…

  17. Carbon monoxide budget in the northern hemisphere

    Energy Technology Data Exchange (ETDEWEB)

    Bakwin, P.S.; Tans, P.P. (Climate Monitoring and Diagnostics Lab., Boulder, CO (United States)); Novelli, P.C. (Univ. of Colorado, Boulder, CO (United States))

    1994-03-15

    To improve urban air quality the major industrialized nations of the West took steps during the 1970s and 1980s to reduce carbon monoxide (CO) emissions from automobiles and other industrial sources. Overall, CO/CO[sub 2] emission ratios from the mix of fossil fuel combustion sources have been reduced by about half during 1976-1990. Also, the tropospheric abundance of hydroxyl radical (OH), which is the main sink for CO, is proposed to have increased globally by about 1.0 [+-] 0.8% yr[sup [minus]1]. The authors use a simple two-box model to examine the impact of shrinking emissions and increasing OH on the global abundance of CO. They find that these factors contribute about equally in reducing CO levels in the Northern Hemisphere troposphere by about 1.8 [+-] 0.8 ppb yr[sup [minus]1] on average. 19 refs., 1 fig.

  18. Selected constituents in the smokes of foreign commercial cigaretts: tar, nicotine, carbon monoxide, and carbon dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, R.A.; Quincy, R.B.; Guerin, M.R.

    1979-05-01

    The tar, nicotine, carbon monoxide, and carbon dioxide contents of the smokes of 220 brands of foreign commercial cigarettes are reported. In some instances, filter cigarettes of certain brands were found to deliver as much or more smoke constituents than their nonfilter counterparts. Also, data indicated that there can be a great variation in the tar, nicotine, or carbon monoxide content of the smoke of samples of a given brand of cigarettes, depending on the nation in which they are purchased. 24 tables.

  19. 78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

    Science.gov (United States)

    2013-08-05

    ... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide (SO 2 ) National Ambient Air Quality Standard (NAAQS). The EPA is issuing this rule to identify areas...

  20. 40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... the data handling procedures for the reported data). 2.3Comparisons with the Primary and Secondary... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY...

  1. Carbon monoxide, smoking, and atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Astrup, P

    1973-10-01

    Studies on the effects of carbon monoxide and smoking on atherosclerosis are reviewed. Nonsmokers do not run the risk of getting significantly elevated carboxyhemoglobin levels from automobile exhaust in the streets, however, they do run the risk of getting elevated carboxyhemoglobin levels from exposure to CO in closed areas such as garages and tunnels. Carboxyhemoglobin levels up to 20 percent may also be found in smokers. The central nervous system seems to be influenced by carboxyhemoglobin concentrations up to 20 percent. The myocardium may also be affected. Experimental work with rabbits exposed to carbon monoxide and cholesterol is described which proved that CO has a damaging effect on arterial walls, leading to increased permeability for various plasma components, to the formation of subendothelial edema, and to increased atheromatosis. The results indicate that the much higher risk of smokers of developing arterial disease in comparison to nonsmokers is mainly due to the inhaled CO in the tobacco smoke and not to nicotine. (Air Pollut. Abstr.)

  2. Measurement of Air Pollution from Satellites (MAPS) Space Radar Laboratory - 1 (SRL1) Carbon Monoxide Second by Second data

    Data.gov (United States)

    National Aeronautics and Space Administration — MAPS Overview The MAPS experiment measures the global distribution of carbon monoxide (CO) mixing ratios in the free troposphere. Because of MAPS' previous flights...

  3. Measurement of Air Pollution from Satellites (MAPS) Space Radar Laboratory - 2 (SRL2) Carbon Monoxide Second by Second data

    Data.gov (United States)

    National Aeronautics and Space Administration — MAPS Overview The MAPS experiment measures the global distribution of carbon monoxide (CO) mixing ratios in the free troposphere. Because of MAPS' previous flights...

  4. Catalytic hydrogenation of carbon monoxide

    International Nuclear Information System (INIS)

    Wayland, B.B.

    1993-12-01

    Focus of this project is on developing new approaches for hydrogenation of carbon monoxide to produce organic oxygenates at mild conditions. The strategies to accomplish CO reduction are based on favorable thermodynamics manifested by rhodium macrocycles for producing a series of intermediates implicated in the catalytic hydrogenation of CO. Metalloformyl complexes from reactions of H 2 and CO, and CO reductive coupling to form metallo α-diketone species provide alternate routes to organic oxygenates that utilize these species as intermediates. Thermodynamic and kinetic-mechanistic studies are used in guiding the design of new metallospecies to improve the thermodynamic and kinetic factors for individual steps in the overall process. Electronic and steric effects associated with the ligand arrays along with the influences of the reaction medium provide the chemical tools for tuning these factors. Non-macrocyclic ligand complexes that emulate the favorable thermodynamic features associated with rhodium macrocycles, but that also manifest improved reaction kinetics are promising candidates for future development

  5. Access to primary energy sources - the basis of national energy security

    Science.gov (United States)

    Szlązak, Jan; Szlązak, Rafał A.

    2017-11-01

    National energy security is of fundamental importance for economic development of a country. To ensure such safety energy raw material, also called primary energy sources, are necessary. Currently in Poland primary energy sources include mainly fossil fuels, such as hard coal, brown coal, natural gas and crude oil. Other sources, e.g. renewable energy sources account for c. 15% in the energy mix. Primary energy sources are used to produce mainly electricity, which is considered as the cleanest form of energy. Poland does not have, unfortunately, sufficient energy sources and is forced to import some of them, mainly natural gas and crude oil. The article presents an insightful analysis of energy raw material reserves possessed by Poland and their structure taking account of the requirements applicable in the European Union, in particular, those related to environmental protection. The article also describes demand for electricity now and in the perspective of 2030. Primary energy sources necessary for its production have also been given. The article also includes the possibilities for the use of renewable energy sources in Poland, however, climatic conditions there are not are not particularly favourable to it. All the issues addressed in the article are summed up and ended with conclusions.

  6. National Physical Education Standards: Level of Physical Fitness Male Student Primary School in Malaysia

    OpenAIRE

    Ahmad Hashim; Mohd. Sani Madon; Nur Haziyanti Mohd Khalid; Nelfianty binti Mohd Rashid; Sadzali bin Hassan; Yusop bin Ahmad

    2014-01-01

    This study aims to analyze the level of physical fitness in the development of the National Standards of Physical Education. The study was conducted on 279 primary school boys age 10 years (n = 79), 11 years (n = 94) and 12 years (n = 106) in five randomly selected schools in the state of Perak. FITNESSGRAM was used to test the level of physical fitness among subjects. This includes trunk lift, 90 degree push-ups, modified pull-up, back saver sit and reach and PACER. ANOVA analysis showed a s...

  7. Delayed encephalopathy after acute carbon monoxide poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet İbrahim Turan

    2014-03-01

    Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

  8. Review: hemodynamic response to carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Penney, D.G.

    1988-04-01

    Historically, and at present, carbon monoxide is a major gaseous poison responsible for widespread morbidity and mortality. From threshold to maximal nonlethal levels, a variety of cardiovascular changes occur, both immediately and in the long term, whose homeostatic function it is to renormalize tissue oxygen delivery. However, notwithstanding numerous studies over the past century, the literature remains equivocal regarding the hemodynamic responses in animals and humans, although CO hypoxia is clearly different in several respects from hypoxic hypoxia. Factors complicating interpretation of experimental findings include species, CO dose level and rate, route of CO delivery, duration, level of exertion, state of consciousness, and anesthetic agent used. Augmented cardiac output usually observed with moderate COHb may be compromised in more sever poisoning for the same reasons, such that regional or global ischemia result. The hypotension usually seen in most animal studies is thought to be a primary cause of CNS damage resulting from acute CO poisoning, yet the exact mechanism(s) remains unproven in both animals and humans, as does the way in which CO produces hypotension. This review briefly summarizes the literature relevant to the short- and long-term hemodynamic responses reported in animals and humans. It concludes by presenting an overview using data from a single species in which the most complete work has been done to date.

  9. National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

    Science.gov (United States)

    Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

    2017-12-01

    To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  10. Inhibition of photosynthesis by carbon monoxide and suspension of the carbon monoxide inhibition by light

    Energy Technology Data Exchange (ETDEWEB)

    Gewitz, H S; Voelker, W

    1963-08-01

    The experimental subject was the autotroph Chlorella pyrenoidosa. It was found that growth conditions determine whether the alga is inhibited by carbon monoxide or not. Respiration and photosynthesis are inhibited by carbon monoxide if the cells have grown rapidly under high light intensities. The inhibition of respiration and photosynthesis found in such cells is completely reversible. The inhibition depends not only on carbon monoxide pressure, but also on the oxygen pressure prevailing at the same time. 5 references, 1 figure, 3 tables.

  11. Dental Procedures in Primary Health Care of the Brazilian National Health System

    Directory of Open Access Journals (Sweden)

    Suellen R. Mendes

    2017-12-01

    Full Text Available The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013–2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental need deliver the lowest number of dental procedures. The need to tackle inequalities and further shape the supply of appropriate primary health care (PHC is evident.

  12. Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

    Science.gov (United States)

    Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

    2009-01-01

    Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

  13. Primary care physician decision making regarding referral for bariatric surgery: a national survey.

    Science.gov (United States)

    Stolberg, Charlotte Røn; Hepp, Nicola; Juhl, Anna Julie Aavild; B C, Deepti; Juhl, Claus B

    2017-05-01

    Bariatric surgery is the most effective treatment for severe obesity. It results in significant and sustained weight loss and reduces obesity-related co-morbidities. Despite an increasing prevalence of severe obesity, the number of bariatric operations performed in Denmark has decreased during the past years. This is only partly explained by changes in the national guidelines for bariatric surgery. The purpose of the cross-sectional study is to investigate referral patterns and possible reservations regarding bariatric surgery among Danish primary care physicians (PCPs). Primary care physicians in Denmark METHODS: A total of 300 Danish PCPs were invited to participate in a questionnaire survey regarding experiences with bariatric surgery, reservations about bariatric surgery, attitudes to specific patient cases, and the future treatment of severe obesity. Most questions required a response on a 5-point Likert scale (strongly disagree, disagree, neither agree nor disagree, agree, and strongly agree) and frequency distributions were calculated. 133 completed questionnaires (44%) were returned. Most physicians found that they had good knowledge about the national referral criteria for bariatric surgery. With respect to the specific patient cases, a remarkably smaller part of physicians would refer patients on their own initiative, compared with the patient's initiative. Fear of postoperative surgical complications and medical complications both influenced markedly the decision to refer patients for surgery. Only 9% of the respondents indicated that bariatric surgery should be the primary treatment option for severe obesity in the future. Danish PCPs express severe concerns about surgical and medical complications following bariatric surgery. This might, in part, result in a low rate of referral to bariatric surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  14. Polyketones as alternating copolymers of carbon monoxide

    International Nuclear Information System (INIS)

    Belov, Gennady P; Novikova, Elena V

    2004-01-01

    Characteristic features of the catalytic synthesis of alternating copolymers of carbon monoxide with various olefins, dienes, styrene and its derivatives are considered. The diversity of catalyst systems used for the copolymerisation of carbon monoxide is demonstrated and their influence on the structure and the molecular mass of the resulting copolymers is analysed. The data on the structure and physicochemical and mechanical properties of this new generation of functional copolymers are generalised and described systematically for the first time.

  15. Hearing Loss due to Carbon Monoxide Poisoning

    DEFF Research Database (Denmark)

    Mehrparvar, Amir Houshang; Davari, Mohammad Hossein; Mollasadeghi, Abolfazl

    2013-01-01

    Carbon monoxide poisoning is one of the rare causes of hearing loss which may cause reversible or irreversible, unilateral or bilateral hearing loss after acute or chronic exposure. In this report, we present a case of bilateral sensorineural hearing loss in a secondary smelting workshop worker...... after an acute exposure to carbon monoxide. This complication was diagnosed by pure-tone audiometry and confirmed by transient evoked otoacoustic emissions. Hearing loss has not improved after 3 months of followup....

  16. Electrocatalytic oxidation of carbon monoxide

    Directory of Open Access Journals (Sweden)

    Manuel de Jesus Santiago Farias

    2009-01-01

    Full Text Available Este trabalho discute alguns aspectos importantes relacionados à reação de eletrooxidação do monóxido de carbono sobre monocristais de platina, em meio ácido. Aspectos mecanísticos são discutidos em termos da formação das estruturas compactas que o CO forma quando este é adsorvido. As principais idéias aqui apresentadas, levam em consideração as existências dessas estruturas. Os clássicos mecanismos Lagmuir-Hinshelwood e Eley-Rideal são aqui discutidos, especialmente o primeiro considerando a mobilidade do CO e também a nucleação e crescimento de ilhas formadas por espécies adsorvidas contendo oxigênio.////////// This work discusses some important aspects related to the carbon monoxide electrooxidation reaction on Pt single crystal electrodes in acidic media. The mechanistic aspects are discussed in terms of the formation of compact structures developed when CO is adsorbed. The main ideas presented here are focused on the mechanistic aspects that take into account the existence of such structures. The classical kinetic mechanisms of Lagmuir-Hinshelwood and Eley-Rideal are discussed considering the superficial mobility of CO or nucleation-growing of islands formed by oxygen-containing adsorbates.

  17. 40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section 50.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL...

  18. A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

    Science.gov (United States)

    Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

    2017-08-04

    Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

  19. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

    Science.gov (United States)

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Background Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. Aim To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Design and setting Clinical audit of cancer diagnosis in general practices in England. Method Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Results Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. Conclusion The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. PMID:29255111

  20. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit.

    Science.gov (United States)

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Clinical audit of cancer diagnosis in general practices in England. Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15-86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0-27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. © British Journal of General Practice 2018.

  1. Trends in primary and revision anterior cruciate ligament reconstruction among National Basketball Association team physicians.

    Science.gov (United States)

    Mall, Nathan A; Abrams, Geoffrey D; Azar, Frederick M; Traina, Steve M; Allen, Answorth A; Parker, Richard; Cole, Brian J

    2014-06-01

    Anterior cruciate ligament (ACL) tears are common in athletes. Techniques and methods of treatment for these injuries continue to vary among surgeons. Thirty National Basketball Association (NBA) team physicians were surveyed during the NBA Pre-Draft Combine. Survey questions involved current and previous practice methods of primary and revision ACL reconstruction, including technique, graft choice, rehabilitation, and treatment of combined ACL and medial collateral ligament injuries. Descriptive parametric statistics, Fisher exact test, and logistic regression were used, and significance was set at α = 0.05. All 30 team physicians completed the survey. Eighty-seven percent indicated they use autograft (81% bone-patellar tendon-bone) for primary ACL reconstruction in NBA athletes, and 43% indicated they use autograft for revision cases. Fourteen surgeons (47%) indicated they use an anteromedial portal (AMP) for femoral tunnel drilling, whereas 5 years earlier only 4 (13%) used this technique. There was a significant (P = .009) positive correlation between fewer years in practice and AMP use. NBA team physicians' use of an AMP for femoral tunnel drilling has increased over the past 5 years.

  2. National program for family planning and primary health care Pakistan: a SWOT analysis.

    Science.gov (United States)

    Wazir, Mohammad Salim; Shaikh, Babar Tasneem; Ahmed, Ashfaq

    2013-11-22

    The National Program for Family Planning and Primary Healthcare was launched in 1994. It is one of the largest community based programs in the world, providing primary healthcare services to about 80 million people, most of which is rural poor. The program has been instrumental in improving health related indicators of maternal and child health in the last two decades. SWOT analysis was used by making recourse to the structure and dynamics of the program as well as searching the literature. Strengths of the program include: comprehensive design of planning, implementation and supervision mechanisms aided by an MIS, selection and recruitments processes and evidence created through improving health impact indicators. Weaknesses identified are slow progress, poor integration of the program with health services at local levels including MIS, and de-motivational factors such as job insecurity and non-payment of salaries in time. Opportunities include further widening the coverage of services, its potential contribution to health system research, and its use in areas other than health like women empowerment and poverty alleviation. Threats the program may face are: political interference, lack of funds, social threats and implications for professional malpractices. Strengthening of the program will necessitate a strong political commitment, sustained funding and a just remuneration to this bare foot doctor of Pakistan, the Lady Health Worker.

  3. Determinants of outpatient expenditure within primary care in the Brazilian National Health System

    Directory of Open Access Journals (Sweden)

    Bruna Camilo Turi

    2017-04-01

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP, Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests. Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01, hypertension (OR = 3.04; 95% CI: 1.91-4.82 and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81. Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47 and female sex (OR = 1.70; 95% CI: 1.14-2.55. CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.

  4. A national day with near zero emissions and its effect on primary and secondary pollutants

    Science.gov (United States)

    Levy, Ilan

    2013-10-01

    Traffic related air pollution is a major health concern in many countries. The potential costs and benefits of different abatement policies are usually estimated by either models, case studies or previously implemented intervention measures. Such estimations have, however, limited ability to predict the effect of a reduction in primary pollutants' emissions on secondary pollutants such as ozone, because of the nonlinear nature of the photochemical reactions. This study examines the short term effects of a drastic change in emissions on a national scale during the Jewish holiday of Day of Atonement (DA) in Israel. During the holiday nearly all anthropogenic emission sources are ceased for a period of 25 h, including all vehicles, commercial, industrial and recreational activities. DAs during the 15 years period of 1998-2012 are analyzed at three sites with respect to primary and secondary air pollutants, and in greater details for 2001. A dramatic decrease in primary pollutants emissions (83-98% in NO) causes an 8 ppbv increase in ozone at the urban core. Downwind (27 km), ozone decreases by only 5 ppbv. Nighttime O3 is shown to increase to 20 ppbv at the urban sites and 30 ppbv downwind. In spite of the striking reduction in emissions, changes in ozone are not greater than what is reported in the literature about less significant events like the ozone weekend effect. Changes in ambient pollution levels observed during DA provide some indication to the possible outcomes of a major change in anthropogenic emissions. These may be considered as the best case scenario for emissions reduction intervention measures and thus aid policy makers in evaluating potential benefits of such measures.

  5. Enzymic oxidation of carbon monoxide. II

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, T

    1959-01-01

    An enzyme which catalyzes the oxidation of carbon monoxide into carbon dioxide was obtained in a cell free state from Desulfovibrio desulfuricans. The enzyme activity was assayed manometrically by measuring the rate of gas uptake under the atmosphere of carbon monoxide in the presence of benzyl-viologen as an oxidant. The optimum pH range was 7 to 8. The activity was slightly suppressed by illumination. The enzyme was more stable than hydrogenase or formate dehydrogenase against the heat treatment, suggesting that it is a different entity from these enzymes. In the absence of an added oxidant, the enzyme preparation produced hydrogen gas under the atmosphere of carbon monoxide. The phenomenon can be explained assuming the reductive decomposition of water. 17 references, 4 figures, 2 tables.

  6. Effect of vegetation in reducing carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, J C

    1977-01-01

    Carbon monoxide is a product of incomplete combustion. Because almost all of this gas is produced by motor vehicles, it is considered to have a line rather than a stationary point source. Greatest concentrations of this lethal gas correspond to periods of peak traffic volume and congestion; therefore, there are two daily periods of maxima and minima. Carbon monoxide cannot be detected by sight or smell. For this reason, this gas is especially deadly. During the summer of 1975, a study involving carbon monoxide concentrations at selected sites in Sendai was undertaken in conjunction with an ongoing investigation of urban pollution under the directorship of Professor Toshio Noh of Tohoku University. This study was made possible by a grant from the Japan Society for the Promotion of Science. 5 references, 5 figures, 1 table.

  7. Partnership effectiveness in primary community care networks: A national empirical analysis of partners' coordination infrastructure designs.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh

    2010-01-01

    Previous empirical and managerial studies have ignored the effectiveness of integrated health networks. It has been argued that the varying definitions and strategic imperatives of integrated organizations may have complicated the assessment of the outcomes/performance of varying models, particularly when their market structures and contexts differed. This study aimed to empirically verify a theoretical perspective on the coordination infrastructure designs and the effectiveness of the primary community care networks (PCCNs) formed and funded by the Bureau of National Health Insurance since March 2003. The PCCNs present a model to replace the traditional fragmented providers in Taiwan's health care. The study used a cross-sectional mailed survey designed to ascertain partnership coordination infrastructure and integration of governance, clinical care, bonding, finances, and information. The outcome indicators were PCCNs' perceived performance and willingness to remain within the network. Structural equation modeling examined the causal relationships, controlling for organizational and environmental factors. Primary data collection occurred from February through December 2005, via structured questionnaires sent to 172 PCCNs. Using the individual PCCN as the unit of analysis, the results found that a network's efforts regarding coordination infrastructures were positively related to the PCCN's perceived performance and willingness to remain within the network. In addition, PCCNs practicing in rural areas and in areas with higher density of medical resources had better perceived effectiveness and willingness to cooperate in the network.Practical Implication: The lack of both an operational definition and an information about system-wide integration may have obstructed understanding of integrated health networks' organizational dynamics. This study empirically examined individual PCCNs and offers new insights on how to improve networks' organizational design and

  8. Pulmonary edema in acute carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk

    1974-01-01

    Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis

  9. Occupational medicine effects of carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Coombs, W.M. [South African Society of Occupational Medicine (South Africa)

    1998-10-01

    Carbon monoxide can affect the body if it is inhaled or if liquid carbon monoxide comes in contact with the eyes or skin. The effects of overexposure are discussed and a brief explanation of the toxicological effects of CO given. Methods of control of CO from common operations (exhaust fumes of internal combustion engines, the chemical industry and foundries, welding, mines or tunnels, fire damp explosions, industrial heating) are by local exhaust ventilation or use of a respiratory protective device. The South African hazardous chemical substance regulation NO. R. 1179 of 25 August 1995 stipulates maximum safe levels of CO concentration. 4 refs., 1 photo.

  10. Pulmonary edema in acute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis.

  11. Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

    Science.gov (United States)

    Holt, Kelsey; Janiak, Elizabeth; McCormick, Marie C; Lieberman, Ellice; Dehlendorf, Christine; Kajeepeta, Sandhya; Caglia, Jacquelyn M; Langer, Ana

    2017-07-01

    Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to options counseling for unintended pregnancy. We assessed predictors of physician practices using multivariable logistic regression weighted for sampling design and differential non-response. Response rate was 29%. Seventy-one percent believed residency training in options counseling should be required, and 69% believed PCPs have an obligation to provide abortion referrals even in the presence of a personal objection to abortion. However, only 26% reported routine options counseling when caring for women with unintended pregnancy compared to 60% who routinely discuss prenatal care. Among physicians who see women seeking abortion, 62% routinely provide referrals, while 14% routinely attempt to dissuade women. Family physicians were more likely to provide routine options counseling when seeing patients with unintended pregnancy than internal medicine physicians (32% vs 21%, P=0.002). In multivariable analyses, factors associated with higher odds of routine abortion referrals were more years in practice (OR=1.03 for each additional year, 95% CI: 1.00-1.05), identifying as a woman vs a man (OR=2.11, 95% CI: 1.31-3.40), practicing in a hospital vs private primary care/multispecialty setting (OR=3.17, 95% CI: 1.10-9.15), and no religious affiliation of practice vs religious affiliation (OR for Catholic affiliation=0.27, 95% CI: 0.11-0.66; OR for other religious affiliation=0.36, 95% CI: 0.15-0.83). Personal Christian religious affiliation among physicians who regularly attend religious services vs no religious affiliation was associated with lower odds of counseling (OR=0.48, 95% CI: 0.26-0.90) and referrals (OR=0.31, 95% CI: 0.15-0.62), and higher odds of abortion dissuasion (OR=4.03, 95

  12. A national probability survey of American Medical Association gynecologists and primary care physicians concerning menopause.

    Science.gov (United States)

    Singh, Betsy; Liu, Xiao-Dong; Der-Martirosian, Claudia; Hardy, Mary; Singh, Vijay; Shepard, Neil; Gandhi, Sonal; Khorsan, Raheleh

    2005-09-01

    This survey intended to clarify physicians' understanding of the issues surrounding women, menopause, alternative medicine, and drug therapy for the treatment of menopause. This study was designed as a national probability sample survey of primary care physicians and gynecologists nationwide. Its focus was to identify major concerns and issues identified by patients about menopause and perceived communication with effectiveness how to communicate with their patients. Physicians were also asked to rate their comfort level in recommending the use of herbal remedies and which herbal remedy they felt comfortable recommending to interested patients. Data indicated that a patient's complaint about menopausal symptoms was the most common factor leading to discussion of menopausal issues with physicians (91%) and that the primary concern to the patient was management of menopausal symptoms. Other factors were controversies about hormone replacement therapy, long-term health implications of menopause, and hormone replacement therapy. Eighty percent of the physician found confusing messages with regard to menopause to be the most challenging aspect in patient communication. The second most challenging issue is "inconclusive data about hormone replacement therapy" (56%). Seventy-six percent of the physicians found "showing sympathy" to be the most important factor for the physicians to communicate effectively with patients, whereas "being honest and open" was the most important patient attitude cited for the same purpose. When it comes to herbal therapy for menopause symptom control, only 4% of the physicians indicated that none of their patients take any remedies. Only 18% were not very comfortable in discussing or recommending herbal therapies, whereas the rest ranged from fairly comfortable to completely comfortable. This study has provided data with regard to physician understanding of menopause treatment options and their primary interaction with patients on this issue

  13. Stress sources and manifestations in a nation-wide sample of pre-primary, primary and secondary educators in Greece

    Directory of Open Access Journals (Sweden)

    Nadia eKourmousi

    2016-04-01

    Full Text Available BackgroundTeachers experience high levels of stress as a result of their professional duties and research has shown a growing interest in this phenomenon during the recent years. Aim of this study was to explore the associations of stress sources and manifestations with individual and job-related characteristics in educators of all levels. MethodsIn a cross–sectional design, following an informative e-campaign on the study aims through the official and the main teachers’ portals in Greece, respondents completed online the Teachers Stress Inventory (TSI and the 14-item Perceived Stress Scale (PSS-14. 974 male and 2473 female pre-primary, primary and secondary educators with a mean age of 41.2 years responded. ResultsWomen and younger teachers reported significantly higher levels of stress, mainly due to lack of time and other work-related stressors, and also more emotional and gastronomic manifestations. Increased age and working experience were associated with lower levels of several stress sources. Teachers of administrative positions had increased time management stressors, but less professional distress, professional investment and discipline and motivation stressors. Additionally, working and residing far from family increased teachers’ stress levels associated to control, motivation and investment. Teachers of pre-primary education had reduced professional investment and motivation stress factors while vocational lyceum teachers of secondary education reported less work-related stressors and manifestations and more discipline and motivation related ones. Having students supported or in need of support from special educators and students with difficulties in speaking or comprehension was associated with most of the teachers' stress sources and manifestations (i.e. TSI subscales. Finally, colleagues’ and mainly supervisors' support seemed to provide a strong and consistent protection against both stress sources and manifestations

  14. Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis.

    Science.gov (United States)

    Henderson, E J; Ells, L J; Rubin, G P; Hunter, D J

    2015-11-01

    This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  15. Overview of the current National Primary Drinking Water Regulations and regulation development process

    International Nuclear Information System (INIS)

    Cotruvo, J.A.; Regelski, M.

    1989-01-01

    The promulgation of the National Primary Drinking Water Regulations (NPDWR) follows specific steps. First, the Advance Notice of Proposed Rule Making (ANPRM) is published. Second, the EPA, as mandated by the SDWA Amendments, proposes maximum contaminant levels (MCLs), (enforceable standards) and maximum contaminant level goals (MCLGs) simultaneously. The Office of Drinking Water developed a six-phase schedule that has attempted to parallel the SDWA-specified deadlines: Phase I - Voltile organic chemicals - July 8, 1987; Phase II - Synthetic organic chemicals and inorganic chemicals - June 1989, microbials and surface water treatment - June 1989, and Lead/copper - December 1988; Phase III - Radionuclides - December 1988; Phase IV - Disinfectants and disinfection by-products - June 1989; Phase V - Other inorganic chemicals, synthetic organic chemicals, and pesticides - June 1989; and Phase VI - 25 additional chemicals - January 199. In selecting contaminants for regulation, the most relevant criteria are (1) potential health risk; (2) ability to detect a contaminant in the drinking water; and (3) occurrence or potential occurrence in drinking water. The EPA uses a three category approach for setting maximum contaminant level goals for carcinogens: Category I, strong evidence of carcinogenicity-zero; Category II, equivocal evidence - reference dose (RfD) approach or 0.00001 to 0.000001 cancer risk range; and Category III, inadequate or no evidence from animal studies - RfD approach. 10 refs., 5 tabs

  16. Comparing MODIS Net Primary Production Estimates with Terrestrial National Forest Inventory Data in Austria

    Directory of Open Access Journals (Sweden)

    Mathias Neumann

    2015-04-01

    Full Text Available The mission of this study is to compare Net Primary Productivity (NPP estimates using (i forest inventory data and (ii spatio-temporally continuous MODIS (MODerate resolution Imaging Spectroradiometer remote sensing data for Austria. While forest inventories assess the change in forest growth based on repeated individual tree measurements (DBH, height etc., the MODIS NPP estimates are based on ecophysiological processes such as photosynthesis, respiration and carbon allocation. We obtained repeated national forest inventory data from Austria, calculated a “ground-based” NPP estimate and compared the results with “space-based” MODIS NPP estimates using different daily climate data. The MODIS NPP estimates using local Austrian climate data exhibited better compliance with the forest inventory driven NPP estimates than the MODIS NPP predictions using global climate data sets. Stand density plays a key role in addressing the differences between MODIS driven NPP estimates versus terrestrial driven inventory NPP estimates. After addressing stand density, both results are comparable across different scales. As forest management changes stand density, these findings suggest that management issues are important in understanding the observed discrepancies between MODIS and terrestrial NPP.

  17. Perspectives on the value of advanced medical imaging: a national survey of primary care physicians.

    Science.gov (United States)

    Hughes, Christine M; Kramer, Erich; Colamonico, Jennifer; Duszak, Richard

    2015-05-01

    To understand perceptions of primary care physicians (PCPs) about the value of advanced medical imaging. A national quantitative survey of 500 PCPs was conducted using an online self-administered questionnaire. Questions focused on advanced medical imaging (CT, MRI, and PET) and its perceived impact on the delivery of patient care. Responses were stratified by physician demographics. Large majorities of the PCPs indicated that advanced imaging increases their diagnostic confidence (441; 88%); provides data not otherwise available (451; 90%); permits better clinical decision making (440; 88%); increases confidence in treatment choices (438; 88%), and shortens time to definitive diagnosis (430; 86%]). Most (424; 85%) believe that patient care would be negatively affected without access to advanced imaging. PCPs whose clinical careers predated the proliferation of advanced imaging modalities (>20 years of practice) assigned higher value to advanced imaging on several dimensions compared with younger physicians whose training overlapped widespread technology availability. By a variety of metrics, large majorities of PCPs believe that advanced medical imaging provides considerable value to patient care. Those whose careers predated the widespread availability of advanced imaging tended to associate it with even higher value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Mixing ratios of carbon monoxide in the troposphere

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, P.C.; Steele, L.P. (Univ. of Colorado, Boulder (United States)); Tans, P.P. (NOAA, Boulder, CO (United States))

    1992-12-20

    Carbon monoxide (CO) mixing ratios were measured in air samples collected weekly at eight locations. The air was collected as part of the CMDL/NOAA cooperative flask sampling program (Climate Monitoring and Diagnostics Laboratory, formerly Geophysical Monitoring for Climatic Change, Air Resources Laboratory/National Oceanic and Atmospheric Administration) at Point Barrow, Alaska, Niwot Ridge, Colorado, Mauna Loa and Cape Kumakahi, Hawaii, Guam, Marianas Islands, Christmas Island, Ascension Island and American Samoa. Half-liter or 3-L glass flasks fitted with glass piston stopcocks holding teflon O rings were used for sample collection. CO levels were determined within several weeks of collection using gas chromatography followed by mercuric oxide reduction detection, and mixing ratios were referenced against the CMDL/NOAA carbon monoxide standard scale. During the period of study (mid-1988 through December 1990) CO levels were greatest in the high latitudes of the northern hemisphere (mean mixing ratio from January 1989 to December 1990 at Point Barrow was approximately 154 ppb) and decreased towards the south (mean mixing ratio at Samoa over a similar period was 65 ppb). Mixing ratios varied seasonally, the amplitude of the seasonal cycle was greatest in the north and decreased to the south. Carbon monoxide levels were affected by both local and regional scale processes. The difference in CO levels between northern and southern latitudes also varied seasonally. The greatest difference in CO mixing ratios between Barrow and Samoa was observed during the northern winter (about 150 ppb). The smallest difference, 40 ppb, occurred during the austral winter. The annually averaged CO difference between 71[degrees]N and 14[degrees]S was approximately 90 ppb in both 1989 and 1990; the annually averaged interhemispheric gradient from 71[degrees]N to 41[degrees]S is estimated as approximately 95 ppb. 66 refs., 5 figs., 5 tabs.

  19. 21 CFR 177.1312 - Ethylene-carbon monoxide copolymers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Ethylene-carbon monoxide copolymers. 177.1312... Basic Components of Single and Repeated Use Food Contact Surfaces § 177.1312 Ethylene-carbon monoxide copolymers. The ethylene-carbon monoxide copolymers identified in paragraph (a) of this section may be safely...

  20. Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood

    DEFF Research Database (Denmark)

    Andersson, Mette F; Møller, Ann M

    2010-01-01

    Smoking increases perioperative complications. Carbon monoxide concentrations can estimate patients' smoking status and might be relevant in preoperative risk assessment. In smokers, we compared measurements of carbon monoxide in expired air (COexp) with measurements of carboxyhaemoglobin (COHb) ...

  1. Measurement of Air Pollution from Satellites (MAPS) Space Radar Laboratory - 2 (SRL2) Carbon Monoxide 5 degree by 5 degree data

    Data.gov (United States)

    National Aeronautics and Space Administration — MAPS OverviewThe MAPS experiment measures the global distribution of carbon monoxide (CO) mixing ratios in the free troposphere. Because of MAPS' previous flights on...

  2. Hearing Loss due to Carbon Monoxide Poisoning

    DEFF Research Database (Denmark)

    Mehrparvar, Amir Houshang; Davari, Mohammad Hossein; Mollasadeghi, Abolfazl

    2013-01-01

    Carbon monoxide poisoning is one of the rare causes of hearing loss which may cause reversible or irreversible, unilateral or bilateral hearing loss after acute or chronic exposure. In this report, we present a case of bilateral sensorineural hearing loss in a secondary smelting workshop worker a...

  3. CARBON MONOXIDE AND THE NERVOUS SYSTEM

    Science.gov (United States)

    Carbon monoxide (CO) is a colorless, tasteless, odorless, and non-irritating gas formed when carbon in fuel is not burned completely. It enters the bloodstream through the lungs and attaches to hemoglobin (Hb), the body's oxygen carrier, forming carboxyhemoglobin (COHb) and there...

  4. Vacancy distribution in nonstoichiometric vanadium monoxide

    International Nuclear Information System (INIS)

    Gusev, A.I.; Davydov, D.A.; Valeeva, A.A.

    2011-01-01

    Graphical abstract: Display Omitted Research highlights: → A certain fraction of vanadium atoms in disordered cubic vanadium monoxide VO y and ordered tetragonal phase V 52 O 64 is located in tetrahedral positions of a basic cubic lattice. → These positions are never occupied by any atoms in other strongly nonstoichiometric carbides, nitrides and oxides. → Both disordered and ordered structures of vanadium monoxide are characterized by the presence of short-range order of displacements in the oxygen sublattice and short-range order of substitution in the metal sublattice. → The short-range order of displacement is caused by the local displacements of O atoms from V (t) atoms occupying tetrahedral positions. The short-range order of substitution appears because V (t) atoms in the tetrahedral positions are always in the environment of four vacancies □ of the vanadium sublattice. - Abstract: Structural vacancy distribution in the crystal lattice of the tetragonal V 52 O 64 superstructure which is formed on the basis of disordered superstoichiometric cubic vanadium monoxide VO y ≡V x O z is experimentally determined and the presence of significant local atomic displacements and large local microstrains in a crystal lattice of real ordered phase is established. It is shown that the relaxation of local microstrains takes place owing to the basic disordered cubic phase grain refinement and a formation of ordered phase domains. The ordered phase domains grow in the direction from the boundaries to the centre of grains of the disordered basic cubic phase. Isothermal evolution at 970 K of the average domain size in ordered VO 1.29 vanadium monoxide is established. It is shown that the short-range order presents in a metal sublattice of disordered cubic VO y vanadium monoxide. The character of the short-range order is such that vanadium atoms occupying tetrahedral positions are in the environment of four vacant sites of the vanadium sublattice. This means that the

  5. Aesthetic Education of Primary School Pupils as an Integral Part of the National System of Continuous Art Education in Japan

    Science.gov (United States)

    Kuchai, Tetiana

    2014-01-01

    The article examines aesthetic education of primary school pupils as an integral part of the national system of continuous art education in Japan. One of the most important traditional means of aesthetic education in Japan, according to L. Tsaryova is considered nature. Analysis of the scientific literature by domestic and foreign scientists…

  6. Primary Percutaneous Coronary Intervention as a National Reperfusion Strategy in Patients With ST-Segment Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Terkelsen, Christian J; Jensen, Lisette O; Hansen, Hans-Henrik Tilsted

    2011-01-01

    In Denmark, primary percutaneous coronary intervention (PPCI) was chosen as a national reperfusion strategy for patients with ST-segment elevation myocardial infarction in 2003. This study describes the temporal implementation of PPCI in Western Denmark, the gradual introduction of field triage...

  7. English Language Teaching in Public Primary Schools in Mexico: The Practices and Challenges of Implementing a National Language Education Program

    Science.gov (United States)

    Ramírez Romero, José Luis; Sayer, Peter; Pamplón Irigoyen, Elva Nora

    2014-01-01

    Over the past 15?years, many state governments in Mexico have initiated local programs to introduce English at the primary school level. In 2009, the Mexican Ministry of Education formalized the "Programa Nacional de Inglés en Educación Básica" (PNIEB) as part of the national curriculum, based on the argument that increasing the number…

  8. Carbon monoxide: The 21st century poison that goes unnoticed

    International Nuclear Information System (INIS)

    Hoskins, J.A.

    1999-01-01

    This editorial article describes the effects of carbon monoxide poisoning on human beings and the mechanisms involving carbon monoxide saturation of haemoglobin that are responsible for it. The initial research done in the mid-1800s by Claude Bernard is presented. Methods of treatment for persons poisoned by carbon monoxide are discussed and the experiments made by J.B.S. Haldane on himself by breathing in carbon monoxide are described. Acclimatisation effects observed by Haldane and his co-workers and concerning persons occupationally exposed to carbon monoxide emissions are described

  9. Carbon monoxide: The 21st century poison that goes unnoticed

    Energy Technology Data Exchange (ETDEWEB)

    Hoskins, J.A. [Reigate, Surrey (United Kingdom)

    1999-07-01

    This editorial article describes the effects of carbon monoxide poisoning on human beings and the mechanisms involving carbon monoxide saturation of haemoglobin that are responsible for it. The initial research done in the mid-1800s by Claude Bernard is presented. Methods of treatment for persons poisoned by carbon monoxide are discussed and the experiments made by J.B.S. Haldane on himself by breathing in carbon monoxide are described. Acclimatisation effects observed by Haldane and his co-workers and concerning persons occupationally exposed to carbon monoxide emissions are described.

  10. AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989–2003

    International Nuclear Information System (INIS)

    Haldorsen, Ingfrid S; Kråkenes, Jostein; Goplen, Anne K; Dunlop, Oona; Mella, Olav; Espeland, Ansgar

    2008-01-01

    Primary central nervous system lymphoma (PCNSL) is a frequent complication in acquired immunodeficiency syndrome (AIDS). The objective of this survey was to investigate incidence, clinical features, radiological findings, histologic diagnosis, treatment and outcome for all patients with histologically verified AIDS-related PCNSL diagnosed in Norway in 1989–2003. We identified the patients by chart review of all cases recorded as PCNSL in The Norwegian Cancer Registry (by law recording all cases of cancer in Norway) and all cases recorded as AIDS-related PCNSL in the autopsy registry at a hospital having 67% autopsy rate and treating 59% of AIDS patients in Norway, from 1989 to 2003. Histologic material and radiological images were reviewed. We used person-time techniques to calculate incidence rates of PCNSL among AIDS patients based on recordings on AIDS at the Norwegian Surveillance System for Communicable Diseases (by law recording all cases of AIDS in Norway). Twenty-nine patients had histologically confirmed, newly diagnosed AIDS-related PCNSL in Norway from 1989–2003. Only 2 patients had this diagnosis established while alive. AIDS patients had 5.5% lifetime risk of PCNSL. Their absolute incidence rate of PCNSL per 100 person-years was 1.7 (95%CI: 1.1–2.4) and decreased during the consecutive 5-year periods from 3.6, to 2.5, and to 0.4 (p < 0.001). Median survival from initial symptom of PCNSL was 2.3 months, but one patient was still alive 4 years after completed radiotherapy. This is the first national survey to confirm decreasing incidence of AIDS-related PCNSL. Despite dismal survival in most patients, the possibility of long term survival should prompt more aggressive diagnostics in suspected PCNSL

  11. US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

    Science.gov (United States)

    Brauer, Simon G; Yoon, John D; Curlin, Farr A

    2016-02-01

    Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. [Development of national neglect norm for urban primary school students of China].

    Science.gov (United States)

    Pan, Jian-ping; Wang, Fei; Li, Min; Chen, Jing-qi; Zhang, Hui-ying; Wang, Gui-xiang; Gu, Gui-xiong; Guo, Wei-wei; Peng, Yu-lin; Shi, Shu-hua; Chen, Guang-hu; Yi, Hua-ni; Fu, Ping; Xia, Li; Yu, Hong; Lu, Biao; Duan, Zhi-xian; Wang, Ying-xiong; Zhong, Zhao-hui; Li, Jian; Wang, Lin; Cao, Chun-hong; Luo, Sha-sha; Zhang, Song-jie; Zhang, Hua

    2013-02-01

    To develop the national neglect norms for urban primary school students in China. According to multi-stage stratified cluster sampling principle, 24 cities of 13 provinces (municipalities) in China were selected during December 1 to 31, 2008. A total of 1491 students in grade 1 - 3 and 2236 students in grade 4 - 6 were selected. Questionnaire was designed by authors and the final norms were determined through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norms. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm was completed. The two questionnaires of grade 1 - 3 and grade 4 - 6 students consisted of 55 and 57 items, respectively, whose item loadings were ranged from 0.301 to 0.687 and 0.321 to 0.730, which met the statistical requirements. For grade 1 - 3 students, the scale's total Cronbach α coefficients was 0.914, the total split-half reliability coefficients was 0.896, the Cronbach α coefficients of four level was above 0.737 except medical and social neglect, split-half reliability was ranged from 0.461 to 0.757; for grade 4-6 students, the scale's total Cronbach α coefficients was 0.916, split-half reliability was 0.883, except social neglect, the Cronbach α coefficients of other level was ranged 0.457 to 0.856, split-half reliability was ranged from 0.500 to 0.798. The total neglect cut-off score of the two scales grade 1-3 and 4-6 were 125 and 155, respectively. The structure of two norms was reasonable. The scales have good stability and reliability.

  13. Population need for primary eye care in Rwanda: A national survey.

    Directory of Open Access Journals (Sweden)

    Tess Bright

    Full Text Available Universal access to Primary Eye Care (PEC is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI. PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa.A national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12 was assessed using Portable Eye Examination Kit (PEEK; URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression.4618 participants were examined and interviewed out of 5361 enumerated (86% response rate. The adjusted population prevalence of VI was 3.7% (95%CI = 3.0-4.5%, URE was 2.2% (95%CI = 1.7-2.8% and overall need for PEC was 34.0% (95%CI = 31.8-36.4%. Women and older people were more likely to need PEC and require a referral.Nearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women.

  14. The user with respiratory symptoms of tuberculosis in the primary care: assessment of actions according to national recommendations

    Directory of Open Access Journals (Sweden)

    Luize Barbosa Antunes

    2016-06-01

    Full Text Available Objective: to investigate the evaluation of the user with respiratory symptoms of tuberculosis in Primary Health Care services according to the norms of the National Program for Tuberculosis Control. Methods: cross-sectional study with application of a form to 99 people with pulmonary tuberculosis. Results: a total of 87.9% participants reported cough as the symptom that motivated the search for Primary Care; from these, 27.3% sought Primary Care units, 96.3% received care in this service, of which 46.2% reported that sputum smear was requested by professionals in the units. Conclusion: more than half of participants sought secondary or tertiary services due to the symptoms of tuberculosis, and also less than half of patients assisted in Primary Care had diagnostic tests requested by professionals of that service.

  15. Occupational carbon monoxide violations in the State of Washington, 1994-1999.

    Science.gov (United States)

    Lofgren, Don J

    2002-07-01

    Occupational exposure to carbon monoxide continues to cause a number of injuries and deaths. This study reviewed the State of Washington OSHA inspection records for occupational safety or health violations related to carbon monoxide for the time period 1994-1999 to assess the agency's efforts and further identify and characterize causative factors. Inspection data were also compared with carbon monoxide claims data from a companion study to determine if the agency was visiting the most at risk work operations. Inspections were identified by searching computerized violation texts for "carbon monoxide" or "CO." The study found 142 inspections with one or more carbon monoxide violations. Inspections were spread over 84 different 4-digit Standard Industrial Classification codes. Most inspections were initiated as a result of a complaint or other informant. Inspections were predominantly in construction and manufacturing, whereas carbon monoxide claims were mores evenly distributed between the major industries. Inspections also may have failed to find violations for some types of equipment responsible for carbon monoxide claims. Forklifts were the source of carbon monoxide most often associated with a violation, followed by compressors for respirators, auto/truck/bus, and temporary heating devices. Inspections in response to poisonings found common factors associated with lack of recognition and failure to use or maintain equipment and ventilation. Some work sites with one or more poisonings were not being inspected. Only 10 of the 51 incidents with industrial insurance claim reports of carboxyhemoglobin at or above 20 percent were inspected. Further, it was found more preventive efforts should be targeted at cold storage operations and certain warehouse and construction activities. It is proposed that more specific standards, both consensus and regulatory, would provide additional risk reduction. Reliance upon safe work practices as a primary method of control in the

  16. Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

    Science.gov (United States)

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2007-01-01

    This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

  17. Net primary productivity of subalpine meadows in Yosemite National Park in relation to climate variability

    Science.gov (United States)

    Peggy E. Moore; Jan W. van Wagtendonk; Julie L. Yee; Mitchel P. McClaran; David N. Cole; Neil K. McDougald; Matthew L. Brooks

    2013-01-01

    Subalpine meadows are some of the most ecologically important components of mountain landscapes, and primary productivity is important to the maintenance of meadow functions. Understanding how changes in primary productivity are associated with variability in moisture and temperature will become increasingly important with current and anticipated changes in climate....

  18. Y-12 Groundwater Protection Program Extent Of The Primary Groundwater Contaminants At The Y-12 National Security Complex

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2013-12-01

    This report presents data summary tables and maps used to define and illustrate the approximate lateral extent of groundwater contamination at the U.S. Department of Energy (DOE) Y-12 National Security Complex (Y-12) in Oak Ridge, Tennessee. The data tables and maps address the primary (i.e., most widespread and mobile) organic, inorganic, and radiological contaminants in the groundwater. The sampling locations, calculated contaminant concentrations, plume boundary values, and paired map format used to define, quantify, delineate, and illustrate the approximate extent of the primary organic, inorganic, and radiological contaminants in groundwater at Y-12 are described.

  19. On the composition of nonstoichiometric europium monoxide

    International Nuclear Information System (INIS)

    Ignat'eva, N.I.

    1990-01-01

    Consideration is given to results of of investigation into chemical composition, homogeneity region, type of disordering of nonstoichiometric europium monoxide. Precision methods of X-ray diffraction, electron-microscopic, atomic-absorption chemical analysis were used. It is shown that lattice volume reduces with increase of oxygen content in the oxide. For monocrystal of EuO 1.01 composition a=5.146 A. All samples of europium monoxide are characterized by low conductivity. Conductivity value changes by two orders (from 10 -8 to 10 -6 Θ -1 ·cm -1 ) when passing from the sample of stoichiometric composition to maximally disordered one. The disordering is considered according to the type of charged cation vacancies, leading to occurrence of equivalent number of electron defects of positive holes. 4 refs.; 1 tab

  20. Sensorineural Hearing Loss following Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Joseph P. Pillion

    2012-01-01

    Full Text Available A case study is presented of a 17-year-old male who sustained an anoxic brain injury and sensorineural hearing loss secondary to carbon monoxide poisoning. Audiological data is presented showing a slightly asymmetrical hearing loss of sensorineural origin and mild-to-severe degree for both ears. Word recognition performance was fair to poor bilaterally for speech presented at normal conversational levels in quiet. Management considerations of the hearing loss are discussed.

  1. Carbon Monoxide Exposure in Youth Ice Hockey.

    Science.gov (United States)

    Macnow, Theodore; Mannix, Rebekah; Meehan, William P

    2017-11-01

    To examine the effect of ice resurfacer type on carboxyhemoglobin levels in youth hockey players. We hypothesized that players in arenas with electric resurfacers would have normal, stable carboxyhemoglobin levels during games, whereas those in arenas with internal combustion engine (IC) resurfacers would have an increase in carboxyhemoglobin levels. Prospective cohort study. Enclosed ice arenas in the northeastern United States. Convenience sample of players aged 8 to 18 years old in 16 games at different arenas. Eight arenas (37 players) used an IC ice resurfacer and 8 arenas (36 players) an electric resurfacer. Carboxyhemoglobin levels (SpCO) were measured using a pulse CO-oximeter before and after the game. Arena air was tested for carbon monoxide (CO) using a metered gas detector. Players completed symptom questionnaires. The change in SpCO from pregame to postgame was compared between players at arenas with electric versus IC resurfacers. Carbon monoxide was present at 6 of 8 arenas using IC resurfacers, levels ranged from 4 to 42 parts per million. Carbon monoxide was not found at arenas with electric resurfacers. Players at arenas with IC resurfacers had higher median pregame SpCO levels compared with those at electric arenas (4.3% vs 1%, P carboxyhemoglobin during games and have elevated baseline carboxyhemoglobin levels compared with players at arenas with electric resurfacers. Electric resurfacers decrease the risk of CO exposure.

  2. Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia.

    Science.gov (United States)

    Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E

    2016-01-01

    In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders.

  3. The potential impact of the next influenza pandemic on a national primary care medical workforce

    OpenAIRE

    Wilson, Nick; Baker, Michael; Crampton, Peter; Mansoor, Osman

    2005-01-01

    Abstract Background Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. Methods The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta) was applied to the New Zealand primary care medical workforce (i.e., general practitioners). Results At its peak (week 4) the pandemic would lead to...

  4. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

    Directory of Open Access Journals (Sweden)

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  5. Satellite observations of tropospheric ammonia and carbon monoxide: Global distributions, regional correlations and comparisons to model simulations

    Science.gov (United States)

    Ammonia (NH3) and carbon monoxide (CO) are primary pollutants emitted to the Earth's atmosphere from common as well as distinct sources associated with anthropogenic and natural activities. The seasonal and global distributions and correlations of NH3 and CO from the Tropospheric...

  6. Catalyst for Carbon Monoxide Oxidation

    Science.gov (United States)

    Davis, Patricia; Brown, Kenneth; VanNorman, John; Brown, David; Upchurch, Billy; Schryer, David; Miller, Irvin

    2010-01-01

    In many applications, it is highly desirable to operate a CO2 laser in a sealed condition, for in an open system the laser requires a continuous flow of laser gas to remove the dissociation products that occur in the discharge zone of the laser, in order to maintain a stable power output. This adds to the operating cost of the laser, and in airborne or space applications, it also adds to the weight penalty of the laser. In a sealed CO2 laser, a small amount of CO2 gas is decomposed in the electrical discharge zone into corresponding quantities of CO and O2. As the laser continues to operate, the concentration of CO2 decreases, while the concentrations of CO and O2 correspondingly increase. The increasing concentration of O2 reduces laser power, because O2 scavenges electrons in the electrical discharge, thereby causing arcing in the electric discharge and a loss of the energetic electrons required to boost CO2 molecules to lasing energy levels. As a result, laser power decreases rapidly. The primary object of this invention is to provide a catalyst that, by composition of matter alone, contains chemisorbed water within and upon its structure. Such bound moisture renders the catalyst highly active and very long-lived, such that only a small quantity of it needs to be used with a CO2 laser under ambient operating conditions. This object is achieved by a catalyst that consists essentially of about 1 to 40 percent by weight of one or more platinum group metals (Pt, Pd, Rh, Ir, Ru, Os, Pt being preferred); about 1 to 90 percent by weight of one or more oxides of reducible metals having multiple valence states (such as Sn, Ti, Mn, Cu, and Ce, with SnO2 being preferred); and about 1 to 90 percent by weight of a compound that can bind water to its structure (such as silica gel, calcium chloride, magnesium sulfate, hydrated alumina, and magnesium perchlorate, with silica gel being preferred). Especially beneficial results are obtained when platinum is present in the

  7. Variation in primary site resection practices for advanced colon cancer: a study using the National Cancer Data Base.

    Science.gov (United States)

    Healy, Mark A; Pradarelli, Jason C; Krell, Robert W; Regenbogen, Scott E; Suwanabol, Pasithorn A

    2016-10-01

    Treatment of metastatic colon cancer may be driven as much by practice patterns as by features of disease. To optimize management, there is a need to better understand what is determining primary site resection use. We evaluated all patients with stage IV cancers in the National Cancer Data Base from 2002 to 2012 (50,791 patients, 1,230 hospitals). We first identified patient characteristics associated with primary tumor resection. Then, we assessed nationwide variation in hospital resection rates. Overall, 27,387 (53.9%) patients underwent primary site resection. Factors associated with resection included younger age, having less than 2 major comorbidities, and white race (P primary tumor resection rates ranged from 26.0% to 87.8% with broad differences across geographical areas and hospital accreditation types. There is statistically significant variation in hospital rates of primary site resection. This demonstrates inconsistent adherence to guidelines in the presence of conflicting evidence regarding resection benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Perceived Barriers to Implementing Individual Choosing Wisely® Recommendations in Two National Surveys of Primary Care Providers.

    Science.gov (United States)

    Zikmund-Fisher, Brian J; Kullgren, Jeffrey T; Fagerlin, Angela; Klamerus, Mandi L; Bernstein, Steven J; Kerr, Eve A

    2017-02-01

    While some research has examined general attitudes about efforts to reduce overutilization of services, such as the Choosing Wisely ® (CW) initiative, little data exists regarding primary care providers' attitudes regarding individual recommendations. We sought to identify whether particular CW recommendations were perceived by primary care providers as difficult to follow, difficult for patients to accept, or both. Two national surveys, one by mail to a random sample of 2000 U.S. primary care physicians in November 2013, and the second electronically to a random sample of 2500 VA primary care providers (PCPs) in October-December 2014. A total of 603 U.S. primary care physicians and 1173 VA primary care providers. Response rates were 34 and 48 %, respectively. PCP ratings of whether 12 CW recommendations for screening, testing and treatments applicable to adult primary care were difficult to follow and difficult for patients to accept; and ratings of potential barriers to reducing overutilization. For four recommendations regarding not screening or testing in asymptomatic patients, less than 20 % of PCPs found the CW recommendations difficult to accept (range 7.2-16.6 %) or difficult for patients to follow (12.2-19.3 %). For five recommendations regarding testing or treatment for symptomatic conditions, however, there was both variation in reported difficulty to follow (9.8-32 %) and a high level of reported difficulty for patients to accept (35.7-87.1 %). The most frequently reported barriers to reducing overuse included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists. While PCPs found many CW recommendations easy to follow, they felt that some, especially those for symptomatic conditions, would be difficult for patients to accept. Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and

  9. 76 FR 76259 - National Emissions Standards for Hazardous Air Pollutants: Primary Aluminum Reduction Plants

    Science.gov (United States)

    2011-12-06

    ... Emissions From Maleic Anhydride Plants, Ethylbenzene/Styrene Plants, Benzene Storage Vessels, Benzene...). The rule is applicable to facilities with affected sources associated with the production of aluminum... are subject to the requirements of this NESHAP: 14 primary aluminum production plants and one carbon...

  10. PATTERNS OF DOMINANCE OF LANGUAGE VITALITIES AMONG MALAYSIAN STUDENTS IN PRIMARY NATIONAL-TYPE AND SECONDARY SCHOOLS

    Directory of Open Access Journals (Sweden)

    Soo Ying How

    2017-01-01

    Full Text Available Multilingualism is embedded in the Malaysian Education Blueprint (2015-2025 as a stated goal towards nation building. The education system provides opportunity to learn Malay which is the national language, the mother tongue (Mandarin or Tamil and the English language as part of formal schooling. In fact, Malaysian primary schools are classified into two major divisions. Students can opt to study in national schools in which the medium of instruction is Malay with the provision for the learning of English and a mother tongue. The other option allows students to enrol in national-type schools of which the medium of instruction is either Mandarin or Tamil, with English and Malay taught as academic subjects. At secondary level, the medium of instruction in national schools is Malay and students are provided the opportunity to learn their mother tongue and English. Other than in school, other social milieus also allow the use and practice of these languages. Given this linguistic environment, there exists a myriad of language experiences within and outside formal learning which together would influence the totality of language vitality. This paper investigates language vitality featured in this multilingual environment. It focuses on the vitality of the English language among students that appears to co-exist with the learning and use of other languages as they progress through the primary and secondary levels. The vitality is measured by the following indicators: language preference, choice, dominance, use, attitude and motivation and proficiency which were used to develop a questionnaire to obtain data on strength evaluation of these languages. The methodology encompasses random and convenient sampling to obtain representative responses from students with different levels of education and language experiences. The study reveals relative vitalities of languages used and highlights values attached to languages at different points of language

  11. Characteristics of exogenous carbon monoxide deliveries

    Directory of Open Access Journals (Sweden)

    Hui-jun Hu

    2016-01-01

    Full Text Available Carbon monoxide (CO has long been considered an environmental pollutant and a poison. Exogenous exposure to amounts of CO beyond the physiologic level of the body can result in a protective or adaptive response. However, as a gasotransmitter, endogenous CO is important for multiple physiologic functions. To date, at least seven distinct methods of delivering CO have been utilized in animal and clinical studies. In this mini-review, we summarize the exogenous CO delivery methods and compare their advantages and disadvantages.

  12. Treatment in carbon monoxide poisoning patients with headache: a prospective, multicenter, double-blind, controlled clinical trial.

    Science.gov (United States)

    Ocak, Tarik; Tekin, Erdal; Basturk, Mustafa; Duran, Arif; Serinken, Mustafa; Emet, Mucahit

    2016-11-01

    There is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning. To compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache. A prospective, multicenter, double-blind, controlled trial. Three emergency departments in Turkey. Adult carbon monoxide poisoning patients with headache. A total of 117 carbon monoxide-intoxicated patients with headache were randomized into 3 groups and assessed at baseline, 30 minutes, 90 minutes, and 4 hours. The primary outcome was patient-reported improvement rates for headache. Secondary end points included nausea, need for rescue medication during treatment, and reduction in carboxyhemoglobin levels. During observation, there was no statistical difference between drug type and visual analog scale score change at 30 minutes, 90 minutes, or 4 hours, for either headache or nausea. No rescue medication was needed during the study period. The reduction in carboxyhemoglobin levels did not differ among the 3 groups. The use of "oxygen alone" is as efficacious as "oxygen plus metoclopramide" or "oxygen plus metamizole sodium" in the treatment of carbon monoxide-induced headache. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China.

    Science.gov (United States)

    Liu, Cong; Yin, Peng; Chen, Renjie; Meng, Xia; Wang, Lijun; Niu, Yue; Lin, Zhijing; Liu, Yunning; Liu, Jiangmei; Qi, Jinlei; You, Jinling; Kan, Haidong; Zhou, Maigeng

    2018-01-01

    Evidence of the acute health effects of ambient carbon monoxide air pollution in developing countries is scarce and mixed. We aimed to evaluate short-term associations between carbon monoxide and daily cardiovascular disease mortality in China. We did a nationwide time-series analysis in 272 major cities in China from January, 2013, to December, 2015. We extracted daily cardiovascular disease mortality data from China's Disease Surveillance Points system. Data on daily carbon monoxide concentrations for each city were obtained from the National Urban Air Quality Real-time Publishing Platform. City-specific associations between carbon monoxide concentrations and daily mortality from cardiovascular disease, coronary heart disease, and stroke were estimated with over-dispersed generalised linear models. Bayesian hierarchical models were used to obtain national and regional average associations. Exposure-response association curves and potential effect modifiers were evaluated. Two-pollutant models were fit to evaluate the robustness of the effects of carbon monoxide on cardiovascular mortality. The average annual mean carbon monoxide concentration in these cities from 2013 to 2015 was 1·20 mg/m 3 , ranging from 0·43 mg/m 3 to 2·45 mg/m 3 . For a 1 mg/m 3 increase in average carbon monoxide concentrations on the present day and previous day (lag 0-1), we observed significant increments in mortality of 1·12% (95% posterior interval [PI] 0·42-1·83) from cardiovascular disease, 1·75% (0·85-2·66) from coronary heart disease, and 0·88% (0·07-1·69) from stroke. These associations did not vary substantially by city, region, and demographic characteristics (age, sex, and level of education), and the associations for cardiovascular disease and coronary heart disease were robust to the adjustment of criteria co-pollutants. We did not find a threshold below which carbon monoxide exposure had no effect on cardiovascular disease mortality. This analysis is, to our

  14. Absolute measurement of the DT primary neutron yield on the National Ignition Facility

    Directory of Open Access Journals (Sweden)

    Leeper R.J.

    2013-11-01

    Full Text Available The measurement of the absolute neutron yield produced in inertial confinement fusion target experiments conducted on the National Ignition Facility (NIF is essential in benchmarking progress towards the goal of achieving ignition on this facility. This paper describes three independent diagnostic techniques that have been developed to make accurate and precise DT neutron yield measurements on the NIF.

  15. [Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

    Science.gov (United States)

    Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

    2017-01-23

    This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

  16. Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples

    Directory of Open Access Journals (Sweden)

    McDermott Robyn

    2010-05-01

    Full Text Available Abstract Background Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE project has facilitated the implementation of modern Continuous Quality Improvement (CQI approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1 explore the factors associated with variation in clinical performance; 2 examine specific strategies that have been effective in improving primary care clinical performance; and 3 work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. Methods/Design The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. Discussion By linking researchers directly to users of research (service providers, managers and policy makers, the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary

  17. Primary Cyst adenocarcinoma: exceptional etiology of a retroperitoneal cystic tumor.First National Communication

    International Nuclear Information System (INIS)

    Gonzalez, D.; Ruso, L.; Ettlin, A.

    2010-01-01

    This work is about the clinical case of a 29 year old patient who consulted for right lank pain, where a tumor was identified. Ultrasound confirmed the existence of a cystic process, and complete surgical abscission/exeresis was performed next to an area in the in the abdominal wall. Anatomopathological report confirmed a primary retroperitoneal cistoadenocarcinoma. No adjuvant treatment was applied, evolution was good 11 months after surgery, no evidence of the disease

  18. Carbon monoxide toxicity. April 1978-November 1989 (A Bibliography from the Life Sciences Collection data base). Report for April 1978-November 1989

    Energy Technology Data Exchange (ETDEWEB)

    1990-03-01

    This bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include carbon monoxide binding affinity studies with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels as related to tobacco and marijuana smoke, occupational exposure and the NIOSH biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (This updated bibliography contains 237 citations, 16 of which are new entries to the previous edition.)

  19. Carbon monoxide toxicity. January 1978-March 1989 (Citations from the Life Sciences Collection data base). Report for January 1978-March 1989

    Energy Technology Data Exchange (ETDEWEB)

    1989-03-01

    This bibliography contains citations concerning the mechanism and clinical manifestations of carbon monoxide exposure, including the effects on the liver, cardiovascular, and nervous systems. Topics include carbon monoxide binding affinity studies with hemoglobin, measurement of carboxyhemoglobin in humans and various animal species, carbon monoxide levels as related to tobacco and marijuana smoke, occupational exposure and the NIOSH biological exposure index, symptomology and percent of blood CO, and intrauterine exposure. Air pollution, tobacco smoking, and occupational exposure are discussed as primary sources of carbon monoxide exposure. The effects of cigarette smoking on fetal development and health are excluded and examined in a separate bibliography. (This updated bibliography contains 221 citations, 19 of which are new entries to the previous edition.)

  20. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

    Science.gov (United States)

    Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

    2017-11-13

    In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

  1. Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Terminal Operations HITL 1B Primary Results

    Science.gov (United States)

    Rorie, Conrad; Monk, Kevin; Roberts, Zach; Brandt, Summer

    2018-01-01

    This presentation provides an overview of the primary results from the Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project's second Terminal Operations human-in-the-loop simulation. This talk covers the background of this follow-on experiment, which includes an overview of the first Terminal Operations HITL performed by the project. The primary results include a look at the number and durations of detect and avoid (DAA) alerts issued by the two DAA systems under test. It also includes response time metrics and metrics on the ability of the pilot-in-command (PIC) to maintain sufficient separation. Additional interoperability metrics are included to illustrate how pilots interact with the tower controller. Implications and conclusions are covered at the end.

  2. Communication between secondary and primary care following self-harm: are National Institute of Clinical Excellence (NICE guidelines being met?

    Directory of Open Access Journals (Sweden)

    Jordan Rita

    2008-10-01

    Full Text Available Abstract Background Most patients contact their general practitioner (GP following presentation to an Emergency Department (ED after a self-harm incident, and strategies to help GPs manage these patients include efficient communication between services. The aim of this study was to assess the standard of documentation and communication to primary care from secondary care as recommended by the National Institute of Clinical Excellence (NICE guidelines on the short-term management of people who self-harm. Methods An audit of medical records (ED and Psychiatric on people aged 16 years and over who had presented to the ED following self-harm, benchmarked according to government guidelines, was performed. Data were collected over a 4-week period at a general teaching hospital. Results We collected data on 93 consecutive episodes of self-harm; 62% of episodes were communicated to primary care, 58% of these communications were within 24 h and most within 3 days. Patient identifying details and follow-up arrangements were specified in most cases. Communication via psychiatric staff was most detailed. ED clinicians provided few communications and were of limited content. Communication with the patient's GP was not made in half of those cases seen by a mental health specialist. Conclusion Government guidelines are only partially being met. Reliance on communication by ED staff would leave a substantial proportion of patients discharged from the ED with no or minimal communication to primary care. Psychiatric services need to improve the rate of communication to the patient's GP following assessment A national sample of National Health Service (NHS trusts would establish if this is a problem elsewhere.

  3. Radiology standards for primary dental care: report by the Royal College of Radiologists and the National Radiological Protection Board

    International Nuclear Information System (INIS)

    Hudson, Tony

    1994-01-01

    In 1992 a joint venture between the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) resulted in the formation of a Working Party (WP) to consider dental radiology. Although individual doses to patients are low, WP identified considerable scope for reducing the collective dose to patients and for improving the diagnostic quality of radiographs. The report published in the Documents of the NRPB series presents the WP conclusions in the form of guidelines that deal with all aspects of dental radiology in primary dental care. (Author)

  4. A national cohort study of long-course preoperative radiotherapy in primary fixed rectal cancer in Denmark

    DEFF Research Database (Denmark)

    Bulow, S.; Jensen, L.H.; Altaf, R.

    2010-01-01

    OBJECTIVE: Preoperative radiotherapy has been shown to enable a fixed rectal cancer to become resectable which in turn may result in long-time survival. In this study, we analysed the outcome of long-course preoperative radiotherapy in fixed rectal cancer in a national cohort including all Danish...... patients registered with primary inoperable rectal cancer and treated in the period May 2001 to December 2005. METHOD: The study was based on surgical and demographic data from a continuously updated and validated national database. In addition, retrospective data were retrieved from all departments...... of radiotherapy concerning technique of radiotherapy, dose and fractionation and use of concomitant chemotherapy. Outcome was determined by actuarial analysis of local control, disease-free survival and overall survival. RESULTS: A total of 258 patients with fixed rectal cancer received long-course radiotherapy...

  5. [Carbon monoxide poisoning by a heating system].

    Science.gov (United States)

    Dietz, Eric; Gehl, Axel; Friedrich, Peter; Kappus, Stefan; Petter, Franz; Maurer, Klaus; Püschel, Klaus

    2016-01-01

    A case of accidental carbon monoxide poisoning in several occupants of two neighboring residential buildings in Hamburg-Harburg (Germany) caused by a defective gas central heating system is described. Because of leaks in one of the residential buildings and the directly adjacent wall of the neighboring house, the gas could spread and accumulated in both residential buildings, which resulted in a highly dangerous situation. Exposure to the toxic gas caused mild to severe intoxication in 15 persons. Three victims died still at the site of the accident. Measures to protect the occupants were taken only with a great delay. As symptoms were unspecific, it was not realized that the various alarms given by persons involved in the accident were related to the same cause. In order to take appropriate measures in time it is indispensible to recognize, assess and check potential risks, which can be done by using carbon monoxide warning devices and performing immediate COHb measurements with special pulse oximeters on site. Moreover, the COHb content in the blood should be routinely determined in all patients admitted to an emergency department with unspecific symptoms.

  6. Cardiological aspects of carbon monoxide poisoning.

    Science.gov (United States)

    Marchewka, Jakub; Gawlik, Iwona; Dębski, Grzegorz; Popiołek, Lech; Marchewka, Wojciech; Hydzik, Piotr

    2017-01-01

    The aim of this study was to assess cardiological manifestations of carbon monoxide (CO) poisoning. Background/introduction: Carbon monoxide intoxication is one of the most important toxicological causes of morbidity and mortality worldwide. Early clinical manifestation of CO poisoning is cardiotoxicity. We enrolled 75 patients (34 males and 41 females, mean age 37.6 ± 17.7 y/o) hospitalized due to CO poisoning. Laboratory tests including troponin I, blood pressure measurements, HR and electrocardiograms (ECG) were collected. Pach's scale scoring and grading system was used to establish severity of poisoning. Grade of poisoning is positively correlated with troponin I levels and systolic blood pressure. Moreover, troponin levels are significantly correlated with exposition time, lactates and are higher in tachycardiac, hypertensive and positive ECG subpopulations. COHb levels are indicative of exposure but do not correlate with grade of poisoning. The main cause of CO poisoning were bathroom heaters - 83%, only 11% of examined intoxicated population were equipped with CO detectors. Complex cardiological screening covering troponin levels, ECG, blood pressure and heart rate measurements as well as complete blood count with particular attention to platelet parameters should be performed in each case where CO intoxication is suspected. More emphasis on education on CO poisoning is needed.

  7. 40 CFR 86.1322-84 - Carbon monoxide analyzer calibration.

    Science.gov (United States)

    2010-07-01

    ... be used. (2) Zero the carbon monoxide analyzer with either zero-grade air or zero-grade nitrogen. (3... columns is one form of corrective action which may be taken.) (b) Initial and periodic calibration. Prior... calibrated. (1) Adjust the analyzer to optimize performance. (2) Zero the carbon monoxide analyzer with...

  8. Hydrogen bonding of formamide, urea, urea monoxide and their thio

    Indian Academy of Sciences (India)

    Ab initio and DFT methods have been employed to study the hydrogen bonding ability of formamide, urea, urea monoxide, thioformamide, thiourea and thiourea monoxide with one water molecule and the homodimers of the selected molecules. The stabilization energies associated with themonohydrated adducts and ...

  9. Placebo use in the United kingdom: results from a national survey of primary care practitioners.

    Directory of Open Access Journals (Sweden)

    Jeremy Howick

    Full Text Available OBJECTIVES: Surveys in various countries suggest 17% to 80% of doctors prescribe 'placebos' in routine practice, but prevalence of placebo use in UK primary care is unknown. METHODS: We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into 'pure' and 'impure'. 'Impure' placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. 'Pure' placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. RESULTS: We surveyed 1715 general practitioners and 783 (46% completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15 of respondents used pure placebos while 97% (95% CI 96 to 98 used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79 used impure placebos at least once per week. Most (66% for pure, 84% for impure respondents stated placebos were ethical in some circumstances. CONCLUSION AND IMPLICATIONS: Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.

  10. The potential impact of the next influenza pandemic on a national primary care medical workforce

    Directory of Open Access Journals (Sweden)

    Crampton Peter

    2005-08-01

    Full Text Available Abstract Background Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. Methods The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta was applied to the New Zealand primary care medical workforce (i.e., general practitioners. Results At its peak (week 4 the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88% would be lost due to illness, followed by hospitalisation (8%, and then premature death (4%. Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64% of lost workdays would be due to illness, followed by caring for others (31%, hospitalisation (4%, and then premature death (1%. Conclusion Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

  11. The potential impact of the next influenza pandemic on a national primary care medical workforce.

    Science.gov (United States)

    Wilson, Nick; Baker, Michael; Crampton, Peter; Mansoor, Osman

    2005-08-11

    Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta) was applied to the New Zealand primary care medical workforce (i.e., general practitioners). At its peak (week 4) the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88%) would be lost due to illness, followed by hospitalisation (8%), and then premature death (4%). Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64%) of lost workdays would be due to illness, followed by caring for others (31%), hospitalisation (4%), and then premature death (1%). Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

  12. Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

    Science.gov (United States)

    Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

    2014-01-01

    Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

  13. Patient experience of access to primary care: identification of predictors in a national patient survey.

    Science.gov (United States)

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger

  14. Patient experience of access to primary care: identification of predictors in a national patient survey

    Directory of Open Access Journals (Sweden)

    Kontopantelis Evangelos

    2010-08-01

    Full Text Available Abstract Background The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. Methods 8,307 English general practices were included in the survey (of 8,403 identified. 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. Results After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. Conclusions This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given

  15. Thermal Reactions in Mixtures of Micron-sized Silicon Monoxide and Titanium Monoxide - Redox Paths Overcoming Passivation Shells.

    Czech Academy of Sciences Publication Activity Database

    Jandová, Věra; Pokorná, Dana; Kupčík, Jaroslav; Bezdička, Petr; Křenek, T.; Netrvalová, M.; Cuřínová, Petra; Pola, Josef

    2018-01-01

    Roč. 44, č. 1 (2018), s. 503-516 ISSN 0922-6168 R&D Projects: GA TA ČR TA04010169 Institutional support: RVO:67985858 Keywords : silicon monoxide * titanium monoxide * hifh-temperature Subject RIV: CF - Physical ; Theoretical Chemistry OBOR OECD: Physical chemistry Impact factor: 1.369, year: 2016

  16. Thermal reactions in mixtures of micron-sized silicon monoxide and titanium monoxide: redox paths overcoming passivation shells

    Czech Academy of Sciences Publication Activity Database

    Jandová, V.; Pokorná, D.; Kupčík, Jaroslav; Bezdička, Petr; Křenek, T.; Netrvalová, M.; Cuřínová, P.; Pola, J.

    2018-01-01

    Roč. 44, č. 1 (2018), s. 503-516 ISSN 0922-6168 Institutional support: RVO:61388980 Keywords : Silicon monoxide * Titanium monoxide * High-temperature * Oxygen-transfer reactions * Titanium suboxides * Titanium silicide * Methylene blue depletion Subject RIV: CA - Inorganic Chemistry OBOR OECD: Inorganic and nuclear chemistry Impact factor: 1.369, year: 2016

  17. Geostatistical modelling of carbon monoxide levels in Khartoum State (Sudan) - GIS pilot based study

    Energy Technology Data Exchange (ETDEWEB)

    Alhuseen, A [Comenius University in Bratislava, Faculty of Natural Sciences, Dept. of Landscape Ecology, 84215 Bratislava (Slovakia); Madani, M [Ministry of Environment and Physical Development, 1111 Khartoum (Sudan)

    2012-04-25

    The objective of this study is to develop a digital GIS model; that can evaluate, predict and visualize carbon monoxide (CO) levels in Khartoum state. To achieve this aim, sample data had been collected, processed and managed to generate a dynamic GIS model of carbon monoxide levels in the study area. Parametric data collected from the field and analysis carried throughout this study show that (CO) emissions were lower than the allowable ambient air quality standards released by National Environment Protection Council (NEPC-USA) for 1998. However, this pilot study has found emissions of (CO) in Omdurman city were the highest. This pilot study shows that GIS and geostatistical modeling can be used as a powerful tool to produce maps of exposure. (authors)

  18. Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study.

    LENUS (Irish Health Repository)

    Whitford, David L

    2009-01-01

    BACKGROUND: Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. METHODS: Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. RESULTS: Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. CONCLUSION: General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

  19. Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

    Directory of Open Access Journals (Sweden)

    O'Sullivan Bernadette

    2009-04-01

    Full Text Available Abstract Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response. Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

  20. Risk of subsequent primary malignancies after dermatofibrosarcoma protuberans diagnosis: a national study.

    Science.gov (United States)

    Kurlander, David E; Martires, Kathryn J; Chen, Yanwen; Barnholtz-Sloan, Jill S; Bordeaux, Jeremy S

    2013-05-01

    Patients frequently live many years after diagnosis of dermatofibrosarcoma protuberans (DFSP). We sought to determine the risk of subsequent primary malignancy (SPM) after DFSP diagnosis. Using the Surveillance, Epidemiology, and End Results database (1973-2008) for 3734 patients with DFSP, we compared the risk of developing 14 SPMs (12 most prevalent cancers in the United States plus other nonepithelial and soft tissue) relative to risk in the general population of same sex, race, and age and year of diagnosis. Patients given the diagnosis of DFSP had an overall increased risk of SPM (observed:expected [O:E], 1.20; 95% confidence intervals [CI], 1.04-1.39), with much of the overall increased risk attributable to increased risk of nonepithelial skin cancer (O:E, 9.94; 95% CI, 3.38-22.30). Specifically, female patients with DFSP were at increased risk of other nonepithelial skin cancer (O:E, 14.50; 95% CI, 3.46-38.98), melanoma (O:E, 2.59; 95% CI, 1.02-5.35), and breast cancer (O:E, 1.44; 95% CI, 1.00-2.00). Male patients were not at increased overall risk (O:E, 1.18; 95% CI, 0.96-1.44) of SPM or at increased risk of any specific malignancy (P > .05) adjusted for multiplicity of t tests. Surveillance bias may have led to increased rates and earlier detection of primary malignances in patients with DFSP compared with the general population. Individual data that may reveal shared environmental causes of DFSP and SPM were unavailable. Patients with DFSP are at increased risk of a number of SPMs. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  1. A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol

    OpenAIRE

    Cohen, Deborah J.; Balasubramanian, Bijal A.; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I.; Crabtree, Benjamin F.; Stange, Kurt C.; Davis, Melinda; Miller, William L.; Damschroder, Laura J.; McConnell, K. John; Creswell, John

    2016-01-01

    Background The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to...

  2. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

    Directory of Open Access Journals (Sweden)

    Darko Gvozdanovi_

    2007-09-01

    Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

  3. The Danish National Health Service Register (NHSR) as a Source for Research on Primary Care

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan

    . The data is easy accessible from the Danish National Board of Health. Conclusion: The register's strengths include completeness, size and long follow-up period. It is useful for research purposes especially when linked with other registers. However, grave reservations must be made regarding the validity...... of the register as no studies of this point have been made. Knowledge of the working conditions in general practice is necessary in order to use the NHSR for research purposes.......Aim: To describe NHSR in relation to research. Content: The data in the register from general practice is generated through the GPs’ electronic invoices to the Regional Health Administration. Data from 1990 onwards is available covering more than 600 million patient contacts. For each service...

  4. Teale National Ambient Air Quality Standards for carbon monoxide

    Data.gov (United States)

    California Natural Resource Agency — California Spatial Information System (CaSIL) is a project designed to improve access to geo-spatial and geo-spatial related data information throughout the state of...

  5. The Impacts of Retention, Expenditures, and Class Size on Primary School Completion in Sub-Saharan Africa: A Cross-National Analysis

    Science.gov (United States)

    Ruff, Ryan Richard

    2016-01-01

    Education in Sub-Saharan Africa is increasingly viewed as a means of emancipation and a transformative project for social mobility. Developing nations have pursued policies such as universal or free primary education to increase access to education and improve student outcomes. In this study, direct and indirect precursors to primary school…

  6. Social franchising primary healthcare clinics--a model for South African National Health Insurance?

    Science.gov (United States)

    Robinson, Andrew Ken Lacey

    2015-09-21

    This article describes the first government social franchise initiative in the world to deliver a 'brand' of quality primary healthcare (PHC) clinic services. Quality and standards of care are not uniformly and reliably delivered across government PHC clinics in North West Province, South Africa, despite government support, numerous policies, guidelines and in-service training sessions provided to staff. Currently the strongest predictor of good-quality service is the skill and dedication of the facility manager. A project utilising the social franchising business model, harvesting best practices, has been implemented with the aim of developing a system to ensure reliably excellent healthcare service provision in every facility in North West. The services of social franchising consultants have been procured to develop the business model to drive this initiative. Best practices have been benchmarked, and policies, guidelines and clinic support systems have been reviewed, evaluated and assessed, and incorporated into the business plan. A pilot clinic has been selected to refine and develop a working social franchise model. This will then be replicated in one clinic to confirm proof of concept before further scale-up. The social franchise business model can provide solutions to a reliable and recognisable 'brand' of quality universal coverage of healthcare services.

  7. PRIMARY HEALTH CARE IN THE VILLAGES AROUND LORE LINDU NATIONAL PARK, CENTRAL SULAWESI

    Directory of Open Access Journals (Sweden)

    M. Sudomo

    2012-10-01

    Full Text Available The general pattern of service provision provides specialist and maternity hospitals at the tertiary care level, general hospitals as secondary level care, while the PUSKESMAS, PUSKESTU, POSYANDU and Village Delivery Units (POLINDES make up the primary care facilities. A PUSKESMAS is staffed by a medical doctor (general physician, a dental surgeon, nurses, midwives, assistant pharmacist and sanitarians, alongside the necessary administrative staff. Usually the facilities of a PUSKESMAS will include a minor operations surgery, a delivery room, a dental surgery and a small inpatient ward. The PUSKESMAS may also have minor laboratory facilities, such as the capacity to diagnose malaria, helminth infection or tuberculosis. The PUSKESTU has nurses only. The Village Delivery Unit is used by both the Village Midwife (Bidem Desa, usually a newly qualified midwife, and the traditional midwife (Dukun who may or may not be trained. Facilities are open Monday to Friday during normal office hours, with emergency cover only outside these times. Care is generally provided on a fee-for-service basis.

  8. Assessing mixed anxiety-depressive disorder. A national primary care survey.

    Science.gov (United States)

    Balestrieri, Matteo; Isola, Miriam; Quartaroli, Mauro; Roncolato, Maurizio; Bellantuono, Cesario

    2010-04-30

    Prevalence and risk factors associated with mixed anxiety-depressive disorder (MAD) have yet to be established. Using MINI 5.0.1 and HADS, a two-week survey involving 21,644 primary care patients was carried out. We found 1.8% of subjects with MAD and 20% of subjects with a co-morbid anxiety and depression (CAD) disorder. MAD patients without a past history of anxiety/affective episodes were defined as "pure MAD" (pMAD: 0.9% of the sample). While MAD patients showed a number of differences vs. the other groups of patients in the socio-demographic statistics, pMAD patients were not different, apart from a higher proportion of males vs. CAD patients. Nearly in all the comparisons, MAD and pMAD patients showed lower association with life events and with a familial predisposition than the other patients. On HADS assessment, MAD showed a higher risk of anxiety and depressive symptoms than anxiety diagnoses, a lower risk of depressive symptoms than depressive diagnoses and a lower risk of both anxiety and depressive symptoms than CAD. Since more than a half of MAD patients were classified as pMAD, the hypothesis that MAD should be viewed as a partial remission of a major depression is not entirely confirmed in our study. Copyright (c) 2008 Elsevier Ltd. All rights reserved.

  9. [Primary immune thrombocytopenia in adults in Mexico: national characteristics and the relation to international literature].

    Science.gov (United States)

    Meillón-García, Luis Antonio; García-Chávez, Jaime; Gómez-Almaguer, David; Gutiérrez-Espíndola, Guillermo R; Martínez-Murillo, Carlos

    2014-01-01

    In order to identify the clinical approach of a sample of Mexican hematologists for primary immune thrombocytopenia (ITP) in adults in Mexico, we applied an electronic survey via the internet to identify common practices for the diagnosis and treatment of ITP and draw a comparison between the information from these hematologists with international guidelines or the international literature. The results were analyzed using measures of central tendency. The sample was 21 medical hematologists, predominantly from Mexico City (average age: 51.4 years). A total of 66.7% of the surveyed physicians use international guidelines to make therapeutic decisions, and 43% defined ITP including the numerical concept (< 100 x 10(9)/l). We found some differences between requested clinical exams and tests indicated by the guidelines. In first-line treatment (except emergency), 91% of the participants start with prednisone and 24% use dexamethasone. Danazol is used in persistent ITP by most (41%) of the specialists. In second-line treatment, 67% would indicate splenectomy. Some differences were found between clinical practice of the hematologists in Mexico versus guidelines recommendations.

  10. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    Directory of Open Access Journals (Sweden)

    Bordonaba-Bosque Daniel

    2011-06-01

    Full Text Available Abstract Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain. Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®. Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

  11. Residential indoor air quality guideline : carbon monoxide

    International Nuclear Information System (INIS)

    2010-01-01

    Carbon monoxide (CO) is a tasteless, odourless, and colourless gas that can be produced by both natural and anthropogenic processes, but is most often formed during the incomplete combustion of organic materials. In the indoor environment, CO occurs directly as a result of emissions from indoor sources or as a result of infiltration from outdoor air containing CO. Studies have shown that the use of specific sources can lead to increased concentrations of CO indoors. This residential indoor air quality guideline examined the factors influencing the introduction, dispersion and removal of CO indoors. The health effects of exposure to low and higher concentrations of CO were discussed. Residential maximum exposure limits for CO were presented. Sources and concentrations in indoor environments were also examined. 17 refs., 2 tabs.

  12. Recent changes in atmospheric carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, P.C.; Masarie, K.A. (Univ. of Colorado, Boulder, CO (United States)); Tans, P.P.; Lang, P.M. (National Oceanic and Atmospheric Administration, Boulder, CO (United States))

    1994-03-18

    Measurements of carbon monoxide (CO) in air samples collected from 27 locations between 71[degrees]N and 41[degrees]S show that atmospheric levels of this gas have decreased worldwide over the past 2 to 5 years. During this period, CO decreased at nearly a constant rate in the high northern latitudes. In contrast, in the tropics an abrupt decrease occurred beginning at the end of 1991. In the Northern Hemisphere, CO decreased at a spatially and temporally averaged rate of 7.3 ([+-]0.9) parts per billion per year (6.1 percent per year) from June 1990 to June 1993, whereas in the Southern Hemisphere, CO decreased 4.2 ([+-]0.5) parts per billion per year (7.0 percent per year). This recent change is opposite a long-term trend of a 1 to 2 percent per year increase inferred from measurements made in the Northern Hemisphere during the past 30 years.

  13. Health effects of carbon monoxide environmental pollution

    Energy Technology Data Exchange (ETDEWEB)

    1974-01-01

    Carbon monoxide's (CO) chronic effects on man, its sources, and measuring methods are reviewed, and guidelines to determine health criteria are considered. The European data exchange included CO measuring methods in air and blood and their use in survey and experimental work, atmospheric CO pollution and sampling methods in urban thoroughfares and road tunnels in the European countries, a population survey of carboxyhemoglobin levels from cigarette smoking and atmospheric exposure, and physiological kinetics (uptake, distribution, and elimination) of CO inhalation. Additional topics are CO and the central nervous system, effects of moderate CO exposure on the cardiovascular system and on fetal development, and the current views on existing air quality criteria for CO.

  14. Primary Maternity Units in rural and remote Australia: Results of a national survey.

    Science.gov (United States)

    Kruske, Sue; Kildea, Sue; Jenkinson, Bec; Pilcher, Jennifer; Robin, Sarah; Rolfe, Margaret; Kornelsen, Jude; Barclay, Lesley

    2016-09-01

    Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. the PMUs were, on average, 56km or 49minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. a small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Onboard measurement system of atmospheric carbon monoxide over the Pacific Ocean by voluntary observing ships

    Science.gov (United States)

    Nara, H.; Tanimoto, H.; Nojiri, Y.; Mukai, H.; Machida, T.; Tohjima, Y.

    2011-07-01

    Long-term monitoring of carbon monoxide (CO) mixing ratios in the atmosphere over the Pacific Ocean is being carried out on commercial cargo vessels participating in the National Institute for Environmental Studies Voluntary Observing Ships program. The program provides a regular platform for measurement of atmospheric CO along four cruising routes: from Japan to Oceania, from Japan to the United States, from Japan to Canada, and from Japan to Southeast Asia. Flask samples are collected during every cruise for subsequent analysis in the laboratory, and in 2005, continuous shipboard CO measurements were initiated on three of the routes. Here, we describe the system we developed for onboard measurement of CO mixing ratios with a commercially available gas filter correlation CO analyzer. The fully automated system measures CO in ambient air, and the detector sensitivity and background signals are calibrated by referencing the measurements to a CO-in-air standard gas (~1 ppmv) and to CO-free air scrubbed with a catalyst, respectively. We examined the artificial production of CO in the high-pressure working gas standards (CO balanced with purified air at ppmv levels) during storage by referencing the measurements to CO standard gases maintained as our primary scale before and after use on the ships. The onboard performance of the continuous CO measurement system was evaluated by comparing its data with data from laboratory analyses of flask samples using gas chromatography with a reduction gas detector. The reasonably good consistency between the two independent measurement methods demonstrated the good performance of both methods over the course of 3-5 yr. The continuous measurement system was more useful than the flask sampling method for regionally polluted air masses, which were often encountered on Southeast Asian cruises.

  16. Onboard measurement system of atmospheric carbon monoxide in the Pacific by voluntary observing ships

    Science.gov (United States)

    Nara, H.; Tanimoto, H.; Nojiri, Y.; Mukai, H.; Machida, T.; Tohjima, Y.

    2011-11-01

    Long-term monitoring of carbon monoxide (CO) mixing ratios in the atmosphere over the Pacific Ocean is being carried out on commercial cargo vessels participating in the National Institute for Environmental Studies Voluntary Observing Ships program. The program provides a regular platform for measurement of atmospheric CO along four cruise routes: from Japan to Oceania, the United States, Canada, and Southeast Asia. Flask samples are collected during every cruise for subsequent analysis in the laboratory, and in 2005, continuous shipboard CO measurements were initiated on three of the routes. Here, we describe the system we developed for onboard measurement of CO mixing ratios with a commercially available gas filter correlation CO analyzer. The fully automated system measures CO in ambient air, and the detector sensitivity and background signals are calibrated by referencing the measurements to a CO-in-air standard gas (~1 ppmv) and to CO-free air scrubbed with a catalyst, respectively. We examined the artificial production of CO in the high-pressure working gas standards during storage by referencing the measurements to CO standard gases maintained as our primary scale before and after use on the ships. The onboard performance of the continuous CO measurement system was evaluated by comparing its data with data from laboratory analyses of flask samples using gas chromatography with a reduction gas detector. The reasonably good consistency between the two independent measurement methods demonstrated the good performance of both methods over the course of 3-5 years. The continuous measurement system was more useful than the flask sampling method for regionally polluted air masses, which were often encountered on Southeast Asian cruises.

  17. Onboard measurement system of atmospheric carbon monoxide in the Pacific by voluntary observing ships

    Directory of Open Access Journals (Sweden)

    H. Nara

    2011-11-01

    Full Text Available Long-term monitoring of carbon monoxide (CO mixing ratios in the atmosphere over the Pacific Ocean is being carried out on commercial cargo vessels participating in the National Institute for Environmental Studies Voluntary Observing Ships program. The program provides a regular platform for measurement of atmospheric CO along four cruise routes: from Japan to Oceania, the United States, Canada, and Southeast Asia. Flask samples are collected during every cruise for subsequent analysis in the laboratory, and in 2005, continuous shipboard CO measurements were initiated on three of the routes. Here, we describe the system we developed for onboard measurement of CO mixing ratios with a commercially available gas filter correlation CO analyzer. The fully automated system measures CO in ambient air, and the detector sensitivity and background signals are calibrated by referencing the measurements to a CO-in-air standard gas (~1 ppmv and to CO-free air scrubbed with a catalyst, respectively. We examined the artificial production of CO in the high-pressure working gas standards during storage by referencing the measurements to CO standard gases maintained as our primary scale before and after use on the ships. The onboard performance of the continuous CO measurement system was evaluated by comparing its data with data from laboratory analyses of flask samples using gas chromatography with a reduction gas detector. The reasonably good consistency between the two independent measurement methods demonstrated the good performance of both methods over the course of 3–5 years. The continuous measurement system was more useful than the flask sampling method for regionally polluted air masses, which were often encountered on Southeast Asian cruises.

  18. The Security Education Concepts in the Textbooks of the National and Civic Education of the Primary Stage in Jordan--An Analytical Study

    Science.gov (United States)

    Al-Edwan, Zaid Suleiman

    2016-01-01

    The present study aimed at exploring the concepts of the security education in the textbooks of the national and civic education of the higher primary stage in Jordan. It adopted the descriptive analytical method. The study sample consisted of the textbooks of the national and civic education for the basic eighth, ninth and tenth grades. To…

  19. 40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data.... Primary and Secondary Ambient Air Quality Standards for Ozone. 2.1 Data Reporting and Handling Conventions... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of...

  20. Internet Gaming Disorder Among Slovenian Primary Schoolchildren: Findings From a Nationally Representative Sample of Adolescents

    Science.gov (United States)

    Pontes, Halley M.; Macur, Mirna; Griffiths, Mark D.

    2016-01-01

    Background and aims Since the inclusion of Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a tentative disorder, a few psychometric screening instruments have been developed to assess IGD, including the 9-item Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) – a short, valid, and reliable instrument. Methods Due to the lack of research on IGD in Slovenia, this study aimed to examine the psychometric properties of the IGDS9-SF in addition to investigating the prevalence rates of IGD in a nationally representative sample of eighth graders from Slovenia (N = 1,071). Results The IGDS9-SF underwent rigorous psychometric scrutiny in terms of validity and reliability. Construct validation was investigated with confirmatory factor analysis to examine the factorial structure of the IGDS9-SF and a unidimensional structure appeared to fit the data well. Concurrent and criterion validation were also investigated by examining the association between IGD and relevant psychosocial and game-related measures, which warranted these forms of validity. In terms of reliability, the Slovenian version IGDS9-SF obtained excellent results regarding its internal consistency at different levels, and the test appears to be a valid and reliable instrument to assess IGD among Slovenian youth. Finally, the prevalence rates of IGD were found to be around 2.5% in the whole sample and 3.1% among gamers. Discussion and conclusion Taken together, these results illustrate the suitability of the IGDS9-SF and warrants further research on IGD in Slovenia. PMID:27363464

  1. The retention of health human resources in primary healthcare centers in Lebanon: a national survey.

    Science.gov (United States)

    Alameddine, Mohamad; Saleh, Shadi; El-Jardali, Fadi; Dimassi, Hani; Mourad, Yara

    2012-11-22

    Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Two out of five respondents indicated likelihood to quit their jobs within the next 1-3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should

  2. The retention of health human resources in primary healthcare centers in Lebanon: a national survey

    Directory of Open Access Journals (Sweden)

    Alameddine Mohamad

    2012-11-01

    Full Text Available Abstract Background Critical shortages of health human resources (HHR, associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. Methods A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory. A total of 755 providers completed the questionnaire (60.5% response rate. Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Results Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%, better job opportunities outside the country (35.1% and lack of professional development (33.7%. A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. Conclusions The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits

  3. How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level.

    Science.gov (United States)

    Hansen, P. J. K.

    2009-09-01

    How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level. Pål J. Kirkeby Hansen Faculty of Education and International Studies, Oslo University College (PalKirkeby.Hansen@lui.hio.no) Weather and climate are topics in natural science and geography in primary and secondary education in most countries. The pupils are often doing own weather observations and measurements and are presenting the results oral, by posters or with digital aids. They also use the Internet with all its relevant resources in their studies to develop vocabulary, practical and conceptual knowledge. Knowledge about weather and climate is parts of liberal education and could be projected to other topics in science and to topics in other subjects, for instance: history, social geography, literature and arts. This article reports from a case study in grade 3 classes (age 9 year) during their Weather Week. Their science teacher was, quite untypical, also educated in art history. She arranged a visited to The National Gallery with the double agenda: 1. To introduce the pupils to Norwegian canon paintings from the national romantic period, our so-called "golden age”. 2. To look for and discuss weather elements in this paintings. For one hour the museum curator guided the pupils around the water cycle by using the paintings. While the pupils' own observations of weather, clouds and wind and measurements of temperature and precipitation during the Weather Week only are point checks, the guided tour in The National Gallery gave literally "the whole picture” of the Norwegian weather and climate and of the water cycle. During the tour, the curator constantly invited the pupils to tell about and discuss what weather and water elements they were looking at when standing in front of a painting. The pupils were responsive and interested all the time. Back at school, they demonstrated that they had learned much about both weather elements, the water

  4. Monoxides of small terbium clusters: A density functional theory investigation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, G. L.; Yuan, H. K., E-mail: yhk10@swu.edu.cn; Chen, H.; Kuang, A. L.; Li, Y.; Wang, J. Z.; Chen, J. [School of Physical Science and Technology, Southwest University, Chongqing 400715 (China)

    2014-12-28

    To investigate the effect of oxygen atom on the geometrical structures, electronic, and magnetic properties of small terbium clusters, we carried out the first-principles calculations on Tb{sub n}O (n = 1-14) clusters. The capping of an oxygen atom on one trigonal-facet of Tb{sub n} structures is always favored energetically, which can significantly improve the structural stability. The far-infrared vibrational spectroscopies are found to be different from those of corresponding bare clusters, providing a distinct signal to detect the characteristic structures of Tb{sub n}O clusters. The primary effect of oxygen atom on magnetic properties is to change the magnetic orderings among Tb atoms and to reduce small of local magnetic moments of the O-coordinated Tb atoms, both of which serve as the key reasons for the experimental magnetic evolution of an oscillating behavior. These calculations are consistent with, and help to account for, the experimentally observed magnetic properties of monoxide Tb{sub n}O clusters [C. N. Van Dijk et al., J. Appl. Phys. 107, 09B526 (2010)].

  5. The Role of Oxygen Therapies in Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Suleyman Metin

    2011-08-01

    Full Text Available Due to climate and socio-economic issues in Turkey, the incidence of carbon monoxide (CO poisoning is high, especially in winter. Clinical manifestations may vary depending on the type of CO source, concentration and duration of exposure. The symptoms of CO poisoning predominantly manifest in lots of organs and systems with high oxygen utilization, especially the brain and the heart. The primary aim in oxygen therapy is to eliminate CO and to reduce its toxic effects. In this context, normobaric and hyperbaric oxygen therapy are used to achieve these goals. Normobaric oxygen (NBO treatment is an easily accessible and relatively not expensive modality, where hyperbaric oxygen (HBO therapy requires specific equipment, certified staff and is available only in some centers. Additionally, HBO treatment has several additional advantages over NBO treatment. Despite its benefits, it is compulsory to search for some criteria in selecting patients to be treated because of the limited availability and access of hyperbaric facilities. For an effective evaluation and an optimal treatment, advanced education of the healthcare professionals on the use of oxygen delivery modalities in the management of CO poisoning is imperative. In this review, it has been aimed to outline the significance of oxygen treatment modalities and to determine patient selection criteria for HBO treatment in the management of CO poisoning which continues to be an important threat to community health care. [TAF Prev Med Bull 2011; 10(4.000: 487-494

  6. Experimental and clinical study of chronic poisoning by carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Thiele, H.; Gohlke, R.; Rothe, R.

    1973-01-01

    Animal and clinical tests on carbon monoxide-exposed subjects are described in an attempt to demonstrate the specific chronic action of CO. Rabbits exposed to 802 ppM and 284 ppM CO for 103 and 112 days, respectively, for 5 days a week showed carboxyhemoglobin values in the respective ranges of 2.5 to 11.9% and 2.5 to 8.3%. The macroscopic findings and gain in weight were normal, except for an increase by 20% and 14% in the weight of the liver. Dose-dependent increases in the hemoglobin and hematocrit levels, significant increases in the pyruvate level of the first group, and significant reductions of the cholinesterase, inorganic phosphate levels, hepatic lipase, phosphate, phosphatase, and cytochrome-C oxidase were observed. An increased cholinesterase level was found in brain homogenates. Inhibition of the glucose-6-phosphatase was observed. There is a specific damage due to CO in addition to merely the hypoxic effect. Clinical tests in humans with and without acute, subacute, or chronic exposure to CO revealed that acute and subacute poisoning have no additional pathogenic effect in chronic exposure, i.e., indicate the existence of primary chronic poisoning with CO.

  7. Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

    Directory of Open Access Journals (Sweden)

    Oparanya Wamukoya Windrick

    2015-06-01

    Full Text Available ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performance. This study adapted a descriptive survey design as a major method of research where data was collected by the researcher members of a population under study. The target population comprised of Head teachers teachers pupils parents and parent schools representatives. Purposive sampling and simple random technique were used. Data was collected by use of questionnaires and interview guides. Data was analyzed by use of descriptive statistics constituting frequencies and percentages.The study established that girls were exposed to harsh school environmental conditions they walked long distances to school schools lacked facilities like toilets libraries and were exposed to male pest teachers. There were also teacher factors like training teacher shortage and motivation that affected girls performance.The study came up with recommendations for improvement of girls academic performance. More public schools should be build to reduce on distance and also overpopulation. The ministry of Education should monitor and evaluate the academic performance of girls in rural areas. The government should put up strict rules on pest teachers. The ministry should hire more teachers.

  8. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data.

    Science.gov (United States)

    Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-12-01

    Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  9. Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

    Science.gov (United States)

    Gill, James M; Klinkman, Michael S; Chen, Ying Xia

    2010-01-01

    Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

  10. High Resolution Trajectory-Based Smoke Forecasts Using VIIRS Aerosol Optical Depth and NUCAPS Carbon Monoxide Retrievals

    Science.gov (United States)

    Pierce, R. B.; Smith, N.; Barnet, C.; Barnet, C. D.; Kondragunta, S.; Davies, J. E.; Strabala, K.

    2016-12-01

    We use Suomi National Polar-orbiting Partnership (S-NPP) Visible Infrared Imaging Radiometer Suite (VIIRS) Aerosol Optical Depth (AOD) and combined Cross-track Infrared Sounder (CrIS) and Advanced Technology Microwave Sounder (ATMS) NOAA-Unique CrIS-ATMS Processing System (NUCAPS) carbon monoxide (CO) retrievals to initialize trajectory-based, high spatial resolution North American smoke dispersion forecasts during the May 2016 Fort McMurray wildfire in northern Alberta and the July 2016 Soberanes Fire in Northern California. These two case studies illustrate how long range transport of wild fire smoke can adversely impact surface air quality thousands of kilometers downwind and how local topographic flow can lead to complex transport patterns near the wildfire source region. The NUCAPS CO retrievals are shown to complement the high resolution VIIRS AOD retrievals by providing retrievals in partially cloudy scenes and also providing information on the vertical distribution of the wildfire smoke. This work addresses the need for low latency, web-based, high resolution forecasts of smoke dispersion for use by NWS Incident Meteorologists (IMET) to support on-site decision support services for fire incident management teams. The primary user community for the IDEA-I smoke forecasts is the Western regions of the NWS and US EPA due to the significant impacts of wildfires in these regions. Secondary users include Alaskan NWS offices and Western State and Local air quality management agencies such as the Western Regional Air Partnership (WRAP).

  11. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    Science.gov (United States)

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

  12. The distribution of lung cancer across sectors of society in the United Kingdom: a study using national primary care data

    Directory of Open Access Journals (Sweden)

    Iyen-Omofoman Barbara

    2011-11-01

    Full Text Available Abstract Background There is pressing need to diagnose lung cancer earlier in the United Kingdom (UK and it is likely that research using computerised general practice records will help this process. Linkage of these records to area-level geo-demographic classifications may also facilitate case ascertainment for public health programmes, however, there have as yet been no extensive studies of data validity for such purposes. Methods To first address the need for validation, we assessed the completeness and representativeness of lung cancer data from The Health Improvement Network (THIN national primary care database by comparing incidence and survival between 2000 and 2009 with the UK National Cancer Registry and the National Lung Cancer Audit Database. Secondly, we explored the potential of a geo-demographic social marketing tool to facilitate disease ascertainment by using Experian's Mosaic Public Sector ™ classification, to identify detailed profiles of the sectors of society where lung cancer incidence was highest. Results Overall incidence of lung cancer (41.4/100, 000 person-years, 95% confidence interval 40.6-42.1 and median survival (232 days were similar to other national data; The incidence rate in THIN from 2003-2006 was found to be just over 93% of the national cancer registry rate. Incidence increased considerably with area-level deprivation measured by the Townsend Index and was highest in the North-West of England (65.1/100, 000 person-years. Wider variations in incidence were however identified using Mosaic classifications with the highest incidence in Mosaic Public Sector ™types 'Cared-for pensioners, ' 'Old people in flats' and 'Dignified dependency' (191.7, 174.2 and 117.1 per 100, 000 person-years respectively. Conclusions Routine electronic data in THIN are a valid source of lung cancer information. Mosaic ™ identified greater incidence differentials than standard area-level measures and as such could be used as a tool

  13. CT and clinical patterns in suicidal carbon monoxide

    International Nuclear Information System (INIS)

    Grobovschek, M.; Geretsegger, C.; Weinberger, R.; Fartacek, R.

    1988-01-01

    Cranial CT is important to exclude the presence of a mass in the cavum cranii in case of an unclear suicide attempt, particularly a traumatic mass. It can be helpful also in cases of carbon monoxide intoxications. (orig.) [de

  14. Atmospheric analyzer, carbon monoxide monitor and toluene diisocyanate monitor

    Science.gov (United States)

    Shannon, A. V.

    1977-01-01

    The purpose of the atmospheric analyzer and the carbon monoxide and toluene diisocyanate monitors is to analyze the atmospheric volatiles and to monitor carbon monoxide and toluene diisocyanate levels in the cabin atmosphere of Skylab. The carbon monoxide monitor was used on Skylab 2, 3, and 4 to detect any carbon monoxide levels above 25 ppm. Air samples were taken once each week. The toluene diisocyanate monitor was used only on Skylab 2. The loss of a micrometeoroid shield following the launch of Skylab 1 resulted in overheating of the interior walls of the Orbital Workshop. A potential hazard existed from outgassing of an isocyanate derivative resulting from heat-decomposition of the rigid polyurethane wall insulation. The toluene diisocyanate monitor was used to detect any polymer decomposition. The atmospheric analyzer was used on Skylab 4 because of a suspected leak in the Skylab cabin. An air sample was taken at the beginning, middle, and the end of the mission.

  15. Hydrogenation of carbon monoxide over supported palladium catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, K.; Hashimoto, H.; Kunugi, T.

    1978-03-01

    An alumina-supported 2% palladium catalyst had higher activity for carbon monoxide hydrogenation than a silica-supported 2% palladium catalyst, at 250/sup 0/-400/sup 0/C and 1 atm. The addition of lanthanum oxide or thorium oxide, but not of potassium oxide, to the silica-supported catalyst increased the conversion at 350/sup 0/C from 1.1% to 81.0% with a selectivity of 56.1% for methane, 1.4% for C/sub 2/ compounds, 0.1% for C/sub 3/ compounds, and 42.5% for carbon dioxide. Temperature-programed desorption of carbon monoxide in a hydrogen stream showed that of two desorption peaks observed for carbon monoxide, the one at higher temperature corresponded to the carbon monoxide species which hydrogenates to methane and that the area of this peak increased with increasing thorium content of the catalyst. Graphs, tables, and 12 references.

  16. Carbon Monoxide Hazards from Small Gasoline Powered Engines

    Science.gov (United States)

    ... DHHS (NIOSH) Publication No. 96-118 (1996) Describes health effects and current standards and guidelines relating to carbon monoxide, as well as recommendations for workers, employers, and manufacturers regarding small gasoline powered engine ...

  17. An interesting cause of pulmonary emboli: Acute carbon monoxide poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Sevinc, A.; Savli, H.; Atmaca, H. [Gaziantep University, Gaziantep (Turkey). School of Medicine

    2005-07-01

    Carbon monoxide poisoning, a public health problem of considerable significance, is a relatively frequent event today, resulting in thousands of hospitalizations annually. A 70-year-old lady was seen in the emergency department with a provisional diagnosis of carbon monoxide poisoning. The previous night, she slept in a tightly closed room heated with coal ember. She was found unconscious in the morning with poor ventilation. She had a rare presentation of popliteal vein thrombosis, pulmonary emboli, and possible tissue necrosis with carbon monoxide poisoning. Oxygen treatment with low-molecular-weight heparin (nadroparine) and warfarin therapy resulted in an improvement in both popliteal and pulmonary circulations. In conclusion, the presence of pulmonary emboli should be sought in patients with carbon monoxide poisoning.

  18. CT and clinical patterns in suicidal carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Grobovschek, M.; Geretsegger, C.; Weinberger, R.; Fartacek, R.

    1988-12-01

    Cranial CT is important to exclude the presence of a mass in the cavum cranii in case of an unclear suicide attempt, particularly a traumatic mass. It can be helpful also in cases of carbon monoxide intoxications.

  19. Catalytic Copolymerization of Ethene and Carbon Monoxide on Nickel Complexes.

    Science.gov (United States)

    Domhöver, Bernd; Kläui, Wolfgang; Kremer-Aach, Andreas; Bell, Ralf; Mootz, Dietrich

    1998-11-16

    Can palladium be replaced by nickel? For the industrial copolymerization of carbon monoxide and ethene a palladium catalyst is used which cannot be recovered-a cheaper procedure would be desirable. The presented complex 1 is the first structurally characterized nickel compound which does not polymerize ethene but a mixture from carbon monoxide and ethene unter mild conditions to give a perfectly alternating polyketone. © 1998 WILEY-VCH Verlag GmbH, Weinheim, Fed. Rep. of Germany.

  20. Carbon monoxide and coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Scheidemandel, V

    1974-01-01

    Studies on the relationship between increased carboxyhemoglobin levels in the blood and coronary heart disease in smokers and city dwellers are reviewed. The evidence of myocardial infarction is significantly higher in smokers than in nonsmokers which is due, apart from nicotine which promotes coronary arteriosclerosis, to inhaled carbon monoxide which leads to increased carboxyhemoglobin levels and most likely plays a role in the risk of arteriosclerosis and the coronary heart disease. Apart from combining with hemoglobin, CO increases the circulation rate and the coronary blood flow, and reduces the coronary arteriovenous oxygen difference, which is indicative of a reduced rate of oxygen extraction by the myocardium against an increased myocardial oxygen demand. The reduction of the oxygen extraction correlates with the increased COHb level. Inhaled CO lowers the threshold of angina pectoris due to the reduced myocardial oxygen tension. Also, considerable reduction of the oxygen diffusion from the capillaries toward the mitochondria due to the combination of CO with myoglobin is observed. Chronically increased CO levels in the blood and tissues not only accelerate the development of arteriosclerosis, but also induce a process directly injurious to the myocardial metabolism. (Air Pollut. Abstr.)

  1. First-Principles Investigations on Europium Monoxide

    KAUST Repository

    Wang, Hao

    2011-05-01

    Europium monoxide is both an insulator and a Heisenberg ferromagnet (Tc=69 K). In the present thesis, the author has investigated the electronic structure of different types of EuO by density functional theory. The on-site Coulomb interaction of the localized Eu 4f and 5d electrons, which is wrongly treated in the standard generalized gradient approximation method, is found to be crucial to obtain the correct insulating ground state as observed in experiments. Our results show that the ferromagnetism is stable under pressure, both hydrostatic and uniaxial. For both types of pressure an insulator-metal transition is demonstrated. Moreover, the experimentally observed insulator-metal transition in oxygen deficient and gadolinium-doped EuO is reproduced in our calculations for impurity concentrations of 6.25% and 25%. Furthermore, a 10- layer EuO thin film is theoretically predicted to be an insulator with a narrow band gap of around 0.08 eV, while the Si/EuO interface shows metallic properties with the Si and O 2p as well as Eu 5d bands crossing the Fermi level.

  2. Carbon Monoxide Hydrogenation on Ice Surfaces.

    Science.gov (United States)

    Kuwahata, Kazuaki; Ohno, Kaoru

    2018-03-14

    We have performed density functional calculations to investigate the carbon monoxide hydrogenation reaction (H+CO→HCO), which is important in interstellar clouds. We found that the activation energy of the reaction on amorphous ice is lower than that on crystalline ice. In the course of this study, we demonstrated that it is roughly possible to use the excitation energy of the reactant molecule (CO) in place of the activation energy. This relationship holds also for small water clusters at the CCSD level of calculation and the two-layer-level ONIOM (CCSD : X3LYP) calculation. Generally, since it is computationally demanding to estimate activation energies of chemical reactions in a circumstance of many water molecules, this relationship enables one to determine the activation energy of this reaction on ice surfaces from the knowledge of the excitation energy of CO only. Incorporating quantum-tunneling effects, we discuss the reaction rate on ice surfaces. Our estimate that the reaction rate on amorphous ice is almost twice as large as that on crystalline ice is qualitatively consistent with the experimental evidence reported by Hidaka et al. [Chem. Phys. Lett., 2008, 456, 36.]. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Carbon monoxide measurements at Mace Head, Ireland

    Science.gov (United States)

    Doddridge, Bruce G.; Dickerson, Russell R.; Spain, T. Gerard; Oltmans, Samuel J.; Novelli, Paul C.

    1994-01-01

    The North Atlantic Ocean is bordered by continents which may each, under the influence of seasonal weather patterns, act as sources of natural and anthropogenic trace gas and particulate species. Photochemically active species such as carbon monoxide (CO) react to form ozone (O3), a species of critical importance in global climate change. CO is sparingly soluble in water, and the relatively long lifetime of CO in the troposphere makes this species an ideal tracer of air masses with origin over land. We have measured CO using a nondispersive infrared gas filter correlation analyzer at Mace Head on the west coast of Ireland nearly continuously since August 9, 1991. Measurements of CO were acquired at 20-sec resolution and recorded as 60-sec averages. Daily, monthly, and diurnal variation data characteristics of CO mixing ratios observed at this site are reported. Depending on source regions of air parcels passing over this site, 60-min concentrations of CO range from clean air values of approximately 90 ppbv to values in excess of 300 ppbv. Data characterizing the correlation between 60-min CO and O3 mixing ratio data observed at this site are reported also.

  4. Residential carbon monoxide poisoning from motor vehicles.

    Science.gov (United States)

    Hampson, Neil B

    2011-01-01

    Although morbidity and mortality from accidental carbon monoxide (CO) poisoning are high in the United States, identification of common but poorly recognized sources should help prevention efforts. The study aimed to describe CO poisoning of home occupants due to a vehicle left running in an attached garage. News stories reporting incidents of US CO poisoning were collected daily from March 2007 to September 2009 via a news.Google.com search and data extracted. Patients were individuals reported in the media to have been poisoned with CO in their home by a vehicle running in the attached garage. Main outcome measures were frequency of occurrence, geographic distribution, patient demographics, and mortality. Of 837 CO poisoning incidents reported in US news media over 2 and a half years, 59 (8%) were the result of a vehicle left running in the garage. The elderly were disproportionately affected, with incidents most common in states with larger elderly populations and 29% of cases with age specified occurring in individuals older than 80 years. Among those older than 80 years, 15 of 17 were found dead at the scene. Residential CO poisoning from a vehicle running in the garage is common, disproportionately affects the elderly, has a high mortality rate, and should be preventable with a residential CO alarm. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Carbon Monoxide: An Essential Signalling Molecule

    Science.gov (United States)

    Mann, Brian E.

    Carbon monoxide (CO), like nitric oxide (NO), is an essential signalling molecule in humans. It is active in the cardiovascular system as a vasodilator. In addition, CO possesses anti-inflammatory, anti-apoptotic and anti-proliferative properties and protects tissues from hypoxia and reperfusion injury. Some of its applications in animal models include suppression of organ graft rejection and safeguarding the heart during reperfusion after cardiopulmonary bypass surgery. CO also suppresses arteriosclerotic lesions following angioplasty, reverses established pulmonary hypertension and mitigates the development of post-operative ileus in the murine small intestine and the development of cerebral malaria in mice as well as graft-induced intimal hyperplasia in pigs. There have been several clinical trials using air-CO mixtures for the treatment of lung-, heart-, kidney- and abdominal-related diseases. This review examines the research involving the development of classes of compounds (with particular emphasis on metal carbonyls) that release CO, which could be used in clinically relevant conditions. The review is drawn not only from published papers in the chemical literature but also from the extensive biological literature and patents on CO-releasing molecules (CO-RMs).

  6. Elevated carboxyhemoglobin: sources of carbon monoxide exposure.

    Science.gov (United States)

    Buchelli Ramirez, Herminia; Fernández Alvarez, Ramón; Rubinos Cuadrado, Gemma; Martinez Gonzalez, Cristina; Rodriguez Jerez, Francisco; Casan Clara, Pere

    2014-11-01

    Inhalation of carbon monoxide (CO) can result in poisoning, with symptoms ranging from mild and nonspecific to severe, or even death. CO poisoning is often underdiagnosed because exposure to low concentrations goes unnoticed, and threshold values for normal carboxyhemoglobin vary according to different authors. The aim of our study was to analyze carboxyhemoglobin (COHb) levels in an unselected population and detect sources of CO exposure In a cross-sectional descriptive study, we analyzed consecutive arterial blood gas levels processed in our laboratory. We selected those with COHb≥2.5% in nonsmokers and ≥5% in smokers. In these cases a structured telephone interview was conducted. Elevated levels of COHb were found in 64 (20%) of 306 initial determinations. Of these, data from 51 subjects aged 65±12 years, 31 (60%) of which were men, were obtained. Mean COHb was 4.0%. Forty patients (78%) were non-smokers with mean COHb of 3.2%, and 11 were smokers with COHb of 6.7%. In 45 patients (88.2%) we detected exposure to at least one source of ambient CO other than cigarette smoke. A significant proportion of individuals from an unselected sample had elevated levels of COHb. The main sources of CO exposure were probably the home, so this possibility should be explored. The population should be warned about the risks and encouraged to take preventive measures. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  7. Assessment of carbon monoxide values in smokers: a comparison of carbon monoxide in expired air and carboxyhaemoglobin in arterial blood

    DEFF Research Database (Denmark)

    Andersson, Mette F; Møller, Ann M

    2010-01-01

    Smoking increases perioperative complications. Carbon monoxide concentrations can estimate patients' smoking status and might be relevant in preoperative risk assessment. In smokers, we compared measurements of carbon monoxide in expired air (COexp) with measurements of carboxyhaemoglobin (COHb) ......) in arterial blood. The objectives were to determine the level of correlation and to determine whether the methods showed agreement and evaluate them as diagnostic tests in discriminating between heavy and light smokers....

  8. An online photographic catalog of primary types of Platygastroidea (Hymenoptera in the National Museum of Natural History, Smithsonian Institution

    Directory of Open Access Journals (Sweden)

    Elijah J. Talamas

    2017-06-01

    Full Text Available A photographic catalog of primary types of Platygastroidea housed in the National Insect Collection, National Museum of Natural History, is here made available online at the image database at The Ohio State University (specimage.osu.edu. Following examination of this collection we enact the following taxonomic changes: Leptacis piniella MacGown syn. n. is treated as a junior synonym of Leptacis pinicola MacGown; Sacespalus indicus Mani is transferred to Platygaster Latreille; Platygaster indica Mukerjee is given the replacement name Platygaster chaos Talamas, n. n.; Synopeas rugiceps (Ashmead, comb. n. is transferred from Leptacis Förster; Axea atriclava (Kieffer, comb. n. is transferred from Psilanteris Kieffer; Chakra pachmarhica (Sharma, comb. n. is transferred from Paridris Kieffer; Paridris dubeyi Sharma, syn. n. is treated as a junior synonym of Chakra pachmarhica; Holoteleia indica (Mani is transferred to Opisthacantha Ashmead and given a replacement name, Opisthacantha nomados Talamas, n. n.; Psilanteris nigriclavata (Ashmead, comb. n. is transferred from Anteris Förster; Probaryconus grenadensis (Ashmead, comb. n. is transferred from Monoteleia Kieffer; Monoteleia syn.n. is treated as a junior synonym of Probaryconus Kieffer; Paridris karnatakensis Sharma, syn. n is treated as a junior synonym of Probaryconus cauverycus Saraswat; Probaryconus punctatus (Ashmead, comb. n. is transferred from Oxyteleia Kieffer; Triteleia bengalensis (Saraswat, comb. n. is transferred from Alloteleia Kieffer; Trimorus varius Fouts, syn. n. and Trimorus pulchricornis Fouts, syn. n. are treated as junior synonyms of Trimorus annulicornis (Ashmead; Neotypes are designated for Gryon leptocorisae (Howard, Idris seminiger (Ashmead, Telenomus graptae Howard, Telenomus persimilis Ashmead, and Telenomus rileyi Howard; lectotypes are designated for Cremastobaeus bicolor Ashmead, Oethecoctonus insularis (Ashmead, Oethecoctonus laticinctus (Ashmead and Probaryconus

  9. Prescribing tamoxifen in primary care for the prevention of breast cancer: a national online survey of GPs' attitudes.

    Science.gov (United States)

    Smith, Samuel G; Foy, Robbie; McGowan, Jennifer A; Kobayashi, Lindsay C; DeCensi, Andrea; Brown, Karen; Side, Lucy; Cuzick, Jack

    2017-06-01

    The cancer strategy for England (2015-2020) recommends GPs prescribe tamoxifen for breast cancer primary prevention among women at increased risk. To investigate GPs' attitudes towards prescribing tamoxifen. In an online survey, GPs in England, Northern Ireland, and Wales ( n = 928) were randomised using a 2 × 2 between-subjects design to read one of four vignettes describing a healthy patient seeking a tamoxifen prescription. In the vignette, the hypothetical patient's breast cancer risk (moderate versus high) and the clinician initiating the prescription (GP prescriber versus secondary care clinician [SCC] prescriber) were manipulated in a 1:1:1:1 ratio. Outcomes were willingness to prescribe, comfort discussing harms and benefits, comfort managing the patient, factors affecting the prescribing decision, and awareness of tamoxifen and the National Institute for Health and Care Excellence (NICE) guideline CG164. Half (51.7%) of the GPs knew tamoxifen can reduce breast cancer risk, and one-quarter (24.1%) were aware of NICE guideline CG164. Responders asked to initiate prescribing (GP prescriber) were less willing to prescribe tamoxifen than those continuing a prescription initiated in secondary care (SCC prescriber) (68.9% versus 84.6%, P preventive therapy in secondary care before asking GPs to continue the patient's care may overcome some prescribing barriers. © British Journal of General Practice 2017.

  10. Solar cycle variations in mesospheric carbon monoxide

    Science.gov (United States)

    Lee, Jae N.; Wu, Dong L.; Ruzmaikin, Alexander; Fontenla, Juan

    2018-05-01

    As an extension of Lee et al. (2013), solar cycle variation of carbon monoxide (CO) is analyzed with MLS observation, which covers more than thirteen years (2004-2017) including maximum of solar cycle 24. Being produced primarily by the carbon dioxide (CO2) photolysis in the lower thermosphere, the variations of the mesospheric CO concentration are largely driven by the solar cycle modulated ultraviolet (UV) variation. This solar signal extends down to the lower altitudes by the dynamical descent in the winter polar vortex, showing a time lag that is consistent with the average descent velocity. To characterize a global distribution of the solar impact, MLS CO is correlated with the SORCE measured total solar irradiance (TSI) and UV. As high as 0.8 in most of the polar mesosphere, the linear correlation coefficients between CO and UV/TSI are more robust than those found in the previous work. The photochemical contribution explains most (68%) of the total variance of CO while the dynamical contribution accounts for 21% of the total variance at upper mesosphere. The photochemistry driven CO anomaly signal is extended in the tropics by vertical mixing. The solar cycle signal in CO is further examined with the Whole Atmosphere Community Climate Model (WACCM) 3.5 simulation by implementing two different modeled Spectral Solar Irradiances (SSIs): SRPM 2012 and NRLSSI. The model simulations underestimate the mean CO amount and solar cycle variations of CO, by a factor of 3, compared to those obtained from MLS observation. Different inputs of the solar spectrum have small impacts on CO variation.

  11. Autumn photoproduction of carbon monoxide in Jiaozhou Bay, China

    Science.gov (United States)

    Ren, Chunyan; Yang, Guipeng; Lu, Xiaolan

    2014-06-01

    Carbon monoxide (CO) plays a significant role in global warming and atmospheric chemistry. Global oceans are net natural sources of atmospheric CO. CO at surface ocean is primarily produced from the photochemical degradation of chromophoric dissolved organic matter (CDOM). In this study, the effects of photobleaching, temperature and the origin (terrestrial or marine) of CDOM on the apparent quantum yields (AQY) of CO were studied for seawater samples collected from Jiaozhou Bay. Our results demonstrat that photobleaching, temperature and the origin of CDOM strongly affected the efficiency of CO photoproduction. The concentration, absorbance and fluorescence of CDOM exponentially decreased with increasing light dose. Terrestrial riverine organic matter could be more prone to photodegradation than the marine algae-derived one. The relationships between CO AQY and the dissolved organic carbon-specific absorption coefficient at 254 nm for the photobleaching study were nonlinear, whereas those of the original samples were strongly linear. This suggests that: 1) terrestrial riverine CDOM was more efficient than marine algae-derived CDOM for CO photoproduction; 2) aromatic and olefinic moieties of the CDOM pool were affected more strongly by degradation processes than by aliphatic ones. Water temperature and the origin of CDOM strongly affected the efficiency of CO photoproduction. The photoproduction rate of CO in autumn was estimated to be 31.98 μmol m-2 d-1 and the total DOC photomineralization was equivalent to 3.25%-6.35% of primary production in Jiaozhou Bay. Our results indicate that CO photochemistry in coastal areas is important for oceanic carbon cycle.

  12. Carbon Monoxide in Meat and Fish Packaging: Advantages and Limits

    Science.gov (United States)

    Roncalés, Pedro

    2018-01-01

    Due to increased demands for greater expectation in relation to quality, convenience, safety and extended shelf-life, combined with growing demand from retailers for cost-effective extensions of fresh muscle foods’ shelf-life, the food packaging industry quickly developed to meet these expectations. During the last few decades, modified atmosphere packaging (MAP) of foods has been a promising area of research, but much remains to be known regarding the use of unconventional gases such carbon monoxide (CO). The use of CO for meat and seafood packaging is not allowed in most countries due to the potential toxic effect, and its use is controversial in some countries. The commercial application of CO in food packaging was not then considered feasible because of possible environmental hazards for workers. CO has previously been reported to mask muscle foods’ spoilage, and this was the primary concern raised for the prohibition, as this may mislead consumers. This review was undertaken to present the most comprehensive and current overview of the widely-available, scattered information about the use of CO in the preservation of muscle foods. The advantages of CO and its industrial limits are presented and discussed. The most recent literature on the consumer safety issues related to the use of CO and consumer acceptance of CO especially in meat packaging systems were also discussed. Recommendations and future prospects were addressed for food industries, consumers and regulators on what would be a “best practice” in the use of CO in food packaging. All this promotes high ethical standards in commercial communications by means of effective regulation, for the benefit of consumers and businesses in the world, and this implies that industrialized countries and members of their regulatory agencies must develop a coherent and robust systems of regulation and control that can respond effectively to new challenges. PMID:29360803

  13. Carbon Monoxide in Meat and Fish Packaging: Advantages and Limits

    Directory of Open Access Journals (Sweden)

    Djamel Djenane

    2018-01-01

    Full Text Available Due to increased demands for greater expectation in relation to quality, convenience, safety and extended shelf-life, combined with growing demand from retailers for cost-effective extensions of fresh muscle foods’ shelf-life, the food packaging industry quickly developed to meet these expectations. During the last few decades, modified atmosphere packaging (MAP of foods has been a promising area of research, but much remains to be known regarding the use of unconventional gases such carbon monoxide (CO. The use of CO for meat and seafood packaging is not allowed in most countries due to the potential toxic effect, and its use is controversial in some countries. The commercial application of CO in food packaging was not then considered feasible because of possible environmental hazards for workers. CO has previously been reported to mask muscle foods’ spoilage, and this was the primary concern raised for the prohibition, as this may mislead consumers. This review was undertaken to present the most comprehensive and current overview of the widely-available, scattered information about the use of CO in the preservation of muscle foods. The advantages of CO and its industrial limits are presented and discussed. The most recent literature on the consumer safety issues related to the use of CO and consumer acceptance of CO especially in meat packaging systems were also discussed. Recommendations and future prospects were addressed for food industries, consumers and regulators on what would be a “best practice” in the use of CO in food packaging. All this promotes high ethical standards in commercial communications by means of effective regulation, for the benefit of consumers and businesses in the world, and this implies that industrialized countries and members of their regulatory agencies must develop a coherent and robust systems of regulation and control that can respond effectively to new challenges.

  14. Nation

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2014-01-01

    Nation er et gammelt begreb, som kommer af det latinske ord for fødsel, natio. Nationalisme bygger på forestillingen om, at mennesker har én og kun én national identitet og har ret til deres egen nationalstat. Ordet og forestillingen er kun godt 200 år gammel, og i 1900-tallet har ideologien bredt...

  15. Carbon monoxide poisoning from waterpipe smoking: a retrospective cohort study.

    Science.gov (United States)

    Eichhorn, Lars; Michaelis, Dirk; Kemmerer, Michael; Jüttner, Björn; Tetzlaff, Kay

    2018-04-01

    Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center. This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016. Patients' initial symptoms and carbon monoxide blood levels were retrieved from records and neurologic status was assessed before and after hyperbaric oxygen treatment. Sixty-one subjects with carbon monoxide poisoning were included [41 males, 20 females; mean age 23 (SD ± 6) years; range 13-45] with an initial mean carboxyhemoglobin of 26.93% (SD ± 9.72). Most common symptoms included syncope, dizziness, headache, and nausea; 75% had temporary syncope. Symptoms were not closely associated with blood COHb levels. CO poisoning after waterpipe smoking may present in young adults with a wide variability of symptoms from none to unconsciousness. Therefore diagnosis should be suspected even in the absence of symptoms.

  16. Carbon monoxide and COHb concentration in blood in various circumstances

    Energy Technology Data Exchange (ETDEWEB)

    Modic, J. [Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana (Slovenia)

    2003-07-01

    On the basis of known medical experiments we find out the correlation between the concentration of carbon monoxide (CO) in inhaling air and the concentration of carboxihemoglobyne (COHb) in human blood. All internal combustion engines produce exhaust gases containing noxious compounds: carbon monoxide, nitrogen oxides (NO{sub x}), carbon oxides (CxHy) and smoke. In a living room is important the smoke of cigarettes, smoke of furnaces, improper ventilation. In tunnel is most dangerous the carbon monoxide if it exceeds an allowable level. In human blood the carbon monoxide causes increasing the concentration of carboxihemoglobyne and in this case the hypoxia of web. With help of mathematical model the concentrations of some dangerous substances at the end of tunnel were calculated. For this case a differential equation also was developed and it shows the correlation between concentration of carbon monoxide in the air and concentration of carboxihemoglobyne in the blood. The constructed mathematical model shows circumstances in the tunnel (velocity of air moving as effect of induction, concentration of noxious substances and criterial number). Also a corresponding computer program was developed, which makes possible a quick and simple calculation. All the results are proved by experiments. Finally the differential equation was done, which shows a temporal connection between both parameters as a function of tunnel characteristics. (author)

  17. Low-cost measurement techniques to characterize the influence of home heating fuel on carbon monoxide in Navajo homes.

    Science.gov (United States)

    Casey, Joanna Gordon; Ortega, John; Coffey, Evan; Hannigan, Michael

    2018-06-01

    A large fraction of the global population relies on the inefficient combustion of solid fuels for cooking and home heating, resulting in household exposure to combustion byproducts. In the southwestern United States, unhealthy air quality has been observed in some homes that use solid fuels as a primary source of heat on the Navajo Nation. In order to better understand how home heating fuel choice can influence indoor air quality in this region, we used recently developed low-cost electrochemical sensors to measure carbon monoxide (CO) air mole fractions continuously inside and outside 41 homes in two communities on the Navajo Nation. Using low-cost sensors in this study, which don't require extensive training to operate, enabled collaboration with local Diné College students and faculty in the planning and implementation of home deployments. Households used natural gas, propane, pellets, wood, and/or coal for heating. We developed quantification methods that included uncertainty estimation for Alphasense CO-B4 sensors, for measurements both inside and outside homes. CO concentrations elevated above background were observed in homes in each heating fuel group, but the highest hourly concentrations were observed in wood and coal burning homes, some of which exceeded World Health Organization Guidelines on both an hourly and eight-hourly basis. In order to probe the many factors that can influence indoor pollutant concentrations, we developed and implemented methods that employ CO emission and decay time periods observed in homes during everyday activities to estimate air exchange rates as well as CO emission rates on the basis of a given well-mixed volume of air. The air quality measurement tools and methods demonstrated in this study can be readily extended to indoor air quality studies in other communities around the world to inform how home heating and cooking practices are influencing indoor air quality during normal daily activities. Copyright © 2018 Elsevier

  18. New reduced variant in gadolinium and samarium monoxide thin films

    Energy Technology Data Exchange (ETDEWEB)

    Bist, B M.S.; Kumar, J; Srivastava, O N [Banaras Hindu Univ. (India). Dept. of Physics

    1977-01-01

    A new reduced phase has been observed in the thin films of gadolinium and samarium monoxides. This phase results on imparting an annealing treatment to the monoxides and is formed as a result of the creation and ordering of vacancies in the oxygen sublattice. The new phase has been analysed to possess a rhombohedral unit cell with lattice parameters a/sub R/ = a/sub 0/ square root of (3/2) and c/sub R/ = a/sub 0/ square root of 3 (based on hexagonal axes, a/sub 0/ being the lattice parameter of the fundamental zinc blende type unit cell of the monoxide). Based on the proposed structure, the new phase can be assigned the solid state chemical formula RO/sub x/ where R = Gd, Sm and x = 0.66.

  19. Development of an enzymatic sensor for carbon monoxide

    International Nuclear Information System (INIS)

    Hurtado, Clara; Gomez, Diana; Larmat, Fernando; Torres, Walter; Cuervo, Raul; Bravo, Enrique; Benitez, Neyla

    2003-01-01

    The detection and the pursuit of gases that contribute in the increase of the atmospheric contamination are a necessity, for what the electrochemical sensors have potential industrial applications for the control of the quality of the air. The development of amperometric sensor based on enzymes offers advantages, since the use of the biological component provides him high selectivity due to the great specificity of the substrate of the enzyme. The monoxide of carbon (CO) it is a polluting, poisonous gas, taken place during the incomplete combustion of organic materials (natural gas, petroleum, gasoline, coal and vegetable material). The determination of monoxide of carbon (CO) it can be reached by electrochemical mediums using the methylene blue like the electronic mediator for the enzyme monoxide of carbon oxidase (COx)

  20. Primary non-Hodgkin's lymphomas of the breast: 23 years of experience at the Colombian national cancer institute

    International Nuclear Information System (INIS)

    Rodriguez, Myriam; Grajales, Marco; Londono, Sonia; Ortiz, Natascha

    2004-01-01

    Primary non- Hodgkin's lymphomas of the breast (PNHLB) are an infrequent malignancy. In a review of the literature, in which six Latin American journals are included, approximately 450 cases have been reported during the past two decades. in this paper we present the experience of the national cancer institute of Colombia during the last 23 years. Objective: to carry out a retrospective analysis of the characteristics, natural history, prognostic factors, and outcome of patients with PNHLB at the NCI of Colombia. Methods: the medical histories of patients diagnosed with PNHLB between 1980 and 2003 were reviewed; likewise, the clinical characteristics, treatment protocols, and final outcomes were analyzed. Results: 25 patients were identified as PNHLB. The average follow-up was 57 months. The medium age was 58, ranging from 26 to 83. 84% had diffused large cell lymphoma. The Karnofsky index was over 80 in 92% of the patients. 72% received chop chemotherapy. Two patients received a combination without doxorubicin. 68% received combined chemo- and radiation therapy. Two patients refused therapy. Two patients died before receiving any type of treatment. CNS compromise was observed in 20% of patients during the evolution of their disease. The youngest patient, whose case deserves special comment, obtained a second complete remission with simple mastectomy, after having relapsed after conventional chemotherapy, radiotherapy, and autologous bone marrow transplant. No significant prognostic variables were found using the univariate analysis. Conclusions: a high rate of complete remission can be achieved by using combined treatment in patients with PNHLB. The medium overall survival was not reached after 71 months of follow-up. The most frequent relapse site was the CNS

  1. A population-based exposure assessment methodology for carbon monoxide: Development of a carbon monoxide passive sampler and occupational dosimeter

    Energy Technology Data Exchange (ETDEWEB)

    Apte, Michael G. [Univ. of California, Berkeley, CA (United States)

    1997-09-01

    Two devices, an occupational carbon monoxide (CO) dosimeter (LOCD), and an indoor air quality (IAQ) passive sampler were developed for use in population-based CO exposure assessment studies. CO exposure is a serious public health problem in the U.S., causing both morbidity and mortality (lifetime mortality risk approximately 10{sup -4}). Sparse data from population-based CO exposure assessments indicate that approximately 10% of the U.S. population is exposed to CO above the national ambient air quality standard. No CO exposure measurement technology is presently available for affordable population-based CO exposure assessment studies. The LOCD and IAQ Passive Sampler were tested in the laboratory and field. The palladium-molybdenum based CO sensor was designed into a compact diffusion tube sampler that can be worn. Time-weighted-average (TWA) CO exposure of the device is quantified by a simple spectrophotometric measurement. The LOCD and IAQ Passive Sampler were tested over an exposure range of 40 to 700 ppm-hours and 200 to 4200 ppm-hours, respectively. Both devices were capable of measuring precisely (relative standard deviation <20%), with low bias (<10%). The LOCD was screened for interferences by temperature, humidity, and organic and inorganic gases. Temperature effects were small in the range of 10°C to 30°C. Humidity effects were low between 20% and 90% RH. Ethylene (200 ppm) caused a positive interference and nitric oxide (50 ppm) caused a negative response without the presence of CO but not with CO.

  2. Terpolymerization of ethylene, sulfur dioxide and carbon monoxide

    Science.gov (United States)

    Johnson, R.; Steinberg, M.

    This invention relates to high molecular weight terpolymer of ethylene, sulfur dioxide and carbon monoxide stable to 280/sup 0/C and containing as little as 36 mo1% ethylene and about 41 to 51 mo1% sulfur dioxide, and to the method of producing said terpolymer by irradiation of a liquid and gaseous mixture of ethylene, sulfur dioxide and carbon monoxide by means of Co-60 gamma rays or an electron beam, at a temperature of about 10 to 50/sup 0/C, and at a pressure of about 140 to 680 atmospheres, to initiate polymerization.

  3. Modeling chemisorption kinetics of carbon monoxide on polycrystalline platinum

    Energy Technology Data Exchange (ETDEWEB)

    Donnelly, R.G.; Modell, M.; Baddour, R.F.

    1978-04-01

    Seven distinct desorption surface states of carbon monoxide on polycrystalline platinum were detected by deconvoluting temperature-programed desorption spectra of 4-100% carbon monoxide monolayer coverage. The adstates had fixed activation energies of desorption (22.5-32.6 kcal/mole) over the entire coverage range. Rates of formation and populations were derived. The chemisorption was modeled by a Hinshelwood-type expression which allowed for site creation and suggested that adsorbed molecules are sufficiently mobile during desorption heating to fill ordered states of minimum energy and that chemisorption into these states is noncompetitive and determined by the surface. Spectra, diagrams, graphs, tables, and 49 references.

  4. Primary Hyperparathyroidism

    Science.gov (United States)

    ... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

  5. Availability of herbal medicines and medicinal plants in the primary health facilities of the state of São Paulo, Southeast Brazil: results from the National Program for Access and Quality Improvement in Primary Care.

    Science.gov (United States)

    Caccia-Bava, Maria do Carmo Gullaci Guimarães; Bertoni, Bianca Waléria; Pereira, Ana Maria Soares; Martinez, Edson Zangiacomi

    2017-05-01

    This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants. Among the 645 municipalities, 104 (16.1%) had at least one health facility that provided these drugs. We observed that the availability of herbal medicines is greater in larger cities with better social and economic conditions. Furthermore, we found that use of industrialized herbal medicines prevailed over that of vegetal drugs or compounded herbal medicines.

  6. Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

    Science.gov (United States)

    Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

    2015-02-17

    For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of

  7. Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial.

    Science.gov (United States)

    Park, Elyse R; Gareen, Ilana F; Japuntich, Sandra; Lennes, Inga; Hyland, Kelly; DeMello, Sarah; Sicks, JoRean D; Rigotti, Nancy A

    2015-09-01

    The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking cessation treatment as an adjunct to screening, but the frequency and effectiveness of clinician-delivered smoking cessation interventions delivered after lung screening are unknown. To determine the association between the reported clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. A matched case-control study (cases were quitters and controls were continued smokers) of 3336 NLST participants who were smokers at enrollment examined participants' rates and patterns of 5A delivery after a lung screen and reported smoking cessation behaviors. Prevalence of the clinician-delivered 5As and associated smoking cessation after lung screening. Delivery of the 5As 1 year after screening were as follows: ask, 77.2%; advise, 75.6%; assess, 63.4%; assist, 56.4%; and arrange follow-up, 10.4%. Receipt of ask, advise, and assess was not significantly associated with quitting in multivariate models that adjusted for sociodemographic characteristics, medical history, screening results, nicotine dependence, and motivation to quit. Assist was associated with a 40% increase in the odds of quitting (odds ratio, 1.40; 95% CI, 1.21-1.63), and arrange was associated with a 46% increase in the odds of quitting (odds ratio, 1.46; 95% CI, 1.19-1.79). Assist and arrange follow-up delivered by primary care providers to smokers who were participating in the NLST were associated with increased quitting; less intensive interventions (ask, advise, and assess) were not. However, rates of assist and arrange

  8. Aboveground Net Primary Production of tree cover at the post-disturbance area in the Tatra National Park, Slovakia

    Directory of Open Access Journals (Sweden)

    Konôpka Bohdan

    2015-09-01

    Full Text Available Large-scale disturbances under the conditions of Slovakia, caused especially by storm and bark beetle, bring dramatic decline in carbon budget of the country, besides other negative consequences. The largest disturbance in modern history of the Slovak forestry was the storm damage that occurred in November 2004. The Tatra National Park (TNP was one of the most affected regions. Thus, in this territory, two transects (T1 – the Danielov dom site and T2 – near the Horný Smokovec village were established to survey basic dendrometric properties of trees in young stands established after the disaster. The standing stock of aboveground biomass in tree cover for the spring and autumn 2014 was calculated using the recorded variables, i.e. tree height and diameter measured at the stem base, together with the region-specific allometric relations. Then, the Aboveground Net Primary Production (ANPP in tree cover was estimated with respect to its components (stem, branches and foliage. ANPP was 315 g m−2 per year (Transect T1, and 391 g m−2 per year (Transect T2. The differences in the structure of ANPP, i.e. contribution of tree components, were found between transects T1 and T2. They were caused by the contrasting tree species composition, specifically the ratios between Norway spruce and broadleaved species. Broadleaves allocated more biomass production to foliage than spruce. This phenomenon together with higher turnover (once a year of foliage caused that broadleaves manifest higher share of fast-cycling carbon in comparison to the amount of carbon sequestrated in woody parts (stem and branches. High variability of ANPP was found within the transects, i.e. among the plots (microsites. As for the representative estimation of the standing stock of aboveground part of tree cover as well as ANPP at the post-disturbance area in the TNP territory, the survey should be performed on a net of research plots. Only this approach enables reliable estimates

  9. A Rare Cause of Chronic Headache that May Be Misdiagnosed as Migraine: Chronic Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet Kenan KANBUROGLU

    2014-09-01

    Full Text Available SUMMARY: Differential diagnosis of primary headache disorders can be challenging for physicians. Although the association of headache with acute carbon monoxide intoxication is very well-defined, in refractory nonspecific headaches associated with chronic low dose exposure to carbon monoxide, CO intoxication is usually overlooked, mostly due to vague symptoms. Herein we present a 15-year-old female patient with chronic carbon monoxide poisoning who was undergoing two years of follow-up care for migraines. Chronic carbon monoxide intoxication may mimic the episodic nature and familial predisposition of migraine attacks. Normal carboxyhemoglobin levels do not exclude the diagnosis, and smoking is a confounding factor. In emergency rooms, patients presenting with headaches had higher levels of carboxyhemoglobin, but, as far as we know, there have been no studies investigating carboxyhemoglobin levels in migraine patients. Chronic carbon monoxide poisoning should be suspected in migraine patients, especially if the attacks occur during winter months. ÖZET: Primer baş ağrısında ayırıcı tanının yapılması bazen doktorlar açısından zor olabilmektedir. Literatürde karbon monoksit ile baş ağrısı arasındaki ilişki çok iyi ortaya konulmuş olmasına karşın, dirençli ve nonspesifik başağrısı nedenlerinden biri olan kronik düşük doz karbon monoksit maruziyeti kendine özgü bulgusu olmadığından sıklıkla atlanmaktadır. Bu yazıda, iki yıl migren tanısı ile takip ve tedavi edilen kronik karbon monoksit zehirlenmesi olan bir olgu sunuldu. Kronik karbon monoksit zehirlenmesi epizodik paterni ve aile fertlerinde benzer şikayetlerin olması nedeniyle migren ataklarını andırabilmektedir. Karboksihemoglobin konsantrasyonlarının normal saptanması tanıyı ekarte ettirmemekte, ayrıca sigara kullanımı da karıştırıcı bir faktör olabilmektedir. Acil servislerine baş ağrısı ile başvuran hastalar

  10. Optimization of Treatment Policy for Acute Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    R. N. Akalayev

    2012-01-01

    Full Text Available Objective: to evaluate the efficiency of combination use of hyperbaric oxygenation, succinate-containing solutions, and anti-edematous agents in patients with acute carbon monoxide poisoning. Subjects and methods. The results of treatment were analyzed in 32 patients admitted in 2009—2011 for severe acute carbon monoxide poisoning and a Glasgow coma score of 6—8. The patients were divided into 2 groups: 1 patients whose combination therapy involved hyperbaric oxygenation, Succinasol infusions, and L-lysine-aescinate injections; 2 those who received traditional therapy. All the patients underwent complex clinical, laboratory, and neurophysiologic examinations. Results. Just 24 hours after the combination use of Succinasol and L-lysine-aescinate, Group I patients were observed to have substantially reduced lactate, the content of the latter approached the normal value following 48 hours, which was much below the values in the control group. The similar pattern was observed when endogenous intoxication parameters were examined. During the performed therapy, the level of consciousness and that of intellect according to the MMSE and FAB scales were restored more rapidly in the study group patients than in Group 2. Conclusion. The combination use of hyperbaric oxygenation, the succinate-containing solution Succinasol, and the anti-edematous agent L-lysine-aescinate considerably enhances the efficiency of intensive therapy for acute carbon monoxide poisoning. Key words: carbon monoxide, toxic hypoxic encephalopathy, combination therapy, hyperbaric oxygenation, succinic acid, L-lysine-aescinate.

  11. Production of Ethylene and Carbon Monoxide by Microorganisms

    Science.gov (United States)

    T. H. Filer; L. R. Brown; S. Brown-Sarobot; S. Martin

    1984-01-01

    Various quantities of ethylene and carbon monoxide were produced on PDA by Fusicladium effusum, Pestilotia nucicola, Alternaria tenuis, and Fusarium oxysporum subcultured from diseased pecan shucks. Repeated subculturing of these fungi on potato dextrose broth supplemented with iron powder produced ethylene. The production of...

  12. Ethylene and Carbon Monoxide Production by Septoria musiva

    Science.gov (United States)

    S. Brown-Skrobot; L. R. Brown; T. H. Filer

    1984-01-01

    An investigation into the mechanism by which Septoria musiva causes the premature defoliation of cottonwood trees was undertaken. Gas-chromatograpic analysis of the atmosphere overlying the original culture indicated that this fungus produced significant quantities of ethylene and carbon monoxide. Subcultures failed to produce either gas on a variety...

  13. Poisoning by carbon monoxide in Morocco from 1991 to 2008.

    Science.gov (United States)

    Aghandous, Rachida; Chaoui, Hanane; Rhalem, Naima; Semllali, Ilham; Badri, Mohamed; Soulaymani, Abdelmajid; Ouammi, Lahcen; Soulaymani-Bencheikh, Rachida

    2012-04-01

    To describe the characteristics relating to the provenance of statements, patients and to evaluate the spatiotemporal evolution of carbon monoxide poisoning reported to Poison Control Center and Pharmacovigilance of Morocco (CAPM). This is a retrospective study over a period of 18 years from 1991 to 2008, for all cases of poisoning by carbon monoxide reported to CAPM. The epidemiological study focused on 12 976 cases of carbon monoxide poisoning reported to CAPM between 1991 and 2008. The average age of patients was 25.5 +/- 15.6 years, sex ratio was 0.5. The poisoning occurred by accident in 98.7% of cases, especially at home (96.7%) and in cold months. The urban population was the most affected (89.0%). The region of Meknes Tafilalt was the most concerned with 16.6% of cases. The symptomatology was characterized by the predominance of gastrointestinal tract diseases (37.1%). Deaths have reached a percentage of 0.9%. These qualitative and quantitative information is useful to highlight warnings and plan a strategy against carbon monoxide poisoning in Morocco.

  14. Pathways and bioenergetics of anaerobic carbon monoxide fermentation

    NARCIS (Netherlands)

    Diender, Martijn; Stams, Fons; Machado de Sousa, Diana

    2015-01-01

    Carbon monoxide can act as a substrate for different modes of fermentative anaerobic metabolism. The trait of utilizing CO is spread among a diverse group of microorganisms, including members of bacteria as well as archaea. Over the last decade this metabolism has gained interest due to the

  15. [Cerebellar Infarction After Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy].

    Science.gov (United States)

    Wick, Matthias; Schneiker, André; Bele, Sylvia; Pawlik, Michael; Meyringer, Helmut; Graf, Bernhard; Wendl, Christina; Kieninger, Martin

    2017-06-01

    We report on a patient who developed a space-occupying cerebellar infarction with occlusive hydrocephalus after a poisoning with carbon monoxide with the intention to commit suicide. A neurosurgical and intensive care therapy were needed. The patient's survival without severe neurological deficits could be secured due to the early detection of the intracerebral lesions. Georg Thieme Verlag KG Stuttgart · New York.

  16. Carbon Monoxide Poisoning in a Child: A Case Report | Asani ...

    African Journals Online (AJOL)

    The exact incidence of carbon monoxide (CO) poisoning in Nigeria is unknown. Globally, CO poisoning is frequently unrecognized and under-reported since the clinical presentation is relatively non-specific. The circumstances usually involve an unsuspected increase of CO in an enclosed environment. We present the ...

  17. Flash flip book applications to measure the level of nationalism with quasi experiment on primary school students

    Science.gov (United States)

    Asri, Yessy; Fitriani, Yessy

    2017-08-01

    Great nation is a nation that respects the the sacrifice of the heroes and the history of his people. This young generation is the root of a nation who need to know and respect the values of which has been laid the founding fathers. The history continues to be written by people, in all civilizations and in all times,History in writing or documentation becomes an important tool in studying the progress and setbacks of a nation that is contained in various events in the past. Indonesia is a pluralistic nation consisting of various tribes, culture and history are scattered throughout the country. Interactive flash flip book application built to pack the local stories and history of the nation which is widespread in the thirty-three provinces to to elementary school children through teachers, especially elementary school teachers Islam Bani Saleh 5 and SDN Setiadarma 04 Bekasi in the subjects of Citizenship Education (PKn). The main problem in this research is "Whether a flash flip book can give effect to increase the spirit of nationalism elementary school students ? ". The method used is the One group pretest posttest design. Population in this research is class student V SD Islam Bani Saleh and SDN Setiadarma 04 Bekasi. Results of this study was to measure the influence of media flash flip book to foster a sense of nationalism graders V SD in the subjects of Citizenship Education (PKn) in SD Islam Bani Saleh 5 and SDN Setiadarma 04 Bekasi Bekasi.

  18. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Science.gov (United States)

    2010-07-01

    ... Ambient Air Quality Standards for Oxides of Nitrogen (Nitrogen Dioxide) S Appendix S to Part 50 Protection... National Ambient Air Quality Standards for Oxides of Nitrogen (Nitrogen Dioxide) 1. General (a) This... national ambient air quality standards for oxides of nitrogen as measured by nitrogen dioxide (“NO2 NAAQS...

  19. Observation of carbonaceous aerosols and carbon monoxide in Mid-Atlantic region: Seasonal and inter-annual variations

    Science.gov (United States)

    Chen, L. A.; Doddridge, B. G.; Doddridge, B. G.; Dickerson, R. R.; Dickerson, R. R.

    2001-05-01

    As part of Maryland Aerosol Research and Characterization (MARCH-Atlantic) study, a long-term monitoring of ambient elemental and organic carbon (EC and OC) aerosols has been made at Fort Meade, MD (39.16° N 76.51° W; elevation 46 m MSL), a suburban site within the Baltimore-Washington (B-W) corridor, since July 1999. 24-hr average EC and OC are measured every day during the season-representative months (July 1999, October 1999, January 2000, April 2000 and July 2000). Carbon monoxide (CO) was also measured nearly continuously over the period. Strong correlation between EC and CO (r = 0.7 ~ 0.9) in every month suggests common or proximate sources, likely traffic emissions. The EC versus CO slope, however, varies in different seasons and is found to increase nonlinearly with the ambient temperature. EC source strength may peak in summer. OC shows strong correlation with EC (r ~ 0.95) only in winter, suggesting that OC is also of the same primary sources during wintertime. The Interagency Monitoring of Protected Visual Environments (IMPROVE) network has been measuring EC and OC around the United States since 1988. The FME data during July 1999 are also compared with simultaneous measurements at nearby IMPROVE sites, showing B-W corridor could be a major contributor to the carbonaceous aerosols in the Mid-Atlantic region. A decreasing trend of EC level is found in three IMPROVE sites in this region. This actually agrees with the decreasing trend of CO observed previously at Big Meadow, Shenandoah National Park if CO and EC are both influenced by traffic emissions.

  20. Comparison of measurement capability with 100 μmol/mol of carbon monoxide in nitrogen

    Science.gov (United States)

    Lee, Jeongsoon; Lee, JinBok; Lim, Jeongsik; Tarhan, Tanıl; Liu, Hsin-Wang; Aggarwal, Shankar G.

    2018-01-01

    Carbon monoxide (CO) in nitrogen was one of the first types of gas mixtures used in an international key comparison. The comparison dates back to 1998 (CCQMK1a) [1]. Since then, many National Metrology Institutes (NMIs) have developed calibration and measurement capabilities (CMCs) for these mixtures. Recently, NMIs in the APMP region have actively participated in international comparisons to provide domestic services. At the 2013 APMP meeting, several NMIs requested a CO comparison to establish CO/N2 certification for industrial applications, which was to be coordinated by KRISS. Consequently, this comparison provides an opportunity for APMP regional NMIs to develop CO/N2 CMC claims. The goal of this supplementary comparison is to support CMC claim for carbon monoxide in the N2 range of 50–2000 μmol/mol. An extended range may be supported as described in the GAWG strategy for comparisons and CMC claims. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  1. European recommendations for primary prevention of congenital anomalies: a joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans.

    Science.gov (United States)

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca; Barisic, Ingeborg; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Calzolari, Elisa; Carbone, Pietro; Curran, Rhonda; Garne, Ester; Gatt, Miriam; Latos-Bieleńska, Anna; Khoshnood, Babak; Irgens, Lorentz; Mantovani, Alberto; Martínez-Frías, Maria Luisa; Neville, Amanda; Rißmann, Anke; Ruggeri, Stefania; Wellesley, Diana; Dolk, Helen

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe. © 2014 S. Karger AG, Basel.

  2. A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

    Science.gov (United States)

    Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

    2016-06-29

    The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is

  3. Using Large-Scale Linkage Data to Evaluate the Effectiveness of a National Educational Program on Antithrombotic Prescribing and Associated Stroke Prevention in Primary Care.

    Science.gov (United States)

    Liu, Zhixin; Moorin, Rachael; Worthington, John; Tofler, Geoffrey; Bartlett, Mark; Khan, Rabia; Zuo, Yeqin

    2016-10-13

    The National Prescribing Service (NPS) MedicineWise Stroke Prevention Program, which was implemented nationally in 2009-2010 in Australia, sought to improve antithrombotic prescribing in stroke prevention using dedicated interventions that target general practitioners. This study evaluated the impact of the NPS MedicineWise Stroke Prevention Program on antithrombotic prescribing and primary stroke hospitalizations. This population-based time series study used administrative health data linked to 45 and Up Study participants with a high risk of cardiovascular disease (CVD) to assess the possible impact of the NPS MedicineWise program on first-time aspirin prescriptions and primary stroke-related hospitalizations. Time series analysis showed that the NPS MedicineWise program was significantly associated with increased first-time prescribing of aspirin (P=0.03) and decreased hospitalizations for primary ischemic stroke (P=0.03) in the at-risk study population (n=90 023). First-time aspirin prescription was correlated with a reduction in the rate of hospitalization for primary stroke (P=0.02). Following intervention, the number of first-time aspirin prescriptions increased by 19.8% (95% confidence interval, 1.6-38.0), while the number of first-time stroke hospitalizations decreased by 17.3% (95% confidence interval, 1.8-30.0). Consistent with NPS MedicineWise program messages for the high-risk CVD population, the NPS MedicineWise Stroke Prevention Program (2009) was associated with increased initiation of aspirin and a reduced rate of hospitalization for primary stroke. The findings suggest that the provision of evidence-based multifaceted large-scale educational programs in primary care can be effective in changing prescriber behavior and positively impacting patient health outcomes. © 2016 The Authors and NPS MedicineWise. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. A comparison of UK primary care data with other national data sources for monitoring the prevalence of smoking during pregnancy.

    Science.gov (United States)

    Dhalwani, Nafeesa N; Tata, Laila J; Coleman, Tim; Fiaschi, Linda; Szatkowski, Lisa

    2015-09-01

    We aimed to assess the potential usefulness of primary care data in the UK for estimating smoking prevalence in pregnancy by comparing the primary care data estimates with those obtained from other data sources. In The Health Improvement Network (THIN) primary care database, we identified pregnant smokers using smoking information recorded during pregnancy. Where this information was missing, we used smoking information recorded prior to pregnancy. We compared annual smoking prevalence from 2000 to 2012 in THIN with measures from the Infant Feeding Survey (IFS), Smoking At Time of Delivery (SATOD), Child Health Systems Programme (CHSP) and Scottish Morbidity Record (SMR). Smoking estimates from THIN data converged with estimates from other sources after 2004, though still do not agree completely. For example, in 2012 smoking prevalence at booking was 11.6% in THIN using data recorded only during pregnancy, compared with 19.6% in SMR data. However, the use of smoking data recorded up to 27 months before conception increased the THIN prevalence to 20.3%, improving the comparability. Under-recording of smoking status during pregnancy results in unreliable prevalence estimates from primary care data and needs improvement. However, in the absence of gestational smoking data, the inclusion of pre-conception smoking records may increase the utility of primary care data. One strategy to improve gestational smoking status recording in primary care could be the inclusion of pregnancy in the Quality and Outcome's Framework as a condition for which smoking status and smoking cessation advice must be recorded electronically in patient records. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

  5. Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: A national longitudinal analysis.

    Directory of Open Access Journals (Sweden)

    Thomas Hone

    2017-05-01

    Full Text Available Universal health coverage (UHC can play an important role in achieving Sustainable Development Goal (SDG 10, which addresses reducing inequalities, but little supporting evidence is available from low- and middle-income countries. Brazil's Estratégia de Saúde da Família (ESF (family health strategy is a community-based primary healthcare (PHC programme that has been expanding since the 1990s and is the main platform for delivering UHC in the country. We evaluated whether expansion of the ESF was associated with differential reductions in mortality amenable to PHC between racial groups.Municipality-level longitudinal fixed-effects panel regressions were used to examine associations between ESF coverage and mortality from ambulatory-care-sensitive conditions (ACSCs in black/pardo (mixed race and white individuals over the period 2000-2013. Models were adjusted for socio-economic development and wider health system variables. Over the period 2000-2013, there were 281,877 and 318,030 ACSC deaths (after age standardisation in the black/pardo and white groups, respectively, in the 1,622 municipalities studied. Age-standardised ACSC mortality fell from 93.3 to 57.9 per 100,000 population in the black/pardo group and from 75.7 to 49.2 per 100,000 population in the white group. ESF expansion (from 0% to 100% was associated with a 15.4% (rate ratio [RR]: 0.846; 95% CI: 0.796-0.899 reduction in ACSC mortality in the black/pardo group compared with a 6.8% (RR: 0.932; 95% CI: 0.892-0.974 reduction in the white group (coefficients significantly different, p = 0.012. These differential benefits were driven by greater reductions in mortality from infectious diseases, nutritional deficiencies and anaemia, diabetes, and cardiovascular disease in the black/pardo group. Although the analysis is ecological, sensitivity analyses suggest that over 30% of black/pardo deaths would have to be incorrectly coded for the results to be invalid. This study is limited by

  6. Carbon monoxide exposure and information processing during perceptual-motor performance

    Energy Technology Data Exchange (ETDEWEB)

    Mihevic, P.M.; Gliner, J.A.; Horvath, S.M.

    1983-01-01

    This study examined the influence of exposure to ambient carbon monoxide resulting in final carboxyhemoglobin (COHb) levels of approximately 5.0% on the ability to process information during motor performance. Subjects (n . 16) performed a primary reciprocal tapping task and a secondary digit manipulation task singly and/or concurrently during 2.5 h exposure to room air (0 ppm CO) or 100 ppm CO. Five levels of tapping difficulty and two levels of digit manipulation were employed. Tapping performance was unaffected when COHb levels were as high as 5%. However, at this level of COHb it was noted that CO exposure interacted with task difficulty of both tasks to influence reaction time on the digit manipulation task. It was concluded that motor performance was not influenced by exposure to CO leading to COHb concentrations of 5%. Task difficulty was a significant factor mediating behavioral effects of CO exposure.

  7. Carbon monoxide exposure and information processing during perceptual-motor performance

    Energy Technology Data Exchange (ETDEWEB)

    Mihevic, P.M.; Gliner, J.A.; Horvath, S.M.

    1983-04-01

    This study examined the influence of exposure to ambient carbon monoxide resulting in final carboxyhemoglobin (COHb) levels of approximately 5.0% on the ability to process information during motor performance. Subjects (n = 16) performed a primary reciprocal tapping task and a secondary digit manipulation task singly and/or concurrently during 2.5 h exposure to room air (0 ppm CO) or 100 ppm CO. Five levels of tapping difficulty and two levels of digit manipulation were employed. Tapping performance was unaffected when COHb levels were as high as 5%. However, at this level of COHb it was noted that CO exposure interacted with task difficulty of both tasks to influence reaction time on the digit manipulation task. It was concluded that motor performance was not influenced by exposure to CO leading to COHb concentrations of 5%. Task difficulty was a significant factor mediating behavioral effects of CO exposure.

  8. Acute Carbon Monoxide Poisoning Resulting in ST Elevation Myocardial Infarction: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Po-Chao Hsu

    2010-05-01

    Full Text Available Acute carbon monoxide (CO poisoning with cardiac complications is well documented in the literature. However, ST segment elevation is a rare presentation, and most of these cases with ST elevation have revealed non-occlusive or normal coronary arteries. We report a case of CO poisoning complicated with ST elevation myocardial infarction. Emergency coronary angiography revealed total occlusion of the left anterior descending artery and primary percutaneous coronary intervention was performed. This report of a rare case should remind physicians that cardiovascular investigations, including electrocardiography, must be performed in cases with CO poisoning because mortality might increase if reperfusion therapy or appropriate medical treatments are not performed in patients with acute coronary artery occlusion.

  9. Historicizing Teaching in Awgni as a Mother Tongue Language at Primary Schools of Awi Nationality Administrative Zone: Challenges and Implementation

    Science.gov (United States)

    Engida, Alemayehu Erkihun

    2015-01-01

    This study examined the challenges facing the teaching as well as the implementation of Awgni as a mother tongue language in primary schools of Awi administrative zone. The need to teach through mother tongue in Ethiopia was widely discussed following the change of the politics in 1991. To this end, the government issued new education and training…

  10. Cross-National Comparisons of Background and Confidence in Visual Arts and Music Education of Pre-Service Primary Teachers

    Science.gov (United States)

    Russell-Bowie, Deirdre

    2010-01-01

    This paper reports the findings of a study on pre-service teachers' background and confidence in music and visual arts education. The study involved 939 non-specialist pre-service primary teachers from five countries. Initially the paper identifies the students' perceptions of their background and confidence in relation to music and visual arts…

  11. Kinetics of heterogeneous catalysis oxidation of carbon monoxide

    International Nuclear Information System (INIS)

    Khawaja, Y.; Sadiq, A.

    1987-10-01

    An irreversible kinetic surface-reaction model, based upon the reaction of carbon monoxide nd oxygen on a catalyst surface is investigated by means of Monte Carlo simulation. The adsorbed molecules/atoms on the surface undergo both first and second order kinetic phase transitions. The first order transition is found to occur at x/sub/co=x/sub/2=0.5255 with an error bar of 0.0003, where x/sub/co is the concentration of carbon monoxide in the gas phase. The time evolution of this catalytic reaction is studied both analytically and by computer simulation. Slightly above x/sub/2, the oxygen coverage relaxation time for the oxygen is found to diverage as the inverse of 3.54 times the absolute of the difference of x/sub/2 and x/sub/co. (orig./A.B.)

  12. Composite catalyst for carbon monoxide and hydrocarbon oxidation

    Science.gov (United States)

    Liu, Wei; Flytzani-Stephanopoulos, Maria

    1996-01-01

    A method and composition for the complete oxidation of carbon monoxide and/or hydrocarbon compounds. The method involves reacting the carbon monoxide and/or hydrocarbons with an oxidizing agent in the presence of a metal oxide composite catalyst. The catalyst is prepared by combining fluorite-type oxygen ion conductors with active transition metals. The fluorite oxide, selected from the group consisting of cerium oxide, zirconium oxide, thorium oxide, hafnium oxide, and uranium oxide, and may be doped by alkaline earth and rare earth oxides. The transition metals, selected from the group consisting of molybdnum, copper, cobalt, maganese, nickel, and silver, are used as additives. The atomic ratio of transition metal to fluorite oxide is less than one.

  13. Digit and letter alexia in carbon monoxide poisoning

    Institute of Scientific and Technical Information of China (English)

    Qingyu Shen; Xiaoming Rong; Rui Pan; Ying Peng; Wei Peng; Yamei Tang

    2012-01-01

    This study examined a 24-year-old patient with delayed encephalopathy, who was admitted to hospital with complaints of headache and visual impairment 1 week after acute carbon monoxide poisoning. The results of a visual field assessment, electroencephalography and head magnetic resonance imaging indicated damage to the cerebral cortex. After a 2-week treatment period, the patient had recovered from the visual impairment, but exhibited digit- and letter-reading difficulty. The Chinese aphasia battery and the number and letter battery supplement were conducted. The results revealed that the patient exhibited digit and letter alexia, while the ability to read Chinese characters was preserved. In contrast, the patient exhibited a deficit in Chinese character writing, while number and letter writing remained intact. Following treatment, reading and writing ability was improved and electroencephalographic abnormalities were ameliorated. Overall, our experimental findings demonstrated that delayed encephalopathy following acute carbon monoxide poisoning was characterized by digit and letter alexia.

  14. Interactions of carbon monoxide and hemoglobin at high altitude

    Energy Technology Data Exchange (ETDEWEB)

    Collier, C.R. (Univ. of Southern California Medical Center, Los Angeles); Goldsmith, J.R.

    1983-01-01

    The health risks to U.S. populations who are exposed to ambient carbon monoxide and live at altitudes (such as Denver, Salt Lake City, and Albuquerque) were evaluated using a set of mathematical models. The assumption that a given increase in carboxyhemoglobin would require a more stringent volumetric air quality standard was tested. The results using the model predict that the 8-h or 1-h standards adopted for sea level condition need not be altered to protect individuals against health risks at altitude, if the standards are in volumetric terms. They would need to be reduced if the standards are left in gravimetric terms. If the guideline is to be based on a given decrement of oxygen tension, many other variables must be specified, but expected differences in ambient carbon monoxide have a small impact compared to the effect of altitude itself.

  15. Pathways and bioenergetics of anaerobic carbon monoxide fermentation.

    OpenAIRE

    Martijn eDiender; Alfons J.M. Stams; Alfons J.M. Stams; Diana Z. Sousa

    2015-01-01

    Carbon monoxide can act as a substrate for different modes of fermentative anaerobic metabolism. The trait of utilizing CO is spread among a diverse group of microorganisms, including members of bacteria as well as archaea. Over the last decade this metabolism has gained interest due to the potential of converting CO rich gas, such as synthesis gas, into bio-based products. Three main types of fermentative CO metabolism can be distinguished: hydrogenogenesis, methanogenesis and acetogenesis, ...

  16. Carbon Monoxide Poisoning: Death on Mount McKinley,

    Science.gov (United States)

    1987-05-08

    Additionally, studies by Astrup(5) and Thomas(6) have reported decreased erythrocytic 2, 3- diphosphoglycerate (2, 3-DPG) concentrations with acute...Halebian, et al found no significant difference in measured 02 consumption or extraction between dogs subjected to CO poisoning vs nitrogen anoxia .(9...Astrup P: Intraerythrocytic 2,3- diphosphoglycerate and carbon monoxide exposure. Ann NY Acad Sci 1970;174:252-254. 6. Thomas MF, Penny DG: Hematologic

  17. Diffusion-weighted MR imaging findings in carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Teksam, M.; Casey, S.O.; Michel, E.; Liu, H.; Truwit, C.L.

    2002-01-01

    Diffusion-weighted MR imaging (DWI) of two patients with carbon monoxide (CO) poisoning demonstrated white matter and cortical hyperintensities. In one patient, the changes on the FLAIR sequence were more subtle than those on DWI. The DWI abnormality in this patient represented true restriction. In the second patient, repeated exposure to CO caused restricted diffusion. DWI may be helpful for earlier identification of the changes of acute CO poisoning. (orig.)

  18. Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

    Science.gov (United States)

    Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

    2015-04-01

    Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

  19. A divalent rare earth oxide semiconductor: Yttrium monoxide

    Science.gov (United States)

    Kaminaga, Kenichi; Sei, Ryosuke; Hayashi, Kouichi; Happo, Naohisa; Tajiri, Hiroo; Oka, Daichi; Fukumura, Tomoteru; Hasegawa, Tetsuya

    Rare earth sesquioxides like Y2O3 are known as widegap insulators with the highly stable closed shell trivalent rare earth ions. On the other hand, rare earth monoxides such as YO have been recognized as gaseous phase, and only EuO and YbO were thermodynamically stable solid-phase rock salt monoxides. In this study, solid-phase rock salt yttrium monoxide, YO, was synthesized in a form of epitaxial thin film by pulsed laser deposition method. YO possesses unusual valence of Y2+ ([Kr] 4d1) . In contrast with Y2O3, YO was narrow gap semiconductor with dark-brown color. The electrical conductivity was tunable from 10-1 to 103 Ω-1 cm-1 by introducing oxygen vacancies as electron donor. Weak antilocalization behavior was observed indicating significant spin-orbit coupling owing to 4 d electron carrier. The absorption spectral shape implies the Mott-Hubbard insulator character of YO. Rare earth monoixdes will be new platform of functional oxides. This work was supported by JST-CREST, the Japan Society for the Promotion of Science (JSPS) with Grant-in-Aid for Scientific Research on Innovative Areas (Nos. 26105002 and 26105006), and Nanotechnology Platform (Project No.12024046) of MEXT, Japan.

  20. Carbon monoxide and carbon dioxide interaction with tantalum

    International Nuclear Information System (INIS)

    Belov, V.D.; Ustinov, Yu.K.; Komar, A.P.

    1978-01-01

    The adsorption of carbon monoxide and carbon dioxide on tantalum and the dissolution of these gases in the adsorbent at T >= 300 K have been studied. The flash-filament method (FFM) in a monopole mass-spectrometer and a field emission microscopy was used in the same apparatus. Carbon monoxide and carbon dioxide dissociate on the tantalum surface, carbon monoxide being desorbed in both cases during the flash. The desorption curves of CO reveal three different binding states: two of them (α and β' 1 ) for the adsorbed particles whereas the high temperature desorption state relates to the adsorbate dissolved in the metal. For the β' 1 state of CO the activation energy, the pre-exponential factor and the kinetic order in the kinetic equation of desorption have been estimated. They turned out to be E = 110 kcal/mol, C = 3 X 10 12 sec -1 , and γ = 1. The activation energy of diffusion for CO in tantalum and the energy of outgassing for the metal were found to be 9.4 and 49 kcal/mole, respectively. (Auth.)

  1. Carbon monoxide and carbon dioxide interaction with tantalum

    Energy Technology Data Exchange (ETDEWEB)

    Belov, V D; USTINOV, YU K; KOMAR, A P [AN SSSR, LENINGRAD. FIZIKO-TEKHNICHESKIJ INST.

    1978-03-01

    The adsorption of carbon monoxide and carbon dioxide on tantalum and the dissolution of these gases in the adsorbent at T >= 300 K have been studied. The flash-filament method (FFM) in a monopole mass-spectrometer and a field emission microscopy was used in the same apparatus. Carbon monoxide and carbon dioxide dissociate on the tantalum surface, carbon monoxide being desorbed in both cases during the flash. The desorption curves of CO reveal three different binding states: two of them (..cap alpha.. and ..beta..'/sub 1/) for the adsorbed particles whereas the high temperature desorption state relates to the adsorbate dissolved in the metal. For the ..beta..'/sub 1/ state of CO the activation energy, the pre-exponential factor and the kinetic order in the kinetic equation of desorption have been estimated. They turned out to be E = 110 kcal/mol, C = 3 X 10/sup 12/ sec/sup -1/, and ..gamma.. = 1. The activation energy of diffusion for CO in tantalum and the energy of outgassing for the metal were found to be 9.4 and 49 kcal/mole, respectively.

  2. Mobile Carbon Monoxide Monitoring System Based on Arduino-Matlab for Environmental Monitoring Application

    Science.gov (United States)

    Azieda Mohd Bakri, Nur; Junid, Syed Abdul Mutalib Al; Razak, Abdul Hadi Abdul; Idros, Mohd Faizul Md; Karimi Halim, Abdul

    2015-11-01

    Nowadays, the increasing level of carbon monoxide globally has become a serious environmental issue which has been highlighted in most of the country globally. The monitoring of carbon monoxide content is one of the approaches to identify the level of carbon monoxide pollution towards providing the solution for control the level of carbon monoxide produced. Thus, this paper proposed a mobile carbon monoxide monitoring system for measuring the carbon monoxide content based on Arduino-Matlab General User Interface (GUI). The objective of this project is to design, develop and implement the real-time mobile carbon monoxide sensor system and interfacing for measuring the level of carbon monoxide contamination in real environment. Four phases or stages of work have been carried out for the accomplishment of the project, which classified as sensor development, controlling and integrating sensor, data collection and data analysis. As a result, a complete design and developed system has been verified with the handheld industrial standard carbon monoxide sensor for calibrating the sensor sensitivity and measurement in the laboratory. Moreover, the system has been tested in real environments by measuring the level of carbon monoxide in three different lands used location; industrial area; residential area and main road (commercial area). In this real environment test, the industrial area recorded the highest reading with 71.23 ppm and 82.59 ppm for sensor 1 and sensor 2 respectively. As a conclusion, the mobile realtime carbon monoxide system based on the Arduino-Matlab is the best approach to measure the carbon monoxide concentration in different land-used since it does not require a manual data collection and reduce the complexity of the existing carbon monoxide level concentration measurement practise at the same time with a complete data analysis facilities.

  3. Potential Teaching Model for Applying Novel Approaches of Renewed Estonian National Curriculum into Visual Art Classes in Primary School

    Science.gov (United States)

    Vahter, Edna

    2015-01-01

    In 2010, the renewed national curriculum was legislated in Estonia. Major changes include a new list of cross-curricular topics, increased importance of integration and specification of the components of the art learning process. In this situation, the question arises--how to fully implement the challenges of the renewed curriculum in primary…

  4. The relative influence of secondary versus primary prevention using the national cholesterol education program adult treatment panel II guidelines

    NARCIS (Netherlands)

    Goldman, L; Coxson, P; Hunink, MGM; Goldman, PA; Tosteson, ANA; Mittleman, M; Williams, L; Weinstein, MC

    OBJECTIVES This study was undertaken to project the population-wide effect of full implementation of the Adult Treatment Panel (ATP) II guidelines of the National Cholesterol Education Program (NCEP). BACKGROUND The ATP II has proposed guidelines for cholesterol reduction, but the long-term

  5. Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana

    NARCIS (Netherlands)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

    2015-01-01

    Background: Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited

  6. The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics.

    Science.gov (United States)

    Campbell, John; Smith, Patten; Nissen, Sonja; Bower, Peter; Elliott, Marc; Roland, Martin

    2009-08-22

    The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3%) was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%). Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care) accounting for 68.3% of the variance in the sample. The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of pound sterling 65 million ($107 million) of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  7. The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics

    Directory of Open Access Journals (Sweden)

    Bower Peter

    2009-08-01

    Full Text Available Abstract Background The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9 involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. Methods The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. Results The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3% was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%. Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care accounting for 68.3% of the variance in the sample. Conclusion The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of £65 million ($107 million of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  8. Frequency and distribution of primary site among gender minority cancer patients: An analysis of U.S. national surveillance data.

    Science.gov (United States)

    Nash, Rebecca; Ward, Kevin C; Jemal, Ahmedin; Sandberg, David E; Tangpricha, Vin; Goodman, Michael

    2018-03-09

    Transgender people and persons with disorders of sex development (DSD) are two separate categories of gender minorities, each characterized by unique cancer risk factors. Although cancer registry data typically include only two categories of sex, registrars have the option of indicating that a patient is transgender or has a DSD. Data for primary cancer cases in 46 states and the District of Columbia were obtained from the North American Association of Central Cancer Registries (NAACCR) database for the period 1995-2013. The distributions of primary sites and categories of cancers with shared risk factors were examined separately for transgender and DSD patients and compared to the corresponding distributions in male and female cancer patients. Proportional incidence ratios were calculated by dividing the number of observed cases by the number of expected cases. Expected cases were calculated based on the age- and year of diagnosis-specific proportions of cases in each cancer category observed among male and female patients. Transgender patients have significantly elevated proportional incidence ratios (95% confidence intervals) for viral infection induced cancers compared to either males (2.3; 2.0-2.7) or females (3.3; 2.8-3.7). Adult DSD cancer patients have a similar distribution of primary sites compared to male or female patients but DSD children with cancer have ten times more cases of testicular malignancies than expected (95% confidence interval: 4.7-20). The proportions of certain primary sites and categories of malignancies among transgender and DSD cancer patients are different from the proportions observed for male or female patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

    Science.gov (United States)

    Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

    2017-12-01

    Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly

  10. Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

    Science.gov (United States)

    Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

    2014-10-01

    In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

  11. Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

    Science.gov (United States)

    Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

    2015-10-01

    Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

  12. Monitoring of carbon monoxide in residences with bulk wood pellet storage in the Northeast United States.

    Science.gov (United States)

    Rossner, Alan; Jordan, Carolyn E; Wake, Cameron; Soto-Garcia, Lydia

    2017-10-01

    The interest in biomass fuel is continuing to expand globally and in the northeastern United States as wood pellets are becoming a primary source of fuel for residential and small commercial systems. Wood pellets for boilers are often stored in basement storage rooms or large bag-type containers. Due to the enclosed nature of these storage areas, the atmosphere may exhibit increased levels of carbon monoxide. Serious accidents in Europe have been reported over the last decade in which high concentrations of carbon monoxide (CO) have been found in or near bulk pellet storage containers. The aim of this study was to characterize the CO concentrations in areas with indoor storage of bulk wood pellets. Data was obtained over approximately 7 months (December 2013 to June 2014) at 25 sites in New Hampshire and Massachusetts: 16 homes using wood pellet boilers with indoor pellet storage containers greater than or equal to 3 ton capacity; 4 homes with wood pellet heating systems with outdoor pellet storage; 4 homes using other heating fuels; and a university laboratory site. CO monitors were set up in homes to collect concentrations of CO in the immediate vicinity of wood pellet storage containers, and data were then compared to those of homes using fossil fuel systems. The homes monitored in this study provided a diverse set of housing stock spanning two and a half centuries of construction, with homes built from 1774 to 2013, representing a range of air exchange rates. The CO concentration data from each home was averaged hourly and then compared to a threshold of 9 ppm. While concentrations of CO were generally low for the homes studied, the need to properly design storage locations for pellets is and will remain a necessary component of wood pellet heating systems to minimize the risk of CO exposure. This paper is an assessment of carbon monoxide (CO) exposure from bulk wood pellet storage in homes in New Hampshire and Massachusetts. Understanding the CO concentrations

  13. Increased ultrafine particles and carbon monoxide concentrations are associated with asthma exacerbation among urban children

    Science.gov (United States)

    Evans, Kristin A.; Halterman, Jill S.; Hopke, Philip K.; Fagnano, Maria; Rich, David Q.

    2014-01-01

    Objectives Increased air pollutant concentrations have been linked to several asthma-related outcomes in children, including respiratory symptoms, medication use, and hospital visits. However, few studies have examined effects of ultrafine particles in a pediatric population. Our primary objective was to examine the effects of ambient concentrations of ultrafine particles on asthma exacerbation among urban children and determine whether consistent treatment with inhaled corticosteroids could attenuate these effects. We also explored the relationship between asthma exacerbation and ambient concentrations of accumulation mode particles, fine particles (≤ 2.5 micrograms [μm]; PM2.5), carbon monoxide, sulfur dioxide, and ozone. We hypothesized that increased 1 to 7 day concentrations of ultrafine particles and other pollutants would be associated with increases in the relative odds of an asthma exacerbation, but that this increase in risk would be attenuated among children receiving school-based corticosteroid therapy. Methods We conducted a pilot study using data from 3–10 year-old children participating in the School-Based Asthma Therapy trial. Using a time-stratified case-crossover design and conditional logistic regression, we estimated the relative odds of a pediatric asthma visit treated with prednisone (n=96 visits among 74 children) associated with increased pollutant concentrations in the previous 7 days. We re-ran these analyses separately for children receiving medications through the school-based intervention and children in a usual care control group. Results Interquartile range increases in ultrafine particles and carbon monoxide concentrations in the previous 7 days were associated with increases in the relative odds of a pediatric asthma visit, with the largest increases observed for 4-day mean ultrafine particles (interquartile range=2088 p/cm3; OR=1.27; 95% CI=0.90–1.79) and 7-day mean carbon monoxide (interquartile range=0.17 ppm; OR=1.63; 95

  14. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    OpenAIRE

    Metin Uysalol; Ezgi Paslı Uysalol; Gamze Varol Saraçoğlu; Semra Kayaoğlu

    2011-01-01

    Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female) who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide into...

  15. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Directory of Open Access Journals (Sweden)

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  16. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-04-30

    The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  17. Carbon monoxide poisoning - Immediate diagnosis and treatment are crucial to avoid complications.

    Energy Technology Data Exchange (ETDEWEB)

    Rosenthal, L.D. [Case Western Reserve University, Cleveland, OH (United States)

    2006-03-15

    Carbon monoxide is an odorless, colorless, tasteless gas produced by the incomplete combustion of carbon-containing fuels (oil, kerosene, coal, wood) or the inadequate ventilation of natural gas. When carbon monoxide is introduced into the bloodstream, it binds to hemoglobin, reducing the number of binding sites available for oxygen. Carbon monoxide also changes the structure of the hemoglobin molecule, which makes it even more difficult for oxygen that has attached to be released into tissues. The resulting tissue ischemia can lead to organ failure, permanent changes in cognition, or death. Carbon monoxide poisoning is the leading cause of death by poisoning in industrialized countries.

  18. XPS study on the surface reaction of uranium metal with carbon monoxide at 200 degree C

    International Nuclear Information System (INIS)

    Wang Xiaoling; Fu Yibei; Xie Renshou; Huang Ruiliang

    1996-12-01

    The surface reaction of uranium metal with carbon monoxide at 200 degree C has been studied by X-ray photoelectron spectroscopy (XPS). The carbon monoxide adsorption on the surface oxide layer resulted in U4f peak shifting to the lower binding energy and the content of oxygen in the oxide is decreased. O/U radio decreases with increasing the exposure of carbon monoxide to the surface layer. The investigation indicated the surface layer of uranium metal was further reduced in the atmosphere of carbon monoxide at high temperature. (3 refs., 5 figs.)

  19. Study on the surface oxidation resistance of uranium metal in the atmosphere of carbon monoxide

    International Nuclear Information System (INIS)

    Wang Xiaolin; Fu Yibei; Xie Renshou

    1999-01-01

    The surface reactions of different layers on uranium metal with carbon monoxide at 25, 80 and 200 degree C are studied by X-ray photoelectron spectroscopy (XPS). The experimental results show that the carbon monoxide is adsorbed on the surface oxide layer of uranium and interacted each other. The content of oxygen in the surface oxide and O/U ratio are decreased with increasing the exposure of carbon monoxide to the surface layer. The effect of reduction on the metal surface is more obviously with a higher temperature and increasing of layer thickness. The investigation indicates the uranium metal has resistance to further oxidation in the atmosphere of carbon monoxide

  20. The impact of family planning on primary school enrolment in sub-national areas within 25 African countries.

    Science.gov (United States)

    Longwe, Abiba; Smits, Jeroen

    2013-06-01

    We study how the availability and use of family planning services in African countries influences the family planning situation of households and through this the educational participation of young children. A district panel dataset is used for 441 urban and rural areas within 233 districts of 25 countries. Path analysis shows that a decrease in the number of births is associated with an increase in educational participation in the area. The number of births is negatively associated with acceptance, knowledge and actual use of contraceptives in the area. As reversed causality and selection bias seem unlikely, the identified relationship probably is at least partially causal. Hence, investments in family planning services in poor areas are not only important because they allow women to plan their births better, but also because they may lead to higher primary enrolment rates and thus contribute to the region's future economic growth.

  1. Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia.

    Science.gov (United States)

    Zaki, M; Robaayah, Z; Chan, S P; Vadivale, M; Lim, T O

    2010-06-01

    Abdominal obesity (AO), measured by waist circumference (WC), is a stronger predictor of subsequent development of cardiovascular disease (CVD) than generalised obesity, which is measured by body mass index (BMI). This study aimed to measure WC and prevalence of AO in Malaysians visiting primary care physicians. 1893 patients between the ages of 18 and 80 attending primary care clinics in Malaysia were recruited over two days for this multi-centre cross-sectional study. Pregnant women were excluded, their medical history, weight, height and WC were examined. The prevalence of co-morbidities were as follows: (1) CVD-4%, lipid disorder-17%, hypertension-26%, diabetes-14% and any of the clinical characteristics of CVD/lipid disorder/hypertension/diabetes-38%. The mean BMI for men and women was 25.62 +/- 4.73 kg/m2 and 26.63 +/- 5.72 kg/m2, respectively. Based on WHO criteria for BMI (overweight, 25-29.9 kg/m2; obese, > 30 kg/m2), 34.2% were overweight and 20.4% were obese. The mean WC for men and women was 89.03 +/- 13.45 cm and 84.26 +/- 12.78 cm, respectively. Overall, 55.6% had AO and there was higher prevalence among women (based on International Diabetes Federation criteria: WC > or = 90 cm for men and > or = 80 cm for women). AO was present in approximately 71% patients with lipid disorder, in 76% with hypertension and in 75% with diabetes. Patients with AO were also at a higher risk of developing co-morbidities. Malaysia has a high prevalence of AO and associated cardiovascular risk factors. This needs to be addressed by public health programs, which should also include routine measurement of WC.

  2. Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

    Science.gov (United States)

    Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

    2018-03-01

    HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © 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.

  3. Pathology of carbon monoxide poisoning in two cats.

    Science.gov (United States)

    Sobhakumari, Arya; Poppenga, Robert H; Pesavento, J Brad; Uzal, Francisco A

    2018-03-05

    Carbon monoxide (CO), a common cause of poisoning in human beings has also been implicated in the death of animals. Though there are multiple studies on CO poisoning and relevant lethal blood COHb concentrations in humans, there are no reliable reports of diagnostic lethal carboxyhemoglobin percentage of saturation (COHb%) in cats. Additionally, due to shared housing environments, exposures to companion animals can be a surrogate for lethal exposures in human beings and provide valuable information in concurrent forensic investigations. Two adult Singapura brown ticked cats were submitted to the California Animal Health and Food Safety Laboratory (CAHFS) for necropsy and diagnostic work-up. These animals were found dead along with their two deceased owners. Similar lesions were observed in both cats. At necropsy, gross lesions consisted of multifocal, large, irregular, bright red spots on the skin of the abdomen and the inner surface of ear pinnae, bright red muscles and blood. The carcasses, and tissues fixed in formalin retained the bright red discoloration for up to two weeks. Microscopic lesions included diffuse pulmonary congestion and edema, and multifocal intense basophilia of cardiomyocytes mostly affecting whole fibers or occasionally a portion of the fiber. Based on the clinical history,gross and microscopic changes, cyanide or carbon monoxide poisoning was suspected. Blood samples analyzed for carbon monoxide showed 57 and 41% carboxyhemoglobin COHb%. Muscle samples were negative for cyanide. There are no established reference values for lethal COHb concentration in cats. The COHb % values detected in this case which fell within the lethal range reported for other species, along with the gross lesions and unique histological findings in the heart suggest a helpful criteria for diagnosis of CO intoxication associated death in cats. This case demonstrates that since pets share the same environment as human beings and often are a part of their activities

  4. The deployment of carbon monoxide wireless sensor network (CO-WSN) for ambient air monitoring.

    Science.gov (United States)

    Chaiwatpongsakorn, Chaichana; Lu, Mingming; Keener, Tim C; Khang, Soon-Jai

    2014-06-16

    Wireless sensor networks are becoming increasingly important as an alternative solution for environment monitoring because they can reduce cost and complexity. Also, they can improve reliability and data availability in places where traditional monitoring methods are difficult to site. In this study, a carbon monoxide wireless sensor network (CO-WSN) was developed to measure carbon monoxide concentrations at a major traffic intersection near the University of Cincinnati main campus. The system has been deployed over two weeks during Fall 2010, and Summer 2011-2012, traffic data was also recorded by using a manual traffic counter and a video camcorder to characterize vehicles at the intersection 24 h, particularly, during the morning and evening peak hour periods. According to the field test results, the 1 hr-average CO concentrations were found to range from 0.1-1.0 ppm which is lower than the National Ambient Air Quality Standards (NAAQS) 35 ppm on a one-hour averaging period. During rush hour periods, the traffic volume at the intersection varied from 2,067 to 3,076 vehicles per hour with 97% being passenger vehicles. Furthermore, the traffic volume based on a 1-h average showed good correlation (R2 = 0.87) with the 1-h average CO-WSN concentrations for morning and evening peak time periods whereas CO-WSN results provided a moderate correlation (R2 = 0.42) with 24 hours traffic volume due to fluctuated changes of meteorological conditions. It is concluded that the performance and the reliability of wireless ambient air monitoring networks can be used as an alternative method for real time air monitoring.

  5. Iodine monoxide in the north subtropical free troposphere [Discussion paper

    OpenAIRE

    Puentedura, Olga; Gil-Ojeda, Manuel; Saiz-Lopez, Alfonso; Hay, Tim; Navarro Comas, Mónica; Gómez Peláez, Ángel Jesús; Cuevas Agulló, Emilio; Iglesias, J.

    2011-01-01

    Iodine monoxide (IO) was retrieved using a new multi-axis DOAS instrument deployed at the Izaña subtropical observatory as part of the Network for the Detection of Atmospheric Composition Change (NDACC) programme. The station is located at 2370 m a.s.l., well above the trade wind inversion that limits the top of the marine boundary layer, and is hence representative of the free troposphere. We report daily observations from May to August 2010 at different viewing angles. During this period, t...

  6. Iodine monoxide in the north subtropical free troposphere

    OpenAIRE

    O. Puentedura; M. Gil; A. Saiz-Lopez; T. Hay; M. Navarro-Comas; A. Gómez-Pelaez; E. Cuevas; J. Iglesias; L. Gomez

    2012-01-01

    Iodine monoxide (IO) differential slant column densities (DSCD) have been retrieved from a new multi-axis differential optical absorption spectroscopy (MAX-DOAS) instrument deployed at the Izaña subtropical observatory as part of the Network for the Detection of Atmospheric Composition Change (NDACC) programme. The station is located at 2370 m a.s.l., well above the trade wind inversion that limits the top of the marine boundary layer, and hence is representative of the free troposphere. We r...

  7. Thermal Degradation of Lead Monoxide Filled Polymer Composite Radiation Shields

    International Nuclear Information System (INIS)

    Harish, V.; Nagaiah, N.

    2011-01-01

    Lead monoxide filled Isophthalate resin particulate polymer composites were prepared with different filler concentrations and investigated for physical, thermal, mechanical and gamma radiation shielding characteristics. This paper discusses about the thermo gravimetric analysis of the composites done to understand their thermal properties especially the effect of filler concentration on the thermal stability and degradation rate of composites. Pristine polymer exhibits single stage degradation whereas filled composites exhibit two stage degradation processes. Further, the IDT values as well as degradation rates decrease with the increased filler content in the composite.

  8. Chlorination of niobium oxide in the presence of carbon monoxide

    International Nuclear Information System (INIS)

    Freitas, L.R. de

    1984-01-01

    The chlorination kinetics of niobium pentoxide in the presence of carbon monoxide between 500-800 0 C of temperature is studied. The following variable that influences on the reaction rate are analysed: gas flow, geometry and volume of the Nb 2 O 5 samples, reaction temperature and composition of the chlorinated mixture. At the same time, two other materials were studied: the CaO.Nb 2 O 5 (synthetized in laboratory) and pyrochlorine concentrates. The three materials are compared for the chlorination method used. (M.A.C.) [pt

  9. Thermodynamic properties of liquid mixtures of carbon monoxide and methane

    Energy Technology Data Exchange (ETDEWEB)

    Calado, J.C.G.; Guedes, H.J.R.; Nunes da Ponte, M.; Streett, W.B.

    1984-04-01

    Researchers conducted pressure-volume-temperature measurements of liquid methane at -230/sup 0/F and of six liquid mixtures of carbon monoxide and methane at -250/sup 0/, -240/sup 0/, and -230/sup 0/F from just above the saturation vapor pressure to the freezing pressure of methane. The excess volume proved to be large and negative at low pressures but less negative as the pressure increased, being almost zero at the highest pressure. Of the thermodynamic functions, excess enthalpy and excess entropy were much more sensitive to pressure than excess Gibbs energy. Conformal solution theory in the van der Waals one-fluid form reproduced the experimental results very successfully.

  10. Pathways and bioenergetics of anaerobic carbon monoxide fermentation.

    Directory of Open Access Journals (Sweden)

    Martijn eDiender

    2015-11-01

    Full Text Available Carbon monoxide can act as a substrate for different modes of fermentative anaerobic metabolism. The trait of utilizing CO is spread among a diverse group of microorganisms, including members of bacteria as well as archaea. Over the last decade this metabolism has gained interest due to the potential of converting CO rich gas, such as synthesis gas, into bio-based products. Three main types of fermentative CO metabolism can be distinguished: hydrogenogenesis, methanogenesis and acetogenesis, generating hydrogen, methane and acetate, respectively. Here, we review the current knowledge on these three variants of microbial CO metabolism with an emphasis on the potential enzymatic routes and bio-energetics involved.

  11. Pathways and Bioenergetics of Anaerobic Carbon Monoxide Fermentation.

    Science.gov (United States)

    Diender, Martijn; Stams, Alfons J M; Sousa, Diana Z

    2015-01-01

    Carbon monoxide can act as a substrate for different modes of fermentative anaerobic metabolism. The trait of utilizing CO is spread among a diverse group of microorganisms, including members of bacteria as well as archaea. Over the last decade this metabolism has gained interest due to the potential of converting CO-rich gas, such as synthesis gas, into bio-based products. Three main types of fermentative CO metabolism can be distinguished: hydrogenogenesis, methanogenesis, and acetogenesis, generating hydrogen, methane and acetate, respectively. Here, we review the current knowledge on these three variants of microbial CO metabolism with an emphasis on the potential enzymatic routes and bio-energetics involved.

  12. 76 FR 72218 - National Environmental Policy Act; NASA Routine Payloads on Expendable Launch Vehicles

    Science.gov (United States)

    2011-11-22

    ...) 358-0167). (b) Central Brevard Library and Reference Center, 308 Forrest Avenue, Cocoa, FL 32922 ((321...-products. The primary emission products from the liquid engines include carbon dioxide, carbon monoxide...

  13. Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey.

    Science.gov (United States)

    Burt, Jenni; Lloyd, Cathy; Campbell, John; Roland, Martin; Abel, Gary

    2016-01-01

    Doctor-patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor-patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. To determine how reported GP-patient communication varies between patients from different ethnic groups, stratified by age and gender. Analysis of data from the English GP Patient Survey from 2012-2013 and 2013-2014, including 1,599,801 responders. A composite score was created for doctor-patient communication from five survey items concerned with interpersonal aspects of care. Mixed-effect linear regression models were used to estimate age- and gender-specific differences between white British patients and patients of the same age and gender from each other ethnic group. There was strong evidence (Pcommunication varied by both age and gender. The difference in scores between white British and other responders on doctor-patient communication items was largest for older, female Pakistani and Bangladeshi responders, and for younger responders who described their ethnicity as 'Any other white'. The identification of groups with particularly marked differences in experience of GP-patient communication--older, female, Asian patients and younger 'Any other white' patients--underlines the need for a renewed focus on quality of care for these groups. © British Journal of General Practice 2016.

  14. National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy.

    Science.gov (United States)

    Soeyonggo, Tony; Locke, Jennifer; Giudice, Maria Elizabeth Del; Alibhai, Shabbir; Fleshner, Neil Eric; Warde, Padraig

    2014-03-01

    Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians' (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area. A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs' demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management. In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively). PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.

  15. The association between socioeconomic status and visual impairments among primary glaucoma: the results from Nationwide Korean National Health Insurance Cohort from 2004 to 2013.

    Science.gov (United States)

    Sung, Haejune; Shin, Hyun Ho; Baek, Yunseng; Kim, Gyu Ah; Koh, Jae Sang; Park, Eun-Cheol; Shin, Jaeyong

    2017-08-23

    Glaucoma is one of the most leading causes of permanent visual impairments in Korea, and social expenses spent for the glaucoma are increasing. This study is to identify association between socioeconomic status and the visual impairments caused by primary glaucoma in Korea. This study is based on a cohort study using stratified representative samples in the National Health Insurance claim data from 2002 to 2013 with 1,025,340 representative subjects. Target subjects were patients who are newly diagnosed with primary glaucoma from 2004 to 2013. We conducted a multiple logistic regression analysis depending on the occurrence of visual impairment and its temporal order compared to the glaucoma diagnosis. Among 1728 patients with primary glaucoma, those with low and middle income shows higher odds ratio (OR) of the visual impairments than those with high income group (low income; OR = 3.42, 95% Confidential Interval (CI):2.06-5.66, middle income; OR = 2.13, 95% CI: 1.28-3.55), in case of the occurrence of the visual impairments preceded the diagnosis of glaucoma. Glaucoma patients without pre-existing glaucoma history before visual impairment have higher association between socioeconomic status and the occurrence of visual impairments by primary glaucoma. Since glaucoma had not been diagnosed and recognized yet, the differences may have been derived from the disparities of the awareness of the glaucoma. These findings call attention to the correlation between socioeconomic factors and the visual impairments by glaucoma, and raise public health needs over the importance of glaucoma awareness and eye screening for glaucoma, especially for low socioeconomic status.

  16. Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

    Directory of Open Access Journals (Sweden)

    Fei Chen

    Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

  17. Determinants of use of the bronchodilator test in primary and secondary care: results of a national survey in Spain.

    Science.gov (United States)

    Lopez-Campos, Jose Luis; Soriano, Joan B; Calle, Myriam

    2016-03-01

    A recent study evaluated the use of spirometry in primary (PC) and secondary care (SC) in Spain. In the present study, we aimed to analyze the determinants of use of the bronchodilator test (BDT) with a special emphasis in the type of drugs used, waiting times and positive test criteria followed. Cross-sectional trial surveying 605 PC and 200 SC centers in Spain. Regarding the BDT, variables collected were: name of the drugs available for the BDT, name of the drug normally used, number of inhalations, waiting time for the second spirometry, staff involved and criteria used for a positive test. Adherence to actual guidelines according to five quality criteria was evaluated. Although a range of short-acting bronchodilators were used, only 25.9% of centers used a correct dose. The waiting time was correct in 63.7% and 72.8% of PC and SC, respectively (P = 0.023). A threshold higher than 12% and 200 mL to consider a positive test was fulfilled in 55.8% and 52.8% of PC and SC, respectively. Altogether, only 7.6% of PC and 6.0% of SC fulfilled all five quality criteria. Factors identified to be associated with this fulfillment were the number of spirometries per week, not being conducted by a nurse, periodical retraining, training for interpreting and daily calibration. The present study identifies determinants of the performance of the BDT in Spain identifying strengths and weaknesses. Health managers should use this information to improve the quality of spirometries in chronic respiratory patients. © 2014 John Wiley & Sons Ltd.

  18. Standard cardiovascular disease risk algorithms underestimate the risk of cardiovascular disease in schizophrenia: evidence from a national primary care database.

    Science.gov (United States)

    McLean, Gary; Martin, Julie Langan; Martin, Daniel J; Guthrie, Bruce; Mercer, Stewart W; Smith, Daniel J

    2014-10-01

    Schizophrenia is associated with increased cardiovascular mortality. Although cardiovascular disease (CVD) risk prediction algorithms are widely in the general population, their utility for patients with schizophrenia is unknown. A primary care dataset was used to compare CVD risk scores (Joint British Societies (JBS) score), cardiovascular risk factors, rates of pre-existing CVD and age of first diagnosis of CVD for schizophrenia (n=1997) relative to population controls (n=215,165). Pre-existing rates of CVD and the recording of risk factors for those without CVD were higher in the schizophrenia cohort in the younger age groups, for both genders. Those with schizophrenia were more likely to have a first diagnosis of CVD at a younger age, with nearly half of men with schizophrenia plus CVD diagnosed under the age of 55 (schizophrenia men 46.1% vs. control men 34.8%, pschizophrenia women 28.9% vs. control women 23.8%, prisk factors within the schizophrenia group, only a very small percentage (3.2% of men and 7.5% of women) of those with schizophrenia under age 55 were correctly identified as high risk for CVD according to the JBS risk algorithm. The JBS2 risk score identified only a small proportion of individuals with schizophrenia under the age of 55 as being at high risk of CVD, despite high rates of risk factors and high rates of first diagnosis of CVD within this age group. The validity of CVD risk prediction algorithms for schizophrenia needs further research. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis

    Directory of Open Access Journals (Sweden)

    David A Ellis, PhD

    2017-12-01

    Full Text Available Summary: Background: Addressing the causes of low engagement in health care is a prerequisite for reducing health inequalities. People who miss multiple appointments are an under-researched group who might have substantial unmet health needs. Individual-level patterns of missed general practice appointments might thus provide a risk marker for vulnerability and poor health outcomes. We sought to ascertain the contributions of patient and practice factors to the likelihood of missing general practice appointments. Methods: For this national retrospective cohort analysis, we extracted UK National Health Service general practice data that were routinely collected across Scotland between Sept 5, 2013, and Sept 5, 2016. We calculated the per-patient number of missed appointments from individual appointments and investigated the risk of missing a general practice appointment using a negative binomial model offset by number of appointments made. We then analysed the effect of patient-level factors (including age, sex, and socioeconomic status and practice-level factors (including appointment availability and geographical location on the risk of missing appointments. Findings: The full dataset included information from 909 073 patients, of whom 550 083 were included in the analysis after processing. We observed that 104 461 (19·0% patients missed more than two appointments in the 3 year study period. After controlling for the number of appointments made, patterns of non-attendance could be differentiated, with patients who were aged 16–30 years (relative risk ratio [RRR] 1·21, 95% CI 1·19–1·23 or older than 90 years (2·20, 2·09–2·29, and of low socioeconomic status (Scottish Index of Multiple Deprivation decile 1: RRR 2·27, 2·22–2·31 significantly more likely to miss multiple appointments. Men missed fewer appointments overall than women, but were somewhat more likely to miss appointments

  20. The Future of Carbon Monoxide Measurements from Space

    Science.gov (United States)

    Drummond, J.

    It is now over 20 years since the Measurements of Air Pollution from Space MAPS instrument made the first measurements of tropospheric carbon monoxide from the shuttle Since that time a number of instruments have flown including the Measurements Of Pollution In The Troposphere MOPITT Tropospheric Emission Spectrometer TES and SCanning Imaging Absorption SpectroMeter for Atmospheric CHartographY SCIAMCHY to name only three of many Each of these instruments has a unique observing method and unique mission characteristics It is accepted that measurements of carbon monoxide provide a useful proxy of the pollution of the troposphere and contribute significantly to studies of various phenomena in the atmosphere and atmosphere-surface interactions These measurements should therefore be continued -- but in what form Technology has progresses significantly since the current generation of instruments was designed and our ability to interpret the data from such instrumentation has likewise expanded It is therefore fruitful to consider what is the best set of measurements that can be made which parameters should be emphasized and which compromised on the way to the next generation of sensors The Measurements of Air Pollution Levels in the Environment MAPLE instrument is a study financed by the Canadian Space Agency to design a next-generation instrument and since instrument spacecraft and mission are now intimately linked a consideration of the whole mission is appropriate This talk will outline some potential developments in the hardware

  1. A carbon monoxide passive sampler: Research and development needs

    Energy Technology Data Exchange (ETDEWEB)

    Traynor, G.W.; Apte, M.G.; Diamond, R.C.; Woods, A.L.

    1991-11-01

    In rare instances, carbon monoxide (CO) levels in houses can reach dangerously high concentrations, causing adverse health effects ranging from mild headaches to, under extreme conditions, death. Hundreds of fatal accidental carbon monoxide poisonings occur each year primarily due to the indoor operation of motor vehicles, the indoor use of charcoal for cooking, the operation of malfunctioning vented and unvented combustion appliances, and the misuse combustion appliances. Because there is a lack of simple, inexpensive, and accurate field sampling instrumentation, it is difficult for gas utilities and researchers to conduct field research studies designed to quantify the concentrations of CO in residences. Determining the concentration of CO in residences is the first step towards identifying the high risk appliances and high-CO environments which pose health risks. Thus, there exists an urgent need to develop and field-validate a CO-quantifying technique suitable for affordable field research. A CO passive sampler, if developed, could fulfill these requirements. Existing CO monitoring techniques are discussed as well as three potential CO-detection methods for use in a CO passive sampler. Laboratory and field research needed for the development and validation of an effective and cost-efficient CO passive sampler are also discussed.

  2. The electric dipole moment of cobalt monoxide, CoO.

    Science.gov (United States)

    Zhuang, Xiujuan; Steimle, Timothy C

    2014-03-28

    A number of low-rotational lines of the E(4)Δ7/2 ← X(4)Δ7/2 (1,0) band system of cobalt monoxide, CoO, were recorded field free and in the presence of a static electric field. The magnetic hyperfine parameter, h7/2, and the electron quadrupole parameter, eQq0, for the E(4)Δ7/2(υ = 1) state were optimized from the analysis of the field-free spectrum. The permanent electric dipole moment, μ(→)(el), for the X(4)Δ7/2 (υ = 0) and E(4)Δ7/2 (υ = 1) states were determined to be 4.18 ± 0.05 D and 3.28 ± 0.05 D, respectively, from the analysis of the observed Stark spectra of F' = 7 ← F″ = 6 branch feature in the Q(7/2) line and the F' = 8 ← F″ = 7 branch feature in the R(7/2) line. The measured dipole moments of CoO are compared to those from theoretical predictions and the trend across the 3d-metal monoxide series discussed.

  3. The electric dipole moment of cobalt monoxide, CoO

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Xiujuan, E-mail: zhuangxj@hnu.edu.cn [College of Physics and Microelectronics Science, Key Laboratory for Micro-Nano Physics and Technology of Hunan Province, Hunan University, Changsha 410082 (China); Steimle, Timothy C. [Department of Chemistry and Biochemistry, Arizona State University, Tempe, Arizona 85287-1604 (United States)

    2014-03-28

    A number of low-rotational lines of the E{sup 4}Δ{sub 7/2} ← X{sup 4}Δ{sub 7/2} (1,0) band system of cobalt monoxide, CoO, were recorded field free and in the presence of a static electric field. The magnetic hyperfine parameter, h{sub 7/2}, and the electron quadrupole parameter, eQq{sub 0}, for the E{sup 4}Δ{sub 7/2}(υ = 1) state were optimized from the analysis of the field-free spectrum. The permanent electric dipole moment, μ{sup -vector}{sub el}, for the X{sup 4}Δ{sub 7/2} (υ = 0) and E{sup 4}Δ{sub 7/2} (υ = 1) states were determined to be 4.18 ± 0.05 D and 3.28 ± 0.05 D, respectively, from the analysis of the observed Stark spectra of F′ = 7 ← F″ = 6 branch feature in the Q(7/2) line and the F′ = 8 ← F″ = 7 branch feature in the R(7/2) line. The measured dipole moments of CoO are compared to those from theoretical predictions and the trend across the 3d-metal monoxide series discussed.

  4. Cumulative exposure to carbon monoxide during the day

    Energy Technology Data Exchange (ETDEWEB)

    Joumard, R. (INRETS, 69 - Bron (FR))

    The carbon monoxide, CO, has the advantage of being very easily and accurately measured under various conditions. In addition, it allows the translation of CO concentrations into their biological effects. The cumulative CO exposure should be considered according to current environment conditions during a given period of life, e.g. the day. In addition, the translation of concentrations and exposure times of CO fixed on blood haemoglobine (carboxyhaemoglobine) depends on physiological factors such as age, size, sex, or physical activity. This paper gives some examples of CO exposure translated into curves of carboxyhaemoglobine: case of 92 persons whose schedule was studied in details, of customs officers whose exposure was measured during one week, or other theoretical cases. In all the cases studied, smoking is by far the first factor of pollution by carbon monoxide. If not considering this case, the CO contents observed are preoccupying for sensitive subjects (in particular children) only in very rare cases. Furthermore, this approach allows the assessment of maximal allowable concentrations during specific exposures (work, e.g. in a tunnel) by integrating them into normal life conditions and population current exposure.

  5. 40 CFR 51.241 - Nonattainment areas for carbon monoxide and ozone.

    Science.gov (United States)

    2010-07-01

    ... Intergovernmental Consultation Agency Designation § 51.241 Nonattainment areas for carbon monoxide and ozone. (a... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Nonattainment areas for carbon monoxide and ozone. 51.241 Section 51.241 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

  6. Carbon monoxide may be an important molecule in migraine and other headaches

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Schytz, Henrik W; Hauge, Mette K

    2014-01-01

    INTRODUCTION: Carbon monoxide was previously considered to just be a toxic gas. A wealth of recent information has, however, shown that it is also an important endogenously produced signalling molecule involved in multiple biological processes. Endogenously produced carbon monoxide may thus play...

  7. Carbon Monoxide Photoproduction from Particles and Solutes in the Delaware Estuary under Contrasting Hydrological Conditions.

    Science.gov (United States)

    Song, Guisheng; Richardson, John D; Werner, James P; Xie, Huixiang; Kieber, David J

    2015-12-15

    Full-spectrum, ultraviolet (UV), and visible broadband apparent quantum yields (AQYs) for carbon monoxide (CO) photoproduction from chromophoric dissolved organic matter (CDOM) and particulate organic matter (POM) were determined in the Delaware Estuary in two hydrologically contrasting seasons in 2012: an unusually low flow in August and a storm-driven high flow in November. Average AQYs for CDOM and POM in November were 10 and 16 times the corresponding AQYs in August. Maximum AQYs in November occurred in a midestuary particle absorption maximum zone. Although POM AQYs were generally smaller than CDOM AQYs, the ratio of the former to the latter increased substantially from the UV to the visible. In both seasons, UV solar radiation was the primary driver for CO photoproduction from CDOM whereas visible light was the principal contributor to POM-based CO photoproduction. CDOM dominated CO photoproduction in the uppermost water layer while POM prevailed at deeper depths. On a depth-integrated basis, the Delaware Estuary shifted from a CDOM-dominated system in August to a POM-dominated system in November with respect to CO photoproduction. This study reveals that flood events may enhance photochemical cycling of terrigenous organic matter and switch the primary photochemical driver from CDOM to POM.

  8. Rapid decline in carbon monoxide emissions and export from East Asia between years 2005 and 2016

    Science.gov (United States)

    Zheng, Bo; Chevallier, Frederic; Ciais, Philippe; Yin, Yi; Deeter, Merritt N.; Worden, Helen M.; Wang, Yilong; Zhang, Qiang; He, Kebin

    2018-04-01

    Measurements of Pollution in the Troposphere (MOPITT) satellite and ground-based carbon monoxide (CO) measurements both suggest a widespread downward trend in CO concentrations over East Asia during the period 2005–2016. This negative trend is inconsistent with global bottom-up inventories of CO emissions, which show a small increase or stable emissions in this region. We try to reconcile the observed CO trend with emission inventories using an atmospheric inversion of the MOPITT CO data that estimates emissions from primary sources, secondary production, and chemical sinks of CO. The atmospheric inversion indicates a ~ ‑2% yr‑1 decrease in emissions from primary sources in East Asia from 2005–2016. The decreasing emissions are mainly caused by source reductions in China. The regional MEIC inventory for China is the only bottom up estimate consistent with the inversion-diagnosed decrease of CO emissions. According to the MEIC data, decreasing CO emissions from four main sectors (iron and steel industries, residential sources, gasoline-powered vehicles, and construction materials industries) in China explain 76% of the inversion-based trend of East Asian CO emissions. This result suggests that global inventories underestimate the recent decrease of CO emission factors in China which occurred despite increasing consumption of carbon-based fuels, and is driven by rapid technological changes with improved combustion efficiency and emission control measures.

  9. CW-Laser-Induced Solid-State Reactions in Mixed Micron-Sized Particles of Silicon Monoxide and Titanium Monoxide: Nano-Structured Composite with Visible Light Absorption

    Czech Academy of Sciences Publication Activity Database

    Křenek, T.; Tesař, J.; Kupčík, Jaroslav; Netrvalová, M.; Pola, M.; Jandová, Věra; Pokorná, Dana; Cuřínová, Petra; Bezdička, Petr; Pola, Josef

    2017-01-01

    Roč. 27, č. 6 (2017), s. 1640-1648 ISSN 1574-1443 Institutional support: RVO:61388980 ; RVO:67985858 Keywords : Cw CO2 laser heating * IR laser imaging * Silicon monoxide * Solid state redox reactions * Ti/Si/O composite * Titanium monoxide Subject RIV: CA - Inorganic Chemistry; CI - Industrial Chemistry, Chemical Engineering (UCHP-M) OBOR OECD: Inorganic and nuclear chemistry; Chemical process engineering (UCHP-M) Impact factor: 1.577, year: 2016

  10. Method of removing nitrogen monoxide from a nitrogen monoxide-containing gas using a water-soluble iron ion-dithiocarbamate, xanthate or thioxanthate

    Science.gov (United States)

    Liu, D. Kwok-Keung; Chang, Shih-Ger

    1987-08-25

    The present invention relates to a method of removing of nitrogen monoxide from a nitrogen monoxide-containing gas which method comprises contacting a nitrogen oxide-containing gas with an aqueous solution of water soluble organic compound-iron ion chelate complex. The NO absorption efficiency of ferrous urea-dithiocarbamate and ferrous diethanolamine-xanthate as a function of time, oxygen content and solution ph is presented. 3 figs., 1 tab.

  11. Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care.

    Science.gov (United States)

    Netuveli, Gopalakrishnan; Hurwitz, Brian; Sheikh, Aziz

    2005-10-21

    Recent studies have demonstrated marked international variations in the prevalence of asthma, but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma. Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma, South Asian and Afro-Caribbean people in the UK are significantly (3x and 2x respectively) more likely to be admitted to hospital for asthma related problems than Whites. Using data from the Fourth National Study of Morbidity Statistics in General Practice, a one-percent broadly representative prospective cohort study of consultations in general practice, we investigated ethnic variations in incident asthma consultations (defined as new or first consultations), and compared consultation rates between those born inside and outside the UK (migrant status). Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations. Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied (mean age-adjusted consultation rates per 1000 patient-years: Whites 26.4 (95%CI 26.4, 26.4); South Asians 30.4 (95%CI 30.3, 30.5); Afro-Caribbeans 35.1 (95%CI 34.9, 35.3); and Others 27.8 (27.7, 28.0). Within each of these ethnic groups, those born outside of the UK showed consistently lower rates of incident asthma consultations. Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites. Non-UK born Whites however experienced reduced risks (adjusted OR 0.82, 95%CI 0.69, 0.97) whilst non-UK born South Asians experienced increased risks (adjusted OR 1.33, 95%CI 1.04, 1.70) compared to UK-born Whites. These findings

  12. Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data.

    Science.gov (United States)

    Harcourt, Sally; Morbey, Roger A; Bates, Chris; Carter, Helen; Ladhani, Shamez N; de Lusignan, Simon; Smith, Gillian E; Elliot, Alex J

    2018-01-25

    In September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51-61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination. We used research-level general practitioner consultations to identify any increase in attendances for all-cause fever in vaccine-eligible infants following 4CMenB introduction in England. Consultations for infant all-cause fever in the year following the vaccine introduction were identified from The Phoenix Partnership (TPP) ResearchOne general practice database using Read (CTV3) codes. Average daily consultation rates and incidence rate ratios (IRRs) were calculated for vaccine-eligible age groups and compared to the two years preceding vaccine introduction. The difference between pre- and post-vaccine all-cause fever consultations was estimated. All-cause fever consultations in vaccine-eligible 7-10 week olds were 1.6-fold higher (IRR, 1.58; 95% CI, 1.22-2.05) compared to the two previous years and 1.5-fold higher (IRR 1.47; 95% CI, 1.17-1.86) in 15-18 week-olds. There were no significant differences in 0-6 or 11-14 week-olds. Applying the difference between pre- and post-vaccine consultation rates to the 4CMenB vaccine-eligible age groups across England estimated 1825 additional fever consultations in the year following 4CMenB introduction. We found a small but significant difference in all-cause fever consultation rates in vaccine-eligible infants who would have received 4CMenB with other vaccines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  13. Second primary cancers after adjuvant radiotherapy in early breast cancer patients: A national population based study under the Danish Breast Cancer Cooperative Group (DBCG)

    International Nuclear Information System (INIS)

    Grantzau, Trine; Mellemkjær, Lene; Overgaard, Jens

    2013-01-01

    Background and purpose: To analyze the long-term risk of second primary solid non-breast cancer in a national population-based cohort of 46,176 patients treated for early breast cancer between 1982 and 2007. Patients and methods: All patients studied were treated according to the national guidelines of the Danish Breast Cancer Cooperative Group. The risk of second primary cancers was estimated by Standardised incidence ratios (SIRs) and multivariate Cox regression models were used to estimate adjusted hazard ratios (HR) among irradiated women compared to non-irradiated. All irradiated patients were treated on linear accelerators. Second cancers were a priori categorized into two groups; radiotherapy-associated- (oesophagus, lung, heart/mediastinum, pleura, bones, and connective tissue) and non-radiotherapy-associated sites (all other cancers). Results: 2358 second cancers had occurred during the follow-up. For the radiotherapy-associated sites the HR among irradiated women was 1.34 (95% CI 1.11–1.61) with significantly increased HRs for the time periods of 10–14 years (HR 1.55; 95% CI 1.08–2.24) and ⩾15 years after treatment (HR 1.79; 95% CI 1.14–2.81). There was no increased risk for the non-radiotherapy-associated sites (HR 1.04; 95% CI 0.94–1.1). The estimated attributable risk related to radiotherapy for the radiotherapy-associated sites translates into one radiation-induced second cancer in every 200 women treated with radiotherapy. Conclusions: Radiotherapy treated breast cancer patients have a small but significantly excess risk of second cancers

  14. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas

    OpenAIRE

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been o...

  15. The Impact of the National Essential Medicines Policy on Rational Drug Use in Primary Care Institutions in Jiangsu Province of China.

    Science.gov (United States)

    Chao, Jianqian; Gu, Jiangyi; Zhang, Hua; Chen, Huanghui; Wu, Zhenchun

    2018-01-01

    Essential medicine policy is a successful global health policy to promote rational drug use. The aim of this study was to evaluate the impact of the National Essential Medicines Policy (NEMP) on the rational drug use in primary care institutions in Jiangsu Province of China. In this exploratory study, a multistage, stratified, random sampling was used to select 3400 prescriptions from 17 primary care institutions who implemented the NEMP before (Jan 2010) and after the implementation of the NEMP (Jan 2014). The analyses were performed in SPSS 18.0 and SPSS Clementine client. After the implementation of the NEMP, the percentage of prescribed EML (Essential Medicines List) drugs rose significantly, the average number of drugs per prescription and average cost per prescription were declined significantly, while the differences of the prescription proportion of antibiotics and injection were not statistically significant. BP (Back Propagation) neural network analysis showed that the average number of drugs per prescription, the number of using antibiotics and hormone, regional differences, size of institutions, sponsorship, financial income of institutions, doctor degree, outpatient and emergency visits person times were important factors affecting the prescription costs, among these the average number of drugs per prescription has the greatest effect. The NEMP can promote the rational use of drugs in some degree, but its role is limited. We should not focus only on the EML but also make comprehensive NEMP.

  16. Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education.

    Science.gov (United States)

    Melo, Débora Gusmão; de Paula, Pamela Karen; de Araujo Rodrigues, Stephania; da Silva de Avó, Lucimar Retto; Germano, Carla Maria Ramos; Demarzo, Marcelo Marcos Piva

    2015-07-01

    As discoveries regarding the genetic contribution to disease have grown rapidly, health care professionals are expected to incorporate genetic and genomic perspectives into health education and practice. Genetic competencies common to all health professionals have been identified by the US National Coalition for Health Professional Education in Genetics (NCHPEG), which defined the knowledge, skills, and attitudes required to achieve these competencies. The aim of this study is to analyze genetic competencies of primary health care professionals in Brazil. It is a descriptive survey study, whereby doctors, nurses, and dentists were invited to participate by answering a questionnaire including 11 issues based on competencies established by the NCHPEG. Data were presented as percentages. Differences between groups of participants were assessed by the Fisher exact test, with the level of significance set at p < 0.05. Results showed that concerning knowledge, about 80 % of the participants recognized basic genetics terminology, but practitioners had difficulty in identifying patterns of inheritance. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and identify situations where referral of patients to specialists was necessary. Nevertheless, there were challenges in the process of valuing and gathering information about family history. Regarding attitudes, 68.9 % of the participants thought about the comprehensiveness of care but faced challenges in counselling parents. The results of this study may contribute to developing an ongoing education program for primary health care professionals, leading to a strategy to overcome the challenges of including genetics in the Brazilian Unified Health System.

  17. Vaporization study on vanadium monoxide and two-phase mixture of vanadium and vanadium monoxide by mass-spectrometric method

    International Nuclear Information System (INIS)

    Banchorndhevakul, W.; Matsui, Tsuneo; Naito, Keiji

    1986-01-01

    The vapor pressures over single phase vanadium monoxide VO 1.022 (s) and the two-phase mixture of vanadium metal (β phase) and vanadium monoxide were measured by mass-spectrometric method in the temperature range of 1,803 ∼ 1,990 and 1,703 ∼ 1,884 K, respectively. The main gas species over both systems were found to be VO(g) and V(g). The vapor pressure of VO(g) over the two-phase mixture of V(s) and VO(s) was a little lower than that over single phase VO(s). The vapor pressure of V(g) over the two-phase mixture was nearly equal to that over single phase. From the vapor pressure data, the enthalpies of vaporization, the enthalpies of formation for VO(g) and V(g) and the dissociation energy of VO(g) were determined. The oxygen partial pressure was calculated as a function of temperature from the vapor pressures of VO(g) and V(g), from which the partial molar enthalpies and entropies of oxygen in both systems were obtained. (author)

  18. 40 CFR 415.330 - Applicability; description of the carbon monoxide and by-product hydrogen production subcategory.

    Science.gov (United States)

    2010-07-01

    ... carbon monoxide and by-product hydrogen production subcategory. 415.330 Section 415.330 Protection of... MANUFACTURING POINT SOURCE CATEGORY Carbon Monoxide and By-Product Hydrogen Production Subcategory § 415.330 Applicability; description of the carbon monoxide and by-product hydrogen production subcategory. The provisions...

  19. 40 CFR 89.112 - Oxides of nitrogen, carbon monoxide, hydrocarbon, and particulate matter exhaust emission standards.

    Science.gov (United States)

    2010-07-01

    ....112 Oxides of nitrogen, carbon monoxide, hydrocarbon, and particulate matter exhaust emission... emissions of oxides of nitrogen, carbon monoxide, hydrocarbon, and nonmethane hydrocarbon are measured using... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Oxides of nitrogen, carbon monoxide...

  20. Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

    Science.gov (United States)

    Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

    2018-04-10

    In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or

  1. Nonfatal, unintentional, non--fire-related carbon monoxide exposures--United States, 2004-2006.

    Science.gov (United States)

    2008-08-22

    Carbon monoxide (CO) is a colorless, odorless, nonirritating gas that is produced through the incomplete combustion of hydrocarbons. Sources of CO include combustion devices (e.g., boilers and furnaces), motor-vehicle exhaust, generators and other gasoline or diesel-powered engines, gas space heaters, woodstoves, gas stoves, fireplaces, tobacco smoke, and various occupational sources. CO poisoning is a leading cause of unintentional poisoning deaths in the United States; it was responsible for approximately 450 deaths each year during 1999-2004 and an estimated 15,200 emergency department (ED) visits each year during 2001-2003. Health effects of CO exposure can range from viral-like symptoms (e.g., fatigue, dizziness, headache, confusion, and nausea) to more severe conditions (e.g., disorientation, unconsciousness, long-term neurologic disabilities, coma, cardiorespiratory failure, and death). CO poisoning often is misdiagnosed and underdetected because of the nonspecific nature of symptoms. To update a previously published report and provide national estimates of CO-related ED visits during 2004-2006, CDC analyzed data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) database. During 2004-2006, an estimated average of 20,636 ED visits for nonfatal, unintentional, non-fire-related CO exposures occurred each year. Approximately 73% of these exposures occurred in homes, and 41% occurred during winter months (December-February). Prevention efforts targeting residential and seasonal CO exposures can substantially reduce CO-related morbidity.

  2. Lethal carbon monoxide toxicity in a concrete shower unit.

    Science.gov (United States)

    Heath, Karen; Byard, Roger W

    2018-05-23

    A 47-year-old previously-well woman was found dead on the floor of a shower cubicle on a property in rural South Australia. The impression of the attending doctor and police was of collapse due to natural disease. Although there was significant stenosing coronary artery atherosclerosis found at autopsy, cherry pink discoloration of tissues prompted measurement of the blood carboxyhemoglobin level which was found to be 55%. The source of the gas was a poorly-maintained hot water heater that was mounted on the inside wall of the shower. Construction of the shower using an impermeable concrete rain water tank had caused gas accumulation when the water heater malfunctioned. Had lethal carbon monoxide exposure not been identified others using the same shower unit would also have been at risk.

  3. The effect of carbon monoxide on planetary haze formation

    Energy Technology Data Exchange (ETDEWEB)

    Hörst, S. M.; Tolbert, M. A, E-mail: sarah.horst@colorado.edu [Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO (United States)

    2014-01-20

    Organic haze plays a key role in many planetary processes ranging from influencing the radiation budget of an atmosphere to serving as a source of prebiotic molecules on the surface. Numerous experiments have investigated the aerosols produced by exposing mixtures of N{sub 2}/CH{sub 4} to a variety of energy sources. However, many N{sub 2}/CH{sub 4} atmospheres in both our solar system and extrasolar planetary systems also contain carbon monoxide (CO). We have conducted a series of atmosphere simulation experiments to investigate the effect of CO on the formation and particle size of planetary haze analogues for a range of CO mixing ratios using two different energy sources, spark discharge and UV. We find that CO strongly affects both number density and particle size of the aerosols produced in our experiments and indicates that CO may play an important, previously unexplored, role in aerosol chemistry in planetary atmospheres.

  4. Carbon monoxide (CO) intoxication: Computerized tomography and magnetic resonance

    International Nuclear Information System (INIS)

    Benitez Gomez, S.; Aguilera Navarro, J.M.; Gonzalez Garcia, A.; Gonzalez Marcos, J.R.; Fernandez Cruz, J.

    1993-01-01

    We present a case of acute carbon monoxide (CO) intoxication in a previously healthy 13-year-old girl, who was found in the bathroom, unconscious and with the gas-burning hot water thank operating. The neuroradiological study showed bilateral, symmetrical cortical and subcortical parietooccipital and temporal lesions as well as damage to the basal lymph nodes. These lesions were related to the anoxic situation induced by this type of intoxication. Clinicoradiological follow-up included CT and MR sequences over a period of 10 months. In this cases, we stress the greater sensitivity of MR in the early detection of the characteristic lesions in this situation and we analyze the evolution of the process. (Author)

  5. Investigation of Carbon Monoxide Adsorption on Cationic Gold- Palladium Clusters

    Science.gov (United States)

    Chen, Yang-Mei; Kuang, Xiao-Yu; Sheng, Xiao-Wei; Wang, Huai-Qian; Shao, Peng; Zhong, Min-Ming

    2013-11-01

    Density functional calculations have been performed for the carbon monoxide molecule adsorption on AunPd+m(n+m ≤ 6) clusters. In the process of CO adsorption, small Au clusters and Pd clusters tend to be an Au atom and three Pd atoms adsorption, respectively. For the mixed Au-Pd clusters, an Au atom, a Pd atom, two atoms consisted of an Au atom and a Pd atom, two Pd atoms, and three Pd atoms adsorption structures are displayed. The highest occupied molecular orbital-lowest unoccupied molecular orbital (HOMO-LUMO) gaps and natural bond orbital charge population are calculated. Moreover, CO adsorption energy, CO stretching frequency, and CO bond length (upon adsorption) are also analysed in detail. The results predict that the adsorption strength of Au clusters with CO and the C-O vibration strength is enhanced and reduced after doping of Pd in the AunPdmCO+ complexes, respectively

  6. Reactivity of niobium cluster anions with nitrogen and carbon monoxide

    Science.gov (United States)

    Mwakapumba, Joseph; Ervin, Kent M.

    1997-02-01

    Reactions of small niobium cluster anions, Nbn-(n = 2-7), with CO and N2 are investigated using a flow tube reactor (flowing afterglow) apparatus. Carbon monoxide chemisorption on niobium cluster anions occurs with faster reaction rates than nitrogen chemisorption on corresponding cluster sizes. N2 addition to niobium cluster anions is much more size-selective than is CO addition. These general trends follow those reported in the literature for reactions of neutral and cationic niobium clusters with CO and N2. Extensive fragmentation of the clusters is observed upon chemisorption. A small fraction of the larger clusters survive and sequentially add multiple CO or N2 units without fragmentation. However, chemisorption saturation is not reached at the experimentally accessible pressure and reagent concentration ranges. The thermochemistry of the adsorption processes and the nature of the adsorbed species, molecular or dissociated, are discussed.

  7. A divalent rare earth oxide semiconductor: Yttrium monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Kaminaga, Kenichi; Sei, Ryosuke [Department of Chemistry, The University of Tokyo, Tokyo 113-0033 (Japan); Department of Chemistry, Tohoku University, Sendai 980-8578 (Japan); Hayashi, Kouichi [Department of Environmental and Materials Engineering, Nagoya Institute of Technology, Nagoya 466-8555 (Japan); Happo, Naohisa [School of Information Sciences, Hiroshima City University, Hiroshima 731-3194 (Japan); Tajiri, Hiroo [Japan Synchrotron Radiation Research Institute (JASRI)/SPring-8, Sayo 679-5198 (Japan); Oka, Daichi; Fukumura, Tomoteru, E-mail: tomoteru.fukumura.e4@tohoku.ac.jp [Department of Chemistry, Tohoku University, Sendai 980-8578 (Japan); Hasegawa, Tetsuya [Department of Chemistry, The University of Tokyo, Tokyo 113-0033 (Japan)

    2016-03-21

    Rare earth oxides are usually widegap insulators like Y{sub 2}O{sub 3} with closed shell trivalent rare earth ions. In this study, solid phase rock salt structure yttrium monoxide, YO, with unusual valence of Y{sup 2+} (4d{sup 1}) was synthesized in a form of epitaxial thin film by pulsed laser deposition method. YO has been recognized as gaseous phase in previous studies. In contrast with Y{sub 2}O{sub 3}, YO was dark-brown colored and narrow gap semiconductor. The tunable electrical conductivity ranging from 10{sup −1} to 10{sup 3} Ω{sup −1 }cm{sup −1} was attributed to the presence of oxygen vacancies serving as electron donor. Weak antilocalization behavior observed in magnetoresistance indicated significant role of spin-orbit coupling as a manifestation of 4d electron carrier.

  8. Ferromagnetic semiconductor-metal transition in heterostructures of europium monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Stollenwerk, Tobias; Kroha, Johann [Physikalisches Institut der Universitaet Bonn (Germany)

    2012-07-01

    Experiments on thin films of electron doped europium monoxide show a simultaneous ferromagnetic semiconductor-metal transition which goes along with a huge drop in resistivity over several orders of magnitude. Therefore, this material is a very promising candidate for spintronics applications. We have developed a theory which correctly predicts the simultaneous phase transition in thin films of electron doped EuO and the increase of the Curie temperature T{sub C} with doping concentration. The origin of the increased T{sub C} lies in the enhanced RKKY interaction between the localized 4f moments of the Eu atoms. Therefore, the phase transition is controlled by the population of the conduction band. We investigate the influence of film thickness and interface effects on the population of the conduction band and on the magnetic and electronic properties of the EuO film.

  9. UV-induced carbon monoxide emission from living vegetation

    DEFF Research Database (Denmark)

    Bruhn, Dan; Albert, Kristian Rost; Mikkelsen, Teis Nørgaard

    2013-01-01

    The global burden of carbon monoxide (CO) is rather uncertain. In this paper we address the potential for UV-induced CO emission by living terrestrial vegetation surfaces. Real-time measurements of CO concentrations were made with a cavity enhanced laser spectrometer connected in closed loop...... to either an ecosystem chamber or a plant-leaf scale chamber. Leaves of all examined plant species exhibited emission of CO in response to artificial UV-radiation as well as the UV-component of natural solar radiation. The UV-induced rate of CO emission exhibited a rather low dependence on temperature......, indicating an abiotic process. The emission of CO in response to the UV-component of natural solar radiation was also evident at the ecosystem scale....

  10. Four deaths due to carbon monoxide poisoning in car washes.

    Science.gov (United States)

    Carson, H J; Stephens, P J

    1999-09-01

    In a period of 13 months, three separate incidents of lethal carbon monoxide (CO) poisoning in closed car wash bays resulted in the deaths of 4 white men aged 20 to 36 years. Each man appears to have been intoxicated with mind-altering substances, which may impair judgment, perception of outside conditions, and self-awareness. All four died in winter months. For three men, the deaths were ruled accidental, and for the remaining man, the previous deaths appear to have provided a model for suicide. Warning signs may not be effective to prevent future CO deaths in car washes because of the possible role of intoxication. Mechanical or electronic methods to prevent a bay door from closing completely may be preferable.

  11. An Unusual Cause of Supraventricular Tachycardia: Acute Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Suat Zengin

    2014-03-01

    Full Text Available      Carbon monoxide (CO is a toxic gas produced by the incomplete combustion of carbon-containing compounds. Exposure to high concentrations of CO can be letha and is the most common cause of death from poisoning worldwide. Cardiac manifestations after exposure to CO, including myocardial ischemia, heart failure, and arrhythmias, have been reported. A 28-year-old a patient was admitted to our emergency department with altered consciousness as a consequence of acute domestic exposure to CO from a stove. His carboxyhemoglobin level was 39%. The oxygen treatment was started promptly, and therapeutic red cell exchange was performed. An electrocardiogram revealed supraventricular tachycardia (SVT, and an echocardiographic examination demonstrated normal cardiac functions. To the best of our knowledge, this study is the second to report a case of SVT attack due to acute CO intoxication. This paper discusses the management of this complication in patients poisoned with CO.

  12. [Etiology of combined inhalational hydrocyanic acid and carbon monoxide poisoning].

    Science.gov (United States)

    Sigrist, T; Dirnhofer, R

    1979-01-01

    A young man was found dead in a kitchen, that was partly burnt. Autopsy revealed, as cause of death, a combined intoxication following inhalation of carbon monoxide and hydrocyanic acid. Own investigations on the pyrolysis of pieces of furniture found in the kitchen (plastic plates containing melamine and plates containing formaldehyde) showed, that hydrocyanic acid was liberated through combustion of such substances and inhaled by the victim. The poisoning picture is discussed, and discussion includes especially considerations on the peculiar sensitivity of the brain toward the action of hydrocyanic acid and the relative insensitivity of the heart muscle. It is thought that the cause of such sensitivity difference lies in the physiological differences of the intracellular energy production. Finally the dangers of combustion gases developing from burning plastic materials are reemphasized.

  13. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

    Science.gov (United States)

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-09-05

    In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among

  14. Campaign to prevent carbon monoxide poisoning : fall-winter 2007-2008

    International Nuclear Information System (INIS)

    Lefebvre, B.; Chabot, L.; Gratton, J.; Lacoursiere, D.

    2009-01-01

    Quebec launched a public health campaign for the Montreal region to prevent carbon monoxide poisoning. The objectives of the campaign were to communicate the dangers of carbon monoxide poisoning, its potential sources, its effects on public health, and the means to prevent poisoning. Its purpose was to inform the public of the risks and strategies to be used in case of carbon monoxide poisoning and to lay out the merits of household carbon monoxide alarms. The communication was done by way of the media, in cooperation with community organizations and school boards. Other tools used in the campaign included the Internet, flyers and press releases. A poll taken in 2008 showed that 59 per cent of the respondents had one or more sources for carbon monoxide in their homes, including fireplaces, and that 28 per cent had a functioning alarm for carbon monoxide detection. A future survey will be held to follow-up on the evolution of the campaign. The development of various activities will help decrease the risk of carbon monoxide poisoning. tabs., figs.

  15. Reevaluation of the NOAA/CMDL carbon monoxide reference scale and comparisons with CO reference gases at NASA-Langley and the Fraunhofer Institut

    Energy Technology Data Exchange (ETDEWEB)

    Novelli, P.C.; Collins, J.E. Jr.; Myers, R.C.; Sachse, G.W.; Scheel, H.E. [Univ. of Colordo, Boulder, CO (United States)]|[Science and Technology Corporation, Hampton, VA (United States)]|[NOAA, Boulder, CO (United States)]|[NASA, Langley Research Center, Hampton, VA (United States)]|[Fraunhofer-Inst. fuer Atmospharishce Umweltforschung (Germany)

    1994-06-01

    The carbon monoxide (CO) reference scale created by the National Oceanic and Atmospheric Administration/Climate Monitoring and Diagnostics Laboratory (NOAA/CMDL) is used to quantify measurements of CO in the atmosphere, calibrate standards of other laboratories and to otherwise provide reference gases to the community measuring atmospheric CO. This reference scale was created based upon a set of primary standards prepared by gravimetric methods at CMDL and has been propagated to a set of working standards. In this paper we compare CO mixing ratios assigned to the working standards by three approaches: (1) calibration against the original gravimetric standards, (2) calibration using only working standards as the reference gas, and (3) calibration against three new gravimetric standards prepared to CMDL. The agreement between these values was typically better than 1%. The calibration histories of CMDL working standards are reviewed with respect to expected rates of CO change in the atmosphere. Using a Monte Carlo approach to simulate the effect of drifting standards on calculated mixing ratios, we conclude that the error solely associated with the maintenance of standards will limit the ability to detect small CO changes in the atmosphere. We also report results of intercalibration experiments conducted between CMDL and the Diode Laser Sensor Group (DACOM) at the NASA Langley Research Center (Hampton, Virginia), and CMDL and the Fraunhofer-Institut (Garmisch-Partenkirchen, Germany). Each laboratory calibrated several working standards for CO using their reference gases, and these results were compared to calibrations conducted by CMDL. The intercomparison of eight standards (CO concentrations between approximately 100 and approximately 165 ppb) by CMDL and NASA agreed to better than +/- 2%. (Abstract Truncated)

  16. Reevaluation of the NOAA/CMDL carbon monoxide reference scale and comparisons with CO reference gases at NASA-Langley and the Fraunhofer Institut

    Science.gov (United States)

    Novelli, P. C.; Collins, J. E., Jr.; Myers, R. C.; Sachse, G. W.; Scheel, H. E.

    1994-01-01

    The carbon monoxide (CO) reference scale created by the National Oceanic and Atmospheric Administration/Climate Monitoring and Diagnostics Laboratory (NOAA/CMDL) is used to quantify measurements of CO in the atmosphere, calibrate standards of other laboratories and to otherwise provide reference gases to the community measuring atmospheric CO. This reference scale was created based upon a set of primary standards prepared by gravimetric methods at CMDL and has been propagated to a set of working standards. In this paper we compare CO mixing ratios assigned to the working standards by three approaches: (1) calibration against the original gravimetric standards, (2) calibration using only working standards as the reference gas, and (3) calibration against three new gravimetric standards prepared to CMDL. The agreement between these values was typically better than 1%. The calibration histories of CMDL working standards are reviewed with respect to expected rates of CO change in the atmosphere. Using a Monte Carlo approach to simulate the effect of drifting standards on calculated mixing ratios, we conclude that the error solely associated with the maintenance of standards will limit the ability to detect small CO changes in the atmosphere. We also report results of intercalibration experiments conducted between CMDL and the Diode Laser Sensor Group (DACOM) at the NASA Langley Research Center (Hampton, Virginia), and CMDL and the Fraunhofer-Institut (Garmisch-Partenkirchen, Germany). Each laboratory calibrated several working standards for CO using their reference gases, and these results were compared to calibrations conducted by CMDL. The intercomparison of eight standards (CO concentrations between approximately 100 and approximately 165 ppb) by CMDL and NASA agreed to better than +/- 2%. The calibration of six standards (CO concentrations between approximately 50 and approximately 210 ppb) by CMDL and the Fraunhofer-Institut agreed to within +/- 2% for four

  17. Evaluation of carbon monoxide in blood samples from the second health and nutrition survey. Progress report No. 1

    Energy Technology Data Exchange (ETDEWEB)

    Radford, E.P.

    1976-01-01

    This is a study of carbon monoxide (CO) in the blood of human subjects participating in the Second National Health and Nutrition Survey (HANES II), a detailed study of health indicators in sample populations of many communities throughout the U.S. The purpose of this aspect of the survey is to evaluate the levels of blood carboxyhemoglobin in normal individuals of all ages in typical U.S. communities, from whom accurate histories and clinical studies are available. This report gives results of the first of three years of analyses. A careful calibration of the analytical method has been completed, and more than 3000 blood samples have been analyzed. Although smoking histories are not yet available to permit evaluation of carboxyhemoglobin in non-smokers, in children under 12 years of age, blood COHb has been found to be consistently low, with less than 3% greater than 1.5% COHb. These preliminary results suggest that urban exposure to carbon monoxide among the general population is not now significant in the U.S., at least during the period of these early examinations.

  18. A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol

    Directory of Open Access Journals (Sweden)

    Ying Yue

    2015-01-01

    Full Text Available Background. Acute carbon monoxide poisoning (ACOP is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM for more than 3000 years. This randomized controlled trial (RCT is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients’ basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning.

  19. Inquiry-Based Science Education Competencies of Primary School Teachers: A literature study and critical review of the American National Science Education Standards

    Science.gov (United States)

    Alake-Tuenter, Ester; Biemans, Harm J. A.; Tobi, Hilde; Wals, Arjen E. J.; Oosterheert, Ida; Mulder, Martin

    2012-11-01

    Inquiry-based science education is an important innovation. Researchers and teachers consider it to be stimulating for pupils' application of research skills, construction of meaning and acquiring scientific knowledge. However, there is ambiguity as to what competencies are required to teach inquiry-based science. Our purpose is to develop a profile of professional competence, required for effective inquiry-based science teaching in primary schools in the Netherlands. This article reviews literature and compares the outcomes to the American National Science Education Standards (NSES). In so doing, it seeks to answer the following research questions: What elements of competencies required by primary school teachers who teach inquiry-based science are mentioned, discussed and researched in recent literature? To what extent are the American NSES (introduced 15 years ago) consistent with elements of competencies found in recent literature? A comprehensive literature review was conducted using Educational Resources Information Centre and Google Scholar databases. Fifty-seven peer-reviewed scientific journal articles from 2004 to 2011 were found using keyword combinations. Analysis of these articles resulted in the identification and classification of 22 elements of competencies. This outcome was compared to the American NSES, revealing gaps in the standards with respect to a lack of focus on how teachers view science teaching and themselves as teachers. We also found that elements of competencies are connected and poor mastery of one may affect a teacher's mastery of another. Therefore, we propose that standards for the Netherlands should be presented in a non-linear, holistic, competence-based model.

  20. Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

    Science.gov (United States)

    Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

    2015-07-30

    To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.

  1. Content of carbon monoxide in the tissues of rats intoxicated with carbon monoxide in various conditions of acute exposure

    Energy Technology Data Exchange (ETDEWEB)

    Sokal, J.A.; Majka, J.; Palus, J.

    1984-12-01

    Tissue carbon monoxide (CO) content was investigated in rats severely intoxicated with CO under various exposure conditions: 1% CO for 4 min, 0.4% CO for 40 min and 0.12% CO for 12 h. Extravascular CO was determined in the heart and skeletal muscles immediately after termination of exposure, and carboxymyoglobin (MbCO) percent saturation was calculated. Total brain CO was estimated immediately after termination of exposure and after the time periods of restitution. After the same exposure conditions, MbCO percent saturation was higher in the heart than in skeletal muscle. In both types of muscle, saturation on myoglobin (Mb) with CO depended on blood carboxyhemoglobin (HbCO) level and not on the duration of exposure. The time course of CO elimination was the same for blood and brain, irrespective of CO exposure conditions. The results obtained showed that acute CO intoxication induced by long duration exposures did not involve CO accumulation in the tissues.

  2. Study on the influence of carbon monoxide to the surface oxide layer of uranium metal

    International Nuclear Information System (INIS)

    Wang Xiaolin; Duan Rongliang; Fu Yibei; Xie Renshou; Zuo Changming; Zhao Chunpei; Chen Hong

    1997-01-01

    The influence of carbon monoxide to the surface oxide layer of uranium metal has been studied by X-ray photoelectron spectroscopy (XPS) and gas chromatography (GC). Carbon monoxide adsorption on the oxide layer resulted in U4f peak shifting to the lower binding energy. The content of oxygen in the oxide is decreased and the atomic ratio (O/U) is decreased by 7.2%. The amount of carbon dioxide in the atmosphere after the surface reaction is increased by 11.0%. The investigation indicates that the surface layer can prevent the further oxidation uranium metal in the atmosphere of carbon monoxide

  3. Influence of carbon monoxide to the surface layer of uranium metal and its oxides

    International Nuclear Information System (INIS)

    Wang Xiaoling; Fu Yibei; Xie Renshou; Huang Ruiliang

    1996-09-01

    The surface structures of uranium metal and triuranium octaoxide (U 3 O 8 ) and the influence of carbon monoxide to the surface layers have been studied by X-ray photoelectron spectroscopy (XPS). After exposure to carbon monoxide, contents of oxygen in the surface oxides of uranium metal and U 3 O 8 are decreased and O/U ratios decrease 7.2%, 8.0% respectively. The investigation indicated the surface layers of uranium metal and its oxides were forbidden to further oxidation in the atmosphere of carbon monoxide. (11 refs., 9 figs., 2 tabs.)

  4. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F

    2015-01-01

    Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, pquality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the need to intensify client education and balanced

  5. Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross-sectional study.

    Science.gov (United States)

    Alameddine, Mohamad; Baroud, Maysa; Kharroubi, Samer; Hamadeh, Randa; Ammar, Walid; Shoaib, Hikma; Khodr, Hiba

    2017-11-01

    Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross-sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio-demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory-HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological

  6. Carbon monoxide in clouds at low metallicity in the dwarf irregular galaxy WLM.

    Science.gov (United States)

    Elmegreen, Bruce G; Rubio, Monica; Hunter, Deidre A; Verdugo, Celia; Brinks, Elias; Schruba, Andreas

    2013-03-28

    Carbon monoxide (CO) is the primary tracer for interstellar clouds where stars form, but it has never been detected in galaxies in which the oxygen abundance relative to hydrogen is less than 20 per cent of that of the Sun, even though such 'low-metallicity' galaxies often form stars. This raises the question of whether stars can form in dense gas without molecules, cooling to the required near-zero temperatures by atomic transitions and dust radiation rather than by molecular line emission; and it highlights uncertainties about star formation in the early Universe, when the metallicity was generally low. Here we report the detection of CO in two regions of a local dwarf irregular galaxy, WLM, where the metallicity is 13 per cent of the solar value. We use new submillimetre observations and archival far-infrared observations to estimate the cloud masses, which are both slightly greater than 100,000 solar masses. The clouds have produced stars at a rate per molecule equal to 10 per cent of that in the local Orion nebula cloud. The CO fraction of the molecular gas is also low, about 3 per cent of the Milky Way value. These results suggest that in small galaxies both star-forming cores and CO molecules become increasingly rare in molecular hydrogen clouds as the metallicity decreases.

  7. Influence of surface vacancy defects on the carburisation of Fe 110 surface by carbon monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Chakrabarty, Aurab, E-mail: aurab.chakrabarty@qatar.tamu.edu; Bouhali, Othmane [Texas A& M University at Qatar, P.O. Box 23874, Doha (Qatar); Mousseau, Normand [Département de Physique and RQMP, Université de Montréal, Case Postale 6128, Succursale Centre-Ville, Montréal (QC) H3C 3J7 (Canada); Becquart, Charlotte S. [UMET, UMR CNRS 8207, ENSCL, Université Lille I, 59655 Villeneuve d’Ascq cédex (France); El-Mellouhi, Fedwa, E-mail: felmellouhi@qf.org.qa [Qatar Environment and Energy Research Institute, Hamad Bin Khalifa University, P.O. Box 5825 Doha (Qatar)

    2016-07-28

    Adsorption and dissociation of gaseous carbon monoxide (CO) on metal surfaces is one of the most frequently occurring processes of carburisation, known as primary initiator of metal dusting corrosion. Among the various factors that can significantly influence the carburisation process are the intrinsic surface defects such as single surface vacancies occurring at high concentrations due to their low formation energy. Intuitively, adsorption and dissociation barriers of CO are expected to be lowered in the vicinity of a surface vacancy, due to the strong attractive interaction between the vacancy and the C atom. Here the adsorption energies and dissociation pathways of CO on clean and defective Fe 110 surface are explored by means of density functional theory. Interestingly, we find that the O adatom, resulting from the CO dissociation, is unstable in the electron-deficit neighbourhood of the vacancy due to its large electron affinity, and raises the barrier of the carburisation pathway. Still, a full comparative study between the clean surface and the vacancy-defected surface reveals that the complete process of carburisation, starting from adsorption to subsurface diffusion of C, is more favourable in the vicinity of a vacancy defect.

  8. Carbon monoxide mediates heme oxygenase 1 induction via Nrf2 activation in hepatoma cells

    International Nuclear Information System (INIS)

    Lee, Bok-Soo; Heo, JungHee; Kim, Yong-Man; Shim, Sang Moo; Pae, Hyun-Ock; Kim, Young-Myeong; Chung, Hun-Taeg

    2006-01-01

    Carbon monoxide (CO) and nitric oxide (NO) are two gas molecules which have cytoprotective functions against oxidative stress and inflammatory responses in many cell types. Currently, it is known that NO produced by nitric oxide synthase (NOS) induces heme oxygenase 1 (HO1) expression and CO produced by the HO1 inhibits inducible NOS expression. Here, we first show CO-mediated HO1 induction and its possible mechanism in human hepatocytes. Exposure of HepG2 cells or primary hepatocytes to CO resulted in dramatic induction of HO1 in dose- and time-dependent manner. The CO-mediated HO1 induction was abolished by MAP kinase inhibitors (MAPKs) but not affected by inhibitors of PI3 kinase or NF-κB. In addition, CO induced the nuclear translocation and accumulation of Nrf2, which suppressed by MAPKs inhibitors. Taken together, we suggest that CO induces Nrf2 activation via MAPKs signaling pathways, thereby resulting in HO1 expression in HepG2 cells

  9. Use of carbon monoxide and hydrogen by a bacteria–animal symbiosis from seagrass sediments

    Science.gov (United States)

    Holler, Thomas; Lavik, Gaute; Harder, Jens; Lott, Christian; Littmann, Sten; Kuypers, Marcel M. M.; Dubilier, Nicole

    2015-01-01

    Summary The gutless marine worm O lavius algarvensis lives in symbiosis with chemosynthetic bacteria that provide nutrition by fixing carbon dioxide (CO 2) into biomass using reduced sulfur compounds as energy sources. A recent metaproteomic analysis of the O . algarvensis symbiosis indicated that carbon monoxide (CO) and hydrogen (H 2) might also be used as energy sources. We provide direct evidence that the O . algarvensis symbiosis consumes CO and H 2. Single cell imaging using nanoscale secondary ion mass spectrometry revealed that one of the symbionts, the γ3‐symbiont, uses the energy from CO oxidation to fix CO 2. Pore water analysis revealed considerable in‐situ concentrations of CO and H 2 in the O . algarvensis environment, Mediterranean seagrass sediments. Pore water H 2 concentrations (89–2147 nM) were up to two orders of magnitude higher than in seawater, and up to 36‐fold higher than previously known from shallow‐water marine sediments. Pore water CO concentrations (17–51 nM) were twice as high as in the overlying seawater (no literature data from other shallow‐water sediments are available for comparison). Ex‐situ incubation experiments showed that dead seagrass rhizomes produced large amounts of CO. CO production from decaying plant material could thus be a significant energy source for microbial primary production in seagrass sediments. PMID:26013766

  10. Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003-10: data from the Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Lane, Stephen E; Lorimer, Michelle; Buchbinder, Rachelle; Wluka, Anita E; Page, Richard S; Osborne, Richard H; Pasco, Julie A; Sanders, Kerrie M; Cashman, Kara; Ebeling, Peter R; Graves, Stephen E

    2014-10-28

    Relatively little is known about the social distribution of total knee joint replacement (TKR) uptake in Australia. We examine associations between socioeconomic status (SES) and TKR performed for diagnosed osteoarthritis 2003-10 for all Australian males and females aged ≥ 30 yr. Data of primary TKR (n=213,018, 57.4% female) were ascertained from a comprehensive national joint replacement registry. Residential addresses were matched to Australian Census data to identify area-level social disadvantage, and categorised into deciles. Estimated TKR rates were calculated. Poisson regression was used to model the relative risk (RR) of age-adjusted TKR per 1,000py, stratified by sex and SES. A negative relationship was observed between TKR rates and SES deciles. Females had a greater rate of TKR than males. Surgery utilisation was greatest for all adults aged 70-79 yr. In that age group differences in estimated TKR per 1,000py between deciles were greater for 2010 than 2003 (females: 2010 RR 4.32 and 2003 RR 3.67; males: 2010 RR 2.04 and 2003 RR 1.78). Identifying factors associated with TKR utilisation and SES may enhance resource planning and promote surgery utilisation for end-stage osteoarthritis.

  11. Characterization of Carbon Monoxide Exposure During Hurricane Sandy and Subsequent Nor'easter.

    Science.gov (United States)

    Schnall, Amy; Law, Royal; Heinzerling, Amy; Sircar, Kanta; Damon, Scott; Yip, Fuyuen; Schier, Josh; Bayleyegn, Tesfaye; Wolkin, Amy

    2017-10-01

    Carbon monoxide (CO) is an odorless, colorless gas produced by fossil fuel combustion. On October 29, 2012, Hurricane Sandy moved ashore near Atlantic City, New Jersey, causing widespread morbidity and mortality, $30 to $50 billion in economic damage, and 8.5 million households to be without power. The combination of power outages and unusually low temperatures led people to use alternate power sources, placing many at risk for CO exposure. We examined Hurricane Sandy-related CO exposures from multiple perspectives to help identify risk factors and develop strategies to prevent future exposures. This report combined data from 3 separate sources (health departments, poison centers via the National Poison Data System, and state and local public information officers). Results indicated that the number of CO exposures in the wake of Hurricane Sandy was significantly greater than in previous years. The persons affected were mostly females and those in younger age categories and, despite messaging, most CO exposures occurred from improper generator use. Our findings emphasize the continued importance of CO-related communication and ongoing surveillance of CO exposures to support public health response and prevention during and after disasters. Additionally, regional poison centers can be a critical resource for potential on-site management, public health promotion, and disaster-related CO exposure surveillance. (Disaster Med Public Health Preparedness. 2017;11:562-567).

  12. Mechanism of obtaining carbon monoxide and hydrogen during brown coal radiolysis. [Gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Rustamov, V R; Kurbanov, M A; Dzantiev, B T; Kerimov, V K; Musaeva, P F

    1982-05-01

    This article analyzes effects of gamma radiation on the yield of products of coal gasification: hydrogen and carbon monoxide. Samples of brown coal from the Kansk-Achins basin were treated by gamma radiation with cobalt 60 radiation source. Analyses show that accumulation of hydrogen and carbon monoxide in brown coal under influence of gamma radiation is characterized by a constant rate. Yields of carbon monoxide and hydrogen amount to 0.16 molecule/100 electro volt and 0.21 molecule/electro volt respectively. Reducing radiation dose from 2.5 to 0.7 millirad/h reduces yields of hydrogen and carbon monoxide. Increasing temperature of vacuum brown coal pyrolysis from 200 to 600 C causes decrease of hydrogen yield. Hydrogen yield decrease during temperature increase is caused by a high content of aromatic nuclei in the samples used in the radiolysis. (5 refs.)

  13. Environmental variables and levels of exhaled carbon monoxide and carboxyhemoglobin in elderly people taking exercise.

    Science.gov (United States)

    Salicio, Marcos Adriano; Mana, Viviane Aparecida Martins; Fett, Waléria Christiane Rezende; Gomes, Luciano Teixeira; Botelho, Clovis

    2016-04-01

    This article aims to analyze levels of exhaled carbon monoxide, carboxyhemoglobinand cardiopulmonary variables in old people practicing exercise in external environments, and correlate them with climate and pollution factors. Temporal ecological study with118 active elderly people in the city of Cuiabá, in the state of Mato Grosso, Brazil. Data were obtained on use of medication, smoking, anthropometric measurements, spirometry, peak flow, oxygen saturation, heart rate, exhaled carbon monoxide, carboxyhemoglobin, climate, number of farm fires and pollution. Correlations were found between on the one hand environmental temperature, relative humidity of the air and number of farmers' fires, and on the other hand levels of carbon monoxide exhaled and carboxyhemoglobin (p carboxyhemoglobin and heart rate. There is thus a need for these to be monitored during exercise. The use of a carbon monoxide monitor to evaluate exposure to pollutants is suggested.

  14. Four-electron deoxygenative reductive coupling of carbon monoxide at a single metal site

    Science.gov (United States)

    Buss, Joshua A.; Agapie, Theodor

    2016-01-01

    Carbon dioxide is the ultimate source of the fossil fuels that are both central to modern life and problematic: their use increases atmospheric levels of greenhouse gases, and their availability is geopolitically constrained. Using carbon dioxide as a feedstock to produce synthetic fuels might, in principle, alleviate these concerns. Although many homogeneous and heterogeneous catalysts convert carbon dioxide to carbon monoxide, further deoxygenative coupling of carbon monoxide to generate useful multicarbon products is challenging. Molybdenum and vanadium nitrogenases are capable of converting carbon monoxide into hydrocarbons under mild conditions, using discrete electron and proton sources. Electrocatalytic reduction of carbon monoxide on copper catalysts also uses a combination of electrons and protons, while the industrial Fischer-Tropsch process uses dihydrogen as a combined source of electrons and electrophiles for carbon monoxide coupling at high temperatures and pressures. However, these enzymatic and heterogeneous systems are difficult to probe mechanistically. Molecular catalysts have been studied extensively to investigate the elementary steps by which carbon monoxide is deoxygenated and coupled, but a single metal site that can efficiently induce the required scission of carbon-oxygen bonds and generate carbon-carbon bonds has not yet been documented. Here we describe a molybdenum compound, supported by a terphenyl-diphosphine ligand, that activates and cleaves the strong carbon-oxygen bond of carbon monoxide, enacts carbon-carbon coupling, and spontaneously dissociates the resulting fragment. This complex four-electron transformation is enabled by the terphenyl-diphosphine ligand, which acts as an electron reservoir and exhibits the coordinative flexibility needed to stabilize the different intermediates involved in the overall reaction sequence. We anticipate that these design elements might help in the development of efficient catalysts for

  15. Contributions of distinct gold species to catalytic reactivity for carbon monoxide oxidation

    Science.gov (United States)

    Guo, Li-Wen; Du, Pei-Pei; Fu, Xin-Pu; Ma, Chao; Zeng, Jie; Si, Rui; Huang, Yu-Ying; Jia, Chun-Jiang; Zhang, Ya-Wen; Yan, Chun-Hua

    2016-11-01

    Small-size (carbon monoxide at room temperature, by the aid of in situ X-ray absorption fine structure analysis and in situ diffuse reflectance infrared Fourier transform spectroscopy. We find that the metallic gold component in clusters or particles plays a much more critical role as the active site than the cationic single-atom gold species for the room-temperature carbon monoxide oxidation reaction.

  16. Influence of cation size and surface coverage upon the infrared spectrum of carbon monoxide

    OpenAIRE

    Huang, Jimin

    1991-01-01

    Adsorbed carbon monoxide is utilized as a double layer probe molecule because of its strong absorption in infrared region and because of the high sensitivity of the carbon-oxygen bond to changes in the environment local to the electrode surface. Potential Difference Infrared Spectroscopy was used to investigate the structural behavior of CO adsorbed on a platinum electrode. Carbon monoxide was found to be exclusively linear-bonded on platinum electrode in the presence of tetran...

  17. Performance simulation of planar SOFC using mixed hydrogen and carbon monoxide gases as fuel

    Energy Technology Data Exchange (ETDEWEB)

    Inui, Y. [Department of Electrical and Electronic Engineering, Toyohashi University of Technology, Tempaku-cho, Toyohashi 441-8580 (Japan)]. E-mail: inui@eee.tut.ac.jp; Urata, A. [Department of Electrical and Electronic Engineering, Toyohashi University of Technology, Tempaku-cho, Toyohashi 441-8580 (Japan); Ito, N. [Department of Electrical and Electronic Engineering, Toyohashi University of Technology, Tempaku-cho, Toyohashi 441-8580 (Japan); Nakajima, T. [Department of Electrical and Electronic Engineering, Toyohashi University of Technology, Tempaku-cho, Toyohashi 441-8580 (Japan); Tanaka, T. [Department of Electrical and Electronic Engineering, Toyohashi University of Technology, Tempaku-cho, Toyohashi 441-8580 (Japan)

    2006-08-15

    The authors investigate in detail the influence of the mixing ratio of hydrogen and carbon monoxide in the fuel on the cell performance of the SOFC through numerical simulations for a single cell plate of the co-flow type planar cell. It is made clear that the cell performance is almost the same and excellent, independent of the mixing ratio of hydrogen and carbon monoxide under the nominal operating condition. The electromotive force of the hydrogen rich fuel gas is a little higher than that of the carbon monoxide rich fuel gas. The internal voltage drop in the cell decreases as the fraction of carbon monoxide becomes high. Since the value of the single cell voltage is determined by the balance of these two phenomena, the lowering of the electromotive force is dominant and the single cell voltage of the hydrogen rich fuel gas is higher when the inlet gas temperature is high, whereas the voltage drop reduction is dominant and the single cell voltage of the carbon monoxide rich fuel gas is higher when the temperature is low. The effect of the additional gases of water vapor and carbon dioxide is restricted to the single cell voltage shift, and the qualitative dependence of the single cell voltage on the inlet gas temperature is determined by the mixing ratio of hydrogen and carbon monoxide.

  18. Optimization of mass flow rate in RGTT200K coolant purification for Carbon Monoxide conversion process

    International Nuclear Information System (INIS)

    Sumijanto; Sriyono

    2016-01-01

    Carbon monoxide is a species that is difficult to be separated from the reactor coolant helium because it has a relatively small molecular size. So it needs a process of conversion from carbon monoxide to carbondioxide. The rate of conversion of carbon monoxide in the purification system is influenced by several parameters including concentration, temperature and mass flow rate. In this research, optimization of the mass flow rate in coolant purification of RGTT200K for carbon monoxide conversion process was done. Optimization is carried out by using software Super Pro Designer. The rate of reduction of reactant species, the growth rate between the species and the species products in the conversion reactions equilibrium were analyzed to derive the mass flow rate optimization of purification for carbon monoxide conversion process. The purpose of this study is to find the mass flow rate of purification for the preparation of the basic design of the RGTT200K coolant helium purification system. The analysis showed that the helium mass flow rate of 0.6 kg/second resulted in an un optimal conversion process. The optimal conversion process was reached at a mass flow rate of 1.2 kg/second. A flow rate of 3.6 kg/second – 12 kg/second resulted in an ineffective process. For supporting the basic design of the RGTT200K helium purification system, the mass flow rate for carbon monoxide conversion process is suggested to be 1.2 kg/second. (author)

  19. Carbon monoxide exposure in households in Ciudad Juárez, México.

    Science.gov (United States)

    Montoya, Teresa; Gurian, Patrick L; Velázquez-Angulo, Gilberto; Corella-Barud, Verónica; Rojo, Analila; Graham, Jay P

    2008-03-01

    This study assessed exposure to carbon monoxide from gas and wood heater emissions in a sample of 64 households in peri-urban residential areas in Ciudad Juárez, Chihuahua, México. Indoor and outdoor carbon monoxide concentrations and temperatures were monitored for a continuous period of 1 week at 1 and 6-min intervals, respectively. The moving average carbon monoxide concentrations were compared to the World Health Organization (WHO) standards for carbon monoxide. Sixty-seven percent of households with gas heaters and 60% of households with wood heaters exceeded a health-based standard at some point during the monitoring. The difference between indoor and outdoor temperatures was modestly correlated with average carbon monoxide exposure (r=0.35, p-value h standard of 9ppm (odds ratio=5.1, p-value=0.031). These results highlight the need for further efforts to identify and mitigate potentially hazardous carbon monoxide exposures, particularly in moderate-income countries with cooler climates.

  20. Performance simulation of planar SOFC using mixed hydrogen and carbon monoxide gases as fuel

    International Nuclear Information System (INIS)

    Inui, Y.; Urata, A.; Ito, N.; Nakajima, T.; Tanaka, T.

    2006-01-01

    The authors investigate in detail the influence of the mixing ratio of hydrogen and carbon monoxide in the fuel on the cell performance of the SOFC through numerical simulations for a single cell plate of the co-flow type planar cell. It is made clear that the cell performance is almost the same and excellent, independent of the mixing ratio of hydrogen and carbon monoxide under the nominal operating condition. The electromotive force of the hydrogen rich fuel gas is a little higher than that of the carbon monoxide rich fuel gas. The internal voltage drop in the cell decreases as the fraction of carbon monoxide becomes high. Since the value of the single cell voltage is determined by the balance of these two phenomena, the lowering of the electromotive force is dominant and the single cell voltage of the hydrogen rich fuel gas is higher when the inlet gas temperature is high, whereas the voltage drop reduction is dominant and the single cell voltage of the carbon monoxide rich fuel gas is higher when the temperature is low. The effect of the additional gases of water vapor and carbon dioxide is restricted to the single cell voltage shift, and the qualitative dependence of the single cell voltage on the inlet gas temperature is determined by the mixing ratio of hydrogen and carbon monoxide

  1. Metallic and insulating 3d transition-element monoxides and their stability

    International Nuclear Information System (INIS)

    Johansson, H.B.

    1977-01-01

    The binding properties of the 3d monoxides are studied in detail, and it is shown that the metallic character of TiO and VO is directly reflected in their heat of formation. The same holds true for NbO. From a stability analysis of the 3d monoxides versus decomposition, it is found that TiO, VO, and FeO are close to an instability. Further, it can be concluded that both ScO and CrO must be very near existence. The general occurrence of transition-metal monoxides is shown to be directly correlated with ionic properties of the transition elements. An investigation of the absorption edge in the 3d monoxides is also undertaken. The importance of the crystal-field splitting is noticed, and it is shown that the heat of formation of the monoxides can be used to derive the crystal-field parameter Δ. The change from a delocalized to a localized behavior of the d electrons in the 3d monoxides is compared with a similar change of the f electrons in the actinides. Some similarities between these two series of materials are pointed out

  2. Accuracy of national key performance indicator reporting from two Aboriginal medical services: potential to underestimate the performance of primary health care.

    Science.gov (United States)

    2017-05-09

    Objective The aim of the present study was to assess the accuracy of extracting national key performance indicator (nKPI) data for the Online Community Health Reporting Environment for Health Services (OCHREStreams) program using the Pen Computer Systems (Leichhardt, NSW, Australia) Clinical Audit Tool (CAT) from Communicare (Telstra Health Communicare Systems, Perth, WA, Australia), a commonly used patient information management system (PIMS) in Aboriginal primary care. Methods Two Aboriginal Community-Controlled Health Services (ACCHSs) were recruited to the present study. A sample of regular clients aged ≥55 years from each ACCHS was selected and a subset of 13 nKPIs was examined. A manual case note audit of the nKPI subset within Communicare was undertaken by a clinician at each participating ACCHS and acted as a 'gold standard' comparator for three query methods: (1) internal Communicare nKPI reports; (2) PenCS CAT nKPI manual filtering (a third-party data-extraction tool); and (3) nKPI data submitted to the Improvement Foundation qiConnect portal. Results No errors were found in nKPI data extraction from Communicare using the CAT and subsequent submission to the qiConnect portal. However, the Communicare internal nKPI report included deceased clients and past patients, and we can be very confident that deceased clients and past patients are also included in the qiConnect portal data. This resulted in inflation of client denominators and an underestimation of health service performance, particularly for nKPIs recording activity in the past 6 months. Several minor errors were also detected in Communicare internal nKPI reports. Conclusions CAT accurately extracts a subset of nKPI data from Communicare. However, given the widespread use of Communicare in ACCHSs, the inclusion of deceased clients and past patients in the OCHREStreams nKPI data program is likely to have resulted in systematic under-reporting of health service performance nationally. What is known

  3. The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

    Science.gov (United States)

    Bahar, Ismail F. S.

    A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

  4. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    Directory of Open Access Journals (Sweden)

    Lin Blossom Yen-Ju

    2007-06-01

    Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

  5. Carbon Monoxide Epidemic Among Immigrant Populations: King County, Washington, 2006

    Science.gov (United States)

    Kwan-Gett, Tao; Hampson, Neil B.; Baer, Atar; Shusterman, Dennis; Shandro, Jamie R.; Duchin, Jeffrey S.

    2009-01-01

    Objectives. We investigated an outbreak of carbon monoxide (CO) poisoning after a power outage to determine its extent, identify risk factors, and develop prevention measures. Methods. We reviewed medical records and medical examiner reports of patients with CO poisoning or related symptoms during December 15 to 24, 2006. We grouped patients into households exposed concurrently to a single source of CO. Results. Among 259 patients with CO poisoning, 204 cases were laboratory confirmed, 37 were probable, 10 were suspected, and 8 were fatal. Of 86 households studied, 58% (n = 50) were immigrant households from Africa (n = 21), Asia (n = 15), Latin America (n = 10), and the Middle East (n = 4); 34% (n = 29) were US-born households. One percent of households was European (n = 1), and the origin for 7% (n = 6) was unknown. Charcoal was the most common fuel source used among immigrant households (82%), whereas liquid fuel was predominant among US-born households (34%). Conclusions. Educational campaigns to prevent CO poisoning should consider immigrants’ cultural practices and languages and specifically warn against burning charcoal indoors and incorrect ventilation of gasoline- or propane-powered electric generators. PMID:19608962

  6. The neurotoxicology of carbon monoxide - Historical perspective and review.

    Science.gov (United States)

    Sykes, Oliver T; Walker, Edward

    2016-01-01

    Carbon monoxide (CO) has been recognized as a poison for centuries, and remains one of the most common causes of both accidental and deliberate poisoning worldwide. Despite this, there are widespread misconceptions with regards to the mechanisms, diagnosis and outcomes of CO induced poisoning such as the idea that CO poisoning is rare; that carboxyhaemoglobin levels above 20% and loss of consciousness are required before nervous system damage ensues; and that the binding of CO to haemoglobin is the only mechanism of toxicity. Prevention and diagnosis of CO poisoning is hampered by the lack of awareness of CO as a cause of illness, among both the general public and healthcare professionals. To complicate matters further there is no standardized definition of CO poisoning. Carboxyhaemoglobin levels are often used as a marker of CO poisoning, yet plasma levels rapidly reduce upon removal of the source and are therefore an unreliable biomarker of exposure and tissue damage. Adverse neuropsychiatric outcomes after CO poisoning are difficult to define, especially as they fluctuate, mimic other non-specific complaints, and are not present in all survivors. This paper challenges a number of misconceptions about CO poisoning which can result in misdiagnosis, and consequently in mismanagement. We illustrate how recent developments in the understanding of CO toxicology explain the particular susceptibility of the central nervous system to the effects of CO exposure. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  7. Composition of amino acid using carbon monoxide. Amide carbonylation reaction

    Energy Technology Data Exchange (ETDEWEB)

    Izawa, Kunisuke (Ajinomoto Co., Inc., Tokyo (Japan))

    1989-02-01

    Amide carbonylation reaction is a method to compose N-acyl-{alpha}-amino acid from aldehyde, carboxylic acid amide, and carbon monoxide in a phase and with high yield. Unlike the conventional Strecker reaction, this method does not use HCN which is in question on public pollution and does not require hydrolysis. This amide carbonylation reaction was discovered by Wakamatsu and others of Ajinomoto Co.,Ltd. Present application examples of this method are the composition of N-acetyl amino acid from the aldehyde class, the composition of N-Acyl amino acid from olefin, the composition of N-acyl or acetyl amino acid from the raw material of alcohol and the halide class, the composition of N-acyl or acetyl amino acid via the isomerization of epoxide and allyl alcohol, the composition of amino dicarboxylic acid, applying deoxidation of ring acid anhydride, the composition of N-acyl amino acid from the raw material of the amine class, the stereoselective composition of -substitution ring-{alpha}-amino acid, and the composition of amino aldehyde. 24 refs., 2 figs., 2 tabs.

  8. Carbon monoxide: from toxin to endogenous modulator of cardiovascular functions

    Directory of Open Access Journals (Sweden)

    R.A. Johnson

    1999-01-01

    Full Text Available Carbon monoxide (CO is a pollutant commonly recognized for its toxicological attributes, including CNS and cardiovascular effects. But CO is also formed endogenously in mammalian tissues. Endogenously formed CO normally arises from heme degradation in a reaction catalyzed by heme oxygenase. While inhibitors of endogenous CO production can raise arterial pressure, heme loading can enhance CO production and lead to vasodepression. Both central and peripheral tissues possess heme oxygenases and generate CO from heme, but the inability of heme substrate to cross the blood brain barrier suggests the CNS heme-heme oxygenase-CO system may be independent of the periphery. In the CNS, CO apparently acts in the nucleus tractus solitarii (NTS promoting changes in glutamatergic neurotransmission and lowering blood pressure. At the periphery, the heme-heme oxygenase-CO system can affect cardiovascular functions in a two-fold manner; specifically: 1 heme-derived CO generated within vascular smooth muscle (VSM can promote vasodilation, but 2 its actions on the endothelium apparently can promote vasoconstriction. Thus, it seems reasonable that the CNS-, VSM- and endothelial-dependent actions of the heme-heme oxygenase-CO system may all affect cardiac output and vascular resistance, and subsequently blood pressure.

  9. Risk and protective behaviours for residential carbon monoxide poisoning.

    Science.gov (United States)

    Rupert, Douglas J; Poehlman, Jon A; Damon, Scott A; Williams, Peyton N

    2013-04-01

    Unintentional, non-fire-related carbon monoxide (CO) poisoning is a leading cause of poisoning death and injury in the USA. Residential poisonings caused by faulty furnaces are the most common type of CO exposure. However, these poisonings are largely preventable with annual furnace inspections and CO alarm installation. This study aimed to identify the knowledge, attitudes and beliefs that might lead consumers to adopt these protective behaviours. In August 2009, four focus groups (n=29) were conducted with homeowners in Chicago, Illinois, USA, to identify the knowledge, attitudes and beliefs that lead consumers to adopt risk and protective behaviours. Discussions were transcribed and the findings were analysed using an ordered meta-matrix. Focus group participants were aware of CO poisoning and supported the idea of regular furnace inspections. However, few participants consistently scheduled professional inspections for fear of costly repairs and unscrupulous contractors. Participants often owned CO alarms, but many did not locate them properly, nor maintain them. Some participants confused CO and natural gas and were unsure how to react if a CO alarm sounds. Participants stated that incentives, such as discounts and inspector selection tips, would make them more likely to schedule furnace inspections. Participants also identified trustworthy sources for CO education, including realtors, fire departments, home insurance agents and local media outlets. Participants' residential CO risk behaviours are not random but driven by underlying knowledge, attitudes and beliefs. Correcting misperceptions, providing incentives and partnering with trustworthy sources might encourage greater consumer adoption of protective behaviours.

  10. Variability in hyperbaric oxygen treatment for acute carbon monoxide poisoning.

    Science.gov (United States)

    Byrne, Brendan T; Lu, Jenny J; Valento, Matthew; Bryant, Sean M

    2012-01-01

    In patients with acute carbon monoxide (CO) poisoning, we have noted wide clinical variability in both criteria for hyperbaric oxygen (HBO2) treatment as well as HBO2 treatment regimens. Our aim was to survey Midwest hyperbaric centers for insight into specific criteria and protocols for treating acute CO toxicity with HBO2. Hyperbaric centers were identified from the published list of the Undersea and Hyperbaric Medical Society. Ninety-three centers from nine Midwestern states were contacted via telephone. A standard script was used to minimize surveyor bias. Thirty centers that treat CO poisonings were identified. One did not participate in the study. Nineteen reported a specific level of carboxyhemoglobin (COHb) that served as an independent indication for initiation of HBO2 treatment. Four centers used the COHb level as the exclusive indication for HBO2 treatment. Ten centers relied solely on reported symptoms, while the remaining centers used a combination of symptoms plus COHb levels. There were 19 separate treatment protocols. No uniform practice for either the initiation or implementation of HBO2 therapy for CO poisoning exists among U.S. Midwest hyperbaric centers responding to a survey. We see opportunity for specific targeted educational programs as well as further study.

  11. A Wireless and Batteryless Intelligent Carbon Monoxide Sensor.

    Science.gov (United States)

    Chen, Chen-Chia; Sung, Gang-Neng; Chen, Wen-Ching; Kuo, Chih-Ting; Chue, Jin-Ju; Wu, Chieh-Ming; Huang, Chun-Ming

    2016-09-23

    Carbon monoxide (CO) poisoning from natural gas water heaters is a common household accident in Taiwan. We propose a wireless and batteryless intelligent CO sensor for improving the safety of operating natural gas water heaters. A micro-hydropower generator supplies power to a CO sensor without battery (COSWOB) (2.5 W at a flow rate of 4.2 L/min), and the power consumption of the COSWOB is only ~13 mW. The COSWOB monitors the CO concentration in ambient conditions around natural gas water heaters and transmits it to an intelligent gateway. When the CO level reaches a dangerous level, the COSWOB alarm sounds loudly. Meanwhile, the intelligent gateway also sends a trigger to activate Wi-Fi alarms and sends notifications to the mobile device through the Internet. Our strategy can warn people indoors and outdoors, thereby reducing CO poisoning accidents. We also believe that our technique not only can be used for home security but also can be used in industrial applications (for example, to monitor leak occurrence in a pipeline).

  12. The immunomodulatory role of carbon monoxide during transplantation

    Directory of Open Access Journals (Sweden)

    Amano Mariane

    2013-01-01

    Full Text Available Abstract The number of organ and tissue transplants has increased worldwide in recent decades. However, graft rejection, infections due to the use of immunosuppressive drugs and a shortage of graft donors remain major concerns. Carbon monoxide (CO had long been regarded solely as a poisonous gas. Ultimately, physiological studies unveiled the endogenous production of CO, particularly by the heme oxygenase (HO-1 enzyme, recognizing CO as a beneficial gas when used at therapeutic doses. The protective properties of CO led researchers to develop uses for it, resulting in devices and molecules that can deliver CO in vitro and in vivo. The resulting interest in clinical investigations was immediate. Studies regarding the CO/HO-1 modulation of immune responses and their effects on various immune disorders gave rise to transplantation research, where CO was shown to be essential in the protection against organ rejection in animal models. This review provides a perspective of how CO modulates the immune system to improve transplantation and suggests its use as a therapy in the field.

  13. Carbon Monoxide Poisoning Cases Autopsied in South Marmara Region

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    Filiz Eren

    2014-10-01

    Full Text Available Carbonmonoxide (CO related deaths, which are generally preventable accidents that include accidents due to the coal stoves and water heaters in bath at home, the mining accidents, and other accidents. CO accept as the most common cause of poisoning cases in many countries and its prominent feature is being a colorless, odorless and nonirritant gas. In the period from 2007 until the end of 2011, the autopsy records of the ........ of Turkey were reviewed. Over a period of 5 years a total of 5782 autopsies were done of which 218 involved CO poisoning, constituting 3,8 % of total cases. Information regarding age, sex, month, year, and as well as various aspects were examined. Study data were encoded with computer and Statistical analysis was performed using SPSS for windows program. Of the cases 76 were (34,9% female, 142 were (65,1% male and male/female ratio was 1,9. Of the cases average age was 46.8, range between 1 and 90 years. 57,8% of deaths were in winter markedly. The highest carboxyhemoglobin saturation was 92% in the blood. Poisoning due to CO leaks from coal heaters is an important problem in our country and surrounding regions. The mining accidents should be reduced by increasing safety in the workplace. We must more expend efforts to educate the public and prevent CO poisoning. Key words: Carbon monoxide, poisoning, autopsy.

  14. Carbon monoxide poisoning at motels, hotels, and resorts.

    Science.gov (United States)

    Weaver, Lindell K; Deru, Kayla

    2007-07-01

    Each year, more than 200 people in the United States die from carbon monoxide (CO) poisoning. Poisoning has occurred at motels, hotels, and resorts. Congressional mandate requires smoke alarms in all guest rooms; however, smoke alarms do not detect CO. Data on patients poisoned at hotels, motels, and resorts were evaluated at a hyperbaric medicine service. In 2005, legal databases and online news databanks were searched to discover additional incidents. Only victims evaluated in hospitals or declared dead at the scene were included. Cases of intentional poisoning and poisoning from fires were excluded. Between 1989 and 2004, 68 incidents of CO poisoning occurring at hotels, motels, and resorts were identified, resulting in 772 accidentally poisoned: 711 guests, 41 employees or owners, and 20 rescue personnel. Of those poisoned, 27 died, 66 had confirmed sequelae, and 6 had sequelae resulting in a jury verdict. Lodging-operated, faulty room heating caused 45 incidents, pool/spa boilers 16, CO entrained from outdoors 5, and unreported sources caused 2 incidents. Public verdicts have averaged $4.8 million per incident (range, $1 million to $17.5 million). Poisoning occurred at hotels of all classes. Despite these incidents, most properties did not install CO alarms, and requirements for CO alarms at hotels, motels, and resorts are rare. Guests of motels, hotels, and resorts remain at risk for injury or death from CO poisoning. Measures to prevent CO poisoning of guests and employees of the lodging industry should be evaluated.

  15. Retrieval of tropospheric carbon monoxide for the MOPITT experiment

    Science.gov (United States)

    Pan, Liwen; Gille, John C.; Edwards, David P.; Bailey, Paul L.; Rodgers, Clive D.

    1998-12-01

    A retrieval method for deriving the tropospheric carbon monoxide (CO) profile and column amount under clear sky conditions has been developed for the Measurements of Pollution In The Troposphere (MOPITT) instrument, scheduled for launch in 1998 onboard the EOS-AM1 satellite. This paper presents a description of the method along with analyses of retrieval information content. These analyses characterize the forward measurement sensitivity, the contribution of a priori information, and the retrieval vertical resolution. Ensembles of tropospheric CO profiles were compiled both from aircraft in situ measurements and from chemical model results and were used in retrieval experiments to characterize the method and to study the sensitivity to different parameters. Linear error analyses were carried out in parallel with the ensemble experiments. Results of these experiments and analyses indicate that MOPITT CO column measurements will have better than 10% precision, and CO profile measurement will have approximately three pieces of independent information that will resolve 3-5 tropospheric layers to approximately 10% precision. These analyses are important for understanding MOPITT data, both for application of data in tropospheric chemistry studies and for comparison with in situ measurements.

  16. General circulation model study of atmospheric carbon monoxide

    International Nuclear Information System (INIS)

    Pinto, J.P.; Yung, Y.L.; Rind, D.; Russell, G.L.; Lerner, J.A.; Hansen, J.E.; Hameed, S.

    1983-01-01

    The carbon monoxide cycle is studied by incorporating the known and hypothetical sources and sinks in a tracer model that uses the winds generated by a general circulation model. Photochemical production and loss terms, which depend on OH radical concentrations, are calculated in an interactive fashion. The computed global distribution and seasonal variations of CO are compared with observations to obtain constraints on the distribution and magnitude of the sources and sinks of CO, and on the tropospheric abundance of OH. The simplest model that accounts for available observations requires a low latitude plant source of about 1.3 x 10 15 g yr -1 , in addition to sources from incomplete combustion of fossil fuels and oxidation of methane. The globally averaged OH concentration calculated in the model is 7 x 10 5 cm -3 . Models that calculate globally averaged OH concentrations much lower than our nominal value are not consistent with the observed variability of CO. Such models are also inconsistent with measurements of CO isotopic abundances, which imply the existence of plant sources

  17. CT of the brain in acute carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Ohno, Masato; Uchino, Akira; Hayashi, Kazuji; Nakata, Hajime.

    1988-01-01

    Cerebral computed tomographic (CT) findings of acute carbon monoxide (Co) poisoning were analized in thirty-six cases treated with hyperbraric oxygen therapy and their relationship with prognosis was evaluated. The cases were classified into there groups, early stage, interval form, and non-interval form groups. In all groups, the initial abnormality was low density areas presumably due to edema, demyelination and/or softening. It was seen in the globus pallidus and/or white matter. Following these initial changes, cerebral hemorrhage, ventricular dilatation, and cerebral atrophy developed in a few cases. The frequency of abnormal CT findings was higher in the interval form group (85 %) or non-interval group (83 %) than the early stage group (41 %). The prognosis was good in most cases with normal CT findings. The possibility of recovery diminished in the patients with abnormal CT findings. The prognosis was particularly poor in cases showing abnormality both in globus pallidus and white matter. We conclude that CT is useful not only for detecting the pathologic change but also for predicting the prognosis of the patient with acute Co poisoning. (author)

  18. Brain CT scan in acute carbon monoxide poisoning

    International Nuclear Information System (INIS)

    We, En-Huei

    1986-01-01

    The brain CT findings in 19 patients with acute carbon monoxide poisoning was analysed and the emphasis was placed on the relationship between CT findings and prognosis. Five had a normal manifestation in CT ; eight had the findings of ovoid or patchy low density area in globus pallidus, bilateral or unlateral, during the second day to fifth week after poisoning, and the low density areas were decreasing and blurring in edge in follow up and at last disappeared during 3 - 14 weeks in three cases of them ; nine showed the appearance of diffuse low density of white matter and of globus pallidus in some of them ; two had an appearance of brain atrophy. The pathology of CT findings mentioned above may be brain edema, necrosis, malacia and degeneration in gray matter and globus pallidus. The result suggested the cases with normal CT manifestation, cerebral edema and decreasing and disappearing low density area had a good prognosis, in contrary, the cases with persistant low density in globus pallidus had a poorer prognosis. (author)

  19. Heme oxygenase and carbon monoxide protect from muscle dystrophy.

    Science.gov (United States)

    Chan, Mun Chun; Ziegler, Olivia; Liu, Laura; Rowe, Glenn C; Das, Saumya; Otterbein, Leo E; Arany, Zoltan

    2016-11-28

    Duchenne muscle dystrophy (DMD) is one of the most common lethal genetic diseases of children worldwide and is 100% fatal. Steroids, the only therapy currently available, are marred by poor efficacy and a high side-effect profile. New therapeutic approaches are urgently needed. Here, we leverage PGC-1α, a powerful transcriptional coactivator known to protect against dystrophy in the mdx murine model of DMD, to search for novel mechanisms of protection against dystrophy. We identify heme oxygenase-1 (HO-1) as a potential novel target for the treatment of DMD. Expression of HO-1 is blunted in the muscles from the mdx murine model of DMD, and further reduction of HO-1 by genetic haploinsufficiency worsens muscle damage in mdx mice. Conversely, induction of HO-1 pharmacologically protects against muscle damage. Mechanistically, HO-1 degrades heme into biliverdin, releasing in the process ferrous iron and carbon monoxide (CO). We show that exposure to a safe low dose of CO protects against muscle damage in mdx mice, as does pharmacological treatment with CO-releasing molecules. These data identify HO-1 and CO as novel therapeutic agents for the treatment of DMD. Safety profiles and clinical testing of inhaled CO already exist, underscoring the translational potential of these observations.

  20. Gene expression in rat striatum following carbon monoxide poisoning

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    Shuichi Hara

    2017-06-01

    Full Text Available Carbon monoxide (CO poisoning causes brain damage, which is attenuated by treatment with hydrogen [1,2], a scavenger selective to hydroxyl radical (·≡OH [3]. This suggests a role of ·≡OH in brain damage due to CO poisoning. Studies have shown strong enhancement of ·≡OH production in rat striatum by severe CO poisoning with a blood carboxyhemoglobin (COHb level >70% due to 3000 ppm CO, but not less severe CO poisoning with a blood COHb level at approximately 50% due to 1000 ppm CO [4]. Interestingly, 5% O2 causes hypoxia comparable with that by 3000 ppm CO and produces much less •OH than 3000 ppm CO does [4]. In addition, cAMP production in parallel with ·≡OH production [5] might contribute to ·≡OH production [6]. It is likely that mechanisms other than hypoxia contribute to brain damage due to CO poisoning [7]. To search for the mechanisms, we examined the effects of 1000 ppm CO, 3000 ppm CO and 5% O2 on gene expression in rat striatum. All array data have been deposited in the Gene Expression Omnibus (GEO database under accession number GSE94780.

  1. Subclinical carbon monoxide poisoning in our health area

    Energy Technology Data Exchange (ETDEWEB)

    Arroyo, I.G.; Testa, A.F.; Sangrador, C.O.; Garcia, M.T.A.; Berrocal, J.L.S.; Pastor, N.R.; Martin, J.M.; Garcia, L.S.; Garcia, M.C.F.; Maire-Richard, E.G. [Hospital of Virgen Concha, Zamora (Spain)

    2003-08-01

    We present an observation study on the relationship between high levels of carboxyhemoglobin (COHB) and subclinical poisoning by carbon monoxide (CO) in our health area. The study was carried out in February and March 2000 in 228 over 18-year-old patients of both sexes who went to the Emergency Room for various reasons. After an informed consent was conceded, a venous blood sample was obtained in order to determine the level of COHB; later, we collected the anthropometric data, the data relative to the tobacco use, and the data of the type of heating at home. The values limit of the COHB obtained were the following: in non smokers, 1.9%; in 1-10 cigarettes/day smokers, 5.2%; in 11-20 cigarettes/day smokers, 6.9%; in {gt}20 cigarettes/day smokers, 9.6%. A COHB high level was observed in 25% of the patients regardless of the smoking habits, being the coal-dust slack brazier the source of most frequent exposure to CO.

  2. Magnetic resonance imaging of carbon monoxide poisoning in chronic stage

    International Nuclear Information System (INIS)

    Kojima, Shigeyuki; Kawamura, Mitsuru; Shibata, Noriyuki; Takahashi, Nobuyoshi; Hirayama, Keizo

    1986-01-01

    Magnetic resonance imaging (MRI) was evaluated in three patients with carbon monoxide (CO) poisoning in chronic stage by comparison with serial X-ray computed tomography (CT). In Case 1 and 3, no pallidal lesions believed to be the most common lesion of the gray matter in CO poisoning were found in the serial X-ray CT scans. In the other case (Case 2), the typical initial bilateral symmetrical low density areas in the globus pallidus were found to have decreased markedly in size and finally disappeared in the latter X-ray CT scan. But MRI using inversion recovery (IR) or spin echo (SE) pulse sequence clearly showed bilateral symmetrical decreased or increased signal intensity areas in the globus pallidus in all three cases. In Case 3, chronic CO poisoning was confirmed by the bilateral symmetrical pallidal lesions on MRI, although differential diagnosis was difficult. Furthermore, in Case 2, with pure alexia, MRI using IR or SE pulse sequence demonstrated a patchy decreased or increased signal intensity area in the subcortical white matter at the left angular gyrus, although X-ray CT scan showed no abnormal findings. MRI is useful in the diagnosis of CO poisoning, especially chronic CO poisoning, because necrosis, cavitation, demyelination, gliosis and so on due to hypoxia of CO poisoning were sensitively detected from changes in the proton density and the T1 or T2 relaxation time value on MRI. (J.P.N.)

  3. Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background A recent HTA review concluded that there was a need for RCTs of exercise referral schemes (ERS) for people with a medical diagnosis who might benefit from exercise. Overall, there is still uncertainty as to the cost-effectiveness of ERS. Evaluation of public health interventions places challenges on conventional health economics approaches. This economic evaluation of a national public health intervention addresses this issue of where ERS may be most cost effective through subgroup analysis, particularly important at a time of financial constraint. Method This economic analysis included 798 individuals aged 16 and over (55% of the randomised controlled trial (RCT) sample) with coronary heart disease risk factors and/or mild to moderate anxiety, depression or stress. Individuals were referred by health professionals in a primary care setting to a 16 week national exercise referral scheme (NERS) delivered by qualified exercise professionals in local leisure centres in Wales, UK. Health-related quality of life, health care services use, costs per participant in NERS, and willingness to pay for NERS were measured at 6 and 12 months. Results The base case analysis assumed a participation cost of £385 per person per year, with a mean difference in QALYs between the two groups of 0.027. The incremental cost-effectiveness ratio was £12,111 per QALY gained. Probabilistic sensitivity analysis demonstrated an 89% probability of NERS being cost-effective at a payer threshold of £30,000 per QALY. When participant payments of £1 and £2 per session were considered, the cost per QALY fell from £12,111 (base case) to £10,926 and £9,741, respectively. Participants with a mental health risk factor alone or in combination with a risk of chronic heart disease generated a lower ICER (£10,276) compared to participants at risk of chronic heart disease only (£13,060). Conclusions Results of cost-effectiveness analyses suggest that NERS is cost saving in fully

  4. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001. Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in

  5. Knowledge and implementation of the National Malaria Control Programme among health-care workers in primary health-care centers in Ogun State, Nigeria

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    Temitope Wunmi Ladi-Akinyemi

    2018-01-01

    Full Text Available Background: Lack of capacity to implement programs effectively and low public education about malaria is some of the factors that Nigeria governments must address to effectively combat malaria. Methods: This descriptive cross-sectional study assessed the knowledge and implementation of the National Malaria Control Programme (NMCP among health-care workers in the primary health-care centers in Ogun state. Three hundred and twenty-five respondents were recruited into the study using cluster sampling method. A pretested self-administered questionnaire was used to collect necessary information. Analysis and statistical calculation was done using SPSS version 20.0. Relationships between categorical variables were tested using Chi-square test with P value at 0.05. Results: One hundred and twenty-five (38.5% of the respondents were from Ado-odo/Ota local government areas (LGAs, 120 (36.9% of the respondents were from Ijebu-ode LGA and 80 (24.6% were from Ewekoro LGA. About 37.8% of the respondents were within age range of 45–54 years, with mean of 41.7 ± 8.5. Over 90% of the respondents knew the mode of transmission of malaria, <50% of them could identified case definition of simple and complicated malaria. Large percentage of the respondents knew the signs and symptoms of simple malaria. The respondents who were older (P = 0.004 with more than 15-year work experience (P = 0.006 had good knowledge score of the NMCP. Conclusion: Knowledge and implementation of NMCP by health-care workers in some of the LGAs in this study was inadequate. Regular visit to the health facilities, especially those in the remote areas by the staff of malaria control unit were recommended.

  6. Gender Differences in the Prevalence of Overweight and Obesity, Associated Behaviors, and Weight-related Perceptions in a National Survey of Primary School Children in China.

    Science.gov (United States)

    Zhang, Juan; Zhai, Yi; Feng, Xiao Qi; Li, Wei Rong; Lyu, Yue Bin; Astell-Burt, Thomas; Zhao, Peng Yu; Shi, Xiao Ming

    2018-01-01

    To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio (OR) 2.30, 95% CI 2.00 to 2.65] and rural areas (OR = 1.85, 95% CI 1.55 to 2.20). Girls reported healthier diets (e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85) whereas boys consumed fried food (OR = 1.21, 95% CI 1.06 to 1.38) and sugar-sweetened drinks more often (OR = 1.49, 95% CI 1.34 to 1.65). Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers (OR = 1.35, 95% CI 1.09 to 1.68), less educated fathers (OR = 0.79, 95% CI 0.63 to 0.99), and if they frequently consumed carbonated drinks (OR = 1.48, 95% CI 1.07 to 2.05). Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls. Copyright © 2018 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  7. Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.

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    Ronan Roussel

    Full Text Available According to guidelines, diabetic patients with high cardiovascular risk should receive a statin. Despite this consensus, fibrate monotherapy is commonly used in this population. We assessed the frequency and clinical consequences of the use of fibrates for primary prevention in patients with diabetes and high cardiovascular risk.Retrospective cohort study based on nationwide data from the medical and administrative databases of French national health insurance systems (07/01/08-12/31/09 with a follow-up of up to 30 months.Lipid-lowering drug-naive diabetic patients initiating fibrate or statin monotherapy were identified. Patients at high cardiovascular risk were then selected: patients with a diagnosis of diabetes and hypertension, and > 50 (men or 60 (women, but with no history of cardiovascular events. The composite endpoint comprised myocardial infarction, stroke, amputation, or death.Of the 31,652 patients enrolled, 4,058 (12.8% received a fibrate. Age- and gender-adjusted annual event rates were 2.42% (fibrates and 2.21% (statins. The proportionality assumption required for the Cox model was not met for the fibrate/statin variable. A multivariate model including all predictors was therefore calculated by dividing data into two time periods, allowing Hazard Ratios to be calculated before (HR 540 of follow-up. Multivariate analyses showed that fibrates were associated with an increased risk for the endpoint after 540 days: HR 540 = 1.73 (1.28-2.32.Fibrate monotherapy is commonly prescribed in diabetic patients with high cardiovascular risk and is associated with poorer outcomes compared to statin therapy.

  8. Non-specific low back pain in primary care in the Spanish National Health Service: a prospective study on clinical outcomes and determinants of management

    Directory of Open Access Journals (Sweden)

    Muriel Alfonso

    2006-05-01

    Full Text Available Abstract Background The Spanish National Health Service is a universal and free health care system. Non-specific low back pain (LBP is a prevalent disorder, generating large health and social costs. The objectives of this study were to describe its management in primary care, to assess patient characteristics that influence physicians' decisions, and to describe clinical outcome at 2 months. Methods A cross-sectional sample of 648 patients with non-specific low back pain was recruited by 75 physicians (out of 361 – 20.8% working in 40 primary care centers in 10 of the 17 administrative regions in Spain, covering 693,026 out of the 40,499,792 inhabitants. Patients were assessed on the day they were recruited, and prospectively followed-up 14 and 60 days later. The principal patient characteristics that were analyzed were: sex, duration of the episode, history of LBP, working status, severity of LBP, leg pain and disability, and results of straight leg raising test. Descriptors of management were: performance of the straight leg raising test, ordering of diagnostic procedures, prescription of drug treatment, referral to physical therapy, rehabilitation or surgery, and granting of sick leave. Regression analysis was used to analyze the relationship between patients' baseline characteristics and physicians' management decisions. Only workers were included in the models on sick leave. Results Mean age (SD of included patients was 46.5 (15.5 years, 367 (56.6% were workers, and 338 (52.5% were females. Median (25th–75th interquartile range duration of pain when entering the study was 4 (2–10 days and only 28 patients (4.3% had chronic low back pain. Diagnostic studies included plain radiographs in 43.1% of patients and CT or MRI scans in 18.8%. Drug medication was prescribed to 91.7% of patients, 19.1% were sent to physical therapy or rehabilitation, and 9.6% were referred to surgery. The main determinants of the clinical management were duration

  9. Computation of diatomic molecular spectra for selected transitions of aluminum monoxide, cyanide, diatomic carbon, and titanium monoxide

    Energy Technology Data Exchange (ETDEWEB)

    Parigger, Christian G., E-mail: cparigge@tennessee.edu [The University of Tennessee/University of Tennessee Space Institute, Center for Laser Applications, 411 B.H. Goethert Parkway, Tullahoma, TN 37388-9700 (United States); Woods, Alexander C.; Surmick, David M.; Gautam, Ghaneshwar; Witte, Michael J. [The University of Tennessee/University of Tennessee Space Institute, Center for Laser Applications, 411 B.H. Goethert Parkway, Tullahoma, TN 37388-9700 (United States); Hornkohl, James O. [Hornkohl Consulting, Tullahoma, TN 37388 (United States)

    2015-05-01

    Laser ablation studies with laser-induced breakdown spectroscopy (LIBS) typically emphasize atomic species yet fingerprints from molecular species can occur subsequently or concurrently. In this work, selected molecular transitions of aluminum monixide (AlO), diatomic carbon (C{sub 2}), cyanide (CN), and titanium monoxide (TiO) are accurately computed. Line strength tables are used to describe the radiative transitions of diatomic molecules primarily in the visible, optical region. Details are elaborated of the computational procedure that allows one to utilize diatomic spectra as a predictive and as a diagnostic tool. In order to create a computed spectrum, the procedure requires information regarding the temperature of the diatomic transitions along with other input such as the spectral resolution. When combined with a fitting algorithm to optimize such parameters, this procedure is used to infer information from an experimentally obtained spectrum. Furthermore, the programs and data files are provided for LIBS investigations that also reveal AlO, C{sub 2}, CN, and TiO diatomic spectra. - Highlights: • We present a program for fitting of molecular spectra. • This includes data base for AlO, C{sub 2}, CN, and TiO. • We discuss the details of the program including fitting. • We show computed examples and reference current work.

  10. Carbon monoxide poisoning-induced cardiomyopathy from charcoal at a barbecue restaurant: a case report.

    Science.gov (United States)

    Kim, Hyun-Jun; Chung, Yun Kyung; Kwak, Kyeong Min; Ahn, Se-Jin; Kim, Yong-Hyun; Ju, Young-Su; Kwon, Young-Jun; Kim, Eun-A

    2015-01-01

    Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker. A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications. Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours. Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.

  11. Conversion of carbon monoxide intensities tomolecular hydrogen abundances

    International Nuclear Information System (INIS)

    Kutner, M.L.; Leung, C.M.

    1985-01-01

    We present results of theoretical models (static spherical clouds with a microturbulent velocity field) to study the conversion of carbon monoxide (CO) line parameters into molecular hydrogen (H 2 ) column densities, N2. The three potential H 2 tracers that we investigate are the integrated 12 CO and 13 CO intensities, I 12 and I 13 , and the 13 CO LTE column density, N( 13 . We find that I 12 may be a reasonable tracer of N2 under conditions appropriate to the envelopes of giant molecular clouds and for studies involving cloud ensembles of different cloud sizes and velocity dispersions. However, it saturates under higher density conditions. It is important that empirical conversion factors be set using the types of objects to which they will be applied. For this reason, our analysis suggests that the conversion factor N2/I 12 for giant molecular clouds in the molecular ring of our galaxy may be a factor of 2 lower than the average used by many observers. This lower value is supported by some recent empirical determinations. The quantity I 13 is a good tracer of N2 over a wide range of densities but it is more sensitive to the actual 13 CO abundance. The quantity N( 13 is similar to I 13 as a good tracer of N2 except at low densities and temperatures. The ratio I 12 /I 13 may be used to delineate temperature and column density effects. Finally, we find a strong temperature dependence in the various conversion factors, with N2/I 12 scaling with gas temperature (T/sub k/ approximately as (T/sub k/)/sup -1.3/

  12. Titanium monoxide spectroscopy following laser-induced optical breakdown

    International Nuclear Information System (INIS)

    Parigger, Christian G.; Woods, Alexander C.; Keszler, Anna; Nemes, László; Hornkohl, James O.

    2012-01-01

    This work investigates Titanium Monoxide (TiO) in ablation-plasma by employing laser-induced breakdown spectroscopy (LIBS) with 1 to 10 TW/cm 2 irradiance, pulsed, 13 nanosecond, Q-switched Nd:YAG laser radiation at the fundamental wavelength of 1064 nm. The analysis of TiO is based on our first accurate determination of transition line strengths for selected TiO A-X, B-X, and E-X transitions, particularly TiO A-X γ and B-X γ′ bands. Electric dipole line strengths for the A 3 Φ-X 3 δ and B 3 Π-X 3 δ bands of TiO are computed. The molecular TiO spectra are observed subsequent to laser-induced breakdown (LIB). We discuss analysis of diatomic molecular spectra that may occur simultaneously with spectra originating from atomic species. Gated detection is applied to investigate the development in time of the emission spectra following LIB. Collected emission spectra allow one to infer micro-plasma parameters such as temperature and electron density. Insight into the state of the micro-plasma is gained by comparing measurements with predictions of atomic and molecular spectra. Nonlinear fitting of recorded and computed diatomic spectra provides the basis for molecular diagnostics, while atomic species may overlap and are simultaneously identified. Molecular diagnostic approaches similar to TiO have been performed for diatomic molecules such as AlO, C 2 , CN, CH, N 2 , NH, NO and OH.

  13. Magnetic Resonance Imaging Findings in Chronic Carbon Monoxide Intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Durak, A. C.; Coskun, A.; Yikilmaz, A.; Erdogan, F.; Mavili, E.; Guven, M. [Hospital of Erciyes Univ., Kayseri (Turkey). Dept. of Radiology

    2005-05-01

    Purpose: To define the cranial magnetic resonance imaging (MRI) features of the chronic stage of carbon monoxide (CO) poisoning in patients with and without neuropsychiatric sequelae. Material and Methods: Eight patients who had neither symptoms nor neurological sequelae and eight patients with neuropsychiatric sequelae were included in the study. Patients aged between 9 to 57 (mean 32.2 years). All patients had been comatose at initial admittance and awoke after normobaric 100% oxygen therapy within 1-7 days. In this study, the patients were being examined with routine cranial MRI between 1 and 10 years (mean 3.4 years) after exposure to CO. Results: The most common finding was bilateral symmetric hyperintensity of the white matter, which was more significant in the centrum semiovale, with relative sparing of the temporal lobes and anterior parts of the frontal lobes on T2-weighted and FLAIR images in all patients. Cerebral cortical atrophy was seen in 10 patients; mild atrophy of cerebellar hemispheres in 8; and vermian atrophy in 11. Corpus callosum was atrophic in one patient. Bilateral globus pallidus lesions were seen in three patients. The lesions were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. Conclusion: Patients with severe CO intoxication may develop persistent cerebral changes independently of their neuropsychiatric findings in the chronic stage. They may present with characteristic MRI findings as described here, even if asymptomatic. The history of CO exposure is therefore helpful for recognizing and interpreting the MRI findings of chronic stage CO intoxication.

  14. Mitochondria recycle nitrite back to the bioregulator nitric monoxide

    International Nuclear Information System (INIS)

    Nohl, H.; Staniek, K.; Sobhian, B.; Bahrami, S.; Redl, H.; Kozlov, A.V.

    2000-01-01

    Nitric monoxide (NO) exerts a great variety of physiological functions. L-Arginine supplies amino groups which are transformed to NO in various NO-synthase-active isoenzyme complexes. NO-synthesis is stimulated under various conditions increasing the tissue of stable NO-metabolites. The major oxidation product found is nitrite. Elevated nitrite levels were reported to exist in a variety of diseases including HIV, reperfusion injury and hypovolemic shock. Denitrifying bacteria such as Paracoccus denitrificans have a membrane bound set of cytochromes (cyt cd 1 , cyt bc) which were shown to be involved in nitrite reduction activities. Mammalian mitochondria have similar cytochromes which form part of the respiratory chain. Like in bacteria quinols are used as reductants of these types of cytochromes. The observation of one-e - divergence from this redox-couple to external dioxygen made us to study whether this site of the respiratory chain may also recycle nitrite back to its bioactive form NO. Thus, the aim of the present study was therefore to confirm the existence of a reductive pathway which reestablishes the existence of the bioregulator NO from its main metabolite NO 2 - . Our results show that respiring mitochondria readily reduce added nitrite to NO which was made visible by nitrosylation of deoxyhemoglobin. The adduct gives characteristic triplet-ESR-signals. Using inhibitors of the respiratory chain for chemical sequestration of respiratory segments we were able to identify the site where nitrite is reduced. The results confirm the ubiquinone/cyt bc 1 couple as the reductant site where nitrite is recycled. The high affinity of NO to the heme-iron of cytochrome oxidase will result in an impairment of mitochondrial energy-production. ''Nitrite tolerance'' of angina pectoris patients using NO-donors may be explained in that way. (author)

  15. Erythropoietin in the treatment of carbon monoxide neurotoxicity in rat.

    Science.gov (United States)

    Moallem, Seyed Adel; Mohamadpour, Amir Hooshang; Abnous, Khalil; Sankian, Mojtaba; Sadeghnia, Hamid Reza; Tsatsakis, Aristidis; Shahsavand, Shabnam

    2015-12-01

    Erythropoietin (EPO) plays a critical role in the development of the nervous system. In this study, the effects of EPO in carbon monoxide (CO) neurotoxicity were examined. Rats were exposed to 3000 ppm CO for 1 h and then different doses of EPO were administrated intraperitoneally. After 24 h, glial fibrillary acidic protein (GFAP) levels in the serum were determined and water content of brain and the extravasation of a tracer (Evans blue) were measured. Brain lipid peroxidation, myeloperoxidase activity Myelin basic protein (MBP) and BAX/BcL2 protein relative expressions were determined. Cation exchange chromatography was used to evaluate MBP alterations. Seven days after exposure, pathological assessment was performed after Klüver-Barrera staining. EPO reduced malondialdehyde levels at all doses (2500, 5000 and 10,000 u/kg). Lower doses of EPO (625, 1250, 2500 u/kg) significantly decreased the elevated serum levels of GFAP. EPO could not reduce the water content of the edematous poisoned brains. However, at 5000 and 10,000 u/kg it protected the blood brain barrier against integrity loss as a result of CO. EPO could significantly decrease the MPO activity. CO-mediated oxidative stress caused chemical alterations in MBP and EPO could partially prevent these biochemical changes. Fewer vacuoles and demyelinated fibers were found in the EPO-treated animals. EPO (5000 u/kg) could restore the MBP density. CO increased brain BAX/Bcl-2 ratio 38.78%. EPO reduced it 38.86%. These results reveal that EPO could relatively prevent different pathways of neurotoxicity by CO poisoning and thus has the potential to be used as a novel approach to manage this poisoning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Unusual way of suicide by carbon monoxide. Case Report.

    Science.gov (United States)

    Zelený, Michal; Pivnička, Jan; Šindler, Martin; Kukleta, Pavel

    2015-01-01

    Authors discuss the case of a suicide of a 29-year-old man caused by carbon monoxide (CO) intoxication. What the authors found interesting was the unusual way of committing suicide that required good technical skills and expert knowledge. The level of carboxyhemoglobin (COHb) in the blood of the deceased man was routinely determined by the modified method by Blackmoore (1970), using gas chromatography/thermal conductivity detection. The level of saturation of the hemoglobin by CO in the collected blood sample is determined relatively to the same sample saturated to 100%. In the blood sample of the deceased man the lethal concentration of COHb of 76.5% was determined. Within the following examinations the blood alcohol concentration of 0.05 g.kg(-1) was determined. Further analysis revealed traces of sertraline, its metabolite N-desmethylsertraline, omeprazole and caffeine in the liver tissue, traces of N-desmethylsertraline, ibuprofen and caffeine in urine sample, and only traces of caffeine in the stomach content and blood samples were proved. To commit suicide the man used a sophisticated double container-system equipped with a timer for controlled generation of CO based on the chemical reaction of concentrated sulphuric acid and formic acid. The used timer was set by an electromechanical timer switch that triggered the fatal reaction of the acids while the man was sleeping. The authors discuss an unusual case of suicide by CO intoxication rarely seen in the area of forensic medicine and toxicology that is specific due to its sophisticated way of execution.

  17. CROSS-CORRELATIONS AS A COSMOLOGICAL CARBON MONOXIDE DETECTOR

    International Nuclear Information System (INIS)

    Pullen, Anthony R.; Doré, Olivier; Chang, Tzu-Ching; Lidz, Adam

    2013-01-01

    We present a new procedure to measure the large-scale carbon monoxide (CO) emissions across cosmic history. As a tracer of large-scale structure (LSS), the CO gas content as a function of redshift can be quantified by its three-dimensional fluctuation power spectra. Furthermore, cross-correlating CO emission with other LSS tracers offers a way to measure the emission as a function of scale and redshift. Here we introduce the model relevant for such a cross-correlation measurement between CO and other LSS tracers, and between different CO rotational lines. We propose a novel use of cosmic microwave background (CMB) data and attempt to extract redshifted CO emissions embedded in the Wilkinson Microwave Anisotropy Probe (WMAP) data set. We cross-correlate the all-sky WMAP7 data with LSS data sets, namely, the photometric quasar sample and the luminous red galaxy sample from the Sloan Digital Sky Survey Data Releases 6 and 7, respectively. We are unable to detect a cross-correlation signal with either CO(1-0) or CO(2-1) lines, mainly due to the instrumental noise in the WMAP data. However, we are able to rule out models more than three times greater than our more optimistic model. We discuss the cross-correlation signal from the thermal Sunyaev-Zeldovich effect and dust as potential contaminants, and quantify their impact for our CO measurements. We discuss forecasts for current CMB experiments and a hypothetical future CO-focused experiment, and propose to cross-correlate CO temperature data with the Hobby-Eberly Telescope Dark Energy Experiment Lyα-emitter sample, for which a signal-to-noise ratio of 58 is possible.

  18. Carbon monoxide inhalation increases microparticles causing vascular and CNS dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Jiajun; Yang, Ming [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Kosterin, Paul [Department of Neuroscience, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Salzberg, Brian M. [Department of Physiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Milovanova, Tatyana N.; Bhopale, Veena M. [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States); Thom, Stephen R., E-mail: sthom@smail.umaryland.edu [Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 (United States)

    2013-12-01

    We hypothesized that circulating microparticles (MPs) play a role in pro-inflammatory effects associated with carbon monoxide (CO) inhalation. Mice exposed for 1 h to 100 ppm CO or more exhibit increases in circulating MPs derived from a variety of vascular cells as well as neutrophil activation. Tissue injury was quantified as 2000 kDa dextran leakage from vessels and as neutrophil sequestration in the brain and skeletal muscle; and central nervous system nerve dysfunction was documented as broadening of the neurohypophysial action potential (AP). Indices of injury occurred following exposures to 1000 ppm for 1 h or to 1000 ppm for 40 min followed by 3000 ppm for 20 min. MPs were implicated in causing injuries because infusing the surfactant MP lytic agent, polyethylene glycol telomere B (PEGtB) abrogated elevations in MPs, vascular leak, neutrophil sequestration and AP prolongation. These manifestations of tissue injury also did not occur in mice lacking myeloperoxidase. Vascular leakage and AP prolongation were produced in naïve mice infused with MPs that had been obtained from CO poisoned mice, but this did not occur with MPs obtained from control mice. We conclude that CO poisoning triggers elevations of MPs that activate neutrophils which subsequently cause tissue injuries. - Highlights: • Circulating microparticles (MPs) increase in mice exposed to 100 ppm CO or more. • MPs are lysed by infusing the surfactant polyethylene glycol telomere B. • CO-induced MPs cause neutrophil activation, vascular leak and CNS dysfunction. • Similar tissue injuries do not arise with MPs obtained from air-exposed, control mice.

  19. Selective carbon monoxide oxidation over Ag-based composite oxides

    Energy Technology Data Exchange (ETDEWEB)

    Guldur, C. [Gazi University, Ankara (Turkey). Chemical Engineering Department; Balikci, F. [Gazi University, Ankara (Turkey). Institute of Science and Technology, Environmental Science Department

    2002-02-01

    We report our results of the synthesis of 1 : 1 molar ratio of the silver cobalt and silver manganese composite oxide catalysts to remove carbon monoxide from hydrogen-rich fuels by the catalytic oxidation reaction. Catalysts were synthesized by the co-precipitation method. XRD, BET, TGA, catalytic activity and catalyst deactivation studies were used to identify active catalysts. Both CO oxidation and selective CO oxidation were carried out in a microreactor using a reaction gas mixture of 1 vol% CO in air and another gas mixture was prepared by mixing 1 vol% CO, 2 vol% O{sub 2}, 84 vol% H{sub 2}, the balance being He. 15 vol% CO{sub 2} was added to the reactant gas mixture in order to determine the effect of CO{sub 2}, reaction gases were passed through the humidifier to determine the effect of the water vapor on the oxidation reaction. It was demonstrated that metal oxide base was decomposed to the metallic phase and surface areas of the catalysts were decreased when the calcination temperature increased from 200{sup o}C to 500{sup o}C. Ag/Co composite oxide catalyst calcined at 200{sup o}C gave good activity at low temperatures and 90% of CO conversion at 180{sup o}C was obtained for the selective CO oxidation reaction. The addition of the impurities (CO{sub 2} or H{sub 2}O) decreased the activity of catalyst for selective CO oxidation in order to get highly rich hydrogen fuels. (author)

  20. Exhaled carbon monoxide in asthmatics: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Huang Mao

    2010-04-01

    Full Text Available Abstract Background The non-invasive assessment of airway inflammation is potentially advantageous in asthma management. Exhaled carbon monoxide (eCO measurement is cheap and has been proposed to reflect airway inflammation and oxidative stress but current data are conflicting. The purpose of this meta-analysis is to determine whether eCO is elevated in asthmatics, is regulated by steroid treatment and reflects disease severity and control. Methods A systematic search for English language articles published between 1997 and 2009 was performed using Medline, Embase and Cochrane databases. Observational studies comparing eCO in non-smoking asthmatics and healthy subjects or asthmatics before and after steroid treatment were included. Data were independently extracted by two investigators and analyzed to generate weighted mean differences using either a fixed or random effects meta-analysis depending upon the degree of heterogeneity. Results 18 studies were included in the meta-analysis. The eCO level was significantly higher in asthmatics as compared to healthy subjects and in intermittent asthma as compared to persistent asthma. However, eCO could not distinguish between steroid-treated asthmatics and steroid-free patients nor separate controlled and partly-controlled asthma from uncontrolled asthma in cross-sectional studies. In contrast, eCO was significantly reduced following a course of corticosteroid treatment. Conclusions eCO is elevated in asthmatics but levels only partially reflect disease severity and control. eCO might be a potentially useful non-invasive biomarker of airway inflammation and oxidative stress in nonsmoking asthmatics.

  1. Evaluation of exposure to carbon monoxide associated with passive smoking

    International Nuclear Information System (INIS)

    Jo, W.-K.; Oh, J.-W.; Dong, J.-I.

    2004-01-01

    The current study measured breath carbon monoxide (CO) concentrations prior to and at prescribed time intervals after exposure to passive smoking under controlled conditions, along with the air CO concentration in the exposure room during the exposure periods. The postexposure breath CO levels were 1.4-2.7 times higher than the background breath CO levels after 30 min of exposure, yet only slightly higher after 10 min of exposure, thereby confirming that exposure to CO from passive smoking causes a significant body burden of CO. The air CO concentration gradually increased during the burning of a cigarette(s), regardless of the exposure duration, whereas it slightly decreased after burning. However, the pattern of breath CO decay was similar for the two different types of exposure (during and after a cigarette(s)) in each subject. The decrease in the postexposure alveolar CO concentrations was slow even in the early phase of the decay curves, indicating a monocompartment uptake and elimination model for the human body. The half-lives (78-277 min) estimated in the present study were comparable to those reported in previous studies associated with CO exposure from active smoking or other activities. The current study also evaluated the CO exposure of visitors and workers at three different types of recreation facility (bars, Internet cafes, and billiard halls) typically associated with passive smoking. The results confirmed that passive smoking is the major contributor to the CO exposure of nonsmoking visitors in a recreation environment. In addition, workplace exposure to CO from passive smoking was found to be the most important contributor to the daily CO exposure of nonsmoking recreation workers

  2. Computed Tomographic Findings of Acute Carbon Monoxide Posioning

    International Nuclear Information System (INIS)

    Park, Young Keun; Won, Hee Sun; Lee, Seung Ro; Hahm, Chang Kok

    1983-01-01

    Carbon monoxide (CO) is a kind of frequent toxic gas around our living lives, for common use of briquets as fuel, and its pathologic effect has been known due to mainly hypoxia and direct cytotoxicity in some part to almost all organs, especially to the brain and heart. Some authors have reported pathologic and anatomic changes of the acute of poisoning, although in a few cases, that bilaterally symmetrical lesions of the globs pallidus or cerebral white matter regarded as typical. After using computed tomography (CT), those findings have been discovered more easily and accurately. Authors analysed CT findings of 32 cases, who had a history of acute CO poisoning and performed CT at Hanyang University Hospital from May 1970 to June 1983. The results were as follows: 1. Of all 32 cases with CT scan, low density lesions were demonstrated in 28 cases (88%) and others were hemorrhage and calcified in 2(6%), respectively. 2. All lesions were seen as bilaterally symmetrical, except 2 cases of hemorrhage and 1 of low density. 3. Of all 28 cases of the low densities, 15 cases(53.6%) were located in the globs pallidus, 10(35.7%) in the cerebral white matter and 3(10.7%) in both of them. 4. Of all 113 cases of the low density lesions in the cerebral white matter, common locations were in the frontal and parietal lobes (65.6%), and more in frontal (40.6%). 5. Of all 113 cases of low density lesions in the cerebral white matter, cases of involving all of the lobes were found in only 4. 6. All of 2 cases of the calcified lesions were seen at both sides of the globs pallidus, symmetrically. 7. All of 2 cases of the hemorrhage were seen at thalamus, ventricles and head of caudate nucleus, and these locations were different from those of the low densities or calcifications.

  3. Prevention of Glucocorticoid-Induced Osteoporosis: Clinical audit to evaluate the implementation of National Osteoporosis Guideline Group 2017 guidelines in a primary care setting.

    Science.gov (United States)

    Carter, Matthew

    2018-04-12

    Treatment with glucocorticoids is the leading cause of drug-induced osteoporosis. National Osteoporosis Guideline Group (NOGG) 2017 guidelines advise a case-finding strategy for patients at risk. The aims of the audit were to evaluate the implementation of the NOGG 2017 guidelines for patients receiving long-term glucocorticoid therapy in a suburban general practice, to instigate changes to ensure 90% of patients are investigated and treated appropriately, and to evaluate impact at a 6-mo re-audit. Reporting Analysis and Intelligence Delivering Results (RAIDR) is a health-care intelligence tool accessing primary care clinical data. Using RAIDR, data on relevant osteoporotic risk factors were combined to produce FRAX scores for patients who had been prescribed glucocorticoids 3 or more times in the past 12 months. FRAX data were displayed in a NOGG guidance graph for major osteoporotic fracture probability. Patients were assessed as high, intermediate, or low risk. High- and intermediate-risk patients above the NOGG threshold were recommended to start bisphosphonates; these patients were sent a prescription for alendronate and a letter of explanation. There were no intermediate patients below the NOGG threshold. Low-risk patients were recommended to have lifestyle advice; a leaflet was produced and sent to these patients. Initial results showed that only 25% of patients recommended to be on bisphosphonates were taking them. Steps were taken to educate the general practitioners in the FRAX tool and NOGG guidelines; the chronic obstructive pulmonary disease annual template was amended to aid adherence by alerting the nurse to the number of glucocorticoid courses prescribed, with additional boxes for prescribing alendronate and printing the lifestyle leaflet; and 2-monthly RAIDR searches by the practice pharmacist were started. A re-audit 6 mo later showed improvement to 92%. This audit showed that education, reminders, and simple computer prompts can greatly improve

  4. Dissemination of the Project's Findings. National Seminar (14th, Zagreb, Yugoslavia, July 5-7, 1989). The CDCC's Project No. 8: "Innovation in Primary Education."

    Science.gov (United States)

    Galton, Maurice

    A 3-day conference was convened in Zagreb, Yugoslavia for the purpose of disseminating results of the Council of Europe's Council for Cultural Cooperation's (CDCC) Project 8, Innovation in Primary Education (IPE). Changes in theoretical approaches to and organizational practices of primary education in Yugoslavia were discussed. A total of 61…

  5. Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology

    DEFF Research Database (Denmark)

    Grau, Cai; Johansen, L V; Jakobsen, J

    2000-01-01

    The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark.......The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark....

  6. Catalytic hydrogenation of carbon monoxide. Progress report, December 15, 1991--December 14, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Wayland, B.B.

    1992-12-01

    This project is focused on developing strategies to accomplish the reduction and hydrogenation of carbon monoxide to produce organic oxygenates at mild conditions. Our approaches to this issue are based on the recognition that rhodium macrocycles have unusually favorable thermodynamic values for producing a series of intermediate implicated in the catalytic hydrogenation of CO. Observations of metalloformyl complexes produced by reactions of H{sub 2} and CO, and reductive coupling of CO to form metallo {alpha}-diketone species have suggested a multiplicity of routes to organic oxygenates that utilize these species as intermediates. Thermodynamic and kinetic-mechanistic studies are used in constructing energy profiles for a variety of potential pathways, and these schemes are used in guiding the design of new metallospecies to improve the thermodynamic and kinetic factors for individual steps in the overall process. Variation of the electronic and steric effects associated with the ligand arrays along with the influences of the reaction medium provide the chemical tools for tuning these factors. Emerging knowledge of the factors that contribute to M-H, M-C and M-O bond enthalpies is directing the search for ligand arrays that will expand the range of metal species that have favorable thermodynamic parameters to produce the primary intermediates for CO hydrogenation. Studies of rhodium complexes are being extended to non-macrocyclic ligand complexes that emulate the favorable thermodynamic features associated with rhodium macrocycles, but that also manifest improved reaction kinetics. Multifunctional catalyst systems designed to couple the ability of rhodium complexes to produce formyl and diketone intermediates with a second catalyst that hydrogenates these imtermediates are promising approaches to accomplish CO hydrogenation at mild conditions.

  7. Carbon monoxide induced PPARγ SUMOylation and UCP2 block inflammatory gene expression in macrophages.

    Directory of Open Access Journals (Sweden)

    Arvand Haschemi

    Full Text Available Carbon monoxide (CO dampens pro-inflammatory responses in a peroxisome proliferator-activated receptor-γ (PPARγ and p38 mitogen-activated protein kinase (MAPK dependent manner. Previously, we demonstrated that CO inhibits lipopolysaccharide (LPS-induced expression of the proinflammatory early growth response-1 (Egr-1 transcription factor in macrophages via activation of PPARγ. Here, we further characterize the molecular mechanisms by which CO modulates the activity of PPARγ and Egr-1 repression. We demonstrate that CO enhances SUMOylation of PPARγ which we find was attributed to mitochondrial ROS generation. Ectopic expression of a SUMOylation-defective PPARγ-K365R mutant partially abolished CO-mediated suppression of LPS-induced Egr-1 promoter activity. Expression of a PPARγ-K77R mutant did not impair the effect of CO. In addition to PPARγ SUMOylation, CO-activated p38 MAPK was responsible for Egr-1 repression. Blocking both CO-induced PPARγ SUMOylation and p38 activation, completely reversed the effects of CO on inflammatory gene expression. In primary macrophages isolated form C57/BL6 male mice, we identify mitochondrial ROS formation by CO as the upstream trigger for the observed effects on Egr-1 in part through uncoupling protein 2 (UCP2. Macrophages derived from bone marrow isolated from Ucp2 gene Knock-Out C57/BL6 mice (Ucp2(-/-, produced significantly less ROS with CO exposure versus wild-type macrophages. Moreover, absence of UCP2 resulted in a complete loss of CO mediated Egr-1 repression. Collectively, these results indentify p38 activation, PPARγ-SUMOylation and ROS formation via UCP2 as a cooperative system by which CO impacts the inflammatory response.

  8. Contribution of post-harvest agricultural paddy residue fires in the N.W. Indo-Gangetic Plain to ambient carcinogenic benzenoids, toxic isocyanic acid and carbon monoxide

    Science.gov (United States)

    Praphulla Chandra, Boggarapu; Sinha, Vinayak

    2016-04-01

    In the North West Indo-Gangetic Plain (N.W.IGP), large scale post-harvest paddy residue fires occur every year during the months of October-November. This anthropogenic perturbation causes contamination of the atmospheric environment with adverse impacts on regional air quality posing health risks for the population exposed to high concentrations of carcinogens such as benzene and toxic VOCs such as isocyanic acid. These gases and carbon monoxide are known to be emitted from biomass fires along with acetonitrile. Yet no long-term in-situ measurements quantifying the impact of this activity have been carried out in the N.W. IGP. Using high quality continuous online in-situ measurements of these gases at a strategic downwind site over a three year period from 2012 to 2014, we demonstrate the strong impact of this anthropogenic emission activity on ambient concentrations of these gases. In contrast to the pre-paddy harvest period, excellent correlation of benzenoids, isocyanic acid and CO with acetonitrile (a biomass burning chemical tracer); (r ≥ 0.82) and distinct VOC/acetonitrile emission ratios were observed for the post-paddy harvest period which was also characterized by high ambient concentrations of these species. The average concentrations of acetonitrile (1.62 ± 0.18 ppb), benzene (2.51 ± 0.28 ppb), toluene (3.72 ± 0.41 ppb), C8-aromatics (2.88 ± 0.30 ppb), C9-aromatics (1.55 ± 0.19 ppb) and CO (552 ± 113 ppb) in the post-paddy harvest periods were about 1.5 times higher than the annual average concentrations. For isocyanic acid, a compound with both primary and secondary sources, the concentration in the post-paddy harvest period was 0.97 ± 0.17 ppb. The annual average concentrations of benzene, a class A carcinogen, exceeded the annual exposure limit of 1.6 ppb at NTP mandated by the National Ambient Air Quality Standard of India (NAAQS). We show that mitigating the post-harvest paddy residue fires can lower the annual average concentration of

  9. Environmental tobacco smoke exposure among non-smoking waiters: measurement of expired carbon monoxide levels

    Directory of Open Access Journals (Sweden)

    Ronaldo Laranjeira

    2000-07-01

    Full Text Available CONTEXT: Exposure to environmental tobacco smoke is a health risk that is of concern to patrons and of particular concern to employees of restaurants and bars. OBJECTIVE: To assess environmental tobacco smoke exposure (using expired carbon monoxide levels in non-smoking waiters before and after a normal day's shift and to compare pre-exposure levels with non-smoking medical students. DESIGN: An observational study. SETTING: Restaurants with more than 50 tables or 100 places in São Paulo. SUBJECTS: 100 non-smoking restaurant waiters and 100 non-smoking medical students in São Paulo, Brazil. MAIN MEASUREMENTS: Levels of expired carbon monoxide, measured with a Smokerlyser (Bedfont EC 50 Scientific, before and after a normal day's work. RESULTS: Waiters' pre-exposure expired carbon monoxide levels were similar to those of medical students, but after a mean of 9 hours exposure in the workplace, median levels more than doubled (2.0 ppm vs. 5.0 ppm, P <0.001. Post-exposure carbon monoxide levels were correlated with the number of tables available for smokers (Kendall's tau = 0.2, P <0.0001. CONCLUSIONS: Exposure to environmental tobacco smoke is the most likely explanation for the increase in carbon monoxide levels among these non-smoking waiters. These findings can be used to inform the ongoing public health debate on passive smoking.

  10. [Protective effects of endogenous carbon monoxide against myocardial ischemia-reperfusion injury in rats].

    Science.gov (United States)

    Zhou, Zhen; Ma, Shuang; Liu, Jie; Ji, Qiao-Rong; Cao, Cheng-Zhu; Li, Xiao-Na; Tang, Feng; Zhang, Wei

    2018-04-25

    The present study is aimed to explore the effects of endogenous carbon monoxide on the ischemia-reperfusion in rats. Wistar rats were intraperitoneally injected with protoporphyrin cobalt chloride (CoPP, an endogenous carbon monoxide agonist, 5 mg/kg), zinc protoporphyrin (ZnPP, an endogenous carbon monoxide inhibitor, 5 mg/kg) or saline. Twenty-four hours after injection, the myocardial ischemia-reperfusion model was made by Langendorff isolated cardiac perfusion system, and cardiac function parameters were collected. Myocardial cGMP content was measured by ELISA, and the endogenous carbon monoxide in plasma and myocardial enzymes in perfusate at 10 min after reperfusion were measured by colorimetry. The results showed that before ischemia the cardiac functions of CoPP, ZnPP and control groups were stable, and there were no significant differences. After reperfusion, cardiac functions had significant differences among the three groups (P endogenous carbon monoxide can maintain cardiac function, shorten the time of cardiac function recovery, and play a protective role in cardiac ischemia-reperfusion.

  11. Vapor Pressure and Evaporation Coefficient of Silicon Monoxide over a Mixture of Silicon and Silica

    Science.gov (United States)

    Ferguson, Frank T.; Nuth, Joseph A., III

    2012-01-01

    The evaporation coefficient and equilibrium vapor pressure of silicon monoxide over a mixture of silicon and vitreous silica have been studied over the temperature range (1433 to 1608) K. The evaporation coefficient for this temperature range was (0.007 plus or minus 0.002) and is approximately an order of magnitude lower than the evaporation coefficient over amorphous silicon monoxide powder and in general agreement with previous measurements of this quantity. The enthalpy of reaction at 298.15 K for this reaction was calculated via second and third law analyses as (355 plus or minus 25) kJ per mol and (363.6 plus or minus 4.1) kJ per mol respectively. In comparison with previous work with the evaporation of amorphous silicon monoxide powder as well as other experimental measurements of the vapor pressure of silicon monoxide gas over mixtures of silicon and silica, these systems all tend to give similar equilibrium vapor pressures when the evaporation coefficient is correctly taken into account. This provides further evidence that amorphous silicon monoxide is an intimate mixture of small domains of silicon and silica and not strictly a true compound.

  12. The Effect of Carbon Monoxide Poisoning on Platelet Volume in Children

    Directory of Open Access Journals (Sweden)

    Halise Akça

    2017-04-01

    Full Text Available Introduction: Carbon monoxide poisoning is one of the most important causes of morbidity and mortality. There is increasing evidence supporting the important role of mean platelet volume (MPV as a marker of hypoxia and inflammation. In this study, we aimed to determine changes in MPV values in pediatric patients with carbon monoxide poisoning. Methods: We retrospectively evaluated children who were diagnosed with carbon monoxide poisoning in our hospital between January 2005 and 2014. Results: We included 228 children with carbon monoxide poisoning (49% male in this retrospective, controlled study. The mean age of the patients was 88±56 months. Control group consisted of 200 age-matched healthy children. There was no statistically significant difference in MPV levels between the study and control groups (8.43±1.1 fL and 8.26±0.7 fL, respectively. No correlation of MPV and platelet count with carboxyhemoglobin (COHb was found. Conclusion: In our study, it was determined that MPV value was not a helpful parameter for predicting the diagnosis of acute carbon monoxide poisoning in childhood. The difference between the MPV values and the lack of significance and the absence of correlation between MPV value and COHb level led to the fact that MPV was not a guide indicating the clinical severity of the condition.

  13. Correlation of computed tomography, magnetic resonance imaging and clinical outcome in acute carbon monoxide poisoning.

    Science.gov (United States)

    Ozcan, Namik; Ozcam, Giray; Kosar, Pinar; Ozcan, Ayse; Basar, Hulya; Kaymak, Cetin

    2016-01-01

    Carbon monoxide is a toxic gas for humans and is still a silent killer in both developed and developing countries. The aim of this case series was to evaluate early radiological images as a predictor of subsequent neuropsychological sequelae, following carbon monoxide poisoning. After carbon monoxide exposure, early computed tomography scans and magnetic resonance imaging findings of a 52-year-old woman showed bilateral lesions in the globus pallidus. This patient was discharged and followed for 90 days. The patient recovered without any neurological sequela. In a 58-year-old woman exposed to carbon monoxide, computed tomography showed lesions in bilateral globus pallidus and periventricular white matter. Early magnetic resonance imaging revealed changes similar to that like in early tomography images. The patient recovered and was discharged from hospital. On the 27th day of exposure, the patient developed disorientation and memory impairment. Late magnetic resonance imaging showed diffuse hyperintensity in the cerebral white matter. White matter lesions which progress to demyelination and end up in neuropsychological sequelae cannot always be diagnosed by early computed tomography and magnetic resonance imaging in carbon monoxide poisoning. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  14. Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.

    Science.gov (United States)

    Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; Casula, Anna; Caskey, Fergus J; Aitken, Grant; Fraser, Simon D S; Roderick, Paul J; Nitsch, Dorothea

    2017-04-01

    Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) primary care data have good external validity for the prevalence of decreased kidney function and RRT. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  15. Solubility of carbon monoxide in bio-oil compounds

    International Nuclear Information System (INIS)

    Qureshi, Muhammad Saad; Le Nedelec, Tom; Guerrero-Amaya, Hernando; Uusi-Kyyny, Petri; Richon, Dominique; Alopaeus, Ville

    2017-01-01

    Highlights: • CO solubility was measured in four bio-oil compounds using static-analytic VLE equipment. • A comparison on the performance of different EoS (PC-SAFT, SRK and PR) was made. • Modelling of polar compounds with Polar PC-SAFT was tested. • Polar PC-SAFT is not needed for weakly polar compounds (μ < 1.0 D). - Abstract: The solubility of carbon monoxide is measured in four different bio-oil compounds (furan, diacetyl, 2-methylfuran, and trans-crotonaldehyde) at temperatures (273.15, 283.15, 298.15, and 323.15 K) and pressures up to 8 MPa using a static-analytical VLE measurement method. The equipment was validated by measuring the solubility of CO 2 in methanol at 298.15 K and pressures (P = 2.9–5.7 MPa). The results were compared with the abundantly available literature values. PC-SAFT, Polar PC-SAFT (PPC-SAFT), and Cubic (SRK, PR) EoS, part of commercial process simulator Aspen Plus V. 8.6, are used here for modelling purpose. The pure component parameters needed for PC-SAFT and PPC-SAFT EoS models, are regressed using the experimental liquid density and vapour pressure data of the pure components. It was observed that furan, 2-methylfuran and diacetyl, having weak dipole moments (μ < 1.0 D), could be modelled reasonably well without the addition of polar contribution using conventional PC-SAFT, while it is recommended to use PPC-SAFT for the description of a polar compound like trans-crotonaldehyde (μ ∼ 3.67 D). It was observed that SRK and PR EoS have similar predictive ability in comparison to PC-SAFT for a mixture of CO with weakly polar compounds in this study. A comparison between the performances of EoS models was made in two ways: first by setting the binary interaction parameter k ij to zero, and second by adjusting a temperature-dependent binary interaction parameter (k ij ). All the models perform with comparable accuracy with adjusted binary interaction parameters. However, due to the large differences between the chemical and

  16. Neurological Effects of Acute Carbon Monoxide Poisoning in Children

    Directory of Open Access Journals (Sweden)

    Coskun YARAR

    2009-11-01

    Full Text Available Carbon monoxide poisoning (COP is one of the most common causes of mortality and morbidity due to poisoning in all over the world. Although the incidence of COP has not been known exactly in the childhood, almost one-third of CO exposures occurred in children. The data regarding COP in children are inconclusive. Children may be more vulnerable to CO exposure than adults as a result of their high respiration and metabolic rates, high oxygen metabolism, and immature central nervous system. Recent researches proposed new theories about neurological effects of CO toxicity. The clinical presentations associated acute COP may be various and nonspecific. Unrecognized CO exposure may lead to significant morbidity and mortality. CO exposed children often become symptomatic earlier, and recover more rapidly, than similarly CO exposed adults. Mild clinical signs and symptoms associated with COP are headache, dizziness, weakness, lethargy, and myalgia; however, severe signs and symptoms such as blurred vision, syncope, convulsion, coma, cardiopulmonary arrest and death can also accompany with COP. Neurologic manifestations can include altered mental status at different degrees, neck stiffness, tremor, ataxia, and positive Babinski's sign. Delayed neurologic sequels (DNS of COP might be seen in children like adults. DNS symptoms and signs in children include memory problems, mental retardation, mutism, fecal and urinary incontinence, motor deficits, facial palsy, psychosis, chronic headache, seizures, and epilepsy. After CO exposure children must be cared to detect and treat DNS. Although hyperbaric oxygen therapy (HBOT is reported to prevent development of DNS, its indications, application duration and procedures are controversial in both of the children and adults. Although their predictive values are limited, exposing to CO more than eight hours and suffering from CO-induced coma, cardiac arrest, lactic acidosis, high COHb levels, and pathologic findings

  17. The Association between Working Memory and Educational Attainment as Measured in Different Mathematical Subtopics in the Swedish National Assessment: Primary Education

    Science.gov (United States)

    Nyroos, Mikaela; Wiklund-Hornqvist, Carola

    2012-01-01

    The aim of this study was to examine the relationship between working memory capacity and mathematical performance measured by the national curriculum assessment in third-grade children (n = 40). The national tests concerned six subareas within mathematics. One-way ANOVA, two-tailed Pearson correlation and multiple regression analyses were…

  18. Absorption of nicotine and carbon monoxide from passive smoking under natural conditions of exposure.

    Science.gov (United States)

    Jarvis, M J; Russell, M A; Feyerabend, C

    1983-01-01

    Seven non-smokers were exposed to tobacco smoke under natural conditions for two hours in a public house. Measures of nicotine and cotinine in plasma, saliva, and urine and expired air carbon monoxide all showed reliable increases. The concentrations of carbon monoxide and nicotine after exposure averaged 15.7% and 7.5% respectively of the values found in heavy smokers. Although the increase in expired air carbon monoxide of 5.9 ppm was similar to increases in smokers after a single cigarette, the amount of nicotine absorbed was between a tenth and a third of the amount taken in from one cigarette. Since this represented a relatively extreme acute natural exposure, any health risks of passive smoking probably depend less on quantitative factors than on qualitative differences between sidestream and mainstream smoke. PMID:6648864

  19. [Carboxyhemoglobin concentration in carbon monoxide poisoning. Critical appraisal of the predictive value].

    Science.gov (United States)

    Köthe, L; Radke, J

    2010-06-01

    In cases of unclear depression of conciousness, arrhythmia and symptoms of cardiac insufficiency inadvertent carbon monoxide intoxication should always be taken into consideration. Rapid diagnosis of acute carbon monoxide intoxication with mostly unspecific symptoms requires an immediate supply of high dose oxygen which enables a distinct reduction of mortality and long-term morbidity. Levels of carboxyhemoglobin, however, should not be used as a parameter to decide whether to supply normobaric or the more efficient hyperbaric oxygen. There is no sufficient coherence between carboxyhemoglobin blood levels and clinical symptoms. Increased carboxyhemoglobin concentrations help to diagnose acute carbon monoxide intoxication but do not allow conclusions to be drawn about possible long-term neuropsychiatric or cardiac consequences.

  20. 76 FR 8157 - National Ambient Air Quality Standards for Carbon Monoxide

    Science.gov (United States)

    2011-02-11

    ... identified by ST segment depression, is asymptomatic (i.e., silent). Patients who experience angina typically...). \\15\\ Statistical analyses of the data from Sheps et al., (1987) by Bissette et al (1986) indicate a... measures of myocardial ischemia (ST-segment depression) \\18\\ were assessed, as well as the subjective...

  1. 76 FR 54293 - Review of National Ambient Air Quality Standards for Carbon Monoxide

    Science.gov (United States)

    2011-08-31

    ...), hypertension (high blood pressure), and peripheral vascular diseases. Heart disease, in turn, comprises several... further concludes that no secondary standard should be set for CO at this time. EPA is also making changes.... Consideration of a Secondary Standard A. Introduction B. Rationale for Proposed Decision C. Comments on...

  2. Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey.

    Science.gov (United States)

    Zhou, Yin; Abel, Gary; Warren, Fiona; Roland, Martin; Campbell, John; Lyratzopoulos, Georgios

    2015-05-01

    It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. We analysed data from 567,049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Occupational carbon monoxide poisoning in the State of Washington, 1994-1999.

    Science.gov (United States)

    Lofgren, Don J

    2002-04-01

    Carbon monoxide poisonings continue to be significant and preventable for a number of work operations. This study assesses occupational carbon monoxide morbidity and mortality for the state of Washington based on a review of workers' compensation records for the years 1994-1999. The study characterizes sources, industries, and causative factors, and further attempts to identify work operations most at risk. Records were identified by both injury source and diagnostic codes. The study limits itself to non-fire-related carbon monoxide poisonings and primarily those from acute exposure. A decline in the number of claims was not evident, but the number of incidents per year showed a slight decline. Carbon monoxide poisonings were found to occur throughout all types of industries. The greatest number of claims was found in agriculture, followed by construction and wholesale trade, with these three accounting for more than half the claims and nearly half of the incidents. The more severe poisonings did not necessarily occur in industries with the greatest number of incidents. The major source for carbon monoxide poisoning was forklift trucks, followed by auto/truck/bus, portable saws, and more than 20 other sources. Fruit packing and storage had the highest number of incidents mostly due to fuel-powered forklift activity, with nearly half of the incidents occurring in cold rooms. Adverse health effects as measured by carboxyhemoglobin, hyperbaric oxygen treatment, unconsciousness, and number and cost of claims were indexed by source. Though several specific work operations were identified, the episodic nature of carbon monoxide poisonings, as well as the diverse industries and sources, and the opportunity for a severe poisoning in any number of operations, poses challenges for effective intervention.

  4. Assessment of exposure to carbon monoxide group of firefighters from fire fighting and rescue units

    Directory of Open Access Journals (Sweden)

    Jadwiga Lembas-Bogaczyk

    2011-03-01

    Full Text Available Firemen threat during fire burning of chemical substances indicated presence of carbon monoxide (CO in all cases. Carbon monoxide causes death of fire. Inhaled through respiratory system, links with hemoglobin, thus blocking transport and distribution of oxygen in the body. This leads to tissue anoxia, which is a direct threat to firefighters’ life. The purpose of this study was to assess the exposure to carbon monoxide of participating firefighters extinguishing fire. Estimation of carbon monoxide quantity absorbed by firefighters was isolated in a group of 40 firefighters from Fire Extinguishing and Rescue Unit of State Fire in Nysa. The study was conducted by measuring carbon monoxide in exhaled air. For measurement of carbon monoxide concentration in exhaled air Micro CO meter was used. Results were demonstrated separately for nonsmokers (n425 and smokers (n415. Mean COHb[%] levels in nonsmokers, measured prior the rescue action was 0,3950,3% and increased statistically significant after the action to 0,6150,34%, while in the group smokers, this level was 2,1750,64% before the action and increased insignificantly after the action to 2,3350,63%. The average COHb level in the same groups before and after exercise, was respectively: for nonsmokers prior to exercise was 0,4850,28% and after exercise decreased statistically significant to 0,3050,27%. In the group of smokers before exercise was 2,2350,61% and decreased statistically significant up to 1,5450,71%. It was no difference between the group of age and time of employment.

  5. Accidental carbon monoxide poisoning during yagya for faith healing--a case report.

    Science.gov (United States)

    Behera, C; Millo, T M; Jaiswal, A; Dogra, T D

    2013-03-01

    A 20-year-old female and a 45-year-old male were found lying dead on the floor with frothand vomitus stain present over mouth, nose and face in a closed room. An earthen bowl with incomplete burnt woods, flowers, food materials, agarbati, etc, was also found lying near the body of the two deceased. The cause of death, established by autopsy and toxicological examination was carbon monoxide poisoning in both victims. The source of carbon monoxide was incomplete burnt woods used for yagya during puja (a faith healing practice) for bearing children.

  6. Cyclic process for producing methane from carbon monoxide with heat removal

    Science.gov (United States)

    Frost, Albert C.; Yang, Chang-lee

    1982-01-01

    Carbon monoxide-containing gas streams are converted to methane by a cyclic, essentially two-step process in which said carbon monoxide is disproportionated to form carbon dioxide and active surface carbon deposited on the surface of a catalyst, and said carbon is reacted with steam to form product methane and by-product carbon dioxide. The exothermic heat of reaction generated in each step is effectively removed during each complete cycle so as to avoid a build up of heat from cycle-to-cycle, with particularly advantageous techniques being employed for fixed bed, tubular and fluidized bed reactor operations.

  7. The Range of 1-3 keV Electrons in Solid Oxygen and Carbon Monoxide

    DEFF Research Database (Denmark)

    Oehlenschlæger, M.; Andersen, H.H.; Schou, Jørgen

    1985-01-01

    The range of 1-3 keV electrons in films of solid oxygen and carbon monoxide has been measured by a mirror substrate method. The technique used here is identical to the one previously used for range measurements in solid hydrogen and nitrogen. The range in oxygen is slightly shorter than that in n......The range of 1-3 keV electrons in films of solid oxygen and carbon monoxide has been measured by a mirror substrate method. The technique used here is identical to the one previously used for range measurements in solid hydrogen and nitrogen. The range in oxygen is slightly shorter than...

  8. 40 CFR Table 5 to Subpart Jjj of... - Carbon Monoxide Emission Limits for Existing Small Municipal Waste Combustion Units

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Carbon Monoxide Emission Limits for Existing Small Municipal Waste Combustion Units 5 Table 5 to Subpart JJJ of Part 62 Protection of... of Part 62—Carbon Monoxide Emission Limits for Existing Small Municipal Waste Combustion Units...

  9. 40 CFR Table 2 to Subpart Aaaa of... - Carbon Monoxide Emission Limits for New Small Municipal Waste Combustion Units

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Carbon Monoxide Emission Limits for New... Pt. 60, Subpt. AAAA, Table 2 Table 2 to Subpart AAAA of Part 60—Carbon Monoxide Emission Limits for.... Compliance is determined by continuous emission monitoring systems. b Block averages, arithmetic mean. See...

  10. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas

    Directory of Open Access Journals (Sweden)

    Makoto Onodera

    2016-01-01

    Full Text Available Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p=0.021, but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time.

  11. Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas.

    Science.gov (United States)

    Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

    2016-01-01

    Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p = 0.021), but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time.

  12. Stable isotope composition of atmospheric carbon monoxide. A modelling study

    International Nuclear Information System (INIS)

    Gromov, Sergey S.

    2014-01-01

    This study aims at an improved understanding of the stable carbon and oxygen isotope composition of the carbon monoxide (CO) in the global atmosphere by means of numerical simulations. At first, a new kinetic chemistry tagging technique for the most complete parameterisation of isotope effects has been introduced into the Modular Earth Submodel System (MESSy) framework. Incorporated into the ECHAM/MESSy Atmospheric Chemistry (EMAC) general circulation model, an explicit treatment of the isotope effects on the global scale is now possible. The expanded model system has been applied to simulate the chemical system containing up to five isotopologues of all carbon- and oxygen-bearing species, which ultimately determine the δ 13 C, δ 18 O and Δ 17 O isotopic signatures of atmospheric CO. As model input, a new stable isotope-inclusive emission inventory for the relevant trace gases has been compiled. The uncertainties of the emission estimates and of the resulting simulated mixing and isotope ratios have been analysed. The simulated CO mixing and stable isotope ratios have been compared to in-situ measurements from ground-based observatories and from the civil-aircraft-mounted CARIBIC-1 measurement platform. The systematically underestimated 13 CO/ 12 CO ratios of earlier, simplified modelling studies can now be partly explained. The EMAC simulations do not support the inferences of those studies, which suggest for CO a reduced input of the highly depleted in 13 C methane oxidation source. In particular, a high average yield of 0.94 CO per reacted methane (CH 4 ) molecule is simulated in the troposphere, to a large extent due to the competition between the deposition and convective transport processes affecting the CH 4 to CO reaction chain intermediates. None of the other factors, assumed or disregarded in previous studies, however hypothesised to have the potential in enriching tropospheric CO in 13 C, were found significant when explicitly simulated. The

  13. Amenorrhea - primary

    Science.gov (United States)

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  14. European recommendations for primary prevention of congenital anomalies: A joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans

    DEFF Research Database (Denmark)

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention t...

  15. Attitudes about carbon monoxide safety in the United States: results from the 2005 and 2006 HealthStyles Survey.

    Science.gov (United States)

    King, Michael E; Damon, Scott A

    2011-01-01

    We sought to identify attitudes and behaviors related to carbon monoxide (CO) safety that can be targeted with public health prevention strategies in the U.S. The Centers for Disease Control and Prevention added questions about (1) proper placement of gas-powered generators, (2) maintenance of fuel-burning appliances, and (3) use of CO detectors to the 2005 and 2006 HealthStyles national health marketing surveys. In 2005, 63.3% of HealthStyles respondents agreed with or were uncertain about the incorrect statement, "It is safe to run a generator in a garage as long as the door is open," while 43.1% agreed with or were uncertain about the incorrect statement, "It is safe to run a generator in the basement." Most of the 2006 respondents (63.5%) agreed that it is important to have their furnace inspected annually. However, fewer than half of the 2006 respondents (42.0%)-most of whom were homeowners-reported owning a CO detector. A large proportion of adults in the U.S. reported attitudes and behaviors that may place them at increased risk for unintentional, non-fire-related CO poisoning, suggesting that current safety messages may not be reaching much of the public. Prevention messages should continue to promote proper generator placement, maintenance of fuel-burning appliances, and use of CO detectors. Development of a comprehensive national strategy for CO surveillance and communication may help identify populations at increased risk and prevent future poisonings.

  16. Integrated Science Assessment (ISA) for Carbon Monoxide (Second External Review Draft, Sep 2009)

    Science.gov (United States)

    EPA announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of t...

  17. Catalytic Reduction of Nitrous Oxide with Carbon Monoxide over Calcined Co–Mn–Al Hydrotalcite

    Czech Academy of Sciences Publication Activity Database

    Pacultová, K.; Obalová, L.; Kovanda, F.; Jirátová, Květa

    2008-01-01

    Roč. 137, 2-4 (2008), s. 358-389 ISSN 0920-5861 R&D Projects: GA ČR(CZ) GA106/05/0366 Institutional research plan: CEZ:AV0Z40720504 Keywords : nitrous oxide * carbon monoxide * mixed oxide catalysts Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 3.004, year: 2008

  18. Multimodel simulations of carbon monoxide: Comparison with observations and projected near-future changes

    NARCIS (Netherlands)

    Shindell, D.T.; Faluvegi, G.; Stevenson, D.S.; Krol, M.C.; Emmons, L.K.; Lamarque, J.F.; Petron, G.; Dentener, F.J.; Ellingsen, K.; Schultz, M.G.; Wild, O.; Amann, M.; Atherton, C.S.; Bergmann, D.J.; Bey, I.; Butler, T.; Cofala, J.; Collins, W.J.; Derwent, R.G.; Doherty, R.M.; Drevet, J.; Eskes, H.J.; Fiore, A.M.; Gauss, M.; Hauglustaine, D.A.; Horowitz, L.W.; Isaksen, I.S.A.; Lawrence, M.G.; Montanaro, V.; Muller, J.F.; Pitari, G.; Prather, M.J.; Pyle, J.A.; Rast, S.; Rodriguez, J.M.; Sanderson, M.G.; Savage, N.H.; Strahan, S.E.; Sudo, K.; Szopa, S.; Unger, N.; Noije, van T.P.C.; Zeng, G.

    2006-01-01

    We analyze present-day and future carbon monoxide (CO) simulations in 26 state-of-the-art atmospheric chemistry models run to study future air quality and climate change. In comparison with near-global satellite observations from the MOPITT instrument and local surface measurements, the models show

  19. SEASONAL SOIL FLUXES OF CARBON MONOXIDE IN BURNED AND UNBURNED BRAZILIAN SAVANNAS

    Science.gov (United States)

    Soil-atmosphere fluxes of carbon monoxide (CO) were measured from September 1999 through November 2000 in savanna areas in central Brazil (Cerrado) under different fire regimes using transparent and opaque static chambers. Studies focused on two vegetation types, cerrado stricto...

  20. Chemical production from waste carbon monoxide: its potential for energy conservation

    Energy Technology Data Exchange (ETDEWEB)

    Rohrmann, C.A.; Schiefelbein, G.F.; Molton, P.M.; Li, C.T.; Elliott, D.C.; Baker, E.G.

    1977-11-01

    Results of a study of the potential for energy conservation by producing chemicals from by-product or waste carbon monoxide (CO) from industrial sources are summarized. Extensive compilations of both industrial sources and uses for carbon monoxide were developed and included. Reviews of carbon monoxide purification and concentration technology and preliminary economic evaluations of carbon monoxide concentration, pipeline transportation and utilization of CO in the synthesis of ammonia and methanol are included. Preliminary technical and economic feasibility studies were made of producing ammonia and methanol from the by-product CO produced by a typical elemental phosphorus plant. Methanol synthesis appears to be more attractive than ammonia synthesis when using CO feedstock because of reduced water gas shift and carbon dioxide removal requirements. The economic studies indicate that methanol synthesis from CO appears to be competitive with conventional technology when the price of natural gas exceeds $0.82/million Btu, while ammonia synthesis from CO is probably not competitive until the price of natural gas exceeds $1.90/million Btu. It is concluded that there appears to be considerable potential for energy conservation in the chemical industry, by collecting CO rather than flaring it, and using it to make major chemicals such as ammonia and methanol.

  1. MODELLING OF CARBON MONOXIDE AIR POLLUTION IN LARG CITIES BY EVALUETION OF SPECTRAL LANDSAT8 IMAGES

    Directory of Open Access Journals (Sweden)

    M. Hamzelo

    2015-12-01

    Full Text Available Air pollution in large cities is one of the major problems that resolve and reduce it need multiple applications and environmental management. Of The main sources of this pollution is industrial activities, urban and transport that enter large amounts of contaminants into the air and reduces its quality. With Variety of pollutants and high volume manufacturing, local distribution of manufacturing centers, Testing and measuring emissions is difficult. Substances such as carbon monoxide, sulfur dioxide, and unburned hydrocarbons and lead compounds are substances that cause air pollution and carbon monoxide is most important. Today, data exchange systems, processing, analysis and modeling is of important pillars of management system and air quality control. In this study, using the spectral signature of carbon monoxide gas as the most efficient gas pollution LANDSAT8 images in order that have better spatial resolution than appropriate spectral bands and weather meters،SAM classification algorithm and Geographic Information System (GIS , spatial distribution of carbon monoxide gas in Tehran over a period of one year from the beginning of 2014 until the beginning of 2015 at 11 map have modeled and then to the model valuation ،created maps were compared with the map provided by the Tehran quality comparison air company. Compare involved plans did with the error matrix and results in 4 types of care; overall, producer, user and kappa coefficient was investigated. Results of average accuracy were about than 80%, which indicates the fit method and data used for modeling.

  2. Intra-pulse Cavity Enhanced Measurements of Carbon Monoxide in a Rapid Compression Machine

    KAUST Repository

    Nasir, Ehson Fawad; Farooq, Aamir

    2018-01-01

    A laser absorption sensor for carbon monoxide concentration was developed for combustion studies in a rapid compression machine using a pulsed quantum cascade laser near 4.89 μm. Cavity enhancement reduced minimum detection limit down to 2.4 ppm

  3. Carbon monoxide oxidation using Zn-Cu-Ti hydrotalcite-derived ...

    Indian Academy of Sciences (India)

    Multioxide catalysts of zinc, copper and titanium with different ratios obtained from layered double hydroxide (LDH) precursors were used in the oxidation of carbon monoxide. The catalysts were characterized by energy-dispersive X-ray spectrometry, X-ray diffraction, thermal analyses (TG, DTG and DTA) and scanning ...

  4. Room-temperature cold-welding of gold nanoparticles for enhancing the electrooxidation of carbon monoxide.

    Science.gov (United States)

    Liu, Cai; Li, Yong-Jun; Sun, Shi-Gang; Yeung, Edward S

    2011-04-21

    A cold-welding strategy is proposed to rapidly join together Au nanoparticles (AuNPs) into two-dimensional continuous structures for enhancing the electrooxidation of carbon monoxide by injecting a mixture of ethanol and tolulene into the bottom of a AuNP solution. © The Royal Society of Chemistry 2011

  5. Forensic aspects of carbon monoxide poisoning by charcoal burning in Denmark, 2008-2012

    DEFF Research Database (Denmark)

    Nielsen, Pia Rude; Gheorghe, Alexandra; Lynnerup, Niels

    2014-01-01

    Carbon monoxide (CO) inhalation is a well-known method of committing suicide. There has been a drastic increase in suicide by inhalation of CO, produced from burning charcoal, in some parts of Asia, and a few studies have reported an increased number of these deaths in Europe. CO-related deaths c...

  6. Evidence for long-range transport of carbon monoxide in the Southern Hemisphere from SCIAMACHY observations

    NARCIS (Netherlands)

    Gloudemans, A.M.S.; Krol, M.C.; Meirink, J.F.; de Laat, A.T.J.; van der Werf, G.R.; Schrijver, H.; van den Broek, M.M.P.; Aben, I.

    2006-01-01

    The SCIAMACHY satellite instrument shows enhanced carbon monoxide (CO) columns in the Southern Hemisphere during the local Spring. Chemistry-transport model simulations using the new GFEDv2 biomass-burning emission database show a similar temporal and spatial CO distribution, indicating that the

  7. An infrared spectroscopic study of the adsorption of carbon monoxide on silica-supported copper particles

    NARCIS (Netherlands)

    Jong, K.P. de; Geus, John W.; Joziasse, J.

    Infrared spectroscopy is used to study the adsorption of carbon monoxide (20°C; 0.1– 100 Torr) on copper-on-silica catalysts differently prepared and pretreated. As determined by electron microscopy and X-ray line broadening, the catalysts contain copper particles having sizes of 60 to 5000 Å

  8. 77 FR 8252 - Adequacy Status of the Anchorage, Alaska, Carbon Monoxide Maintenance Plan for Transportation...

    Science.gov (United States)

    2012-02-14

    ... a SIP means that transportation activities will not produce new air quality violations, worsen... Anchorage, Alaska, Carbon Monoxide Maintenance Plan for Transportation Conformity Purposes AGENCY... Transportation & Public Facilities, and the U.S. Department of Transportation will be required to use [[Page 8253...

  9. Calculated Specific Volumes and Magnetic Moments of the 3d Transition Metal Monoxides

    DEFF Research Database (Denmark)

    Skriver, Hans Lomholt; Andersen, O. K.; Johansson, B.

    1980-01-01

    We have performed self-consistent, spin-polarized band structure calculations as a function of the lattice spacing for the 3d metal monoxides in order to obtain the equilibrium lattice constants. The calculated binding from the 3d electrons and the occurrence of antiferromagnetism account...

  10. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    Directory of Open Access Journals (Sweden)

    Metin Uysalol

    2011-09-01

    Full Text Available Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide intoxication was heaters, waterheaters and fi re in 82.1%, 7.1% and 6% of cases, respectively. There was a statistically signifi cant difference between the carboxyhemoglobin levels of the patients according to the clinical classifi cation (p<0.05. The intoxication caused by heaters was observed signifi cantly in November, December and January (p<0.001, between 16:00-24:00 hours (p<0.001 and among more than one member of a family (p<0.001. A medium level correlation was detected between the treatment approach and clinical classifi cation (r=0.50, p<0.001. Conclusion: Carbon monoxide intoxication, in the presented series, was found to develop accidentally; mostly in the Winter season; during night hours when the family members gathered together. The carboxyhemoglobin levels were appropriate with the developing clinical findings. Carboxyhemoglobin level solely was not enough for achieving the diagnosis and planning the treatment.

  11. Carbon monoxide poisoning in Nigeria - it is time to pay attention ...

    African Journals Online (AJOL)

    Background: Carbon monoxide (CO) is a colourless, odourless gas and a cause of thousands of deaths across the world annually but its lethal consequences often go unrecognized, especially in developing countries. Aim: To discuss the subject of CO poisoning using local examples. Methods: Information was drawn from ...

  12. Multimodel simulations of carbon monoxide: comparison with observations and projected near-future changes

    NARCIS (Netherlands)

    Shindell, D.T.; Krol, M.C.

    2006-01-01

    We analyze present-day and future carbon monoxide (CO) simulations in 26 state-ofthe- art atmospheric chemistry models run to study future air quality and climate change. In comparison with near-global satellite observations from the MOPITT instrument and local surface measurements, the models show

  13. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Science.gov (United States)

    Bintabara, Deogratius; Mpondo, Bonaventura C T

    2018-01-01

    Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary

  14. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Directory of Open Access Journals (Sweden)

    Deogratius Bintabara

    Full Text Available Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania.This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50% of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level.Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension.The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership

  15. Experimental and Theoretical Mechanistic Investigation of the Iridium-Catalyzed Dehydrogenative Decarbonylation of Primary Alcohols

    DEFF Research Database (Denmark)

    Olsen, Esben Paul Krogh; Singh, Thishana; Harris, Pernille

    2015-01-01

    The mechanism for the iridium-BINAP catalyzed dehydrogenative decarbonylation of primary alcohols with the liberation of molecular hydrogen and carbon monoxide was studied experimentally and computationally. The reaction takes place by tandem catalysis through two catalytic cycles involving...... cycles. One carbon monoxide ligand was shown to remain coordinated to iridium throughout the reaction, and release of carbon monoxide was suggested to occur from a dicarbonyl complex. IrH2Cl(CO)(rac-BINAP) was also synthesized and detected in the dehydrogenation of benzyl alcohol. In the same experiment......, IrHCl2(CO)(rac-BINAP) was detected from the release of HCl in the dehydrogenation and subsequent reaction with IrCl(CO)(rac-BINAP). This indicated a substitution of chloride with the alcohol to form a square planar iridium alkoxo complex that could undergo a beta-hydride elimination. A KIE of 1...

  16. Japan's Colonial Policies--From National Assimilation to the Kominka Movement: A Comparative Study of Primary Education in Taiwan and Korea (1937-1945)

    Science.gov (United States)

    Peng, Huan-Sheng; Chu, Jo-Ying

    2017-01-01

    The eight-year-long period from Japan's initiation of the Second Sino-Japanese War in 1937 to its unconditional surrender in 1945 forced Japan to invest its national economy and industrial and scientific technologies in the war. In addition, in the name of the Greater East Asia Co-Prosperity Sphere, Japan initiated its assimilation and Kominka…

  17. School performance from primary education in the adolescent offspring of parents with schizophrenia and bipolar disorder- a national, register-based study.

    Science.gov (United States)

    Ranning, Anne; Laursen, Thomas; Agerbo, Esben; Thorup, Anne; Hjorthøj, Carsten; Jepsen, Jens Richardt Møllegaard; Nordentoft, Merete

    2017-12-14

    Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents' severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment in offspring is still unclear. We included all children (N = 684.248) born and living in Denmark between 1986 and 1996 and their parents. Our follow-up lasted from 1986 until children's graduation in 2014. The main outcome variable was their school grades following their primary education. School outcomes were divided into four categories: not graduated, low-grade point average (GPA), medium GPA and high GPA. We then performed a multiple logistic regression with medium GPA as the reference category, with the children of parents without SZ or BP as the reference group. Children of parents with SZ faced higher odds than their peers of not graduating primary education (OR 2.6), along with low GPA (odds ratios (OR) 1.6) and lower odds for a high GPA (OR 0.7). Moreover, it was the children of mothers rather than fathers with BP who had higher odds of not graduating primary education (OR 1.6). Lastly, child placement was associated with lower grades and lower graduation rates, and outcomes for children of parents with SMI were favorable compared with other children placed in care. For children, parental SZ is associated with lower grades and lower chances for graduating primary education. In contrast, the children of parents with BP were indistinguishable from the reference group regarding school grades. This signifies that specificity of parental severe mental illness is important in relation to educational achievement of children.

  18. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana

    OpenAIRE

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-01-01

    Background In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universa...

  19. Carbon monoxide poisoning in Iran during 1999-2016: A systematic review and meta-analysis.

    Science.gov (United States)

    Hosseininejad, Seyed Mohammad; Aminiahidashti, Hamed; Goli Khatir, Iraj; Ghasempouri, Seyed Khosro; Jabbari, Ali; Khandashpour, Mahmoud

    2018-01-01

    Carbon monoxide (CO) poisoning is a common cause of emergency department (ED) visits worldwide with high levels of morbidity and mortality. No inclusive nationally statistics of CO poisoning in Iran is available. The present review aimed to describe and review the pattern of CO poisoning in Iran. The search of Medline, SCOPUS, Cochrane library, Google Scholar, Magiran, IranDoc and SID (Scientific Information Database) yielded only 10 studies discussing the epidemiology of CO poisoning in Iran. Outcomes of interest were determining the demographic characteristics, prevalence and mortality rates, annual trends, main sources and mechanisms, location of incidents of CO poisoning as well as providing the safety awareness and precautions. Totally, 10 studies including 6372 victims of CO poisoning were reviewed. The estimated incidence rate of CO poisoning was 38.91 per 100,000, the proportionate mortality rate was 11.6 per 1000 death and the pooled case fatality rate of was 9.5% (95% CI 6.3%-14.30%). Of the total 5105 individuals with CO poisoning, 2048 (40.12%) were male and 3057 (59.88%) were female. In addition, of 5105 poisoned, 4620 (90.50%) were alive and 485 (9.50%) were dead. The number of fatal CO poisoning cases among men and women were 259 (5.07%) and 226 (4.43%) victims, respectively; while the number of non-fatal CO poisoning cases among men and women were 1790 (35.06%) and 2830 (55.44%) individuals, respectively. The mean age of victims was about 30 years. Most of the victims (36.37%) had the educational level of secondary school, marital status of single (52.74%), and occupational status of housekeeper (27.48%). The incidence, proportionate mortality and case fatality rates of CO poisoning is high in Iran, particularly in young individuals. It seems that preventive strategies should be taught by health care providers more thoroughly and implemented by policy makers more strictly as a mandatory law. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and

  20. Hydrogen Oxidation on Gas Diffusion Electrodes for Phosphoric Acid Fuel Cells in the Presence of Carbon Monoxide and Oxygen

    DEFF Research Database (Denmark)

    Gang, Xiao; Li, Qingfeng; Hjuler, Hans Aage

    1995-01-01

    Hydrogen oxidation has been studied on a carbon-supported platinum gas diffusion electrode in a phosphoric acidelectrolyte in the presence of carbon monoxide and oxygen in the feed gas. The poisoning effect of carbon monoxide presentin the feed gas was measured in the temperature range from 80...... to 150°C. It was found that throughout the temperaturerange, the potential loss due to the CO poisoning can be reduced to a great extent by the injection of small amounts ofgaseous oxygen into the hydrogen gas containing carbon monoxide. By adding 5 volume percent (v/o) oxygen, an almost...

  1. Efficacy and safety of human papillomavirus vaccine for primary prevention of cervical cancer: A review of evidence from phase III trials and national programs

    Directory of Open Access Journals (Sweden)

    Partha Basu

    2013-01-01

    Full Text Available The Human Papillomavirus (HPV vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways - it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention programs. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of the clinical trial results convincingly and consistently proving their efficacy and safety. Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost-effective approach to reduce the burden of cervical cancer. The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries.

  2. Clustering of unhealthy lifestyle behaviours and associations with perceived and actual weight status among primary school children in China: A nationally representative cross-sectional study.

    Science.gov (United States)

    Zhang, Juan; Feng, Xiaoqi; Zhai, Yi; Li, Weirong; Lv, Yue-Bin; Astell-Burt, Thomas; Shi, Xiaoming

    2018-07-01

    Few studies have focused on clustering of unhealthy lifestyle behaviours among primary school children and potential associations with perceived and actual weight status. An index was constructed from adding up 13 unhealthy behaviours measured by survey responses. Multilevel linear regressions were used to analyse associations between child personal characteristics, perceived and actual weight status with the unhealthy lifestyle index among 11,157 children in primary schools across China. Parental and area factors were also taken into account, including education, weight status, physical activity, urban/rural and area socioeconomic circumstances. The unhealthy lifestyle index normally distributed, with 84.5% of children reporting between 2 and 6 unhealthy behaviours. Boys reported more unhealthy behaviours compared with girls (coefficient 0.32, 95%CI 0.26 to 0.37) and children in urban areas had fewer unhealthy behaviours than their rural counterparts (-0.29, 95%CI -0.56 to -0.03). An interaction revealed stronger 'protective' effects of living in cities for girls than boys, which were not explained by differences in child overweight/obesity. More unhealthy behaviours were characteristic of children in more affluent areas, and of those born to mothers and/or fathers with lower educational attainment. Children who perceived themselves as overweight or underweight both scored higher on the unhealthy lifestyle index. Unhealthy behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. There was no effect of actual weight status on number of unhealthy behaviours. Perceived, but not actual weight status, was also a significant correlate of unhealthy behaviours. Clustering of unhealthy lifestyle behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly

  3. The management of lactose intolerance among primary care physicians and its correlation with management by gastroenterologists: the SEPD-SEMG national survey

    Directory of Open Access Journals (Sweden)

    Federico Argüelles-Arias

    2015-09-01

    Full Text Available Introduction and aims: The understanding of lactose intolerance (LI is limited in some professional settings. Sociedad Española de Patología Digestiva (SEPD and Sociedad Española de Medicina General (SEMG have developed a survey in order to: a Analyze primary care physicians (PCPs knowledge and clinical management; and b to compare results with those of a previous survey of Spanish gastroenterologists (GEs. Material and methods: An online questionnaire was sent to SEMG members with 27 items on various issues: Demographics, occupational characteristics, outlook on LI, diagnostic tests, treatment, and follow-up. Results were compared to those from a survey of GEs. Results: A total of 456 PCPs responded, versus 477 GEs. PCPs had an older mean age and longer professional experience. Level of understanding of LI was similar, albeit a higher proportion of PCPs lacked epidemiological awareness (p 0.001, and LI symptoms as overlapping those of irritable bowel syndrome (93.5 vs. 88.2%; p = 0.005, although symptoms perceived as suspicious of LI were similar in both groups. Dietary recommendations were recognized as the primary therapeutic approach. Conclusion: This study reveals the outlook of PCPs on LI, and allows comparison with that of GEs, as a basis for the development of strategies aimed at improving LI understanding, approach and management in our setting.

  4. Management of the clinical issue of constipation with abdominal complaints in adults: a national survey of Primary Care physicians and gastroenterologists

    Directory of Open Access Journals (Sweden)

    Enrique Rey

    Full Text Available Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care. Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation and a response rate potentially biased by professional motivation.

  5. Primary care ... where?

    Science.gov (United States)

    Adcock, G B

    1999-07-01

    Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

  6. Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data.

    Science.gov (United States)

    Ashworth, Mark; White, Patrick; Jongsma, Hannah; Schofield, Peter; Armstrong, David

    2016-01-01

    Concerns about adverse effects on patient satisfaction may be an important obstacle to attempts to curtail antibiotic prescribing. To determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction. Retrospective cross-sectional study of general practices in England. Data were obtained from the General Practice Patient Survey (GPPS) in 2012 (2.7 million questionnaires in England; 982 999 responses; response rate 36%); the national Quality and Outcomes Framework dataset for England, 2011-2012 (8164 general practices); and general practice and demographic characteristics. Standardised measures of antibiotic prescribing volumes were obtained for each practice in England during 2012-2013, together with 12 other nationally available prescribing variables. The role of antibiotic prescribing volume was identified as a determinant of GPPS scores and adjusted for demographic and practice factors using multiple linear regression. The final dataset consisted of 7800 (95.5%) practices. A total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients. Antibiotic prescribing volume was a significant positive predictor of all 'doctor satisfaction' and 'practice satisfaction' scores in the GPPS, and was the strongest predictor of overall satisfaction out of 13 prescribing variables. A theoretical 25% reduction in antibiotic prescribing volume would be associated with 0.5-1.0% lower patient satisfaction scores, a drop of 3-6 centile points in national satisfaction ranking. Patients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction. © British Journal of General Practice 2016.

  7. National collegiate athletic association division and primary job title of athletic trainers and their job satisfaction or intention to leave athletic training.

    Science.gov (United States)

    Terranova, Aaron B; Henning, Jolene M

    2011-01-01

    Membership in the National Athletic Trainers' Association (NATA) has declined in recent years, generating much debate about professional commitment. To compare the contributing factors of job satisfaction and intention to leave athletic training of certified athletic trainers (ATs) employed in National Collegiate Athletic Association (NCAA) institutions. Cross-sectional study. A link to a Web-based questionnaire containing the Spector Job Satisfaction Survey (JSS) and an original Intention to Leave Survey (ITLS) was distributed by e-mail to 1003 certified members of the National Athletic Trainers' Association. A total of 191 certified members of the NATA employed in a college or university setting in a primarily clinical capacity; representing all NCAA divisions; and having the job title of head athletic trainer, associate/assistant athletic trainer, or graduate assistant/intern athletic trainer. We used separate 3 x 3 factorial analyses of variance to compare the mean scores of each JSS subscale and of the ITLS with NCAA division and job title. A stepwise multiple regression was used to determine the strength of the relationships between the JSS subscales and the ITLS. We found differences for job title in the subscales of Fringe Benefits (F(2182) = 7.82, P = .001 ) and Operating Conditions (F(2,182) = 12.01, P < .001). The JSS subscale Nature of Work was the'greatest indicator of intention to leave (β = -0.45). We found a strong negative correlation between various facets of job satisfaction and intention to leave athletic training. The NCAA division seemed to have no effect on an individual's job satisfaction or intention to leave the profession. In addition, only Fringe Benefits and Operating Conditions seemed to be affected by job title. The ATs had similar levels of job satisfaction regardless of NCAA division, and their job titles were not a major factor in job satisfaction.

  8. Chemical analysis of rainfall and throughfall in primary forest in the Tapajós National Forest, Belterra, Pará, Brazil

    Science.gov (United States)

    R.C. Oliveira Junior; M. Keller; J. F. da F. Ramos; T.P. Beldini; P.M Crill; P.B. de Camargo; J. van Haren

    2015-01-01

    The Tapajós National Forest (FLONA Tapajós) has 600,000 hectares of protected forest, and is situated 50 km south of the city of Santarém, Pará, Brazil, a port city of 250,000 inhabitants that is located at the confluence of the Tapajós and Amazon Rivers. There is a lot of farmland in the region, which offers many opportunities to study changes in land use. Selective...

  9. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study

    Directory of Open Access Journals (Sweden)

    Alexander Bischoff

    2016-05-01

    Full Text Available Background: In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO nursing school and make recommendations for other similar initiatives. Design: This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Results: Six themes emerged from the experiences that shaped the course of the project: 1 Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public–private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2 Communication was an important and often underrated factor for all types of development projects. 3 Managing the unknown and 4 managing expectations characterised the project inception. Almost all themes had to do with 5 handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6 the need to adjust to ever-changing targets. Conclusions: This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1 Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2 Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve

  10. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study.

    Science.gov (United States)

    Bischoff, Alexander

    2016-01-01

    In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO) nursing school and make recommendations for other similar initiatives. This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Six themes emerged from the experiences that shaped the course of the project: 1) Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public-private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2) Communication was an important and often underrated factor for all types of development projects. 3) Managing the unknown and 4) managing expectations characterised the project inception. Almost all themes had to do with 5) handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6) the need to adjust to ever-changing targets. This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1) Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2) Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve themselves; 3) Think flexibly and do not stubbornly

  11. Spatiotemporal analysis of particulate matter, sulfur dioxide and carbon monoxide concentrations over the city of Rio de Janeiro, Brazil

    Science.gov (United States)

    Zeri, Marcelo; Oliveira-Júnior, José Francisco; Lyra, Gustavo Bastos

    2011-09-01

    Time series of pollutants and weather variables measured at four sites in the city of Rio de Janeiro, Brazil, between 2002 and 2004, were used to characterize temporal and spatial relationships of air pollution. Concentrations of particulate matter (PM10), sulfur dioxide (SO2) and carbon monoxide (CO) were compared to national and international standards. The annual median concentration of PM10 was higher than the standard set by the World Health Organization (WHO) on all sites and the 24 h means exceeded the standards on several occasions on two sites. SO2 and CO did not exceed the limits, but the daily maximum of CO in one of the stations was 27% higher on weekends compared to weekdays, due to increased activity in a nearby Convention Center. Air temperature and vapor pressure deficit have both presented the highest correlations with pollutant's concentrations. The concentrations of SO2 and CO were not correlated between sites, suggesting that local sources are more important to those pollutants compared to PM10. The time series of pollutants and air temperature were decomposed in time and frequency by wavelet analysis. The results revealed that the common variability of air temperature and PM10 is dominated by temporal scales of 1-8 days, time scales that are associated with the passage of weather events, such as cold fronts.

  12. Using exhaled carbon monoxide and carboxyhemoglobin to evaluate the effectiveness of a chimney stove model in Peru.

    Science.gov (United States)

    Eppler, Adam R; Fitzgerald, Christopher; Dorner, Stephen C; Aguilar-Villalobos, Manuel; Rathbun, Stephen L; Adetona, Olorunfemi; Naeher, Luke P

    2013-01-01

    Measurement of biological indicators of physiological change may be useful in evaluating the effectiveness of stove models, which are intended to reduce indoor smoke exposure and potential health effects. We examined changes in exhaled carbon monoxide (CO), percentage carboxy-hemoglobin, and total hemoglobin in response to the installation of a chimney stove model by the Juntos National Program in Huayatan, Peru in 2008. Biomarkers were measured in a convenience sample comprising 35 women who met requirements for participation, and were measured before and three weeks after installation of a chimney stove. The relationships between exposure to indoor smoke and biomarker measurements were also analyzed using simple linear regression models. Exhaled CO reduced from 6.71 ppm (95% CI 5.84-7.71) to 3.14 ppm (95% CI 2.77-3.66) three weeks after stove installation (P < 0.001) while % COHb reduced from 1.76% (95% CI 1.62-1.91) to 1.18% (95% CI 1.12-1.25; P < 0.001). Changes in exhaled CO and % COHb from pre- to post-chimney stove installation were not correlated with corresponding changes in exposure to CO and PM2.5 even though the exposures also reduced after stove installation. Exhaled CO and % COHb both showed improvement with reduction in concentration after the installation of the chimney cook stoves, indicating a positive physiological response subsequent to the intervention.

  13. Monitoring biodiversity loss with primary species-occurrence data: toward national-level indicators for the 2010 target of the convention on biological diversity.

    Science.gov (United States)

    Soberón, Jorge; Peterson, A Townsend

    2009-02-01

    Development of effective indicators is indispensable for countries and societies to monitor effects of their actions on biodiversity, as is recognized in decision VI/26 of the Convention on Biological Diversity. Good indicators would ideally be scalable, at least for the different scales that characterize biodiversity patterns and process. Existing indicators are mostly global in scope, and often based on secondary information, such as classifications of endangered species, rather than on primary data. We propose a complementary approach, based on the increased availability of raw data about occurrences of species, cutting-edge modeling techniques for estimating distributional areas, and land-use information based on remotely sensed data to allow estimation of rates of range loss for species affected by land-use conversion. This method can be implemented by developing countries, given increasing availability of data and the open and well-documented nature of the techniques required.

  14. Municipal Management, Infrastructure And Perception Of Users: A Description Of National Program For Improving Access And Quality Of Primary Care In The Brazilian Semiarid

    Directory of Open Access Journals (Sweden)

    Marília Gomes de Sousa Bezerra

    2017-09-01

    Full Text Available Introduction: The Ministry of Health with the aim of improving the service provided by the Unified Health System has been creating work tools to identify which points need to receive more attention to be optimized. Objective: Description of the role of municipal management, infrastructure assessment and perception of users of primary care. Method: Cross-sectional and descriptive study, conducted with Basic Units of Piauí municipality in 2015. The data were represented by tables. Results: 90% of the units reported receiving support for the planning and organization of the work process. Only 14, 81% of the units have equipment and supplies for proper operation. Users recommend the service in 92,62% of the cases. Conclusion: despite the precarious structure of the basic units of the county, the population still recognizes them as the best care.

  15. How do primary care doctors in England and Wales code and manage people with chronic kidney disease? Results from the National Chronic Kidney Disease Audit.

    Science.gov (United States)

    Kim, Lois G; Cleary, Faye; Wheeler, David C; Caplin, Ben; Nitsch, Dorothea; Hull, Sally A

    2017-10-16

    In the UK, primary care records are electronic and require doctors to ascribe disease codes to direct care plans and facilitate safe prescribing. We investigated factors associated with coding of chronic kidney disease (CKD) in patients with reduced kidney function and the impact this has on patient management. We identified patients meeting biochemical criteria for CKD (two estimated glomerular filtration rates 90 days apart) from 1039 general practitioner (GP) practices in a UK audit. Clustered logistic regression was used to identify factors associated with coding for CKD and improvement in coding as a result of the audit process. We investigated the relationship between coding and five interventions recommended for CKD: achieving blood pressure targets, proteinuria testing, statin prescription and flu and pneumococcal vaccination. Of 256 000 patients with biochemical CKD, 30% did not have a GP CKD code. Males, older patients, those with more severe CKD, diabetes or hypertension or those prescribed statins were more likely to have a CKD code. Among those with continued biochemical CKD following audit, these same characteristics increased the odds of improved coding. Patients without any kidney diagnosis were less likely to receive optimal care than those coded for CKD [e.g. odds ratio for meeting blood pressure target 0.78 (95% confidence interval 0.76-0.79)]. Older age, male sex, diabetes and hypertension are associated with coding for those with biochemical CKD. CKD coding is associated with receiving key primary care interventions recommended for CKD. Increased efforts to incentivize CKD coding may improve outcomes for CKD patients. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  16. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jianhua Wu

    Full Text Available Guidelines indicate eligibility for lipid lowering drugs, but it is not known to what extent GPs' follow guidelines in routine clinical practice or whether additional clinical factors systematically influence their prescribing decisions.A retrospective cohort analysis was undertaken using electronic primary care records from 421 UK general practices. At baseline (May 2008 patients were aged 30 to 74 years, free from cardiovascular disease and not taking lipid lowering drugs. The outcome was prescription of a lipid lowering drug within the next two years. The proportions of eligible and ineligible patients prescribed lipid lowering drugs were reported and multivariable logistic regression models were used to investigate associations between age, sex, cardiovascular risk factors and prescribing.Of 365,718 patients with complete data, 13.8% (50,558 were prescribed lipid lowering drugs: 28.5% (21,101/74,137 of those eligible and 10.1% (29,457/291,581 of those ineligible. Only 41.7% (21,101/50,558 of those prescribed lipid lowering drugs were eligible. In multivariable analysis prescribing was most strongly associated with increasing age (OR for age ≥ 65 years 4.21; 95% CI 4.05-4.39; diabetes (OR 4.49; 95% CI 4.35-4.64; total cholesterol level ≥ 7 mmol/L (OR 2.20; 95% CI 2.12-2.29; and ≥ 4 blood pressure measurements in the past year (OR 4.24; 95% CI 4.06-4.42. The predictors were similar in eligible and ineligible patients.Most lipid lowering drugs for primary prevention are prescribed to ineligible patients. There is underuse of lipid lowering drugs in eligible patients.

  17. Measuring Quality of Healthcare Outcomes in Type 2 Diabetes from Routine Data: a Seven-nation Survey Conducted by the IMIA Primary Health Care Working Group.

    Science.gov (United States)

    Hinton, W; Liyanage, H; McGovern, A; Liaw, S-T; Kuziemsky, C; Munro, N; de Lusignan, S

    2017-08-01

    Background: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. Objective: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets. Method: We conducted a survey to assess healthcare outcomes data quality of existing databases and disseminated this through professional networks. We examined the data sources used to collect the data, frequency of data uploads, and data types used for identifying people with T2DM. We compared data completeness across the six areas of healthcare quality, using selected measures pertinent to T2DM management. Results: We received 14 responses from seven countries (Australia, Canada, Italy, the Netherlands, Norway, Portugal, Turkey and the UK). Most databases reported frequent data uploads and would be capable of near real time analysis of healthcare quality.The majority of recorded data related to safety (particularly medication adverse events) and treatment efficacy (glycaemic control and microvascular disease). Data potentially measuring equity was less well recorded. Recording levels were lowest for patient-centred care, timeliness of care, and system efficiency, with the majority of databases containing no data in these areas. Databases using primary care sources had higher data quality across all areas measured. Conclusion: Data quality could be improved particularly in the areas of patient-centred care, timeliness, and efficiency. Primary care derived datasets may be most suited to healthcare quality assessment. Georg Thieme Verlag KG Stuttgart.

  18. Acute Compartment Syndrome Which Causes Rhabdomyolysis by Carbon Monoxide Poisoning and Sciatic Nerve Injury Associated with It: A Case Report.

    Science.gov (United States)

    Ji, Jung-Woo

    2017-09-01

    Rhabdomyolysis is most frequently caused by soft tissue injury with trauma to the extremities. Non-traumatic rhabdomyolysis may be caused by alcohol or drug abuse, infection, collagen disease, or intensive exercise, but incidence is low. In particular, rhabdomyolysis resulting from carbon monoxide poisoning is especially rare. If caught before death, carbon monoxide poisoning has been shown to cause severe muscle necrosis and severe muscle damage leading to acute renal failure. In cases of carbon-monoxide-induced rhabdomyolsis leading to acute compartment syndrome in the buttocks and sciatic nerve injury are rare. We have experience treating patients with acute compartment syndrome due to rhabdomyolysis following carbon monoxide poisoning. We report the characteristic features of muscle necrosis observed during a decompression operation and magnetic resonance imaging findings with a one-year follow-up in addition to a review of the literature.

  19. Toxicity of carbon monoxide hydrogen cyanide gas mixtures : exposure concentration, time to incapacitation, carboxyhemoglobin and blood cyanide parameters.

    Science.gov (United States)

    1994-04-01

    During aircraft interior fires, carbon monoxide (CO) and hydrogen cyanide (HCN) are produced in sufficient amounts to cause incapacitation and death. Time-to-incapacitation (ti) is a practical parameter for estimating escape time in fire environments...

  20. Fetal brain damage following maternal carbon monoxide intoxication: an experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Ginsberg, M D; Myers, R E

    1974-01-01

    Techniques of fetal monitoring, including fetal blood sampling in utero, were employed to study the physiological effects of acute maternal carbon monoxide intoxication on nine term-pregnant female rhesus monkeys exposed to 0.1 to 0.3% inspired carbon monoxide over 1 to 3 hr. The mothers tolerated carboxyhemoglobin levels exceeding 60% without clinical sequelae, whereas the fetuses promptly developed profound hypoxia upon exposure of the mothers to CO. The fetal COHb levels rose only gradually over 1 to 3 hr, and thus contributed only slightly to the development of early fetal hypoxia. The fetal hypoxia was associated with bradycardia, hypotension, and metabolic and respiratory acidosis. Severity of intrauterine hypoxia was closely correlated with the appearance of brain damage. Brain swelling associated with hemorrhagic necrosis of the cerebral hemispheres (severe brain damage) appeared only in fetuses whose arterial oxygen content was reduced below 1.0 ml/100 ml for at least 45 min during the maternal CO intoxication.

  1. Vibrationally Excited Carbon Monoxide Produced via a Chemical Reaction Between Carbon Vapor and Oxygen

    Science.gov (United States)

    Jans, Elijah R.; Eckert, Zakari; Frederickson, Kraig; Rich, Bill; Adamovich, Igor V.

    2017-06-01

    Measurements of the vibrational distribution function of carbon monoxide produced via a reaction between carbon vapor and molecular oxygen has shown a total population inversion on vibrational levels 4-7. Carbon vapor, produced using an arc discharge to sublimate graphite, is mixed with an argon oxygen flow. The excited carbon monoxide is vibrationally populated up to level v=14, at low temperatures, T=400-450 K, in a collision-dominated environment, 15-20 Torr, with total population inversions between v=4-7. The average vibrational energy per CO molecule formed by the reaction is 0.6-1.2 eV/molecule, which corresponds to 10-20% of the reaction enthalpy. Kinetic modeling of the flow reactor, including state specific vibrational processes, was performed to infer the vibrational distribution of the products of the reaction. The results show viability of developing of a new chemical CO laser from the reaction of carbon vapor and oxygen.

  2. Exposure to carbon monoxide, respirable suspended particulates, and volatile organic compounds while commuting by bicycle

    International Nuclear Information System (INIS)

    Bevan, M.A.J.; Proctor, C.J.; Baker-Rogers, J.; Warren, N.D.

    1991-01-01

    A portable air sampling system has been used to assess exposures to various substances while commuting by bicycle in an urban area. The major source of pollutants in this situation is motor vehicle exhaust emissions. Carbon monoxide, measured by electrochemical detection, was found at peak concentrations in excess of 62 ppm, with mean values over 16 individual 35-mm journeys being 10.5 ppm. Respirable suspended particulates, averaged over each journey period, were found at higher concentrations (mean 130 μg m -3 ) than would be expected in indoor situations. Mean exposure to benzene (at 56 μg m -3 ) and other aromatic volatile organic compounds was also relatively high. The influence of wind conditions on exposure was found to be significant. Commuting exposures to carbon monoxide, respirable suspended particulates, and aromatic VOCs were found to be higher than exposures in a busy high street and on common parkland

  3. Experimental study on surface wrinkling of silicon monoxide film on compliant substrate under thermally induced loads

    Science.gov (United States)

    Li, Chuanwei; Kong, Yingxiao; Jiang, Wenchong; Wang, Zhiyong; Li, Linan; Wang, Shibin

    2017-06-01

    The wrinkling of a silicon monoxide thin film on a compliant poly(dimethylsiloxane) (PDMS) substrate structure was experimentally investigated in this study. The self-expansion effect of PDMS during film deposition was utilized to impose a pretensile strain on the structure through a specially made fixture. A laser scanning confocal microscope (LSCM) system with an in situ heating stage was employed for the real-time measurement. The Young’s modulus of the silicon monoxide thin film as well as the PDMS substrate was measured on the basis of the elasticity theory. Moreover, the effects of temperature variations on geometric parameters in the postbuckling state, such as wavelength and amplitude, were analyzed. It was proved that wavelength is relatively immune to thermal loads, while amplitude is much more sensitive.

  4. Supply Ventilation and Prevention of Carbon Monoxide (II) Ingress into Building Premises

    Science.gov (United States)

    Litvinova, N. A.

    2017-11-01

    The article contains the relationships of carbon monoxide (II) concentration versus height-above-ground near buildings derived based on results of studies. The results of studies are crucial in preventing external pollutants ingress into a ventilation system. Being generated by external emission sources, such as motor vehicles and city heating plants, carbon monoxide (II) enters the premises during operation of a supply ventilation system. Fresh air nomographic charts were drawn to select the height of a fresh air intake into the ventilation system. Nomographic charts take into account external sources. The selected emission sources are located at various levels above ground relative to the building. The recommendations allow designing supply ventilation taking into account the quality of ambient air through the whole building height.

  5. Unique case of fatal carbon monoxide poisoning in the absence of a combustible fossil fuel.

    Science.gov (United States)

    Morgan, D R; Poon, P; Titley, J; Jagger, S F; Rutty, G N

    2001-09-01

    A 37-year-old man died as a result of exposure to carbon monoxide within an apartment. An investigation of the apartment showed no gas appliances or gas supply to the apartment and no evidence of any combustion event to any part of the apartment or roof space. Inhalation of dichloromethane was excluded. Heating to the apartment was found to be via an electrical storage heater, the examination of which revealed that the cast-iron core and insulating material showed evidence of heat damage with significant areas devoid of carbon. This electric storage heater is hypothesized to be the source of carbon for the fatal production of carbon monoxide within the apartment.

  6. Range measurements of keV hydrogen ions in solid oxygen and carbon monoxide

    International Nuclear Information System (INIS)

    Schou, J.; Soerensen, H.; Andersen, H.H.; Nielsen, M.; Rune, J.

    1984-01-01

    Ranges of 1.3-3.5 keV/atom hydrogen and deuterium molecular ions have been measured by a thin-film reflection method. The technique, used here for range measurements in solid oxygen and carbon monoxide targets, is identical to the one used previously for range measurements in hydrogen and nitrogen. The main aim was to look for phase-effects, i.e. gas-solid differences in the stopping processes. While measured ranges in solid oxygen were in agreement with known gas data, the ranges in solid carbon monoxide were up to 50% larger than those calculated from gas-stopping data. The latter result agrees with that previously found for solid nitrogen. (orig.)

  7. Theoretical studies on the catalytic oxidation of carbon monoxide on nickel clusters

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, A.K.; Kojima, I.; Miyazaki, E.

    1986-01-01

    Complete neglect of differential overlap (CNDO) molecular orbital calculations using the method of Anno and Sakai for the evaluation of the valence orbital ionization potential (VOIP) were performed with the aim of studying the oxidation of carbon monoxide on nickel clusters. A cluster surface was assumed to be preadsorbed with oxygen and the variation of various bond energies with the approach of a carbon monoxide molecule was studied for different models. Various possibilities for the reaction path are discussed in the light of the theoretical findings and it is suggested that at a low coverage of oxygen the reaction may follow a Langmuir-Hinshelwood path, whereas at a high coverage, an Eley-Rideal path might be more probable. 55 references, 13 figures.

  8. Hyperbaric oxygen for carbon monoxide poisoning : a systematic review and critical analysis of the evidence.

    Science.gov (United States)

    Buckley, Nicholas A; Isbister, Geoffrey K; Stokes, Barrie; Juurlink, David N

    2005-01-01

    Poisoning with carbon monoxide (CO) is an important cause of unintentional and intentional injury worldwide. Hyperbaric oxygen (HBO) enhances CO elimination and has been postulated to reduce the incidence of neurological sequelae. These observations have led some clinicians to use HBO for selected patients with CO poisoning, although there is considerable variability in clinical practice. This article assesses the effectiveness of HBO compared with normobaric oxygen (NBO) for the prevention of neurological sequelae in patients with acute CO poisoning. The following databases were searched: MEDLINE (1966 to present), EMBASE (1980 to present), and the Controlled Trials Register of the Cochrane Collaboration, supplemented by a manual review of bibliographies of identified articles and discussion with recognised content experts. All randomised controlled trials involving people acutely poisoned with CO, regardless of severity, were examined. The primary analysis included all trials from which data could be extracted. Sensitivity analysis examined trials with better validity (defined using the validated instrument of Jadad) and those enrolling more severely poisoned patients. Two reviewers independently extracted from each trial, including information on the number of randomised patients, types of participants, the dose and duration of the intervention, and the prevalence of neurological sequelae at follow-up. A pooled odds ratio (OR) for the presence of neurological symptoms at 1-month follow-up was calculated using a random effects model. Bayesian models were also investigated to illustrate the degree of certainty about clinical effectiveness. Eight randomised controlled trials were identified. Two had no evaluable data and were excluded. The remaining trials were of varying quality and two have been published only as abstracts. The severity of CO poisoning varied among trials. At 1-month follow-up after treatment, sequelae possibly related to CO poisoning were

  9. Patient satisfaction with primary health care - a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana

    DEFF Research Database (Denmark)

    Fenny, Ama Pokuah; Enemark, Ulrika; Asante, Felix A

    2014-01-01

    Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative...... system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand...... for health services, but have been quiet on supply side issues. The main aim of this study is to examine the overall satisfaction with health care among the insured and uninsured under the NHIS. The second aim is to explore the relations between overall satisfaction and socio-demographic characteristics...

  10. In-hospital mortality, 30-day readmission, and length of hospital stay after surgery for primary colorectal cancer: A national population-based study.

    Science.gov (United States)

    Pucciarelli, S; Zorzi, M; Gennaro, N; Gagliardi, G; Restivo, A; Saugo, M; Barina, A; Rugge, M; Zuin, M; Maretto, I; Nitti, D

    2017-07-01

    The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included. The adjusted odd ratios for risk factors for in-hospital mortality, 30-day readmission, and LOS were calculated using multilevel multivariable logistic regression. Among the 353 941 patients, rates of in-hospital mortality and 30-day readmission were 2.5% and 6%, respectively, and the median LOS was 13 days. High comorbidity, emergent/urgent admission, male gender, creation of a stoma, and an open approach increased the risks of all the outcomes at multivariable analysis. Age, hospital volume, hospital geographic location, and discharge to home/non-home produced different effects depending on the outcome considered. The most frequent causes of readmission were infection (19%) and bowel obstruction (14.6%). We assessed national averages for mortality, LOS and readmission and related trends over a 10-year time. Laparoscopic surgery was the only one that could be modified by improving surgical education. Higher hospital volume was associated with a LOS reduction, but our findings only partially support a policy of centralization for colorectal cancer procedures. Surgical site infection was identified as the most preventable cause of readmission. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  11. New Class of Hybrid Materials for Detection, Capture, and "On-Demand" Release of Carbon Monoxide.

    Science.gov (United States)

    Pitto-Barry, Anaïs; Lupan, Alexandru; Ellingford, Christopher; Attia, Amr A A; Barry, Nicolas P E

    2018-04-25

    Carbon monoxide (CO) is both a substance hazardous to health and a side product of a number of industrial processes, such as methanol steam reforming and large-scale oxidation reactions. The separation of CO from nitrogen (N 2 ) in industrial processes is considered to be difficult because of the similarities of their electronic structures, sizes, and physicochemical properties (e.g., boiling points). Carbon monoxide is also a major poison in fuel cells because of its adsorption onto the active sites of the catalysts. It is therefore of the utmost economic importance to discover new materials that enable effective CO capture and release under mild conditions. However, methods to specifically absorb and easily release CO in the presence of contaminants, such as water, nitrogen, carbon dioxide, and oxygen, at ambient temperature are not available. Here, we report the simple and versatile fabrication of a new class of hybrid materials that allows capture and release of carbon monoxide under mild conditions. We found that carborane-containing metal complexes encapsulated in networks made of poly(dimethylsiloxane) react with CO, even when immersed in water, leading to dramatic color and infrared signature changes. Furthermore, we found that the CO can be easily released from the materials by simply dipping the networks into an organic solvent for less than 1 min, at ambient temperature and pressure, which not only offers a straightforward recycling method, but also a new method for the "on-demand" release of carbon monoxide. We illustrated the utilization of the on-demand release of CO from the networks by carrying out a carbonylation reaction on an electron-deficient metal complex that led to the formation of the CO-adduct, with concomitant recycling of the gel. We anticipate that our sponge-like materials and scalable methodology will open up new avenues for the storage, transport, and controlled release of CO, the silent killer and a major industrial poison.

  12. Influence of solvent on the infared spectrum of carbon monoxide adsorbed on platinum electrodes

    OpenAIRE

    Feltovich, Susanne D.

    1993-01-01

    The behavior of adsorbed carbon monoxide on platinum was studied using potential difference infrared spectroscopy. Three solvents and three electrolytes were chosen, and data gathered at both high and low adsorbate coverages. The rate of change of IR peak position with applied potential, the Stark tuning rate, was used as an indicator of the local electric field strength at the interface. It was determined that neither solvated cation size nor bulk dielectric constant accoun...

  13. IR Laser Ablation of Silicon Monoxide in Gaseous Methanol and Hydrocarbons: Deposition of Polyoxocarbosilane

    Czech Academy of Sciences Publication Activity Database

    Dřínek, Vladislav; Bastl, Zdeněk; Šubrt, Jan; Pola, Josef

    2004-01-01

    Roč. 71, č. 2 (2004), s. 431-444 ISSN 0165-2370 R&D Projects: GA ČR GA203/00/1288 Institutional research plan: CEZ:AV0Z4072921; CEZ:AV0Z4032918; CEZ:AV0Z4040901 Keywords : silicon monoxide * reactive laser ablation * polyoxocarbosilane coatings Subject RIV: CH - Nuclear ; Quantum Chemistry Impact factor: 1.352, year: 2004

  14. Carbon monoxide poisoning in children riding in the back of pickup trucks.

    Science.gov (United States)

    Hampson, N B; Norkool, D M

    OBJECTIVE - To describe the case characteristics of a series of children poisoned with carbon monoxide while traveling in the back of pickup trucks. DESIGN - Pediatric cases referred for treatment of carbon monoxide poisoning with hyperbaric oxygen between 1986 and 1991 were reviewed. Those cases that occurred during travel in the back of pickup trucks were selected. Clinical follow-up by telephone interview ranged from 2 to 55 months. SETTING - A private, urban, tertiary care center in Seattle, Wash. PATIENTS - Twenty children ranging from 4 to 16 years of age. INTERVENTION - All patients were treated with hyperbaric oxygen. MAIN OUTCOME MEASURES - Characteristics of the poisoning incident and clinical patient outcome. RESULTS - Of 68 pediatric patients treated for accidental carbon monoxide poisoning, 20 cases occurred as children rode in the back of pickup trucks. In 17 of these, the children were riding under a rigid closed canopy on the rear of the truck, while three episodes occurred as children rode beneath a tarpaulin. Average carboxyhemoglobin level on emergency department presentation was 18.2% +/- 2.4% (mean +/- SEM; range, 1.6% to 37.0%). Loss of consciousness occurred in 15 of the 20 children. One child died of cerebral edema, one had permanent neurologic deficits, and 18 had no recognizable sequelae related to the episode. In all cases, the truck exhaust system had a previously known leak or a tail pipe that exited at the rear rather than at the side of the pickup truck. CONCLUSIONS - Carbon monoxide poisoning is a significant hazard for children who ride in the back of pickup trucks. If possible, this practice should be avoided.

  15. Intra-pulse Cavity Enhanced Measurements of Carbon Monoxide in a Rapid Compression Machine

    KAUST Repository

    Nasir, Ehson Fawad

    2018-05-07

    A laser absorption sensor for carbon monoxide concentration was developed for combustion studies in a rapid compression machine using a pulsed quantum cascade laser near 4.89 μm. Cavity enhancement reduced minimum detection limit down to 2.4 ppm at combustion relevant conditions. Off-axis alignment and rapid intra-pulse down-chirp resulted in effective suppression of cavity noise.

  16. Relation of Hydrogen and Methane to Carbon Monoxide in Exhaust Gases from Internal-Combustion Engines

    Science.gov (United States)

    Gerrish, Harold C; Tessmann, Arthur M

    1935-01-01

    The relation of hydrogen and methane to carbon monoxide in the exhaust gases from internal-combustion engines operating on standard-grade aviation gasoline, fighting-grade aviation gasoline, hydrogenated safety fuel, laboratory diesel fuel, and auto diesel fuel was determined by analysis of the exhaust gases. Two liquid-cooled single-cylinder spark-ignition, one 9-cylinder radial air-cooled spark-ignition, and two liquid-cooled single-cylinder compression-ignition engines were used.

  17. Multiple Victims of Carbon Monoxide Poisoning in the Aftermath of a Wildfire: A Case Series

    Directory of Open Access Journals (Sweden)

    Luís Ramos dos Santos

    2018-03-01

    Conclusion: Use of hyperbaric oxygen appears to have reduced the incidence of the syndrome. This seems to be the first Portuguese series reporting use of hyperbaric oxygen in carbon monoxide poisoning due to wildfires. The authors intend to alert to the importance of referral of these patients because the indications and benefits of this treatment are well documented. This is especially important given the ever-growing issue of wildfires in Portugal.

  18. The indigenous Sea Gypsy divers of Thailand's west coast: measurement of carbon monoxide in the breathing air.

    Science.gov (United States)

    Gold, D; Geater, A; Aiyarak, S; Juengpraert, W

    1999-07-01

    Approximately 400 indigenous divers live and work on Thailand's west coast. They dive with surface supplied air from primitive compressor units mounted on open boats which measure from seven to 11 meters in length. It was suspected that carbon monoxide was present in the breathing air of at least the gasoline-driven compressor units. To determine the presence of carbon monoxide gas in the breathing air, compressed air from the compressor was pumped through the diver air supply hose through a plenum (monitoring) chamber established on the boat. After a compressor warm-up of 15 minutes, the diving air was measured with the boat at eight different bearings to the wind, each 45 degrees apart at intervals of five minutes. Three of the four gasoline-driven compressor units tested showed presence of carbon monoxide in the breathing air. One diesel-driven unit showed a very low concentration of carbon monoxide (3-4 ppm) and six diesel-driven units showed no detectable carbon monoxide. Although not tested, diesel exhaust emissions could also enter the breathing air by the same route. A locally made modification to the compressor air intake was designed and successfully tested on one gasoline-driven compressor unit. An information sheet on the hazards of carbon monoxide as well as on the modification has been developed for distribution among the villages.

  19. Life in Hot Carbon Monoxide: The Complete Genome Sequence of Carboxydothermus hydrogenoformans Z-2901.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available We report here the sequencing and analysis of the genome of the thermophilic bacterium Carboxydothermus hydrogenoformans Z-2901. This species is a model for studies of hydrogenogens, which are diverse bacteria and archaea that grow anaerobically utilizing carbon monoxide (CO as their sole carbon source and water as an electron acceptor, producing carbon dioxide and hydrogen as waste products. Organisms that make use of CO do so through carbon monoxide dehydrogenase complexes. Remarkably, analysis of the genome of C. hydrogenoformans reveals the presence of at least five highly differentiated anaerobic carbon monoxide dehydrogenase complexes, which may in part explain how this species is able to grow so much more rapidly on CO than many other species. Analysis of the genome also has provided many general insights into the metabolism of this organism which should make it easier to use it as a source of biologically produced hydrogen gas. One surprising finding is the presence of many genes previously found only in sporulating species in the Firmicutes Phylum. Although this species is also a Firmicutes, it was not known to sporulate previously. Here we show that it does sporulate and because it is missing many of the genes involved in sporulation in other species, this organism may serve as a "minimal" model for sporulation studies. In addition, using phylogenetic profile analysis, we have identified many uncharacterized gene families found in all known sporulating Firmicutes, but not in any non-sporulating bacteria, including a sigma factor not known to be involved in sporulation previously.

  20. Life in hot carbon monoxide: the complete genome sequence of Carboxydothermus hydrogenoformans Z-2901.

    Directory of Open Access Journals (Sweden)

    Martin Wu

    2005-11-01

    Full Text Available We report here the sequencing and analysis of the genome of the thermophilic bacterium Carboxydothermus hydrogenoformans Z-2901. This species is a model for studies of hydrogenogens, which are diverse bacteria and archaea that grow anaerobically utilizing carbon monoxide (CO as their sole carbon source and water as an electron acceptor, producing carbon dioxide and hydrogen as waste products. Organisms that make use of CO do so through carbon monoxide dehydrogenase complexes. Remarkably, analysis of the genome of C. hydrogenoformans reveals the presence of at least five highly differentiated anaerobic carbon monoxide dehydrogenase complexes, which may in part explain how this species is able to grow so much more rapidly on CO than many other species. Analysis of the genome also has provided many general insights into the metabolism of this organism which should make it easier to use it as a source of biologically produced hydrogen gas. One surprising finding is the presence of many genes previously found only in sporulating species in the Firmicutes Phylum. Although this species is also a Firmicutes, it was not known to sporulate previously. Here we show that it does sporulate and because it is missing many of the genes involved in sporulation in other species, this organism may serve as a "minimal" model for sporulation studies. In addition, using phylogenetic profile analysis, we have identified many uncharacterized gene families found in all known sporulating Firmicutes, but not in any non-sporulating bacteria, including a sigma factor not known to be involved in sporulation previously.