National CrossTalk. Volume 17, Number 2

Science.gov (United States)

Trombley, William, Ed.

2009-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

National CrossTalk. Volume 18, Number 2

Science.gov (United States)

National Center for Public Policy and Higher Education, 2010

2010-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

Satellite NO2 data improve national land use regression models for ambient NO2 in a small densely populated country

NARCIS (Netherlands)

Hoek, G.; Eeftens, M.; Beelen, R.; Fischer, P.; Brunekreef, B.; Boersma, K.F.; Veefkind, P.

2015-01-01

Land use regression (LUR) modelling has increasingly been applied to model fine scale spatial variation of outdoor air pollutants including nitrogen dioxide (NO2). Satellite observations of tropospheric NO2 improved LUR model in very large study areas, including Canada, United States and Australia.

Satellite NO2 data improve national land use regression models for ambient NO2 in a small densely populated country

NARCIS (Netherlands)

Hoek, Gerard; Eeftens, Marloes; Beelen, Rob; Fischer, Paul; Brunekreef, Bert; Boersma, K. Folkert; Veefkind, Pepijn

Land use regression (LUR) modelling has increasingly been applied to model fine scale spatial variation of outdoor air pollutants including nitrogen dioxide (NO2). Satellite observations of tropospheric NO2 improved LUR model in very large study areas, including Canada, United States and Australia.

75 FR 1566 - National Industrial Security Program Directive No. 1

Science.gov (United States)

2010-01-12

... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information Security Oversight Office 32 CFR Part 2004 [NARA-09-0005] RIN 3095-AB34 National Industrial Security Program Directive No. 1 AGENCY... the National Industrial Security Program Directive No. 1. This correction assigns a Federal Docket...

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

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.…

National CrossTalk. Volume 14, Number 2, Spring 2006

Science.gov (United States)

Trombley, William, Ed.

2006-01-01

The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher education issues. This issue contains the following articles: (1) "Effectiveness and Efficiency": The University System of Maryland's Campaign to Control Costs and Increase Student Aid (Kay Mills); (2) Remote Access: Western…

Journal of Community Medicine and Primary Health Care - Vol 23 ...

African Journals Online (AJOL)

Journal of Community Medicine and Primary Health Care - Vol 23, No 1-2 (2011) ... The Nigerian National Health Bill 2011: Delay of Presidential Assent to an Act: ... Knowledge And Practice of Occupational Safety Among Quarry Workers in A ...

Coronary artery ectasia, an independent predictor of no-reflow after primary PCI for ST-elevation myocardial infarction.

Science.gov (United States)

Schram, H C F; Hemradj, V V; Hermanides, R S; Kedhi, E; Ottervanger, J P

2018-04-25

The no-reflow phenomenon is a serious complication after primary percutaneous coronary intervention (PCI) for ST-elevation Myocardial Infarction (STEMI). Coronary artery ectasia (CAE) may increase the risk of no-reflow, however, only limited data is available on the potential impact of CAE. The aim of this study was to determine the potential association between CAE and no-reflow after primary PCI. A case control study was performed based on a prospective cohort of STEMI patients from January 2000 to December 2011. All patients with TIMI 0-1 flow post primary PCI, in the absence of dissection, thrombus, spasm or high-grade residual stenosis, were considered as no-reflow case. Control subjects were two consecutive STEMI patients after each case, with TIMI flow ≥2 after primary PCI. CAE was defined as dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal coronary artery. In the no-reflow group, frequency of CAE was significantly higher (33.8% vs 3.9%, p PCI (91% vs 71% p = 0.03), less often anterior STEMI (3% vs 37%, p PCI with stenting (47% vs 74%, p = 0.003). After multivariate analysis, CAE remained a strong and independent predictor of no-reflow (OR 13.9, CI 4.7-41.2, p PCI for STEMI. Future studies should assess optimal treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

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…

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

National Geoscience Data Repository System: Phase 2 final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-07-01

The American Geological Institute (AGI) has completed Phase 2 of a project to establish a National Geoscience Data Repository System (NGDRS). The project`s primary objectives are to preserve geoscience data in jeopardy of being destroyed and to make that data available to those who have a need to use it in future investigations. These data are available for donation to the public as a result of the downsizing that has occurred in the major petroleum and mining companies in the US for the past decade. In recent years, these companies have consolidated domestic operations, sold many of their domestic properties and relinquished many of their leases. The scientific data associated with those properties are no longer considered to be useful assets and are consequently in danger of being lost forever. The national repository project will make many of these data available to the geoscience community for the first time. Phase 2 encompasses the establishment of standards for indexing and cataloging of geoscience data and determination of the costs of transferring data from the private sector to public-sector data repositories. Pilot projects evaluated the feasibility of the project for transfer of different data types and creation of a Web-based metadata supercatalog and browser. Also as part of the project, a national directory of geoscience data repositories was compiled to assess what data are currently available in existing facilities. The next step, Phase 3, will focus on the initiation of transfer of geoscience data from the private sector to the public domain and development of the web-based Geotrek metadata supercatalog.

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.

National Atomic Energy Commission. Decree No. 1540, August 30 1994

International Nuclear Information System (INIS)

1994-01-01

One of the objectives of the reorganization process of Argentina's public sector was to transfer to the private sector some of the Nation's productive activities, including those concerning the nuclear field. As a consequence, by Decree No. 1540 of August 30, 1994, (B.O. 2-Dec-94), CNEA's functions were partially reorganized. According to Decree No. 1540, the National Atomic Energy Commission (CNEA) maintained the missions and functions established by Decree-Law No. 22.498/56, with the exception of the regulation and surveillance of nuclear activities and the nuclear power generation activities. For the fulfillment of these activities, both the National Board of Nuclear Regulation (Ente Nacional Regulador Nuclear - ENREN) and Nucleoelectrica Argentina S.A. (NASA), were created. The National Board of Nuclear Regulation (ENREN), as an autarchical entity reporting to the Presidency of the Nation, shall be administered by a Board of Directors and shall be responsible for surveying and controlling all nuclear activities, shall suggest regulations and standards to ensure radiological and nuclear safety, personal protection, a controlled use of nuclear materials, licensing and surveillance of nuclear installations, and compliance with international safeguards. Nucleoelectrica Argentina S.A. (NASA) shall be organised as a corporation, reporting to the Ministry of Economy and Public Works and Services (Ministerio de Economia y Obras y Servicios Publicos) who will approve its statures. NASA shall take care of nuclear power generation at the Atucha I and Embalse nuclear power plants, as well as the construction, start-up and operation of the Atucha II nuclear power plant. As far as royalties are concerned, the Decree obliges Nucleoelectrica Argentina S.A. to pay CNEA for the performance of research and development activities, and to the ENREN an yearly regulatory tax per megawatt of installed nuclear power generation capacity. Also, Nucleoelectrica Argentina S.A. is declared

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....

Secondary organic aerosol formation from primary aliphatic amines with NO3 radical

Science.gov (United States)

Malloy, Q. G. J.; Qi, Li; Warren, B.; Cocker, D. R., III; Erupe, M. E.; Silva, P. J.

2009-03-01

Primary aliphatic amines are an important class of nitrogen containing compounds emitted from automobiles, waste treatment facilities and agricultural animal operations. A series of experiments conducted at the UC-Riverside/CE-CERT Environmental Chamber is presented in which oxidation of methylamine, ethylamine, propylamine, and butylamine with O3 and NO3 have been investigated. Very little aerosol formation is observed in the presence of O3 only. However, after addition of NO, and by extension NO3, large aerosol mass yields (~44% for butylamine) are seen. Aerosol generated was determined to be organic in nature due to the small fraction of NO and NO2 in the total signal (tested) as detected by an aerosol mass spectrometer (AMS). We propose a reaction mechanism between carbonyl containing species and the parent amine leading to formation of particulate imine products. These findings can have significant impacts on rural communities with elevated nighttime PM loadings, when significant levels of NO3 exist.

Secondary organic aerosol formation from primary aliphatic amines with NO3 radical

Directory of Open Access Journals (Sweden)

P. J. Silva

2009-03-01

Full Text Available Primary aliphatic amines are an important class of nitrogen containing compounds emitted from automobiles, waste treatment facilities and agricultural animal operations. A series of experiments conducted at the UC-Riverside/CE-CERT Environmental Chamber is presented in which oxidation of methylamine, ethylamine, propylamine, and butylamine with O3 and NO3 have been investigated. Very little aerosol formation is observed in the presence of O3 only. However, after addition of NO, and by extension NO3, large aerosol mass yields (~44% for butylamine are seen. Aerosol generated was determined to be organic in nature due to the small fraction of NO and NO2 in the total signal (<1% for all amines tested as detected by an aerosol mass spectrometer (AMS. We propose a reaction mechanism between carbonyl containing species and the parent amine leading to formation of particulate imine products. These findings can have significant impacts on rural communities with elevated nighttime PM loadings, when significant levels of NO3 exist.

Examination of failed studs from No. 2 steam generator at the Maine Yankee Nuclear Power Station

International Nuclear Information System (INIS)

Czajkowski, C.

1983-02-01

Three studs removed from service on the primary manway cover from steam generator No. 2 of the Maine Yankee station were sent to Brookhaven National Laboratory (BNL) for examination. The examination consisted of visual/dye penetrant examination, optical metallography and Scanning Electron Microscopy/Energy Dispersive Spectroscopy (SEM/EDS) evaluation. One bolt was through cracked and its fracture face was generally transgranular in nature with numerous secondary intergranular cracks. The report concludes that the environmenally assisted cracking of the stud was due to the interaction of the various lubricants used with steam leaks associated with this manway cover

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

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...

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.

The rate coefficient for the reaction NO2 + NO3 yielding NO + NO2 + O2 from 273 to 313 K

Science.gov (United States)

Cantrell, Chris A.; Shetter, Richard E.; Mcdaniel, Anthony H.; Calvert, Jack G.

1990-01-01

The ratio of rate constants for the reaction NO3 + NO yielding 2 NO2 (k3) and the reaction NO2 + NO3 yielding NO + NO2 + O2 (k4) were determined by measuring of NO and NO2 concentrations of NO and NO2 in an N2O5/NO2/N2 mixture over the temperature range 273-313 K. The measured ratio was found to be expressed by the equation k3/k4 = 387 exp(-1375/T). The results are consistent with those of Hammer et al. (1986).

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…

LBA-ECO CD-10 CO2 and H2O Eddy Flux Data at km 67 Tower Site, Tapajos National Forest

Data.gov (United States)

National Aeronautics and Space Administration — This data set reports eddy flux measurements of CO2 and H2O exchange and associated meteorological measurements at the Para Western (Santarem) - km 67, Primary...

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…

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.

OMI NO2 in the Central US Great Plains: How Well Do We Interpret NO2 Trends?

Science.gov (United States)

Kollonige, D. E.; Duncan, B. N.; Thompson, A. M.; Lamsal, L. N.

2017-12-01

Several areas over the Central US show statistically significant increases in OMI NO2 levels of 10-30% in the last 10 years versus the generally decreasing trends over most of CONUS. Are these changes in OMI NO2 a result of human activity, meteorology, or a combination of both? To answer this, we examine regions in the Central US Great Plains that have multiple plausible sources for the observed trends, considering impacts of land surface changes, agriculture growth, oil and gas operations, and drought conditions. We find that changes to the land surface appear to contribute to some of the observed anomalies due to tree removal in the Black Hills National Forest, South Dakota, and additional livestock farming in the Sandhills of Nebraska. However, increasing OMI NO2 also corresponds to several areas with growing agriculture business (ex. South Dakota and Nebraska) and oil and gas activity (ex. Williston Basin in North Dakota and Permian Basin in TX). To understand the relationship between the observed NO2 variability and the regional meteorological conditions over the last decade, we analyze the time series and correlations between OMI NO2, NH3 (an agriculture tracer), surface temperature, normalized difference vegetation index (NDVI) from Landsat, and the Palmer Drought Severity Index (PDSI). In 2012, drought conditions affect NO2, NH3 and NDVI observations across the Central US. Areas where dryland farming and livestock grazing are predominant (Central SD, ND, KS, and NE) are less sensitive to drought and changes in temperature. This suggests positive OMI NO2 trends are caused by increased production in wheats and livestock in the Northern Great Plains. These study regions in the Central US, impacted by local emissions and meteorology, are valuable for evaluating future trend analyses including the continuation of OMI-type NO2 retrievals from the TROPOMI and TEMPO satellite instruments.

Analysis on concentration variety characteristics of SO2/NO2 in Chengdu city, southwest China

Science.gov (United States)

Wang, C.; Xiao, T.; Luo, Q.; WU, L.

2017-12-01

SO2 and NO2, the important gaseous precursors of atmospheric fine particles, are closely related to urban air quality. Chengdu located in the western China, is the capital city of Sichuan province. Though Sichuan province is one of four heavily polluted areas in China, the air pollution research in Chengdu is in a relative lack, when compared to developed cities as Beijing, Guangzhou, etc. This paper, based on characteristics of SO2 and NO2 in Chengdu, shows that: the average concentration of SO2, NO2 was 25.29 (mainly in the rage 10-40 ), 64.41 (mainly in the range 30-80 ), respectively. There is a similar annual and seasonal variation for them, yet significant differences in diurnal variation. Except summer, the air condition in Chengdu is seriously affected by SO2 and NO2, while the latter plays a more significant role. Multiple regression has good fitting performance to the diurnal variation in Chengdu. The purification efficiency of precipitation in different magnitude is also discussed. Key words: Chengdu; Pollution gas; Variety characteristics Acknowledgements: This study was supported by Pollution program in Wenjiang District, National Natural Science Foundation of China Fund Project (91337215,41575066), National Science and Technology Support Program(2015BAC03B05),Special Fund for Meteorological Re-search in the Public Interest (GYHY201406015),National Key Basic Research Program (2013CB733206), and Risk Assessment System of Significant Climate Events in Tibet (14H046), Scientific Research Foundation of CUIT (CRF201606)

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.

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.

Phase 2 safety analysis report: National Synchrotron Light Source

International Nuclear Information System (INIS)

Stefan, P.

1989-06-01

The Phase II program was established in order to provide additional space for experiments, and also staging and equipment storage areas. It also provides additional office space and new types of advanced instrumentation for users. This document will deal with the new safety issues resulting from this extensive expansion program, and should be used as a supplement to BNL Report No. 51584 ''National Synchrotron Light Source Safety Analysis Report,'' July 1982 (hereafter referred to as the Phase I SAR). The initial NSLS facility is described in the Phase I SAR. It comprises two electron storage rings, an injection system common to both, experimental beam lines and equipment, and office and support areas, all of which are housed in a 74,000 sq. ft. building. The X-ray Ring provides for 28 primary beam ports and the VUV Ring, 16. Each port is capable of division into 2 or 3 separate beam lines. All ports receive their synchrotron light from conventional bending magnet sources, the magnets being part of the storage ring lattice. 4 refs

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,…

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.

Hydrogen treatment system in the Genkai nuclear power plant No. 2

International Nuclear Information System (INIS)

Nakamura, Masayuki; Kodama, Hideo; Murashima, Masayasu

1977-01-01

The new hydrogen treatment system which injects hydrogen into the volume control tank for purging the mixed waste gas of Kr, Xe, etc. is adopted in the Genkai nuclear power plant No. 2. The system is composed of mainly the waste gas pretreatment equipment, a palladium alloy membrane type hydrogen separator, a hydrogen compressor, and a waste gas decay tank. The outline of the primary cooling system and the chemical volume control system of PWR, the hydrogen treatment system, and the gaseous waste disposal system of original and new types for the Genkai nuclear power plants No. 1 and 2 are explained in this paper. This newly added hydrogen treatment system will be able to reduce the rare gas concentration rate in the primary coolant to about 1/2 and 1/5 for Kr 85 and Xe 133 , respectively. (auth.)

Hard Lessons: Primary Schools, Community, and Social Capital in Nigeria. World Bank Technical Paper No. 420. Africa Region Series.

Science.gov (United States)

Francis, Paul A.

This study, based on data from a 1997 survey of 54 Nigerian primary schools and their client communities, was commissioned in order to assist the National Primary Education Commission (NPEC) in improving primary education services. Stakeholders consulted included parents, pupils, teachers and head teachers, community leaders, educational…

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

National CrossTalk. Volume 13, Number 2, Spring 2005

Science.gov (United States)

Trombley, William, Ed.

2005-01-01

The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher education issues. This issue contains the following articles: (1) CUNY [City University of New York] Sheds Reputation as "Tutor U": The Nation's Largest Urban University Raises Standards, and Grapples with Remediation (Jon…

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

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

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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.

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

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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.

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

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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

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…

Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

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Suh Beomseok

2012-11-01

Full Text Available Abstract Background While knowledge and risk perception have been associated with screening for second primary cancer (SPC, there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected is associated with subsequent completion of all appropriate SPC screening in cancer survivors. Methods Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. Results Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33, after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. Conclusions The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

Healthcare is primary

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Raman Kumar

2015-01-01

Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

Science.gov (United States)

2017-08-18

Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

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.

Emissions of NO, NO2 and PM from inland shipping

Directory of Open Access Journals (Sweden)

R. Kurtenbach

2016-11-01

Full Text Available Particulate matter (PM and nitrogen oxides NOx (NOx =  NO2+ NO are key species for urban air quality in Europe and are emitted by mobile sources. According to European recommendations, a significant fraction of road freight should be shifted to waterborne transport in the future. In order to better consider this emission change pattern in future emission inventories, in the present study inland water transport emissions of NOx, CO2 and PM were investigated under real world conditions on the river Rhine, Germany, in 2013. An average NO2 ∕ NOx emission ratio of 0.08 ± 0.02 was obtained, which is indicative of ship diesel engines without exhaust gas aftertreatment systems. For all measured motor ship types and operation conditions, overall weighted average emission indices (EIs, as emitted mass of pollutant per kg burnt fuel of EINOx =  54 ± 4 g kg−1 and a lower limit EIPM1 ≥  2.0 ± 0.3 g kg−1, were obtained. EIs for NOx and PM1 were found to be in the range of 20–161 and  ≥  0.2–8.1 g kg−1 respectively. A comparison with threshold values of national German guidelines shows that the NOx emissions of all investigated motor ship types are above the threshold values, while the obtained lower limit PM1 emissions are just under. To reduce NOx emissions to acceptable values, implementation of exhaust gas aftertreatment systems is recommended.

The National Map 2.0 Tactical Plan: "Toward the (Integrated) National Map"

Science.gov (United States)

Zulick, Carl A.

2008-01-01

The National Map's 2-year goal, as described in this plan, is to provide a range of geospatial products and services that meet the basic goals of the original vision for The National Map while furthering the National Spatial Data Infrastructure that underpins U.S. Geological Survey (USGS) science. To accomplish this goal, the National Geospatial Program (NGP) will acquire, store, maintain, and distribute base map data. The management team for the NGP sets priorities for The National Map in three areas: Data and Products, Services, and Management. Priorities for fiscal years 2008 and 2009 (October 1, 2007 through September 30, 2009), involving the current data inventory, data acquisition, and the integration of data, are (1) incorporating current data from Federal, State, and local organizations into The National Map to the degree possible, given data availability and program resources; (2) collaborating with other USGS programs to incorporate data that support the USGS Science Strategy; (3) supporting the Department of the Interior (DOI) high-priority geospatial information needs; (4) emergency response; (5) homeland security, natural hazards; and (6) graphics products delivery. The management team identified known constraints, enablers, and drivers for the acquisition and integration of data. The NGP management team also identified customer-focused products and services of The National Map. Ongoing planning and management activities direct the development and delivery of these products and services. Management of work flow processes to support The National Map priorities are identified and established through a business-driven prioritization process. This tactical plan is primarily for use as a document to guide The National Map program for the next two fiscal years. The document is available to the public because of widespread interest in The National Map. The USGS collaborates with a broad range of customers and partners who are essential to the success of The

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

Rate of generation of tritium during the operation of Tsuruga Power Station Unit No. 2

International Nuclear Information System (INIS)

Funamoto, Hisao; Yoshinari, Masaharu; Fukuda, Masayuki; Makino, Shinichi; Watari, Tuneo

1994-01-01

Total amount of 3 H activity in primary coolant due to the operation of Tsuruga Power Station Unit No. 2 was estimated. The 3 H inventory was measured for samples from the spent fuel pool, primary coolant and miscellaneous tanks. From the result of the measurement and the data of environmental release of 3 H, the rate of generation of 3 H in the reactor was found to be 25 TBq/GWa. Since Tsuruga Power Station Unit No. 2 is a PWR type reactor, we presume that most of the 3 H in primary coolant is formed by 10 B(n, 2α) 3 H reaction. It is necessary to release about 23 TBq/GWa of 3 H to maintain the station inventory at the present level. (author)

Roles of free radicals in NO oxidation by Fenton system and the enhancement on NO oxidation and H2O2 utilization efficiency.

Science.gov (United States)

Zhao, Haiqian; Dong, Ming; Wang, Zhonghua; Wang, Huaiyuan; Qi, Hanbing

2018-06-20

Low H 2 O 2 utilization efficiency is the main problem when Fenton system was used to oxidize NO in flue gas. To understand the behavior of the free radicals during NO oxidation process in Fenton system is crucial to solving this problem. The oxidation capacity of ·OH and HO 2 · on NO in Fenton system was compared and the useless consumption path of ·OH and HO 2 · that caused the low utilization efficiency of H 2 O 2 were studied. A method to enhance the oxidation ability and H 2 O 2 utilization efficiency by adding reducing additives in Fenton system was proposed. The results showed that both of ·OH and HO 2 · were active substances that oxidize NO. However, the oxidation ability of ·OH radicals was stronger. The vast majority of ·OH and HO 2 · was consumed by rapid reaction ·OH+HO 2 ·→H 2 O+O 2 , which was the primary reason for the low utilization efficiency of H 2 O 2 in Fenton system. Hydroxylamine hydrochloride and ascorbic acid could accelerate the conversion of Fe 3+ to Fe 2+ , thereby increase the generation rate of ·OH and decrease the generation rate of HO 2 ·. As a result, the oxidation ability and H 2 O 2 utilization efficiency were enhanced.

Impact of NO2 Profile Shape in OMI Tropospheric NO2 Retrievals

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Lamsal, Lok; Krotkov, Nickolay A.; Pickering, K.; Schwartz, W. H.; Celarier, E. A.; Bucsela, E. J.; Gleason, J. F.; Philip, S.; Nowlan, C.; Martin, R. V.;

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

Electric vehicles, primary energy sources and CO2 emissions: Romanian case study

International Nuclear Information System (INIS)

Varga, Bogdan Ovidiu

2013-01-01

Starting on the 24th of April, 2011, the Romanian government offered to subsidize all potential buyers of electric vehicles, both private and corporate, offering 25% off of the retail price up to 5000 euros with no pollution tax. The Romanian government encourages all governmental institutions to consider buying electric vehicles when deciding to change their existing vehicles stock. This decision is strictly related to the Romanian government's approval of a long-term Energy Strategy, building on the National Energy Strategy for the Medium Term. The government's strategy emphasizes increasing energy efficiency and boosting renewable energy use. The first electric vehicles distributed in the Romanian market are the Citroen-C-Zero, the Mitsubishi i-MiEV, the Renault Kangoo Z.E. and the Renault Fluence Z.E. The energy consumption of these vehicles was analyzed, considering the CO 2 generation characteristics of a Romanian electric power plant. -- Highlights: ► Tax and governmental support for electrical vehicles in Romania. ► Evaluate the CO 2 pollution of the electrical vehicles in Romania's case. ► Comprehensive understanding of the influence of primary energy source over the pollution of an electrical vehicle. ► Approach to decrees the pollution of the electrical vehicles.

Metformin regulates glycemic homeostasis in patients with type 2 diabetes mellitus as an NO donor

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Ivan Sergeevich Kuznetsov

2013-11-01

Full Text Available Aim. To evaluate the influence of metformin on nitric oxide bioavailability in patients with type 2 diabetes mellitus (T2DM regarding glycemic homeostasis, and to investigate a correlation between metformin dosage and NO levels in vivo. Materials and Methods. Two groups ? primary and control ? were assembled for the clinical section of this study. Patients with newly diagnosed T2DM on metformin therapy were included to the primary group, while drug-naive T2DM patients were enrolled as control subjects. Glycemic parameters and NO bioavailability was tested in both groups prior to and after the follow-up period. Experimental section was dedicated to the elucidation of potential dose-dependent effects of metformin on NO bioavailability. Mice were intraperitoneally infused with metformin at 0.5; 1.1; 5.6 mg per subject. Tissue detection of NO was performed with diethyldithiocarbamate (DETC iron complexes to form mononitrosyl iron compounds (MIC with paramagnetic properties. Control rodents were intraperitoneally infused with metformin without spin trapping. Results. We found nitrite and methaemoglobin (a marker for NO bioavailability to increase in parallel along with glycemic compensation in the primary but not control group. In vivo rodent models showed linear correlation between accumulation of DETC/MIC and dose of metformin, as well as formation of dinitrosyl iron complexes, known as endogenous NO transporters. Conclusion. Our data suggests that metformin benefits glycemic homeostasis in T2DM as an NO donor via formation of dinitrosyl iron complexes.

LBA-ECO CD-10 H2O Profiles at km 67 Tower Site, Tapajos National Forest

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National Aeronautics and Space Administration — This data set contains a single text file which reports vertical profiles of H2O vapor concentrations measured at the Para Western (Santarem) - km 67, Primary Forest...

Primary Science Education in China

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Pook, Gayle

2013-01-01

Consider the extent to which primary science teaching has evolved since it became a core subject in England with the introduction of the National Curriculum in 1988, and the pace at which theory-driven classroom practice has advanced. It is no wonder that, given the recent economic restructuring and boom in technological development in China,…

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.

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.

Integrated primary health care in Australia

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Gawaine Powell Davies

2009-10-01

Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Integrated primary health care in Australia.

Science.gov (United States)

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

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.

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...

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

Oak Ridge National Laboratory Review: Volume 24, No. 2, 1991

Energy Technology Data Exchange (ETDEWEB)

Krause, C. (ed.)

1991-01-01

The Oak Ridge National Laboratory (ORNL) is a multiprogram, multipurpose laboratory that conducts research in the physical, chemical, and life sciences; in fusion, fission, and fossil energy; and in energy conservation and other energy-related technologies. This review outlines some current endeavors of the lab. A state of the laboratory presentation is given by director, Alvin Trivelpiece. Research of single crystals for welding is described. The Science Alliance, a partnership between ORNL and the University of Tennessee, is chronicled. And several incites into distinguished personnel at the laboratory are given. (GHH)

Oak Ridge National Laboratory Review: Volume 24, No. 2, 1991

Energy Technology Data Exchange (ETDEWEB)

Krause, C. [ed.

1991-12-31

The Oak Ridge National Laboratory (ORNL) is a multiprogram, multipurpose laboratory that conducts research in the physical, chemical, and life sciences; in fusion, fission, and fossil energy; and in energy conservation and other energy-related technologies. This review outlines some current endeavors of the lab. A state of the laboratory presentation is given by director, Alvin Trivelpiece. Research of single crystals for welding is described. The Science Alliance, a partnership between ORNL and the University of Tennessee, is chronicled. And several incites into distinguished personnel at the laboratory are given. (GHH)

The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI) Registry.

Science.gov (United States)

Peiyuan, He; Jingang, Yang; Haiyan, Xu; Xiaojin, Gao; Ying, Xian; Yuan, Wu; Wei, Li; Yang, Wang; Xinran, Tang; Ruohua, Yan; Chen, Jin; Lei, Song; Xuan, Zhang; Rui, Fu; Yunqing, Ye; Qiuting, Dong; Hui, Sun; Xinxin, Yan; Runlin, Gao; Yuejin, Yang

2016-01-01

Only a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI) patients (≥ 75 years old). Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population. Based on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared. The primary endpoint was defined as death. Secondary endpoints included recurrent myocardial infarction, ischemia driven revascularization, myocardial infarction related complications, and major bleeding. Multivariable regression analysis was performed to adjust for the baseline disparities between the groups. Patients who had primary percutaneous coronary intervention (PCI) or fibrinolysis were relatively younger. They came to hospital earlier, and had lower risk of death compared with patients who had no reperfusion. The guideline recommended medications were more frequently used in patients with primary PCI during the hospitalization and at discharge. The rates of death were 7.7%, 15.0%, and 19.9% respectively, with primary PCI, fibrinolysis, and no reperfusion (P PCI also had lower rates of heart failure, mechanical complications, and cardiac arrest compared with fibrinolysis and no reperfusion (P PCI, fibrinolysis, and no reperfusion group (P > 0.05). In the multivariable regression analysis, primary PCI outweighs no reperfusion in predicting the in-hospital death in patients ≥ 75 years old. However, fibrinolysis does not. Early reperfusion, especially primary PCI was safe and effective with absolute reduction of mortality compared with no reperfusion. However, certain randomized trials were encouraged to support the conclusion.

Green primary explosives: 5-nitrotetrazolato-N2-ferrate hierarchies.

Science.gov (United States)

Huynh, My Hang V; Coburn, Michael D; Meyer, Thomas J; Wetzler, Modi

2006-07-05

The sensitive explosives used in initiating devices like primers and detonators are called primary explosives. Successful detonations of secondary explosives are accomplished by suitable sources of initiation energy that is transmitted directly from the primaries or through secondary explosive boosters. Reliable initiating mechanisms are available in numerous forms of primers and detonators depending upon the nature of the secondary explosives. The technology of initiation devices used for military and civilian purposes continues to expand owing to variations in initiating method, chemical composition, quantity, sensitivity, explosive performance, and other necessary built-in mechanisms. Although the most widely used primaries contain toxic lead azide and lead styphnate, mixtures of thermally unstable primaries, like diazodinitrophenol and tetracene, or poisonous agents, like antimony sulfide and barium nitrate, are also used. Novel environmentally friendly primary explosives are expanded here to include cat[Fe(II)(NT)(3)(H(2)O)(3)], cat(2)[Fe(II)(NT)(4)(H(2)O)(2)], cat(3)[Fe(II)(NT)(5)(H(2)O)], and cat(4)[Fe(II)(NT)(6)] with cat = cation and NT(-) = 5-nitrotetrazolato-N(2). With available alkaline, alkaline earth, and organic cations as partners, four series of 5-nitrotetrazolato-N(2)-ferrate hierarchies have been prepared that provide a plethora of green primaries with diverse initiating sensitivity and explosive performance. They hold great promise for replacing not only toxic lead primaries but also thermally unstable primaries and poisonous agents. Strategies are also described for the systematic preparation of coordination complex green primaries based on appropriate selection of ligands, metals, and synthetic procedures. These strategies allow for maximum versatility in initiating sensitivity and explosive performance while retaining properties required for green primaries.

NO2 inhalation promotes Alzheimer’s disease-like progression: cyclooxygenase-2-derived prostaglandin E2 modulation and monoacylglycerol lipase inhibition-targeted medication

Science.gov (United States)

Yan, Wei; Yun, Yang; Ku, Tingting; Li, Guangke; Sang, Nan

2016-03-01

Air pollution has been reported to be associated with increased risks of cognitive impairment and neurodegenerative diseases. Because NO2 is a typical primary air pollutant and an important contributor to secondary aerosols, NO2-induced neuronal functional abnormalities have attracted greater attention, but the available experimental evidence, modulating mechanisms, and targeting medications remain ambiguous. In this study, we exposed C57BL/6J and APP/PS1 mice to dynamic NO2 inhalation and found for the first time that NO2 inhalation caused deterioration of spatial learning and memory, aggravated amyloid β42 (Aβ42) accumulation, and promoted pathological abnormalities and cognitive defects related to Alzheimer’s disease (AD). The microarray and bioinformation data showed that the cyclooxygenase-2 (COX-2)-mediated arachidonic acid (AA) metabolism of prostaglandin E2 (PGE2) played a key role in modulating this aggravation. Furthermore, increasing endocannabinoid 2-arachidonoylglycerol (2-AG) by inhibiting monoacylglycerol lipase (MAGL) prevented PGE2 production, neuroinflammation-associated Aβ42 accumulation, and neurodegeneration, indicating a therapeutic target for relieving cognitive impairment caused by NO2 exposure.

CO_2 emission trends of China's primary aluminum industry: A scenario analysis using system dynamics model

International Nuclear Information System (INIS)

Li, Qiang; Zhang, Wenjuan; Li, Huiquan; He, Peng

2017-01-01

China announced its promise on CO_2 emission peak. When and what level of CO_2 emission peak China's primary aluminum industry will reach is in suspense. In this paper, a system dynamic model is established, with five subsystems of economy development, primary aluminum production, secondary aluminum production, CO_2 emission intensity and policies making involved. The model is applied to examine potential CO_2 emission trends of China's primary aluminum industry in next fifteen years with three scenarios of “no new policies”, “13th five-year plan” and “additional policies”. Simulation results imply that: merely relying on rapid expansion of domestic scarps recycling and reuse could not mitigate CO_2 emission continuously. Combination of energy-saving technology application and electrolytic technology innovation, as well as promoting hydropower utilization in primary aluminum industry are necessary for long term low-carbon development. From a global prospective, enhancing international cooperation on new primary aluminum capacity construction in other countries, especially with rich low-carbon energy, could bring about essential CO_2 emission for both China's and global primary aluminum industry. - Highlights: • A system dynamic model is established for future CO_2 emission trend of China's primary aluminum industry. • Three potential policy scenarios are simulated. • The impacts of potential policies implication on the CO_2 emission trend are discussed.

Ship-based MAX-DOAS measurements of tropospheric NO2, SO2, and HCHO distribution along the Yangtze River

Science.gov (United States)

Hong, Qianqian; Liu, Cheng; Chan, Ka Lok; Hu, Qihou; Xie, Zhouqing; Liu, Haoran; Si, Fuqi; Liu, Jianguo

2018-04-01

In this paper, we present ship-based Multi-Axis Differential Optical Absorption Spectroscopy (MAX-DOAS) measurements of tropospheric trace gases' distribution along the Yangtze River during winter 2015. The measurements were performed along the Yangtze River between Shanghai and Wuhan, covering major industrial areas in eastern China. Tropospheric vertical column densities (VCDs) of nitrogen dioxide (NO2), sulfur dioxide (SO2), and formaldehyde (HCHO) were retrieved using the air mass factor calculated by the radiative transfer model. Enhanced tropospheric NO2 and SO2 VCDs were detected over downwind areas of industrial zones over the Yangtze River. In addition, spatial distributions of atmospheric pollutants are strongly affected by meteorological conditions; i.e., positive correlations were found between concentration of pollutants and wind speed over these areas, indicating strong influence of transportation of pollutants from high-emission upwind areas along the Yangtze River. Comparison of tropospheric NO2 VCDs between ship-based MAX-DOAS and Ozone Monitoring Instrument (OMI) satellite observations shows good agreement with each other, with a Pearson correlation coefficient (R) of 0.82. In this study, the NO2 / SO2 ratio was used to estimate the relative contributions of industrial sources and vehicle emissions to ambient NO2 levels. Analysis results of the NO2 / SO2 ratio show a higher contribution of industrial NO2 emissions in Jiangsu Province, while NO2 levels in Jiangxi and Hubei provinces are mainly related to vehicle emissions. These results indicate that different pollution control strategies should be applied in different provinces. In addition, multiple linear regression analysis of ambient carbon monoxide (CO) and odd oxygen (Ox) indicated that the primary emission and secondary formation of HCHO contribute 54.4 ± 3.7 % and 39.3 ± 4.3 % to the ambient HCHO, respectively. The largest contribution from primary emissions in winter suggested that

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.

Nitrogen uptake by wheat seedlings, interactive effects of four nitrogen sources: NO3-, NO2-, NH4+, and urea

Science.gov (United States)

Criddle, R. S.; Ward, M. R.; Huffaker, R. C.

1988-01-01

The net influx (uptake) rates of NO3-, NH4+, NO2-, and urea into roots of wheat (Triticum aestivum cv Yecora Rojo) seedlings from complete nutrient solutions containing all four compounds were monitored simultaneously. Although urea uptake was too slow to monitor, its presence had major inhibitory effects on the uptake of each of the other compounds. Rates of NO3-, NH4+, and NO2- uptake depended in a complex fashion on the concentration of all four N compounds. Equations were developed which describe the uptake rates of each of the compounds, and of total N, as functions of concentrations of all N sources. Contour plots of the results show the interactions over the range of concentrations employed. The coefficients of these equations provide quantitative values for evaluating primary and interactive effects of each compound on N uptake.

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

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…

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...

Association between postgraduate year 2 residency program characteristics and primary project publication.

Science.gov (United States)

Swanson, Joseph M; Shafeeq, Hira; Hammond, Drayton A; Li, Chenghui; Devlin, John W

2018-03-15

The association among residency program and research mentor characteristics, program director perceptions, and the publication of the primary research project for postgraduate year 2 (PGY2) graduates was assessed. Using a validated electronic survey, residency program directors (RPDs) of critical care PGY2 graduates were asked about primary research project publication success, program and research project mentor characteristics, and RPDs' perceptions surrounding project completion. All 55 RPDs surveyed responded; 44 (79%) reported being a research project mentor. PGY2 research project publications in 2011 and 2012 totaled 26 (37%) and 27 (35%), respectively. A significant relationship existed between research project publication and the number of residents in the program ( p project publication is important to their employer ( p projects versus no publications included the number of graduates in the PGY2 program (odds ratio [OR], 5.6; p project publication (OR, 10.2; p project versus no research projects was also independently associated with the RPD's perception that the employer valued research project publication (OR, 5.1; p = 0.04). A survey of RPDs of critical care PGY2 residents found that the number of PGY2 residents, the number of publications by the least experienced research mentor, and the perception that publishing the residents' research projects is important to the employer were independently associated with publication rates of residency research projects. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Experiment data report for semiscale Mod-2A primary feed and bleed experiment series (Tests S-SR-1 and S-SR-2)

International Nuclear Information System (INIS)

Fogdall, S.P.

1982-10-01

This report presents test data recorded for Tests S-SR-1 and S-SR-2 of the Semiscale Mod-2A Primary Feed and Bleed Tests. These tests are part of a series of Semiscale tests that investigate the thermal-hydraulic phenomena resulting from a hypothesized loss-of-coolant accident (LOCA) or abnormal operating transient. These tests provide experimental data for assessing the analytical capability of computer codes used in LOCA and operational transient analysis. The primary objectives of Tests S-SR-1 and -2 were to provide data on primary system recovery through the use of primary feed and bleed cooling, with no heat transfer to the secondaries. Data was obtained using high- and low-head pump curves for the safety injection (SI) pumps. This report presents the uninterpreted data from Tests S-SR-1 and -2 for analysis. The data, presented as graphs in engineering units, have been analyzed only to the extent necessary to ensure that they are reasonable and consistent

Patient satisfaction with primary health-care services in Kuwait.

Science.gov (United States)

Alotaibi, Muhammad; Alazemi, Talal; Alazemi, Fahad; Bakir, Yusif

2015-06-01

The study aims to evaluate patient satisfaction with respect to primary health-care services in Kuwait.A total of 245 patients completed the General Practice Assessment Questionnaire postconsultation version 2.0. Two statistically significant differences of patients' satisfaction with sex and level of education were found. Overall satisfaction was higher among men than women (P = 0.002), and it was also higher among those with university degree of education than the other levels of education (P = 0.049). We also found statistically significant differences of patients' responses over sex for three themes, namely: satisfaction with receptionists, satisfaction with access and satisfaction with communication; and over the age for one theme: satisfaction with access. There was no statistically significant differences of patients' responses over nationality for all themes. Satisfaction is a multifactorial and no one factor alone could provide satisfaction with primary health services in Kuwait. © 2014 Wiley Publishing Asia Pty Ltd.

The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI Registry.

Directory of Open Access Journals (Sweden)

He Peiyuan

Full Text Available Only a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI patients (≥ 75 years old. Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population.Based on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared. The primary endpoint was defined as death. Secondary endpoints included recurrent myocardial infarction, ischemia driven revascularization, myocardial infarction related complications, and major bleeding. Multivariable regression analysis was performed to adjust for the baseline disparities between the groups.Patients who had primary percutaneous coronary intervention (PCI or fibrinolysis were relatively younger. They came to hospital earlier, and had lower risk of death compared with patients who had no reperfusion. The guideline recommended medications were more frequently used in patients with primary PCI during the hospitalization and at discharge. The rates of death were 7.7%, 15.0%, and 19.9% respectively, with primary PCI, fibrinolysis, and no reperfusion (P 0.05. In the multivariable regression analysis, primary PCI outweighs no reperfusion in predicting the in-hospital death in patients ≥ 75 years old. However, fibrinolysis does not.Early reperfusion, especially primary PCI was safe and effective with absolute reduction of mortality compared with no reperfusion. However, certain randomized trials were encouraged to support the conclusion.

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

National competent authorities. List no. 2. Regulations for the safe transport of radioactive materials. 1967 edition (Safety series no. 6)

International Nuclear Information System (INIS)

1968-08-01

Any national or international authority designated or otherwise recognised as such for any purpose in connection with the transport Regulations is known as a competent authority. In the Member States such a body has the responsibility for establishing national legislation to bring the Agency's transport Regulations into effect and for assuring compliance with its requirements. Depending on the national regulatory or institutional framework the functions of the competent authority may be assigned to one or more bodies. To assist Member States in implementing the transport Regulations and carrying out responsibility for compliance assurance, the IAEA continues to maintain this updated list of designated national competent authorities. Member States are annually requested to verify the list for correctness and completeness

National competent authorities. List no. 2. Regulations for the safe transport of radioactive materials. 1967 edition (Safety series no. 6)

Energy Technology Data Exchange (ETDEWEB)

NONE

1968-08-01

Any national or international authority designated or otherwise recognised as such for any purpose in connection with the transport Regulations is known as a competent authority. In the Member States such a body has the responsibility for establishing national legislation to bring the Agency's transport Regulations into effect and for assuring compliance with its requirements. Depending on the national regulatory or institutional framework the functions of the competent authority may be assigned to one or more bodies. To assist Member States in implementing the transport Regulations and carrying out responsibility for compliance assurance, the IAEA continues to maintain this updated list of designated national competent authorities. Member States are annually requested to verify the list for correctness and completeness.

Kinetics and branching ratios of the reactions NH2+NO2->N2O+H2O and NH2+NO2->H2NO+NO studied by pulse radiolysis combined with time-resolved infrared diode laser spectroscopy

DEFF Research Database (Denmark)

Meunier, H.; Pagsberg, Palle Bjørn; Sillesen, A.

1996-01-01

studied by monitoring the decay of NH2 and the simultaneous formation of N2O and NO by time-resolved infrared diode laser spectroscopy. The decay rate of NH2 was studied as a function of NO2 concentration to obtain an overall rate constant k(NH2 + NO2) = (1.35 +/- 0.15) X 10(-11) molecule(-1) cm(3) s(-1...

β-Arrestin2 mediates progression of murine primary myelofibrosis.

Science.gov (United States)

Rein, Lindsay Am; Wisler, James W; Kim, Jihee; Theriot, Barbara; Huang, LiYin; Price, Trevor; Yang, Haeyoon; Chen, Minyong; Chen, Wei; Sipkins, Dorothy; Fedoriw, Yuri; Walker, Julia Kl; Premont, Richard T; Lefkowitz, Robert J

2017-12-21

Primary myelofibrosis is a myeloproliferative neoplasm associated with significant morbidity and mortality, for which effective therapies are lacking. β-Arrestins are multifunctional adaptor proteins involved in developmental signaling pathways. One isoform, β-arrestin2 (βarr2), has been implicated in initiation and progression of chronic myeloid leukemia, another myeloproliferative neoplasm closely related to primary myelofibrosis. Accordingly, we investigated the relationship between βarr2 and primary myelofibrosis. In a murine model of MPLW515L-mutant primary myelofibrosis, mice transplanted with donor βarr2-knockout (βarr2-/-) hematopoietic stem cells infected with MPL-mutant retrovirus did not develop myelofibrosis, whereas controls uniformly succumbed to disease. Although transplanted βarr2-/- cells homed properly to marrow, they did not repopulate long-term due to increased apoptosis and decreased self-renewal of βarr2-/- cells. In order to assess the effect of acute loss of βarr2 in established primary myelofibrosis in vivo, we utilized a tamoxifen-induced Cre-conditional βarr2-knockout mouse. Mice that received Cre (+) donor cells and developed myelofibrosis had significantly improved survival compared with controls. These data indicate that lack of antiapoptotic βarr2 mediates marrow failure of murine hematopoietic stem cells overexpressing MPLW515L. They also indicate that βarr2 is necessary for progression of primary myelofibrosis, suggesting that it may serve as a novel therapeutic target in this disease.

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.

MODELING THE RADIO EMISSION FROM Cyg OB2 NO. 5: A QUADRUPLE SYSTEM?

International Nuclear Information System (INIS)

Kennedy, M.; Dougherty, S. M.; Fink, A.; Williams, P. M.

2010-01-01

Fifty observations at frequencies between 1.4 GHz and 43 GHz of the 6.6 day O6.5-7+O5.5-6 binary Cyg OB2 No. 5 using the Very Large Array over 20 years are re-examined. The aim is to determine the location and character of the previously detected variable radio emission. The radio emission from the system consists of a primary component that is associated with the binary, and a non-thermal source (NE), 0.''8 to the NE of the binary that has been ascribed to a wind-collision region (WCR) between the stellar winds of the binary and that of a B-type star (Star D) to the NE. Previous studies have not accounted for the potential contribution of NE to the total radio emission, most especially in observations where the primary and NE sources are not resolved as separate sources. NE shows no evidence of variation in 23 epochs where it is resolved separately from the primary radio component, demonstrating that the variable emission arises in the primary component. Since NE is non-variable, the radio flux from the primary can now be well determined for the first time, most especially in observations that do not resolve both the primary and NE components. The variable radio emission from the primary component has a period of 6.7 ± 0.3 years which is described by a simple model of a non-thermal source orbiting within the stellar wind envelope of the binary. Such a model implies the presence of a third, unresolved stellar companion (Star C) orbiting the 6.6 day binary with a period of 6.7 years and independent of Star D to the NE. The variable non-thermal emission arises from either a WCR between Star C and the binary system, or possibly from Star C directly. The model gives a mass-loss rate of 3.4 x 10 -5 M sun yr -1 for Cyg OB2 No. 5, unusually high for an Of supergiant and comparable to that of WR stars, and consistent with an unusually strong He I 1.083 μm emission line, also redolent of WR stars. An examination of radial velocity observations available from the

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

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.

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…

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...

OMI/Aura Nitrogen Dioxide (NO2) Total and Tropospheric Column 1-orbit L2 Swath 13x24 km V003

Data.gov (United States)

National Aeronautics and Space Administration — The second release of collection 3 OMI/Aura Level-2 NO2 data product OMNO2 is now available (http://disc.gsfc.nasa.gov/Aura/OMI/omno2_v003.shtml ) to public and...

Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors.

Science.gov (United States)

Valaitis, Ruta K; O'Mara, Linda; Wong, Sabrina T; MacDonald, Marjorie; Murray, Nancy; Martin-Misener, Ruth; Meagher-Stewart, Donna

2018-04-12

AimThe aim of this paper is to examine Canadian key informants' perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration. Primary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context. This interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor - effective communication - interacted with all of them. Results support and extend our understanding of what influences

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

German standard problem No. 2

International Nuclear Information System (INIS)

Burkhardt, R.

1980-02-01

The German Standard Problem Nr. 2 (primary circuits) is meant to check whether the presently available computing programs dealing with ECCS problems are suitable to reflect with sufficient accuracy reload and flooding processes. Changing from conventional calculation methods to the ''best-estimate'' method requires for possibility of exact comparison, as is the case here because of experimental results from the primary circuit test plant. The test plant of KWU Erlangen with primary circuit modeups on a 1:134 scale with exact level indications allows comparative testing where emergency cooling water is loaded into the system filled with saturated steam over cold lanes, or rather over the annulus modeup. The report on hand goes into detail about calculations, anticipated results and their comparison to experimental results. (orig./RW) [de

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

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

Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012

OpenAIRE

Hwang, Jongnam; Shon, Changwoo

2014-01-01

Objective To examine the relationship between socioeconomic status (SES) and type 2 diabetes using the Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012. Design A pooled sample cross-sectional study. Setting A nationally representative population survey data. Participants A total of 14 330 individuals who participated in the KNHANES 2010–2012 were included in our analysis. Primary outcome Prevalence of type 2 diabetes. Results The relationship between SES and type 2 d...

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...

Teacher of primary English

CERN Multimedia

2003-01-01

Part-time teacher of primary English needed for September 2003 to teach English National Curriculum (KS2) and NLS to mother tongue or good second language English-speakers aged 7-10. 4 hours contact time per week, team planning, marking and meetings. Candidates should be English mother tongue qualified teachers, confident, flexible classroom practitioners and team players. For further details and how to apply see http://enpferney.org/staff_vacancies.htm English National Programme, Lycée International, Ferney-Voltaire (http://enpferney.org/)

28 CFR 501.2 - National security cases.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false National security cases. 501.2 Section... ADMINISTRATION SCOPE OF RULES § 501.2 National security cases. (a) Upon direction of the Attorney General, the... unauthorized disclosure of such information would pose a threat to the national security and that there is a...

Human health no-effect levels of TiO_2 nanoparticles as a function of their primary size

International Nuclear Information System (INIS)

Laurent, Alexis; Harkema, Jack R.; Andersen, Elisabeth W.; Owsianiak, Mikołaj; Vea, Eldbjørg B.; Jolliet, Olivier

2017-01-01

As engineered nanomaterials are increasingly introduced on the market into a broad range of commodities or nanoproducts, there is a need for operational, reliable tool, enabling to consistently assess the risks and impacts associated with the releases of nanoparticles. The lack of a developed metric that accurately represents their toxic effects while capturing the influence of the most relevant physicochemical properties is one of the major impediments. Here, we investigate the relationships between the toxic responses of nano-sized and micro-sized particles in in vivo toxicological studies and their physicochemical properties. Our results for TiO_2 particles indicate statistically significant associations between the primary particle size and their toxicity responses for combined inhalation and ingestion exposure routes, although the numerical values should be considered with care due to the inability to encompass influences from other relevant physicochemical properties like surface coatings. These findings allow for expressing mass-based adverse effect levels as a continuous function of the primary size of particles. This meaningful, exploratory metric can thus be used for screening purposes and pave the way for reaching adaptive, robust risk assessments of nanomaterials, e.g. for setting up consistent threshold levels, as well as consistent life cycle assessments of nanoproducts. We provide examples of such applications.

South African Teachers' Perceptions of the Primary Geography Curriculum: An Exploratory Study

Science.gov (United States)

Wilmot, Di; Irwin, Pat

2015-01-01

There is a dearth of research on primary school Geography in South Africa. With no Annual National Assessments (ANAs) being done in the subject, little is known about the quality of geographical learning and teaching in South African primary schools. This article begins to address this shortcoming. More specifically, it responds to the need for…

A comparison between (passive) NO2 measurements and results of calculations for 2010; Een vergelijking tussen (passieve) NO2-metingen en rekenresultaten in 2010

Energy Technology Data Exchange (ETDEWEB)

Uiterwijk, J.W.; Wesseling, J.; Nguyen, L.

2012-02-15

Measurements of Nitrogen dioxide (NO2) concentrations using so-called Palmes tubes and formal reference methods show relatively small differences, of 10-15%, compared to results of calculations using Dutch standard calculation methods. This is concluded from research conducted by the RIVM for the ministry of Infrastructure and the Environment. These measurements were performed in order to determine concentration levels at locations where permanent measurements of the National Air Quality Measurement Network are not available. Palmes tubes are small plastic tubes containing a chemical agent that reacts with NO2, allowing to determine the NO2 concentration. These additional measurements are performed at several background locations in cities, along several highways, near a busy shipping lane and close to several tunnel exits. Where possible the results have been compared to results of calculations using official legal Dutch standard calculation methods. A good agreement was observed between measured and calculated concentrations in streets and along the highways. Measurements along a busy shipping lane showed only a small increase in concentration. Close to exits of traffic tunnels high NO2 concentrations were measured [Dutch] Metingen van stikstofdioxide (NO2) concentraties met zogeheten Palmesbuisjes en formele referentiemethoden laten betrekkelijk kleine verschillen, van 10-15%, zien met resultaten van berekeningen met wettelijk voorgeschreven standaardrekenmethoden. Dit blijkt uit onderzoek van het RIVM in opdracht van het ministerie van Infrastructuur en Milieu. Deze metingen zijn uitgevoerd om een beeld te krijgen van de concentraties in gebieden waar geen continue metingen van het Landelijk Meetnet Luchtkwaliteit (LML) worden verricht. Palmesbuisjes zijn kleine plastic buisjes met daarin een chemisch actieve stof die NO2 aan zich bindt, waarmee de NO2-concentratie worden bepaald. De aanvullende metingen hiermee vinden plaats op verschillende

[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.

11 CFR 106.2 - State allocation of expenditures incurred by authorized committees of Presidential primary...

Science.gov (United States)

2010-01-01

... to any State in which the primary election has already been held. (E) National advertising... production of media advertising, whether or not that advertising is used in more than one State, need not be... to any State if the fees are charged for consulting on national campaign strategy. Expenditures for...

Winter Distribution of On-road NO2 Concentration in Hong Kong

Science.gov (United States)

Zhu, Y.; Chan, K. L.; Boll, J.; Schütt, A. M. N.; Lipkowitsch, I.; Wenig, M.

2017-12-01

In this study, we investigated the spatial distribution of on road NO2 concentration using Cavity-Enhanced Differential Optical Absorption Spectroscopy (DOAS). We performed two measurement campaigns in winter 2010 and 2017. Air pollution is a severe problem for many big cities, especially in Asia. Traffic emission is the primary source of urban pollutants. As Hong Kong is one of the most densely populated cities in the world, many inhabitants are exposed to accumulated pollutants in street canyons. Our mobile measurements were performed for a week in December, 2010 and March, 2017. Additionally, long term air pollution data measured by a long-path DOAS (LP-DOAS) and the Environment Protection Department (EPD) air quality monitoring network were used to investigate the long term trend and seasonal variations of atmospheric NO2 in Hong Kong.The experiment setup and preliminary results of mobile measurements are presented. The measurements were performed along a fixed route which covers most of the urban area. We assembled a NO2 concentration map 2 to 3 times per day in order to cover both morning and evening rush hours. In order to construct a consistent map, we use coinciding LP-DOAS NO2 data to correct for the diurnal cycle. Furthermore, the spatial and temporal distribution of NO2 changes with the day of the week. Traffic load is highly dependent on human activities which typically fall into a 7 days cycle. Therefore, we have analyzed the weekly pattern of on road NO2 distribution to see the differences between anthropogenic emissions during weekdays and weekend.

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.

Primary care research in Denmark

DEFF Research Database (Denmark)

Vedsted, Peter; Kallestrup, Per

2016-01-01

International Perspectives on Primary Care Research examines how the evidence base from primary care research can strengthen health care services and delivery, tackle the growing burden of disease, improve quality and safety, and increase a person-centred focus to health care. Demonstrating...... the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

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.

NCRP Report No.151 versus Norm DIN 6847-2; NCRP Report No. 151 vs Norma DIN 6847-2

Energy Technology Data Exchange (ETDEWEB)

Sanchez Jimenez, J.; Rivas Ballarin, M. A.

2008-07-01

The National Council on Radiation protection and Measurements (NCRP) has recently published its Report No. 151, which presents recommendations and technical information on the design of structural shielding for megavoltage X and gamma-ray radiotherapy facilities. The calculations method introduced by this Report covers aspects like IMRT and other special techniques, as well as the design of structural details like doors, mazes and ducts, or the calculations of skyshine and ground shine radiation. In this work the necessary shielding for a Siemens Oncor treatment unit has been calculated, following NCRP Report No. 151 and DIN 6847-2 standard. In both cases the same isocenter workload W, use factor U, occupancy factor T and shielding design goals P, for workers and public members, are used. The results obtained with DIN 6847 are similar to the ones obtained with this Report, though there are some differences when considering the in-any-one-hour time averaged dose-equivalent rate in low occupancy factor areas, or where scattered radiation reaches the barrier under a small angle. (Author) 9 refs.

Single- and double-photoionization cross-sections of nitrogen dioxide (NO2) and ionic fragmentation of NO2+ and NO22+

International Nuclear Information System (INIS)

Masuoka, Toshio; Kobayashi, Ataru

2004-01-01

Single- and double-photoionization processes of nitrogen dioxide (NO 2 ) have been studied in the photon energy region of 37-125 eV by use of time-of-flight mass spectrometry and the photoion-photoion coincidence method together with synchrotron radiation. The single- and double-photoionization cross-sections of NO 2 are determined. Ion branching ratios and the partial cross-sections for the individual ions, respectively, produced from the parent NO 2 + and NO 2 2+ ions are also determined separately at excitation energies where the molecular and dissociative single- and double-photoionization processes occur simultaneously. It was found that dissociation of the parent ions is dominant both in single and double photoionization. The thresholds for the O + + NO + and N + + O + dissociation channels of NO 2 2+ are at 35.0 ± 0.3 and 43.6 ± 0.3 eV, respectively. Kinetic energy releases in these two dissociation channels of NO 2 2+ have also been elucidated

High-Pressure Synthesis and Study of NO+NO3− and NO2+NO3− Ionic Solids

Directory of Open Access Journals (Sweden)

A. Yu. Kuznetsov

2009-01-01

Full Text Available Nitrosonium-nitrate NO+NO3− and dinitrogen pentoxide NO2+NO3− ionic crystals were synthesized by laser heating of a condensed oxygen-rich O2-N2 mixture compressed to different pressures, up to 40 GPa, in a diamond anvil cell (DAC. High-pressure/high-temperature Raman and X-ray diffraction studies of synthesized samples disclosed a transformation of NO+NO3− compound to NO2+NO3− crystal at temperatures above ambient and pressures below 9 GPa. High-pressure experiments revealed previously unreported bands in Raman spectra of NO+NO3− and NO2+NO3− ionic crystals. Structural properties of both ionic compounds are analyzed. Obtained experimental results support a hypothesis of a rotational disorder of NO+ complexes in NO+NO3− and indicate a rotational disorder of ionic complexes in NO2+NO3− solid.

Development and evaluation of GRAL-C dispersion model, a hybrid Eulerian-Lagrangian approach capturing NO-NO 2-O 3 chemistry

Science.gov (United States)

Oettl, Dietmar; Uhrner, Ulrich

2011-02-01

Based on two recent publications using Lagrangian dispersion models to simulate NO-NO 2-O 3 chemistry for industrial plumes, a similar modified approach was implemented using GRAL-C ( Graz Lagrangian Model with Chemistry) and tested on two urban applications. In the hybrid dispersion model GRAL-C, the transport and turbulent diffusion of primary species such as NO and NO 2 are treated in a Lagrangian framework while those of O 3 are treated in an Eulerian framework. GRAL-C was employed on a one year street canyon simulation in Berlin and on a four-day simulation during a winter season in Graz, the second biggest city in Austria. In contrast to Middleton D.R., Jones A.R., Redington A.L., Thomson D.J., Sokhi R.S., Luhana L., Fisher B.E.A. (2008. Lagrangian modelling of plume chemistry for secondary pollutants in large industrial plumes. Atmospheric Environment 42, 415-427) and Alessandrini S., Ferrero E. (2008. A Lagrangian model with chemical reactions: application in real atmosphere. Proceedings of the 12th Int. Conf. on Harmonization within atmospheric dispersion modelling for regulatory purposes. Croatian Meteorological Journal, 43, ISSN: 1330-0083, 235-239) the treatment of ozone was modified in order to facilitate urban scale simulations encompassing dense road networks. For the street canyon application, modelled daily mean NO x/NO 2 concentrations deviated by +0.4%/-15% from observations, while the correlations for NO x and NO 2 were 0.67 and 0.76 respectively. NO 2 concentrations were underestimated in summer, but were captured well for other seasons. In Graz a fair agreement for NO x and NO 2 was obtained between observed and modelled values for NO x and NO 2. Simulated diurnal cycles of NO 2 and O 3 matched observations reasonably well, although O 3 was underestimated during the day. A possible explanation here might lie in the non-consideration of volatile organic compounds (VOCs) chemistry.

Intercomparison of the medium energy primary standards for X-ray exposure of NPL and ENEA, Italy

International Nuclear Information System (INIS)

Moretti, C.J.; Heaton, J.A.; Laitano, R.F.; Toni, M.P.

1991-04-01

An intercomparison between the primary standards of exposure for medium energy X-rays held by the National Physical Laboratory (NPL) and ENEA in Italy is described. The intercomparison, using four different transfer chambers, took place at NPL in December 1989 and at ENEA during March 1990. Measurements were made at four therapy-level qualities, with half value layers of 0.15, 0.5, 1.0 and 2.5 mm Cu (nominal generating voltages of 100, 135, 180 and 250 kV respectively). At the 2.5 mm Cu HVL quality the primary standards were found to agree to within about 0.8%; for the other three qualities the chambers differed by no more than 0.3%. (author)

International Classification of Primary Care-2 coding of primary care data at the general out-patients' clinic of General Hospital, Lagos, Nigeria.

Science.gov (United States)

Olagundoye, Olawunmi Abimbola; van Boven, Kees; van Weel, Chris

2016-01-01

Primary care serves as an integral part of the health systems of nations especially the African continent. It is the portal of entry for nearly all patients into the health care system. Paucity of accurate data for health statistics remains a challenge in the most parts of Africa because of inadequate technical manpower and infrastructure. Inadequate quality of data systems contributes to inaccurate data. A simple-to-use classification system such as the International Classification of Primary Care (ICPC) may be a solution to this problem at the primary care level. To apply ICPC-2 for secondary coding of reasons for encounter (RfE), problems managed and processes of care in a Nigerian primary care setting. Furthermore, to analyze the value of selected presented symptoms as predictors of the most common diagnoses encountered in the study setting. Content analysis of randomly selected patients' paper records for data collection at the end of clinic sessions conducted by family physicians at the general out-patients' clinics. Contents of clinical consultations were secondarily coded with the ICPC-2 and recorded into excel spreadsheets with fields for sociodemographic data such as age, sex, occupation, religion, and ICPC elements of an encounter: RfE/complaints, diagnoses/problems, and interventions/processes of care. Four hundred and one encounters considered in this study yielded 915 RfEs, 546 diagnoses, and 1221 processes. This implies an average of 2.3 RfE, 1.4 diagnoses, and 3.0 processes per encounter. The top 10 RfE, diagnoses/common illnesses, and processes were determined. Through the determination of the probability of the occurrence of certain diseases beginning with a RfE/complaint, the top five diagnoses that resulted from each of the top five RfE were also obtained. The top five RfE were: headache, fever, pain general/multiple sites, visual disturbance other and abdominal pain/cramps general. The top five diagnoses were: Malaria, hypertension

Production of electronically excited NO via DEA to NO2

Science.gov (United States)

Gope, Krishnendu; Tadsare, Vishvesh; Prabhudesai, Vaibhav S.; Krishnakumar, E.

2017-12-01

Dissociative electron attachment (DEA) to NO2 in the 7-11 eV range is studied using velocity slice imaging technique. Two distinct channels are observed in the DEA corresponding to O- + NO(A 2Σ+) and O- + NO(C 2Π and/or D 2Σ+). While NO(A 2Σ+) is found to be formed only in very high vibrational levels, NO(C 2Π and/or D 2Σ+) is found to be formed with vibrational distribution starting from v = 0. From the angular distribution of the O- ions leading to the NO(C 2Π and/or D 2Σ+) channel, we obtain the symmetry of the negative ion resonance to be dominantly B1 with small contribution from B2. Contribution to the Topical Issue: "Low Energy Positron and Electron Interactions", edited by James Sullivan, Ron White, Michael Bromley, Ilya Fabrikant, and David Cassidy.

ITER EDA newsletter. V. 2, no. 2

International Nuclear Information System (INIS)

1993-02-01

This issue of the ITER EDA (Engineering Design Activities) Newsletter contains a progress report by the Director, a report on the completion of the first activities of the Special Work Group 2 (SWG-2), a report on a magnet technical meeting, held at Naka, Japan, 26-29 January 1993, and on the US Home Team National Meeting, 25-26 January 1993

CO and NO2 pollution in a long two-way traffic road tunnel: investigation of NO2/NOx ratio and modelling of NO2 concentration.

Science.gov (United States)

Indrehus, O; Vassbotn, P

2001-02-01

The CO, NO and NO2 concentrations, visibility and air flow velocity were measured using continuous analysers in a long Norwegian road tunnel (7.5 km) with traffic in both directions in April 1994 and 1995. The traffic density was monitored at the same time. The NO2 concentration exceeded Norwegian air quality limits for road tunnels 17% of the time in 1994. The traffic through the tunnel decreased from 1994 to 1995, and the mean NO2 concentration was reduced from 0.73 to 0.22 ppm. The ventilation fan control, based on the CO concentration only, was unsatisfactory and the air flow was sometimes low for hours. Models for NO2 concentration based on CO concentration and absolute air flow velocity were developed and tested. The NO2/NOx ratio showed an increase for NOx levels above 2 ppm; a likely explanation for this phenomenon is NO oxidation by O2. Exposure to high NO2 concentrations may represent a health risk for people with respiratory and cardiac diseases. In long road tunnels with two-way traffic, this study indicates that ventilation fan control based on CO concentration should be adjusted for changes in vehicle CO emission and should be supplemented by air flow monitoring to limit the NO2 concentration.

Extension of a Computer Assisted Decision Support (CADS) Study to Improve Outcomes in Patients with Type 2 DM Treated Primary Cary Providers

Science.gov (United States)

2013-10-01

latest (2004) National Health and Nutrition Examination Survey (NHANES) data demonstrated that 42.3% of patients with DM have A1Cs over 7% (22). The...military healthcare system (MHS) - where there is no cost to the patient for care and testing supplies - has similar results with hemoglobin A1C’s... Educators in both military and civilian health care settings (23), the vast majority of patients with DM are managed by primary care providers (PCPs

Vibrational spectroscopy of NO + (H2O)n: Evidence for the intracluster reaction NO + (H2O)n --> H3O + (H2O)n - 2 (HONO) at n => 4

Science.gov (United States)

Choi, Jong-Ho; Kuwata, Keith T.; Haas, Bernd-Michael; Cao, Yibin; Johnson, Matthew S.; Okumura, Mitchio

1994-05-01

Infrared spectra of mass-selected clusters NO+(H2O)n for n=1 to 5 were recorded from 2700 to 3800 cm-1 by vibrational predissociation spectroscopy. Vibrational frequencies and intensities were also calculated for n=1 and 2 at the second-order Møller-Plesset (MP2) level, to aid in the interpretation of the spectra, and at the singles and doubles coupled cluster (CCSD) level energies of n=1 isomers were computed at the MP2 geometries. The smaller clusters (n=1 to 3) were complexes of H2O ligands bound to a nitrosonium ion NO+ core. They possessed perturbed H2O stretch bands and dissociated by loss of H2O. The H2O antisymmetric stretch was absent in n=1 and gradually increased in intensity with n. In the n=4 clusters, we found evidence for the beginning of a second solvation shell as well as the onset of an intracluster reaction that formed HONO. These clusters exhibited additional weak, broad bands between 3200 and 3400 cm-1 and two new minor photodissociation channels, loss of HONO and loss of two H2O molecules. The reaction appeared to go to completion within the n=5 clusters. The primary dissociation channel was loss of HONO, and seven vibrational bands were observed. From an analysis of the spectrum, we concluded that the n=5 cluster rearranged to form H3O+(H2O)3(HONO), i.e., an adduct of the reaction products.

Quality of interaction between primary health-care providers and patients with type 2 diabetes in Muscat, Oman: an observational study

Directory of Open Access Journals (Sweden)

Vernby Åsa

2006-12-01

Full Text Available Abstract Background A good patient-physician interaction is particularly important in chronic diseases like diabetes. There are so far no published data regarding the interaction between the primary health-care providers and patients with type 2 diabetes in Oman, where diabetes is a major and growing health problem. This study aimed at exploring how health-care providers interact with patients with type 2 diabetes at primary health-care level in Muscat, Oman, focusing on the consultation environment, and some aspects of care and information. Methods Direct observations of 90 consultations between 23 doctors and 13 diabetes nurses concerned with diabetes management during their consultations with type 2 diabetes patients in six primary health-care centres in the Muscat region, using checklists developed from the National Diabetes Guidelines. Consultations were assessed as optimal if more than 75% of observed aspects were fulfilled and sub-optimal if less than 50% were fulfilled. Results Overall 52% of the doctors' consultations were not optimal. Some important aspects for a positive consultation environment were fulfilled in only about half of the doctors' consultations: ensuring privacy of consultation (49%, eye contact (49%, good attention (52%, encouraging asking questions (47%, and emphasizing on the patients' understanding of the provided information (52%. The doctors enquired about adverse effects of anti-diabetes drugs in less than 10% of consultations. The quality of the nurses' consultations was sub-optimal in about 75% of 85 consultations regarding aspects of consultation environment, care and information. Conclusion The performance of the primary health-care doctors and diabetes nurses needs to be improved. The role of the diabetes nurses and the teamwork should be enhanced. We suggest a multidisciplinary team approach, training and education to the providers to upgrade their skills regarding communication and care. Barriers to

The strength of primary care in Europe: an international comparative study.

Science.gov (United States)

Kringos, Dionne; Boerma, Wienke; Bourgueil, Yann; Cartier, Thomas; Dedeu, Toni; Hasvold, Toralf; Hutchinson, Allen; Lember, Margus; Oleszczyk, Marek; Rotar Pavlic, Danica; Svab, Igor; Tedeschi, Paolo; Wilm, Stefan; Wilson, Andrew; Windak, Adam; Van der Zee, Jouke; Groenewegen, Peter

2013-11-01

A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking. Evaluation of strength of primary care in Europe. International comparative cross-sectional study performed in 2009-2010, involving 27 EU member states, plus Iceland, Norway, Switzerland, and Turkey. Outcome measures covered three dimensions of primary care structure: primary care governance, economic conditions of primary care, and primary care workforce development; and four dimensions of primary care service-delivery process: accessibility, comprehensiveness, continuity, and coordination of primary care. The primary care dimensions were operationalised by a total of 77 indicators for which data were collected in 31 countries. Data sources included national and international literature, governmental publications, statistical databases, and experts' consultations. Countries with relatively strong primary care are Belgium, Denmark, Estonia, Finland, Lithuania, the Netherlands, Portugal, Slovenia, Spain, and the UK. Countries either have many primary care policies and regulations in place, combined with good financial coverage and resources, and adequate primary care workforce conditions, or have consistently only few of these primary care structures in place. There is no correlation between the access, continuity, coordination, and comprehensiveness of primary care of countries. Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.

Crystal and molecular structure of the coordination compounds of Er3+ with 1-(methoxydiphenylphosphoryl)-2-diphenylphosphorylbenzene [ErL21(NO3)2]2[Er(NO3)2(H2O)5]0.333(NO3)2.333 · 2.833H2O and its ethyl substituted derivative [ErL22(NO3)2][Er(NO3)5]0.5 · 0.5H2O

International Nuclear Information System (INIS)

Polyakova, I. N.; Baulin, V. E.; Ivanova, I. S.; Pyatova, E. N.; Sergienko, V. S.; Tsivadze, A. Yu.

2015-01-01

The coordination compounds of Er 3+ with 1-(methoxydiphenylphosphoryl)-2-diphenylphosphorylbenzene [ErL 2 1 (NO 3 ) 2 ] 2 [Er(NO 3 ) 2 (H 2 O) 5 ] 0.333 (NO 3 ) 2.333 · 2.833H 2 O (I) and its ethyl substituted derivative [ErL 2 2 (NO 3 ) 2 ][Er(NO 3 ) 5 ] 0.5 · 0.5H 2 O (II) are synthesized and their crystal structures are studied. I and II contain [ErL 2 (NO 3 ) 2 ] + complex cations of identical composition and close structure. The eight-vertex polyhedron of the Er atom in the shape of a distorted octahedron with two split trans vertices is formed by the O atoms of the phosphoryl groups of L ligands and nitrate anions. L ligands close nine-membered metallocycles. The structures contain spacious channels which are populated differently, namely, by disordered [Er(NO 3 ) 2 (H 2 O) 5 ] + complex cations, NO 3 − anions, and crystallization water molecules in I and disordered [Er(NO 3 ) 5 ] 2− complex anions and crystallization water molecules in II. The IR spectra of I and II are studied

Exploring mechanisms of a tropospheric archetype: CH{sub 3}O{sub 2} + NO

Energy Technology Data Exchange (ETDEWEB)

Launder, Andrew M.; Agarwal, Jay; Schaefer, Henry F., E-mail: ccq@uga.edu [Center for Computational Quantum Chemistry, University of Georgia, Athens, Georgia 30602 (United States)

2015-12-21

Methylperoxy radical (CH{sub 3}O{sub 2}) and nitric oxide (NO) contribute to the propagation of photochemical smog in the troposphere via the production of methoxy radical (CH{sub 3}O) and nitrogen dioxide (NO{sub 2}). This reaction system also furnishes trace quantities of methyl nitrate (CH{sub 3}ONO{sub 2}), a sink for reactive NO{sub x} species. Here, the CH{sub 3}O{sub 2} + NO reaction is examined with highly reliable coupled-cluster methods. Specifically, equilibrium geometries for the reactants, products, intermediates, and transition states of the ground-state potential energy surface are characterized. Relative reaction enthalpies at 0 K (ΔH{sub 0K}) are reported; these values are comprised of electronic energies extrapolated to the complete basis set limit of CCSDT(Q) and zero-point vibrational energies computed at CCSD(T)/cc-pVTZ. A two-part mechanism involving CH{sub 3}O and NO{sub 2} production followed by radical recombination to CH{sub 3}ONO{sub 2} is determined to be the primary channel for formation of CH{sub 3}ONO{sub 2} under tropospheric conditions. Constrained optimizations of the reaction paths at CCSD(T)/cc-pVTZ suggest that the homolytic bond dissociations involved in this reaction path are barrierless.

Incidence and significance of Multiple Primary Malignant Neoplasms

International Nuclear Information System (INIS)

Choi, Eun Kyung; Cho, Moon June; Ha, Sung Whan; Park, Charn Il; Bang, Young Ju; Kim, Noe Kyung

1986-01-01

To know the three questions about multiple primary cancers: 1) what are the characteristics of persons having multiple primary cancer? 2) Dose presence of a single primary concern after the susceptibility to multiple primary cancers? 3) Dose the location of one multiple primary cancer influence the site of others?, we analysed 121 cases of multiple primary malignant neoplasms registered in Seoul National University Hospital during 8years from July 1978 to August 1986. Of 121 cases, double primary malignant neoplasms were 119 cases and triple were 2 cases. The incidence of multiple primary malignant neoplasms was 0.7%. The metachronous tumor(> 6 months) was found in 70 cases and the median time between the first and the second was 32 months. The most commonly associated tumors were stomach and primary liver carcinoma. Cervix and Lung cancer, Stomach and Rectal cancer, Stomach and Esophagus cancer were also commonly associated

Competing Issues in Australian Primary Curriculum: Learning from International Experiences

Science.gov (United States)

Ewing, Robyn

2012-01-01

There is no doubt that the increasing politicisation of education in an economically rationalist climate is contributing to less equity, access, participation and, therefore, social justice for many Australian primary children. This article initially explores how the development of the impending national Australian curriculum replete with a high…

LSD Increases Primary Process Thinking via Serotonin 2A Receptor Activation

Directory of Open Access Journals (Sweden)

Rainer Kraehenmann

2017-11-01

Full Text Available Rationale: Stimulation of serotonin 2A (5-HT2A receptors by lysergic acid diethylamide (LSD and related compounds such as psilocybin has previously been shown to increase primary process thinking – an ontologically and evolutionary early, implicit, associative, and automatic mode of thinking which is typically occurring during altered states of consciousness such as dreaming. However, it is still largely unknown whether LSD induces primary process thinking under placebo-controlled, standardized experimental conditions and whether these effects are related to subjective experience and 5-HT2A receptor activation. Therefore, this study aimed to test the hypotheses that LSD increases primary process thinking and that primary process thinking depends on 5-HT2A receptor activation and is related to subjective drug effects.Methods: Twenty-five healthy subjects performed an audio-recorded mental imagery task 7 h after drug administration during three drug conditions: placebo, LSD (100 mcg orally and LSD together with the 5-HT2A receptor antagonist ketanserin (40 mg orally. The main outcome variable in this study was primary index (PI, a formal measure of primary process thinking in the imagery reports. State of consciousness was evaluated using the Altered State of Consciousness (5D-ASC rating scale.Results: LSD, compared with placebo, significantly increased primary index (p < 0.001, Bonferroni-corrected. The LSD-induced increase in primary index was positively correlated with LSD-induced disembodiment (p < 0.05, Bonferroni-corrected, and blissful state (p < 0.05, Bonferroni-corrected on the 5D-ASC. Both LSD-induced increases in primary index and changes in state of consciousness were fully blocked by ketanserin.Conclusion: LSD induces primary process thinking via activation of 5-HT2A receptors and in relation to disembodiment and blissful state. Primary process thinking appears to crucially organize inner experiences during both dreams and

LSD Increases Primary Process Thinking via Serotonin 2A Receptor Activation

Science.gov (United States)

Kraehenmann, Rainer; Pokorny, Dan; Aicher, Helena; Preller, Katrin H.; Pokorny, Thomas; Bosch, Oliver G.; Seifritz, Erich; Vollenweider, Franz X.

2017-01-01

Rationale: Stimulation of serotonin 2A (5-HT2A) receptors by lysergic acid diethylamide (LSD) and related compounds such as psilocybin has previously been shown to increase primary process thinking – an ontologically and evolutionary early, implicit, associative, and automatic mode of thinking which is typically occurring during altered states of consciousness such as dreaming. However, it is still largely unknown whether LSD induces primary process thinking under placebo-controlled, standardized experimental conditions and whether these effects are related to subjective experience and 5-HT2A receptor activation. Therefore, this study aimed to test the hypotheses that LSD increases primary process thinking and that primary process thinking depends on 5-HT2A receptor activation and is related to subjective drug effects. Methods: Twenty-five healthy subjects performed an audio-recorded mental imagery task 7 h after drug administration during three drug conditions: placebo, LSD (100 mcg orally) and LSD together with the 5-HT2A receptor antagonist ketanserin (40 mg orally). The main outcome variable in this study was primary index (PI), a formal measure of primary process thinking in the imagery reports. State of consciousness was evaluated using the Altered State of Consciousness (5D-ASC) rating scale. Results: LSD, compared with placebo, significantly increased primary index (p LSD-induced increase in primary index was positively correlated with LSD-induced disembodiment (p LSD-induced increases in primary index and changes in state of consciousness were fully blocked by ketanserin. Conclusion: LSD induces primary process thinking via activation of 5-HT2A receptors and in relation to disembodiment and blissful state. Primary process thinking appears to crucially organize inner experiences during both dreams and psychedelic states of consciousness. PMID:29167644

Introducing Cooperative Learning to Primary 1 and Primary 2 Pupils

Science.gov (United States)

Fong, Salim; Ho, Linda; Chew, Lay See; Wong, Kok Wah; Wee, Sheila; Jacobs, George M.

2000-01-01

It was scary at first. Just getting P1 and 2 students to follow basic instructions is hard enough; trying to get them to work together in groups seemed like asking for extra trouble. But, a dash or two of trouble adds a bit of spice to a veteran teacher's life; so the four of us teachers at Mayflower Primary School--a neighbourhood school in Ang…

HIRDLS/Aura Level 3 Nitrogen Dioxide (NO2) 1deg Lat Zonal Fourier Coefficients V007 (H3ZFCNO2) at GES DISC

Data.gov (United States)

National Aeronautics and Space Administration — The "HIRDLS/Aura Level 3 Nitrogen Dioxide (NO2) Zonal Fourier Coefficients" version 7 data product (H3ZFCNO2) contains the entire mission (~3 years) of HIRDLS data...

A comparison of two approaches to managing acute primary angle closure in Asian eyes

Directory of Open Access Journals (Sweden)

Ho H

2013-06-01

Full Text Available Henrietta Ho,1 Paul T Chew,2 Chelvin Sng,1,2 Huiqi Huang,1 Tin Aung,1,2 Shamira A Perera1,21Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, SingaporePurpose: To review the management regimes of acute primary angle closure (APAC in two hospitals in Singapore, and to identify the incidence of and risk factors for progression to glaucomatous optic neuropathy.Methods: We conducted a retrospective review of 40 patients from National University Hospital (NUH and 52 patients from Singapore National Eye Centre (SNEC who were diagnosed with APAC. Patients were treated with similar protocols of intensive medical therapy until laser peripheral iridotomy could be performed. In the event of failed medical treatment, patients at NUH only underwent laser iridoplasty. The 1-year outcomes were reviewed.Results: The demographic features of patients and presenting intraocular pressures (IOP were similar in both centers. More patients from NUH presented within 3 days of symptom onset, compared to those from SNEC (90.0% versus 71.2%, respectively (P = 0.037. The mean ± standard deviation time to break the attack was 18.2 ± 32.9 hours at SNEC and 9.80 ± 10.6 hours at NUH (P = 0.11. The mean follow up duration was 18.8 ± 14.0 months. Nineteen patients (36.5% from SNEC and six patients (22.5% from NUH developed raised IOP (P = 0.032 within 1-year of the attack. Of these, glaucomatous optic neuropathy developed in thirteen patients (68.4% from SNEC and all six patients (100% from NUH. At final review, the mean IOP of the APAC eye was 14.8 ± 4.3 mmHg from SNEC and 13.4 ± 3.0 mmHg from NUH. There was no significant difference in final visual acuity or IOP between both groups.Conclusion: Treatment strategies in both centers were effective in aborting an APAC attack. The development of raised IOP appears to be associated with a longer

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...

Inventories of N₂O and NO emissions from European forest soils

DEFF Research Database (Denmark)

Kesik, M.; Ambus, Per; Baritz, R.

2005-01-01

Forest soils are a significant source for the primary and secondary greenhouse gases N2O and NO. However, current estimates are still uncertain due to the still limited number of field measurements and the herein observed pronounced variability of N trace gas fluxes in space and time, which are d...

National demonstration of full reactor coolant system (RCS) chemical decontamination at Indian Point 2

Energy Technology Data Exchange (ETDEWEB)

Trovato, S.A.; Parry, J.O. [Consolidated Edison Co., New York, NY (United States)

1995-03-01

Key to the safe and efficient operation of the nation`s civilian nuclear power plants is the performance of maintenance activities within regulations and guidelines for personnel radiation exposure. However, maintenance activities, often performed in areas of relatively high radiation fields, will increase as the nation`s plant age. With the Nuclear Regulatory Commission (NRC) lowering the allowable radiation exposure to plant workers in 1994 and considering further reductions and regulations in the future, it is imperative that new techniques be developed and applied to reduce personnel exposure. Full primary system chemical decontamination technology offers the potential to be single most effective method of maintaining workers exposure {open_quotes}as low as reasonably achievable{close_quotes} (ALARA) while greatly reducing plant operation and maintenance (O&M) costs. A three-phase program underway since 1987, has as its goal to demonstrate that full RCS decontamination is a visible technology to reduce general plant radiation levels without threatening the long term reliability and operability of a plant. This paper discusses research leading to and plans for a National Demonstration of Full RCS Chemical Decontamination at Indian Point 2 nuclear generating station in 1995.

National Clearinghouse on Transition from School Newsletter. Vol. 2, No. 1, Part 2.

Science.gov (United States)

National Clearinghouse on Transition from School Newsletter, 1983

1983-01-01

The two papers in this newsletter focus on youth employment and training programs in the United States and the government response to unemployment in Australia. In the first paper, "Looking at Other Countries, No. 1: United States. Youth Employment and Training Programs during the First Two Years of the Reagan Administration" by Ralph E.…

Primary care and health reform in New Zealand.

Science.gov (United States)

Grant, C C; Forrest, C B; Starfield, B

1997-02-14

(1) To describe New Zealand's primary care system (2) to compare New Zealand to other Anglo-American members of the OECD with respect to the adequacy of primary care, and (3) to assess the cost-efficiency and effectiveness of New Zealand's system by comparing health spending and health indicators relevant to primary care. A cross-national comparison of primary care, health spending and health indicators in New Zealand, Australia, Canada, the United Kingdom and the United States of America. Main outcome measures were health spending measured in purchasing power parties. Health indicators: mean life expectancy in years, years of potential life lost and infant mortality rates. New Zealand's primary care system ranked below the UK, above the USA and similar to Canada and Australia. Favourable characteristics of New Zealand's primary care system were the use of generalists as the predominant type of practitioner and the low proportion of active physicians who were specialists. Compared to the other countries, New Zealand scored poorly for financial that are necessary for the practise of good primary care. New Zealand and the UK had the lowest spending per capita on health care. New Zealand and the USA scored lowest for all three of the health care indicators. The quality of primary care in New Zealand is limited by barriers to access to care and the intermediate level of practise characteristics essential to primary care. Compared to other AngloAmerican OECD nations, New Zealand has relatively low levels of national health expenditure. In order to improve the quality of primary care, future reform should aim to facilitate access to care, increase the gatekeeping role of primary care physicians, and promote the practise characteristics essential to primary care.

Primary Surgery vs Radiotherapy for Early Stage Oral Cavity Cancer.

Science.gov (United States)

Ellis, Mark A; Graboyes, Evan M; Wahlquist, Amy E; Neskey, David M; Kaczmar, John M; Schopper, Heather K; Sharma, Anand K; Morgan, Patrick F; Nguyen, Shaun A; Day, Terry A

2018-04-01

Objective The goal of this study is to determine the effect of primary surgery vs radiotherapy (RT) on overall survival (OS) in patients with early stage oral cavity squamous cell carcinoma (OCSCC). In addition, this study attempts to identify factors associated with receiving primary RT. Study Design Retrospective cohort study. Setting National Cancer Database (NCDB, 2004-2013). Subjects and Methods Reviewing the NCDB from 2004 to 2013, patients with early stage I to II OCSCC were identified. Kaplan-Meier estimates of survival, Cox regression analysis, and propensity score matching were used to examine differences in OS between primary surgery and primary RT. Multivariable logistic regression analysis was performed to identify factors associated with primary RT. Results Of the 20,779 patients included in the study, 95.4% (19,823 patients) underwent primary surgery and 4.6% (956 patients) underwent primary RT. After adjusting for covariates, primary RT was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.97; 99% confidence interval [CI], 1.74-2.22). On multivariable analysis, factors associated with primary RT included age ≥70 years, black race, Medicaid or Medicare insurance, no insurance, oral cavity subsite other than tongue, clinical stage II disease, low-volume treatment facilities, and earlier treatment year. Conclusion Primary RT for early stage OCSCC is associated with increased mortality. Approximately 5% of patients receive primary RT; however, this percentage is decreasing. Patients at highest risk for receiving primary RT include those who are elderly, black, with public insurance, and treated at low-volume facilities.

Human health no-effect levels of TiO{sub 2} nanoparticles as a function of their primary size

Energy Technology Data Exchange (ETDEWEB)

Laurent, Alexis, E-mail: alau@dtu.dk [Technical University of Denmark, Division for Quantitative Sustainability Assessment, Department of Management Engineering (Denmark); Harkema, Jack R. [Michigan State University, Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine (United States); Andersen, Elisabeth W. [Technical University of Denmark, Statistics and Data Analysis Section, Department of Applied Mathematics and Computer Science (Denmark); Owsianiak, Mikołaj; Vea, Eldbjørg B. [Technical University of Denmark, Division for Quantitative Sustainability Assessment, Department of Management Engineering (Denmark); Jolliet, Olivier [University of Michigan, Department of Environmental Health Sciences, School of Public Health (United States)

2017-04-15

As engineered nanomaterials are increasingly introduced on the market into a broad range of commodities or nanoproducts, there is a need for operational, reliable tool, enabling to consistently assess the risks and impacts associated with the releases of nanoparticles. The lack of a developed metric that accurately represents their toxic effects while capturing the influence of the most relevant physicochemical properties is one of the major impediments. Here, we investigate the relationships between the toxic responses of nano-sized and micro-sized particles in in vivo toxicological studies and their physicochemical properties. Our results for TiO{sub 2} particles indicate statistically significant associations between the primary particle size and their toxicity responses for combined inhalation and ingestion exposure routes, although the numerical values should be considered with care due to the inability to encompass influences from other relevant physicochemical properties like surface coatings. These findings allow for expressing mass-based adverse effect levels as a continuous function of the primary size of particles. This meaningful, exploratory metric can thus be used for screening purposes and pave the way for reaching adaptive, robust risk assessments of nanomaterials, e.g. for setting up consistent threshold levels, as well as consistent life cycle assessments of nanoproducts. We provide examples of such applications.

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.

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.

Plain radiologic findings of primary lung cancer by histologic types

International Nuclear Information System (INIS)

Lee, Young Seok; Park, Jae Hyung; Choi, Byung In; Yeon, Kyung Mo; Kim, Chu Wan

1983-01-01

Plain chest films are the most useful modality in diagnosis of primary lung cancer, but it is difficult to interpret the radiologic findings by histological types. Authors reviewed chest films of 324 cases of histologically confirmed primary lung cancer from January 1974 to April 1982 at Seoul National University. The results are as follows; 1. Incidence was most common in the 6th decade as 34.4%. Male to female sex radio was 3.8 : 1 and there was no sex difference in Adenocarcinoma. 2. Distribution of histologic types of primary lung cancers as follows; Squamous cell carcinoma 50.6%, Small cell carcinoma 22.5%, Large cell carcinoma 9.3%, Bronchogenic adeno carcinoma 10.5%, Bronchioloalveolar cell carcinoma 1.9%, Adenosquamous carcinoma 0.6%, Carcinoid tumor 0.3%, Adenoid cystic carcinoma 0.3%. 3. Radiologic findings by histologic types are follows; a) Squamous cell carcinoma commonly present as collapse (51.8%), peripheral mass (40.8%), pneumonitis (37.2%), hilar involvement (34.8%), and in single abnormality, peripheral mass (44.4%). b) Small cell carcinoma commonly present as hilar involvement (78.1%), mediastinal widening or mass (53.4%) and in single abnormality, hilar involvement (58.3%). c) Large cell carcinoma commonly present as hilar involvement (50%), pneumonia (46.7%), collapse (40%), peripheral mass (36.7%) and in single abnormality, large peripheral mass (33.3%). d) Bronchogenic adenocarcinoma commonly present as peripheral mass (44.1%), collapse (41.2%), pleural effusion (35.2%) and in single abnormality, peripheral mass (50%). e) Solitary peripheral mass commonly present as lobulation (48%) and spiculated margin (51%), but no specific findings by histologic types. Cavitary formation was most common in Squamous cell carcinoma

Synthesis and crystal structures of nitratocobaltates Na2[Co(NO3)4], K2[Co(NO3)4], and Ag[Co(NO3)3] and potassium nitratonickelate K2[Ni(NO3)4

International Nuclear Information System (INIS)

Morozov, I. V.; Fedorova, A. A.; Albov, D. V.; Kuznetsova, N. R.; Romanov, I. A.; Rybakov, V. B.; Troyanov, S. I.

2008-01-01

The cobalt(II) and nickel(II) nitrate complexes with an island structure (Na 2 [Co(NO 3 ) 4 ] (I) and K 2 [Co(NO 3 ) 4 ] (II)] and a chain structure [Ag[Co(NO 3 ) 3 ] (III) and K 2 [Ni(NO 3 ) 4 ] (IV)] are synthesized and investigated using X-ray diffraction. In the anionic complex [Co(NO 3 ) 4 ] 2− of the crystal structure of compound I, the Co coordination polyhedron is a twisted tetragonal prism formed by the O atoms of four asymmetric bidentate nitrate groups. In the anion [Co(NO 3 ) 4 ] 2− of the crystal structure of compound II, one of the four NO 3 groups is monodentate and the other NO 3 groups are bidentate (the coordination number of the cobalt atom is equal to seven, and the cobalt coordination polyhedron is a monocapped trigonal prism). The crystal structures of compounds III and IV contain infinite chains of the compositions [Co(NO 3 ) 2 (NO 3 ) 2/2 ] − and [Ni(NO 3 ) 3 (NO 3 ) 2/2 ] 2− , respectively. In the crystal structure of compound III, seven oxygen atoms of one monodentate and three bidentate nitrate groups form a dodecahedron with an unoccupied vertex of the A type around the Co atom. In the crystal structure of compound IV, the octahedral polyhedron of the Ni atom is formed by five nitrate groups, one of which is terminal bidentate. The data on the structure of Co(II) coordination polyhedra in the known nitratocobaltates are generalized.

Synthesis and crystal structures of nitratocobaltates Na2[Co(NO3)4], K2[Co(NO3)4], and Ag[Co(NO3)3] and potassium nitratonickelate K2[Ni(NO3)4

International Nuclear Information System (INIS)

Morozov, I. V.; Fedorova, A. A.; Albov, D. V.; Kuznetsova, N. R.; Romanov, I. A.; Rybakov, V. B.; Troyanov, S. I.

2008-01-01

The cobalt(II) and nickel(II) nitrate complexes with an island structure (Na 2 [Co(NO 3 ) 4 ] (I) and K 2 [Co(NO 3 ) 4 ] (II)] and a chain structure [Ag[Co(NO 3 ) 3 ] (III) and K 2 [Ni(NO 3 ) 4 ] (IV)] are synthesized and investigated using X-ray diffraction. In the anionic complex [Co(NO 3 ) 4 ] 2- of the crystal structure of compound I, the Co coordination polyhedron is a twisted tetragonal prism formed by the O atoms of four asymmetric bidentate nitrate groups. In the anion [Co(NO 3 ) 4 ] 2- of the crystal structure of compound II, one of the four NO 3 groups is monodentate and the other NO 3 groups are bidentate (the coordination number of the cobalt atom is equal to seven, and the cobalt coordination polyhedron is a monocapped trigonal prism). The crystal structures of compounds III and IV contain infinite chains of the compositions [Co(NO 3 ) 2 (NO 3 ) 2/2 ] - and [Ni(NO 3 ) 3 (NO 3 ) 2/2 ] 2- , respectively. In the crystal structure of compound III, seven oxygen atoms of one monodentate and three bidentate nitrate groups form a dodecahedron with an unoccupied vertex of the A type around the Co atom. In the crystal structure of compound IV, the octahedral polyhedron of the Ni atom is formed by five nitrate groups, one of which is terminal bidentate. The data on the structure of Co(II) coordination polyhedra in the known nitratocobaltates are generalized

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…

No-Regrets Remodeling, 2nd Edition

Energy Technology Data Exchange (ETDEWEB)

None

2013-12-01

No-Regrets Remodeling, sponsored by Oak Ridge National Laboratory, is an informative publication that walks homeowners and/or remodelers through various home remodeling projects. In addition to remodeling information, the publication provides instruction on how to incorporate energy efficiency into the remodeling process. The goal of the publication is to improve homeowner satisfaction after completing a remodeling project and to provide the homeowner with a home that saves energy and is comfortable and healthy.

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

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.

Heart failure guidelines and prescribing in primary care across Europe

Directory of Open Access Journals (Sweden)

Hobbs FD Richard

2005-08-01

Full Text Available Abstract Background Major international differences in heart failure treatment have been repeatedly described, but the reasons for these differences remain unclear. National guideline recommendations might be a relevant factor. This study, therefore, explored variation of heart failure guideline recommendations in Europe. Methods Treatment recommendations of 14 national guidelines published after 1994 were analyzed in relation to the heart failure treatment guideline of the European Society of Cardiology. To test potential relations between recommendations and prescribing, national prescribing patterns as obtained by a European study in primary care (IMPROVEMENT-HF were related to selected recommendations in those countries. Results Besides the 14 national guidelines used by primary care physicians in the countries contacted, the European guideline was used in four countries, and separate guidelines for specialists and primary care were available in another four countries. Two countries indicated that no guideline was used up to 2000. Comprehensiveness of the guidelines varied with respect to length, literature included and evidence ratings. Relevant differences in treatment recommendations were seen only in drug classes where evidence had changed recently (β-blockers and spironolactone. The relation between recommendation and prescribing for selected recommendations was inconsistent among countries. Conclusion Differences in guideline recommendations are not sufficient to explain variation of prescribing among countries, thus other factors must be considered.

Exchange of nitrogen dioxide (NO2) between plants and the atmosphere under laboratory and field conditions

Science.gov (United States)

Breuninger, C.; Meixner, F. X.; Thielmann, A.; Kuhn, U.; Dindorf, T.; Kesselmeier, J.

2012-04-01

Nitric oxide (NO), nitrogen dioxide (NO2), often denoted as nitrogen oxides (NOx), and ozone (O3) are considered as most important compounds in atmospheric chemistry. In remote areas NOx concentration is related to biological activities of soils and vegetation. The emitted NOx will not entirely be subject of long range transport through the atmosphere. Aside oxidation of NO2 by the OH radical (forming HNO3), a considerable part of it is removed from the atmosphere through the uptake of NO2 by plants. The exchange depends on stomatal activity and on NO2 concentrations in ambient air. It is known that NO2 uptake by plants represents a large NO2 sink, but the magnitude and the NO2 compensation point concentration are still under discussion. Our dynamic chamber system allows exchange measurements of NO2 under field conditions (uncontrolled) as well as studies under controlled laboratory conditions including fumigation experiments. For NO2 detection we used a highly NO2 specific blue light converter (photolytic converter) with subsequent chemiluminescence analysis of the generated NO. Furthermore, as the exchange of NO2 is a complex interaction of transport, chemistry and plant physiology, in our field experiments we determined fluxes of NO, NO2, O3, CO2 and H2O. For a better knowledge of compensation point values for the bi-directional NO2 exchange we investigated a primary representative of conifers, Picea abies, under field and laboratory conditions, and re-analyzed older field data of the deciduous tree Quercus robur.

40 CFR 205.5-2 - National security exemptions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false National security exemptions. 205.5-2... PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS General Provisions § 205.5-2 National security... a national security exemption is required. (c) For purposes of section 11(d) of the Act, any...

Competition and rural primary care programs.

Science.gov (United States)

Ricketts, T C

1990-04-01

Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

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

N2O and NO2 Emissions from Heavy-Duty Diesel Trucks with Advanced Emission Controls

Science.gov (United States)

Preble, C.; Harley, R.; Kirchstetter, T.

2014-12-01

Diesel engines are the largest source of nitrogen oxides (NOx) emissions nationally, and also a major contributor to the black carbon (BC) fraction of fine particulate matter (PM). Recently, diesel particle filter (DPF) and selective catalytic reduction (SCR) emission control systems that target exhaust PM and NOx have become standard equipment on new heavy-duty diesel trucks. However, the deliberate catalytic oxidation of engine-out nitric oxide (NO) to nitrogen dioxide (NO2) in continuously regenerating DPFs leads to increased tailpipe emission of NO2. This is of potential concern due to the toxicity of NO2 and the resulting increases in atmospheric formation of other air pollutants such as ozone, nitric acid, and fine PM. While use of SCR reduces emissions of both NO and NO2, it may lead to increased emissions of nitrous oxide (N2O), a potent greenhouse gas. Here we report results from on-road measurements of heavy-duty diesel truck emissions conducted at the Port of Oakland and the Caldecott Tunnel in the San Francisco Bay Area. Emission factors (g pollutant per kg of diesel) were linked via recorded license plates to individual truck attributes, including engine model year and installed emission control equipment. Between 2009 and 2013, the fraction of DPF-equipped trucks at the Port of Oakland increased from 2 to 99%, and median engine age decreased from 11 to 6 years. Over the same period, fleet-average emission factors for black carbon and NOx decreased by 76 ± 22% and 53 ± 8%, respectively. However, direct emissions of NO2 increased, and consequently the NO2/NOx emission ratio increased from 0.03 ± 0.02 to 0.18 ± 0.03. Older trucks retrofitted with DPFs emitted approximately 3.5 times more NO2 than newer trucks equipped with both DPF and SCR. Preliminary data from summer 2014 measurements at the Caldecott Tunnel suggest that some older trucks have negative emission factors for N2O, and that for newer trucks, N2O emission factors have changed sign and

40 CFR 204.5-2 - National security exemptions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false National security exemptions. 204.5-2... PROGRAMS NOISE EMISSION STANDARDS FOR CONSTRUCTION EQUIPMENT General Provisions § 204.5-2 National security... for a national security exemption is required. (c) For purposes of section 11(d) of the Act, any...

Knowledge and Practice of Sun Protection in Schools in South Africa Where No National Sun Protection Programme Exists

Science.gov (United States)

Wright, Caradee Y.; Reeder, Anthony I.; Albers, Patricia N.

2016-01-01

Interventions in primary schools that increase sun-protective behaviours and decrease ultraviolet radiation exposure, sunburn incidence and skin cancer risk can be effective. SunSmart School Accreditation Programmes (SSAP) are recommended. Prior to SSAP implementation in South Africa, we explored the feasibility of obtaining national baseline…

The Next-generation Berkeley High Resolution NO2 (BEHR NO2) Retrieval: Design and Preliminary Emissions Constraints

Science.gov (United States)

Laughner, J.; Cohen, R. C.

2017-12-01

Recent work has identified a number of assumptions made in NO2 retrievals that lead to biases in the retrieved NO2 column density. These include the treatment of the surface as an isotropic reflector, the absence of lightning NO2 in high resolution a priori profiles, and the use of monthly averaged a priori profiles. We present a new release of the Berkeley High Resolution (BEHR) OMI NO2 retrieval based on the new NASA Standard Product (version 3) that addresses these assumptions by: accounting for surface anisotropy by using a BRDF albedo product, using an updated method of regridding NO2 data, and revised NO2 a priori profiles that better account for lightning NO2 and daily variation in the profile shape. We quantify the effect these changes have on the retrieved NO2 column densities and the resultant impact these updates have on constraints of urban NOx emissions for select cities throughout the United States.

Catalytic oxidation of NO to NO2 on activated carbon

International Nuclear Information System (INIS)

Zhancheng Guo; Yusheng Xie

2001-01-01

Catalytic oxidation of NO to NO 2 over activated carbons PAN-ACF, pitch-ACF and coconut-AC at room temperature (30 o C) were studied to develop a method based on oxidative removal of NO from flue gases. For a dry gas, under the conditions of a gas space flow rate 1500 h -1 in the presence of oxygen of 2-20% in volume concentration, the activated coconut carbon with a surface area 1200 m 2 /g converted about 81-94% of NO with increasing oxygen concentration, the pitch based activated carbon fiber with a surface area 1000 m 2 /g about 44-75%, and the polyacrylonitrile-based activated carbon fiber with a surface area 1810 m 2 /g about 25-68%. The order of activity of the activated carbons was PAN-ACF c P NO P O2 β (F/W), where β is 0.042, 0.16, 0.31 for the coconut-AC, the pitch-ACF and the PAN-ACF respectively, and k c is 0.94 at 30 o C. (author)

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...

Act no. 933 of 11 August 1960. Establishment of the National Nuclear Energy Commission

International Nuclear Information System (INIS)

1960-01-01

This Act which sets up the Comitato Nazionale per l'Energia Nucleare (CNEN) abolishes at the same time the National Committee for Nuclear Research (Comitato nazionale per le ricerche nucleari). This present Act No. 933 was subsequently annulled by Act No. 1240 of 15 December 1971 with the exception of Sections 12 to 16 which remained valid. (NEA) [fr

NJP VOLUME 41 NO 2

African Journals Online (AJOL)

PROF. EZECHUKWU

2013-11-24

Nov 24, 2013 ... nation and volume of urine voided; from1- 2 times to 10. -15 times during the day ... Serum electrolytes, urea and creatinine done on admis- sion showed ... cient synthesis and or release of AVP.7The clinical manifestation of ...

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.

Native-tissue repair of isolated primary rectocele compared with nonabsorbable mesh

DEFF Research Database (Denmark)

Madsen, Lene Duch; Nussler, Emil; Kesmodel, Ulrik Schioler

2017-01-01

and included 3988 women with a primary operation for rectocele between 2006 and 2014: 3908 women had native-tissue repair, 80 were operated with nonabsorbable mesh. No concurrent operations were performed. Pre- and perioperative data were collected from doctors and patients. Patient-reported outcomes were......INTRODUCTION: We evaluated patient-reported outcomes and complications after treatment of isolated primary rectocele in routine health-care settings using native-tissue repair or nonabsorbable mesh. METHODS: We used prospective data from the Swedish National Register for Gynaecological Surgery...

Saúde ambiental e saúde do trabalhador na atenção primária à saúde, no SUS: oportunidades e desafios Environmental and workers' health, within the framework of primary health care in the Brazilian National Health System (SUS: opportunities and challenges

Directory of Open Access Journals (Sweden)

Elizabeth Costa Dias

2009-12-01

Full Text Available O texto busca contribuir para a discussão dos entrecruzamentos entre os campos da saúde ambiental e da saúde do trabalhador, referenciada no cenário brasileiro das relações produção/trabalho, ambiente e saúde e nas mudanças na organização do SUS, com destaque para o papel da atenção primária à saúde (APS, e se destina a contribuir para as discussões no processo de preparação da 1ª Conferência Nacional de Saúde Ambiental (1ª CNSA, prevista para ser realizada em dezembro de 2009. São descritos, de modo sintético, aspectos históricos e conceituais desses campos, algumas das características compartilhadas e as ações esperadas do sistema de saúde, com destaque para o papel da APS e a importância do diálogo com o movimento social. Finalizando, são identificados pontos para uma agenda de trabalho comum.This paper has the purpose of contributing to the discussion of the crossing areas between Environmental Health and Workers´ Health, in the Brazilian context of Labor, Production, Environment and Health. This paper emerges in the context of the current organizational changes of the Brazilian National Health System (SUS, with a major focus on Primary Health Care, having in mind, also, the preparation of the 1st National Environmental Health Conference (1ª CNSA to be held in December of 2009. So, historical and conceptual aspects of those fields are described in a summarized manner, as well as some shared features and expected actions of the Health System, with emphasis to the role of Primary Health Care and to the importance of the dialogue with the social movement. Finally, some topics for a common agenda were identified by the authors.

Folded tubular photometer for atmospheric measurements of NO2 and NO

Science.gov (United States)

Birks, John W.; Andersen, Peter C.; Williford, Craig J.; Turnipseed, Andrew A.; Strunk, Stanley E.; Ennis, Christine A.; Mattson, Erick

2018-05-01

We describe and characterize a modular folded tubular photometer for making direct measurements of the concentrations of nitrogen dioxide (NO2) and specify how this method could be extended to measure other pollutants such as sulfur dioxide (SO2), ozone (O3), and black carbon particulate matter. Direct absorbance measurements using this photometer can be made across the spectral range from the ultraviolet (UV) to the near infrared. The absorbance cell makes use of modular components (tubular detection cells and mirror cubes) that allow construction of path lengths of up to 2 m or more while maintaining low cell volumes. The long path lengths and low cell volumes enable sensitive detection of ambient air pollutants down to low part-per-billion levels for gas species and aerosol extinctions down to 1 Mm-1, corresponding to ˜ 0.1 µg m-3 for black carbon particulates. Pressure equalization throughout the stages of the absorbance measurement is shown to be critical to accurate measurements of analyte concentrations. The present paper describes the application of this photometer to direct measurements of nitrogen dioxide (NO2) and the incorporation of design features that also enable measurement of nitric oxide (NO) in the same instrument. Excellent agreement for ambient measurements along an urban roadside was found for both NO2 and NO measured by the folded tubular photometer compared to existing standard techniques. Compared to commonly used methods for measurements of NOx species, the advantages of this approach include (1) an absolute quantification for NO2 based on the Beer-Lambert law, thereby greatly reducing the frequency at which calibrations are required; (2) the direct measurement of NO2 concentration without prior conversion to NO as is required for the commonly used chemiluminescence method; (3) the use of modular components that allow construction of absorbance detection cells of varying lengths for extending the dynamic range of concentrations that can

Radiation therapy for primary orbital lymphoma

International Nuclear Information System (INIS)

Chao, Cliff K.S.; Lin Hsiusan; Rao Devineni, V.; Smith, Morton

1995-01-01

Purpose: The influence of tumor size, grade, thoroughness of staging workup, and radiation dose on disease control, radiation-related complications, and incidence of systemic progression of primary orbital lymphoma is analyzed. Methods and Materials: Twenty patients with Stage I primary orbital lymphoma were treated from August 1976 through August 1991 at Mallinckrodt Institute of Radiology. Staging workups included physical examination, chest x-ray, complete blood count (CBC), liver function test, and computerized tomography (CT) scan of the orbit, abdomen, and pelvis. Nineteen patients had bone marrow biopsy. The histological types based on the National Cancer Institute working formulation were 9 low-grade and 11 intermediate-grade, including five lymphocytic lymphomas of intermediate differentiation. The extension of disease and the volume of tumor were evaluated by CT scan of the orbit. The most commonly used radiation therapy technique was single anterior direct field with 4 MV or 6 MV photons. Lens was shielded or not treated in eight patients. Dose ranged from 20 to 43.2 Gy. Thirteen of 20 patients received 30 Gy. Minimum follow-up was 24 months (median, 4 years). Results: Local control was achieved in all 20 patients. One patient with lymphocytic lymphoma with intermediate differentiation developed disseminated disease. Actuarial disease-free survival (DFS) was 100% and 90% at 2 and 5 years, respectively. No retinopathy was observed. Cataracts were noted in seven patients at 1 to 10 years following irradiation (median, 2 years). Three patients developed lacrimal function disorder, however, no corneal ulceration occurred. Conclusions: Thirty Gy in 15 fractions appears to be a sufficient dose for local control with acceptable morbidity, especially for low-grade, as well as certain types of intermediate-grade lymphomas, such as diffuse small cleaved cell and lymphocytic lymphoma of intermediate differentiation. Systemic dissemination is minimal, provided local

Radiation therapy for primary orbital lymphoma

Energy Technology Data Exchange (ETDEWEB)

Chao, Cliff K.S.; Hsiusan, Lin; Rao Devineni, V; Smith, Morton

1995-02-15

Purpose: The influence of tumor size, grade, thoroughness of staging workup, and radiation dose on disease control, radiation-related complications, and incidence of systemic progression of primary orbital lymphoma is analyzed. Methods and Materials: Twenty patients with Stage I primary orbital lymphoma were treated from August 1976 through August 1991 at Mallinckrodt Institute of Radiology. Staging workups included physical examination, chest x-ray, complete blood count (CBC), liver function test, and computerized tomography (CT) scan of the orbit, abdomen, and pelvis. Nineteen patients had bone marrow biopsy. The histological types based on the National Cancer Institute working formulation were 9 low-grade and 11 intermediate-grade, including five lymphocytic lymphomas of intermediate differentiation. The extension of disease and the volume of tumor were evaluated by CT scan of the orbit. The most commonly used radiation therapy technique was single anterior direct field with 4 MV or 6 MV photons. Lens was shielded or not treated in eight patients. Dose ranged from 20 to 43.2 Gy. Thirteen of 20 patients received 30 Gy. Minimum follow-up was 24 months (median, 4 years). Results: Local control was achieved in all 20 patients. One patient with lymphocytic lymphoma with intermediate differentiation developed disseminated disease. Actuarial disease-free survival (DFS) was 100% and 90% at 2 and 5 years, respectively. No retinopathy was observed. Cataracts were noted in seven patients at 1 to 10 years following irradiation (median, 2 years). Three patients developed lacrimal function disorder, however, no corneal ulceration occurred. Conclusions: Thirty Gy in 15 fractions appears to be a sufficient dose for local control with acceptable morbidity, especially for low-grade, as well as certain types of intermediate-grade lymphomas, such as diffuse small cleaved cell and lymphocytic lymphoma of intermediate differentiation. Systemic dissemination is minimal, provided local

Interlibrary loan in primary access libraries: challenging the traditional view.

Science.gov (United States)

Dudden, R F; Coldren, S; Condon, J E; Katsh, S; Reiter, C M; Roth, P L

2000-10-01

Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher

BODY MASS STATUS AMONG PRIMARY SCHOOL GOING CHILDREN

Directory of Open Access Journals (Sweden)

Kashmala khan

2016-08-01

Full Text Available Background: School going children is important part of our society. Their growth, development and body weight is of utmost significance and presents general health status of a community and nation as a whole. For the assessment of nutritional status WHO Asian cuts-off BMI for age recommended BMI less than 18.5 kg/m considered underweight, 18.5-24.9 normal weight, more than 25 overweight. The objective of this study is to access body mass status among primary school going children of Hyderabad. Methods: The study design was cross sectional study in which different school of Hyderabad were selected to collect data (semi government and private sector.This study has assessed the body mass index between 7-14 years old age group of both genders of primary school going children of Hyderabad. BMI has calculated with the help of weight and height of the body. Result: In this study out of 100 children 10%were 7-8 year old 20% were 9-10 year old, 20% were 11-12year old and 30% were 13-14 year old. The analysis shows 80% were underweight (below 18.5, 18% were normal weight (18.5-24.9 and only 2% overweight (above 25 according to the Asian cut-off value of BMI for Asian children. When it was analyzed by gender 62% of the boys and 18% of the girls were underweight, 6% of boys and 12% out of girls were normal weight, 2% of the boys were overweight no girl found overweight in the study. In the above study 80% found underweight, 18% normal weight, 2% overweight. Conclusion: Under nutrition among the school going children is currently a health problem faced by Hyderabad school going children. There is need to be taken address these problems in order to prevent nation from nutritional deficiency among school going children and buildup a strong and healthy nation in future.

Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design

Directory of Open Access Journals (Sweden)

Cully Jeffrey A

2012-07-01

Full Text Available Abstract Background Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. Methods This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1 to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases primary care patients and (2 to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200 or usual care (n = 120. Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points and

Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design.

Science.gov (United States)

Cully, Jeffrey A; Armento, Maria E A; Mott, Juliette; Nadorff, Michael R; Naik, Aanand D; Stanley, Melinda A; Sorocco, Kristen H; Kunik, Mark E; Petersen, Nancy J; Kauth, Michael R

2012-07-11

Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e.g., focus interviews

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.

Folded tubular photometer for atmospheric measurements of NO2 and NO

Directory of Open Access Journals (Sweden)

J. W. Birks

2018-05-01

Full Text Available We describe and characterize a modular folded tubular photometer for making direct measurements of the concentrations of nitrogen dioxide (NO2 and specify how this method could be extended to measure other pollutants such as sulfur dioxide (SO2, ozone (O3, and black carbon particulate matter. Direct absorbance measurements using this photometer can be made across the spectral range from the ultraviolet (UV to the near infrared. The absorbance cell makes use of modular components (tubular detection cells and mirror cubes that allow construction of path lengths of up to 2 m or more while maintaining low cell volumes. The long path lengths and low cell volumes enable sensitive detection of ambient air pollutants down to low part-per-billion levels for gas species and aerosol extinctions down to 1 Mm−1, corresponding to  ∼  0.1 µg m−3 for black carbon particulates. Pressure equalization throughout the stages of the absorbance measurement is shown to be critical to accurate measurements of analyte concentrations. The present paper describes the application of this photometer to direct measurements of nitrogen dioxide (NO2 and the incorporation of design features that also enable measurement of nitric oxide (NO in the same instrument. Excellent agreement for ambient measurements along an urban roadside was found for both NO2 and NO measured by the folded tubular photometer compared to existing standard techniques. Compared to commonly used methods for measurements of NOx species, the advantages of this approach include (1 an absolute quantification for NO2 based on the Beer–Lambert law, thereby greatly reducing the frequency at which calibrations are required; (2 the direct measurement of NO2 concentration without prior conversion to NO as is required for the commonly used chemiluminescence method; (3 the use of modular components that allow construction of absorbance detection cells of varying lengths for extending the

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.

26 CFR 1.132-2 - No-additional-cost services.

Science.gov (United States)

2010-04-01

... traveling on a space-available basis are merely incidental to the primary service being provided (i.e., air transportation). Similarly, maid service provided to hotel employees renting hotel rooms on a space-available.... Assume that a commercial airline permits its employees to take personal flights on the airline at no...

Validation of NO2 and NO from the Atmospheric Chemistry Experiment (ACE

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M. Schneider

2008-10-01

Full Text Available Vertical profiles of NO2 and NO have been obtained from solar occultation measurements by the Atmospheric Chemistry Experiment (ACE, using an infrared Fourier Transform Spectrometer (ACE-FTS and (for NO2 an ultraviolet-visible-near-infrared spectrometer, MAESTRO (Measurement of Aerosol Extinction in the Stratosphere and Troposphere Retrieved by Occultation. In this paper, the quality of the ACE-FTS version 2.2 NO2 and NO and the MAESTRO version 1.2 NO2 data are assessed using other solar occultation measurements (HALOE, SAGE II, SAGE III, POAM III, SCIAMACHY, stellar occultation measurements (GOMOS, limb measurements (MIPAS, OSIRIS, nadir measurements (SCIAMACHY, balloon-borne measurements (SPIRALE, SAOZ and ground-based measurements (UV-VIS, FTIR. Time differences between the comparison measurements were reduced using either a tight coincidence criterion, or where possible, chemical box models. ACE-FTS NO2 and NO and the MAESTRO NO2 are generally consistent with the correlative data. The ACE-FTS and MAESTRO NO2 volume mixing ratio (VMR profiles agree with the profiles from other satellite data sets to within about 20% between 25 and 40 km, with the exception of MIPAS ESA (for ACE-FTS and SAGE II (for ACE-FTS (sunrise and MAESTRO and suggest a negative bias between 23 and 40 km of about 10%. MAESTRO reports larger VMR values than the ACE-FTS. In comparisons with HALOE, ACE-FTS NO VMRs typically (on average agree to ±8% from 22 to 64 km and to +10% from 93 to 105 km, with maxima of 21% and 36%, respectively. Partial column comparisons for NO2 show that there is quite good agreement between the ACE instruments and the FTIRs, with a mean difference of +7.3% for ACE-FTS and +12.8% for MAESTRO.

Influence of trade on national CO2 emissions

International Nuclear Information System (INIS)

Munksgaard, Jesper; Pade, Lise-Lotte; Minx, Jan; Lenzen, Manfred

2005-01-01

International trade has an impact on national CO 2 emissions and consequently on the ability to fulfil national CO 2 reduction targets. Through goods and services traded in a globally interdependent world, the consumption in each country is linked to greenhouse gas emissions in other countries. It has been argued that in order to achieve equitable reduction targets, international trade has to be taken into account when assessing nations' responsibility for abating climate change. Especially for open economies such as Denmark, greenhouse gases embodied in internationally traded commodities can have a considerable influence on the national 'greenhouse gas responsibility'. By using input-output modelling, we analyse the influence from international trade on national CO 2 emissions. The aim is to show that trade is the key to define CO 2 responsibility on a macroeconomic level and that imports should be founded in a multi-region model approach. Finally, the paper concludes on the need to consider the impact from foreign trade when negotiating reduction targets and base line scenarios. (Author)

Reactor primary coolant system pipe rupture study. Progress report No. 33, January--June 1975

International Nuclear Information System (INIS)

1975-10-01

The pipe rupture study is designed to extend the understanding of failure-causing mechanisms and to provide improved capability for evaluating reactor piping systems to minimize the probability of failures. Following a detailed review to determine the effort most needed to improve nuclear system piping (Phase 1), analytical and experimental efforts (Phase 2) were started in 1965. This progress report summarizes the recent accomplishments of a broad program in (a) basic fatigue crack growth rate studies focused on LWR primary piping materials in a simulated BWR primary coolant environment, (b) at-reactor tests of the effect of primary coolant environment on the fatigue behavior of piping steels, (c) studies directed at quantifying weld sensitization in Type 304 stainless steel, (d) support studies to characterize the electrochemical potential behavior of a typical BWR primary water environment and (e) special tests related to simulation of fracture surfaces characteristic of IGSCC field failures

Hanford 200 East Area ambient NO/sub x/ concentrations, February 1968 through February 1969

International Nuclear Information System (INIS)

Ramsdell, J.V.

1981-09-01

Ambient concentrations of oxides of nitrogen (NO/sub x/) were measured in the vicinity of the 200 East Area of Hanford from late February 1968 through February 1969. This report contains an analysis of the complete set to document the ambient NO/sub x/ concentrations during time periods when the Purex Plant was emitting NO/sub x/. It is not intended to represent either current ambient NO/sub x/ concentrations or concentrations during Purex Plant operation in the future. However, it does provide a reference for use in comparison of ambient NO/sub x/ concentrations during future periods of Purex emissions with those occurring in past periods. It is also of interest to compare the annual average concentrations estimated from the measurements with the national primary ambient air quality standard for NO 2 , which is 50 parts per billion (ppb) annual arithmetic mean

HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity

Data.gov (United States)

National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

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 ...

Elevated plasma angiopoietin-2 levels and primary graft dysfunction after lung transplantation.

Directory of Open Access Journals (Sweden)

Joshua M Diamond

Full Text Available Primary graft dysfunction (PGD is a significant contributor to early morbidity and mortality after lung transplantation. Increased vascular permeability in the allograft has been identified as a possible mechanism leading to PGD. Angiopoietin-2 serves as a partial antagonist to the Tie-2 receptor and induces increased endothelial permeability. We hypothesized that elevated Ang2 levels would be associated with development of PGD.We performed a case-control study, nested within the multi-center Lung Transplant Outcomes Group cohort. Plasma angiopoietin-2 levels were measured pre-transplant and 6 and 24 hours post-reperfusion. The primary outcome was development of grade 3 PGD in the first 72 hours. The association of angiopoietin-2 plasma levels and PGD was evaluated using generalized estimating equations (GEE.There were 40 PGD subjects and 79 non-PGD subjects included for analysis. Twenty-four PGD subjects (40% and 47 non-PGD subjects (59% received a transplant for the diagnosis of idiopathic pulmonary fibrosis (IPF. Among all subjects, GEE modeling identified a significant change in angiopoietin-2 level over time in cases compared to controls (p = 0.03. The association between change in angiopoietin-2 level over the perioperative time period was most significant in patients with a pre-operative diagnosis of IPF (p = 0.02; there was no statistically significant correlation between angiopoietin-2 plasma levels and the development of PGD in the subset of patients transplanted for chronic obstructive pulmonary disease (COPD (p = 0.9.Angiopoietin-2 levels were significantly associated with the development of PGD after lung transplantation. Further studies examining the regulation of endothelial cell permeability in the pathogenesis of PGD are indicated.

Selective measurements of isoprene and 2-methyl-3-buten-2-ol based on NO+ ionization mass spectrometry

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W. Jud

2012-12-01

Full Text Available Biogenic VOC emissions are often dominated by 2-methyl-1,3-butadiene (isoprene and 2-methyl-3-buten-2-ol (232 MBO. Here we explore the possibility to selectively distinguish these species using NO+ as a primary ion in a conventional PTR-MS equipped with an SRI unit. High purity of NO+ (>90% as a primary ion was utilized in laboratory and field experiments using a conventional PTR-TOF-MS. Isoprene is ionized via charge transfer leading to the major product ion C5H8+ (>99% (e.g. Spanel and Smith, 1998. 232 MBO undergoes a hydroxide ion transfer reaction resulting in the major product ion channel C5H9+ (>95% (e.g. Amelynck et al., 2005. We show that both compounds are ionized with little fragmentation (>5% under standard operating conditions. Typical sensitivities of 11.1 ± 0.1 (isoprene and 12.9 ± 0.1 (232 MBO ncps ppbv−1 were achieved, which correspond to limit of detections of 18 and 15 pptv respectively for a 10 s integration time. Sensitivities decreased at higher collisional energies. Calibration experiments showed little humidity dependence. We tested the setup at a field site in Colorado dominated by ponderosa pine, a 232 MBO emitting plant species. Our measurements confirm 232 MBO as the dominant biogenic VOC at this site, exhibiting typical average daytime concentrations between 0.2–1.4 ppbv. The method is able to detect the presence of trace levels of isoprene at this field site (90–250 ppt without any interference from 232 MBO, which would not be feasible using H3O+ ionization chemistry, and which currently also remains a challenge for other analytical techniques (e.g. gas chromatographic methods.

Tropospheric NO2 over China

NARCIS (Netherlands)

A, van der R.J.; Peters, D.H.M.U.; Kuenen, J.J.P.; Eskes, H.J.; Boersma, K.F.; Roozendael, Van M.; Smedt, de I.; Zhang, P.; Kelder, H.M.; Lacoste, H.; Ouwehand, L.

2006-01-01

The results are presented of a study to tropospheric NO2 over China, based on measurements from the satellite instruments GOME and SCIAMACHY. A data set of 10 year tropospheric NO2 has been processed from GOME and SCIAMACHY observations using a combined retrieval/assimilation approach. This approach

Primary energy and greenhouse gases embodied in Australian final consumption: an input-output analysis

International Nuclear Information System (INIS)

Lenzen, M.

1998-01-01

Input-output modeling of primary energy and greenhouse gas embodiments in goods and services is a useful technique for designing greenhouse gas abatement policies. The present paper describes direct and indirect primary energy and greenhouse gas requirements for a given set of Australian final consumption. It considers sectoral disparities in energy prices, capital formation and international trade flows and it accounts for embodiments in the Gross National Expenditure as well as the Gross Domestic Product. Primary energy and greenhouse gas intensities in terms of MJ/$ and kg CO 2 -e/$ are reported, as well as national balance of primary energy consumption and greenhouse gas emissions. (author)

Evaluation of OMI operational standard NO2 column retrievals using in situ and surface-based NO2 observations

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L. N. Lamsal

2014-11-01

Full Text Available We assess the standard operational nitrogen dioxide (NO2 data product (OMNO2, version 2.1 retrieved from the Ozone Monitoring Instrument (OMI onboard NASA's Aura satellite using a combination of aircraft and surface in~situ measurements as well as ground-based column measurements at several locations and a bottom-up NOx emission inventory over the continental US. Despite considerable sampling differences, NO2 vertical column densities from OMI are modestly correlated (r = 0.3–0.8 with in situ measurements of tropospheric NO2 from aircraft, ground-based observations of NO2 columns from MAX-DOAS and Pandora instruments, in situ surface NO2 measurements from photolytic converter instruments, and a bottom-up NOx emission inventory. Overall, OMI retrievals tend to be lower in urban regions and higher in remote areas, but generally agree with other measurements to within ± 20%. No consistent seasonal bias is evident. Contrasting results between different data sets reveal complexities behind NO2 validation. Since validation data sets are scarce and are limited in space and time, validation of the global product is still limited in scope by spatial and temporal coverage and retrieval conditions. Monthly mean vertical NO2 profile shapes from the Global Modeling Initiative (GMI chemistry-transport model (CTM used in the OMI retrievals are highly consistent with in situ aircraft measurements, but these measured profiles exhibit considerable day-to-day variation, affecting the retrieved daily NO2 columns by up to 40%. This assessment of OMI tropospheric NO2 columns, together with the comparison of OMI-retrieved and model-simulated NO2 columns, could offer diagnostic evaluation of the model.

Catalytic conversion of CO, NO and SO2 on supported sulfide catalysts. Part 2. Catalytic reduction of NO and SO2 by CO

International Nuclear Information System (INIS)

Zhuang, S.-X.; Yamazaki, M.; Omata, K.; Takahashi, Y.; Yamada, M.

2001-01-01

To investigate the possibility of simultaneous catalytic reduction of NO and SO 2 by CO, reactions of NO, NO-CO, and NO-SO 2 -CO were performed on γ-alumina-supported sulfides of transition metals including Co, Mo, CoMo and FeMo. NO was decomposed into N 2 O and N 2 accompanied with the formation of SO 2 ; this serious oxidation of lattice sulfur resulted in the deactivation of the catalysts. The addition of CO to the NO stream suppressed SO 2 formation and yielded COS instead. A stoichiometric conversion of NO and CO to N 2 and CO 2 was observed above 350C on the CoMo and the FeMo catalysts. Although the CO addition lengthened catalyst life, it was not enough to maintain activity. After the NO-CO reaction, an XPS analysis showed the growth of Mo 6+ and SO 4 2- peaks, especially for the sulfided FeMo/Al 2 O 3 ; the FeMo catalyst underwent strong oxidation in the NO-CO reaction. The NO and the NO-CO reactions proceeded non-catalytically, consuming catalyst lattice sulfur to yield SO 2 or COS. The addition of SO 2 in the NO-CO system enabled in situ regeneration of the catalysts; the catalysts oxidized through abstraction of lattice sulfur experienced anew reduction and sulfurization through the SO 2 -CO reaction at higher temperature. NO and SO 2 were completely and catalytically converted at 400C on the sulfided CoMo/Al 2 O 3 . By contrast, the sulfided FeMo/Al 2 O 3 was easily oxidized by NO and hardly re-sulfided under the test conditions. Oxidation states of the metals before and after the reactions were determined. Silica and titania-supported CoMo catalysts were also evaluated to study support effects

History and National Development | Oyeranmi | Journal of History ...

African Journals Online (AJOL)

Volumes of works have been written on the subject of the relevance of history to national development in Nigeria. To „.non historians.. history teaches no particular skill “since the primary focus of history is the past... Does history still serve any purpose especially in the 21st century? What are those values embedded in ...

Photodissociation constant of NO2

International Nuclear Information System (INIS)

Nootebos, M.A.; Bange, P.

1992-01-01

The velocity of the dissociation of NO 2 into ozone and NO mainly depends on the ultraviolet sunlight quantity, and with that the cloudiness. A correct value for this reaction constant is important for the accurate modelling of O 3 - and NO 2 -concentrations in plumes of electric power plants, in particular in the case of determination of the amount of photochemical summer smog. An advanced signal processing method (deconvolution, correlation) was applied on the measurements. The measurements were carried out from aeroplanes

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.

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.

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

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.

Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

Directory of Open Access Journals (Sweden)

Tsima BM

2016-08-01

Full Text Available Billy M Tsima,1 Vincent Setlhare,1 Oathokwa Nkomazana2 1Department of Family Medicine and Public Health, 2Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana Background: Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers.Methods: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list.Results: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed.Conclusion: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better

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

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…

40 CFR 211.110-2 - National security exemptions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false National security exemptions. 211.110... ABATEMENT PROGRAMS PRODUCT NOISE LABELING General Provisions § 211.110-2 National security exemptions. (a) A new product which is produced to conform with specifications developed by national security agency...

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.

Trabecular metal acetabular components in primary total hip arthroplasty

DEFF Research Database (Denmark)

Laaksonen, Inari; Lorimer, Michelle; Gromov, Kirill

2018-01-01

Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship...... of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were...

45 CFR 650.2 - National Science Foundation patent policy.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false National Science Foundation patent policy. 650.2... FOUNDATION PATENTS § 650.2 National Science Foundation patent policy. As authorized by the National Science... adopted the following statement of NSF patent policy. (a) In accordance with the Bayh-Dole Act and the...

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.

Draft environmental statement: Related to operation of the Edwin I. Hatch Nuclear Plant Unit No. 2, Georgia Power Company: Docket No. 50-366

International Nuclear Information System (INIS)

1977-04-01

The proposed action is the issuance of an operation license to the Georgia Power Company for the startup and operation of the Edwin I. Hatch Nuclear Plant, Unit No. 2 (Docket No. 50-366), located on the Altamaha River in Appling County, approximately 11 miles north from Baxley, Georgia. The information in this Statement represents the second, assessment of the environmental impact associated with the Edwin I. Hatch Nuclear Plant, Unit No. 2, pursuant to the guidelines of the National Environmental Policy Act of 1969 (NEPA) and 10 CFR Part 51 of the Commission's Regulations. After receipt of an application, in 1970, to construct this plant, the staff carried out a review of impact that would occur during the construction and operation of this plant. That evaluation was issued as a Final Environmental Statement in October 1972. As the result of that environmental review, a safety review, an evaluation by the Advisory Committee on Reactor Safeguards, and a public hearing in Baxley, Georgia and Washington, D.C., the AEC (now NRC) issued a permit in December 1972, for the construction of Unit No. 2 of the Edwin I. Hatch Nuclear Plant. As of February 1977, the construction of Unit No. 2 was 70% complete. With a proposed fuel-loading date of April 1978 for Unit No. 2, the applicant has petitioned for license to operate Unit No. 2 and has submitted (July 1975) the required safety and environmental reports to substantiate this petition. 97 refs., 18 figs., 37 tabs

Primary tetralogy of Fallot repair: predictors of intensive care unit morbidity.

Science.gov (United States)

Egbe, Alexander C; Uppu, Santosh C; Mittnacht, Alexander J C; Joashi, Umesh; Ho, Deborah; Nguyen, Khanh; Srivastava, Shubhika

2014-09-01

Primary repair of tetralogy of Fallot has low surgical mortality, but some patients still experience significant postoperative morbidity. Our objectives were to review our institutional experience with primary tetralogy of Fallot repair, and identify predictors of intensive care unit morbidity. We reviewed all patients with tetralogy of Fallot who underwent primary repair in infancy from 2001 to 2012. Preoperative, operative, and postoperative demographic and morphologic data were analyzed. Intensive care unit morbidity was defined as prolonged intensive care unit stay (≥ 7 days) and/or prolonged duration of mechanical ventilation (≥ 48 h). 97 patients who underwent primary surgical repair during the study period were included in the study. The median age was 4.9 months (range 1-9 months) and the median weight was 5.3 kg (range 3.1-9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median intensive care unit stay was 6 days (range 2-21 days) and the median duration of mechanical ventilation was 19 h (range 0-136 h). Age and weight were independent predictors of intensive care unit stay, while surgical era predicted the duration of mechanical ventilation. Primary tetralogy of Fallot repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery were significant predictors of morbidity. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

NO2 decreases paracellular resistance to ion and solute flow in alveolar epithelial monolayers

International Nuclear Information System (INIS)

Cheek, J.M.; Kim, K.J.; Crandall, E.D.

1990-01-01

Primary cultured monolayers of rat alveolar epithelial cells grown on tissue culture-treated Nuclepore filters were exposed to 2.5 ppm nitrogen dioxide NO 2 for 2-20 min. Changes in monolayer bioelectric properties and solute permeabilities were subsequently measured. Exposure to NO 2 produced a dose-dependent decrease in monolayer transepithelial electrical resistance (Rt), whereas monolayer short-circuit current was unaffected. Post-exposure monolayer permeability to 14 C-sucrose (which primarily crosses alveolar epithelium via the paracellular pathway) increased markedly. That for 3 H-glycerol (which permeates through both paracellular and transcellular pathways) increased to a lesser extent. Partial recovery of Rt and solute permeabilities was noted by 48-h post-exposure. The time courses of the decrease in Rt and increase in solute permeabilities were similar. These results suggest that NO 2 primarily impairs passive alveolar epithelial barrier functions in vitro, probably by altering intercellular junctions, and does not appear to directly affect cell membrane active ion transport processes. When correlated with results obtained from experimental approaches, studies of in vitro alveolar epithelial monolayers may facilitate investigations of dosimetry, sites, and mechanisms of oxidant injury in the lung

48 CFR 204.470-2 - National security exclusion.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false National security... Within Industry 204.470-2 National security exclusion. (a) The U.S.-IAEA AP permits the United States... associated with such activities, with direct national security significance. (b) In order to ensure that all...

Primary health care and public policy.

Science.gov (United States)

Mangelsdorf, K L; Luna, J; Smith, H L

1988-01-01

The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

Room and high temperature interactions in sodium and rubidium rich ternary nitrate mixtures of UO2(NO3)2.6H2O - NaNO3 - RbNO3

International Nuclear Information System (INIS)

Kalekar, Bhupesh B.; Reddy, A.V.R.; Raje, Naina

2016-01-01

High temperature interaction behavior of nitrates is important for characterizing different intermediate products and their thermal stabilities during the calcination of nuclear waste before their immobilization in the stable glass matrix. Mixtures of UO 2 (NO 3 ) 2 .6H 2 O (UNH) with NaNO 3 (NaN) and RbNO 3 (RbN) were prepared by mixing the weighed amounts of component nitrates and grinding gently in a mortar and pestle. The mixing and grinding of individual nitrate components in a mortar with pestle showed the agglomeration of solid particles and subsequent dissolution probably in the water of crystallization of UNH. The continued grinding and mixing showed the reappearance of the solid powder. The original yellow color of the mixture was changed to greenish yellow color. The mixtures were subjected to thermal measurements using Netzsch Thermobalance (Model No.: STA 409 PC Luxx) coupled to Bruker FTIR system (Model No.: Tensor 27) via a heated Teflon capillary (1 m long, 2 mm i.d.). TG - DTG curves of equimolar mixture are displayed. The plateau was observed on TG curve in the temperature region of 31- 250 °C. It is reported that Na(UO 2 (NO 3 ) 3 ).H 2 O and Rb(UO 2 (NO 3 ) 3 ) formed around 250 °C in the equimolar nitrate mixtures of UNH-NaN and UNH-RbN. Thermal and XRD results indicated the formation of Na(UO 2 (NO 3 ) 3 ).H 2 O and Rb(UO 2 (NO) 3 ) 3 ) even by mixing the UNH, NaN and RbN in equimolar ratios at room temperature

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…

The Professional Development Needs of Special Needs Assistants in Irish Post-Primary Schools

Science.gov (United States)

Kerins, Pauline; Casserly, Ann Marie; Deacy, Evelyn; Harvey, Deirdre; McDonagh, Dolores; Tiernan, Bairbre

2018-01-01

According to government policy in Ireland, special needs assistants (SNAs) may be employed in post-primary schools to support students deemed to have chronic and serious care needs. There is currently no national policy regarding the continuing professional development (CPD) of SNAs, to meet the requirements of their role. This study investigated…

Fetal antigen 2 in primary and secondary brain tumors

DEFF Research Database (Denmark)

Rasmussen, H Boje; Teisner, B; Schrøder, H D

1991-01-01

Immunohistochemical deposition and distribution of fetal antigen 2 (FA2) was examined in normal brain tissue and in primary and metastatic tumors of the brain. In normal brain tissue FA2 was exclusively found linearly around the vessels, along pia and in arachnoidea. A similar localization was seen...

Primary Meningeal Rhabdomyosarcoma

Directory of Open Access Journals (Sweden)

Manisha Palta

2011-01-01

Full Text Available Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13. Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC systemic therapy.

Primary meningeal rhabdomyosarcoma.

Science.gov (United States)

Palta, Manisha; Riedel, Richard F; Vredenburgh, James J; Cummings, Thomas J; Green, Scott; Chang, Zheng; Kirkpatrick, John P

2011-01-01

Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy.

Primary Meningeal Rhabdomyosarcoma

Science.gov (United States)

Palta, Manisha; Riedel, Richard F.; Vredenburgh, James J.; Cummings, Thomas J.; Green, Scott; Chang, Zheng; Kirkpatrick, John P.

2011-01-01

Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy. PMID:21772793

Mercury distribution characteristics in primary manganese smelting plants

International Nuclear Information System (INIS)

Back, Seung-Ki; Sung, Jin-Ho; Moon, Young-Hoon; Kim, Young-Hee; Seok, Kwang-Seol; Song, Geum-Ju; Seo, Yong-Chil

2017-01-01

The mercury (Hg) distribution characteristics were investigated in three primary manganese smelting plants in Korea for the assessment of anthropogenic Hg released. Input and output materials were sampled from each process, and Hg concentrations in the samples were analyzed. Among the input materials, the most mercury was found in the manganese ore (83.1–99.7%) and mercury was mainly released through fly ash or off gas, depending on the condition of off gas cleaning system. As off gas temperature decreases, proportion and concentration of emitted gaseous elemental mercury (Hg 0 ) in off gas decreases. Based on mass balance study from these three plants and national manganese production data, the total amount of mercury released from those Korean plants was estimated to 644 kg/yr. About half of it was emitted into the air while the rest was released to waste as fly ash. With the results of this investigation, national inventory for Hg emission and release could be updated for the response to Minamata Convention on Mercury. - Graphical abstract: 1. Lack of data on mercury (Hg) distribution in manganese smelters. 2. Mass distribution of Hg released from 3 plants (as normalized values) were made as follows by measurements. 3. Information of distribution of Hg in Manganese smelters would be used for emission in to air and releases to other streams for the nation and globe in UNEP mercury report. - Highlights: • The mass balance study by on-site measurement from primary manganese smelting plants was made at first time in the world. • Hg distribution and main input and release pathways of Hg from primary manganese smelting plants could be found as the first time. • Gas temperature in bag filter affects Hg behavior and speciation changes in APCDs. • National inventory of Hg emssion has been updated with new data. - Mercury distribution in manganese smelting plant was investigated as the first measurements at commercial plants in the world. National Hg release

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…

[Characteristics of N2, N2O, NO, CO2 and CH4 Emissions in Anaerobic Condition from Sandy Loam Paddy Soil].

Science.gov (United States)

Cao, Na; Wang, Rui; Liao, Ting-ting; Chen, Nuo; Zheng, Xun-hua; Yao, Zhi-sheng; Zhang, Hai; Butterbach-Bahl, Klaus

2015-09-01

Understanding the characteristics of the production of nitrogen gases (N2, N2O and NO), CO2 and CH4 in anaerobic paddy soils is not only a prerequisite for an improved mechanistic understanding of key microbial processes involved in the production of atmospheric greenhouse gases (GHG), but might also provide the basis for designing greenhouse gas mitigation strategies. Moreover, quantifying the composition fractions of denitrification gaseous products is of key importance for improving parameterization schemes of microbial processes in process-oriented models which are increasingly used for assessing soil GHG emissions at site and national scales. In our experiments we investigated two sandy loam soils from two paddy fields. The initial concentrations of soil nitrate and dissolved organic carbon (DOC) were set at approximately 50 mg.kg-1 and mg.kg-1, respectively, by adding a mixture solution of KNO3 and glucose. The emissions of N2, N2O NO, CO2 and CH4, as well as concentrations of carbon and nitrogen substrates for each soil sample were measured simultaneously, using a gas-flow-soil-core technique and a paralleling substrate monitoring system. The results showed that the accumulative emissions of N2, N2O and NO of the two soil samples for the entire incubation period were 6 - 8, 20, and 15 - 18 mg.kg-1, respectively. By measuring the cumulative emissions of denitrification gases (N, = N2 + N2O + NO) we were able to explain 95% to 98% of observed changes in s1ifr nilrate concentrations. The mass fractions of N2, N2O and NO emissions to Nt were approximately 15% -19%, 47% -49%, and 34% -36%, respectively. Thus, in our experiments N2O and NO were the main products of denitrification for the entire incubation period. However, as the temporal courses of hourly or daily production of the denitrification gases showed, NO production dominated and peaked firstly, and then N2O, before finally N2 became the dominant product. Our results show the high temporal dynamic of

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

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/

Semantic Categorization and Reading Skill across Dutch Primary Grades: Development Yes, Relationship No

Science.gov (United States)

Gijsel, Martine A. R.; Ormel, Ellen A.; Hermans, Daan; Verhoeven, L.; Bosman, Anna M. T.

2011-01-01

In the present study, the development of semantic categorization and its relationship with reading was investigated across Dutch primary grade students. Three Exemplar-level tasks (Experiment 1) and two Superordinate-level tasks (Experiment 2) with different types of distracters (phonological, semantic and perceptual) were administered to assess…

Pacific Northwest National Laboratory Apatite Investigation at the 100-NR-2 Quality Assurance Project Plan

Energy Technology Data Exchange (ETDEWEB)

Fix, N. J.

2008-03-28

This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by staff working on the 100-NR-2 Apatite Project. The U.S. Department of Energy, Fluor Hanford, Inc., Pacific Northwest National Laboratory, and the Washington Department of Ecology agreed that the long-term strategy for groundwater remediation at 100-N would include apatite sequestration as the primary treatment, followed by a secondary treatment. The scope of this project covers the technical support needed before, during, and after treatment of the targeted subsurface environment using a new high-concentration formulation.

Investigation into the association between P2RX7 gene polymorphisms and susceptibility to primary gout and hyperuricemia in a Chinese Han male population.

Science.gov (United States)

Ying, Ying; Chen, Yong; Li, Zhen; Huang, Haiyan; Gong, Qiongyao

2017-04-01

The purpose of this study was to investigate the relationship between P2RX7 gene single nucleotide polymorphisms and primary gout and hyperuricemia in a Chinese Han male population. The genetic distributions of the single nucleotide polymorphisms (SNPs) rs2230911, rs208294, rs435309, rs28360447, rs1718119, rs28360457, and rs3751143 in P2RX7 were detected in 293 primary gout patients, 187 hyperuricemia patients and 269 controls using SNaPshot technology. Statistical analyses were implemented using SPSS version 20.0. The genetic distributions of each group were tested for Hardy-Weinberg equilibrium (HWE). T test, analysis of variance, rank sum test and Chi-square test were measured to assess differences in clinical data and polymorphisms among groups. Logistic regression was used to assess susceptibility to disease with odds ratios (ORs) and 95% confidence intervals (95% CIs). SHEsis software was used to calculate linkage disequilibrium blocks and haplotype association risk. P  .05). In the comparison between primary gout and control, the frequencies of rs2230911 genotypes were significantly different (P = .002), and allele G was associated with a higher risk of primary gout than allele C [OR (95% CI) = 1.755 (1.278, 2.410), P gout in genotype (CG + GG) compared with genotype CC [OR (95% CI) = 1.876 (1.303, 2.701), P = .001]. However, no significant difference in allelic or genotypic frequency was observed between primary gout patients and hyperuricemia patients (P > .0167). Similarly, there were no obvious differences in the other two polymorphisms among the three groups (P > .05). Our results reveal that P2RX7 rs2230911 may be associated with primary gout risk in a Chinese Han male population and allele G may be a susceptibility factor for primary gout.

Kinetics of the Reactions of IO Radicals with NO and NO2

Science.gov (United States)

Daykin, E. P.; Wine, P. H.

1997-01-01

A laser flash photolysis-long path absorption technique has been employed to study the kinetics of the reactions of IO radicals with NO and NO2 as a function of temperature and pressure. The IO and NO rate coefficient is independent of pressure over the range 40-200 Torr of N2, and its temperature dependence over the range 242-359 K is adequately described by the Arrhenius expression k(sub 1) = (6.9 +/- 1.7) x 10(exp -12) exp[(328 +/- 71)/T] cu cm/(molecule.s) (errors are 2 sigma, precision only). These Arrhenius parameters are similar to those determined previously for the ClO + NO and BrO + NO reactions. The IO and NO2 association reaction is found to be in the falloff regime over the temperature and pressure ranges investigated (254-354 K and 40-750 Torr of N2). Assuming F(sub c) = 0.4 independent of temperature, a physically reasonable set of falloff parameters which adequately describe the data are k(sub 0) = 7.7 x 10(exp -31)(T/300)(exp -5.0) cm(exp 6)/(molecule(exp 2).s) and k(sub infinity) = 1.55 x 10(exp -11)cu cm/(molecule.s) independent of temperature. The IO + NO2 rate coefficients determined in this study are about a factor of 2 faster than those reported in the only previous study of this reaction.

[Primary care in Ireland].

Science.gov (United States)

Sánchez-Sagrado, T

Spanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Next-Generation Aura/OMI NO2 and SO2 Products

Science.gov (United States)

Krotkov, Nickolay; Yang, Kai; Bucsela, Eric; Lamsal, Lok; Celarier, Edward; Swartz, William; Carn, Simon; Bhartia, Pawan; Gleason, James; Pickering, Ken;

Assessing primary care data quality.

Science.gov (United States)

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

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

Rev-Changes in Primary Energy Use and CO2 Emissions—An Impact Assessment for a Building with Focus on the Swedish Proposal for Nearly Zero Energy Buildings

Directory of Open Access Journals (Sweden)

Mattias Gustafsson

2017-07-01

Full Text Available In the European Union’s Energy Performance of Buildings Directive, the energy efficiency goal for buildings is set in terms of primary energy use. In the proposal from the National Board of Housing, Building, and Planning, for nearly zero energy buildings in Sweden, the use of primary energy is expressed as a primary energy number calculated with given primary energy factors. In this article, a multi-dwelling building is simulated and the difference in the primary energy number is investigated when the building uses heat from district heating systems or from heat pumps, alone or combined with solar thermal or solar photovoltaic systems. It is also investigated how the global CO2 emissions are influenced by the different energy system combinations and with different fuels used. It is concluded that the calculated primary energy number is lower for heat pump systems, but the global CO2 emissions are lowest when district heating uses mostly biofuels and is combined with solar PV systems. The difference is up to 140 tonnes/year. If the aim with the Swedish building code is to decrease the global CO2 emissions then the ratio between the primary energy factors for electricity and heat should be larger than three and considerably higher than today.

Analysis of long-term impacts of TRU waste remaining at generator/storage sites for No Action Alternative 2

International Nuclear Information System (INIS)

Buck, J.W.; Bagaasen, L.M.; Bergeron, M.P.; Streile, G.P.

1997-09-01

This report is a supplement to the Waste Isolation Pilot Plant Disposal-Phase Final Supplemental Environmental Impact Statement (SEIS-II). Described herein are the underlying information, data, and assumptions used to estimate the long-term human-health impacts from exposure to radionuclides and hazardous chemicals in transuranic (TRU) waste remaining at major generator/storage sites after loss of institutional control under No Action Alternative 2. Under No Action Alternative 2, TRU wastes would not be emplaced at the Waste Isolation Pilot Plant (WIPP) but would remain at generator/storage sites in surface or near-surface storage. Waste generated at smaller sites would be consolidated at the major generator/storage sites. Current TRU waste management practices would continue, but newly generated waste would be treated to meet the WIPP waste acceptance criteria. For this alternative, institutional control was assumed to be lost 100 years after the end of the waste generation period, with exposure to radionuclides and hazardous chemicals in the TRU waste possible from direct intrusion and release to the surrounding environment. The potential human-health impacts from exposure to radionuclides and hazardous chemicals in TRU waste were analyzed for two different types of scenarios. Both analyses estimated site-specific, human-health impacts at seven major generator/storage sites: the Hanford Site (Hanford), Idaho National Engineering and Environmental Laboratory (INEEL), Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Oak Ridge National Laboratory (ORNL), Rocky Flats Environmental Technology Site (RFETS), and Savannah River Site (SRS). The analysis focused on these seven sites because 99 % of the estimated TRU waste volume and inventory would remain there under the assumptions of No Action Alternative 2

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.

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.

The interaction of NO2 with BaO: from cooperative adsorption to Ba(NO3)2 formation

International Nuclear Information System (INIS)

Yi, Cheol-Woo W.; Kwak, Ja Hun H.; Szanyi, Janos

2007-01-01

The effect of water on the morphology of BaO/Al2O3-based NOx storage materials was investigated using Fourier transform infrared spectroscopy, temperature programmed desorption, and time-resolved synchrotron X-ray diffraction techniques. The results of this multi-spectroscopy study reveal that, in the presence of water, surface Ba-nitrates convert to bulk nitrates, and water facilitates the formation of large Ba(NO3)2 particles. The conversion of surface to bulk Ba-nitrates is completely reversible, i.e. after the removal of water from the storage material a significant fraction of the bulk nitrates re-convert to surface nitrates. NO2 exposure of a H2O-containing (wet) BaO/Al2O3 sample results in the formation of nitrites and bulk nitrates exclusively, i.e. no surface nitrates form. After further exposure to NO2, the nitrites completely convert to bulk nitrates. The amount of NOx taken up by the storage material is, however, essentially unaffected by the presence of water, regardless of whether the water was dosed prior to or after NO2 exposure. Based on the results of this study we are now able to explain most of the observations reported in the literature on the effect of water on NOx uptake on similar storage materials

New proposal to measure NO2 formation rate from NO emissions in the atmosphere

International Nuclear Information System (INIS)

Frins, Erna; Osorio, MatIas; Casaballe, Nicolas; Wagner, Thomas; Platt, Ulrich

2011-01-01

As result from combustion processes, SO 2 , NO, NO 2 and other substances are emitted in the atmosphere. We present a new method to measure the formation rate of a trace gas (e.g., NO 2 ), whose precursor (NO) was emitted in the atmosphere by a source like a stack. In the case under study, the presence of ozone determines the formation of NO 2 . We will demonstrate that measuring the slant column densities across the emitted plume and knowing the flux of another trace gas (e.g. SO 2 ), also emitted by the source but that could be considered stable under the conditions of the observation, it is possible to monitor remotely (from an arbitrary location) the formation rate of NO 2 due to conversion of NO to NO 2 .

Calculation of cobalt-60 primary and scatter dose in layered heterogeneous phantoms using primary and scatter dose spread arrays

International Nuclear Information System (INIS)

Iwasaki, Akira

1993-01-01

A method of making 60 Co γ-ray primary and scatter dose spread arrays in water is described. The primary dose spread array is made using forward and backward primary dose spread equations (h 1 and h 2 ), where both equations contain a laterally spread primary dose equation (G), made from measured dose data in a cork phantom. The scatter dose spread array is made using differential scatter-maximum ratio (dSMR) and differential backscatter factor (dBSF) equations (k 1 and k 2 ), where both equations are made to be continuous on the boundary. Primary and scatter dose calculations are performed along the beam axis in layered cork heterogeneous phantoms. It is found, even for 60 Co γ-rays, that when a small tumor in the lung is irradiated with a field that just surrounds the tumor, the beam entrance surface and lateral side of the tumor may obtain no therapeutic dose, because of loss of longitudinal and lateral electronic equilibrium, and when a large tumor in the lung is irradiated with a field just surrounding the tumor, the lateral side of the tumor may obtain no therapeutic dose due to loss of lateral electronic equilibrium. (author)

Temperature dependence of CO2-enhanced primary production in the European Arctic Ocean

KAUST Repository

Holding, J. M.

2015-08-31

The Arctic Ocean is warming at two to three times the global rate1 and is perceived to be a bellwether for ocean acidification2, 3. Increased CO2 concentrations are expected to have a fertilization effect on marine autotrophs4, and higher temperatures should lead to increased rates of planktonic primary production5. Yet, simultaneous assessment of warming and increased CO2 on primary production in the Arctic has not been conducted. Here we test the expectation that CO2-enhanced gross primary production (GPP) may be temperature dependent, using data from several oceanographic cruises and experiments from both spring and summer in the European sector of the Arctic Ocean. Results confirm that CO2 enhances GPP (by a factor of up to ten) over a range of 145–2,099 μatm; however, the greatest effects are observed only at lower temperatures and are constrained by nutrient and light availability to the spring period. The temperature dependence of CO2-enhanced primary production has significant implications for metabolic balance in a warmer, CO2-enriched Arctic Ocean in the future. In particular, it indicates that a twofold increase in primary production during the spring is likely in the Arctic.

An approach estimating the short-term effect of NO2 on daily mortality in Spanish cities.

Science.gov (United States)

Linares, Cristina; Falcón, Isabel; Ortiz, Cristina; Díaz, Julio

2018-04-07

Road traffic is the most significant source of urban air pollution. PM 2.5 is the air pollutant whose health effects have been most closely studied, and is the variable most commonly used as a proxy indicator of exposure to air pollution, whereas evidence on NO 2 concentrations per se is still under study. In the case of Spain, there are no specific updated studies which calculate short-term NO 2 -related mortality. To quantify the relative risks (RRs) and attributable risks (ARs) of daily mortality associated with NO 2 concentrations recorded in Spain across the study period, 2000-2009; and to calculate the number of NO 2 -related deaths. We calculated daily mortality due to natural causes (ICD-10: A00 R99), circulatory causes (ICD-10: I00 I99) and respiratory causes (ICD-10: J00 J99) for each province across the period 2000-2009, using data supplied by the National Statistics Institute. Mean daily NO 2 concentrations in μg/m 3 for each provincial capital were furnished by the Ministry of Agriculture & Environment, along with the equivalent figures for the control pollutants (PM 10 ). To estimate RRs and ARs, we used generalised linear models with a Poisson link, controlling for maximum and minimum daily temperature, trend of the series, seasonalities, and the autoregressive nature of the series. A meta-analysis with random effects was used to estimate RRs and ARs nationwide. The overall RRs obtained for Spain, corresponding to increases of 10 μg/m 3 in NO 2 concentrations were 1.012 (95% CI: 1.010 1.014) for natural-cause mortality, 1.028 (95% CI: 1.019 1.037) for respiratory-cause mortality, and 1.016 (95% CI: 1.012 1.021) for circulatory-cause mortality. This amounted to an annual overall 6085 deaths (95% CI: 3288 9427) due to natural causes, 1031 (95% CI: 466 1585) due to respiratory causes, and 1978 (95% CI: 828 3197) due to circulatory causes. By virtue of the number of cities involved and the nature of the analysis performed, with quantification of the

Swedish National Registry of Urinary Bladder Cancer: No difference in relative survival over time despite more aggressive treatment.

Science.gov (United States)

Jahnson, Staffan; Hosseini Aliabad, Abolfazl; Holmäng, Sten; Jancke, Georg; Liedberg, Fredrik; Ljungberg, Börje; Malmström, Per-Uno; Rosell, Johan

2016-01-01

The aim of this study was to use the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) to investigate changes in patient and tumour characteristics, management and survival in bladder cancer cases over a period of 15 years. All patients with newly detected bladder cancer reported to the SNRUBC during 1997-2011 were included in the study. The cohort was divided into three groups, each representing 5 years of the 15 year study period. The study included 31,266 patients (74% men, 26% women) with a mean age of 72 years. Mean age was 71.7 years in the first subperiod (1997-2001) and 72.5 years in the last subperiod (2007-2011). Clinical T categorization changed from the first to the last subperiod: Ta from 45% to 48%, T1 from 21.6% to 22.4%, and T2-T4 from 27% to 25%. Also from the first to the last subperiod, intravesical treatment after transurethral resection for T1G2 and T1G3 tumours increased from 15% to 40% and from 30% to 50%, respectively, and cystectomy for T2-T4 tumours increased from 30% to 40%. No differences between the analysed subperiods were found regarding relative survival in patients with T1 or T2-T4 tumours, or in the whole cohort. This investigation based on a national bladder cancer registry showed that the age of the patients at diagnosis increased, and the proportion of muscle-invasive tumours decreased. The treatment of all tumour stages became more aggressive but relative survival showed no statistically significant change over time.

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

Perfusion lung scintigraphy in primary pulmonary hypertension

International Nuclear Information System (INIS)

Ogawa, Yoji; Nishimura, Tsunehiko; Kumita, Shin-ichirou; Hayashida, Kohei; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Ohno, Akira

1991-01-01

Fifteen cases with primary pulmonary hypertension (PPH) were classified into two groups by using the perfusion lung scan pattern. Eight cases had multiple, small, ill-defined defects (mottled pattern), and remaining seven cases had no mottled pattern. These two groups were compared with mean pulmonary arterial pressure (mean PAP), right ventricular ejection fraction (RVEF), blood gas at room air (PaO 2 ), and alveolar-arterial O 2 difference (A-aDo 2 ). The cases with mottled pattern showed a significant increase in mean PAP. There were no significant differences in RVEF, PaO 2 , and A-aDo 2 , between the groups. The survival rate of the patients with mottled pattern was significantly lower than that without mottled pattern (p<0.05). We concluded that perfusion lung scan is very useful for evaluation of the prognosis in primary pulmonary hypertension. (author)

Solubility Modeling of the Binary Systems Fe(NO3)3–H2O, Co(NO3)2–H2O and the Ternary System Fe(NO3)3–Co(NO3)2–H2O with the Extended Universal Quasichemical (UNIQUAC) Model

DEFF Research Database (Denmark)

Arrad, Mouad; Kaddami, Mohammed; Goundali, Bahija El

2016-01-01

Solubility modeling in the binary system Fe(NO3)3–H2O, Co(NO3)2–H2O and the ternary system Fe(NO3)3–Co(NO3)2–H2O is presented. The extended UNIQUAC model was applied to the thermodynamic assessment of the investigated systems. The model parameters obtained were regressed simultaneously using...... the available databank but with more experimental points, recently published in the open literature. A revision of previously published parameters for the cobalt ion and new parameters for the iron(III) nitrate system are presented. Based on this set of parameters, the equilibrium constants of hydrates...

Contaminant monitoring of biota downstream of a radioactive liquid waste treatment facility, Los Alamos National Laboratory

International Nuclear Information System (INIS)

Bennett, K.D.; Biggs, J.R.; Fresquez, P.R.

1996-01-01

Small mammals, plants, and sediments were sampled at one upstream location (Site 1) and two downstream locations (Site 2 and Site 3) from the National Pollution Discharge Elimination System (NPDES) outfall number-sign 051-051 in Mortandad Canyon, Los Alamos National Laboratory, Los Alamos, New Mexico. The purpose of the sampling was to identify radionuclides potentially present, to quantitatively estimate and compare the amount of radionuclide uptake at specific locations (Site 2 and Site 3) within Mortandad Canyon to an upstream site (Site 1), and to identify the primary mode (inhalation/ingestion or surface contact) of contamination to small mammals. Three composite samples of at least five animals per sample were collected at each site. The pelt was separated from the carcass of each animal and both were analyzed independently. In addition, three composite samples were also collected for plants and sediments at each site. Samples were analyzed for americium ( 241 Am), strontium ( 90 Sr), plutonium ( 238 Pu and 239 Pu), and total uranium (U). With the exception of total U, all mean radionuclide concentrations in small mammal carcasses and sediments were significantly higher at Site 2 than Site 1 or Site 3. No differences were detected in the mean radionuclide concentration of plant samples between sites. However, some radionuclide concentrations found at all three sites were higher than regional background. No differences were found between mean carcass radionuclide concentrations and mean pelt radionuclide concentrations, indicating that the two primary modes of contamination may be equally occurring

[Primary care in Italy].

Science.gov (United States)

Sánchez-Sagrado, T

Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Improving the identification of people with dementia in primary care: evaluation of the impact of primary care dementia coding guidance on identified prevalence.

Science.gov (United States)

Russell, Paul; Banerjee, Sube; Watt, Jen; Adleman, Rosalyn; Agoe, Belinda; Burnie, Nerida; Carefull, Alex; Chandan, Kiran; Constable, Dominie; Daniels, Mark; Davies, David; Deshmukh, Sid; Huddart, Martin; Jabin, Ashrafi; Jarrett, Penelope; King, Jenifer; Koch, Tamar; Kumar, Sanjoy; Lees, Stavroula; Mir, Sinan; Naidoo, Dominic; Nyame, Sylvia; Sasae, Ryuichiro; Sharma, Tushar; Thormod, Clare; Vedavanam, Krish; Wilton, Anja; Flaherty, Breda

2013-12-23

Improving dementia care is a policy priority nationally and internationally; there is a 'diagnosis gap' with less than half of the cases of dementia ever diagnosed. The English Health Department's Quality and Outcomes Framework (QOF) encourages primary care recognition and recording of dementia. The codes for dementia are complex with the possibility of underidentification through miscoding. We developed guidance on coding of dementia; we report the impact of applying this to 'clean up' dementia coding and records at a practice level. The guidance had five elements: (1) identify Read Codes for dementia; (2) access QOF dementia register; (3) generate lists of patients who may have dementia; (4) compare search with QOF data and (5) review cases. In each practice, one general practitioner conducted the exercise. The number of dementia QOF registers before and after the exercise was recorded with the hours taken to complete the exercise. London primary care. 23 (85%) of 27 practices participated, covering 79 312 (19 562 over 65 s) participants. The number on dementia QOF registers; time taken. The number of people with dementia on QOF registers increased from 1007 to 1139 (χ(2)=8.17, p=0.004), raising identification rates by 8.8%. It took 4.7 h per practice, on an average. These data demonstrate the potential of a simple primary care coding exercise, requiring no specific training, to increase the dementia identification rate. An improvement of 8.8% between 2011 and 2012 is equivalent to that of the fourth most improved primary care trust in the UK. In absolute terms, if this effects were mirrored across the UK primary care, the number of cases with dementia identified would rise by over 70 000 from 364 329 to 434 488 raising the recognition rate from 46% to 54.8%. Implementing this exercise appears to be a simple and effective way to improve recognition rates in primary care.

National Land Cover Database 2001 (NLCD01) Imperviousness Layer Tile 2, Northeast United States: IMPV01_2

Science.gov (United States)

LaMotte, Andrew E.; Wieczorek, Michael

2010-01-01

This 30-meter resolution data set represents the imperviousness layer for the conterminous United States for the 2001 time period. The data have been arranged into four tiles to facilitate timely display and manipulation within a Geographic Information System, browse graphic: nlcd01-partition. The National Land Cover Data Set for 2001 was produced through a cooperative project conducted by the Multi-Resolution Land Characteristics (MRLC) Consortium. The MRLC Consortium is a partnership of Federal agencies (www.mrlc.gov), consisting of the U.S. Geological Survey (USGS), the National Oceanic and Atmospheric Administration (NOAA), the U.S. Environmental Protection Agency (USEPA), the U.S. Department of Agriculture (USDA), the U.S. Forest Service (USFS), the National Park Service (NPS), the U.S. Fish and Wildlife Service (USFWS), the Bureau of Land Management (BLM), and the USDA Natural Resources Conservation Service (NRCS). One of the primary goals of the project is to generate a current, consistent, seamless, and accurate National Land Cover Database (NLCD) circa 2001 for the United States at medium spatial resolution. For a detailed definition and discussion on MRLC and the NLCD 2001 products, refer to Homer and others (2004) and http://www.mrlc.gov/mrlc2k.asp.. The NLCD 2001 was created by partitioning the United States into mapping-zones. A total of 68 mapping-zones browse graphic: nlcd01-mappingzones.jpg were delineated within the conterminous United States based on ecoregion and geographical characteristics, edge-matching features, and the size requirement of Landsat mosaics. Mapping-zones encompass the whole or parts of several states. Questions about the NLCD mapping zones can be directed to the NLCD 2001 Land Cover Mapping Team at the USGS/EROS, Sioux Falls, SD (605) 594-6151 or mrlc@usgs.gov.

The Utility of the OMI HCHO/NO2 in Air Quality Decision-Making Activities

Science.gov (United States)

Duncan, Bryan

2010-01-01

I will discuss a novel and practical application of the OMI HCHU and NO2 data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2 may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. In addition, the observed OMI HCHO/NO2 may be used to define new emission control strategies as the photochemical environments of urban areas evolve over time. I will demonstrate the utility of the OMI HCHO/NO2 over the U.S. for air quality applications with support from simulations with both a regional model and a photochemical box model. These results support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. However, I'm attending the meeting as the Aura Deputy Project Scientist, so I don't technically need to present anything to justify the travel.

Updating and improving the National Population Database to National Population Database 2

OpenAIRE

SMITH, Graham; FAIRBURN, Jonathan

2008-01-01

In 2004 Staffordshire University delivered the National Population Database for use in estimating populations at risk under the Control of Major Accident Hazards Regulations (COMAH). In 2006 an assessment of the updating and potential improvements to NPD was delivered to HSE. Between Autumn 2007 and Summer 2008 an implementation of the feasibility report led to the creation of National Population Database 2 which both updated and expanded the datasets contained in the original NPD. This repor...

Concordance Between FISH Analysis of Her-2/Neu Gene in Breast Duct Carcinoma and Corresponding Axillary Nodal Metastases: Egyptian National Cancer Institute Experience.

Science.gov (United States)

Badawy, Omnia M; Hassan, Hannan; ELBakey, Heba A; Mosaad, Maha

2018-05-10

Breast cancer is a major health problem in Egypt. Her-2/Neu gene is routinely assessed for all breast cancer patients primarily by immunohistochemistry. At National Cancer Institute (NCI), Cairo University, Flourescence In Situ hybridization (FISH) analysis of Her-2/Neu gene is carried out for Her-2/Neu score 2 and for some cases of score 3 (particularly those assessed outside NCI). The test is performed essentially on the primary tumor. However, some situations require testing on corresponding lymph node metastases. There is a debate about the concordance between Her-2/Neu status in the primary tumor and synchronous lymph node metastases in various studies. The aim of this study was to test for the concordance between Her-2/Neu status in the primary breast tumor and corresponding axillary nodal metastases. This is a retrospective study in which FISH analysis of Her-2/Neu was carried out simultaneously on archived material of 50 cases previously diagnosed as invasive duct carcinoma and the corresponding nodal metastases from the Pathology Department, NCI. There was complete concordance between Her-2 status in the primary tumor and the corresponding axillary lymph node metastatic deposits in which Her-2 was amplified in 44% of the studied cohort of Egyptian patients. Her-2/Neu gene assessed by FISH analysis on synchronous lymph node metastases is strongly correlated with the primary tumor. Hence, it is justified to carry out the Her-2/Neu test on synchronous lymph nodes to decide on whether to carry out anti-Her-2/Neu target therapy. Further studies on other metastatic sites is recommended.

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

NO accumulation alleviates H2 O2 -dependent oxidative damage induced by Ca(NO3 )2 stress in the leaves of pumpkin-grafted cucumber seedlings.

Science.gov (United States)

Li, Lin; Shu, Sheng; Xu, Qing; An, Ya-Hong; Sun, Jin; Guo, Shi-Rong

2017-05-01

Nitric oxide (NO) and hydrogen peroxide (H 2 O 2 ), two important signaling molecules, are stimulated in plants by abiotic stresses. In this study, we investigated the role of NO and its interplay with H 2 O 2 in the response of self-grafted (S-G) and salt-tolerant pumpkin-grafted (Cucurbita maxima × C. moschata) cucumber seedlings to 80 mM Ca(NO 3 ) 2 stress. Endogenous NO and H 2 O 2 production in S-G seedlings increased in a time-dependent manner, reaching maximum levels after 24 h of Ca(NO 3 ) 2 stress. In contrast, a transient increase in NO production, accompanied by H 2 O 2 accumulation, was observed at 2 h in rootstock-grafted plants. N w -Nitro-l-Arg methyl ester hydrochloride (l-NAME), an inhibitor of nitric oxide synthase (NOS), tungstate, an inhibitor of nitrate reductase (NR), and 2-(4-carboxyphenyl)-4,4,5,5-tetramethy-limidazoline-1-oxyl-3-oxide (cPTIO), a scavenger of NO, were found to significantly inhibit NO accumulation induced by salt stress in rootstock-grafted seedlings. H 2 O 2 production was unaffected by these stress conditions. Ca(NO 3 ) 2 stress-induced NO accumulation was blocked by pretreatment with an H 2 O 2 scavenger (dimethylthiourea, DMTU) and an inhibitor of NADPH oxidase (diphenyleneiodonium, DPI). In addition, maximum quantum yield of PSII (Fv/Fm), as well as the activities and transcript levels of antioxidant enzymes, were significantly decreased by salt stress in rootstock grafted seedlings after pretreatment with these above inhibitors; antioxidant enzyme transcript levels and activities were higher in rootstock-grafted seedlings compared with S-G seedlings. These results suggest that rootstock grafting could alleviate the oxidative damage induced by Ca(NO 3 ) 2 stress in cucumber seedlings, an effect that may be attributable to the involvement of NO in H 2 O 2 -dependent antioxidative metabolism. © 2016 Scandinavian Plant Physiology Society.

Development of a cumulative risk assessment for the Idaho National Engineering Laboratory's waste area group 2

International Nuclear Information System (INIS)

Burns, D.E.

1995-01-01

In 1989, the Idaho National Engineering Laboratory (INEL) was added to the Environmental Protection Agency's (EPA) National Priorities List of Superfund sites. A Federal Facility Agreement and Consent Order (FFA/CO) for the INEL was signed by the Department of Energy, Idaho Operations Office (DOE-ID), EPA, and the State of Idaho in December 1991. The goal of this agreement is to ensure that potential or actual INEL releases of hazardous substances to the environment are thoroughly investigated in accordance with the National Contingency Plan (NCP) and that appropriate response actions are taken as necessary to protect human health and the environment. The Test Reactor Area (TRA) is included as Waste Area Group (WAG) 2 of ten INEL WAGs identified in the FFA/CO. WAG 2 consists of 13 operable units (OUs) which include pits, tanks, rubble piles, ponds, cooling towers, wells, french drains, perched water and spill areas. OU 2-13 is the Comprehensive Remedial Investigation/Feasibility Study (RI/FS) for WAG 2. The study presented here is a preliminary evaluation of the comprehensive risk for WAG-2. This investigation will be used as the basis of the WAG-2 comprehensive baseline risk assessment (BRA), and it will serve as a model for other INEL comprehensive risk assessments. The WAG-2 preliminary risk evaluation consisted of two broad phases. These phases were (1) a site and contaminant screening that was intended to support the identification of COPCs and risk assessment data gaps, and (2) an exposure pathway analysis that evaluated the comprehensive human health risks associated with WAG-2. The primary purposes of the investigation were to screen WAG-2 release sites and contaminants, and to identify risk assessment data gaps, so the investigation will be referred to as the WAG-2 Screening and Data Gap Analysis (SDGA) for the remainder of this report

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

Science.gov (United States)

Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Villar, Eugenio; Magar, Veronica

2018-01-01

ABSTRACT The World Health Organization’s Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals’ commitment to ‘leave no one behind’. In 2014–2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This ‘methods forum’ article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a ‘leave no one behind’ approach. As follow-up during 2015–2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs’ commitment to leave no one behind, in particular in relation to

No evidence of cholesteatoma in untreated otitis media with effusion in children with primary ciliary dyskinesia.

Science.gov (United States)

Ghedia, Reshma; Ahmed, Jahangir; Navaratnam, Annakan; Harcourt, Jonny

2018-02-01

Primary Ciliary Dyskinesia (PCD) describes a group of inherited disorders that result in abnormal ciliary motion leading to mucous stasis. Clinical features include almost universally otitis media with effusion (OME), particularly in infants. PCD patients provide us with a cohort of patients with OME that is not treated with ventilatory tube (VT) insertion as these have been shown to result in frequent complications including chronic otorrhoea, early extrusion and persistent perforation without significant improvement to hearing in the long term. This cohort was used to investigate whether children with PCD and OME not treated with VT were predisposed to cholesteatoma formation in the setting of a paediatric quaternary referral centre. A retrospective chart review was performed of all the children attending a multi-disciplinary PCD clinic at a national quaternary referral centre with a diagnosis of OME. We reviewed otoscopic findings, and audiometry and tympanometry results. We assessed the children in four groups: Watchful waiting, hearing aids, VT, and VT and hearing aids. One-hundred-and-one of 107 patients included in the study had a diagnosis of otitis media with effusion. No child with OME and PCD was diagnosed with a cholesteatoma during the follow up period. The only children who had insertion of a ventilatory tube were those who had the procedure prior to the formal diagnosis of PCD. We found a significant complication rate in the children with VT insertion. Hearing improved over time. The prevalence of retraction pockets in untreated OME was 1.72% (3 out of 174 ears). In children with PCD, OME is an almost universal finding in younger children, but not in adolescents. The study supports the current preference to avoid VT insertion in children with PCD as it confers a significantly higher rate of complications. No cases of cholesteatoma were found in this cohort of PCD children with OME managed without VTs. Crown Copyright © 2017. Published by Elsevier B

77 FR 8895 - Public Land Order No. 7788; Withdrawal of National Forest System Land for the Red Cloud...

Science.gov (United States)

2012-02-15

... Land Order No. 7788; Withdrawal of National Forest System Land for the Red Cloud Campground; New Mexico... Cloud Campground within the Cibola National Forest, and to protect a capital investment in the... (FIRS) at 1-800-877-8339 to contact either of the above individuals during normal business hours. The...

Environment and Obesity in the National Children's Study Ambiente e obesidade no National Children's Study

Directory of Open Access Journals (Sweden)

Leonardo Trasande

2010-01-01

Full Text Available We describe the approach taken by the National Children's Study (NCS to understanding the role of environmental factors in the development of obesity. We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis. Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. Through its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including geneenvironment and geneobesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.Descrevemos a abordagem do National Children's Study (NCS para entender o papel dos fatores ambientais no desenvolvimento da obesidade. Revisamos a literatura a respeito de duas hipóteses principais no NCS que se relacionam a origens ambientais da obesidade e descrevem estratégias que serão utilizadas para testar cada hipótese. Apesar de estar claro que a obesidade em um indivíduo é resultado de um desequilíbrio entre consumo e gasto de energia, o controle da epidemia de obesidade requer o entendimento de fatores no ambiente moderno e exposições químicas que podem ter a capacidade de interromper a ligação entre o consumo e gasto de energia. Através da aceitação da abordagem do curso de vida a epidemiologia, o NCS será capaz de estudar

Tracing Primary PM2.5 emissions via Chinese supply chains

Science.gov (United States)

Meng, Jing; Liu, Junfeng; Xu, Yuan; Tao, Shu

2015-05-01

In this study, we examine a supply-chain approach to more effectively mitigate primary PM2.5 emissions in China from the perspectives of production, consumption and their linkages using structural path analysis. We identify the pattern of all supply chain paths using principal component analysis. To address the severe haze problems in China, it is important to understand how final demand purchase initiates production processes and ultimately leads to primary PM2.5 emission. We found that consumers’ demands on power and transportation mainly induce direct emissions, quite different from the demands on construction, industry and service products which largely drive emissions in upstream activities. We also found that nearly 80% of the economic sectors in China follow a similar pattern in generating primary PM2.5 emissions in electricity, cement and the ferrous metal industries; but only the construction sector increases the release of PM2.5 due to the production of non-metallic mineral products. These findings indicate that further reduction of end-of-pipe emissions in the power and transportation sectors will facilitate cleaner production in almost all the economic sectors. However, for urbanization induced emissions, China should mitigate PM2.5 emissions through the supply chain of construction, either severely reducing its life-cycle intensity or carefully planning to avoid extensive, unnecessary building activity.

Tracing Primary PM2.5 emissions via Chinese supply chains

International Nuclear Information System (INIS)

Meng, Jing; Liu, Junfeng; Tao, Shu; Xu, Yuan

2015-01-01

In this study, we examine a supply-chain approach to more effectively mitigate primary PM 2.5 emissions in China from the perspectives of production, consumption and their linkages using structural path analysis. We identify the pattern of all supply chain paths using principal component analysis. To address the severe haze problems in China, it is important to understand how final demand purchase initiates production processes and ultimately leads to primary PM 2.5 emission. We found that consumers’ demands on power and transportation mainly induce direct emissions, quite different from the demands on construction, industry and service products which largely drive emissions in upstream activities. We also found that nearly 80% of the economic sectors in China follow a similar pattern in generating primary PM 2.5 emissions in electricity, cement and the ferrous metal industries; but only the construction sector increases the release of PM 2.5 due to the production of non-metallic mineral products. These findings indicate that further reduction of end-of-pipe emissions in the power and transportation sectors will facilitate cleaner production in almost all the economic sectors. However, for urbanization induced emissions, China should mitigate PM 2.5 emissions through the supply chain of construction, either severely reducing its life-cycle intensity or carefully planning to avoid extensive, unnecessary building activity. (letter)

Denmark's National Inventory Reports. Submitted under the United Nations framework convention on climate change

International Nuclear Information System (INIS)

Boll Illerup, J.; Lyck, E.; Winther, M.; Rasmussen, E.

2000-01-01

This report is Denmark's National Inventory Report reported to the Conference of the Parties under the United Nations Framework Convention on Climate Change (UNFCCC) due by 15 April 2000. The report contains information on Denmark's inventories for all years from 1990 to 1998 for CO 2 , CH 4 , N 2 O, NO x , CO, NMVOC, SO 2 , HFCs, PFCs and SF. (au)

Nox2 and p47phox modulate compensatory growth of primary collateral arteries

Science.gov (United States)

DiStasi, Matthew R.; Unthank, Joseph L.

2014-01-01

The role of NADPH oxidase (Nox) in both the promotion and impairment of compensatory collateral growth remains controversial because the specific Nox and reactive oxygen species involved are unclear. The aim of this study was to identify the primary Nox and reactive oxygen species associated with early stage compensatory collateral growth in young, healthy animals. Ligation of the feed arteries that form primary collateral pathways in rat mesentery and mouse hindlimb was used to assess the role of Nox during collateral growth. Changes in mesenteric collateral artery Nox mRNA expression determined by real-time PCR at 1, 3, and 7 days relative to same-animal control arteries suggested a role for Nox subunits Nox2 and p47phox. Administration of apocynin or Nox2ds-tat suppressed collateral growth in both rat and mouse models, suggesting the Nox2/p47phox interaction was involved. Functional significance of p47phox expression was assessed by evaluation of collateral growth in rats administered p47phox small interfering RNA and in p47phox−/− mice. Diameter measurements of collateral mesenteric and gracilis arteries at 7 and 14 days, respectively, indicated no significant collateral growth compared with control rats or C57BL/6 mice. Chronic polyethylene glycol-conjugated catalase administration significantly suppressed collateral development in rats and mice, implying a requirement for H2O2. Taken together, these results suggest that Nox2, modulated at least in part by p47phox, mediates early stage compensatory collateral development via a process dependent upon peroxide generation. These results have important implications for the use of antioxidants and the development of therapies for peripheral arterial disease. PMID:24633549

N=2 no-scale supergravity

Energy Technology Data Exchange (ETDEWEB)

Itoyama, H.; McLerran, L.; Taylor, T.R.; Van der Bij, J.J.

1987-01-12

N=2 extended supergravity is discussed and an assessment is made of the problems encountered in applying it to the construction of phenomenological models of particle physics. A specific class of so-called no-scale models is discussed, in which the two supersymmetries are spontaneously broken in flat space-time, with naturally vanishing cosmological constant and the symmetry breaking undetermined at the classical level. Supergravity-induced supersymmetry breaking generates effective mass terms for spin-1/2 components of the vector gauge multiplets and spin-0 components of the scalar matter multiplets. For finite globally supersymmetric models, this supersymmetry breaking preserves the finiteness. Possible connections of N=2 no-scale supergravity with superstrings and finite range antigravity are mentioned.

N=2 no-scale supergravity

International Nuclear Information System (INIS)

Itoyama, H.; McLerran, L.; Taylor, T.R.; Van der Bij, J.J.

1987-01-01

N=2 extended supergravity is discussed and an assessment is made of the problems encountered in applying it to the construction of phenomenological models of particle physics. A specific class of so-called no-scale models is discussed, in which the two supersymmetries are spontaneously broken in flat space-time, with naturally vanishing cosmological constant and the symmetry breaking undetermined at the classical level. Supergravity-induced supersymmetry breaking generates effective mass terms for spin-1/2 components of the vector gauge multiplets and spin-0 components of the scalar matter multiplets. For finite globally supersymmetric models, this supersymmetry breaking preserves the finiteness. Possible connections of N=2 no-scale supergravity with superstrings and finite range antigravity are mentioned. (orig.)

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.

Socioeconomic disadvantage and primary non-adherence with medication in Sweden.

Science.gov (United States)

Wamala, Sarah; Merlo, Juan; Bostrom, Gunnel; Hogstedt, Christer; Agren, Gunner

2007-06-01

Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary non-adherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR=3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR=6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly.

Depressive Disorders in Primary Health Care

OpenAIRE

Vuorilehto, Maria

2008-01-01

The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

Comparison of GOME tropospheric NO2 columns with NO2 profiles deduced from ground-based in situ measurements

Science.gov (United States)

Schaub, D.; Boersma, K. F.; Kaiser, J. W.; Weiss, A. K.; Folini, D.; Eskes, H. J.; Buchmann, B.

2006-08-01

Nitrogen dioxide (NO2) vertical tropospheric column densities (VTCs) retrieved from the Global Ozone Monitoring Experiment (GOME) are compared to coincident ground-based tropospheric NO2 columns. The ground-based columns are deduced from in situ measurements at different altitudes in the Alps for 1997 to June 2003, yielding a unique long-term comparison of GOME NO2 VTC data retrieved by a collaboration of KNMI (Royal Netherlands Meteorological Institute) and BIRA/IASB (Belgian Institute for Space Aeronomy) with independently derived tropospheric NO2 profiles. A first comparison relates the GOME retrieved tropospheric columns to the tropospheric columns obtained by integrating the ground-based NO2 measurements. For a second comparison, the tropospheric profiles constructed from the ground-based measurements are first multiplied with the averaging kernel (AK) of the GOME retrieval. The second approach makes the comparison independent from the a priori NO2 profile used in the GOME retrieval. This allows splitting the total difference between the column data sets into two contributions: one that is due to differences between the a priori and the ground-based NO2 profile shapes, and another that can be attributed to uncertainties in both the remaining retrieval parameters (such as, e.g., surface albedo or aerosol concentration) and the ground-based in situ NO2 profiles. For anticyclonic clear sky conditions the comparison indicates a good agreement between the columns (n=157, R=0.70/0.74 for the first/second comparison approach, respectively). The mean relative difference (with respect to the ground-based columns) is -7% with a standard deviation of 40% and GOME on average slightly underestimating the ground-based columns. Both data sets show a similar seasonal behaviour with a distinct maximum of spring NO2 VTCs. Further analysis indicates small GOME columns being systematically smaller than the ground-based ones. The influence of different shapes in the a priori and

[Primary care evaluation of the hypertensive patient management in specialized care after derivation (DERIVA-2 Study)].

Science.gov (United States)

Martell-Claros, Nieves; Galgo Nafría, Alberto; Abad-Cardiel, María; Álvarez-Álvarez, Beatriz; García Donaire, José Antonio; Márquez-Contreras, Emilio; Molino-González, Ángel

2017-10-13

To know the opinion/evaluation of the primary care physicians (PCPH) of the received information about patients that were attended in specialized care (SC). Cross-sectional study. Performed nationwide in primary care centers. Researchers from the primary care network. We used the SEH-LELHA derivation criteria guidelines, plus an ad hoc survey that included demographic and anthropometric data, blood pressure levels, and the main reason for derivation to SC at the baseline and final (post-derivation) visit. In addition, time deployed for the study of every patient, changes in diagnosis and treatment, type of follow-up, issues throughout the derivation process and assessment of the medical referred to the PCPH were evaluated. With participation of 578 researchers from primary, the study included 1715 patients aged 60.7±13.3years, 62.7% male. Patients were taking 2.3±1.2 (range 0-10) antihypertensive drugs pre-referral and 2.5±1.2 (0-9) after derivation. Blood pressure levels changed from 166±21.6 /97.7±12.6mmHg to 143±14.4 /85.5±10.5mmHg. The number of controlled patients (BP<140 and <90mmHg) increased from 5.8% to 32.2%. Time between pre- and post-derivation visit was 72±64days (median 57days, IQ26-99). The PCPH received a medical report in 80.3% of cases, 76.9% with an explanation of the results of the complementary tests, 75.8% with additional information or a reasoning of treatment and in 71% of cases information about the patient future management. 63% of PCPH were fully agreed with the management of the specialist, 29% agree and 2% strongly disagree. The derivation was evaluated as effective or very effective in 86% of patients and no effective in 9%. Communication between AE and SC in HTA is valued satisfactorily by MAP. However there is still room for improvement in the process. Copyright © 2017. Publicado por Elsevier España, S.L.U.

CCL2 binding is CCR2 independent in primary adult human astrocytes.

Science.gov (United States)

Fouillet, A; Mawson, J; Suliman, O; Sharrack, B; Romero, I A; Woodroofe, M N

2012-02-09

Chemokines are low relative molecular mass proteins, which have chemoattractant actions on many cell types. The chemokine, CCL2, has been shown to play a major role in the recruitment of monocytes in central nervous system (CNS) lesions in multiple sclerosis (MS). Since resident astrocytes constitute a major source of chemokine synthesis including CCL2, we were interested to assess the regulation of CCL2 by astrocytes. We showed that CCL2 bound to the cell surface of astrocytes and binding was not modulated by inflammatory conditions. However, CCR2 protein was not detected nor was activation of the classical CCR2 downstream signaling pathways. Recent studies have shown that non-signaling decoy chemokine receptors bind and modulate the expression of chemokines at site of inflammation. Here, we show that the D6 chemokine decoy receptor is constitutively expressed by primary human adult astrocytes at both mRNA and protein level. In addition, CCL3, which binds to D6, but not CCL19, which does not bind to D6, displaced CCL2 binding to astrocytes; indicating that CCL2 may bind to this cell type via the D6 receptor. Our results suggest that CCL2 binding to primary adult human astrocytes is CCR2-independent and is likely to be mediated via the D6 decoy chemokine receptor. Therefore we propose that astrocytes are implicated in both the establishment of chemokine gradients for the migration of leukocytes into and within the CNS and in the regulation of CCL2 levels at inflammatory sites in the CNS. Copyright © 2011 Elsevier B.V. All rights reserved.

Pulse radiolysis study of NaNO/sub 2/ and NaNO/sub 3/ solutions. [Electrons

Energy Technology Data Exchange (ETDEWEB)

Broszkiewicz, R K [Institute of Nuclear Research, Warsaw (Poland)

1976-01-01

The pulse radiolysis of aqueous solutions of NaNO/sub 2/ and NaNO/sub 3/ has been done. In the nitrate solutions the transient species NO/sup 2 -//sub 2/ and NO/sub 2/ have been observed, the former reacting with water to produce NO, the latter dimerizing to N/sub 2/O/sub 4/. In the presence of O/sub 2/ and unidentified species with absorption maximum at 280 nm, probably a peroxy compound, is being formed. The radiolytic processes occurring in the nitrite solution do not depend on /NO/sub 02// and no effect of the direct energy absorption by NO/sup -//sub 2/ has been noticed. Transient species in the diluted nitrate solution are NO/sup 2 -//sub 3/ and the pernitrous ion; in concentrated solutions NO/sub 3/ is the main transient product. NO/sub 3/ is formed by the direct energy absorption by NO/sup -//sub 3/. Participation in tha effect of the cation should not be disregarded. There is evidence that the 340 nm peak in the transient spectrum is probably connected with N/sub 2/O/sub 4/ and not with NO/sub 3/. The tranient spectra, extinction coefficients of products and rate constants of relevant reactions are given.

Genetic dissimilarity between primary colorectal carcinomas and their lymph node metastases: ploidy, p53, bcl-2, and c-myc expression--a pilot study.

Science.gov (United States)

Zalata, Khaled Refaat; Elshal, Mohamed Farouk; Foda, Abd AlRahman Mohammad; Shoma, Ashraf

2015-08-01

The current paradigm of metastasis proposes that rare cells within primary tumors acquire metastatic capability via sequential mutations, suggesting that metastases are genetically dissimilar from their primary tumors. This study investigated the changes in the level of expression of a well-defined panel of cell proliferation, differentiation, and apoptosis markers between the primary colorectal cancer (CRC) and the corresponding synchronous lymph node (LN) metastasis from the same patients. DNA flow cytometry and immunostaining of p53, bcl-2, and c-myc were carried out on 36 cases of CRC radical resection specimens with their corresponding LN metastases. There was very low probability that the histological patterns of primary tumors and LN metastases are independent (p < 0.001). Metastatic tumors were significantly more diffusely positive for p53 than the primary tumors (p < 0.001). Conversely, primary tumors were significantly more diffusely positive for c-myc than metastatic tumors (p = 0.011). No significant difference was found between the LNs and the primary tumors in bcl-2 positivity (p = 0.538) and DNA aneuploidy (p = 0.35), with a tendency towards negative bcl-2 and less aneuploidy in LN metastases than primary tumors. In conclusion, LN metastatic colorectal carcinomas have a tendency of being less differentiated, with a higher incidence of diffuse p53 staining, lower incidence of bcl-2 staining, and less aneuploidy in comparison to their primary counterparts suggesting a more aggressive biological behavior, which could indicate the necessity for more aggressive adjuvant therapy.

75 FR 82378 - National Medal of Technology and Innovation Call for 2011 Nominations

Science.gov (United States)

2010-12-30

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office [Docket No. PTO-C-2010-0091... Trademark Office, Commerce. ACTION: Notice and request for nominations. SUMMARY: The Department of Commerce... social well-being of the United States. The primary purpose of the National Medal of Technology and...

77 FR 2047 - National Medal of Technology and Innovation Call for 2012 Nominations

Science.gov (United States)

2012-01-13

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office [Docket No. PTO-C-2011-0093... Trademark Office, Commerce. ACTION: Notice and request for nominations. SUMMARY: The Department of Commerce..., environmental or social well-being of the United States. The primary purpose of the National Medal of Technology...

Systems of Na/sup +/NO/sub 3/, Na/sub 2/SO/sub 4/, RbNO/sub 3/, Rb/sub 2/SO/sub 4/-H/sub 2/O and NaNO/sub 3/, Na/sub 2/SO/sub 4/, CsNO/sub 3/, Cs/sub 2/SO/sub 4/-H/sub 2/O at 25 and 75 deg C

Energy Technology Data Exchange (ETDEWEB)

Poletaev, I F; Krasnenkova, L V

1975-08-01

Quaternary Na/sup +/, Rb/sup +///NO/sub 3/-, SO/sub 4//sup 2 -/-H/sub 2/O and Nsub(+), Cs/sup +///NO/sub 3/-, SO/sub 4//sup 2 -/-H/sub 2/O mutual systems have been studied isothermally. The following six fields of crystallization have been revealed in these systems at 25 deg C: Cs/sub 2/SO/sub 4/, Na/sub 2/SO/sub 4/, Na/sub 2/SO/sub 4/x10H/sub 2/O, NaNO/sub 3/xNa/sub 2/SO/sub 4/x2H/sub 2/O, NaNO/sub 3/, and CsNO/sub 3/.

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership.

Science.gov (United States)

Morris, Rebecca Lauren; Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-02-28

To identify the top 10 unanswered research questions for primary care patient safety research. A modified nominal group technique. UK. Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. A top 10, and top 30, future research questions for primary care patient safety. 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. © 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.

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.

Association of Ki-67, p53, and bcl-2 expression of the primary non-small-cell lung cancer lesion with brain metastatic lesion

International Nuclear Information System (INIS)

Bubb, Robbin S.; Komaki, Ritsuko; Hachiya, Tsutomu; Milas, Ivan; Ro, Jae Y.; Langford, Lauren; Sawaya, Raymond; Putnam, Joe B.; Allen, Pamela; Cox, James D.; McDonnell, Timothy J.; Brock, William; Hong, Waun K.; Roth, Jack A.; Milas, Luka

2002-01-01

Purpose: The study was conducted to determine whether immunohistochemical analysis of Ki-67, p53, and bcl-2 in patients with non-small-cell lung cancer is associated with a higher rate of brain metastases and whether the intrapatient expression of these biomarkers (in the primary tumors vs. brain lesions) is similar. Methods and Materials: At the M. D. Anderson Cancer Center, tumors from 29 case patients with primary lung tumor and brain metastasis and 29 control patients with primary lung tumor but no brain metastasis were resected and examined for immunohistochemical expression. Ki-67, p53, and bcl-2 were analyzed in resected primary lung, lymph node, and metastatic brain tumors. Each control patient was matched by age, gender, and histology to a patient with brain metastasis. Results: No significant differences in patient survival characteristics were detected between the case group and control group. Also, difference in patient outcome between the two groups was not generally predicted by biomarker analysis. However, when the groups were combined, the biomarker analysis was predictive for certain patient outcome end points. Using median values as cutoff points between low and high expression of biomarkers, it was observed that high expression of Ki-67 (>40%) in lung primaries was associated with poorer disease-free survival (p=0.04), whereas low expression of p53 in lung primaries was associated with poorer overall survival (p=0.04), and these patients had a higher rate of nonbrain distant metastases (p=0.02). The patients with brain metastases were particularly prone to developing nonbrain distant metastases if the percentage of p53-positive cells in brain metastases was low (p=0.01). There was a positive correlation in the expression of Ki-67 (p=0.02) (r 2 =0.1608), as well as p53 (p 2 =0.7380), between lung primaries and brain metastases. Compared to Ki-67 and p53, bcl-2 was the least predictive. Conclusion: Differences in biomarker expression between the

Salivary gland hypofunction in tyrosylprotein sulfotransferase-2 knockout mice is due to primary hypothyroidism.

Science.gov (United States)

Westmuckett, Andrew D; Siefert, Joseph C; Tesiram, Yasvir A; Pinson, David M; Moore, Kevin L

2013-01-01

Protein-tyrosine sulfation is a post-translational modification of an unknown number of secreted and membrane proteins mediated by two known Golgi tyrosylprotein sulfotransferases (TPST-1 and TPST-2). We reported that Tpst2-/- mice have mild-moderate primary hypothyroidism, whereas Tpst1-/- mice are euthyroid. While using magnetic resonance imaging (MRI) to look at the thyroid gland we noticed that the salivary glands in Tpst2-/- mice appeared smaller than in wild type mice. This prompted a detailed analysis to compare salivary gland structure and function in wild type, Tpst1-/-, and Tpst2 -/- mice. Quantitative MRI imaging documented that salivary glands in Tpst2-/- females were (≈) 30% smaller than wild type or Tpst1-/- mice and that the granular convoluted tubules in Tpst2-/- submandibular glands were less prominent and were almost completely devoid of exocrine secretory granules compared to glands from wild type or Tpst1-/- mice. In addition, pilocarpine-induced salivary flow and salivary α-amylase activity in Tpst2-/- mice of both sexes was substantially lower than in wild type and Tpst1-/- mice. Anti-sulfotyrosine Western blots of salivary gland extracts and saliva showed no differences between wild type, Tpst1-/-, and Tpst2-/- mice, suggesting that the salivary gland hypofunction is due to factor(s) extrinsic to the salivary glands. Finally, we found that all indicators of hypothyroidism (serum T4, body weight) and salivary gland hypofunction (salivary flow, salivary α-amylase activity, histological changes) were restored to normal or near normal by thyroid hormone supplementation. Our findings conclusively demonstrate that low body weight and salivary gland hypofunction in Tpst2-/- mice is due solely to primary hypothyroidism.

Salivary gland hypofunction in tyrosylprotein sulfotransferase-2 knockout mice is due to primary hypothyroidism.

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Andrew D Westmuckett

Full Text Available Protein-tyrosine sulfation is a post-translational modification of an unknown number of secreted and membrane proteins mediated by two known Golgi tyrosylprotein sulfotransferases (TPST-1 and TPST-2. We reported that Tpst2-/- mice have mild-moderate primary hypothyroidism, whereas Tpst1-/- mice are euthyroid. While using magnetic resonance imaging (MRI to look at the thyroid gland we noticed that the salivary glands in Tpst2-/- mice appeared smaller than in wild type mice. This prompted a detailed analysis to compare salivary gland structure and function in wild type, Tpst1-/-, and Tpst2 -/- mice.Quantitative MRI imaging documented that salivary glands in Tpst2-/- females were (≈ 30% smaller than wild type or Tpst1-/- mice and that the granular convoluted tubules in Tpst2-/- submandibular glands were less prominent and were almost completely devoid of exocrine secretory granules compared to glands from wild type or Tpst1-/- mice. In addition, pilocarpine-induced salivary flow and salivary α-amylase activity in Tpst2-/- mice of both sexes was substantially lower than in wild type and Tpst1-/- mice. Anti-sulfotyrosine Western blots of salivary gland extracts and saliva showed no differences between wild type, Tpst1-/-, and Tpst2-/- mice, suggesting that the salivary gland hypofunction is due to factor(s extrinsic to the salivary glands. Finally, we found that all indicators of hypothyroidism (serum T4, body weight and salivary gland hypofunction (salivary flow, salivary α-amylase activity, histological changes were restored to normal or near normal by thyroid hormone supplementation.Our findings conclusively demonstrate that low body weight and salivary gland hypofunction in Tpst2-/- mice is due solely to primary hypothyroidism.

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

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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.

Comparison of GOME tropospheric NO2 columns with NO2 profiles deduced from ground-based in situ measurements

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D. Schaub

2006-01-01

Full Text Available Nitrogen dioxide (NO2 vertical tropospheric column densities (VTCs retrieved from the Global Ozone Monitoring Experiment (GOME are compared to coincident ground-based tropospheric NO2 columns. The ground-based columns are deduced from in situ measurements at different altitudes in the Alps for 1997 to June 2003, yielding a unique long-term comparison of GOME NO2 VTC data retrieved by a collaboration of KNMI (Royal Netherlands Meteorological Institute and BIRA/IASB (Belgian Institute for Space Aeronomy with independently derived tropospheric NO2 profiles. A first comparison relates the GOME retrieved tropospheric columns to the tropospheric columns obtained by integrating the ground-based NO2 measurements. For a second comparison, the tropospheric profiles constructed from the ground-based measurements are first multiplied with the averaging kernel (AK of the GOME retrieval. The second approach makes the comparison independent from the a priori NO2 profile used in the GOME retrieval. This allows splitting the total difference between the column data sets into two contributions: one that is due to differences between the a priori and the ground-based NO2 profile shapes, and another that can be attributed to uncertainties in both the remaining retrieval parameters (such as, e.g., surface albedo or aerosol concentration and the ground-based in situ NO2 profiles. For anticyclonic clear sky conditions the comparison indicates a good agreement between the columns (n=157, R=0.70/0.74 for the first/second comparison approach, respectively. The mean relative difference (with respect to the ground-based columns is −7% with a standard deviation of 40% and GOME on average slightly underestimating the ground-based columns. Both data sets show a similar seasonal behaviour with a distinct maximum of spring NO2 VTCs. Further analysis indicates small GOME columns being systematically smaller than the ground-based ones. The influence of different shapes in the a

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.

Near IR Photolysis of HO2NO2: Supplemental Material

Science.gov (United States)

2002-01-01

MkIV measurements of the volume mixing ratio (VMR) of HO2NO2 at 35 deg N, sunset on Sept. 25, 1993 are given. Measurements of HO2NO2 made between approx. 65 and 70 deg N, sunrise on May 8, 1997 are listed. The uncertainties given are 1 sigma estimates of the measurement precision. Uncertainty in the HO2NO2 line strengths is estimated to be 20%; this is the dominant contribution to the systematic error of the HO2NO2 measurement. Model inputs for the simulations are given. The albedos were obtained from Total Ozone Mapping Spectrometer reflectively data (raw data at ftp://jwocky.gsfc.nasa.gov) for the time and place of observation. Profiles of sulfate aerosol surface area ("Surf. Area") were obtained from monthly, zonal mean profiles measured by SAGE II [Thomason et al., 1997 updated via private communication]. The profile of Be(y) is based on the Wamsley et al. relation with N2O, using MkIV measurements of N20O. All other model inputs given are based on direct MkIV measurements. Finally, we note the latitude of the MkIV tangent point varied considerably during sunrise on May 8, 1997. The simulations shown here were obtained using different latitudes for each altitude.

Cytogenetics, JAK2 and MPL mutations in polycythemia vera, primary myelofibrosis and essential thrombocythemia

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Leonardo Caires dos Santos

2011-12-01

Full Text Available BACKGROUND: The detection of molecular and cytogenetic alterations is important for the diagnosis, prognosis and classification of myeloproliferative neoplasms. OBJECTIVE: The aim of this study was to detect the following mutations: JAK2 V617F, JAK2 exon 12 and MPL W515K/L, besides chromosomal abnormalities. Furthermore, molecular and cytogenetic alterations were correlated with the leukocyte and platelet counts, hemoglobin levels and age in all patients and with the degree of fibrosis in primary myelofibrosis cases. METHODS: Twenty cases of polycythemia vera, 17 of essential thrombocythemia and 21 of primary myelofibrosis were selected in the Hematology Department of the Universidade Federal de São Paulo (UNIFESP between February 2008 and December 2009. The JAK2 V617F, JAK2 exon 12 mutations, MPL W515K and MPL W515L mutations were investigated by real-time PCR and direct sequencing. G-band karyotyping and fluorescence in situ hybridization were used to detect chromosomal abnormalities. RESULTS: Chromosomal abnormalities were observed only in polycythemia vera (11.8% and primary myelofibrosis cases (17.6%, without correlation to clinical data. Chromosomal abnormalities were not detected by fluorescence in situ hybridization. The JAK2 V617F mutation was observed in polycythemia vera (90%, primary myelofibrosis (42.8% and essential thrombocythemia (47%. Patients with JAK2 V617F-negative polycythemia vera had lower platelet and leukocyte counts compared to V617F-positive polycythemia vera (p-value = 0.0001 and p-value = 0.023, respectively. JAK2 V617F-positive and MPL W515L-positive primary myelofibrosis cases had a higher degree of fibrosis than V617F-negative cases (p-value = 0.022. JAK2 exon 12 mutations were not detected in polycythemia vera patients. The MPL W515L mutation was observed in one case of primary myelofibrosis and in one of essential thrombocythemia. The MPL W515K mutation was not found in patients with essential thrombocythemia

Cytogenetics, JAK2 and MPL mutations in polycythemia vera, primary myelofibrosis and essential thrombocythemia.

Science.gov (United States)

Dos Santos, Leonardo Caires; Ribeiro, Juliana Corrêa da Costa; Silva, Neusa Pereira; Cerutti, Janete; da Silva, Maria Regina Regis; Chauffaille, Maria de Lourdes Lopes Ferrari

2011-01-01

The detection of molecular and cytogenetic alterations is important for the diagnosis, prognosis and classification of myeloproliferative neoplasms. THE AIM OF THIS STUDY WAS TO DETECT THE FOLLOWING MUTATIONS: JAK2 V617F, JAK2 exon 12 and MPL W515K/L, besides chromosomal abnormalities. Furthermore, molecular and cytogenetic alterations were correlated with the leukocyte and platelet counts, hemoglobin levels and age in all patients and with the degree of fibrosis in primary myelofibrosis cases. Twenty cases of polycythemia vera, 17 of essential thrombocythemia and 21 of primary myelofibrosis were selected in the Hematology Department of the Universidade Federal de São Paulo (UNIFESP) between February 2008 and December 2009. The JAK2 V617F, JAK2 exon 12 mutations, MPL W515K and MPL W515L mutations were investigated by real-time PCR and direct sequencing. G-band karyotyping and fluorescence in situ hybridization were used to detect chromosomal abnormalities. Chromosomal abnormalities were observed only in polycythemia vera (11.8%) and primary myelofibrosis cases (17.6%), without correlation to clinical data. Chromosomal abnormalities were not detected by fluorescence in situ hybridization. The JAK2 V617F mutation was observed in polycythemia vera (90%), primary myelofibrosis (42.8%) and essential thrombocythemia (47%). Patients with JAK2 V617F-negative polycythemia vera had lower platelet and leukocyte counts compared to V617F-positive polycythemia vera (p-value = 0.0001 and p-value = 0.023, respectively). JAK2 V617F-positive and MPL W515L-positive primary myelofibrosis cases had a higher degree of fibrosis than V617F-negative cases (p-value = 0.022). JAK2 exon 12 mutations were not detected in polycythemia vera patients. The MPL W515L mutation was observed in one case of primary myelofibrosis and in one of essential thrombocythemia. The MPL W515K mutation was not found in patients with essential thrombocythemia or primary myelofibrosis. The MPL W515L

75 FR 6473 - Primary National Ambient Air Quality Standards for Nitrogen Dioxide

Science.gov (United States)

2010-02-09

.... Mortality b. Cardiovascular Effects 3. Health Effects With Long-Term Exposure to NO 2 a. Respiratory... disease, children, and the elderly. The epidemiologic evidence for respiratory health effects was limited...-pollutants. Both cardiovascular and respiratory mortality have been associated with increased NO 2...

The AOTF-Based NO2 Camera

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Dekemper, E.; Fussen, D.; Vanhellemont, F.; Vanhamel, J.; Pieroux, D.; Berkenbosch, S.

2017-12-01

In an urban environment, nitrogen dioxide is emitted by a multitude of static and moving point sources (cars, industry, power plants, heating systems,…). Air quality models generally rely on a limited number of monitoring stations which do not capture the whole pattern, neither allow for full validation. So far, there has been a lack of instrument capable of measuring NO2 fields with the necessary spatio-temporal resolution above major point sources (power plants), or more extended ones (cities). We have developed a new type of passive remote sensing instrument aiming at the measurement of 2-D distributions of NO2 slant column densities (SCDs) with a high spatial (meters) and temporal (minutes) resolution. The measurement principle has some similarities with the popular filter-based SO2 camera (used in volcanic and industrial sulfur emissions monitoring) as it relies on spectral images taken at wavelengths where the molecule absorption cross section is different. But contrary to the SO2 camera, the spectral selection is performed by an acousto-optical tunable filter (AOTF) capable of resolving the target molecule's spectral features. A first prototype was successfully tested with the plume of a coal-firing power plant in Romania, revealing the dynamics of the formation of NO2 in the early plume. A lighter version of the NO2 camera is now being tested on other targets, such as oil refineries and urban air masses.

Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association

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David Little

2003-06-01

Full Text Available The Primary Care Informatics Working Group (PCIWG of the American Medical Informatics Association (AMIA has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI, to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

Glycemic control parameters in insulin-naïve patients with uncontrolled type 2 diabetes referred to endocrinologists, and degree of implementation of the national Spanish consensus for the management of hyperglycemia.

Science.gov (United States)

Azriel, Sharona; Casal, Florentino; Dalama, Belén; Varillas, Francisco; Villarroel, África; Soto, Alfonso; Barberá, Gloria

2014-12-01

To assess blood glucose in patients with uncontrolled type 2 diabetes mellitus treated with oral antidiabetic drugs in primary care at the time of referral to specialized endocrinologists, and the degree of implementation of the national consensus guidelines of the Spanish Society of Diabetes by evaluating steps one (S1), two (S2), and three (S3) of the escalating therapy. Retrospective, observational study where 81 endocrinologists evaluated patients ≥40 years of age referred from primary care between July 2012 and July 2013, treated with 1 to 2 oral antidiabetic drugs but no insulin therapy, and with glycosylated hemoglobin (HbA(1c)) levels ≥6.5%. Patients also had to have HbA(1c) levels and both fasting and postprandial plasma glucose measurements from the previous three months. A total of 285 patients (57.6% males) were assessed. Mean (SD) age was 63.1 (9.7) years, mean HbA1c was 8.5 (1.2) %, mean FPG was 171.7 (43) mg/dL, and mean postprandial plasma glucose was 206.8 (50) mg/dL. In primary care, 26.0% of patients were at S1 and 74.0% were at S2. After referral to the endocrinologist, 9.8% of patients moved onto S1, 42.8% onto S2, and 47.4% onto S3. Oral antidiabetic drugs most commonly prescribed in primary care were metformin (90.2%), DPP-4 inhibitors (34.4%), and sulfonylureas (30.5%), while drugs most commonly used in the specialized endocrinology setting were metformin (86%), insulin (56.8%), and DPP-4 inhibitors (49.8%). The most commonly followed guidelines were those of the American Diabetes Association and the consensus guidelines of the Spanish Society of Diabetes, in 77% and 45% of cases respectively. Approximately half the patients treated with oral antidiabetic drugs in primary care are prescribed insulin after referral to an endocrinology specialist. The most commonly followed guidelines in specialized care are the American Diabetes Association guidelines. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

Lifestyle measures for primary prevention of T2 Diabetes Mellitus (T2DM

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M S A Mansur Ahmed

2014-12-01

Full Text Available Worldwide, the number of adults with diabetes was 285 million in 2010 and it will be 439 million in the year 2030. Although the genes we inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. From this data it can be said that up to 90 percent of diabetes prevention is possible with behavioral and lifestyle factors intervention. This intervention should be given to the people through primary prevention. The purpose of primary prevention is to limit the number of people who develop a disease by controlling causes and risk factors for the disease.

National Land Cover Database 2001 (NLCD01) Tree Canopy Layer Tile 2, Northeast United States: CNPY01_2

Science.gov (United States)

LaMotte, Andrew E.; Wieczorek, Michael

2010-01-01

This 30-meter resolution data set represents the tree canopy layer for the conterminous United States for the 2001 time period. The data have been arranged into four tiles to facilitate timely display and manipulation within a Geographic Information System, browse graphic: nlcd01-partition.jpg The National Land Cover Data Set for 2001 was produced through a cooperative project conducted by the Multi-Resolution Land Characteristics (MRLC) Consortium. The MRLC Consortium is a partnership of Federal agencies (www.mrlc.gov), consisting of the U.S. Geological Survey (USGS), the National Oceanic and Atmospheric Administration (NOAA), the U.S. Environmental Protection Agency (USEPA), the U.S. Department of Agriculture (USDA), the U.S. Forest Service (USFS), the National Park Service (NPS), the U.S. Fish and Wildlife Service (USFWS), the Bureau of Land Management (BLM), and the USDA Natural Resources Conservation Service (NRCS). One of the primary goals of the project is to generate a current, consistent, seamless, and accurate National Land Cover Database (NLCD) circa 2001 for the United States at medium spatial resolution. For a detailed definition and discussion on MRLC and the NLCD 2001 products, refer to Homer and others (2004) and http://www.mrlc.gov/mrlc2k.asp. The NLCD 2001 was created by partitioning the United States into mapping-zones. A total of 68 mapping-zones browse graphic: nlcd01-mappingzones.jpg were delineated within the conterminous United States based on ecoregion and geographical characteristics, edge-matching features, and the size requirement of Landsat mosaics. Mapping-zones encompass the whole or parts of several states. Questions about the NLCD mapping zones can be directed to the NLCD 2001 Land Cover Mapping Team at the USGS/EROS, Sioux Falls, SD (605) 594-6151 or mrlc@usgs.gov.

77 FR 47913 - The National Center for Mobility Management Under FTA's National Research Program

Science.gov (United States)

2012-08-10

... Management Under FTA's National Research Program AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY: Federal Transit Administration (FTA), as the primary staff agency to the Federal... transportation service delivery. FTA, under its National Research Program, plans to fund a National Center for...

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.

Firearm ownership among American veterans: findings from the 2015 National Firearm Survey.

Science.gov (United States)

Cleveland, Emily C; Azrael, Deborah; Simonetti, Joseph A; Miller, Matthew

2017-12-19

While the majority of veteran suicides involve firearms, no contemporary data describing firearm ownership among US veterans are available. This study uses survey data to describe the prevalence of firearm ownership among a nationally representative sample of veterans, as well as veterans' reasons for firearm ownership. A cross-sectional, nationally representative web-based survey conducted in 2015. Nearly half of all veterans own one or more firearms (44.9%, 95% CI 41.3-48.6%), with male veterans more commonly owning firearms than do female veterans (47.2%, 95% CI 43.4-51.0% versus 24.4%, 95%CI 15.6-36.1%). Most veteran firearm owners own both handguns and long guns (56.5%, 95% CI 51.1-61.8%); a majority cite protection as a primary reason for firearm ownership (63.1%, 95% CI 58.2-67.8%). The current study is the first to provide detailed, nationally representative information about firearm ownership among U.S. veterans. Better understanding firearm ownership among veterans can usefully inform ongoing suicide prevention efforts aiming to facilitate lethal means safety among vulnerable veterans during at-risk periods.

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.

Directory of Open Access Journals (Sweden)

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.

Primary structure of the human M2 mitochondrial autoantigen of primary biliary cirrhosis: Dihydrolipoamide acetyltransferase

International Nuclear Information System (INIS)

Coppel, R.L.; McNeilage, L.J.; Surh, C.D.; Van De Water, J.; Spithill, T.W.; Whittingham, S.; Gershwin, M.E.

1988-01-01

Primary biliary cirrhosis is a chronic, destructive autoimmune liver disease of humans. Patient sera are characterized by a high frequency of autoantibodies to a M r 70,000 mitochondrial antigen a component of the M2 antigen complex. The authors have identified a human cDNA clone encoding the complete amino acid sequence of this autoantigen. The predicted structure has significant similarity with the dihydrolipoamide acetyltransferase of the Escherichia coli pyruvate dehydrogenase multienzyme complex. The human sequence preserves the Glu-Thr-Asp-Lys-Ala motif of the lipoyl-binding site and has two potential binding sites. Expressed fragments of the cDNA react strongly with sera from patients with primary biliary cirrhosis but not with sera from patients with autoimmune chronic active hepatitis or sera from healthy subjects

Assessing primary care in Austria: room for improvement.

Science.gov (United States)

Stigler, Florian L; Starfield, Barbara; Sprenger, Martin; Salzer, Helmut J F; Campbell, Stephen M

2013-04-01

There is emerging evidence that strong primary care achieves better health at lower costs. Although primary care can be measured, in many countries, including Austria, there is little understanding of primary care development. Assessing the primary care development in Austria. A primary care assessment tool developed by Barbara Starfield in 1998 was implemented in Austria. This tool defines 15 primary care characteristics and distinguishes between system and practice characteristics. Each characteristic was evaluated by six Austrian primary care experts and rated as 2 (high), 1 (intermediate) or 0 (low) points, respectively, to their primary care strength (maximum score: n = 30). Austria received 7 out of 30 points; no characteristic was rated as '2' but 8 were rated as '0'. Compared with the 13 previously assessed countries, Austria ranks 10th of 14 countries and is classified as a 'low primary care' country. This study provides the first evidence concerning primary care in Austria, benchmarking it as weak and in need of development. The practicable application of an existing assessment tool can be encouraging for other countries to generate evidence about their primary care system as well.

Optimization of NO oxidation by H2O2 thermal decomposition at moderate temperatures.

Science.gov (United States)

Zhao, Hai-Qian; Wang, Zhong-Hua; Gao, Xing-Cun; Liu, Cheng-Hao; Qi, Han-Bing

2018-01-01

H2O2 was adopted to oxidize NO in simulated flue gas at 100-500°C. The effects of the H2O2 evaporation conditions, gas temperature, initial NO concentration, H2O2 concentration, and H2O2:NO molar ratio on the oxidation efficiency of NO were investigated. The reason for the narrow NO oxidation temperature range near 500°C was determined. The NO oxidation products were analyzed. The removal of NOx using NaOH solution at a moderate oxidation ratio was studied. It was proven that rapid evaporation of the H2O2 solution was critical to increase the NO oxidation efficiency and broaden the oxidation temperature range. the NO oxidation efficiency was above 50% at 300-500°C by contacting the outlet of the syringe needle and the stainless-steel gas pipe together to spread H2O2 solution into a thin film on the surface of the stainless-steel gas pipe, which greatly accelerated the evaporation of H2O2. The NO oxidation efficiency and the NO oxidation rate increased with increasing initial NO concentration. This method was more effective for the oxidation of NO at high concentrations. H2O2 solution with a concentration higher than 15% was more efficient in oxidizing NO. High temperatures decreased the influence of the H2O2 concentration on the NO oxidation efficiency. The oxidation efficiency of NO increased with an increase in the H2O2:NO molar ratio, but the ratio of H2O2 to oxidized NO decreased. Over 80% of the NO oxidation product was NO2, which indicated that the oxidation ratio of NO did not need to be very high. An 86.7% NO removal efficiency was obtained at an oxidation ratio of only 53.8% when combined with alkali absorption.

Novel MeCP2 isoform-specific antibody reveals the endogenous MeCP2E1 expression in murine brain, primary neurons and astrocytes.

Directory of Open Access Journals (Sweden)

Robby M Zachariah

Full Text Available Rett Syndrome (RTT is a severe neurological disorder in young females, and is caused by mutations in the X-linked MECP2 gene. MECP2/Mecp2 gene encodes for two protein isoforms; MeCP2E1 and MeCP2E2 that are identical except for the N-terminus region of the protein. In brain, MECP2E1 transcripts are 10X higher, and MeCP2E1 is suggested to be the relevant isoform for RTT. However, due to the unavailability of MeCP2 isoform-specific antibodies, the endogenous expression pattern of MeCP2E1 is unknown. To gain insight into the expression of MeCP2E1 in brain, we have developed an anti-MeCP2E1 antibody and validated its specificity in cells exogenously expressing individual MeCP2 isoforms. This antibody does not show any cross-reactivity with MeCP2E2 and detects endogenous MeCP2E1 in mice brain, with no signal in Mecp2(tm1.1Bird y/- null mice. Additionally, we show the endogenous MeCP2E1 expression throughout different brain regions in adult mice, and demonstrate its highest expression in the brain cortex. Our results also indicate that MeCP2E1 is highly expressed in primary neurons, as compared to primary astrocytes. This is the first report of the endogenous MeCP2E1 expression at the protein levels, providing novel avenues for understanding different aspects of MeCP2 function.

Primary Productivity (PP_Master)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set included primary production for each subregion in the study (Georges Bank, Gulf of Maine, Southern New England, Middle Atlantic Bight) . The data came...

Wenjing decoction (herbal medicine) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis.

Science.gov (United States)

Gao, Li; Jia, Chunhua; Zhang, Heng; Ma, Cuilan

2017-10-01

Wenjing decoction is a well-accepted traditional Chinese medicine for the treatment of primary dysmenorrhea in East Asia, but its clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea. Eight databases were used in our research: the Cochrane Library, the Web of Science, PubMed, EMBASE, the Chinese Biomedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database, and the Wan-fang Database. The following search terms were used: (Wenjing decoction OR Wenjing formula OR Wenjing tang) AND (primary dysmenorrhea OR dysmenorrhea OR painful menstruation) AND (randomized controlled trial). No language limitation was used. A total of 18 studies, including 1736 patients, were included in the meta-analysis. Wenjing decoction was shown to be significantly better than nonsteroidal anti-inflammatory drugs for the improvement of primary dysmenorrhea according to the clinical effective rate (RR 1.41, 95% CI 1.24-1.61), the visual analogue scale (MD -1.77, 95% CI -2.69 to -0.84), and the pain scale for dysmenorrhea (MD -1.81, 95% CI -2.41 to -1.22). The results supported the clinical use of Wenjing decoction for the treatment of primary dysmenorrhea. However, the quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed randomized controlled trials are still needed to further evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea.

Genomic and clinical profiling of a national nephrotic syndrome cohort advocates a precision medicine approach to disease management.

Science.gov (United States)

Bierzynska, Agnieszka; McCarthy, Hugh J; Soderquest, Katrina; Sen, Ethan S; Colby, Elizabeth; Ding, Wen Y; Nabhan, Marwa M; Kerecuk, Larissa; Hegde, Shivram; Hughes, David; Marks, Stephen; Feather, Sally; Jones, Caroline; Webb, Nicholas J A; Ognjanovic, Milos; Christian, Martin; Gilbert, Rodney D; Sinha, Manish D; Lord, Graham M; Simpson, Michael; Koziell, Ania B; Welsh, Gavin I; Saleem, Moin A

2017-04-01

Steroid Resistant Nephrotic Syndrome (SRNS) in children and young adults has differing etiologies with monogenic disease accounting for 2.9-30% in selected series. Using whole exome sequencing we sought to stratify a national population of children with SRNS into monogenic and non-monogenic forms, and further define those groups by detailed phenotypic analysis. Pediatric patients with SRNS were identified via a national United Kingdom Renal Registry. Whole exome sequencing was performed on 187 patients, of which 12% have a positive family history with a focus on the 53 genes currently known to be associated with nephrotic syndrome. Genetic findings were correlated with individual case disease characteristics. Disease causing variants were detected in 26.2% of patients. Most often this occurred in the three most common SRNS-associated genes: NPHS1, NPHS2, and WT1 but also in 14 other genes. The genotype did not always correlate with expected phenotype since mutations in OCRL, COL4A3, and DGKE associated with specific syndromes were detected in patients with isolated renal disease. Analysis by primary/presumed compared with secondary steroid resistance found 30.8% monogenic disease in primary compared with none in secondary SRNS permitting further mechanistic stratification. Genetic SRNS progressed faster to end stage renal failure, with no documented disease recurrence post-transplantation within this cohort. Primary steroid resistance in which no gene mutation was identified had a 47.8% risk of recurrence. In this unbiased pediatric population, whole exome sequencing allowed screening of all current candidate genes. Thus, deep phenotyping combined with whole exome sequencing is an effective tool for early identification of SRNS etiology, yielding an evidence-based algorithm for clinical management. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

ER, HER2, and TOP2A expression in primary tumor, synchronous axillary nodes, and asynchronous metastases in breast cancer

DEFF Research Database (Denmark)

Jensen, Jeanette Dupont; Knoop, Ann; Ewertz, Marianne

2011-01-01

with the primary tumors with respect to ER, HER2, and TOP2A. In the prospective tissue-collection study, 81 patients had biopsy from a suspected relapse. Additional archived paired material was included, leaving a total of 119 patients with paired primary tumor, synchronous axillary nodes (available in 52 patients......At recurrence of breast cancer, the therapeutic target is the metastases. However, it is current practice to base the choice of systemic treatment on the biomarker profile of the primary tumor. In the present study, confirmatory biopsies were obtained from suspected metastatic lesions and compared......) and asyncronous metastases available for analysis. ER, HER2, and TOP2A expression of primary tumors, axillary nodes and metastases were re-analysed and determined centrally by immunohistochemistry, chromogenic in situ hybridization, and fluorescence in situ hybridization. Of the 81 patients with a biopsy from...

National CrossTalk. Volume 17, Number 1

Science.gov (United States)

Trombley, William, Ed.

2009-01-01

The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher education issues. This issue contains the following articles: (1) Florida's Unnatural Disaster: The State's Economic Bubble Has Burst, Leaving Higher Education in a Double Bind (Jon Marcus); (2) Saudi King's Modern University:…

Analysis of the healthcare process of patients with type 2 diabetes mellitus and associated comorbidity treated in Spain's National Health System: A perspective of medical professionals. IMAGINE study.

Science.gov (United States)

Gómez-Huelgas, R; Artola-Menéndez, S; Menéndez-Torre, E

2016-04-01

To analyse the care received by patients with type 2 diabetes mellitus (DM2) and comorbidity in Spain's National Health System. Cross-sectional study using an online survey. A total of 302 family physicians, internists and endocrinologists participated in the study. The participants were recruited voluntarily by their respective scientific societies and received no remuneration. Patients with DM2 and comorbidity are mostly treated in Primary Care (71.8%). Forty percent are referred to hospital care, mainly due to renal failure, poor glycaemic control and for a retinopathy assessment. Only 52% of those surveyed conducted medication reconciliation in the transition between healthcare levels. Fifty-eight percent reported conducting interconsultations, clinical meetings or consultancies between healthcare levels. The 3 main factors identified for improving the follow-up and control of DM2 with comorbidity were the multidisciplinary study (80.8%), the continuing education of health professionals (72.3%) and therapeutic education programmes (72%). A lack of time, a lack of qualified personnel for lifestyle interventions and organisational shortcomings were mentioned as the main obstacles for improving the care of these patients. Most patients with DM2 and comorbidity are treated in Primary Care. Promoting multidisciplinary care and training programmes for practitioners and patients can help improve the quality of care. Therapy reconciliation represents a priority area for improvement in this population. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

77 FR 60966 - Marine Mammals; File No. 16239

Science.gov (United States)

2012-10-05

..., proposed energy and construction areas; (2) movement patterns of marine mammal species most at risk; and (3... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC268 Marine Mammals; File No. 16239 AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric...

Environmental report 1994. Volume No. 2

International Nuclear Information System (INIS)

Rath, K.S.; Harrach, R.J.; Gallegos, G.M.; Failor, R.A.; Christofferson, E.

1995-01-01

This volume 2 of the Lawrence Livermore National Laboratory's (LLNL's) annual Environmental Report 1994 is a detailed data report that provides individual data points, where applicable, along with some summary data and more detailed accounts of sample collection and analytical methods. Six chapters have information on monitoring of air, surface water, groundwater, soil and sediment, vegetation and foodstuffs, and environmental radiation; two other chapters cover compliance sel-monitoring and quality assurance

A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

OpenAIRE

Ghaffari, Firouzeh; Keikha, Fatemeh; Arabipoor, Arezoo

2015-01-01

We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos...

Mass spectrometric determination of partial electron impact ionization cross sections of No, No2, and N2O from threshold up to 180 eV

International Nuclear Information System (INIS)

Kim, Y. B.

1982-01-01

Electron impact ionization of nitric oxide (NO), nitrogen dioxide (NO 2 ) and nitrous oxide (N 2 O) has been studied as a function of electron energy up to 180 eV with a double focussing mass spectrometer Varian MAT CH5 and an improved Nier type electron impact ion source. Relative partial ionization cross sections were measured for the processes NO + + 2e, NO ++ + 3e, and NO 2 + e -> NO + 2 + 2e, NO ++ + 3e and N 2 O + e -> N 2 O + + 2e. An accurate measurement of the cross section ratios q(NO 2+ /NO)/q(NO + /NO) and q(NO 2 2 /NO 2 )/q(NO + 2 /NO 2 ) has been made. Relative cross section functions were calibrated absolutely with two different normalization methods. Moreover, both metastable and collision induced dissociations of N 2 O + were studied quantitatively using the technique of decoupling the acceleration and deflection electric fields. Using the n- th root extrapolation the following ionization potentials have been derived from the cross section functions near threshold: NO + (X 1 Σ + ); NO ++ ; NO + 2 ; NO 2 ++ ; N 2 O + (X 2 π). These results are compared with previous measurements and theoretical calculations, where available. Part of the results presented have been already published in seven papers by the author. (Author)

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)

SU-E-I-100: Heterogeneity Studying for Primary and Lymphoma Tumors by Using Multi-Scale Image Texture Analysis with PET-CT Images

Energy Technology Data Exchange (ETDEWEB)

Li, Dengwang [Shandong Normal University, Jinan, Shandong Province (China); Wang, Qinfen [Shandong Normal University, Jinan, Shandong (China); Li, H; Chen, J [Shandong Cancer Hospital and Institute, Jinan, Shandong (China)

2014-06-01

differences between primary and lymphoma tumor by multi-scale image texture analysis. This work is supported by National Natural Science Foundation of China (No. 61201441), Research Fund for Excellent Young and Middle-aged Scientists of Shandong Province (No. BS2012DX038), Project of Shandong Province Higher Educational Science and Technology Program (No. J12LN23), Jinan youth science and technology star (No.20120109)

Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study.

Science.gov (United States)

Nordeman, Lena; Gunnarsson, Ronny; Mannerkorpi, Kaisa

2014-05-01

To investigate prognostic factors for future work ability in women with chronic low back pain (CLBP) consulting primary health care. A 2-year prospective longitudinal cohort study of female patients with CLBP within the primary health care was conducted. Patients were assessed at the first assessment and after 2 years. Prognostic factors for work ability (yes/no) were analyzed by multivariate regression. A total of 130 patients were included at first assessment. After 2 years, 123 patients (95%) were followed up. The 6-minute walk test, depression, and earlier work ability predicted work ability at the 2-year follow-up. A nomogram was constructed to assess the probability of future work ability. The 6-minute walk test, work ability, and depression predicted work ability for women with CLBP after 2 years.

Studies on the effect of doxorubicin on MDA, NO2, NO3, Se-GSH ...

African Journals Online (AJOL)

SERVER

2007-10-18

Oct 18, 2007 ... Nitric oxide; NO2. - Nitric oxide; NO3- ... The lipid peroxides were determined by the TBA me- ... Effect of different doses of doxorubicin on rat serum nitrite (NO2 .... 2306. Afr. J. Biotechnol. 0. 5. 10. 15. 20. 25. 30. P e rc e n. t c h a n g e o v e ... Doxorubicin induced percent changes of rat serum Nitrate (NO3.

System of Sr(NO2)2-Sr(OH)2-H2O at 25 deg C

International Nuclear Information System (INIS)

Popova, T.B.; Berdyukova, V.A.; Khutsistova, F.M.

1990-01-01

Sr(NO 2 ) 2 -Sr(OH) 2 -H 2 O system was investigated by the methods of solubility, density, viscosity, electric conductivity and refractometry. It was established that its compoments form the compound 4Sr(NO 2 ) 2 xSr(OH) 2 x8H 2 O. The compound was separated from solution; its density, decomposition temperature were determined; IR spectra and X-ray patterns of prepared and initial compounds were obtained

Hydrogen Production Costs of Various Primary Energy Sources

International Nuclear Information System (INIS)

Choi, Jae Hyuk; Tak, Nam Il; Kim, Yong Hee; Park, Won Seok

2005-11-01

Many studies on the economical aspects of hydrogen energy technologies have been conducted with the increase of the technical and socioeconomic importance of the hydrogen energy. However, there is still no research which evaluates the economy of hydrogen production from the primary energy sources in consideration of Korean situations. In this study, the hydrogen production costs of major primary energy sources are compared in consideration of the Korean situations such as feedstock price, electricity rate, and load factor. The evaluation methodology is based on the report of the National Academy of Science (NAS) of U.S. The present study focuses on the possible future technology scenario defined by NAS. The scenario assumes technological improvement that may be achieved if present research and development (R and D) programs are successful. The production costs by the coal and natural gas are 1.1 $/kgH 2 and 1.36 $/kgH 2 , respectively. However, the fossil fuels are susceptible to the price variation depending on the oil and the raw material prices, and the hydrogen production cost also depends on the carbon tax. The economic competitiveness of the renewable energy sources such as the wind, solar, and biomass are relatively low when compared with that of the other energy sources. The estimated hydrogen production costs from the renewable energy sources range from 2.35 $/kgH 2 to 6.03 $/kgH 2 . On the other hand, the production cost by nuclear energy is lower than that of natural gas or coal when the prices of the oil and soft coal are above $50/barrel and 138 $/ton, respectively. Taking into consideration the recent rapid increase of the oil and soft coal prices and the limited fossil resource, the nuclear-hydrogen option appears to be the most economical way in the future

Journal of Agriculture and Social Research (JASR) Vol. 8, No. 2, 2008

African Journals Online (AJOL)

commercial bases only at the National Veterinary Research Institute (NVRI) Vom, Plateau ... The role of family poultry in poverty alleviation, food security and the ... Turkey. Broiler. Local chicken meat availability for sale. Yes. No. Undecided.

NO2-initiated multiphase oxidation of SO2 by O2 on CaCO3 particles

Science.gov (United States)

Yu, Ting; Zhao, Defeng; Song, Xiaojuan; Zhu, Tong

2018-05-01

The reaction of SO2 with NO2 on the surface of aerosol particles has been suggested to be important in sulfate formation during severe air pollution episodes in China. However, we found that the direct oxidation of SO2 by NO2 was slow and might not be the main reason for sulfate formation in ambient air. In this study, we investigated the multiphase reaction of SO2 with an O2 / NO2 mixture on single CaCO3 particles using Micro-Raman spectroscopy. The reaction converted the CaCO3 particle to a Ca(NO3)2 droplet, with CaSO4 ⚫ 2H2O solid particles embedded in it, which constituted a significant fraction of the droplet volume at the end of the reaction. The reactive uptake coefficient of SO2 for sulfate formation was on the order of 10-5, which was higher than that for the multiphase reaction of SO2 directly with NO2 by 2-3 orders of magnitude. According to our observations and the literature, we found that in the multiphase reaction of SO2 with the O2 / NO2 mixture, O2 was the main oxidant of SO2 and was necessary for radical chain propagation. NO2 acted as the initiator of radical formation, but not as the main oxidant. The synergy of NO2 and O2 resulted in much faster sulfate formation than the sum of the reaction rates with NO2 and with O2 alone. We estimated that the multiphase oxidation of SO2 by O2 initiated by NO2 could be an important source of sulfate and a sink of SO2, based on the calculated lifetime of SO2 regarding the loss through the multiphase reaction versus the loss through the gas-phase reaction with OH radicals. Parameterization of the reactive uptake coefficient of the reaction observed in our laboratory for further model simulation is needed, as well as an integrated assessment based on field observations, laboratory study results, and model simulations to evaluate the importance of the reaction in ambient air during severe air pollution episodes, especially in China.

Primary Ectopic Ethmoidal Craniopharyngioma.

Science.gov (United States)

Preti, Andrea; Karligkiotis, Apostolos; Facco, Carla; Ottini, Giorgia; Volpi, Luca; Castelnuovo, Paolo

2017-06-01

Craniopharyngiomas are benign but aggressive epithelial tumors usually originating in the anterior lobe of the pituitary gland from squamous remnants of an incompletely involuted craniopharingeal duct developing from the Rathke pouch. To the authors' knowledge only 1 patient of a primary isolated ethmoidal craniopharyngioma has been reported in the literature.The authors report the case of a 17-year-old boy with a primary extracranial ethmoidal craniopharyngioma. An endoscopic endonasal approach was employed to resect the tumor. After 2 years of clinical and radiological follow-up no recurrence of disease was observed.Primary ethmoidal craniopharyngiomas are rare entities and biopsy is necessary for diagnosis. However, a preoperative assessment by means of nasal endoscopy, computed tomography scan, and enhanced magnetic resonance imaging is mandatory to better evaluate the extension and characteristics of the tumor. The endoscopic endonasal technique is a safe and effective approach for the treatment of these lesions.

Rate Constants for the Reactions of OH with CO, NO and NO2, and of HO2 with NO2 in the Presence of Water Vapour at Lower-Tropospheric Conditions

Science.gov (United States)

Rolletter, Michael; Fuchs, Hendrik; Novelli, Anna; Ehlers, Christian; Hofzumahaus, Andreas

2016-04-01

Recent studies have shown that the chemistry of gaseous nitrous acid (HONO) in the lower troposphere is not fully understood. Aside from heterogenous reactions, the daytime HONO formation in the gas-phase is not well understood (Li et al., Science, 2014). For a better understanding of HONO in the gas-phase, we have reinvestigated the reaction rate constants of important tropospheric reactions of the HOx radical family (OH and HO2) with nitrogen oxides at realistic conditions of the lower troposphere (at ambient temperature/pressure and in humid air). In this study we apply a direct pump and probe technique with high accuracy, using small radical concentrations to avoid secondary chemistry. Pulsed laser photolysis/laser-induced fluorescence (LP/LIF) was used to investigate the reaction rate constants of OH with CO, NO, NO2, and HO2 with NO2 in synthetic air at different water vapor concentrations (up to 5 x 1017 molecules cm-3). Photolysis of ozone in the presence of gaseous water was the source of OH. The reactions took place in a flow-tube at room temperature and atmospheric pressure. The chemical decay of the radicals was monitored by laser-induced fluorescence detection in a low-pressure cell, which sampled air continuously from the end of the flow-tube. Knowing the reactant concentrations subsequently allowed to calculate the bimolecular reaction rate constants at 1 atm from the pseudo-first-order decays. In order to observe HO2 reactions, OH was converted into HO2 with an excess of CO in the flow-tube. The newly measured rate constants for OH with CO, NO and NO2 agree very well with current recommendations by NASA/JPL and IUPAC and have an improved accuracy (uncertainty < 5%). These rate coefficients are independent of the presence of water vapour. The measured rate constant of HO2 with NO2 was found to depend significantly on the water-vapour concentration (probably due to formation of HO2*H2O complexes) and to exceed current recommendations by NASA/JPL and

Relationship of Temperature and NO{sub x} Concentration during Primary Method on Reduction using in Flame of Natural Gas

Energy Technology Data Exchange (ETDEWEB)

Poskart, Monika; Szecowka, Lech [Technical Univ. of Czestochowa (Poland). Dept. of Industrial Furnaces and Environmental Protection

2006-01-15

Nitrogen oxides are some of the most harmful components polluting the atmosphere. Energetic criteria require establishing the complex technological parameters (capacity, temperature, pressure, composition of products, lost of heat and others) with the possibility of the highest energy efficiency. Ecological criteria lead to minimization of harmful substations emission. However, it is possible to limit the negative influence of hazardous components on natural environment. So-called 'primary methods', which relied on the modification of combustion process, are the most effective and cheapest methods of pollution limitation. This paper included the results of NO{sub x} reduction in combustion process with application of primary methods such as: flue gas recirculation, air and fuel staging.

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.

Denmark's National Inventory Reports. Submitted under the United Nations framework convention on climate change

Energy Technology Data Exchange (ETDEWEB)

Boll Illerup, J.; Lyck, E.; Winther, M. [Danmarks Miljoeundersoegelser, Afd. for Systemanalyse (Denmark); Rasmussen, E. [Energistyrelsen (Denmark)

2000-05-01

This report is Denmark's National Inventory Report reported to the Conference of the Parties under the United Nations Framework Convention on Climate Change (UNFCCC) due by 15 April 2000. The report contains information on Denmark's inventories for all years from 1990 to 1998 for CO{sub 2}, CH{sub 4}, N{sub 2}O, NO{sub x}, CO, NMVOC, SO{sub 2}, HFCs, PFCs and SF. (au)

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.

Characterization and Catalytic Activity of Mn-Co/TiO2 Catalysts for NO Oxidation to NO2 at Low Temperature

Directory of Open Access Journals (Sweden)

Lu Qiu

2016-01-01

Full Text Available A series of Mn-Co/TiO2 catalysts were prepared by wet impregnation method and evaluated for the oxidation of NO to NO2. The effects of Co amounts and calcination temperature on NO oxidation were investigated in detail. The catalytic oxidation ability in the temperature range of 403–473 K was obviously improved by doping cobalt into Mn/TiO2. These samples were characterized by nitrogen adsorption-desorption, X-ray diffraction (XRD, X-ray photoelectron spectroscopy (XPS, transmission electron microscope (TEM and hydrogen temperature programmed reduction (H2-TPR. The results indicated that the formation of dispersed Co3O4·CoMnO3 mixed oxides through synergistic interaction between Mn-O and Co-O was directly responsible for the enhanced activities towards NO oxidation at low temperatures. Doping of Co enhanced Mn4+ formation and increased chemical adsorbed oxygen amounts, which also accelerated NO oxidation.

Gender equality in primary immunisation

Directory of Open Access Journals (Sweden)

Deepak S Khismatrao

2015-01-01

Full Text Available Context: Immunization, a well-known and effective method of preventing childhood illnesses is basic service under primary health care. Most surveys in India measure primary immunization coverage and quality, but no "Gender Equality." Aims: Assess "Gender Equality" in primary immunization with reference to coverage, quality, and place of immunization. Settings and Design: Cross-sectional survey in a primary health center, Pune, Maharashtra using World Health Organization 30-cluster sampling method with 14 beneficiaries (7 girls and 7 boys to be selected from each cluster. Instead of 420 children, data collected for 345 children, as requisite numbers of children were not available in low population villages and also children whose mothers were not present during survey were excluded. Materials and Methods: Vaccination data collected from either records and/or history by mother. Children born on or between 13-09-2009 and 13-09-2010, were included. Statistical Analysis Used: SPSS 14.01 version with Chi-square as test of significance. Results: Of the study population, 171 (49.6% were females and 174 (50.4% males. A total of 64.1% children had immunization records with female proportion 69.0% and males 59.2%. Primary immunization coverage was 80.0%, with female proportion 82.5% and males 77.6%. One male child was completely unimmunized and remaining partially immunized, with unaware of schedule and illness of child being major reasons for partial immunization. There was no gender wise statistically significant difference observed in Primary Immunization with reference to coverage, quality, and place of immunization. Conclusions: Immunization coverage is nearing 85% benchmark with major contribution from Universal Immunization Program. Gender Equality observed in primary immunization. Preservation of immunization records by community and timely vaccinations are areas for improvement.

Dresden Nuclear Power Station, Unit No. 1: Primary cooling system chemical decontamination: Draft environmental statement (Docket No. 50-10)

International Nuclear Information System (INIS)

1980-05-01

The staff has considered the environmental impact and economic costs of the proposed primary cooling system chemical decontamination at Dresden Nuclear Power Station, Unit 1. The staff has focused this statement on the occupational radiation exposure associated with the proposed Unit 1 decontamination program, on alternatives to chemical decontamination, and on the environmental impact of the disposal of the solid radioactive waste generated by this decontamination. The staff has concluded that the proposed decontamination will not significantly affect the quality of the human environment. Furthermore, any impacts from the decontamination program are outweighed by its benefits. 2 figs., 7 tabs

Rate Constant and Branching Fraction for the NH2 + NO2 Reaction

DEFF Research Database (Denmark)

Klippenstein, Stephen J.; Harding, Lawrence B.; Glarborg, Peter

2013-01-01

–1, in good agreement with the experimental value in the overlapping temperature range. The two entrance channel adducts H2NNO2 and H2NONO lead to formation of N2O + H2O (R1a) and H2NO + NO (R1b), respectively. The pathways through H2NNO2 and H2NONO are essentially unconnected, even though roaming...

76 FR 2915 - Identification of Foreign Countries Whose Nationals Are Eligible To Participate in the H-2A and H...

Science.gov (United States)

2011-01-18

... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2010-0087] RIN 1601-ZA09 Identification of Foreign Countries Whose Nationals Are Eligible To Participate in the H-2A and H-2B Nonimmigrant Worker Programs... determination that such participation is in the U.S. interest. See 8 CFR 214.2(h)(5)(i)(F) and 8 CFR 214.2(h)(6...

Excess of extracolonic non-endometrial multiple primary cancers in MSH2 germline mutation carriers over MLH1.

Science.gov (United States)

Lin-Hurtubise, Kevin M; Yheulon, Christopher G; Gagliano, Ronald A; Lynch, Henry T

2013-12-01

The lynch syndrome (LS) tumor spectrum involves colorectal cancer (CRC), endometrial cancer (EC), and less frequently various extracolonic non-endometrial cancers (non-EC). The organ-specific survival rates of these patients are well defined, however, the collective survival of all-cancers combined (CRC + EC + non-EC) are unclear. Fifty-two MSH2 patients and 68 MLH1 patients were followed for a median of 6.3 years after diagnosis of first cancer, regardless of type. The proportions of CRC only, EC, non-EC, and multiple primary cancers were compared between the two genotypes. Kaplan-Meier curves were developed for survival comparisons. MSH2 patients present less frequently with only CRC (37% MSH2, 62% MLH1, P = 0.0096), manifest more multiple primary cancers (38% MSH2, 18% MLH1, P = 0.013), develop more extracolonic cancers (62% MSH2, 38% MLH1, P = 0.003), non-EC only cancers (46% MSH2, 24% MLH1, P = 0.028) and carry a greater risk for urinary tract cancer (UTC) (13.4% MSH2, 1.5% MLH1, P = 0.024). There was no difference in 10-year survival between the two groups (P = 0.4). The additional propensity for UTC in MSH2 carriers argues in favor of UTC screening in MSH2 individuals. Other types of cancer screening should be tailored to the expression history of the specific LS mutation. © 2013 Wiley Periodicals, Inc.

System of Sr(NO sub 2 ) sub 2 -Sr(OH) sub 2 -H sub 2 O at 25 deg C. Sistema Sr(NO sub 2 ) sub 2 -H sub 2 O pri 25 grad C

Energy Technology Data Exchange (ETDEWEB)

Popova, T B; Berdyukova, V A; Khutsistova, F M [Kalmytskij Gosudarstvennyj Univ., Ehlista (USSR) Rostovskij-na-Donu Gosudarstvennyj Univ., Rostov-na-Donu (USSR)

1990-02-01

Sr(NO{sub 2}){sub 2}-Sr(OH){sub 2}-H{sub 2}O system was investigated by the methods of solubility, density, viscosity, electric conductivity and refractometry. It was established that its compoments form the compound 4Sr(NO{sub 2}){sub 2}xSr(OH){sub 2}x8H{sub 2}O. The compound was separated from solution; its density, decomposition temperature were determined; IR spectra and X-ray patterns of prepared and initial compounds were obtained.

Management of COPD in the UK primary-care setting: an analysis of real-life prescribing patterns

Science.gov (United States)

Price, David; West, Daniel; Brusselle, Guy; Gruffydd-Jones, Kevin; Jones, Rupert; Miravitlles, Marc; Rossi, Andrea; Hutton, Catherine; Ashton, Valerie L; Stewart, Rebecca; Bichel, Katsiaryna

2014-01-01

Background Despite the availability of national and international guidelines, evidence suggests that chronic obstructive pulmonary disease (COPD) treatment is not always prescribed according to recommendations. This study evaluated the current management of patients with COPD using a large UK primary-care database. Methods This analysis used electronic patient records and patient-completed questionnaires from the Optimum Patient Care Research Database. Data on current management were analyzed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) group and presence or absence of a concomitant asthma diagnosis, in patients with a COPD diagnosis at ≥35 years of age and with spirometry results supportive of the COPD diagnosis. Results A total of 24,957 patients were analyzed, of whom 13,557 (54.3%) had moderate airflow limitation (GOLD Stage 2 COPD). The proportion of patients not receiving pharmacologic treatment for COPD was 17.0% in the total COPD population and 17.7% in the GOLD Stage 2 subset. Approximately 50% of patients in both cohorts were receiving inhaled corticosteroids (ICS), either in combination with a long-acting β2-agonist (LABA; 26.7% for both cohorts) or a LABA and a long-acting muscarinic antagonist (LAMA; 23.2% and 19.9%, respectively). ICS + LABA and ICS + LABA + LAMA were the most frequently used treatments in GOLD Groups A and B. Of patients without concomitant asthma, 53.7% of the total COPD population and 50.2% of the GOLD Stage 2 subset were receiving ICS. Of patients with GOLD Stage 2 COPD and no exacerbations in the previous year, 49% were prescribed ICS. A high proportion of GOLD Stage 2 COPD patients were symptomatic on their current management (36.6% with modified Medical Research Council score ≥2; 76.4% with COPD Assessment Test score ≥10). Conclusion COPD is not treated according to GOLD and National Institute for Health and Care Excellence recommendations in the UK primary-care setting. Some patients receive no

The National Oesophagogastric Cancer Awareness Campaign: a locality outcome analysis from County Durham.

Science.gov (United States)

Koo, Sara; Awadelkarim, Bidour; Dhar, Anjan

2017-10-01

Oesophageal and gastric cancer is common. Despite advances in investigation and treatment, the outcomes from these cancers remain poor. As part of the Be Clear On Cancer Campaign, the Department of Health runs the National Oesophagogastric Cancer Campaign each year, with key messages of (1) 'Having heartburn most days, for 3 weeks or more could be a sign of cancer' and (2) 'if food is sticking when you swallow, tell your doctor'. We evaluated the effect of the National Oesophagogastric Cancer Campaign in our locality. Reviewing new referrals from primary care for upper gastrointestinal symptoms during the campaign period, and a period thereafter, we found that there was no significant impact of the campaign in the diagnosis of oesophagogastric cancers. Furthermore, it increased routine waiting times for elective gastroscopies in our endoscopy units. We believe that alternative strategies need to be considered for earlier detection of oesophagogastric cancer.

Outdoor Primary Education in Bangladesh. Experiments and Innovations in Education No. 40.

Science.gov (United States)

Choudhury, M. Khashruzzaman; Obaidullah, A. K. M.

A brief description of the development, implementation, and evaluation of the Outdoor Primary Education project in Bangladesh is presented in this booklet. A description of the development of the current primary education system in Bangladesh along with a description of the reasons that led to the development of the project are briefly provided in…

[Value of R2(*) in evaluating the biological behavior of primary hepatocellular carcinoma].

Science.gov (United States)

Tian, S F; Liu, A L; Liu, J H; Li, Y; Liu, X D; Huang, K; Song, Q W; Xu, M Z; Guo, W Y

2016-04-19

To investigate the correlation between R2(*) value of enhanced T2 star-weighted angiography (ESWAN) sequence and primary hepatocellular carcinoma infiltration and tumor thrombus, and investigate the biological behavior of HCC. A total of 221 cases of patients' imaging data with MRI examination(including ESWAN sequence) diagnosed as primary HCC were retrospectively analyzed.All the patients were collected from January 2014 to September 2015 in the First Affiliated Hospital of Dalian Medical University.The differences of R2(*) values in different MR types of HCC were analyzed.All patients were divided into infiltration group and non-infiltration group, tumor thrombus group and non-tumor thrombus group, the R2(*) values of the paired groups were compared.The diagnostic efficiency of R2(*) in HCC infiltration and tumor thrombus were evaluated by ROC curve, and to find out the threshold values. The MR types of 221 patients included 90 cases of nodular type, 62 cases of massive type, 69 cases of diffuse type.70 patients had tumor thrombus.The R2(*) values of different MR types were (21.82±8.52), (24.17±8.84)and (34.45±11.73) Hz, respectively.There was no statistically significant difference between the nodular and the massive types (P=0.144), while the difference between the nodular and diffuse type, the massive and diffuse types were statistically significant(P=0.000). The R2(*) values of infiltration group and non-infiltration group were (34.45±11.73) and (22.78±8.70) Hz , the R2(*) values of tumor thrombus group and non-tumor thrombus group were (31.20±12.17) and (24.21±9.90) Hz, the difference also had statistically significant(t=7.397 and 4.534, P=0.000 and 0.000). The AUC of R2(*) values for infiltration and tumor thrombus were 0.804, 0.681. R2(*) ≥24.68 Hz was the threshold value to diagnose the infiltration and tumor thrombus. R2(*) value can be used as a MR non-enhancement quantitative index to evaluate the biological behavior of HCC.

NO and H2O2 contribute to SO2 toxicity via Ca2+ signaling in Vicia faba guard cells.

Science.gov (United States)

Yi, Min; Bai, Heli; Xue, Meizhao; Yi, Huilan

2017-04-01

NO and H 2 O 2 have been implicated as important signals in biotic and abiotic stress responses of plants to the environment. Previously, we have shown that SO 2 exposure increased the levels of NO and H 2 O 2 in plant cells. We hypothesize that, as signaling molecules, NO and H 2 O 2 mediate SO 2 -caused toxicity. In this paper, we show that SO 2 hydrates caused guard cell death in a concentration-dependent manner in the concentration range of 0.25 to 6 mmol L -1 , which was associated with elevation of intracellular NO, H 2 O 2 , and Ca 2+ levels in Vicia faba guard cells. NO donor SNP enhanced SO 2 toxicity, while NO scavenger c-PTIO and NO synthesis inhibitors L-NAME and tungstate significantly prevented SO 2 toxicity. ROS scavenger ascorbic acid (AsA) and catalase (CAT), Ca 2+ chelating agent EGTA, and Ca 2+ channel inhibitor LaCl 3 also markedly blocked SO 2 toxicity. In addition, both c-PTIO and AsA could completely block SO 2 -induced elevation of intracellular Ca 2+ level. Moreover, c-PTIO efficiently blocked SO 2 -induced H 2 O 2 elevation, and AsA significantly blocked SO 2 -induced NO elevation. These results indicate that extra NO and H 2 O 2 are produced and accumulated in SO 2 -treated guard cells, which further activate Ca 2+ signaling to mediate SO 2 toxicity. Our findings suggest that both NO and H 2 O 2 contribute to SO 2 toxicity via Ca 2+ signaling.

40 CFR 91.1008 - National security exemption.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false National security exemption. 91.1008... Engines § 91.1008 National security exemption. (a)(1) Any marine SI engine, otherwise subject to this part... for purposes of national security. No request for exemption is necessary. (2) Manufacturers may...

40 CFR 89.908 - National security exemption.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false National security exemption. 89.908... Provisions § 89.908 National security exemption. (a)(1) Any nonroad engine, otherwise subject to this part... regulations for purposes of national security. No request for exemption is necessary. (2) Manufacturers may...

131I treatment for thyroid cancer and risk of developing primary hyperparathyroidism: a cohort study

International Nuclear Information System (INIS)

Lin, Chien-Mu; Doyle, Pat; Tsan, Yu-Tse; Lee, Chang-Hsing; Wang, Jung-Der; Chen, Pau-Chung

2014-01-01

To evaluate the association between 131 I therapy for thyroid cancer and risk of developing primary hyperparathyroidism. This was a nationwide population-based cohort study of patients with thyroid cancer diagnosed during the period 1997-2008. The data were obtained from the Taiwan National Health Insurance Research dataset. The cumulative 131 I dose in each patient was calculated. Hazard ratios (HRs) were calculated using a proportional hazards model to estimate the effect of 131 I therapy on the risk of developing primary hyperparathyroidism in the cohort. A total of 8,946 patients with thyroid cancer were eligible for the final analysis. Among these patients, 8 developed primary hyperparathyroidism during the follow-up period that represented 38,248 person-years giving an incidence rate of 20.9 per 10 5 person-years. 131 I was used in the treatment of 6,153 patients (68.8 %) with a median cumulative dose of 3.7 GBq. The adjusted HRs were 0.21 (95% CI 0.02-1.86) and 0.46 (95% CI 0.10-2.10) for those receiving a cumulative 131 I dose of 0.1-3.6 GBq and ≥3.7 GBq, respectively, compared to no therapy. The risk of developing primary hyperparathyroidism did not increase with increasing 131 I dose (test for trend p = 0.51). No interaction was found between 131 I dose and age (p = 0.94) or 131 I dose and sex (p = 0.99). 131 I treatment for thyroid cancer did not increase risk of primary hyperparathyroidism during a 10-year follow-up in this study population. Further research with a longer follow-up period is needed to assess late adverse effects beyond 10 years. (orig.)

131I treatment for thyroid cancer and risk of developing primary hyperparathyroidism: a cohort study.

Science.gov (United States)

Lin, Chien-Mu; Doyle, Pat; Tsan, Yu-Tse; Lee, Chang-Hsing; Wang, Jung-Der; Chen, Pau-Chung

2014-02-01

To evaluate the association between (131)I therapy for thyroid cancer and risk of developing primary hyperparathyroidism. This was a nationwide population-based cohort study of patients with thyroid cancer diagnosed during the period 1997-2008. The data were obtained from the Taiwan National Health Insurance Research dataset. The cumulative (131)I dose in each patient was calculated. Hazard ratios (HRs) were calculated using a proportional hazards model to estimate the effect of (131)I therapy on the risk of developing primary hyperparathyroidism in the cohort. A total of 8,946 patients with thyroid cancer were eligible for the final analysis. Among these patients, 8 developed primary hyperparathyroidism during the follow-up period that represented 38,248 person-years giving an incidence rate of 20.9 per 10(5) person-years. (131)I was used in the treatment of 6,153 patients (68.8%) with a median cumulative dose of 3.7 GBq. The adjusted HRs were 0.21 (95% CI 0.02-1.86) and 0.46 (95% CI 0.10-2.10) for those receiving a cumulative (131)I dose of 0.1-3.6 GBq and ≥3.7 GBq, respectively, compared to no therapy. The risk of developing primary hyperparathyroidism did not increase with increasing (131)I dose (test for trend p = 0.51). No interaction was found between (131)I dose and age (p = 0.94) or (131)I dose and sex (p = 0.99). (131)I treatment for thyroid cancer did not increase risk of primary hyperparathyroidism during a 10-year follow-up in this study population. Further research with a longer follow-up period is needed to assess late adverse effects beyond 10 years.

Trend analysis of urban NO2 concentrations and the importance of direct NO2 emissions versus ozone/NOx equilibrium

NARCIS (Netherlands)

Keuken, M.; Roemer, M.; Elshout, S. van den

2009-01-01

The annual air quality standard of NO2 is often exceeded in urban areas near heavy traffic locations. Despite significant decrease of NOx emissions in 1986-2005 in the industrial and harbour area near Rotterdam, NO2 concentrations at the urban background remain at the same level since the end of the

The CO2-tax and its ability to reduce CO2 emissions related to oil and gas production in Norway

International Nuclear Information System (INIS)

Roemo, F.; Lund, M.W.

1994-01-01

The primary ambition of the paper is to illustrate some relevant effects of the CO 2 -tax, and draw the line from company adaptation via national ambitions and goals to global emission consequences. The CO 2 -tax is a success for oil and gas production only to the extent that the CO 2 emission per produced unit oil/gas is reduced as a consequence of the tax. If not, the CO 2 -tax is a pure fiscal tax and has no qualitative impact on the CO 2 emissions. The reduction potential is then isolated to the fact that some marginal fields will not be developed, and the accelerated close down of fields in production. The paper indicates that a significant replacement of older gas turbines at a certain level of the CO 2 -tax could be profitable for the companies. This is dependent on change in turbine energy utilization, and the investment cost. The CO 2 -tax is a political success for the nation if it is a significant contributor to achieve national emission goals. Furthermore, is the CO 2 -tax an environmental success only to the extent it contributes to reductions in the CO 2 emissions globally. The paper indicates that there are possibilities for major suboptimal adaptations in connection with national CO 2 -taxation of the oil and gas production. 13 refs., 6 figs

Effect of deferred or no treatment with ursodeoxycholic acid in patients with early primary biliary cholangitis.

Science.gov (United States)

Tanaka, Atsushi; Hirohara, Junko; Nakano, Toshiaki; Yagi, Minami; Namisaki, Tadashi; Yoshiji, Hitoshi; Nakanuma, Yasuni; Takikawa, Hajime

2018-02-06

As primary biliary cholangitis (PBC) is a heterogeneous disease, we hypothesized that there is a population of patients with early PBC who do not require prompt treatment with ursodeoxycholic acid (UDCA). In this study, we analyzed data from a large-scale PBC cohort in Japan, and retrospectively investigated whether outcomes of early PBC patients were affected with prompt or deferred/no UDCA treatment. We defined early PBC as asymptomatic, serum alkaline phosphatase early PBC patients between the treatment regimens; prompt treatment group (UDCA was initiated within 1 year after diagnosis) and deferred/no treatment group (UDCA initiated >1 year after diagnosis or never initiated). Furthermore, we examined the outcomes of early PBC patients alternatively defined only with symptomatology and biochemistry. We identified 562 early PBC patients (prompt: n = 509; deferred/no treatment: n = 53). Incidence rates (per 1000 patient-years) for liver-related mortality or liver transplantation and decompensating events were 0.5 and 5.4, respectively, in the prompt treatment group, and 0 and 8.7, respectively, in the deferred/no treatment group. Multivariate analyses showed that age and bilirubin were significantly associated with developing decompensating events, whereas the prompt and deferred/no treatments were not. We obtained similar results in early PBC patients defined without histological examination. We showed that deferred/no treatment for early PBC patients did not affect the outcomes. This study provides a rationale for a future prospective, randomized study. © 2018 The Japan Society of Hepatology.

HANPP Collection: Global Patterns in Net Primary Productivity (NPP)

Data.gov (United States)

National Aeronautics and Space Administration — The Global Patterns in Net Primary Productivity (NPP) portion of the Human Appropriation of Net Primary Productivity (HANPP) Collection maps the net amount of solar...

21 CFR 201.2 - Drugs and devices; National Drug Code numbers.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drugs and devices; National Drug Code numbers. 201.2 Section 201.2 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING General Labeling Provisions § 201.2 Drugs and devices; National Drug Code...

Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty.

Science.gov (United States)

Jiang, Jimmy J; Somogyi, Jason R; Patel, Pranay B; Koh, Jason L; Dirschl, Douglas R; Shi, Lewis L

2016-03-01

Few studies have analyzed the association between elevated BMI and complications after total shoulder arthroplasty (TSA). Previous studies have not consistently arrived at the same conclusion regarding whether obesity is associated with a greater number of postoperative complications. We used a national surgical database to compare the 30-day complication profile and hospitalization outcomes after primary TSA among patients in different BMI categories. We asked: (1) Is obesity associated with an increased risk of complications within 30 days of primary TSA? (2) Is obesity associated with increased operative time? The American College of Surgeons National Surgical Quality Improvement Program(®) database for 2006 to 2012 was queried to identify all patients who underwent a primary TSA for osteoarthritis of the shoulder. The ACS-NSQIP(®) database was selected for this study as it is a nationally representative database that provides prospectively collected perioperative data and a comprehensive patient medical profile. Exclusion criteria included revision TSA, infection, tumor, or fracture. We analyzed 4796 patients who underwent a primary TSA for osteoarthritis of the shoulder. Patients who underwent a TSA were divided in four BMI categories: normal (18.5-25 kg/m(2)), overweight (25-30 kg/m(2)), obesity Class 1 (30-35 kg/m(2)), and obesity Class 2 or greater (> 35 kg/m(2)). Perioperative hospitalization data and 30-day postoperative complications were compared among different BMI classes. Differences in patient demographics, preoperative laboratory values, and preexisting patient comorbidities also were analyzed among different BMI groups, and multivariate analysis was used to adjust for any potential confounding variables. There was no association between BMI and 30-day complications after surgery (normal as reference, overweight group relative risk: 0.57 [95% CI, 0.30-1.06], p = 0.076; obesity Class 1 relative risk: 0.52 [95% CI, 0.26-1.03], p = 0.061; obesity

Administrative Circulars No. 12 A (Rev. 2) - "Education fees” and No. 12 B (Rev. 2) - “Education fees and language courses”

CERN Multimedia

2013-01-01

Administrative Circulars No. 12 A (Rev. 2) entitled “Education fees” and No. 12 B (Rev. 2) entitled “Education fees and language courses”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 27 June 2013 and entering into force on 1 August 2013, are available on the intranet site of the Human Resources Department (see here).   Administrative Circular No. 12 A (Rev. 2) is applicable to Staff Members (except former “Local Staff Members”) recruited before 1st January 2007. Administrative Circular No. 12 B (Rev. 2) is applicable to Staff Members recruited on or after 1st January 2007, to Fellows, to Scientific Associates, to Guest Professors and to former “Local Staff” recruited before 1st January 2007. They cancel and replace Administrative Circulars No. 12 A (Rev. 1/Corr.) entitled "Education fees” and No. 12 B (Rev. 1/Corr.) entitled “Edu...

Primary structure of human alpha 2-macroglobulin. V. The complete structure

DEFF Research Database (Denmark)

Sottrup-Jensen, Lars; Stepanik, Terrence M; Kristensen, Torsten

1984-01-01

The primary structure of the tetrameric plasma glycoprotein human alpha 2-macroglobulin has been determined. The identical subunits contain 1451 amino acid residues. Glucosamine-based oligosaccharide groups are attached to asparagine residues 32, 47, 224, 373, 387, 846, 968, and 1401. Eleven......-SH group of Cys-949 is thiol esterified to the gamma-carbonyl group of Glx-952, thus forming an activatable reactive site which can mediate covalent binding of nucleophiles. A putative transglutaminase cross-linking site is constituted by Gln-670 and Gln-671. The primary sites of proteolytic cleavage......-macroglobulin subunit is discussed. A comparison of stretches of sequences from alpha 2-macroglobulin with partial sequence data for complement components C3 and C4 indicates that these proteins are evolutionary related. The properties of alpha 2-macroglobulin are discussed within the context of proteolytically...

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